Adverse Childhood Experiences, Problem Gambling and Disordered Gaming: The Mediating Role of Internalizing and Externalizing Problems Among Adolescents

Adverse childhood experiences (ACEs) and mental health symptoms have been identified as risk factors for problem gambling and gaming. However, no previous research has identified the differential role of specific types of childhood adversity while investigating the mediating role of internalizing and externalizing problems on the risk for problem gambling and disordered gaming in adolescence. As such, the present study aimed to examine how ACEs, ACE categories (i.e., child maltreatment and household dysfunction) and specific type of abuse (i.e., emotional, physical, and sexual) were associated with gambling/gaming behaviors. Moreover, it was examined whether internalizing and externalizing problems were mediators in the association between ACEs and risk for problem gambling/disordered gaming. Surveys were collected from 6,314 public school students aged 10 to 19 in Wood County, Ohio, United States. Results indicated that the presence of ACEs increased the risk for problem gambling and disordered gaming. Childhood maltreatment resulted in a greater risk of problem gambling and disordered gaming compared to household dysfunction. Results of the mediation models indicated that externalizing problems, but not internalizing problems, mediated the relationship between ACEs and risk for problem gambling, whereas both externalizing and internalizing problems mediated the relationship between ACEs and disordered gaming symptoms. These findings underline the differential effect of mental health symptoms in the relationship between ACEs and problem gambling/gaming during adolescence. Implications for future research and prevention are discussed relevant to the risk of specific ACEs and mental health vulnerabilities in adolescence.