Gambling frequency and symptoms of attention-deficit hyperactivity disorder in relation to problem gambling among Swedish adolescents: a population-based study

Abstract

Aim: To investigate the associations between gambling frequency, attention-deficit hyperactivity disorder (ADHD) symptoms, and problem gambling among adolescent boys and girls. One hypothesis was that adolescents with increased ADHD symptoms have a higher frequency of gambling compared to adolescents with fewer ADHD symptoms.

Method: A population-based sample of adolescents (aged 15–18 years) completed a questionnaire on demographics, gambling habits, ADHD symptoms, and problematic gambling; 1412 adolescents (from 4440 sampled) with gambling experience were included in the final sample.

Results: A zero-inflated negative binomial regression analysis revealed that increased ADHD symptoms, higher gambling frequency, and higher age were associated with lower odds for being non-susceptible to gambling problems. Moreover, gambling frequency interacted with ADHD symptoms in predicting probability of being non-susceptible to gambling problems. However, when analysing those already susceptible to problem gambling, ADHD symptoms did not modify the effect of gambling frequency on the expected magnitude of gambling problems. In susceptible individuals, problem gambling increased with both increased ADHD symptoms and increased gambling frequency, but the level of problems due to gambling frequency did not change depending on the ADHD symptom level. There was an interaction effect between sex and gambling frequency in relation to gambling problems.

Conclusions: Adolescents with ADHD symptoms seem to be more sensitive to gambling, in terms of being susceptible to developing gambling problems. However, once susceptible, adolescents with ADHD symptoms are affected by gambling frequency similarly to other susceptible participants.

Keywords:

• Adolescent
• attention-deficit hyperactivity disorder symptoms
• gambling
• problem gambling
• Problem Gambling Severity Index

Acknowledgements

We are grateful to all the participating students and school staff who made this study possible.

C.H., C.Å., and K.W.N. were responsible for the study concept and design. C.H., C.Å., and P.W. performed the statistical analyses and C.H. drafted the manuscript. C.H., C.Å., P.W., K.W.N. and J.L. critically reviewed the content and read and approved the final version of the manuscript for publication.

Disclosure statement

The authors report no conflicts of interest.

Notes on contributors

Charlotta Hellström, PhD, is a Lecturer and Head of Department for Public Health Sciences at School of Health, Care and Social Welfare/Division of Public Health Sciences. Mälardalen University, Västerås, Sweden.

Philippe Wagner is a Statistician as well as a PhD-student at Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden.

Kent W. Nilsson is a Professor of Psychiatry at Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden.

Jerzy Leppert is a Professor Emeritus of Medicine, Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden.

Cecilia Åslund is an Adjunct Professor (Docent) of Psychiatry at Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden.

Additional information

Funding

Grants from the following funds and organizations are acknowledged: The Svenska Spel Research Council, the Uppsala and Örebro Regional Research Council, the Fredrik and Ingrid Thurings Foundation, the County Council of Västmanland, the König-Söderströmska Foundation, the Swedish Psychiatric Foundation, and the Swedish Council for Working Life and Social Research (FAS). The study sponsors had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.