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Gambling Disorder and Childhood Trauma: A Complex Association

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Abstract

Gambling disorder (GD) is classified as a behavioural addiction and has some phenotypic similarities with substance use disorders (SUDs). Childhood adversity and life stressors are associated with increased risk for SUDs in adulthood. However, there is limited research investigating the association between childhood trauma, stressors and behavioural addictions such as GD. In this case–control cross-sectional study, 31 adult patients with GD were compared to 31 matched healthy controls (HCs) in terms of exposure to early adversity using the Childhood Trauma Questionnaire (CTQ-SF). In addition, past 12-month stressful life event exposure was assessed using the Life Event Stress Scale (LESS) and investigated as a possible moderator of the relationship between childhood trauma and GD by means of a two-way analysis of variance (ANOVA). Logistic regression analyses were used to test if childhood trauma (CTQ-SF) and its subtypes were significant predictors of a diagnosis of GD. Severity of childhood trauma in general, and on all five subtypes, was significantly higher in GD patients compared to HCs. Childhood trauma was a significant predictor of a diagnosis of GD, with physical neglect being the single trauma subtype to significantly increase odds of GD in adulthood. Stressful life events moderated the relationship between childhood trauma and GD, i.e. childhood trauma was significantly higher in GD patients compared to HCs when LESS was low. The findings support a link between childhood trauma and GD, with current stress as a moderating variable, and may be useful for future individualized therapeutic strategies.

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Acknowledgements

We would like to acknowledge Mrs Tali Lanesman, Mr Lian Taljaard, Dr Heidi Sinclair and Mrs Patricia van Zyl for assisting with data collection, as well as Professor Martin Kidd for assisting with the statistical analyses conducted in this research study. The financial assistance of the National Research Foundation (NRF) (reference number: CPRR150622119950) towards this research is hereby acknowledged. Opinions expressed and conclusions arrived at are those of the author and are not necessarily to be attributed to the NRF. The Claude Leon Foundation is acknowledged for providing financial support with respect to participants’ travel reimbursements.

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Authors and Affiliations

  1. SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa

    Natascha S. Horak, Dan J. Stein & Christine Lochner

  2. Department of Psychology, University of Witwatersrand, Johannesburg, South Africa

    Natascha S. Horak & Gillian Eagle

  3. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

    Dan J. Stein

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  1. Natascha S. Horak
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  2. Gillian Eagle
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Correspondence to Christine Lochner.

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Conflict of interest

Christine Lochner has received a research grant from the South African National Research Foundation (NRF). Natascha S. Horak has received a grantholder-linked Masters bursary from the NRF. Gillian Eagle and Dan J. Stein declare that they have no conflict of interest. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Natascha S. Horak and supervised by Gillian Eagle and Christine Lochner. The first draft of the manuscript was written by Natascha S. Horak, and Gillian Eagle and Christine Lochner assisted in refining this and subsequent versions of the manuscript. All authors read and approved the final manuscript.

Ethical Approval

The overarching research project involving human participants was approved by the respective Research Ethics Committees at Stellenbosch University (reference number: 14/05/053) and at the University of Cape Town (reference number: 770/2014), and has been conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. In addition, this study was approved by the Human Research Ethics Committee at the University of Witwatersrand (Protocol number: MCLIN/17/004 IH), authorising the first author (NSH) to conduct this sub-study. Participation in the study was on a voluntary basis. All participants provided informed written consent for participation. Participants were compensated for their time and effort in the form of modest grocery vouchers, and transport was provided where necessary.

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Horak, N.S., Eagle, G., Stein, D.J. et al. Gambling Disorder and Childhood Trauma: A Complex Association. J Gambl Stud 37, 515–528 (2021). https://doi.org/10.1007/s10899-020-09983-w

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