Suicidality among gambling helpline callers: A consideration of the role of financial stress and conflict [subscription access article]

Carr, M. M., Ellis, J. D. & Ledgerwood, D. M. (2018). The American Journal on Addictions, 27(6), 531-537. doi:10.1111/ajad.12787

Abstract: Background and Objectives
High rates of suicidal ideation and attempts secondary to gambling are well established among those with gambling disorders. The present study explores potential risk factors for suicidal ideation and/attempt among a sample of help‐line callers.

Participants (N = 202) completed measures assessing demographics; gambling behavior; and financial, family/social, employment, substance use, and legal difficulties related to gambling. Bivariate analyses, logistic regression, and mediation analyses were used to explore relationship between predictors and risk of suicidal ideation and attempt.

Female gender, gambling severity (including engagement in illegal behaviors), a history of mental health problems, financial problems, and conflict related to gambling were associated with current suicidality in this sample. Mediation analyses revealed that financial problems were associated with increased familial conflict, which was in turn associated with increased suicidality.

Family and social conflict may be one important way in which financial problems confer risk for suicidality among problem gamblers. These results align with findings from the substance use disorder (SUD) literature and highlight one potential factor that may merit further assessment and/or intervention.

Scientific Significance
Researchers and clinicians may want to consider the overall level of conflict a patient is experiencing when assessing suicide risk among individuals with gambling problems. Professionals may also want to consider the suitability of interventions to address conflict within the context of gambling treatment. Article details and access conditions


Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems

By Silvia Ronzitti, Emiliano Soldini, Neil Smith, Marc N. Potenza, Massimo Clerici, and Henrietta Bowden-Jones.

Background: Studies show higher lifetime prevalence of suicidality in individuals with pathological gambling. However, less is known about the relationship between pathological gambling and current suicidal ideation.

Objectives: We investigated socio-demographic, clinical and gambling-related variables associated with suicidality in treatment-seeking individuals.

Methods: Bivariate analyses and logistic regression models were generated on data from 903 individuals to identify measures associated with aspects of suicidality.

Results: Forty-six percent of patients reported current suicidal ideation. People with current suicidal thoughts were more likely to report greater problem-gambling severity (p < 0.001), depression (p < 0.001) and anxiety (p < 0.001) compared to those without suicidality. Logistic regression models suggested that past suicidal ideation (p < 0.001) and higher anxiety (p < 0.05) may be predictive factors of current suicidality.

Conclusions: Our findings suggest that the severity of anxiety disorder, along with a lifetime history of suicidal ideation, may help to identify treatment-seeking individuals with pathological gambling with a higher risk of suicidality, highlighting the importance of assessing suicidal ideation in clinical settings.

Ronzitti, S., Soldini, E., Smith, N., Potenza, M. N., Clerici, M., & Bowden-Jones, H. (2017). Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems. Addictive Behaviors, 74, 33–40.

The association between pathological gambling and suicidality in treatment-seeking pathological gamblers in South Africa

BACKGROUND: A number of studies have noted a significant association between suicidality and pathological gambling (PG), but the exact relationship has not been extensively characterized. It is unclear whether gambling precipitates suicidality, or whether underlying psychiatric problems, such as mood disturbances, lead to both gambling and suicidality. Furthermore, all published data on the association between suicidality and gambling is from high-income countries, and the nature of this relationship in low- and middle-income countries, such as South Africa, has not been explored.

METHODS: The relationship between gambling and suicidality was investigated in individuals who had called the South African National Responsible Gambling Programme’s helpline. Associations between sociodemographic factors, severity of gambling symptoms, comorbid psychiatric disorders, family history of psychiatric disorders, and suicidality were assessed…

Source: Stein, G. N., Pretorius, A., Stein, D. J., & Sinclair, H. (2016). The association between pathological gambling and suicidality in treatment-seeking pathological gamblers in South Africa. Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists, 28(1), 43–50.