(PS1-27) Suicide Attempt History in Veterans Receiving Treatment for Gambling Disorder: Demographic and Psychiatric Associates

Abstract Text: Suicide rates among veterans continue to be a cause for concern, with suicide being the 13th leading cause of death among US military veterans in 2021 (VA 2023 Annual Report). Veterans are considered a high-risk population for suicidality, as well as other addictive disorders, including gambling disorder (GD) (Nichter et al. 2022; Pfeiffer et al. 2009; Normal et al. 2018; Etuk et al. 2020). It is known that gambling behavior is a risk factor for suicide (Kristensen et al. 2024), and prior work has linked GD in veterans with increased suicide attempts (Kausch 2003). Prior research has also examined impulsivity as a possible predictor of GD, and its relationship to gambling severity and gambling preferences (non-strategic vs strategic) (Hodgins and Holub 2015; Vintró-Alcaraz et al. 2022). Nevertheless, this link between GD and suicidality in veterans remains understudied.

The present work seeks to build upon prior studies linking suicidality and gambling behavior to focus on their co-occurrence in a clinical sample of US veterans receiving inpatient treatment for GD (N = 603) from diverse backgrounds and military branches. Specifically, the study examines this connection, along with impulsivity, gambling severity, psychiatric comorbidities, and gambling preferences. Suicide attempt history was analyzed. For a subset of the sample (N = 157), the reason for attempting suicide was recorded. GD and comorbid diagnoses were determined at intake through clinician interviews and assessment. The South Oaks Gambling Screen and the Short Urgency, Premeditation, Perseverance, Sensation Seeking, and Positive Urgency Scale were used to assess gambling severity and impulsivity.

Results show that veterans who reported a past suicide attempt were more likely to be non-strategic gamblers. Being a woman, having a current psychiatric diagnosis: mood disorder, personality disorder, post-traumatic stress disorder, and psychotic disorder, including higher negative urgency, predicted a past suicide attempt and likelihood of a future attempt. Veterans who reported their suicide attempt was gambling-related were more likely to be strategic gamblers, have greater gambling severity, and impulsivity, including positive and negative urgency, and sensation seeking.

Therefore, Veterans with GD are particularly vulnerable to increased suicidality and its associations; this is meaningful for ongoing gambling treatment and prevention efforts.