Gambling problems among United Kingdom armed forces veterans: Associations with gambling motivation and posttraumatic stress disorder
Abstract: Military service, mental health, and gambling activities and motivations as predictors of problem gambling in a sample of UK AF veterans. Age-and-gender matched veterans (n = 1,037) and non-veterans (n = 1,148) completed an online survey of problem gambling, gambling motivation, mental health (depression and anxiety), and posttraumatic stress disorder (PTSD). Past year problem gambling rates were higher in veterans compared to non-veterans. Veteran status predicted increased problem gambling risk. The relationship between problem gambling and gambling to cope with distress was significantly stronger among veterans. Veterans experiencing PTSD and complex PTSD (C-PTSD) were at increased risk of problem gambling. Overall, the present, findings contribute further international evidence that veterans are a population vulnerable to problem gambling. Veterans with PTSD or C-PTSD are most at-risk and may engage in problematic gambling to escape/avoid distress. Routine screening for gambling problems should be undertaken with current and former military personnel, and further research is needed on the interplay between gambling motivation and veterans’ mental health.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.