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We investigated relationships between problem gambling, psychological distress, self-efficacy, and stressful life experiences related to identity among patients in SUD treatment. Patients (N\u2009=\u2009590) from 19 residential treatment facilities across California completed a survey on substance use, problem gambling, psychological distress (Kessler Psychological Distress Scale \u2013 K6), self-efficacy, and intersectional discrimination [Intersectional Discrimination Index \u2013 Major (InDI-M)]. Multivariable regression analyses compared three groups on these measures: problem gambling (PG, n\u2009=\u200970), non-problem gambling (NPG, n\u2009=\u2009154), and no gambling (NG, n\u2009=\u2009366). About 38% of the sample reported past-year gambling. Compared to NG, PG had higher lifetime (mean difference [MD]\u2009=\u20092.61, 95% CI\u2009=\u20090.80, 4.42) and past-year (MD\u2009=\u20091.82, 95% CI\u2009=\u20091.37, 2.27) InDI-M scores; and higher K6 scores (MD\u2009=\u20092.09, 95% CI\u2009=\u20091.14, 3.04). PG also had increased risk of lifetime eviction (adjusted odds ratio [AOR]\u2009=\u20092.49, 95% CI\u2009=\u20091.66, 3.75) and property damage\/theft (AOR\u2009=\u20092.99, 95% CI\u2009=\u20091.43, 6.26); and past-year relationship loss (AOR\u2009=\u20094.95, 95% CI\u2009=\u20091.77, 13.83) and physical attack (AOR\u2009=\u20092.57, 95% CI\u2009=\u20091.40, 4.72) compared to NG. In this sample, PG reported more psychological distress and identity-based stressful experiences. Clinical interventions for SUD patients with comorbid PG should prioritize trauma-informed approaches, self-stigma reduction, and case navigation for social determinants of health such as housing insecurity.<\/jats:p>","DOI":"10.1007\/s10899-026-10567-3","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:40:33Z","timestamp":1792028433000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gambling, Discrimination, and Stressful Life Events among Substance Use Disorder Treatment Patients"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1974-2234","authenticated-orcid":false,"given":"Anna","family":"Pagano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8357-8961","authenticated-orcid":false,"given":"Nadra E.","family":"Lisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9892-8224","authenticated-orcid":false,"given":"Jennifer T.","family":"Le","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1898-2431","authenticated-orcid":false,"given":"Caravella","family":"McCuistian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"issue":"2","key":"10567_CR1","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s10899-018-9794-7","volume":"35","author":"A Adolphe","year":"2019","unstructured":"Adolphe, A., Khatib, L., van Golde, C., Gainsbury, S. 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