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1.
Am J Addict ; 23(5): 510-7, 2014.
Article in English | MEDLINE | ID: mdl-25065420

ABSTRACT

BACKGROUND AND OBJECTIVES: Gambling is an increasing concern among adolescence, yet there has been limited investigation into school-level factors that may increase the risk for gambling. The current study examined the relationship between substance use and gambling, and explored the influence of school context on adolescent gambling. METHODS: Data come from 25,456 students in 58 high schools participating in the Maryland Safe and Supportive Schools Initiative. Youth-reports of socio-demographics, lifetime gambling, and past-month substance use (ie, alcohol, cigarette, marijuana, non-medical prescription drug) were collected. School-level characteristics were student suspension rate, student mobility, percentage of students receiving free/reduce-priced meals, percentage of African American students, urbanicity, gambling prevalence, gambling problem prevalence, and substance use prevalence. Weighted multilevel analyses were conducted. RESULTS: One-third (n = 8,318) reported lifetime gambling, and 10% (n = 2,580) of the full sample, or 31% of the gamblers, experienced gambling problems. Being male and alcohol, marijuana, and non-medical prescription drug use were associated with twice the odds of gambling. Among gamblers, being male, African American, and cigarette, marijuana, and non-medical prescription drug use were associated with higher odds of gambling problems. The school-level factors of suspension rate and percentage of African American had minimal, inverse associations with gambling; however, none were related to gambling problems. CONCLUSIONS: Multilevel results indicated that adolescents that are male and use substances are more likely to gamble and have gambling problems. SCIENTIFIC SIGNIFICANCE: The findings indicate a need for prevention programs targeting risky behaviors to also target gambling as such behaviors often co-occur among adolescents.


Subject(s)
Adolescent Behavior/psychology , Gambling/psychology , Students/psychology , Adolescent , Female , Gambling/epidemiology , Health Surveys , Humans , Male , Maryland/epidemiology , Prevalence , Risk Factors , Schools , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology
2.
Am J Addict ; 23(3): 280-7, 2014.
Article in English | MEDLINE | ID: mdl-24724886

ABSTRACT

OBJECTIVES: This study investigated the link between gambling behaviors and the use of alcohol, drugs, and nonprescribed prescription medications, while exploring the moderating role of distinct religious faiths. METHODS: In 2010, 570 students from the American University of Beirut completed a self-reported, anonymous English questionnaire, which included lifetime gambling and past-year substance use measures. RESULTS: Half (55%) were lifetime gamblers, of whom, 12% were probable pathological gamblers. About 60% were strategic gamblers. Lifetime gamblers were more than twice as likely as nongamblers to report past-year illegal drug use and alcohol abuse. Probable pathological gamblers were also more than four times as likely as nongamblers to report nonmedical prescription drug use, illegal drug use, and alcohol abuse. Compared to nonstrategic gamblers, strategic gamblers had more than three times the odds of illegal drug and cigarette use. The link between alcohol abuse and gambling was stronger among Christians than Muslims. Conversely, Muslims were more likely to report the co-occurrence of various gambling behaviors (lifetime, probable pathological, and strategic gambling) with both illegal drug use and cigarette use. CONCLUSIONS: Gambling and substance use behaviors were strongly linked in this sample of youth from Lebanon, corroborating the evidence from North America. Particularly novel are the co-occurrence of pathological gambling and nonmedical prescription drug use and the potential differential role of religion. (Am J Addict 2014;23:280-287).


Subject(s)
Gambling/psychology , Religion and Psychology , Religion , Substance-Related Disorders/psychology , Adolescent , Adult , Diagnosis, Dual (Psychiatry)/psychology , Female , Gambling/complications , Gambling/epidemiology , Humans , Lebanon/epidemiology , Male , Middle Aged , Substance-Related Disorders/complications , Substance-Related Disorders/epidemiology , Young Adult
3.
Addict Behav ; 39(5): 854-60, 2014 May.
Article in English | MEDLINE | ID: mdl-24583275

ABSTRACT

OBJECTIVES: Late adolescence represents a developmental risk period when many youth become involved in multiple forms of high-risk behaviors with adverse consequences. This study assessed the degree to which two such behaviors, adolescent sexual behaviors and gambling, were associated in a community-based sample with a large African-American presence. STUDY DESIGN: Data are derived from a cohort study. This study focuses on 427 African-American participants with complete information on gambling and sexual behaviors by age 18 (72% of original cohort). Gambling involvement and related problems were based on responses to the South Oaks Gambling Screen - Revised for Adolescents. Several questions assessed sexual behaviors, including age of initiation. Multivariable logistic regression models adjusted for demographics, intervention status, impulsivity, depressive and anxiety symptoms, and alcohol and illegal drug use. RESULTS: Almost half of the sample (49%, n=211) had gambled at least once before age 18. More gamblers than non-gamblers had initiated sexual intercourse by age 18 (aOR: 2.29 [1.16, 4.52]). Among those who had initiated sexual activity, more gamblers than non-gamblers with high impulsivity levels at age 13 (vs. low impulsivity levels) had become pregnant or had impregnated someone. Among those who had initiated sexual activity by age 18, more male gamblers had impregnated someone by age 18 as compared to female gamblers becoming pregnant. CONCLUSIONS: Gambling and sexual behaviors often co-occur among adolescents. Such findings prompt the need for the inclusion of gambling, an often overlooked risky behavior, in behavioral prevention/intervention programs targeting adolescents.


Subject(s)
Black or African American/psychology , Gambling/ethnology , Sexual Behavior/ethnology , Adolescent , Age Factors , Baltimore/ethnology , Coitus/psychology , Female , Humans , Male , Pregnancy , Pregnancy in Adolescence/ethnology , Sexual Partners , Unsafe Sex/ethnology
4.
Am J Addict ; 23(4): 386-92, 2014.
Article in English | MEDLINE | ID: mdl-24628694

ABSTRACT

BACKGROUND AND OBJECTIVES: To describe the association between social and problem gambling and first criminal arrest by age 23 in a cohort of urban, mainly African-American youth. METHODS: Data for this study were derived from several annual interviews being completed on a community sample of 617 participants during late adolescence until age 23. Information on gambling status, engagement in deviant behaviors, illegal drug use, and arrest history were collected through yearly interviews. Analysis was carried out using Nelson-Aalen cumulative hazard models and simple and adjusted Cox proportional hazards models. RESULTS: More problem gamblers had been arrested before age 23 than social gamblers and non-gamblers, ie, 65% of problem gamblers were arrested before age 23, compared to 38% of social gamblers and 24% non-gamblers. Social gambling was only significantly associated with the hazard of first arrest by age 23 in the unadjusted model (HR: 1.6, p < .001), but not after adjustment for covariates (HR: 1.1, p = .47). Problem gambling was significantly associated with the hazard of first arrest by age 23 years in the unadjusted (HR: 3.6, p < .001) and adjusted models (HR: 1.6, p = .05). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Problem gambling was significantly associated with earlier age of being arrested. Dilution effects after adjustment for several deviant behaviors and illegal drug use by age 17 suggest that youth exposure to certain common factors may result in engagement in multiple risky behaviors, including problem gambling. Studies are needed to investigate the developmental pathways that lead to these combined behaviors among youth. (Am J Addict 2014;23:386-392).


Subject(s)
Crime/statistics & numerical data , Gambling , Adolescent , Age Factors , Cohort Studies , Female , Health Surveys , Humans , Male , Proportional Hazards Models , Substance-Related Disorders/epidemiology , United States/epidemiology , Urban Population , Young Adult
5.
J Adolesc Health ; 55(2): 188-94, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24656449

ABSTRACT

PURPOSE: The purpose of this study was to examine transitions in gambling participation from late adolescence into emerging adulthood and to identify factors (i.e., gender, race, intervention status, lunch status, conduct disorder, parental monitoring, neighborhood environment, and substance use) that might influence these transitions. METHODS: Markov modeling was used to describe the movement between past-year gambling states (i.e., nongambling and gambling) across 5 years. Annual data on the past-year gambling behavior and substance use were collected from 515 young men and women starting at the age of 17 years. RESULTS: Past-year gambling declined from 51% prevalence at the age of 17 years to 21% prevalence at the age of 22 years. Participants who reported no past-year gambling at a particular annual assessment had more than an 80% probability of also reporting no past-year gambling at the following assessment. Men were 1.07-2.82 times more likely than women to transition from past-year nongambling to gambling year to year, and women were 1.27-5.26 times more likely than men to transition from past-year gambling to nongambling year to year. In addition, gender and past-year tobacco use interacted such that men who used tobacco were most likely (and men who did not use tobacco least likely) to gamble at baseline. CONCLUSIONS: Transition rates between gambling states appear to be relatively stable over time from late adolescence into emerging adulthood; however, men and those who engage in substance use may be at an increased risk of gambling participation.


Subject(s)
Adolescent Behavior/psychology , Aging/psychology , Gambling/epidemiology , Gambling/psychology , Risk-Taking , Adaptation, Psychological , Adolescent , Age Factors , Alcoholism/epidemiology , Cohort Studies , Female , Humans , Male , Markov Chains , Prevalence , Retrospective Studies , Risk Assessment , Socioeconomic Factors , Substance-Related Disorders/epidemiology , Tobacco Use Disorder/epidemiology , United States/epidemiology , Young Adult
6.
Addiction ; 109(6): 977-85, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24321006

ABSTRACT

AIM: To test the strength of the association between parental monitoring trajectories throughout early adolescence (ages 11-14) and gambling behaviours by young adulthood (age 22). DESIGN: Longitudinal cohort design. SETTING: Baltimore, Maryland. PARTICIPANTS: The sample of 514 participants with gambling data between ages 16-22 and parental monitoring data between ages 11-14 were predominantly African American and received subsidized lunches at age 6. MEASUREMENTS: The South Oaks Gambling Screen and South Oaks Gambling Screen-Revised for Adolescents collected self-reports on annual gambling and gambling problems between ages 16-22. The Parental Monitoring Subscale of the Structured Interview of Parent Management Skills and Practices-Youth Version collected self-reports on annual parental monitoring between ages 11-14. FINDINGS: General growth mixture modelling identified two parental monitoring trajectories: (i) 'stable' class (84.9%) began with a high level of parental monitoring at age 11 that remained steady to age 14; (ii) 'declining' class (15.1%) began with a significantly lower level of parental monitoring at age 11 and experienced a significant to through age 14. The declining class had increased significantly unadjusted (OR = 1.91; 95% CI = 1.59, 2.23; P ≤ 0.001) and adjusted (aOR = 1.57; 95% CI = 1.24, 1.99; P = 0.01) odds of problem gambling compared with non-gambling. CONCLUSION: Low and/or declining parental monitoring of children between the ages of 11 and 14 is associated significantly with problem gambling when those children reach young adulthood.


Subject(s)
Gambling/psychology , Parenting/psychology , Urban Population , Adolescent , Baltimore , Child , Cohort Studies , Comorbidity , Female , Gambling/epidemiology , Gambling/rehabilitation , Humans , Juvenile Delinquency/psychology , Juvenile Delinquency/rehabilitation , Juvenile Delinquency/statistics & numerical data , Longitudinal Studies , Male , Peer Group , Social Facilitation , Social Identification , Social Support , Statistics as Topic , Surveys and Questionnaires , Young Adult
7.
Am J Addict ; 22(4): 417-24, 2013.
Article in English | MEDLINE | ID: mdl-23795883

ABSTRACT

BACKGROUND: Young fatherhood is associated with various adverse outcomes. This study aims to describe the relationship of adolescent gambling with young fatherhood (by age 20) while adjusting for several young fatherhood antecedents. METHODS: Data were from 294 males who have been followed for 16 years since entering first grade in nine inner city public schools (86% African Americans, 81% of the original male cohort). Self-reports of impregnation (including age) and gambling were collected during late adolescence. Nelson-Aalen curves and Cox regression models assessed the hazard of young fatherhood among adolescent nongamblers, social gamblers, and problem gamblers. RESULTS: More young fathers than nonfathers reported adolescent social (49.2% vs. 42.5%) and problem gambling (28.3% vs. 13.2%, p < .001). Problem gamblers were the most likely to impregnate someone by age 20, followed by social gamblers, then nongamblers. Problem gambling (aHR = 3.16, 95% CI = 1.75, 5.72, p < .001) had the highest increased hazards of young fatherhood, followed by social gambling (aHR = 1.95, 95% CI = 1.30, 2.94, p = .001), high school dropout (aHR = 1.75, 95% CI = 1.14, 2.70, p = .01), and subsidized lunch status (aHR = 1.69, 95% CI = 1.01, 2.38, p = .04). CONCLUSION: Adolescent male gamblers, particularly problem gamblers, were more likely than their nongambling peers to become fathers by the age of 20. Such a result shows that there is a subpopulation of males who are at high risk for adverse outcomes such as young parenthood and problem behaviors. Only through further studies could the needs of this subpopulation be better assessed so that appropriate assistance could be delivered to better the lives of such individuals.


Subject(s)
Adolescent Behavior/psychology , Fathers/psychology , Gambling/psychology , Adolescent , Age Factors , Humans , Male , Risk Factors , Young Adult
8.
Virology ; 444(1-2): 119-23, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23806387

ABSTRACT

We have isolated and cultured three distinct adenoviruses from wild gorillas. Phylogenetic analysis grouped the viruses with human adenovirus species C based on DNA polymerase, hexon, and E4ORF6 genes. The three wild gorilla adenoviruses clustered with the other species C captive gorilla adenoviruses, forming a branch separate from human and chimpanzee/bonobo adenoviruses. Animal sera to the three newly isolated viruses did not cross-neutralize, demonstrating serological distinctiveness. The human adenovirus 5 fiber knob blocked infection, suggesting use of the Coxsackie and Adenovirus Receptor. These viruses may provide viral vectors with properties distinct from chimpanzee adenovirus and human adenovirus vectors.


Subject(s)
Adenoviridae Infections/veterinary , Adenoviridae/classification , Adenoviridae/genetics , Primate Diseases/virology , Adenoviridae/immunology , Adenoviridae/isolation & purification , Adenoviridae Infections/virology , Animals , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , Cluster Analysis , DNA, Viral/chemistry , DNA, Viral/genetics , Gorilla gorilla , Molecular Sequence Data , Neutralization Tests , Phylogeny , Sequence Analysis, DNA , Serotyping
9.
J Urban Health ; 90(1): 130-40, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22895654

ABSTRACT

Social and environmental influences on gambling behavior are important to understand because localities can control the sanction and location of gambling opportunities. This study explores whether neighborhood disadvantage is associated with gambling among predominantly low-income, urban young adults and to explore if we can find differences in physical vs. compositional aspects of the neighborhood. Data are from a sample of 596 young adults interviewed when they were 21-22 years, who have been participating in a longitudinal study since entering first grade in nine public US Mid-Atlantic inner-city schools (88 % African Americans). Data were analyzed via factor analysis and logistic regression models. One third of the sample (n = 187) were past-year gamblers, 42 % of them gambled more than once a week, and 31 % had gambling-related problems. Those living in moderate and high disadvantaged neighborhoods were significantly more likely to be past-year gamblers than those living in low disadvantaged neighborhoods. Those living in high disadvantaged neighborhoods were ten times more likely than those living in low disadvantaged neighborhoods to have gambling problems. Factor analysis yielded a 2-factor model, an "inhabitant disadvantage factor" and a "surroundings disadvantage factor." Nearly 60 % of the sample lived in neighborhoods with high inhabitants disadvantage (n = 375) or high surroundings disadvantage (n = 356). High inhabitants disadvantage was associated with past-year frequent gambling (odds ratios (aOR) = 2.26 (1.01, 5.02)) and gambling problems (aOR = 2.81 (1.18, 6.69)). Higher neighborhood disadvantage, particularly aspects of the neighborhood concerning the inhabitants, was associated with gambling frequency and problems among young adult gamblers from an urban, low-income setting.


Subject(s)
Gambling/epidemiology , Factor Analysis, Statistical , Humans , Logistic Models , Poverty/statistics & numerical data , United States/epidemiology , Urban Population/statistics & numerical data
10.
Addiction ; 108(4): 780-8, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23130867

ABSTRACT

AIM: Building on the recent emerging literature on the impulsivity trajectory-gambling association, this study investigated the association between developmental trajectories of teacher-rated impulsivity in early adolescence (ages 11-15 years) and subsequent gambling and gambling problems (i.e. at-risk and problem gambling) by age 19. DESIGN: Prospective cohort design. SETTING: Urban communities in Baltimore, Maryland. PARTICIPANTS: The sample consists of 310 predominately minority (87%) and low socio-economic status (SES) (70%) males followed from first grade to late adolescence. MEASUREMENTS: Impulsivity was measured using teacher ratings of classroom behavior. Self-reported gambling behavior was assessed using the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA). FINDINGS: Results from a conventional growth model suggest that the intercept of the impulsivity development (as measured by the repeated assessments of impulsivity across the entire developmental period) was associated significantly with gambling. Results from a general growth mixture model evidenced two distinct trajectories: a high impulsivity trajectory (41% of the sample) and a low impulsivity trajectory (59% of the sample). Despite its non-significant association with any gambling, heterogeneity in impulsivity development was associated significantly with gambling problems. Specifically, being in the high impulsivity trajectory doubled the odds of meeting criteria for at-risk or problem gambling [odds ratio (OR) = 2.09, 95% confidence interval (CI): 1.02, 4.27)] and tripled the odds of meeting criteria for problem gambling (OR = 2.84, 95% CI: 1.02, 7.91). CONCLUSIONS: Development in impulsivity is associated strongly with problem/at-risk gambling in adolescence among urban male youth. Findings highlight the importance of distinguishing gambling problems from any gambling when evaluating programs aimed at reducing youth gambling problems through reducing impulsivity.


Subject(s)
Gambling/psychology , Impulsive Behavior/complications , Adolescent , Child , Humans , Male , Models, Psychological , Prospective Studies , Urban Health , Young Adult
11.
Am J Addict ; 21(6): 516-23, 2012.
Article in English | MEDLINE | ID: mdl-23082829

ABSTRACT

BACKGROUND: Adverse life events have been associated with gambling and substance use as they can serve as forms of escapism. Involvement in gambling and substance use can also place individuals in adversely stressful situations. OBJECTIVES: To explore potential male-female differences in the association between addictive behavior and adverse life events among an urban cohort of adolescents. METHOD: The study sample comprised of 515 adolescent participants in a randomized prevention trial. With self-reported data, four addictive behavior groups were created: nonsubstance users and nongamblers, substance users only, gamblers only, and substance users and gamblers. Multinomial logistic regression analyses with interaction terms of sex and adverse life events were conducted. RESULTS: Adverse life events and engaging in at least one addictive behavior were common for both sexes. Substance users and gamblers had more than twice the likelihood of nonsubstance users and nongamblers to experience any event as well as events of various domains (ie, relationship, violence, and instability). Neither relationship nor instability events' associations with the co-occurrence of substance use and gambling significantly differed between sexes. Conversely, females exposed to violence events were significantly more likely than similarly exposed males to report the co-occurrence of substance use and gambling. CONCLUSION: Findings from the current study prompt future studies to devote more attention to the development of effective programs that teach adaptive coping strategies to adolescents, particularly to females upon exposure to violence.


Subject(s)
Behavior, Addictive/epidemiology , Gambling/epidemiology , Life Change Events , Stress, Psychological/epidemiology , Substance-Related Disorders/epidemiology , Adolescent , Cohort Studies , Depression/epidemiology , Female , Humans , Logistic Models , Male , Randomized Controlled Trials as Topic , Sex Factors , Violence/statistics & numerical data
12.
J Gambl Stud ; 28(2): 325-36, 2012 Jun.
Article in English | MEDLINE | ID: mdl-21614529

ABSTRACT

This study explored the cross sectional association between adverse life events and gambling in a sample of 515 urban adolescents (average age 17, 55% male, 88% African American). Approximately half of the sample had gambled in the past year (51%); 78% of the gamblers gambled monthly and 39% had a gambling-related problem. On the other hand, 88% of the sample had experienced at least one life event in the past year, and those experiencing events tended to live in more disadvantaged neighborhoods. The mere acknowledgement of experiencing a stressful life event in the past year (yes/no) was not associated with an increase in odds of being a gambler, with gambling more frequently, or with having a gambling problem. However, when the context of the event was considered, an association was found between directly experiencing threatening and deviant/violent types of events and frequent gambling (OR > 2). Additionally, the probability of being a gambler increased as the number of events experienced increased (aOR = 1.07, 95% CI = 1.01, 1.13, P = 0.013), but problems among gamblers were not associated with the number of events experienced (aOR = 1.01, 95% CI = 0.92, 1.11, P = 0.876). During adolescence, life events appear to be connected more with the frequency of gambling rather than with problems related to gambling.


Subject(s)
Gambling/psychology , Life Change Events , Urban Population , Adolescent , Child , Cross-Sectional Studies , Family Therapy , Female , Gambling/epidemiology , Gambling/prevention & control , Humans , Longitudinal Studies , Male , Mid-Atlantic Region , Odds Ratio , Personality Assessment/statistics & numerical data , Prospective Studies , Psychometrics/statistics & numerical data , Psychotherapy, Group , Risk Factors , School Health Services , Social Support , Socioeconomic Factors , Statistics as Topic , Urban Population/statistics & numerical data , Vulnerable Populations/psychology , Vulnerable Populations/statistics & numerical data
13.
J Adolesc Health ; 48(2): 164-9, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21257115

ABSTRACT

PURPOSE: Depression and impulsivity have been positively correlated to problem gambling, but no study has focused on their combined effects on the onset of problem gambling. This study examined the possible synergistic effect of depressive symptoms and impulsivity in early adolescence on late adolescence gambling behaviors among a longitudinal cohort of 678 students from Baltimore, Maryland. METHODS: The South Oaks Gambling Screen-Revised for Adolescents, Teacher Observation of Classroom Adaptation-Revised, and Baltimore How I Feel-Adolescent Version, were used to assess late adolescence gambling behaviors, early adolescence impulsivity, and depressive symptoms, respectively. Data analyses were conducted using analysis of variance and binary logistic regression models. RESULTS: Problem gamblers (PGs) were 12% of the sample (includes at-risk and PGs), 87.5% of whom were males and 12.5% were females (p < .001). Among males, there appeared to be a slight association between early adolescence depressive symptoms and late adolescence problem gambling. Compared with nongamblers and social gamblers, depressive symptoms increased the odds of problem gambling by four-fold (PGs vs. nongamblers: OR = 4.1, 95% CI = .73-22.47, p = .11; PGs vs. social gamblers: OR = 3.9, 95% CI = .78-19.31, p = .10). Among those with high depressive symptoms, increases in impulsivity decreased the odds of problem gambling while among those with high impulsivity, increases in depressive symptoms decreased the odds of problem gambling. CONCLUSIONS: Early adolescence depressive symptoms appear to be more positively associated with late adolescence problem gambling than early adolescence impulsivity, there seems to be a divisive interaction between depressive symptoms and impulsivity on problem gambling.


Subject(s)
Depression/psychology , Gambling/psychology , Impulsive Behavior/psychology , Adolescent , Adolescent Behavior , Black or African American/psychology , Baltimore/epidemiology , Comorbidity , Depression/epidemiology , Education/methods , Female , Gambling/epidemiology , Gambling/prevention & control , Humans , Impulsive Behavior/epidemiology , Longitudinal Studies , Male , Risk Assessment , Time
14.
J Addict Dis ; 29(3): 338-51, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20635283

ABSTRACT

This study describes sociodemographic and substance use correlates of gambling behaviors, measured among 9,481 past-year gamblers from the Canadian general population. Compared to non-problem gamblers in this study (N=8,035), the 98 problem gamblers who scored 8 or more points on the Canadian Problem Gambling Research Index were more likely to report being "drunk or high" while gambling (adjusted odds ratio [AOR]: 8.92; 95% confidence interval [CI]: 5.46,14.55; p<.001), to admit to having an alcohol or drug problem (AOR: 3.80; 95% CI:2.21,6.52; p<.001), and to use electronic gambling devices (AOR: 4.85; 95% CI: 3.08-7.66; p<.001).


Subject(s)
Gambling/psychology , Substance-Related Disorders/epidemiology , Adult , Canada , Cocaine-Related Disorders/epidemiology , Cocaine-Related Disorders/psychology , Cognition Disorders/epidemiology , Cognition Disorders/psychology , Comorbidity , Crack Cocaine , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Dysthymic Disorder/epidemiology , Dysthymic Disorder/psychology , Female , Humans , Male , Marijuana Abuse/epidemiology , Marijuana Abuse/psychology , Middle Aged , Neuropsychological Tests/statistics & numerical data , Psychometrics , Reaction Time , Smoking/epidemiology , Smoking/psychology , Social Adjustment , Socioeconomic Factors , Statistics as Topic , Substance-Related Disorders/psychology , Tobacco Use Disorder/epidemiology , Tobacco Use Disorder/psychology
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