NCRG Conference on Gambling and Addiction

Monday, November 12, 2007

Gambling and Co-occurring Disorders: Landmark Research from the National Comorbidity Survey

The author of more than 500 journal articles, book chapters and other reports on mental health, Dr. Ronald Kessler today presented findings from the National Comorbidity Survey Replication (NCS-R), a landmark stud of mental health in the United States that included questions about gambling behaviors for the first time in the 2001-2003 version.

The NCS-R was designed to examine a nationally representative household sample of English-speaking adults (18-years-old and older). The data was collected from February 2001 through April 2003 from households in the continental United States. The survey also used a multistage cluster area probability sampling design, which means it didn’t take samples from places such as New York City, where it would be difficult to find a nationally representative sample.

The sampling design identified 10,843 pre-designated respondents from 177 counties in 34 states. Out of this group, Kessler and his colleagues running the survey were able to secure 9,282 completed interviews, which equates to a 70.9 percent “response” rate. The fieldwork for this survey included the work of more than 300 national, NCS-R certified interviewers from the Survey Research Center (SRC) University of Michigan and 18 SRC regional supervisors. Interviews were conducted face-to-face using a laptop computer-assisted technique, and the average interview lasted 2.5 hours. The data collected was weighted to mirror the U.S. population.

One of the interesting findings from the survey is that 46.4 percent of the respondents had a mental disorder at some point in their lives, as defined by the DSM-IV and WHO Composite International Diagnostic Interview. Kessler pointed out that while this finding may seem surprising, it makes sense given the fact that 99.9 percent of the population has experienced a physical disorder during their life, giving the example of a hangnail.

The survey findings also put the lifetime prevalence estimate of DSM-IV pathological gambling at 0.7 percent. Kessler pointed out that this number actually was lowered to 0.5 percent once respondents with bipolar I and bipolar II were excluded from the sample (according to the diagnostic code, people suffering from bipolar I and II cannot be diagnosed with pathological gambling as problem gambling behavior is considered a symptom of the bipolar disorder).

In addition, the survey was able to identify significant predictors of pathological gamblers. According to Kessler, pathological gamblers are more likely to be young (18-44), male, non-hispanic black, and have less than a college education.

Data from the survey shows several other patterns with relation to pathological gambling, including the prevalence of co-occuring disorders and how many pathological gamblers recover form the disorder. Kessler and his colleagues have made the data publicly available to encourage further, more detailed studies by researchers all over the world. The data can be found at


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