BACKGROUND: Online gambling has become a significant public health concern due to its accessibility and potential negative impact on personal well-being. However, the complex relationships between online gambling and related factors remain insufficiently explored. OBJECTIVE: Therefore, the aim of this study was to investigate the relationships between online gambling disorder (OGD), psychological distress, suicidal ideation, and substance abuse. Additionally, the study examined the influence of adverse childhood experiences (ACEs) on these relationships. METHODOLOGY: Network analyses were conducted using a large nationwide sample of Czech adults (n = 3399). Measured variables included OGD, psychological distress (depression, anxiety, and stress scales), suicidal ideation, and substance use behaviors. Separate networks were estimated for males and females. The effect of ACEs on the relationships within the networks was evaluated via the Network Comparison Test (NCT) and edge weight difference tests. RESULTS: No strong associations between OGD and psychological distress or suicidal ideation were found. Additionally, only weak links were observed between OGD and selected substance use items. Changes in node connections were detected when ACEs were introduced into the networks. Furthermore, the NCT revealed isolated structural and connectivity differences between male and female networks. CONCLUSION: While no direct influence of ACEs on the links between OGD and psychological distress was observed, gender-specific differences emerged in how individual OGD items are interconnected. This underscores the need for further research to explore the potential mechanisms through which OGD manifests differently in men and women. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40359-025-03516-z.

Department of Pedagogy and Psychology Faculty of Education University of Hradec Kralove Hradec Kralove Czech Republic

Olomouc University Social Health Institute Palacky University in Olomouc Olomouc Czech Republic

Zobrazit více v PubMed

Afifi TO, Taillieu T, Salmon S, Davila IG, Stewart-Tufescu A, Fortier J, et al. Adverse childhood experiences (ACEs), peer victimization, and substance use among adolescents. Child Abuse Negl. 2020;106:104504. 10.1016/j.chiabu.2020.104504. PubMed

Afifi TO, Nicholson R, Martins SS, Sareen J. A longitudinal study of the temporal relation between problem gambling and mental and substance use disorders among young adults. The Canadian Journal of Psychiatry. 2016;61(2):102–11. 10.1177/0706743715625950. PubMed PMC

American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc.10.1176/appi.books.9780890425596

Amoah-Nuamah J, Agyemang-Duah W, Mensah B, Opoku B. University students’ reasons and attitudes towards online gambling and its implication on their lives. J Gambl Stud. 2023;39(1):203–24. 10.1007/s10899-022-10143-5. PubMed

Anker, J. J., Nakajima, M., Hatsukami, D., Allen, S. S., & al'Absi, M. The enduring effects of early life adversity on the dysregulation of the stress awakening response among dependent tobacco users. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. Advance online publication. 2025. 10.1093/ntr/ntaf013 PubMed

Armoon B, SoleimanvandiAzar N, Fleury M-J, Noroozi A, Bayat A-H, Mohammadi R, et al. Prevalence, sociodemographic variables, mental health condition, and type of drug use associated with suicide behaviors among people with substance use disorders: a systematic review and meta-analysis. J Addict Dis. 2021;39(4):550–69. 10.1080/10550887.2021.1912572. PubMed

Awaworyi Churchill S, Farrell L. The impact of gambling on depression: new evidence from England and Scotland. Econ Model. 2018;68:475–83. 10.1016/j.econmod.2017.08.021.

Baggio S, Gainsbury S, Starcevic V, Richard J-B, François B, Billieux J. Gender differences in gambling preferences and problem gambling: A network-level analysis. Int Gambl Stud. 2018;18:512–25. 10.1080/14459795.2018.1495750.

Barnes GM, Welte JW, Tidwell M-CO, Hoffman JH. Gambling and substance use: co-occurrence among adults in a recent general population study in the United States. Int Gambl Stud. 2015;15(1):55–71. 10.1080/14459795.2014.990396. PubMed PMC

Barrault S, Bonnaire C, Herrmann F. Anxiety, depression and emotion regulation among regular online poker players. J Gambl Stud. 2017;33(4):1039–50. 10.1007/s10899-017-9669-3. PubMed

Bentley KH, Gallagher MW, Carl JR, Barlow DH. Development and validation of the overall depression severity and impairment scale. Psychol Assess. 2014;26(3):815–30. 10.1037/a0036216. PubMed

Betz LT, Rosen M, Salokangas RKR, Kambeitz J. Disentangling the impact of childhood abuse and neglect on depressive affect in adulthood: a machine learning approach in a general population sample. J Affect Disord. 2022;315:17–26. 10.1016/j.jad.2022.07.042. PubMed

Blanca MJ, Alarcón R, Bono R. Current practices in data analysis procedures in psychology: what has changed? Front Psychol. 2018. 10.3389/fpsyg.2018.02558. PubMed PMC

Błoch M, Misiak B. Understanding the emergence of comorbidity between problematic online gaming and gambling: a network analysis approach. Brain Sci. 2024;14(9):9. 10.3390/brainsci14090929. PubMed PMC

Borsboom D, Deserno MK, Rhemtulla M, Epskamp S, Fried EI, McNally RJ, et al. Network analysis of multivariate data in psychological science. Nature Reviews Methods Primers. 2021;1(1):1–18. 10.1038/s43586-021-00055-w.

Boullier M, Blair M. Adverse childhood experiences. Paediatr Child Health. 2018;28(3):132–7. 10.1016/j.paed.2017.12.008.

Brazeau BW, Hodgins DC, Cunningham JA, et al. Augmenting an online self-directed intervention for gambling disorder with a single motivational interview: study protocol for a randomized controlled trial. Trials. 2021;22:947. 10.1186/s13063-021-05912-3. PubMed PMC

Bristow LA, Afifi TO, Salmon S, Katz LY. Risky Gambling Behaviors: Associations with Mental Health and a History of Adverse Childhood Experiences (ACEs). J Gambl Stud. 2022;38(3):699–716. 10.1007/s10899-021-10040-3. PubMed PMC

Broman N, Prever F, di Giacomo E, Jiménez-Murcia S, Szczegielniak A, Hansson H, et al. Gambling, gaming, and internet behavior in a sexual minority perspective. A cross-sectional study in seven European countries. Front Psychol. 2022. 10.3389/fpsyg.2021.707645. PubMed PMC

Buchanan TW, McMullin SD, Baxley C, Weinstock J. Stress and gambling. Curr Opin Behav Sci. 2020;31:8–12. 10.1016/j.cobeha.2019.09.004.

Campbell-Sills L, Forde DR, Stein MB. Demographic and childhood environmental predictors of resilience in a community sample. J Psychiatr Res. 2009;43(12):1007–12. 10.1016/j.jpsychires.2009.01.013. PubMed

Campbell-Sills L, Norman SB, Craske MG, Sullivan G, Lang AJ, Chavira DA, et al. Validation of a brief measure of anxiety-related severity and impairment: the overall anxiety severity and impairment scale (OASIS). J Affect Disord. 2009;112(1–3):92–101. 10.1016/j.jad.2008.03.014. PubMed PMC

Canadian Centre on Substance Use and Addiction. Online gambling in Canada: Trends and statistics. 2002. https://www.ccsa.ca/

Castrén S, Basnet S, Pankakoski M, Ronkainen J-E, Helakorpi S, Uutela A, et al. An analysis of problem gambling among the Finnish working-age population: a population survey. BMC Public Health. 2013;13(1):519. 10.1186/1471-2458-13-519. PubMed PMC

Chapman DP, Whitfield CL, Felitti VJ, Dube SR, Edwards VJ, Anda RF. Adverse childhood experiences and the risk of depressive disorders in adulthood. J Affect Disord. 2004;82(2):217–25. 10.1016/j.jad.2003.12.013. PubMed

Chóliz M, Marcos M, Lázaro-Mateo J. The risk of online gambling: a study of gambling disorder prevalence rates in Spain. Int J Ment Health Addict. 2021;19(2):404–17. 10.1007/s11469-019-00067-4.

Christensen AP, Golino H. On the equivalency of factor and network loadings. Behav Res. 2021;53:1563–80. 10.3758/s13428-020-01500-6. PubMed

Costantini G, Epskamp S, Borsboom D, Perugini M, Mõttus R, Waldorp LJ, et al. State of the aRt personality research: a tutorial on network analysis of personality data in R. J Res Pers. 2015;54:13–29. 10.1016/j.jrp.2014.07.003.

Costes J-M, Kairouz S, Fiedler I, Bartczuk RP, Lelonkek-Kuleta B, Minutillo A, et al. Online Gambling Practices and Related Problems in Five European Countries: Findings from the Electronic Gam(bl)ing Multinational Empirical Survey (E-GAMES) Project. J Gambl Stud. 2023. 10.1007/s10899-023-10229-8. PubMed

Dalenberg, C. J., Straus, E., & Carlson, E. B. Defining trauma. In APA handbook of trauma psychology: Foundations in knowledge. American Psychological Association. 2017;.15-33. 10.1037/0000019-002

Dash GF, Martin NG, Slutske WS. Childhood maltreatment and disordered gambling in adulthood: disentangling causal and familial influences. Psychol Med. 2022;52(5):979–88. 10.1017/S0033291720002743. PubMed PMC

Doan SN, Dich N, Fuller-Rowell TE, et al. Externalizing behaviors buffer the effects of early life adversity on physiologic dysregulation. Sci Rep. 2019;9:13623. 10.1038/s41598-019-49461-x. PubMed PMC

Dube SR, Anda RF, Felitti VJ, Edwards VJ, Croft JB. Adverse childhood experiences and personal alcohol abuse as an adult. Addict Behav. 2002;27(5):713–25. 10.1016/s0306-4603(01)00204-0. PubMed

Echeburúa E, Salaberría K, Cruz-Sáez M. Contributions and limitations of DSM-5 from clinical psychology. Ter Psicol. 2014;32(1):65–74. 10.4067/S0718-48082014000100007.

Effertz T, Bischof A, Rumpf H-J, Meyer C, John U. The effect of online gambling on gambling problems and resulting economic health costs in Germany. Eur J Health Econ. 2018;19(7):967–78. 10.1007/s10198-017-0945-z. PubMed

Epskamp S, Borsboom D, Fried EI. Estimating psychological networks and their accuracy: A tutorial paper. Behav Res Methods. 2018;50:195–212. 10.3758/s13428-017-0862-1. PubMed PMC

Epskamp S, Cramer AOJ, Waldorp LJ, Schmittmann VD, Borsboom D. Qgraph: network visualizations of relationships in psychometric data. J Stat Softw. 2012;48:1–18. 10.18637/jss.v048.i04.

Epskamp, S. Psychonetrics: Structural Equation Modeling and Confirmatory Network Analysis (Version 0.11.5) [Computer software]. 2023. https://cran.r-project.org/web/packages/psychonetrics/index.html

Epskamp S, Fried EI. A tutorial on regularized partial correlation networks. Psychol Methods. 2018;23(4):617–34. 10.1037/met0000167. PubMed

Epskamp, S., & Fried, E. I. bootnet: Bootstrap Methods for Various Network Estimation Routines (Version 1.5.6) [Computer software]. 2023. https://cran.r-project.org/web/packages/bootnet/index.html

Epskamp S, Waldorp LJ, Mõttus R, Borsboom D. The gaussian graphical model in cross-sectional and time-series data. Multivar Behav Res. 2018;53(4):453–80. 10.1080/00273171.2018.1454823. PubMed

Estevez A, Jauregui P, Momeñe J, Lopez-Gonzalez H. Relationship of gambling disorder with traumatic life events and emotion regulation in adolescents and young adults. J Behav Addict. 2023;12(2):500–9. 10.1556/2006.2023.00016. PubMed PMC

Felsher J, Derevensky J, Gupta R. Young adults with gambling problems: the impact of childhood maltreatment. Int J Ment Health Addict. 2010;8:545–56. 10.1007/s11469-009-9230-4.

Friedman J, Hastie T, Tibshirani R. Regularization paths for generalized linear models via coordinate descent. J Stat Softw. 2010;33:1–22. PubMed PMC

Gainsbury SM, Russell A, Hing N, Wood R, Lubman D, Blaszczynski A. How the internet is changing gambling: findings from an Australian prevalence survey. J Gambl Stud. 2015;31(1):1–15. 10.1007/s10899-013-9404-7. PubMed PMC

Gainsbury S, Liu Y, Russell AMT, Teichert T. Is all Internet gambling equally problematic? Considering the relationship between mode of access and gambling problems. Comput Hum Behav. 2016;55:717–28. 10.1016/j.chb.2015.10.006.

Gignac GE, Szodorai ET. Effect size guidelines for individual differences researchers. Pers Individ Differ. 2016;102:74–8. 10.1016/j.paid.2016.06.069.

Giotakos O, Tsouvelas G, Spourdalaki E, Janikian M, Tsitsika A, Vakirtzis A. Internet gambling in relation to internet addiction, substance use, online sexual engagement and suicidality in a Greek sample. Int Gambl Stud. 2017;17(1):20–9. 10.1080/14459795.2016.1251605.

González-Cabrera J, Machimbarrena JM, Beranuy M, Pérez-Rodríguez P, Fernández-González L, Calvete E. Design and measurement properties of the online gambling disorder questionnaire (OGD-Q) in Spanish adolescents. J Clin Med. 2020;9(1):120. 10.3390/jcm9010120. PubMed PMC

Goodrich, K. M., Trott, A., Rodríguez, M. N., Waller, M., & Lilliott, E. (2023). The Impact of Adverse Childhood Experiences on Problem Gambling in New Mexico. Journal of Prevention. 2022;44(3):309–324. 10.1007/s10935-023-00725-3 PubMed

Grant JE, Chamberlain SR. Gambling and substance use: comorbidity and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry. 2020;99:109852. 10.1016/j.pnpbp.2019.109852. PubMed

Gross JJ. The emerging field of emotion regulation: an integrative review. Rev Gen Psychol. 1998;2(3):271–99. 10.1037/1089-2680.2.3.271.

Håkansson A, Karlsson A. Suicide attempt in patients with gambling disorder—associations with comorbidity including substance use disorders. Front Psychiatry. 2020. 10.3389/fpsyt.2020.593533. PubMed PMC

Harrison JE, Weber S, Jakob R, Chute CG. ICD-11: an international classification of diseases for the twenty-first century. BMC Med Inform Decis Mak. 2021;21(Suppl 6):206. 10.1186/s12911-021-01534-6. PubMed PMC

Helvich J, Novak L, Meier Z, et al. Czech Validation of the Online Gambling Disorder Questionnaire (OGD-Q). Int J Ment Health Addiction. 2025. 10.1007/s11469-025-01539-6.

Hemphill JF. Interpreting the magnitudes of correlation coefficients. Am Psychol. 2003;58(1):78–9. 10.1037/0003-066X.58.1.78. PubMed

Hevey D. Network analysis: a brief overview and tutorial. Health Psychol Behav Med. 2018;6(1):301–28. 10.1080/21642850.2018.1521283. PubMed PMC

Hing, N., Gainsbury, S., Blaszczynski, A., Wood, R., Lubman, D., & Russell, A. (2014).

Hing, N., Rusell, A., Browne, M., Rockloff, M., Greer, N., Rawat, V., Stevens, M., Dowling, N., Merkouris, S., King, D., Breen, H., Salonen, A., & Woo, L. (2021). The Second National Study of Interactive Gambling in Australia (2019–2020) [Report]. Deakin University. https://dro.deakin.edu.au/articles/report/The_Second_National_Study_of_Interactive_Gambling_in_Australia_2019-2020_/26028196/1

Hing N, Russell A, Black A, Rockloff M, Browne M, Rawat V, et al. Gambling prevalence and gambling problems amongst land-based-only, online-only and mixed-mode gamblers in Australia: a national study. Comput Human Behav. 2022;132:107269. 10.1016/j.chb.2022.107269.

Hirai T, Hagiwara K, Chen C, Okubo R, Higuchi F, Matsubara T, et al. The impact of adverse childhood experiences on adult physical, mental health, and abuse behaviors: a sex-stratified nationwide latent class analysis in Japan. J Affect Disord. 2025;369:1071–81. 10.1016/j.jad.2024.10.074. PubMed

Hubert P, Griffiths MD. A comparison of online versus offline gambling harm in Portuguese pathological gamblers: an empirical study. Int J Ment Health Addict. 2018;16(5):1219–37. 10.1007/s11469-017-9846-8. PubMed PMC

Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e356–66. 10.1016/S2468-2667(17)30118-4. PubMed

Isvoranu A-M, Epskamp S. Which estimation method to choose in network psychometrics? Deriving guidelines for applied researchers. Psychol Methods. 2023;28(4):925–46. 10.1037/met0000439. PubMed

Jamshidian, M., Jalal, S., & Jansen, and C. (2015). MissMech: Testing Homoscedasticity, Multivariate Normality, and Missing Completely at Random (Version 1.0.2) [Computer software]. https://CRAN.R-project.org/package=MissMech

Karlamangla AS, Merkin SS, Almeida DM, Friedman EM, Mogle JA, Seeman TE. Early-life adversity and dysregulation of adult diurnal cortisol rhythm. The Journals of Gerontology: Series B. 2019;74(1):160–9. 10.1093/geronb/gby097. PubMed PMC

Kessler RC, Hwang I, LaBrie R, Petukhova M, Sampson NA, Winters KC, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med. 2008;38(9):1351–60. 10.1017/S0033291708002900. PubMed PMC

Khantzian EJ. The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harv Rev Psychiatry. 1997;4(5):231–44. 10.3109/10673229709030550. PubMed

Kim HS, Tabri N, Hodgins DC. A 5-year longitudinal examination of the co-occurring patterns of gambling and other addictive behaviors. Addict Behav. 2024;149:107894. 10.1016/j.addbeh.2023.107894. PubMed

Kirsch DE, Lippard ET. Early life stress and substance use disorders: the critical role of adolescent substance use. Pharmacol Biochem Behav. 2022;215:173360. 10.1016/j.pbb.2022.173360. PubMed PMC

Kotov R, Gamez W, Schmidt F, Watson D. Linking “big” personality traits to anxiety, depressive, and substance use disorders: A meta-analysis. Psychol Bull. 2010;136(5):768–821. 10.1037/a0020327. PubMed

Kotter R, Kräplin A, Pittig A, Bühringer G. A systematic review of land-based self-exclusion programs: demographics, gambling behavior, gambling problems, mental symptoms, and mental health. J Gambl Stud. 2019;35(2):367–94. 10.1007/s10899-018-9777-8. PubMed

Kristensen JH, Pallesen S, Bauer J, Leino T, Griffiths MD, Erevik EK. Suicidality among individuals with gambling problems: a meta-analytic literature review. Psychol Bull. 2024;150(1):82–106. 10.1037/bul0000411. PubMed

Lane W, Sacco P, Downton K, Ludeman E, Levy L, Tracy J. Child maltreatment and problem gambling: a systematic review. Child Abuse Negl. 2016;58:24–38. 10.1016/j.chiabu.2016.06.003. PubMed

Liu D, Epskamp S, Isvoranu A-M, Chen C, Liu W, Hong X. PubMed PMC

Lorains FK, Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction. 2011;106(3):490–8. 10.1111/j.1360-0443.2010.03300.x. PubMed

Lovibond, S. H., & Lovibond, P. F. (1995). Depression Anxiety Stress Scales. Manual for the Depression Anxiety Stress Scales (2nd Ed.). Sydney: Psychology Foundation (Available from The Psychology Foundation, Room 1005 Mathews Building, University of New South Wales, NSW. 2052;Australia. 10.1037/t01004-000

Lucas I, Mora-Maltas B, Granero R, Demetrovics Z, Ciudad-Fernández V, Nigro G, et al. Network analysis of DSM-5 criteria for gambling disorder: considering sex differences in a large clinical sample. Eur Psychiatry. 2024;67(1):e65. 10.1192/j.eurpsy.2024.22. PubMed PMC

Lynch FL, Peterson EL, Lu CY, Hu Y, Rossom RC, Waitzfelder BE, et al. Substance use disorders and risk of suicide in a general US population: a case control study. Addict Sci Clin Pract. 2020;15(1):14. 10.1186/s13722-020-0181-1. PubMed PMC

Marionneau V, Nikkinen J. Gambling-related suicides and suicidality: a systematic review of qualitative evidence. Front Psychiatry. 2022;13:980303. 10.3389/fpsyt.2022.980303. PubMed PMC

Merkouris, S., Thomas, A., Shandley, K., Rodda, S., Oldenhof, E., & Dowling, N. (2016). An Update on Gender Differences in the Characteristics Associated with Problem Gambling: A Systematic Review. Current Addiction Reports. 3. 10.1007/s40429-016-0106-y

Mide M, Mattiasson J, Norlin D, Sehlin H, Rasmusson J, Ljung S, et al. Internet-delivered therapist-assisted cognitive behavioral therapy for gambling disorder: a randomized controlled trial. Front Psychiatry. 2023;14:1243826. 10.3389/fpsyt.2023.1243826. PubMed PMC

Mikoška P, Novák L, Bok T, Ladmanová M, Fülep M, Kořínek R, et al. Validation of the overall depression severity and impairment scale (ODSIS) in the Czech Republic. Ceskoslov Psychol. 2024;68(2):135–55. 10.51561/cspsych.68.2.135.

Mikoska P, Novak L, Pilarik L, Bok T, Fulep M, Korinek R. A Czech version of the Overall Anxiety Severity and Impairment Scale (OASIS): standardization and psychometric properties. BMC Psychiatry. 2022;22(1):822. 10.1186/s12888-022-04365-5. PubMed PMC

Miller GE, Chen E, Parker KJ. Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving towards a model of behavioral and biological mechanisms. Psychol Bull. 2011;137(6):959–97. 10.1037/a0024768. PubMed PMC

Molander O, Lindner P, Ramnerö J, et al. Internet-based cognitive behavior therapy for problem gambling in routine care: protocol for a non-randomized pilot and feasibility trial. Pilot Feasibility Stud. 2020;6:106. 10.1186/s40814-020-00647-5. PubMed PMC

Moñino-García M, Ballesta M, Huerta JM, Correa-Rodríguez JF, Cabrera-Castro N, Llorens N, et al. The adolescent problem gambling prevalence associated with leisure-time activities and risky behaviors in Southern Spain. Int J Ment Health Addict. 2024;22(3):1662–76. 10.1007/s11469-022-00950-7. PubMed PMC

Montiel I, Ortega-Barón J, Basterra-González A, González-Cabrera J, Machimbarrena JM. Problematic online gambling among adolescents: a systematic review about prevalence and related measurement issues. J Behav Addict. 2021. 10.1556/2006.2021.00055. PubMed PMC

Najavits LM, Ledgerwood DM, Afifi TO. A randomized controlled trial for gambling disorder and PTSD: seeking safety and CBT. J Gambl Stud. 2023;39:1865–84. 10.1007/s10899-023-10224-z. PubMed PMC

National Council on Problem Gambling. (2021). National survey of gambling attitudes and gambling experiences 1.0

National Monitoring Centre for Drugs and Addiction. (2023, November 27). Report on Gambling in the Czech Republic 2023. https://www.drogy-info.cz/en/publications/annual-reports/report-on-gambling-in-the-czech-republic-2023/

Ninness C, Henderson R, Ninness SK, Halle S. Probability pyramiding revisited: univariate, multivariate, and neural network analyses of complex data. Behav Soc Issues. 2015;24(1):164–86. 10.5210/bsi.v24i0.6048.

Norman SB, Hami Cissell S, Means-Christensen AJ, Stein MB. Development and validation of an overall anxiety severity and impairment scale (OASIS). Depress Anxiety. 2006;23(4):245–9. 10.1002/da.20182. PubMed

Novak, L. (2021). psychtoolbox: Tools for psychology and psychometric

Østergaard MLD, Nordentoft M, Hjorthøj C. Associations between substance use disorders and suicide or suicide attempts in people with mental illness: a Danish nation-wide, prospective, register-based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personality disorder. Addiction. 2017;112(7):1250–9. 10.1111/add.13788. PubMed

Pfaltz MC, Schnyder U. Allostatic load and allostatic overload: preventive and clinical implications. Psychother Psychosom. 2023;92(5):279–82. 10.1159/000534340. PubMed PMC

Pilver CE, Libby DJ, Hoff RA, Potenza MN. Gender differences in the relationship between gambling problems and the incidence of substance-use disorders in a nationally representative population sample. Drug Alcohol Depend. 2013;133(1):204–11. 10.1016/j.drugalcdep.2013.05.002. PubMed PMC

Pisarska A, Ostaszewski K. Factors associated with youth gambling: longitudinal study among high school students. Public Health. 2020;184:33–40. 10.1016/j.puhe.2020.03.017. PubMed

Pitoňák M, Čihák M. Suicidální ideace LGBT+ osob: Psychometrické vlastnosti Škály suicidální ideace (SIDAS) na českém LGBT+ vzorku. E-psychologie : elektronický časopis ČMPS. 2024;18(1):16–29. 10.29364/epsy.492.

Planzer S, Gray HM, Shaffer HJ. Associations between national gambling policies and disordered gambling prevalence rates within Europe. Int J Law Psychiatry. 2014;37(2):217–29. 10.1016/j.ijlp.2013.11.002. PubMed

Poorolajal J, Haghtalab T, Farhadi M, Darvishi N. Substance use disorder and risk of suicidal ideation, suicide attempt and suicide death: a meta-analysis. J Public Health. 2016;38(3):e282–91. 10.1093/pubmed/fdv148. PubMed

Price A. Online gambling in the midst of COVID-19: a nexus of mental health concerns, substance use and financial stress. Int J Ment Health Addict. 2022;20(1):362–79. 10.1007/s11469-020-00366-1. PubMed PMC

Reeves M, James LM, Pizzarello SM, Taylor JE. Support for Linehan’s biosocial theory from a nonclinical sample. J Pers Disord. 2010;24(3):312–26. 10.1521/pedi.2010.24.3.312. PubMed

Revelle, W. (2023). psych: Procedures for Psychological, Psychometric, and Personality Research (Version 2.3.12) [Computer software]. https://cran.r-project.org/web/packages/psych/index.html

Roberts A, Sharman S, Coid J, Murphy R, Bowden-Jones H, Cowlishaw S, et al. Gambling and negative life events in a nationally representative sample of UK men. Addict Behav. 2017;75:95–102. 10.1016/j.addbeh.2017.07.002. PubMed

Rogosch FA, Dackis MN, Cicchetti D. Child maltreatment and allostatic load: consequences for physical and mental health in children from low-income families. Dev Psychopathol. 2011;23(4):1107–24. 10.1017/S0954579411000587. PubMed PMC

Rohr B, Silber H, Felderer B. Comparing the accuracy of univariate, bivariate, and multivariate estimates across probability and nonprobability surveys with population benchmarks. Sociol Methodol. 2025;55(1):121–54. 10.1177/00811750241280963.

Rolvien L, Buddeberg L, Gehlenborg J, Borsutzky S, Moritz S. A self-guided internet-based intervention for the reduction of gambling symptoms: a randomized clinical trial. JAMA Netw Open. 2024;7(6):e2417282. 10.1001/jamanetworkopen.2024.17282. PubMed PMC

Rosseel, Y., Jorgensen, T. D., Wilde, L. D., Oberski, D., Byrnes, J., Vanbrabant, L., Savalei, V., Merkle, E., Hallquist, M., Rhemtulla, M., Katsikatsou, M., Barendse, M., Rockwood, N., Scharf, F., Du, H., & Jamil, H. (2023). lavaan: Latent Variable Analysis (Version 0.6–17) [Computer software]. https://cran.r-project.org/web/packages/lavaan/index.html

Sandora J, Novak L, Brnka R, van Dijk JP, Tavel P, Malinakova K. The abbreviated overall anxiety severity and impairment scale (OASIS) and the abbreviated overall depression severity and impairment scale (ODSIS): psychometric properties and evaluation of the Czech versions. Int J Environ Res Public Health. 2021;18(19):10337. 10.3390/ijerph181910337. PubMed PMC

Scholes-Balog KE, Hemphill SA. Relationships between online gambling, mental health, and substance use: a review. Cyberpsychol Behav Soc Netw. 2012;15(12):688–92. 10.1089/cyber.2012.0232. PubMed

Shalev I, Hastings WJ, Etzel L, Israel S, Russell MA, Hendrick KA, et al. Investigating the impact of early-life adversity on physiological, immune, and gene expression responses to acute stress: a pilot feasibility study. PLoS ONE. 2020;15(4):e0221310. 10.1371/journal.pone.0221310. PubMed PMC

Sharma A, Sacco P. Adverse childhood experiences and gambling: results from a national survey. J Soc Work Pract Addict. 2015;15:25–43. 10.1080/1533256X.2015.996502.

Suh JJ, Ruffins S, Robins CE, Albanese MJ, Khantzian EJ. Self-medication hypothesis: connecting affective experience and drug choice. Psychoanal Psychol. 2008;25(3):518–32. 10.1037/0736-9735.25.3.518.

Sundqvist K, Wennberg P. The association between problem gambling and suicidal ideations and attempts: a case control study in the general Swedish population. J Gambl Stud. 2022;38(2):319–31. 10.1007/s10899-020-09996-5. PubMed PMC

Valenciano-Mendoza E, Fernández-Aranda F, Granero R, Gómez-Peña M, Moragas L, del Pino-Gutierrez A, et al. Suicidal behavior in patients with gambling disorder and their response to psychological treatment: the roles of gender and gambling preference. J Psychiatr Res. 2021;143:317–26. 10.1016/j.jpsychires.2021.09.027. PubMed

van Borkulo CD, van Bork R, Boschloo L, Kossakowski JJ, Tio P, Schoevers RA, et al. Comparing network structures on three aspects: a permutation test. Psychol Methods. 2023;28(6):1273–85. 10.1037/met0000476. PubMed

van Borkulo C, Boschloo L, Borsboom D, Penninx B, Waldorp L, Schoevers R, Package. ‘NetworkComparisonTest ’ JAMA Psychiatry. 2015;72:1219–26. PubMed

van Spijker BAJ, Batterham PJ, Calear AL, Farrer L, Christensen H, Reynolds J, et al. The suicidal ideation attributes scale (SIDAS): community-based validation study of a new scale for the measurement of suicidal ideation. Suicide & Life-Threatening Behavior. 2014;44(4):408–19. 10.1111/sltb.12084. PubMed

Vilimovský, T., & Kučera, D. (2018). Vilimovský & Kučera Czech DASS21. https://www2.psy.unsw.edu.au/dass//Czech/Vilimovsky%20Czech.htm

Wirkus T, Czernecka R, Bühringer G, Kräplin A. Individual risk factors and prediction of gambling disorder in online sports bettors - the longitudinal RIGAB study. Front Psychiatry. 2024;15:1320592. 10.3389/fpsyt.2024.1320592. PubMed PMC

Vries TR, Arends I, Oldehinkel A, Bültmann U. Direct and indirect associations between childhood adversity and emotional and behavioral problems at age 14: A network analytical approach. Dev Psychopathol. 2023;36:1–12. 10.1017/S0954579423000287. PubMed

WHO. (2020). Adverse Childhood Experiences International Questionnaire (ACE-IQ). https://www.who.int/publications/m/item/adverse-childhood-experiences-international-questionnaire-(ace-iq)

Wong G, Zane N, Saw A, Chan AKK. Examining gender differences for gambling engagement and gambling problems among emerging adults. J Gambl Stud. 2013;29(2):171–89. 10.1007/s10899-012-9305-1. PubMed PMC

Yeung K, Wraith D, Gatton M. The dynamics of psychological distress in the trajectory of at-risk and problem gambling: results from a prospective population-based longitudinal study in Australia. Int J Ment Health Addict. 2025;23:1085–107. 10.1007/s11469-023-01156-1.

Zarate D, Ball M, Montag C, Prokofieva M, Stavropoulos V. Unravelling the web of addictions: a network analysis approach. Addict Behav Rep. 2022;15:100406. 10.1016/j.abrep.2022.100406. PubMed PMC