Marital Status, Childhood Maltreatment, and Family Dysfunction: A Controlled Study of Pathological Gambling [CME]




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Background: Pathological gambling is a prevalent public health problem associated with depression, substance misuse, crime, and suicide. Despite these challenges, little attention has been directed to examining its negative consequences on families and marriages, including divorce rates, childhood maltreatment, and family dysfunction.

Method: From February 2005 to June 2010, subjects with DSM-IV–defined pathological gambling and community controls were assessed for marital and family variables and indices of childhood maltreatment. The Family Assessment Device (FAD) was used to evaluate family functioning.

Results: Ninety-five subjects with DSM-IV pathological gambling and 91 control subjects without pathological gambling were recruited and assessed. They were similar in age, gender, and employment status. Persons with pathological gambling were more likely than controls to have ≥1 divorce (odds ratio [OR]=2.56; 95% CI, 1.35–4.87; P=.004), to live alone (OR=4.49; 95% CI, 1.97–10.25; P<.001), and to report any type of childhood maltreatment (OR=4.02; 95% CI, 2.12–7.64; P<.001). They did not differ on number of siblings or ordinal position among siblings. Pathological gambling subjects reported significantly worse family functioning than control subjects as assessed by all 7 FAD subscales. On the FAD general functioning subscale, 55% of pathological gambling families and 33% of control families were rated “unhealthy” (OR=2.17; 95% CI, 1.14–4.12; P=.018). Severity of gambling was positively correlated with divorce, childhood maltreatment, and the FAD roles subscale.

Conclusions: People with pathological gambling are more likely than controls to have been divorced, to live alone, and to report having experienced childhood maltreatment than controls. They also report greater family dysfunction.

J Clin Psychiatry 2012;73(10):1293–1297

Submitted: March 22, 2012; accepted July 16, 2012(doi:10.4088/JCP.12m07800).

Corresponding author: Donald W. Black, MD, 2-126B MEB, University of Iowa, Carver College of Medicine, Iowa City, IA 52242 (

J Clin Psychiatry 2012;73(10):1293-1297