Screening for Gambling Disorder in VA Primary Care Behavioral Health: A Pilot Study

Abstract

The current pilot study assessed the prevalence of at-risk/problem gambling using the Brief Biosocial Gambling Screen (BBGS) among a sample of U.S. military veterans seeking mental health treatment services in a primary care medical setting at a Veterans Affairs (VA) hospital in the Northeast. Out of the 260 veterans screened, 85 veterans (32.7%) reported gambling behaviors within the past 12 months. No significant differences were found between gambling and nongambling veterans on demographics, medical, or mental health conditions collected in the study. Among veteran past-year gamblers, five veterans (5.9%) screened positive for at-risk/problem gambling. The estimated prevalence of problem gambling was 1.9% among veterans screened in a primary care behavioral health clinic. Results suggest that self-disclosure of problem gambling among veterans, as well as outreach efforts by VA health care providers, could serve to increase veterans' participation in treatment services for problem gambling. Larger, well-powered studies that examine the utility of the BBGS for detecting problem gambling among military populations are needed.

Assessing potential brief screening questions for use within different social care‐related contexts to identify individuals experiencing gambling‐related harms: A scoping review

“…The administration of questions varied between face‐to‐face (Kraus, Potenza, et al, 2020 ), self‐administration using paper questionnaires (Lind et al, 2019 ) or electronic formats (Rockloff, 2012 ). The implications of administration method were unexplored but are important given the accelerated move to online services following the Covid‐19 pandemic (Griffiths et al, 2020 ).…”

“…The implications of administration method were unexplored but are important given the accelerated move to online services following the Covid‐19 pandemic (Griffiths et al, 2020 ). When not self‐administered, the screens were undertaken by researchers (Himelhoch et al, 2015 ), healthcare staff (Kraus, Potenza, et al, 2020 ), or staff in other settings such as credit counselling services (Sacco et al, 2019 ). Face‐to‐face interviews may improve engagement (Harrison et al, 2020 ), while a consideration of the differences in administration by healthcare staff or research staff shows concerns among service users about information sharing among healthcare professionals (Himelhoch et al, 2015 ).…”

“…This focus on clinically diagnosable harm excludes those at risk of GRHs, including affected others who can benefit from support services. There is evidence that staff and service users found screening questions acceptable within the context of broader health and well‐being assessments, through either online or face‐to‐face administration (Blank et al, 2021b ; Kraus, Potenza, et al, 2020 ).…”

Gambling Problems and Military- and Health-Related Behaviour in UK Armed Forces Veterans

“…The finding of a significant difference between veterans and non-veterans in rates of problem gambling, particularly when the data were obtained at a time (2006)(2007) when the threshold for DSM-based diagnosis was higher, demonstrates the necessity for an up-to-date community survey measuring problem gambling amongst both Armed Forces and civilian populations. Further survey-based research should employ a larger sample of veterans than that available from the APMS (e.g., Stefanovics, Potenza, & Pietrzak, 2017) and include questions on pre-service mental health (inclusive of both common mental disorders and severe mental disorders with appropriate rating scales) and details of participants' Armed Forces careers (e.g., Kraus et al, 2019). Moreover, there is potential for other approaches such as qualitative research of the lived experience of gambling problems (e.g., Miller, Thomas, & Robinson, 2018;Wardle, 2019) to further inform the understanding of military psychological health and gambling.…”