Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns

BACKGROUND AND AIMS

There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored.

MATERIALS AND METHODS

The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features.

RESULTS

Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster.

DISCUSSION AND CONCLUSIONS

These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features.

Effects of Caloric Restriction on Spatial Object Recognition Memory, Hippocampal Neuron Loss and Neuroinflammation in Aged Rats

Age-related neurobiological changes significantly affect hippocampal structure and function, such that the main cognitive impairments associated with aging are related to the integrity of this brain structure, including the deterioration in spatial object recognition (SOR) memory. Previous studies have shown that intrinsic factors such as neuroinflammation, as well as lifestyle factors such as diet, can affect aging-associated brain functions and cognitive performance. In this regard, caloric restriction (CR) produces beneficial effects on health and life expectancy, although its ability to slow down age-dependent effects on cognitive decline and hippocampus (HPC) functioning remains unclear. Therefore, we set out to evaluate the effects of CR on SOR memory in aged male Wistar rats, as well as those on hippocampal neuron loss, neurogenesis and inflammation. The data show that CR in aged rats attenuates the decline in SOR memory, age-associated hippocampal neuron loss, and age-dependent microglial activation. Furthermore, we found a significant reduction in neurogenesis in the dentate gyrus of the old animals relative to adult rats. These findings support the positive effect of CR on SOR memory, suggesting that it dampens hippocampal neuronal loss and reduces proinflammatory activity.

Eating disorders during lockdown: the transcultural influence on eating and mood disturbances in Ibero-Brazilian population

BACKGROUND

COVID-19 pandemic has implied exceptional restrictive measures to contain its widespread, with adverse consequences on mental health, especially for those people with a background of mental illness, such as eating disorders (EDs). In this population, the influence of socio-cultural aspects on mental health has been still underexplored. Then, the main aim of this study was to assess changes in eating and general psychopathology in people with EDs during lockdown regarding the ED subtype, age, and provenance, and considering socio-cultural aspects (e.g., socioeconomical factors such as work and financial losses, social support, restrictive measures, or health accessibility, among others).

METHODS

The clinical sample was composed of 264 female participants with EDs (74 anorexia nervosa (AN), 44 bulimia nervosa (BN), 81 binge eating disorder (BED), and 65 other specified feeding and eating disorder (OSFED)), with a mean age of 33.49 years old (SD = 12.54), from specialized ED units in Brazil, Portugal, and Spain. The participants were evaluated using the COVID-19 Isolation Eating Scale (CIES).

RESULTS

A global impairment in mood symptoms and emotion regulation was reported in all the ED subtypes, groups of age, and countries. Spanish and Portuguese individuals seemed more resilient than Brazilian ones (p < .05), who reported a more adverse socio-cultural context (i.e., physical health, socio-familial, occupational, and economic status) (p < .001). A global trend to eating symptoms worsening during lockdown was observed, regardless of the ED subtype, group of age, and country, but without reaching statistical significance. However, the AN and BED groups described the highest worsening of the eating habits during lockdown. Moreover, individuals with BED significantly increased their weight and body mass index, similarly to BN, and in contrast to the AN and OSFED groups. Finally, we failed to find significant differences between groups of age although the younger group described a significant worsening of the eating symptoms during lockdown.

CONCLUSIONS

This study reports a psychopathological impairment in patients with EDs during lockdown, being socio-cultural aspects potential modulatory factors. Individualized approaches to detect special vulnerable groups and long-term follow-ups are still needed.

Gambling disorder duration and cognitive behavioural therapy outcome considering gambling preference and sex

Gambling Disorder (GD) is a behavioural addiction that leads to high level of clinical distress and, in general, it is characterized by enduring symptomatology that presents high rates of chronicity. However, there is high variability of illness duration among patients who seek treatment for GD. Previous studies reported mixed results about the relevance of illness duration in GD treatment outcome. However, there are different profiles of patients who are diagnosed with GD. For this reason, this study aimed to evaluate the effect of illness duration in the treatment outcome of different profiles of GD patients according to their gambling preference and sex. The sample were 1699 patients diagnosed with GD. All patients received cognitive-behavioural therapy in a group format. Treatment outcome was evaluated in terms of relapsing to gambling behaviours and dropout from treatment. Results showed higher probability of poor outcome in the first years of the disorder for strategic gambling compared to non-strategic or mixed forms of gambling. Moreover, women also showed higher probability of poor outcomes than men since the first stages of the disorder. This study draws attention to the relevance of illness duration in the treatment outcome of specific profiles of GD patients. In particular, patients who presented a preference for strategic forms of gambling and women who are diagnosed with GD would have a higher risk of poor treatment outcomes since the first stages of the disorder. These results highlight the importance of an early intervention in these patients in order to prevent the chronicity of the disorder.

Independent component analysis for internet gaming disorder

Introduction: There is a growing interest in the study of the neurobiological correlates of internet gaming disorder (IGD), and new techniques are beginning to be implemented for this purpose, such as independent component analysis (ICA). Aims: The present narrative review aimed to explore the studies that had used ICA for the study of the different brain networks possibly associated with IGD. Methods: We specifically focussed on three of the main networks: default-mode network, executive-control and salience networks. Results: Most studies have identified alterations in these three brain networks in individuals with IGD, which may be involved in the development and maintenance of this disorder. Conclusion: More studies are needed to deepen an understanding of the specific role of each in the symptomatology and treatment of IGD.

Network Analysis of the Structure of the Core Symptoms and Clinical Correlates in Comorbid Schizophrenia and Gambling Disorder

Few studies have analyzed the clinical profile of treatment-seeking patients with the comorbid presence of schizophrenia (SCZ) and gambling disorder (GD), which warrants new research to assess the network structure of this complex mental condition. The aim of this study was to explore the organization of the symptoms and other clinical correlates of SCZ with GD. Network analysis was applied to a sample of N = 179 SCZ patients (age range: 19-70 years, mean=39.5, SD=9.9) who met clinical criteria for gambling disorder-related problems. Variables included in the network were the core GD symptoms according to the DSM-5, psychotic and paranoid ideation levels, global psychological distress, GD severity measures (debts and illegal behavior related with gambling), substances (tobacco, alcohol, and illegal drugs), and personality profile. The nodes with the highest authority in the network (variables of highest relevance) were personality traits and psychological distress. Four empirical modules/clusters were identified, and linkage analysis identified the nodes with the highest closeness (bridge nodes) to be novelty seeking and reward dependence (these traits facilitate the transition between the modules). Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat SCZ with GD.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11469-022-00983-y.

Cognitive and clinical gender‐related differences among binge‐spectrum eating disorders: Analysis of therapy response predictors

OBJECTIVE

This study assessed gender-related differences in executive functions (decision-making, inhibitory control and cognitive flexibility), personality traits and psychopathological symptoms in binge-spectrum eating disorders (EDs). Secondly, we aimed to separately explore the predictive value of gender and executive functions in treatment outcome.

METHOD

A battery of self-reported and neurocognitive measures were answered by a sample of 85 patients (64 females) diagnosed with a binge-spectrum ED (41 BN; 44 binge eating disorder).

RESULTS

Data showed gender-related differences in executive functioning, displaying women lower inhibitory control and lower cognitive flexibility than men. Regarding personality traits and psychopathology symptoms, women presented higher reward dependence and cooperativeness, as well as more drive for thinness, body dissatisfaction, bulimia, and somatisation symptoms than men. Finally, worse executive functioning, particularly having lower ability in concept formation seems to predict worse treatment outcomes and dropout in these patients.

CONCLUSIONS

We described gender specific neuropsychological, personality and psychopathological impairments in patients with binge-spectrum EDs. Moreover, difficulties in executive functioning might have an impact on treatment response, since patients with a lower ability in concept formation are less likely to benefit from treatment. The present results can help improving current treatment approaches by tackling gender and individual differences.

Are Signals Regulating Energy Homeostasis Related to Neuropsychological and Clinical Features of Gambling Disorder? A Case-Control Study

Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case−control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.

Impact of Impulsivity and Therapy Response in Eating Disorders from a Neurophysiological, Personality and Cognitive Perspective

Impulsivity, as a multidimensional construct, has been linked to eating disorders (EDs) and may negatively impact treatment response. The study aimed to identify the dimensions of impulsivity predicting poor remission of ED symptoms. A total of 37 ED patients underwent a baseline assessment of impulsive personality traits and inhibitory control, including the Stroop task and the emotional go/no-go task with event-related potentials (ERPs) analysis. The remission of EDs symptomatology was evaluated after 3 months of cognitive-behavioral therapy (CBT) and at a 2-year follow-up. Poor remission after CBT was predicted by poor inhibitory control, as measured by the Stroop task. At 2 years, the risk of poor remission was higher in patients with higher novelty seeking, lower inhibitory control in the Stroop and in ERPs indices (N2 amplitudes) during the emotional go/no-go task. The present results highlight inhibitory control negatively impacting both short- and long-term symptomatology remission in ED patients. On the other hand, high novelty seeking and ERPs indices of poor inhibition seem to be more specifically related to long-term remission. Therefore, a comprehensive assessment of the impulsivity dimension in patients with ED is recommended to tailor treatments and improve their efficacy.

Common and differential risk factors behind suicidal behavior in patients with impulsivity-related disorders: The case of bulimic spectrum eating disorders and gambling disorder

BACKGROUND AND AIMS

Mental disorders with high levels of impulsivity such as bulimic spectrum eating disorders (BSED) and gambling disorder (GD) are associated with high risk of suicidal behavior. The aim of the present study was to identify the common and differential vulnerability factors behind suicide attempts in a sample of patients with BSED compared to patients with GD.

METHODS

A total of 6,077 adults who sought treatment and met criteria either for BSED (n = 2,391) or GD (n = 3,686) were assessed at a specialized hospital unit. Personality traits, psychopathological symptomatology, lifetime history of suicide attempts and socio-demographic variables were evaluated.

RESULTS

The prevalence of suicide attempts was higher for BSED patients (26.2%) compared to GD patients (7.1%) being anorexia nervosa (Binge/Purge type) and bulimia nervosa the most affected subtypes. In the predictive model, the transdiagnostic vulnerability factors with the highest contribution to the risk of suicidal behavior both in BSED and GD were unemployment, early age of onset of the disorder, worse psychopathological state, and self-transcendence personality trait. However, specific risk factors for suicidal acts were identified in each disorder: longer duration of the disorder, lower education levels and reward dependence were exclusively associated with BSED while female gender, older age, and higher harm avoidance were associated with GD.

DISCUSSION

Patients with GD and BSED share certain vulnerability factors although certain factors are exclusive to each disorder.

CONCLUSIONS

Interventions need to pay special attention to both common and specific vulnerability factors to mitigate the risk of suicidal acts in these disorders.

Exploring the Association between Gambling-Related Offenses, Substance Use, Psychiatric Comorbidities, and Treatment Outcome

Several studies have explored the association between gambling disorder (GD) and gambling-related crimes. However, it is still unclear how the commission of these offenses influences treatment outcomes. In this longitudinal study we sought: (1) to explore sociodemographic and clinical differences (e.g., psychiatric comorbidities) between individuals with GD who had committed gambling-related illegal acts (differentiating into those who had had legal consequences (n = 31) and those who had not (n = 55)), and patients with GD who had not committed crimes (n = 85); and (2) to compare the treatment outcome of these three groups, considering dropouts and relapses. Several sociodemographic and clinical variables were assessed, including the presence of substance use, and comorbid mental disorders. Patients received 16 sessions of cognitive-behavioral therapy. Patients who reported an absence of gambling-related illegal behavior were older, and showed the lowest GD severity, the most functional psychopathological state, the lowest impulsivity levels, and a more adaptive personality profile. Patients who had committed offenses with legal consequences presented the highest risk of dropout and relapses, higher number of psychological symptoms, higher likelihood of any other mental disorders, and greater prevalence of tobacco and illegal drugs use. Our findings uphold that patients who have committed gambling-related offenses show a more complex clinical profile that may interfere with their adherence to treatment.

Finding the vulnerable postoperative population: A two-step cluster analysis of the PAIN-OUT registry

BACKGROUND

Identifying predictors of poor postoperative outcomes is crucial for planning personalized pain treatments. The aim of this study was to examine pain outcomes using cluster analysis in N=2,678 patients from the PAIN-OUT registry at first postoperative day.

METHODS

Indicator variables of the clustering analysis assessed multiple domains, such as clinical and surgical conditions, analgesic-anesthetic variables, desire for more pain treatment and outcome variables of the International Pain Outcome Questionnaire (IPO) summarized as factor scores.

RESULTS

Two-step cluster identified the three-cluster solution as the optimal. Two empirical groups (C1 and C2) included patients with good postoperative outcomes discriminated by peripheral nerve block use, while the other cluster (C3) grouped patients with the worst outcomes, where all patients desired more pain treatment. C3 comprised about 20% of the participants, mostly lower limb, abdominal and spine procedures. The best predictors of belonging to C3 included younger age, being male, preoperative opioid use, bone and fracture reduction procedures, institution, number of comorbidities and morphine equivalents in the recovery room.

CONCLUSIONS

IPO factor scores can be used to select pain outcomes phenotypes in large clinical databases. Most of the predictors were present before the recovery period so perioperative planning should focus in the preoperative and intraoperative periods.

Assessing Alcohol Expectations in University Students: the APNE Scale

The increasing prevalence of alcohol consumption at early ages has led to major efforts to identify alcohol drinking habits within this highly vulnerable group, and individuals with hazardous patterns of alcohol consumption. The aim of this study was to examine the psychometric properties of the Alcohol Positive and Negative Expectations Scale (APNE; a new screening tool developed to identify expectations toward alcohol), and to examine the patterns of alcohol drinking in young adults. The sample included n = 1309 participants (college students) with age range 20 to 25 years. Confirmatory factor analysis (CFA) performed through Generalized Structural Equation Models (GSEM) verified the structure of the APNE, correlational models evaluated convergent-discriminant validity, and logistic regression assessed the discriminative ability to identify harmful drinking. The bifactor structure for the APNE was confirmed (positive and negative expectations toward alcohol drinking), with adequate goodness-of-fit (RMSEA = 0.052, CFI = 0.936, TLI = 0.914, and SRMR = 0.075). Multi-group modeling showed invariance by sex (p = .543) and age (p = .395) for the measurement coefficients. High correlations with external measures of alcohol use/abuse and discriminant capacity to identify harmful drinking were obtained. Compared to men, women reported higher mean scores in the negative expectations factor (p = .003). Polynomial linear trends showed that the likelihood of positive expectations toward alcohol decreased with age, while negative expectations increased. The APNE is a brief, reliable, valid, and accurate tool to assess positive and negative expectations toward alcohol consumption in college students. Tools like the APNE can support policymakers to make informed decisions about the implementation of prevention and treatment programs targeted at this segment of the population, the development of personalized alcohol programs, and the reappraisal of public campaigns.

Motherhood and Treatment Outcome in Female Patients with Compulsive Buying-Shopping Disorder

Motherhood has been proposed as an internal facilitating factor for the recovery of women with mental disorders. However, at the same time, there are significant barriers that may be interfering with the access and adherence to treatment for these women. The present longitudinal study aimed to deepen the sociodemographic and clinical profile of women with children and compulsive buying–shopping disorder (CBSD), and to explore the association between motherhood and response to treatment. The total sample included 77 women with a diagnosis of CBSD (n = 49 mothers) who received cognitive behavioral therapy (CBT) for 12 weeks. No association between psychopathology and motherhood was observed. The group of mothers reported an older age of onset of the CBSD, a lower amount of money spent per compulsive-buying episode, and a higher likelihood of family support for the CBSD. Moreover, this group showed lower risk of relapse. The findings support the theoretical proposal that considers motherhood as an internal facilitating factor for recovery and treatment adherence of mothers with addictions.

Developmental trajectories of gambling severity after cognitive-behavioral therapy

Introduction

Gambling disorder (GD) is characterized by repeated problematic gambling behavior associated with unsuccessful and uncontrollable urges to keep gambling, which leads to considerable distress and impairment. Several types of interventions exist to treat GD, with cognitive behavior therapy (CBT) being one of the most widely used approaches.

Objectives

To estimate trajectories of the gambling disorder (GD) severity for 12 months following a manualized cognitive-behavior-therapy (CBT) program, and to identify the main variables associated with each trajectory.

Methods

Latent Class Growth Analysis examined the longitudinal changes of n = 603 treatment-seeking patients with GD.

Results

Five separate empirical trajectories were identified: T1 (n = 383, 63.5%) was characterized by the most highest baseline gambling severity levels and positive progress to recovery during the follow-up period; T2 (n = 154, 25.5%) featured participants with high baseline gambling severity and good progress to recovery; T3 (n = 30, 5.0%) was made up of patients with high gambling baseline severity and slow progress to recovery; T4 (n = 13, 2.2%) and T5 (n = 23, 3.8%) contained participants with high baseline gambling severity and moderate (T4) and poor (T5) progress in GD severity during the follow-up. Psychopathology, personality traits, poor compliance and relapses discriminated between trajectories.

Conclusions

These results show that treatment seeking patients with GD are heterogeneous. In addition, the obtained findings could be useful in the design of more efficient interventions for this behavioral addiction. Funding oftained from RTI2018-101837B-I00

Disclosure

No significant relationships.

Predictors of Therapy Outcome in Eating Disorders: from Psychopathology to Personality

Eating disorders are severe mental disorders, with high mortality rates and high incidence in adolescence and early adulthood, especially in women. The course of these disorders is uncertain and treatment outcomes are limited. Several factors such as duration of the disorder, dysfunctional personality traits and cognitive profiles, as well as genetic vulnerabilities, will influence adherence and response to treatment. In this presentation we will include recent results on prospective observational studies, analyzing personality and cognitive predictors of treatment response in eating disorders, as well as potential associated neurobiomarkers.

Are Neurotrophin Genes Involved in the Pathophysiology of Gambling Disorder?

Introduction

Gambling Disorder (GD) is considered a multifactorial behavioral addictive disorder, leading to severe psychological, social and economic consequences. Previous studies have investigated genetic mechanisms underlying GD. Growing literature showed a possible link between addiction-related disorders and neurotrophic factors (NTF), involved in synaptic plasticity and neuronal survival. Thus, the study of NTF genes emerged as promising targets in the field of GD.

Objectives

To evaluate genetic implications of the NTF family in the pathophysiology GD. We hypothesized the involvement of some NTF genes polymorphisms in the onset and progression of GD as potential biological risk factors.

Methods

The sample was composed by 166 individuals with GD and 191 healthy controls. 36 Single nucleotide polymorphisms (SNPs) from NTF (NGF, NGFR, NTRK1, BDNF, NTRK2, NTF3, NTRK3, NTF4, CNTF and CNTFR) were selected and genotyped. Linkage disequilibrium and haplotype constructions were assessed, related to the presence of GD. Moreover, regulatory elements overlapping the identified SNPs variants associated with GD was also analyzed.

Results

6 SNPs were potentially associated to GD after the comparisons of allele frequencies between groups. Single and multiple-marker analyses showed a strong association between both NTF3 and NTRK2 genes, and GD.

Conclusions

This study suggests the implication of NTF genes in the development of GD, being the altered cross-regulation of some NTF factors signalling pathways, a potential biological vulnerability factor in GD. Fundings and Acknowledgements: Ministerio de Ciencia, Innovación y Universidades (RTI2018-101837-B-100) Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067, 2019I47), Instituto Salud Carlos III (ISCIII) (PI17/01167, PI20/00132) and CIBERObn, an initiative of ISCIII.

Disclosure

No significant relationships.

Impact of COVID19 Lockdown in Eating Disorders: A Multicenter Collaborative International Study

Introduction

COVID19 lockdown is having a significant impact on mental health, patients with eating disorders (ED) are particularly vulnerable.

Objectives

1) To explore changes in eating and other psychological features due to confinement in patients with ED from various European and Asian countries; and 2) to assess differences related to diagnostic subtypes, age and geography.

Methods

The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID19 Isolation Scale (CIES).

Results

On one hand, patients with Binge Eating Disorder experienced the highest impact on weight and ED symptoms due to confinement. Together with subjects diagnosed with Other Specified Feeding and Eating Disorders (OFSED), they also experienced a deterioration in general psychological state. On the other hand, there was less symptomatic impact on people with Bulimia Nervosa or Anorexia Nervosa and asian and younger individuals appeared to be more resilient in this situation.

Conclusions

The impact of COVID varied by cultural context and individual variation in age and form of illness. Services may need to target preventive measures and adapting therapeutic approaches for the most vulnerable patients.

Disclosure

No significant relationships.

Sports-betting-related gambling disorder: Clinical features and correlates of cognitive behavioral therapy outcomes

BACKGROUND AND AIMS

The number of patients with gambling disorder (GD) whose gambling preference is sports betting is increasing. However, their clinical profile and their responses to psychological treatments -compared to patients with other forms of gambling- have not been thoroughly studied. Therefore, the aims of this study were: (1) to compare the clinical characteristics of GD patients whose primary gambling activity was sports betting (SB+; n = 113) with GD patients with other primary gambling activities (SB-; n = 1,135); (2) to compare treatment outcomes (dropout and relapses) between SB + and SB- patients; and (3) to explore relationships between specific variables (GD severity, psychological distress and personality features) and treatment outcome in SB + and SB- GD patients, through correlation models and path-analysis.

METHODS

The cognitive behavioral treatment consisted of 16 weekly sessions. Personality features, psychopathology, and sociodemographic and clinical factors were assessed.

RESULTS

The SB + group included higher proportions of younger patients who were single and had higher educational levels, older ages of GD onset, and greater GD severities. Regarding treatment outcomes, the dropout rate was lower in the SB + group, and no between-group differences were found regarding relapse. Dropout within the SB + group was related to being unemployed, and relapse was related to being unmarried and experiencing more psychological distress.

DISCUSSION AND CONCLUSION

The differences between SB + and SB- GD patients suggest that GD patients with sports-betting problems may benefit from tailored therapeutic approaches.

The role of neurotrophin genes involved in the vulnerability to gambling disorder

Evidence about the involvement of genetic factors in the development of gambling disorder (GD) has been assessed. Among studies assessing heritability and biological vulnerability for GD, neurotrophin (NTF) genes have emerged as promising targets, since a growing literature showed a possible link between NTF and addiction-related disorders. Thus, we aimed to explore the role of NTF genes and GD with the hypothesis that some NTF gene polymorphisms could constitute biological risk factors. The sample included 166 patients with GD and 191 healthy controls. 36 single nucleotide polymorphisms (SNPs) from NTFs (NGF, NGFR, NTRK1, BDNF, NTRK2, NTF3, NTRK3, NTF4, CNTF and CNTFR) were selected and genotyped. Linkage disequilibrium (LD) and haplotype constructions were analyzed, in relationship with the presence of GD. Finally, regulatory elements overlapping the identified SNPs variants associated with GD were searched. The between groups comparisons of allele frequencies indicated that 6 SNPs were potentially associated with GD. Single and multiple-marker analyses showed a strong association between both NTF3 and NTRK2 genes, and GD. The present study supports the involvement of the NTF family in the aetiopathogenesis of GD. An altered cross-regulation of different NTF members signalling pathways might be considered as a biological vulnerability factor for GD.

Risk patterns in food addiction: a Mexican population approach

BACKGROUND

Food addiction (FA) is a construct that has gained interest in recent years but its relevance in Mexican population is still unexplored.

AIMS

The present study has the aims of explore FA in a community of Mexican population, as well as identifying the risk patterns associated with it, in relation to the different etiological factors that have been described such as impulsivity, emotional regulation and eating styles. Furthermore, to identify a predictive model of FA severity.

METHODS

The sample consisted of 160 female and male university students of Pachuca city in México, who volunteered to participate in the study. Assessment included multidimensional measures for FA, eating disorder severity, eating disorder styles, emotional regulation and impulsivity.

RESULTS

A screening of FA-probable was registered for 13.8% of the sample, while 8.1% met criteria for FA-present. The FA-present group differed from FA-absent in the impulsivity levels and in emotional eating style. Patients with FA-present differed from FA-probable in the impulsivity levels. Differences between FA-probable versus FA-absent were found in the restrained eating style. Path analysis evidenced that FA severity was directly associated with older age, worse eating style profile and higher impulsivity levels, and indirectly related with the ED symptom levels.

CONCLUSIONS

Our findings suggest that it is possible to establish a specific predictive model of the development of FA and its severity in Mexican population to implement adequate prevention and treatment strategies.

EVIDENCE LEVEL

Level III: evidence obtained from well-designed cohort or case-control analytic studies.

Food addiction in anorexia nervosa: Implications for the understanding of crossover diagnosis

Objective

Food addiction (FA) construct was introduced to reflect abnormal eating patterns that resemble behavioural ones found in substance use disorders. FA has been barely explored in anorexia nervosa (AN). This study evaluated FA occurrence and associated factors in a sample of patients with AN, distinguishing between restrictive and binge–purging subtypes and focussing on the influence of FA in the crossover diagnosis between them.

Method

A sample of 116 patients with AN admitted for treatment seeking at an Bellvitge Hospital Eating Disorders Unit were included (72 restrictive [AN‐R]; 44 binge‐purge AN [AN‐BP]), and eating‐related, personality and psychopathological variables were assessed. Most participants were women (92.2%), mean age 27.1 years old (SD = 10.5).

Results

FA was more prevalent in patients with AN‐BP compared to the AN‐R group (75.0% and 54.2%, respectively). The patients with AN‐R FA+, presented more similar ED symptomatology, general psychopathology and personality traits, with the AN‐BP patients, than with the AN‐R FA‐.

Conclusions

Patients with AN‐R FA+, exhibit more similarities with the AN‐BP subgroup than with the AN‐R FA‐. Thus, it is possible to hypothesise that the presence of FA might be an indicator of the possible crossover from AN‐R to AN‐BP.

Patients with anorexia nervosa – restrictive subtype (AN‐R) and patients with anorexia nervosa – bulimic‐purgative subtype (AN‐BP) present a prevalence of food addiction (FA) of 54% and 75%, respectively.

Patients with AN‐R FA+ have more clinical and personality similarities with AN‐BP than with AN‐R FA−.

The presence of FA could be associated with the possible crossover from AN‐R to AN‐BP.

Emotion regulation as a transdiagnostic factor in eating disorders and gambling disorder: Treatment outcome implications

BACKGROUND

A first approach addressed to ascertain whether emotion regulation (ER) could be a transdiagnostic construct between eating disorders (EDs) and gambling disorder (GD) (through a joint clinical clustering analysis of both disorders) was performed by Munguía et al. (2021). Both conditions were represented by a severe, moderate, and low ER profile subgroups, according to the degree of ER difficulties. Results showed a linear relationship between the severity of ER difficulties and the severity of the disorder and the psychopathological state.

AIMS

Based on the aforementioned cross-sectional study, the objective of this longitudinal research was to explore the treatment response of the different ER subgroups.

METHODS

459 adult patients (n = 277 ED; n = 182 GD) were included. Several clinical variables, as well as outcome indicators (after completing 16 weeks of cognitive-behavioral therapy), were evaluated.

RESULTS

The three subgroups found in the previous cross-sectional study were taken for the performance of the present research. ED and GD distribution in each subgroup replicates the one exposed by Munguía et al. (2021), as well as their characterization, considering psychopathology, disorder severity and personality traits. The low ER subgroup reported a better response to treatment, whereas the severe group had the highest rates of non-remission and dropouts.

CONCLUSIONS

Our results suggest that greater difficulties in ER lead to poorer treatment outcomes. Therefore, tailored treatments for patients with poor ER abilities would be recommended to improve adherence and treatment outcomes.

Food Addiction in Eating Disorders: A Cluster Analysis Approach and Treatment Outcome

Background: A first approach of a phenotypic characterization of food addiction (FA) found three clusters (dysfunctional, moderate and functional). Based on this previous classification, the aim of the present study is to explore treatment responses in the sample diagnosed with Eating Disorder(ED) of different FA profiles. Methods: The sample was composed of 157 ED patients with FA positive, 90 with bulimia nervosa (BN), 36 with binge eating disorder (BED), and 31 with other specified feeding or eating disorders (OSFED). Different clinical variables and outcome indicators were evaluated. Results: The clinical profile of the clusters present similar characteristics with the prior study, having the dysfunctional cluster the highest ED symptom levels, the worse psychopathology global state, and dysfunctional personality traits, while the functional one the lowest ED severity level, best psychological state, and more functional personality traits. The dysfunctional cluster was the one with lowest rates of full remission, the moderate one the higher rates of dropouts, and the functional one the highest of full remission. Conclusions: The results concerning treatment outcome were concordant with the severity of the FA clusters, being that the dysfunctional and moderate ones had worst treatment responses than the functional one.