A Meta-Review to Guide Military Screening and Treatment of Gambling Problems.

This article presents a meta-review examining the screening accuracy of gambling assessment tools and the effectiveness of treatments for gambling disorder (GD) among U.S. military Service Members (SMs). It finds that due to the low prevalence of GD and subclinical gambling problems in the general military population, combined with modest sensitivity and specificity of available screening instruments, widescale screening yields high false-positive rates and is therefore not feasible. However, targeted dual-phase screening in higher-risk subpopulations—such as SMs already identified with substance abuse or mental health issues—shows better predictive value and is recommended. Regarding treatment, evidence supports the efficacy of several psychological interventions, notably cognitive behavioral therapy (CBT), motivational interviewing (MI), and exposure therapy, which are already used within military healthcare and can be adapted for SMs with GD. The review suggests focusing screening and treatment efforts within behavioral health settings and calls for further research on GD prevalence, screening accuracy, and treatment outcomes in military contexts.