Pathological gambling and posttraumatic stress disorder: a study of the co-morbidity versus each alone

This report is the first empirical study to compare pathological gambling (PG), posttraumatic stress disorder (PTSD), and their co-occurrence. The sample was 106 adults recruited from the community (35 with current PG; 36 with current PTSD, and 35 with BOTH). Using a cross-sectional design, the three groups were rigorously diagnosed and compared on various measures including sociodemographics, psychopathology (e.g., dissociation, suicidality, comorbid Axis I and II disorders), functioning, cognition, life history, and severity of gambling and PTSD. Overall, the PG group reported better psychological health and higher functioning than PTSD or BOTH; and there were virtually no differences between PTSD and BOTH. This suggests that it is the impact of PTSD, rather than comorbidity per se, that appears to drive a substantial increase in symptoms. We also found high rates of additional co-occurring disorders and suicidality in PTSD and BOTH, which warrants further clinical attention. Across the total sample, many reported a family history of substance use disorder (59%) and gambling problems (34%), highlighting the intergenerational impact of these. We also found notable subthreshold PTSD and gambling symptoms even among those not diagnosed with the disorders, suggesting a need for preventive care. Dissociation measures had mixed results. Discussion includes methodology considerations and future research areas.