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

The aim of this paper is to describe the findings of a survey designed to investigate sociodemographic, military service, mental health, gambling activities, and motivation variables as predictors of problem gambling among a large sample of UK veterans. In total, 5,147 responses were received to the online survey (2,535 veterans and 2,612 nonveterans).

Quantitative Data Highlights

• 43.1% of veterans (and 6.5% of non-veterans) experienced problem gambling.
• Veterans were over 10 times more likely to be distinguished by problem gambling than non-veterans.
• Veterans were over 4 times more likely to have gambled in the past and did so on more activities than non-veterans.
• Veterans who gambled were over 7 times more likely to be motivated to do so due to avoid or escape from distress.

PTSD Related Data

• Notable that 8.6% veterans in the current study met criteria for likely PTSD, with 26.6% indicating probable C-PTSD
• Veterans are almost 7 times more likely than non-veterans to C-PTSD, a diagnosis with more severe criteria than PTSD.

Risk Factors

• Mild anxiety.
• Being in receipt of benefits.
• Being discharged 9–13 years ago.
• Serving for between 0 and 4 years.
• Living in supported accommodation.
• Living in privately rented accommodation.
• Alcohol dependence and higher risk drinking.

Protective Factors

• Age.
• White-British ethnicity.
• Being medically discharged.
• Living with non-family members.
• Being discharged 25+ years ago.
• Serving for between 10 and 19 years.
• Being discharged at their own request.
• Not being deployed during their career.
• Discharge due to a reason listed as ‘other’.
• Achieving a Doctorate as one’s highest qualification.

Qualitative Data Highlights

• UK veterans were at increased risk of problem gambling.
• Veterans gambled on more activities than their non-veterans, and their gambling was motivated by negative reinforcement (escape from or avoidance of distress).
  • This unique finding parallels the elevated levels of alcohol misuse that is considered a potential negative coping strategy in veterans.

Challenges

• Collecting data online may have inadvertently excluded older veterans, those without access to the internet, and the homeless.

Conclusions

• Findings indicate that longer service in the armed forces may be a protective factor.
• Greater difficulties were most pronounced in early service leavers serving in the army as noncommissioned officers (NCOs)/ Other Ranks.
• Problem gambling is significantly higher in UK veterans, is a likely coping mechanism for mental health conditions, and driven by a need to avoid or escape distress.
• In veterans, problem gambling co-occurred with C-PTSD.

Recommendations

• Determining both the antecedents and motivations (i.e. consequences) of gambling may aid in the development of individualized treatment plans and assist with cross-validation of self-report-based assessment interviews.
• Screening for problem gambling should be undertaken to provide improved treatment and support.