Do emotion regulation and impulsivity differ according to gambling preferences in clinical samples of gamblers?

BACKGROUND AND AIMS

Emotion regulation (ER) and impulsivity impairments have been reported in patients with gambling disorder (GD). However, both constructs have not been studied in depth jointly in clinical samples. Therefore, the aim of this study was to analyze ER and impulsive tendencies/traits in a sample of n = 321 treatment-seeking individuals with GD by differentiating them according to their gambling preference (n = 100 strategic; n = 221 non-strategic).

METHODS

Our sample was assessed through the DERS (ER), the UPPS-P (impulsivity), and the DSM-5 (GD severity).

RESULTS

The non-strategic group included a higher proportion of women and reported greater ER impairments, and more impulsive traits/tendencies compared to strategic gamblers. GD severity was associated with all DERS subscale (except for awareness) and with urgency dimensions of the UPPS-P.

DISCUSSION AND CONCLUSIONS

Our findings confirm that strategic and non-strategic gamblers differ in their ER processes and impulsive tendencies, showing the first clinical group a more adaptive profile. These results suggest the relevance of assessing these ER and impulsivity in order to tailor better treatment approaches.

Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders

BACKGROUND AND AIMS

Food addiction (FA) and substance use (SU) have frequently been reported in patients with eating disorders (EDs). Our study aimed to assess the prevalence rates of FA and/or lifetime problematic alcohol and illicit drug use among patients with specific ED, such as: bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorder (OSFED). We sought to identify clinical, psychopathological, and personality profiles involved in these addictive behavior-based phenotypes.

METHODS

The total sample was 527 patients (176 BN, 115 BED, and 236 OSFED). FA was assessed through the Yale Food Addiction Scale 2.0. To determine lifetime SU, a semi-structured clinical interview was carried out.

RESULTS

Patients with BN had the highest rates of FA both with and without SU. No gender differences were obtained for the prevalence of current FA and/or lifetime SU. Patients reporting at least one addictive-related behavior exhibited increased clinical severity compared to those who reported none. Increased impulsivity (such as high lack of premeditation, sensation seeking, and positive urgency) and low self-directedness were differentiating factors for presenting one or two addictive behaviors.

DISCUSSION AND CONCLUSIONS

Overall, patients presenting with at least one addictive-like behavior reported a poorer clinical status than those without. Also, patients with FA and SU exhibited a more dysfunctional profile characterized by high impulsivity and low self-directedness. These findings would support the need for targeted treatments to reduce impulsivity and increase self-directedness, especially in patients with any addictive-related behavior, as a step towards improving their treatment outcome.

Food addiction in Bulimia Nervosa: Analysis of body composition, psychological and problematic foods profile

INTRODUCTION

Food Addiction (FA) has been related with eating disorders (ED), especially Bulimia Nervosa (BN). BN + FA may have different physical characteristics than patients with BN without the comorbidity, such as body mass index (BMI) or body composition, and psychological as emotion regulation. However, the relationship between psychological and physical aspects, connected by problematic food and its influence on body composition, has been barely studied. Therefore, the aims of the present study are.

AIMS

(a) To explore the differences in body composition between FA positive (FA+) and negative (FA-) in women with BN; (b) to identify problematic relationship with certain food types, according with the foods mentioned in the YFAS scale questionnaire, between FA+ and FA- patients; (c) to know the psychological characteristic differences between FA+ and FA- patients, considering emotion regulation, personality traits and general psychopathological state; (d) to identify the relationship between physical and psychological traits, and the identified problematic foods, in patients with BN and FA.

METHODOLOGY

N = 81 BN women patients, with a mean age of 29.73 years ± 9.80 SD, who completed the questionnaires: Yale Food Addiction Scale V 1.0 (YFAS 1.0), Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90 Items-Revised (SCL-90-R), and Difficulties in Emotion Regulation Strategies (DERS). YFAS problematic foods were grouped considering their principal nutrients sources. Body composition and difference in metabolic age was determined using bioimpedance analyzer.

RESULTS

The 88% of patients with BN presented FA+. Patients with BN who were FA+ self-reported more problematic relationships with sweets and starches. Also presented higher emotion regulation difficulties, general psychopathology and eating symptomatology severity, than those without FA. Finally, emotional regulation difficulties were positively associated with higher eating disorder symptomatology and more types of foods self-reported as problematic, which increased indirectly fat mass.

CONCLUSION

The results suggest that BN + FA presented more eating and psychopathology symptomatology and higher problems with specific food types. As well, the path analysis emphasized that emotion regulation difficulties might be related with problematic food relationship in BN, impacting over the ED severity.

IMPLICATIONS

The results may impact the development of precise therapies for patients with BN + FA.

Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout.

Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown).

Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p<0.001, respectively).

Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.

Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study

Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED 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 COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.

Clustering Treatment Outcomes in Women with Gambling Disorder

The rising prevalence of gambling disorder (GD) among women has awakened considerable interest in the study of therapeutic outcomes in females. This study aimed to explore profiles of women seeking treatment for GD based on a set of indicators including sociodemographic features, personality traits, clinical state at baseline, and cognitive behavioral therapy (CBT) outcomes. Two-step clustering, an agglomerative hierarchical classification system, was applied to a sample of n = 163 women of ages ranging from 20 to 73 years-old, consecutively attended to by a clinical unit specialized in the treatment of G. Three mutually exclusive clusters were identified. Cluster C1 (n = 67, 41.1%) included the highest proportion of married, occupationally active patients within the highest social status index. This cluster was characterized by medium GD severity levels, the best psychopathological functioning, and the highest mean in the self-directedness trait. C1 registered 0% dropouts and only 14.9% relapse. Cluster C2 (n = 63; 38.7%) was characterized by the lowest GD severity, medium scores for psychopathological measures and a high risk of dropout during CBT. Cluster C3 (n = 33; 20.2%) registered the highest GD severity, the worst psychopathological state, the lowest self-directedness level and the highest harm-avoidance level, as well as the highest risk of relapse. These results provide new evidence regarding the heterogeneity of women diagnosed with GD and treated with CBT, based on the profile at pre- and post-treatment. Person-centered treatments should include specific strategies aimed at increasing self-esteem, emotional regulation capacities and self-control of GD women.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes

Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive–compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity.

Clinical factors predicting impaired executive functions in eating disorders: The role of illness duration

Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.

Women and gambling disorder: Assessing dropouts and relapses in cognitive behavioral group therapy

BACKGROUND

Gender-specific literature focused on gambling disorder (GD) is scarce, and women with GD have been understudied. Therefore, the aim of this study was to estimate the short-term effectiveness in women with GD (n = 214) of a group standardized cognitive-behavioral therapy (CBT) and to identify the most relevant predictors of the primary therapy outcomes (dropout and relapse).

METHODS

The manualized CBT consisted of 16 weekly outpatient group sessions. Women were provided with resources to obtain a better understanding of the GD, to improve self-control and to manage risk situations.

RESULTS

The dropout risk was higher for women with lower GD severity and higher psychopathological distress. Among other factors, lower education levels were a significant predictor of the relapse risk and and the frequency of relapses was higher for divorced women with a preference for non-strategic gambling and with substances consumption.

CONCLUSIONS

Our findings evidence women-specific predictors of the primary therapy outcomes. The results highlight the need to design psychological interventions that address dropout and relapse risk factors in women.

Subtyping treatment-seeking gaming disorder patients

BACKGROUND AND AIMS

Gaming Disorder (GD) is characterized by a pattern of persistent and uncontrolled gaming behavior that causes a marked impairment in important areas of functioning. The evolution of the worldwide incidence of this disorder warrants further studies focused on examining the existence of different subtypes within clinical samples, in order to tailor treatment. This study explored the existence of different profiles of patients seeking treatment for GD through a data-driven approach.

METHODS

The sample included n = 107 patients receiving treatment for GD (92% men and 8% women) ranging between 14 and 60 years old (mean age = 24.1, SD = 10). A two-step clustering analysis approach explored the existence of different underlying GD profiles based on a broad set of indicators, including sociodemographic features, clinical course of the condition (e.g., onset or evolution), psychopathological symptoms, and personality traits.

RESULTS

Two GD profiles emerged. The first cluster grouped together patients who presented with a lower psychological impact (n = 72, 66.1%), whereas the second cluster comprised patients with a higher psychological impact (n = 35, 32.7%). Cluster comparisons revealed that those patients presenting the higher impact were older, with a later onset of pathological gaming patterns, and more pronounced psychopathological symptoms and dysfunctional personality profiles.

CONCLUSIONS

GD severity is influenced by specific demographic, clinical, and psychopathological factors. The identification of two separate profiles provides empirical evidence that contributes to the conceptualization of this disorder, as well as to the development of reliable and valid screening tools and effective intervention plans focused on the precise characteristics of the treatment-seeking patients.

Where does purging disorder lie on the symptomatologic and personality continuum when compared to other eating disorder subtypes? Implications for the DSM

OBJECTIVES

To assess the clinical significance and distinctiveness of purging disorder (PD) from other eating disorder (ED) diagnoses.

METHOD

Participants included 3127 women consecutively admitted to an ED treatment centre (246 PD, 465 anorexia nervosa restrictive [AN-R], 327 AN-binge purging [AN-BP], 1436 bulimia nervosa [BN], 360 binge eating disorder [BED], 177 atypical AN and 116 unspecified feeding or eating disorder [UFED]) who were diagnosed according to DSM-5 criteria. Additionally, 822 control participants were recruited from the community. All participants completed measures assessing ED symptoms (EDI-2), general psychopathology (SCL-90-R) and personality (TCI-R).

RESULTS

Patients with PD, when compared to controls, scored significantly higher on the EDI-2 and SCL-90-R, and most TCI-R dimensions. Most of the significant differences between PD and the other ED diagnoses emerged between PD and AN-R, followed by Atypical-AN, UFED, AN-BP and BED, with patients with PD typically reporting higher scores on the EDI-2 and SCL-90-R subscales. Significant differences between PD and BN were also present, but to a lesser extent. The findings for personality varied amongst the different ED diagnoses.

CONCLUSIONS

PD is a clinically significant disorder, which seems to be more similar to BN than it is to AN and the other ED subtypes.

Suicidal behavior in patients with gambling disorder and their response to psychological treatment: The roles of gender and gambling preference

Suicidal ideation and attempts are prevalent among patients with gambling disorder (GD). However, patients with GD and a history of lifetime suicidal events are not a homogeneous group. The main objective of this study was to compare sociodemographic, clinical, personality, and psychopathological features among different profiles of adults with GD with and without a history of suicidal behavior, taking into account two relevant variables: gender and gambling preference. The second aim was to examine how the different profiles of patients with a history of suicidal events responded to cognitive-behavioral therapy (CBT). A total of 1112 treatment-seeking adults who met the criteria for GD were assessed at a hospital specialized unit for the treatment of behavioral addictions. The participants completed self-reported questionnaires to explore GD, personality traits, and psychopathological symptomatology. The lifetime histories of suicidal ideation and attempts, and gambling preferences, were assessed during semi-structured face-to-face clinical interviews. Of the total sample, 229 patients (26.6%) reported suicidal ideation and 74 patients (6.7%), suicide attempts. The likelihood of presenting suicidal ideation was higher for women than men, but no differences were observed based on gambling preference. Regarding suicide attempts, the odds were higher among women with non-strategic forms of gambling. Suicidal ideation and attempts were associated with higher GD severity, a worse psychopathological state and higher self-transcendence levels. In terms of treatment outcomes, neither gambling preference nor past suicidal behavior had an influence on dropouts and relapses. Nevertheless, female gender and a lack of family support constitute two good predictors of a worse treatment outcome.

Illness perception in patients with eating disorders: clinical, personality, and food addiction correlates

PURPOSE

Although the role of illness perception in the clinical course of many physical diseases and certain mental disorders has been well described, little is known about illness perception in eating disorders (ED) so far. Therefore, the purpose of this study was to extend our understanding of illness perception in different ED diagnostic types and to explore its association between clinical, psychopathological, motivational, personality, and food addiction (FA) features.

METHODS

The sample consisted of 104 patients with ED [(23 anorexia nervosa (AN), 39 bulimia nervosa (BN), 19 binge eating disorder (BED), and 23 other specified feeding and eating disorders (OSFED)]. Illness perception was assessed by means of the revised version of the Illness Perception Questionnaire (IPQ-R).

RESULTS

The results supported the association between illness perception and clinical, psychopathological, and personality factors. Patients with BN and BED showed greater illness perception than the other types. Improved illness perception was positively associated with a longer duration of the disorder and FA. Furthermore, a relevant finding suggests that at least half of the patients with ED did not achieve a good level of illness perception until after having the disorder for 20 years on average.

CONCLUSION

Our findings suggest that higher levels of FA and longer duration of the ED are positively and directly associated with increased illness perception. This may explain the low levels of initial motivation in these patients and their high dropout rates in the early stages of treatment.

LEVEL OF EVIDENCE III

Case-control analytic study.

Peripheral endocannabinoids in eating disorders and obesity and its relationship with clinical and anthropometric variables

Introduction

Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG) play a pivotal role in food intake and reward aspects of feeding. Aberrant functioning in the endocannabinoid system has been observed in patients with eating disorders (EDs). This dysfunction may influence the incentive processes stimulating behaviors towards food acquisition or the hedonic evaluation of ingested food.

Objectives

The aims of this study are to compare fasting peripheral levels of AEA and 2-AG in ED patients, obese subjects (OB) and healthy controls (HCs), and to explore their association with clinical and anthropometric variables.

Methods

The sample included a total of 63 adult women. Peripheral blood samples were collected to investigate fasting levels of AEA and 2-AG in 31 ED patients: 22 Anorexia Nervosa (AN) and 9 Binge Eating Disorder (BED), compared to 21 OB and 11 HCs. Several clinical and anthropometric variables were also assessed.

Results

Comparing groups, significant differences in AEA levels were found (p=0.001). Specifically, individuals with AN exhibited lower AEA than OB (p<0.001) and BED (p=0.007), while OB showed higher AEA than HCs (p=0.015). 2-AG was positively correlated with hostility dimension in EDs and negatively associated with impulsive traits in OB. AEA showed a direct association with body dissatisfaction in AN, contrary to OB. Finally, in AN, AEA negatively correlated with the body mass index, while 2-AG was positively associated with the fat mass.

Conclusions

These results suggest an interaction between biological and clinical factors defining a vulnerability pathway that could help fitting personalized therapeutic approaches in each condition.

Disclosure

No significant relationships.

Metabolic, Affective and Neurocognitive Characterization of Metabolic Syndrome Patients with and without Food Addiction. Implications for Weight Progression

According to the food addiction (FA) model, the consumption of certain types of food could be potentially addictive and can lead to changes in intake regulation. We aimed to describe metabolic parameters, dietary characteristics, and affective and neurocognitive vulnerabilities of individuals with and without FA, and to explore its influences on weight loss progression. The sample included 448 adults (55-75 years) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus cognition sub-study. Cognitive and psychopathological assessments, as well as dietary, biochemical, and metabolic measurements, were assessed at baseline. Weight progression was evaluated after a 3-year follow up. The presence of FA was associated with higher depressive symptomatology, neurocognitive decline, low quality of life, high body mass index (BMI), and high waist circumference, but not with metabolic comorbidities. No differences were observed in the dietary characteristics except for the saturated and monounsaturated fatty acids consumption. After three years, the presence of FA at baseline resulted in a significantly higher weight regain. FA is associated with worse psychological and neurocognitive state and higher weight regain in adults with metabolic syndrome. This condition could be an indicator of bad prognosis in the search for a successful weight loss process.

Executive functions in binge spectrum eating disorders with comorbid compulsive buying

OBJECTIVE

The aims were to explore if bulimic spectrum disorders (BSD) patients, who also present comorbid compulsive buying (CB), could represent a specific subtype considering its neuropsychological performance; to present a descriptive analysis of different clinical features; and to explore how these variables could influence treatment outcome. It was hypothesised that the comorbid group will present worse neuropsychological performance that will lead to a worse treatment outcome.

METHOD

The study has a longitudinal design. Women (N = 75) diagnosed with BSD, BSD + CB and Healthy Controls (HC); completed an evaluation of: cognitive flexibility, decision making, eating disorder (ED) symptomatology, psychopathological state and personality traits.

RESULTS

BSD + CB was the group with the most severe clinical profile, worst treatment outcome and higher neuropsychological impairment, than other groups. Path-analysis evidenced that deficits in decision making were associated with bad treatment outcome, while deficits in flexibility with the presence of the comorbidity. Self-directedness and novelty seeking were associated with the neuropsychological performance and the comorbidity.

CONCLUSION

BSD + CB exhibit a worse clinical and neuropsychological profile that seems to be related with the treatment outcome, which should be taken into account for the establishment of specific treatment approaches.

The Role of ADHD Symptomatology and Emotion Dysregulation in Gambling Disorder

Objectives: Although emotion regulation deficits have been implicated in gambling disorder and ADHD, the interplay between these factors has yet to be systematically studied. We examined relationships between ADHD symptoms, emotion regulation, and gambling disorder severity in a sample of treatment-seeking gambling disorder patients (n = 98). We also examined clinical differences between patients with and without ADHD symptomatology. Method: Structural equation modeling (SEM) evaluated direct and indirect effects of ADHD and emotion regulation on gambling disorder severity. Results: Significant correlations between ADHD symptomatology and emotion regulation and between emotion regulation and gambling disorder severity were identified. Differences in emotion regulation were found between gambling disorder patients with and without ADHD symptomatology. Path analysis revealed emotion regulation to be a mediator between ADHD and gambling disorder. Conclusion: Our findings indicate the presence of ADHD symptomatology to be associated with greater severity of gambling disorder and greater emotional dysregulation.

Exploring the Predictive Value of Gambling Motives, Cognitive Distortions, and Materialism on Problem Gambling Severity in Adolescents and Young Adults

Gambling motives and cognitive distortions are thought to be associated because both coping and financial motives to gamble appear to be predictors of gambling related cognitive distortions. Therefore, there is an argument to be made that gambling motives, cognitive distortions, and materialism share common attributes and might be related to problem gambling severity. The present paper aims to examine the relationship between these three variables, both in a clinical and community setting, to see if they can predict gambling severity. A sample of 250 participants from the general population and 31 participants from the clinical population was recruited. The results showed that the clinical sample scored higher on gambling severity, cognitive distortions, materialism, and gambling motives. It also showed that low scores in enhancement motives and higher scores in social motives and gambling related cognitions predicted gambling severity in older gamblers, whereas for younger patients, gambling severity was best predicted by higher scores in materialism and coping motives, and lower scores for enhancement and social motives. In the community sample, gambling severity correlated with gambling related cognitive distortions and with gambling motives (except for social and coping motives within the women subsample). These results testify to the importance of materialism, cognitive distortions, and gambling motives as risk factors for problem gambling both in community and clinical samples.

The Severity of Gambling and Gambling Related Cognitions as Predictors of Emotional Regulation and Coping Strategies in Adolescents

People with gambling disorder (GD) exhibit distorted cognitions and superstitious beliefs more often than the general population. Similarly, difficulties in coping and emotion dysregulation are more prevalent among those with GD, and could determine the onset of GD in particularly vulnerable groups such as adolescents. This study examines the relationship between gambling severity and gambling-related cognitions with coping strategies and emotion regulation. Also, it explores how accurately gambling severity and gambling-related cognitions were able to predict emotion regulation and coping strategies. Two groups were recruited and analyzed: a community sample comprising 250 adolescents and young adults from secondary education schools, and a clinical sample of 31 patients with similar age characteristics seeking treatment for GD. The participants from the clinical sample scored higher on gambling severity, emotion dysregulation, cognitive biases, and maladaptive coping strategies. In the community sample, cognitive biases mediated the relationship between sex and emotion dysregulation and disengagement. People with GD use more often than controls maladaptive emotion regulation strategies to manage negative emotional states. This perspective emphasizes the need to focus on coping with emotions, as opposed to coping with problems, as the best approach to tackle gambling problems.

The transition time to gambling disorder: The roles that age, gambling preference and personality traits play

BACKGROUND AND AIMS

Gambling Disorder (GD) is considered a heterogeneous, multidimensional pathology with high personal and social consequences. The transition time (TT) between problematic gaming and pathological gambling, which varies significantly across patients, may predict the disorder's severity. As only limited studies have investigated the factors implicated in the TT, the current study set out to identify its predictors and their relationships with GD severity.

METHODS

Correlation were performed in 725 male GD patients to identify factors associated to TT and GD severity, including: age of onset of gambling behaviors, alcohol/drug use, personality traits and gambling preferences (i.e., strategic, non-strategic, and mixed). Then a regression analysis was performed to identify predictors of TT to GD.

RESULTS

Longer TT correlated with higher GD severity, early age of onset of problematic gambling, substance use and a non-strategic gambling preference. Personality traits including low self-directedness, high novelty seeking, and low cooperativeness were also related with longer TT. The strongest associations with GD severity were substance use, and some of the personality traits (i.e., low self-directedness and cooperativeness, high harm avoidance and self-transcendence). Factors significantly predicting longer transition to GD were older ages, low self-directedness, and non-strategic gambling.

CONCLUSIONS

A clinical profile characterized by a longer TT and more severe GD symptoms pertains to older patients with low self-directedness, and preference for non-strategic gambling. Other relevant factors associated with this profile of patients included early age of onset problematic gambling, substance consumption, high novelty seeking and low cooperativeness.

Effects of a psychosocial intervention at one-year follow-up in a PREDIMED-plus sample with obesity and metabolic syndrome

This study examines if overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms, and if these variables could be modified after 1 year of a multimodal intervention (diet, physical activity, psychosocial support). 342 adults (55-75 years) with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus Cognition study were randomized to the intervention or to the control group (lifestyle recommendations). Cognitive and psychopathological assessments were performed at baseline and after 1-year follow-up. At baseline, higher impulsivity was linked to higher food addiction and depressive symptoms, but not to body mass index (BMI). Food addiction not only predicted higher BMI and depressive symptoms, but also achieved a mediational role between impulsivity and BMI/depressive symptoms. After 1 year, patients in both groups reported significant decreases in BMI, food addiction and impulsivity. BMI reduction and impulsivity improvements were higher in the intervention group. Higher BMI decrease was achieved in individuals with lower impulsivity. Higher scores in food addiction were also related to greater post-treatment impulsivity. To conclude, overweight/obesity are related to higher impulsivity, food addiction and depressive symptoms in mid/old age individuals with MetS. Our results also highlight the modifiable nature of the studied variables and the interest of promoting multimodal interventions within this population.

Psychological and metabolic risk factors in older adults with a previous history of eating disorder: A cross-sectional study from the Predimed-Plus study

GOALS

To explore affective and cognitive status, later in life, in individuals with and without previous history of eating disorder (ED), and also its association with higher risk for metabolic syndrome (MetS) symptomatology.

METHODS

A cross-sectional analysis of 6756 adults, aged 55-75 years with overweight/obesity and MetS participating in the Predimed-Plus study was conducted. Participants completed self-reported questionnaires to examine lifetime history of ED, according to DSM-5 criteria, and other psychopathological and neurocognitive factors. Anthropometric and metabolic measurements were also collected.

RESULTS

Of the whole sample, 24 individuals (0.35%) reported a previous history of ED. In this subsample, there were more women and singles compared to their counterparts, but they also presented higher levels of depressive symptoms and higher cognitive impairment, but also higher body mass index (BMI) and severe obesity, than those without lifetime ED.

CONCLUSIONS

This is one of the first studies to analyse the cognitive and metabolic impact of a previous history of ED. The results showed that previous ED was associated with greater affective and cognitive impairment, but also with higher BMI, later in life. No other MetS risk factors were found, after controlling for relevant variables.

The neural correlates of delay discounting in obesity and binge eating disorder

BACKGROUND AND AIMS

Increased delay discounting is associated with obesity and binge eating disorder (BED). Although BED and obesity frequently co-occur, the neural mechanisms underlying delay discounting in these conditions remain poorly understood.

METHODS

Thirtyfive women with obesity, including 10 participants with obesity and BED and 31 controls completed a monetary delay discounting task during functional magnetic resonance imaging.

RESULTS

We identified that increased discounting rates were associated with decreased activity in the left anterior insula in participants with obesity compared to controls when choosing immediate rewards over delayed rewards (PFWE < 0.05). An exploratory analysis comparing the BED subsample to the other groups did not detect significant differences.

DISCUSSION AND CONCLUSIONS

Our findings suggest decreased activity in the anterior insula may underlie heightened delay discounting in individuals with obesity, contributing the probability of choosing immediate rewards over delayed rewards based on emotional states. Future studies including larger, more diverse samples are required to confirm these effects.