Characteristics of adolescent past-year gamblers and non-gamblers in relation to alcohol drinking

Abstract

A preliminary examination of mental health and gambling characteristics as a function of alcohol use in adolescents was conducted in a nationally representative sample of 16- and 17-year-olds using data from the 1998 Gambling Impact and Behavior Study. Adolescents were stratified by past-year alcohol use into abstainers/low-frequency (ALF) drinkers and moderate to high-frequency (MHF) drinkers as done previously [Desai, R. A., Maciejewski, P. K., Pantalon, M. V., & Potenza, M. N. (in press). Gender differences among recreational gamblers: Association with the frequency of alcohol use. Psychology of Addictive Behaviors]. A greater proportion of MHF drinkers reported past-year gambling than did ALF drinkers (66.1% vs. 38.2%). In the ALF drinking group but not the MHF one, past-year gambling was associated with dysphoria/depression (odds ratio for ALF: 1.94, odds ratio for MHF: 0.88) and drug use (odds ratio for ALF: 2.57, odds ratio for MHF: 0.49). A significant gambling-by-alcohol-use group interaction was observed for drug use (p < 0.01). Among past-year gamblers, MHF drinkers were more likely than ALF ones to report frequent gambling. These results suggest a complex relationship between gambling alcohol use, drug use, and mental health in adolescents.

Introduction

Most adolescents gamble. A meta-analysis of gambling studies concluded that between 77% and 83% adolescents gambled within the past year (Shaffer & Hall, 1996). Studies conducted in the 1980s found adolescent past-year gambling rates of about 45%, while those in the late 1990s found rates of 66% (Jacobs, 2000). Compared to the large proportion of adolescents who gamble, a smaller yet sizable group develops problems with gambling; e.g., 4.4% to 7.4% exhibit pathological patterns of gambling (Shaffer & Hall, 1996). Adolescent gambling is associated with other risk-taking and impulsive behaviors such as drunk driving, fighting, sexual behavior, antisocial behavior, and substance use (Barnes et al., 1999, Proimos et al., 1998, Stinchfield, 2000, Vitaro et al., 1997, Vitaro et al., 2001, Westphal et al., 2000, Winters et al., 1993). Data suggest that early age of gambling onset is a risk factor for severity of adult problem and pathological gambling (National Opinion Research Center, 1999, Volberg, 1994) and substance use disorders (Lynch, Maciejewski, & Potenza, 2004). Thus, gambling that begins in adolescence may significantly and adversely impact upon adult functioning (Lynch et al., 2004, Slutske et al., 2003). Together, these findings indicate that more research is needed into the health correlates of adolescent gambling.

Alcohol is the most commonly used substance by adolescents, and their high rates of drinking represent a substantial public health problem. The most recent Monitoring the Future survey reported that nearly four out of every five (78%) adolescents endorsed having drank alcohol by the time they completed high school and more than half (62%) of 12th grade adolescents reported having been drunk at least once (Johnston, O'Malley, & Bachman, 2003). Alcohol use frequently co-occurs with other risk-taking behaviors, and an improved understanding of the interaction of alcohol use and other psychiatric/risk domains is important in targeting prevention and treatment strategies.

Gambling and alcohol use frequently co-occur in adults at both syndromal (Cunningham-Williams, Cottler, Compton, & Spitznagel, 1998) and subsyndromal (Desai, Maciejewski, Pantalon, & Potenza, in press) levels. Several studies indicate that a similar pattern exists in adolescents. Gupta and Derevensky (1998) found that adolescents with pathological gambling, as compared to those without, engaged in more regular alcohol drinking and drug use. In a study of 11- to 16-year-olds, Gupta and Derevensky (1998) found that adolescent gamblers were more likely to drink alcohol regularly than were non-gamblers. Despite the prevalence of gambling and alcohol consumption in adolescents, little is known about the influence of each alone and in combination on adolescent health.

To investigate the relationship between gambling and alcohol use in adolescents, we examined mental health and gambling characteristics of a nationally representative sample of 16- and 17-year-old adolescents as a function of gambling and alcohol use status (Gerstein et al., 1999). Prior studies have generally been limited by data collection in one geographic region (Proimos et al., 1998, Stinchfield et al., 1997). As such, findings from these studies may have limited generalizability. Adolescents in the current analyses were categorized as abstainers/low-frequency (ALF) drinkers and moderate-/high-frequency (MHF) drinkers as we have done previously (Desai et al., in press), and into past-year gamblers and past-year non-gamblers as previously (Lynch et al., 2004). We anticipated higher rates of mental health problems in association with MHF alcohol consumption regardless of gambling status. In other studies, we have observed that co-occurring disorders or behaviors (e.g., nicotine dependence) weaken the association between gambling and other co-occurring psychopathology (Potenza, Grant, & Desai, submitted). As such, we hypothesized that higher frequency alcohol consumption would weaken the association between gambling and mental health measures, or that a stronger association between gambling and mental health measures would exist in the ALF group compared to the MHF group. We also hypothesized that, within past-year gamblers, MHF drinkers would display heavier patterns of gambling (quantity, frequency) than would ALF drinkers.