Gambling problems among United Kingdom armed forces veterans: Associations with gambling motivation and posttraumatic stress disorder

Dighton, Glen; Wood, Kevin; Armour, Chérie; Fossey, Matt; Hogan, Lee; Kitchiner, Neil J; Larcombe, Justyn; Rogers, Robert D.; Dymond, Simon

doi:10.1080/14459795.2022.2063923

Cited by 14 publications

(9 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings indicated that alcohol consumption and problem gambling were prevalent within the RAF, as were mental health problems related to stress, anxiety, depression, and PTSD. This is consistent with research identifying elevated vulnerability to these problems among current and ex-military personnel compared with the general population (1,12,(24)(25)(26). Let us now consider the four main themes identified.…”

Section: Discussionsupporting

confidence: 81%

“…Previous research has found associations between traumatic events during international military operations, mental health issues, alcohol (28) and gambling problems (25) among military veterans. Generally, however, associations between mental health problems (especially PTSD) arising from military experience and the impact on gambling behavior remains under examined (12,25). On the other hand, the protective nature of service life has been shown to be associated with reduced vulnerability to mental health problems (29,30) and this was evident in the participants' experiences.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gambling problems and help-seeking in serving United Kingdom military personnel: A qualitative study

et al. 2022

Self Cite

View full text Add to dashboard Cite

IntroductionIn military personnel are vulnerable to gambling problems, yet many are reluctant to seek help. The aim of the current study was to explore the lived experience of problem gambling and help-seeking among serving members of the United Kingdom Armed Forces.MethodsSeventeen individuals from a larger, cross-sectional survey of gambling and wellbeing in the Royal Air Force (RAF) completed semi-structured interviews. Interview questions focused on personal experiences, the context of the RAF and its influence, knowledge and experiences of treatment and support services, and the impact of COVID-19.ResultsReflexive thematic analysis revealed four themes: (1) harmful and protective occupational factors; (2) socio-cultural and personal influences; (3) organizational attitudes toward mental health and help-seeking, and (4) current support pathways and provision.DiscussionFindings also indicated that gambling and alcohol use are common within the RAF, and that personnel are actively coping with mental health challenges.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Gambling problems and help-seeking in serving United Kingdom military personnel: A qualitative study

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, the publications that focus on PTSD and/or GD interventions do not include ACT or acceptance-based approaches (Etuk et al, 2020 ; Levy & Tracy, 2018 ). A salient finding of this review is that both GD and comorbid GD and PTSD are largely under-studied, which is concerning as the relationship between GD and PTSD among military populations is robust (Dighton et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…Roberts et al ( 2020 ) found UK veterans were eight times more likely to meet problematic gambling criteria compared to an age/gender-matched general population sample. Likewise, Dighton et al ( 2022 ) found veteran status predicted an increased risk of problem gambling together with the use of gambling as an escape- or avoidance-based coping mechanism (see also, Dighton et al, 2018 ). A recent survey of 3511 Australian military veterans assessed for GD five years post-military service found that 4.6% had experienced problematic gambling, with a further 8.8% classified as ‘at risk’ (Metcalf et al, 2022 ).…”

Section: Introductionmentioning

confidence: 97%

“…Indeed, the DSM-5 diagnostic criteria specify that disordered gambling likely occurs during distress and a key symptom of PTSD is psychological distress (American Psychiatric Association, 2013 ). In effect, disordered gambling may function as a form of experiential avoidance in coping with PTSD symptoms such as emotional dysregulation (Dighton et al, 2022 ; Hayes et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review

Hitch

Leightley

Murphy

et al. 2023

European Journal of Psychotraumatology

Self Cite

View full text Add to dashboard Cite

Background: PTSD and gambling disorder (GD) are frequently comorbid. Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and GD outcomes, yet research into the potential effectiveness of ACT for PTSD and/GD in veterans is scarce. Objective: This review aimed to systematically assess and describe the evidence relating to the use of ACT and acceptance-based therapy for military populations with PTSD and/or GD. Method: Six databases were searched. Selection criteria included studies that featured the armed forces/military, delivered ACT/acceptance-based therapy, and aimed to improve PTSD and/or GD outcomes. A narrative synthesis approach was adopted. Results: From 1,117 results, 39 studies were fully screened and 14 met inclusion criteria. All studies originated from the USA and 9 were associated with United States Department of Veterans Affairs. Therapy use within each study produced an improvement in PTSD and/or GD, yet only one study examined GD and no studies considered comorbid PTSD/GD. The broad range of study designs made it difficult to compare the findings or make generalisations from the collective results. It is unclear which method of ACT delivery is superior (app-based, telehealth, face-to-face, groups, one-to-one, manualised, or unstructured), or what the true effect size is of ACT for PTSD and/or GD. Conclusions: These preliminary findings are promising, yet more research is needed on the delivery format and content of ACT sessions, and whether findings generalise beyond USA-recruited military samples. The cost-effectiveness of remote-based ACT also warrants investigation. HIGHLIGHTS Among veterans, psychological interventions such as Acceptance and Commitment Therapy (ACT) may be effective for Post-Traumatic Stress Disorder (PTSD) and/or Gambling Disorder (GD). There is a paucity of evidence on ACT approaches for treating PTSD and GD in veterans. Further work is needed on context-specific delivery (in-person vs. group), method of ACT intervention (manualised vs unstructured, digital therapeutics) with non-US samples.

show abstract

Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans

Whiteford,

Quigley,

Dighton

et al. 2023

J Clin Psychol

Self Cite

View full text Add to dashboard Cite

ObjectivesLittle is known about whether distress tolerance and anxiety mediate the relationship between comorbid complex posttraumatic stress disorder (CPTSD) and alcohol use among military veterans. Here, we investigated the contribution of distress tolerance and anxiety on the strength of the CPTSD and alcohol use association. We hypothesized that the impact of a two‐factor model of CPTSD derived from subscale scores on the International Trauma Questionnaire (ITQ)—namely ITQ PTSD and ITQ Disturbances in Self Organization (DSO; e.g., issues with affective regulation/self‐belief and shame)—on alcohol use severity would be mediated by anxiety but not by distress tolerance.MethodsParticipants included 403 community‐dwelling United Kingdom (UK) veterans (91.64% male, Mage = 51.15 years, SD = 12.48) recruited as part of a larger, online study.ResultsFindings indicated that the influence of CPTSD symptoms on alcohol use severity was mediated by anxiety, not by distress tolerance, with greater relative impact due to ITQ DSO status than ITQ PTSD status.ConclusionsWe identified the mediational influence of anxiety and distress tolerance on the association between CPTSD subscales and alcohol use in UK veterans. Interventions for anxiety may be adapted for reducing problematic alcohol use and the impact of CPTSD symptoms in veterans with comorbid PTSD and alcohol use disorder.

show abstract

Gambling problems among United Kingdom armed forces veterans: Associations with gambling motivation and posttraumatic stress disorder

Cited by 14 publications

References 55 publications

Gambling problems and help-seeking in serving United Kingdom military personnel: A qualitative study

Gambling problems and help-seeking in serving United Kingdom military personnel: A qualitative study

Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review

Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans

Contact Info

Product

Resources

About