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Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans

Glen Dighton Orcid Logo, Sebastian Whiteford Orcid Logo, Martyn Quigley Orcid Logo, Simon Dymond Orcid Logo

Journal of Gambling Studies

Swansea University Authors: Glen Dighton Orcid Logo, Sebastian Whiteford Orcid Logo, Martyn Quigley Orcid Logo, Simon Dymond Orcid Logo

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DOI (Published version): 10.1007/s10899-025-10449-0

Abstract

Experiences of gambling-related harm are significant concerns among military veterans, particularly those with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). CPTSD, as outlined in the ICD-11, includes disturbances in self-organisation (DSO), encompassing affective dysregulation, nega...

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Published in: Journal of Gambling Studies
ISSN: 1573-3602
Published: Springer Science and Business Media LLC 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70772
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CPTSD, as outlined in the ICD-11, includes disturbances in self-organisation (DSO), encompassing affective dysregulation, negative self-concept, and interpersonal difficulties. While anxiety and distress tolerance (DT) have been implicated in PTSD-related maladaptive behaviours, their roles in the relationship between CPTSD and gambling risk severity remain unclear. This study examines whether anxiety and DT mediate the association between CPTSD symptom clusters (PTSD and DSO) and gambling severity in UK Armed Forces veterans. A cross-sectional study was conducted with UK ex-service personnel (n&#x2009;=&#x2009;346) who completed the International Trauma Questionnaire for CPTSD, the Generalised Anxiety Disorder scale, the Distress Tolerance Scale, and the Problem Gambling Severity Index. Mediation analyses were conducted using bootstrapped regression models. Anxiety was found to be a significant indirect pathway between CPTSD symptoms and gambling risk severity, with a stronger indirect effect observed for DSO symptoms than PTSD-specific symptoms. In contrast, DT did not show a significant indirect pathway, indicating that deficits in DT may not be central to gambling behaviours in veterans with CPTSD. These findings highlight the critical role of anxiety in gambling-related harm among veterans with symptoms of CPTSD, suggesting that interventions targeting anxiety regulation may be beneficial than those targeting distress tolerance in reducing gambling risk severity. 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spelling 2025-11-20T14:46:41.1544970 v2 70772 2025-10-27 Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans 2a413b069254b5edfb6509b4c3b41ad7 0000-0002-9283-5114 Glen Dighton Glen Dighton true false 5bcf7b504f5cb2b2ad68192efc3983f5 0000-0003-3859-7220 Sebastian Whiteford Sebastian Whiteford true false 45ba0b00b12b2a4cd533dcd42f0121d9 0000-0003-4342-1369 Martyn Quigley Martyn Quigley true false 8ed0024546f2588fdb0073a7d6fbc075 0000-0003-1319-4492 Simon Dymond Simon Dymond true false 2025-10-27 PSYS Experiences of gambling-related harm are significant concerns among military veterans, particularly those with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). CPTSD, as outlined in the ICD-11, includes disturbances in self-organisation (DSO), encompassing affective dysregulation, negative self-concept, and interpersonal difficulties. While anxiety and distress tolerance (DT) have been implicated in PTSD-related maladaptive behaviours, their roles in the relationship between CPTSD and gambling risk severity remain unclear. This study examines whether anxiety and DT mediate the association between CPTSD symptom clusters (PTSD and DSO) and gambling severity in UK Armed Forces veterans. A cross-sectional study was conducted with UK ex-service personnel (n = 346) who completed the International Trauma Questionnaire for CPTSD, the Generalised Anxiety Disorder scale, the Distress Tolerance Scale, and the Problem Gambling Severity Index. Mediation analyses were conducted using bootstrapped regression models. Anxiety was found to be a significant indirect pathway between CPTSD symptoms and gambling risk severity, with a stronger indirect effect observed for DSO symptoms than PTSD-specific symptoms. In contrast, DT did not show a significant indirect pathway, indicating that deficits in DT may not be central to gambling behaviours in veterans with CPTSD. These findings highlight the critical role of anxiety in gambling-related harm among veterans with symptoms of CPTSD, suggesting that interventions targeting anxiety regulation may be beneficial than those targeting distress tolerance in reducing gambling risk severity. Future research should explore additional potential pathways, such as impulsivity and trauma-related dissociation to further clarify associations between CPTSD and gambling severity. Journal Article Journal of Gambling Studies 0 Springer Science and Business Media LLC 1573-3602 Veterans; Gambling; Anxiety; Complex PTSD; Disorders of self-organisation; Distress tolerance 31 10 2025 2025-10-31 10.1007/s10899-025-10449-0 COLLEGE NANME Psychology School COLLEGE CODE PSYS Swansea University SU Library paid the OA fee (TA Institutional Deal) The original study, from which this article draws its data, was funded by Forces in Mind Trust (FiMT17/0510S). 2025-11-20T14:46:41.1544970 2025-10-27T12:16:57.3321301 Faculty of Medicine, Health and Life Sciences School of Psychology Glen Dighton 0000-0002-9283-5114 1 Sebastian Whiteford 0000-0003-3859-7220 2 Martyn Quigley 0000-0003-4342-1369 3 Simon Dymond 0000-0003-1319-4492 4 70772__35585__b4118fc3e4e1423ea4bd9045545accc6.pdf 70772.VOR.pdf 2025-11-07T12:11:56.2008140 Output 1027983 application/pdf Version of Record true © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
spellingShingle Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
Glen Dighton
Sebastian Whiteford
Martyn Quigley
Simon Dymond
title_short Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
title_full Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
title_fullStr Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
title_full_unstemmed Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
title_sort Anxiety and Distress Tolerance as Mediators between Complex Posttraumatic Stress Disorder Symptoms and Gambling Severity in Veterans
author_id_str_mv 2a413b069254b5edfb6509b4c3b41ad7
5bcf7b504f5cb2b2ad68192efc3983f5
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8ed0024546f2588fdb0073a7d6fbc075
author_id_fullname_str_mv 2a413b069254b5edfb6509b4c3b41ad7_***_Glen Dighton
5bcf7b504f5cb2b2ad68192efc3983f5_***_Sebastian Whiteford
45ba0b00b12b2a4cd533dcd42f0121d9_***_Martyn Quigley
8ed0024546f2588fdb0073a7d6fbc075_***_Simon Dymond
author Glen Dighton
Sebastian Whiteford
Martyn Quigley
Simon Dymond
author2 Glen Dighton
Sebastian Whiteford
Martyn Quigley
Simon Dymond
format Journal article
container_title Journal of Gambling Studies
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publishDate 2025
institution Swansea University
issn 1573-3602
doi_str_mv 10.1007/s10899-025-10449-0
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
document_store_str 1
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description Experiences of gambling-related harm are significant concerns among military veterans, particularly those with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). CPTSD, as outlined in the ICD-11, includes disturbances in self-organisation (DSO), encompassing affective dysregulation, negative self-concept, and interpersonal difficulties. While anxiety and distress tolerance (DT) have been implicated in PTSD-related maladaptive behaviours, their roles in the relationship between CPTSD and gambling risk severity remain unclear. This study examines whether anxiety and DT mediate the association between CPTSD symptom clusters (PTSD and DSO) and gambling severity in UK Armed Forces veterans. A cross-sectional study was conducted with UK ex-service personnel (n = 346) who completed the International Trauma Questionnaire for CPTSD, the Generalised Anxiety Disorder scale, the Distress Tolerance Scale, and the Problem Gambling Severity Index. Mediation analyses were conducted using bootstrapped regression models. Anxiety was found to be a significant indirect pathway between CPTSD symptoms and gambling risk severity, with a stronger indirect effect observed for DSO symptoms than PTSD-specific symptoms. In contrast, DT did not show a significant indirect pathway, indicating that deficits in DT may not be central to gambling behaviours in veterans with CPTSD. These findings highlight the critical role of anxiety in gambling-related harm among veterans with symptoms of CPTSD, suggesting that interventions targeting anxiety regulation may be beneficial than those targeting distress tolerance in reducing gambling risk severity. Future research should explore additional potential pathways, such as impulsivity and trauma-related dissociation to further clarify associations between CPTSD and gambling severity.
published_date 2025-10-31T05:33:42Z
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