(see Poster Gallery) Predictors of Gambling Participation in Young Adult Survivors of Child Sexual Abuse: Evidence from the National Longitudinal Study of Adolescent to Adult Health (Add Health)

Background and Purpose

Accumulating addictive or compulsive behaviors compound the quality of life in survivors of child sexual abuse (CSA), such as alcoholism, substance misuse, disordered eating behavior, compulsive sexual behavior, and problematic gambling. Such behaviors often co-occur with emotional and mental distresses. Generalized Theory of Addiction (Jacobs, 1986) posits that addictive gambling behaviors can arise from a deep sense of inadequacy developed following traumatic childhood experiences. Further, persistent and recurrent problematic gambling can lead to a clinical impairment of Gambling Disorder. Given the onset of addictive behaviors most prevalent in adolescence or young adulthood, this study examines: 1) the sociodemographic characteristics of young adult survivors of CSA with gambling participation behavior; and 2) the predictors associated with gambling participation in this population. This study fills the research void in the financial well-being of CSA survivors.

Methods

Study data were abstracted from the Wave 4 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N = 14,800). Using Binomial Logistic Regression Model to estimate odds ratios of gambling participation, we included gender, socioeconomic status (personal earnings before taxes), educational attainment, and living arrangement as covariates; and intra-familial CSA, extra-familial CSA and clinical proxies of the traumatic repercussions of CSA (i.e. anxiety/panic, depression, and PTSD diagnoses) as independent variables. We then used several analytical strategies to produce the model with the best goodness of fit. First, we conduct a stepwise regression analysis procedure to compare the models that predict the odds of gambling participation. Second, we ran ANOVA, AIC, and BIC analyses to test models that better predict the odds of gambling participation. Subsequently, we did a Likelihood Ratio test to specify the best predictive model.

Results

About 5.6% of young adults (n=828) reported child sexual abuse history, 72.7% of whom ever participating in gambling. In these subsample of young adults with gambling participation, their current mean age was 29 (s.d.=1.7; R=26-32); 74.5% were female and 25.4% male; 85.6% of them lived with someone else and 10.5% alone; slightly more than a third (35.7%) completed some college, 21.6% high school degree, and 10.5% some high school; and their mean salary before taxes was $24,895 (s.d.=23,237; R=0-150,000).

The Binomial Logistic Regression analyses indicated the model that included sex, income, extra-familial CSA victimization, anxiety and PTSD can best predict gambling participation. Specifically, income (OR= 3.69, p<.01), extra-familial CSA (OR= 0.16), and anxiety (OR= 0.23, p<.05) were positively associated with gambling participation. Female (reference: male; OR= -0.47, p<.001) and PTSD diagnosis (reference: no diagnosis; OR= -0.35, p<.1) were negatively associated with gambling participation.

Conclusions and Implications

Our findings highlight the connection between the financial well-being and mental health among young adult survivors of CSA. CSA survivor support services should screen and intrevene in trauma-induced financial behaviors (e.g. compulsive spending, gambling). Particularly, male young adults with extra-familial CSA history, higher income level and anxiety symptoms are the vulnerable population of gambling participation. Future studies need to profile the heterogeneity of the gambling participation between survivors of intra-familial CSA and extra-familial CSA.