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Sharif-Razi M, Hodgins DC, Goghari VM. Reactive and proactive control mechanisms of response inhibition in gambling disorder. Psychiatry Res 2019; 272:114-121. [PMID: 30580134 DOI: 10.1016/j.psychres.2018.12.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/28/2018] [Accepted: 12/06/2018] [Indexed: 12/15/2022]
Abstract
Response inhibition, one component of cognitive control, refers to the ability to inhibit automatic responses and has been found to be impaired in gambling disorder. Recent models of cognitive control distinguish between two mechanisms: reactive control, the ability to stop in response to a stop-stimulus, and proactive control, the ability to anticipate and prepare for a stop. Previous studies have primarily focused on reactive modes of control in gambling disorder. The aim of the current study was to assess both reactive and proactive modes of response inhibition in individuals with gambling disorder (n = 27) and community controls (n = 21) using a variant of the stop-signal task. Second, the relationship between trait impulsivity, and reactive and proactive control was examined. No group differences in reactive or proactive control were found. However, premeditation, one domain of trait impulsivity, was associated with worse proactive control in the gambling group. These results suggest that difficulties with response inhibition may not be a core deficit in all forms of gambling disorder. Future research should continue to develop and test tasks that involve cognitive control processes in different presentations of gambling disorder.
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Affiliation(s)
- Maryam Sharif-Razi
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| | - David C Hodgins
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| | - Vina M Goghari
- Clinical Neuroscience of Schizophrenia (CNS) Laboratory, Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
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Turner NE, McDonald AJ, Ialomiteanu AR, Mann RE, McCready J, Millstone D, Hamilton H, Elton-Marshall T, Rehm J, Kurdyak P, Ilie G, Wickens CM, Le TL, van der Maas M, Faregh N, Cook S, Bondy S, Sanchez S, Cusimano MD. Moderate to severe gambling problems and traumatic brain injury: A population-based study. Psychiatry Res 2019; 272:692-697. [PMID: 30832188 DOI: 10.1016/j.psychres.2018.12.170] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/12/2018] [Accepted: 12/30/2018] [Indexed: 11/18/2022]
Abstract
Traumatic brain injury (TBI) is a common injury characterized by a change in brain function after an external blow to the head and is associated with substance abuse, psychological distress, risk-taking, and impulsivity. Convenience and clinical samples have also linked TBI to problem gambling, but have not ruled out confounding variables such as hazardous drinking and psychological distress. This study examines the relationship between TBI and moderate to severe problem gambling in a general population probability sample controlling for hazardous drinking and psychological distress. The data were obtained from a 2015-2016 cross-sectional general population telephone survey of adults ages 18+from Ontario, Canada (N = 3809). Logistic regression was used to estimate the association as adjusted odds ratios (AOR). Moderate to severe problem gambling was independently associated with a history of TBI after adjusting for potential confounders (AOR: 2.80), and had a statistically significant relationship with psychological distress (AOR = 2.74), hazardous drinking (AOR = 2.69), and lower educational levels (AOR = 0.37). This study provides further data to suggest a link between TBI and moderate to severe problem gambling; however, more research is needed to determine if there is a causal relationship or the potential implications for prevention and treatment.
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Affiliation(s)
- Nigel E Turner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - André J McDonald
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anca R Ialomiteanu
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Robert E Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - John McCready
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Healthy Horizons Consulting, Toronto, Ontario, Canada
| | - Dov Millstone
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Hayley Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Jurgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Technische Universität Dresden, Dresden, Germany
| | - Paul Kurdyak
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Gabriela Ilie
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Christine M Wickens
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Thao Lan Le
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Mark van der Maas
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Neda Faregh
- Lady Davis Institute of Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Steven Cook
- Department of Social Sciences, Cardiff University, Cardiff, Wales, UK
| | - Susan Bondy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sherald Sanchez
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Michael D Cusimano
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
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53
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Jacob L, Haro JM, Koyanagi A. The association between problem gambling and psychotic experiences: Findings from the Adult Psychiatric Morbidity Survey 2007. Schizophr Res 2018; 201:79-84. [PMID: 29804926 DOI: 10.1016/j.schres.2018.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/13/2018] [Accepted: 05/13/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Studies on the association between psychotic experiences (PEs) and problem gambling are lacking. Thus, we examined the association between PEs and problem gambling in the general UK population. METHODS This study used community-based, cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey (APMS) (n = 7403). Ten items from the DSM-IV criteria and the British Gambling Prevalence Survey studies were used to ascertain problem gambling among individuals who gambled in the past 12 months. Respondents were classified as no problem (0 criteria), at-risk (1 or 2 criteria) and problem gambling (≥3 criteria). Past 12-month PE was assessed with the Psychosis Screening Questionnaire. Multivariable logistic regression models were constructed to assess the association between gambling status (exposure variable) and PE (outcome variable). RESULTS The final sample consisted of 7363 people aged ≥16 years with no definite or probable psychosis [mean (SD) age 46.4 (18.6) years; 51.2% females]. The prevalence of PE in those with no problem, at-risk, and problem gambling were 5.1%, 11.1%, and 29.7%, respectively. In the model adjusted for sociodemographics, common mental disorders and risky health behaviors, at-risk (OR = 1.88; 95% CI: 1.11-3.19) and problem gambling (OR = 4.64; 95% CI: 1.78-12.13) were associated with an increased odds for PE. CONCLUSION Problem gambling and PE tend to co-exist. Further research is needed to gain a better understanding of the mechanisms that underlie the association observed.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris 75006, France.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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Mestre-Bach G, Steward T, Granero R, Fernández-Aranda F, Del Pino-Gutiérrez A, Mallorquí-Bagué N, Mena-Moreno T, Vintró-Alcaraz C, Moragas L, Aymamí N, Gómez-Peña M, Sánchez-González J, Agüera Z, Lozano-Madrid M, Menchón JM, Jiménez-Murcia S. The predictive capacity of DSM-5 symptom severity and impulsivity on response to cognitive-behavioral therapy for gambling disorder: A 2-year longitudinal study. Eur Psychiatry 2018; 55:67-73. [PMID: 30390474 DOI: 10.1016/j.eurpsy.2018.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND DSM-5 proposed a new operational system by using the number of fulfilled criteria as an indicator of gambling disorder severity. This method has proven to be controversial among researchers and clinicians alike, due to the lack of studies indicating whether severity, as measured by these criteria, is clinically relevant in terms of treatment outcome. Additionally, numerous studies have highlighted the associations between gambling disorder and impulsivity, though few have examined the impact of impulsivity on long-term treatment outcomes. METHODS In this study, we aimed to assess the predictive value of DSM-5 severity levels on response to cognitive-behavioral therapy (CBT) in a sample of male adults seeking treatment for gambling disorder (n = 398). Furthermore, we explored longitudinal predictors of CBT treatment response at a follow-up, considering UPPS-P impulsivity traits. RESULTS Our study failed to identify differences in treatment outcomes between patients categorized by DSM-5 severity levels. Higher baseline scores in negative urgency predicted relapse during CBT treatment, and higher levels of sensation seeking were predictive of drop-out from short-term treatment, as well as of drop-out at 24-months. CONCLUSIONS These noteworthy findings raise questions regarding the clinical utility of DSM-5 severity categories and lend support to the implementation of dimensional approaches for gambling disorder.
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Affiliation(s)
- Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Jéssica Sánchez-González
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain.
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55
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A Comparison of Self-Reported Impulsivity in Gambling Disorder and Bipolar Disorder. J Gambl Stud 2018; 35:339-350. [DOI: 10.1007/s10899-018-9808-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Jacob L, Haro JM, Koyanagi A. Relationship between attention-deficit hyperactivity disorder symptoms and problem gambling: A mediation analysis of influential factors among 7,403 individuals from the UK. J Behav Addict 2018; 7:781-791. [PMID: 30238788 PMCID: PMC6426384 DOI: 10.1556/2006.7.2018.72] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Our goal was to examine the association between attention-deficit hyperactivity disorder (ADHD) symptoms and gambling problems, and to identify potential mediating factors of this association. METHODS This study used cross-sectional, community-based data from 7,403 people aged ≥16 years who participated in the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS) Screener. Problem gambling was assessed using a questionnaire based on the 10 DSM-IV diagnostic criteria for pathological gambling. Respondents were classified as having no problem, at-risk, or problem gambling. Logistic regression and mediation analyses were conducted to analyze the association between ADHD symptoms (i.e., ASRS score ≥14) and problem gambling and the role of several variables in this association. RESULTS The prevalence of at-risk (5.3% vs. 2.4%) and problem gambling (2.4% vs. 0.6%) was higher in individuals with ADHD symptoms than in those without ADHD symptoms. ADHD symptoms were significantly associated with both at-risk (OR = 2.15; 95% CI = 1.22-3.79) and problem gambling (OR = 3.57; 95% CI = 1.53-8.31) when adjusted for age, sex, and ethnicity. Common mental disorders (CMDs; i.e., depression and anxiety disorders) (mediated percentage = 22.4%), borderline personality disorder (BPD) traits (22.1%), stressful life events (13.2%), stress at work or home (12.6%), alcohol dependence (11.8%), and impulsivity (11.2%) were significant mediators in the ADHD-gambling association. DISCUSSION AND CONCLUSIONS Overall, ADHD symptoms were positively associated with problem gambling. CMDs, BPD traits, and stressful life events were important mediators in this relationship.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France,Corresponding author: Dr. Louis Jacob; Faculty of Medicine, University of Paris 5, 15 rue de l’École de Médecine, Paris 75006, France; Phone: +33 6 27 88 37 06; E-mail:
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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57
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Granero R, Fernández-Aranda F, Mestre-Bach G, Steward T, García-Caro B, Prever F, Gavriel-Fried B, del Pino-Gutiérrez A, Moragas L, Aymamí N, Gómez-Peña M, Mena-Moreno T, Martín-Romera V, Menchón JM, Jiménez-Murcia S. Clustering of treatment-seeking women with gambling disorder. J Behav Addict 2018; 7:770-780. [PMID: 30238785 PMCID: PMC6426395 DOI: 10.1556/2006.7.2018.93] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prevalence of gambling disorder (GD) in women has increased, but, to date, few studies have explored the features of clinical GD subtypes in female samples. AIMS The aim of this study is to identify empirical clusters based on clinical/sociodemographic variables in a sample of treatment-seeking women with GD. METHODS Agglomerative hierarchical clustering was applied to a sample of n = 280 patients, using sociodemographic variables, psychopathology, and personality traits as indicators for the grouping procedure. RESULTS Three mutually exclusive groups were obtained: (a) Cluster 1 (highly dysfunctional; n = 82, 29.3%) endorsed the highest levels in gambling severity, comorbid psychopathology, novelty seeking, harm avoidance, and self-transcendence, and the lowest scores in self-directedness and cooperativeness; (b) Cluster 2 (dysfunctional; n = 142, 50.7%) achieved medium mean scores in gambling severity and psychopathological symptoms; and (c) Cluster 3 (functional; n = 56, 20.0%) obtained the lowest mean scores in gambling severity and in psychopathology, and a personality profile characterized by low levels in novelty seeking, harm avoidance, and self-transcendence, and the highest levels in self-directedness and cooperativeness. DISCUSSION AND CONCLUSIONS This study sheds light on the clinical heterogeneity of women suffering from GD. Identifying the differing features of women with GD is vital to developing prevention programs and personalized treatment protocols for this overlooked population.
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Affiliation(s)
- Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain
| | - Trevor Steward
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain
| | - Bárbara García-Caro
- Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, Barcelona, Spain
| | - Fulvia Prever
- National Health System Addictions Clinic, Milan, Italy
| | - Belle Gavriel-Fried
- The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain,Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain
| | - Virginia Martín-Romera
- Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Ciber de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain,Department of Psychiatry, Bellvitge University Hospital/IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Corresponding author: Susana Jiménez-Murcia; Department of Psychiatry, Bellvitge University Hospital/IDIBELL; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, c/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail:
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Mallorquí-Bagué N, Tolosa-Sola I, Fernández-Aranda F, Granero R, Fagundo AB, Lozano-Madrid M, Mestre-Bach G, Gómez-Peña M, Aymamí N, Borrás-González I, Sánchez-González J, Baño M, Del Pino-Gutiérrez A, Menchón JM, Jiménez-Murcia S. Cognitive Deficits in Executive Functions and Decision-Making Impairments Cluster Gambling Disorder Sub-types. J Gambl Stud 2018; 34:209-223. [PMID: 29058168 DOI: 10.1007/s10899-017-9724-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
To identify Gambling Disorder (GD) subtypes, in a population of men seeking treatment for GD, according to specific executive function domains (i.e., cognitive flexibility, inhibition and working memory as well as decision making) which are usually impaired in addictive behaviors. A total of 145 males ranging from 18 to 65 years diagnosed with GD were included in this study. All participants completed: (a) a set of questionnaires to assess psychopathological symptoms, personality and impulsivity traits, and (b) a battery of neuropsychological measures to test different executive functioning domains. Two clusters were identified based on the individual performance on the neuropsychological assessment. Cluster 1 [n = 106; labeled as Low Impaired Executive Function (LIEF)] was composed by patients with poor results in the neuropsychological assessment; cluster 2 patients [n = 46; labeled as High Impaired Executive Function (HIEF)] presented significantly higher deficits on the assessed domains and performed worse than the ones of LIEF cluster. Regarding the characterization of these two clusters, patients in cluster 2 were significantly older, unemployed and registered higher mean age of GD onset than patients in cluster 1. Additionally, patients in cluster 2 also obtained higher psychopathological symptoms, impulsivity (in both positive and negative urgency as well as sensation seeking) and some specific personality traits (higher harm avoidance as well as lower self-directedness and cooperativeness) than patients in cluster 1. The results of this study describe two different GD subtypes based on different cognitive domains (i.e., executive function performance). These two GD subtypes display different impulsivity and personality traits as well as clinical symptoms. The results provide new insight into the etiology and characterization of GD and have the potential to help improving current treatments.
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Affiliation(s)
- Núria Mallorquí-Bagué
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain. .,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain.
| | - Iris Tolosa-Sola
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - Fernándo Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain.,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Beatriz Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | | | - Marta Baño
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain. .,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
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Mak C, Tan KK, Guo S. ADHD Symptoms in Pathological and Problem Gamblers in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071307. [PMID: 29932102 PMCID: PMC6069437 DOI: 10.3390/ijerph15071307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/14/2018] [Accepted: 06/19/2018] [Indexed: 11/23/2022]
Abstract
Background: There is relatively little research examining the relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) and gambling addiction. This study seeks to explore for ADHD symptoms in adult gambling addiction patients and to evaluate their gambling-related cognitions. Materials and Methods: A cross-sectional survey was conducted at National Addictions Management Service, Institute of Mental Health, in Singapore. Patients presenting for gambling treatment were screened for ADHD symptoms and assessed for severity of gambling-related cognitions. The primary objective was to observe the rate of patients screening positive for ADHD. Results: 20% of the sample screened positive for ADHD. These individuals also had lower levels of gambling-related cognitions. No significant correlation was noted between ADHD symptoms and gambling-related cognition scores. Conclusions: Positive screening results for ADHD occurred frequently in our sample of Pathological Gambling (PG) and Problem Gambling patients and these affected individuals also exhibited lower levels of gambling-related cognitions. This finding may suggest that the gambling behavior in patients with ADHD-PG comorbidity is driven by impulsivity rather than gambling-related cognitions, which has implication on treatment considerations. Further research with a larger sample size is indicated.
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Affiliation(s)
- Charles Mak
- National Addictions Management Service, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore.
| | - Kok Kah Tan
- National Addictions Management Service, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore.
| | - Song Guo
- National Addictions Management Service, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore 539747, Singapore.
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60
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Kim HS, Cassetta BD, Hodgins DC, Tomfohr-Madsen LM, McGrath DS, Tavares H. Assessing the Relationship between Disordered Gamblers with Psychosis and Increased Gambling Severity: The Mediating Role of Impulsivity. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:370-377. [PMID: 28884607 PMCID: PMC5971405 DOI: 10.1177/0706743717730825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Recent research suggests that disordered gambling and psychosis co-occur at higher rates than expected in the general population. Gamblers with psychosis also report greater psychological distress and increased gambling severity. However, the mechanism by which psychosis leads to greater gambling symptomology remains unknown. The objective of the present research was to test whether impulsivity mediated the relationship between comorbid psychosis and gambling severity. METHOD The sample consisted of 394 disordered gamblers voluntarily seeking treatment at a large university hospital in São Paulo, Brazil. A semistructured clinical interview (Mini-International Neuropsychiatric Interview) was used to diagnosis the presence of psychosis by registered psychiatrists. Severity of gambling symptoms was assessed using the Gambling Symptom Assessment Scale, and the Barratt Impulsiveness Scale-11 provided a measure of impulsivity. RESULTS Of the sample, 7.2% met diagnostic criteria for psychosis. Individuals with a dual diagnosis of psychosis did not report greater gambling severity. Conversely, dual diagnoses of psychosis were associated with greater levels of impulsivity. Higher levels of impulsivity were also associated with greater gambling severity. Importantly, support for our hypothesised mediation model was found such that impulsivity mediated the association between disordered gambling and psychosis and gambling severity. CONCLUSION Impulsivity appears to be a transdiagnostic process that may be targeted in treatment among disordered gamblers with a dual diagnosis of psychosis to reduce problematic gambling behaviours.
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Affiliation(s)
- Hyoun S. Kim
- Department of Psychology, University of Calgary, Calgary, Alberta
| | | | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, Alberta
| | | | | | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, Butantã, São Paulo, Brazil
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Kim HS, von Ranson KM, Hodgins DC, McGrath DS, Tavares H. Demographic, psychiatric, and personality correlates of adults seeking treatment for disordered gambling with a comorbid binge/purge type eating disorder. EUROPEAN EATING DISORDERS REVIEW 2018; 26:508-518. [PMID: 29797743 DOI: 10.1002/erv.2606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/26/2018] [Accepted: 05/06/2018] [Indexed: 02/06/2023]
Abstract
Preliminary evidence suggests that binge/purge type eating disorders and gambling disorder may commonly co-occur. However, this dual-diagnosis population remains understudied. The present research examined the prevalence rates and correlates of binge/purge type eating disorders (i.e., bulimia nervosa, binge-eating disorder, and anorexia nervosa binge/purge type) among adults seeking treatment for their gambling (N = 349). In total, 11.5% of the sample (n = 40) met criteria for a binge/purge type eating disorder, most commonly bulimia nervosa (n = 33). There was a higher preponderance of binge/purge type eating disorders in women. People with a comorbid binge/purge type eating disorder reported more days gambling, gambling-related cognitive distortions, impulsivity, suicidality, and other current psychiatric comorbidities including addictive behaviours. These findings suggest that binge/purge type eating disorders in people seeking treatment for gambling may be more common than previously believed. Furthermore, the increased psychopathology among people with binge/purge type eating disorder and gambling disorder identify vulnerabilities of this dual-diagnosed population that may require clinical attention.
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Affiliation(s)
- Hyoun S Kim
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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Aragay N, Barrios M, Ramirez-Gendrau I, Garcia-Caballero A, Garrido G, Ramos-Grille I, Galindo Y, Martin-Dombrowski J, Vallès V. Impulsivity profiles in pathological slot machine gamblers. Compr Psychiatry 2018; 83:79-83. [PMID: 29625378 DOI: 10.1016/j.comppsych.2018.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/16/2018] [Accepted: 03/17/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION In gambling disorder (GD), impulsivity has been related with severity, treatment outcome and a greater dropout rate. The aim of the study is to obtain an empirical classification of GD patients based on their impulsivity and compare the resulting groups in terms of sociodemographic, clinical and gambling behavior variables. METHODS 126 patients with slot machine GD attending the Pathological Gambling Unit between 2013 and 2016 were included. The UPPS-P Impulsive Behavior Scale was used to assess impulsivity, and the severity of past-year gambling behavior was established with the Screen for Gambling problems questionnaire (NODS). Depression and anxiety symptoms and executive function were also assessed. A two-step cluster analysis was carried out to determine impulsivity profiles. RESULTS According to the UPPS-P data, two clusters were generated. Cluster 1 showed the highest scores on all the UPPS-P subscales, whereas patients from cluster 2 exhibited only high scores on two UPPS-P subscales: Negative Urgency and Lack of premeditation. Additionally, patients on cluster 1 were younger and showed significantly higher scores on the Beck Depression Inventory and on the State-Trait Anxiety Inventory questionnaires, worse emotional regulation and executive functioning, and reported more psychiatric comorbidity compared to patients in cluster 2. With regard to gambling behavior, cluster 1 patients had significantly higher NODS scores and a higher percentage presented active gambling behavior at treatment start than in cluster 2. CONCLUSIONS We found two impulsivity subtypes of slot machine gamblers. Patients with high impulsivity showed more severe gambling behavior, more clinical psychopathology and worse emotional regulation and executive functioning than those with lower levels of impulsivity. These two different clinical profiles may require different therapeutic approaches.
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Affiliation(s)
- Núria Aragay
- Pathological Gambling Unit, Consorci Sanitari de Terrassa, Barcelona, (Spain); Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain).
| | - Maite Barrios
- Quantitative Psychology Unit, Faculty of Psychology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences (Neuro UB), University of Barcelona, Barcelona, Spain
| | - Isabel Ramirez-Gendrau
- Pathological Gambling Unit, Consorci Sanitari de Terrassa, Barcelona, (Spain); Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain)
| | - Anna Garcia-Caballero
- Pathological Gambling Unit, Consorci Sanitari de Terrassa, Barcelona, (Spain); Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain)
| | - Gemma Garrido
- Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain)
| | - Irene Ramos-Grille
- Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain)
| | - Yésika Galindo
- Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain)
| | | | - Vicenç Vallès
- Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain)
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63
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Ronzitti S, Soldini E, Smith N, Clerici M, Bowden-Jones H. Gambling Disorder: Exploring Pre-treatment and In-treatment Dropout Predictors. A UK Study. J Gambl Stud 2018; 33:1277-1292. [PMID: 28332064 DOI: 10.1007/s10899-017-9686-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this study was to identify predictors of treatment dropout in a sample of gamblers attending a specialist clinic for gambling disorder. We analysed data on 846 treatment-seeking pathological gamblers. Firstly, we investigated differences in socio-demographic and clinical variables between treatment completers and pre-treatment dropouts, as well as between treatment completers and during-treatment dropouts. Subsequently, variables were entered into a multinomial logistic regression model to identify significant predictors of pre-treatment and in-treatment dropout. Overall, 44.8% of clients did not complete the treatment: 27.4% dropped out before starting it, while 17.4% dropped out during the treatment. Younger age and use of drugs were associated with pre-treatment dropout, while family history of gambling disorder, a lower PGSI score, and being a smoker were related with in-treatment dropout. Our findings suggest that pre-treatment dropouts differ from in-treatment dropouts, and, thus, further research will benefit from considering these groups separately. In addition, this newly gained knowledge will also be helpful in increasing treatment retention in specific subgroups of problem gamblers.
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Affiliation(s)
- Silvia Ronzitti
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK. .,Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. .,Yale University, 300 George Street, New Haven, CT, USA.
| | - Emiliano Soldini
- Methodology and Statistics Laboratory (LABStat), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Neil Smith
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Department of Mental Health, San Gerardo Hospital, Monza, Italy
| | - Henrietta Bowden-Jones
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK.,Department of Medicine, Imperial College London, London, UK
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Singh PK, Rao VR. Explaining suicide attempt with personality traits of aggression and impulsivity in a high risk tribal population of India. PLoS One 2018; 13:e0192969. [PMID: 29447300 PMCID: PMC5814010 DOI: 10.1371/journal.pone.0192969] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 02/01/2018] [Indexed: 02/05/2023] Open
Abstract
Introduction Suicide is a spectrum of behavior including suicide ideation and suicidal attempt and is undoubtedly the outcome of the interaction of several factors. The role of two main constructs of human nature, aggression and impulsivity, has been discussed broadly in relation to suicide, as endophenotypes or traits of personality, in research and in clinical practice across diagnoses. The objective of our study was to assess impulsive and aggressive behaviors among primitive people of the Idu Mishmi tribe, who are known for high suicide completer and attempter rates. Methods The study group was comprised of 177 unrelated Idu Mishmi participants divided into two sets: 39 suicide attempters and 138 non-attempters. Data on demographic factors and details of suicide attempts were collected. Participants completed a set of instruments for assessment of aggression and impulsivity traits. Results In the Idu Mishimi population we screened (n = 177), 22.03% of the individuals had attempted suicide, a high percentage. The suicide attempters also showed a significant sex difference: 35.9% were male and 64.10% were female (p = .002*). The suicide attempters (A) scored significantly higher than non-attempters (NA) on aggression (A = 23.93,NA = 18.46) and impulsivity (A = 75.53,NA = 71.59, with p value = 0.05). The trait impulsiveness showed a significantly higher difference (F (1, 117) = 7.274) in comparison to aggression (F (1, 117) = 2.647), suggesting a profound role of impulsiveness in suicide attempts in the Idu Mishmi population. Analysis of sub-traits of aggression and impulsivity revealed significant correlations between them. Using different models, multivariate logistic regression implied roles of gender (OR = 1.079 (0.05)) and impulsiveness (OR = 3.355 (0.013)) in suicide attempts. Conclusion Results demonstrate that gender and impulsivity are strong risk factors for suicide attempts in the Idu Mishmi population.
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Affiliation(s)
- Piyoosh Kumar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - V. R. Rao
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
- ICMR Emeritus Medical Scientist, Dept of Genetics, Osmania University, Hyderabad, India
- Honorary Research Professor, Genome Foundation, Hyderabad, India
- * E-mail:
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Harries MD, Redden SA, Leppink EW, Chamberlain SR, Grant JE. Sub-clinical Alcohol Consumption and Gambling Disorder. J Gambl Stud 2017; 33:473-486. [PMID: 27826730 DOI: 10.1007/s10899-016-9649-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
While it is well established that gambling disorder is associated with alcohol use disorder, less is known regarding whether sub-clinical alcohol consumption increases gambling behavior. This study examined the effects of varying levels of alcohol consumption on clinical and cognitive measures. The sample consisted of 572 non-treatment seeking gamblers age 18-29 who were divided into three groups: non-current drinkers, current drinkers who did not qualify for an alcohol use disorder, and those with an alcohol use disorder (AUD). All subjects were assessed on gambling pathology, severity and impulsivity using the Structured Clinical Interview for Gambling Disorder, Yale Brown Obsessive Compulsive Scale for Pathologic Gambling and the Barratt Impulsive Scale-11 and select cognitive tests. In all of the clinical measures, controlling for age, gender and education, the AUD group was significantly more likely than the non-current and current drinkers to be a pathologic gambler and to be impulsive, compulsive and depressed. On cognitive tasks, controlling for age, gender and education, the AUD group had significantly worse strategy use on a spatial working memory task than both other groups. This study suggests that the relationship between alcohol and gambling may only exist when pathology in both alcohol consumption and gambling behavior is present. Examining this relationship with alcohol consumption as a continuous variable would provide additional insight into the potential effects alcohol consumption has on gambling behavior.
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Affiliation(s)
- Michael D Harries
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States.
| | - Sarah A Redden
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States
| | - Eric W Leppink
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States
| | | | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States
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Mallorquí-Bagué N, Fernández-Aranda F, Lozano-Madrid M, Granero R, Mestre-Bach G, Baño M, Pino-Gutiérrez AD, Gómez-Peña M, Aymamí N, Menchón JM, Jiménez-Murcia S. Internet gaming disorder and online gambling disorder: Clinical and personality correlates. J Behav Addict 2017; 6:669-677. [PMID: 29280393 PMCID: PMC6034948 DOI: 10.1556/2006.6.2017.078] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background and aims The recent growth of Internet use has led to an increase of potentially problematic behaviors that can be engaged online, such as online gambling or Internet gaming. The aim of this study is to better conceptualize Internet gaming disorder (IGD) by comparing it with gambling disorder (GD) patients who only gamble online (online GD). Methods A total of 288 adult patients (261 online GD and 27 IGD) completed self-reported questionnaires for exploring psychopathological symptoms, food addiction (FA), and personality traits. Results Both clinical groups presented higher psychopathological scores and less functional personality traits when compared with a normative Spanish population. However, when comparing IGD to online GD, some singularities emerged. First, patients with IGD were younger, more likely single and unemployed, and they also presented lower age of disorder onset. In addition, they displayed lower somatization and depressive scores together with lower prevalence of tobacco use but higher FA scores and higher mean body mass index. Finally, they presented lower novelty seeking and persistence traits. Discussion GD is fully recognized as a behavioral addiction, but IGD has been included in the Appendix of DSM-5 as a behavioral addiction that needs further study. Our findings suggest that IGD and online GD patients share some emotional distress and personality traits, but patients with IGD also display some differential characteristics, namely younger age, lower novelty seeking scores and higher BMI, and FA scores. Conclusions IGD presents some characteristics that are not extensive to online GD. These specificities have potential clinical implications and they need to be further studied.
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Affiliation(s)
- Nuria Mallorquí-Bagué
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Corresponding authors: Susana Jimenez-Murcia; Department of Psychiatry, University Hospital of Bellvitge, Feixa Llarga s/n, 08907, Hospitalet del Llobregat, Barcelona, Spain; Phone: +34 932 60 72 27; Fax: +34 932 60 71 93; E-mail: ; Núria Mallorquí-Bagué; Department of Psychiatry, University Hospital of Bellvitge, Feixa Llarga s/n, 08907, Hospitalet del Llobregat, Barcelona, Spain; Phone: +34 932 60 72 27; Fax: +34 932 60 71 93; E-mail:
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
| | - Marta Baño
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain,Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jimenez-Murcia; Department of Psychiatry, University Hospital of Bellvitge, Feixa Llarga s/n, 08907, Hospitalet del Llobregat, Barcelona, Spain; Phone: +34 932 60 72 27; Fax: +34 932 60 71 93; E-mail: ; Núria Mallorquí-Bagué; Department of Psychiatry, University Hospital of Bellvitge, Feixa Llarga s/n, 08907, Hospitalet del Llobregat, Barcelona, Spain; Phone: +34 932 60 72 27; Fax: +34 932 60 71 93; E-mail:
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Assessing the role of impulsivity in smoking & non-smoking disordered gamblers. Addict Behav 2017; 70:35-41. [PMID: 28189937 DOI: 10.1016/j.addbeh.2017.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/29/2017] [Accepted: 02/02/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Co-morbidity with other addictive behaviors is common in disordered gambling (DG). In particular, tobacco dependence has been found to be among the most prevalent disorders co-morbid with DG. While the extant literature has firmly established the co-occurrence of DG and smoking, there is a paucity of research examining factors that differentiate DGs who smoke from those who do not. OBJECTIVES To address this empirical gap, the current study tested whether dimensions of trait impulsivity as measured by the UPPS-P Impulsive Behavior Scale (positive urgency, negative urgency, lack of premeditation, lack of perseverance, and sensation seeking), discriminated between non-DGs and DGs based on their present smoking status: non-smoker, occasional smoker, and daily smoker. METHODS To this end, 564 community gamblers were recruited through a crowdsourcing platform (Amazon's Mechanical Turk) and completed an online survey, assessing problem gambling severity, tobacco use, and trait impulsivity. RESULTS MANOVA analyses revealed significant main effects for both gambling severity and smoking status groups. Importantly, a significant gambling by smoking interaction was also found. Pairwise comparisons revealed that DGs who were daily smokers scored higher on negative urgency than those who smoked occasionally or not all. Furthermore, among non-DGs, smoking status failed to discriminate between mean scores on negative urgency. No other significant interaction effects were found for the remaining UPPS-P impulsivity facets. CONCLUSIONS Results suggest that individual components of trait impulsivity, and more specifically negative urgency, successfully differentiate DGs who do not smoke, or just smoke occasionally, from DGs who smoke daily. These findings suggest that the degree of trait impulsivity may potentially distinguish between DGs and DGs who are dually addicted to other substances such as tobacco.
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Nautiyal KM, Okuda M, Hen R, Blanco C. Gambling disorder: an integrative review of animal and human studies. Ann N Y Acad Sci 2017; 1394:106-127. [PMID: 28486792 PMCID: PMC5466885 DOI: 10.1111/nyas.13356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/29/2022]
Abstract
Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.
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Affiliation(s)
- Katherine M. Nautiyal
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Mayumi Okuda
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Rene Hen
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Departments of Neuroscience and Pharmacology, Columbia University, New York, New York
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
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Knežević M, Marinković K. Neurodynamic correlates of response inhibition from emerging to mid adulthood. COGNITIVE DEVELOPMENT 2017; 43:106-118. [PMID: 29081593 DOI: 10.1016/j.cogdev.2017.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Response inhibition, a key executive function, continues to develop in early adulthood in parallel with maturational processes of the underlying prefrontal regions known to support it. The current study examined behavioral and neurophysiological correlates of response inhibition during a visual Go/No-Go task in a large sample (N = 120) comprised of participants in their Early 20s (ages 19-21), Mid 20s (ages 23-27), and Early 30s (ages 28-42). The two younger groups had lower accuracy, shorter reaction times, and made more premature responses compared to Early 30s. These impulsive behavioral tendencies were reflected in a delayed N2 latency and reduced P2 and P3 amplitudes for Early 20s compared to Early 30s and were associated with personality traits such as impulsivity in an age-dependent manner. The results suggest that response inhibition may not develop fully before the approximate age of 25, as the refinement of the primarily prefrontal cognitive control network follows a protracted developmental trajectory throughout young adulthood.
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Affiliation(s)
- Martina Knežević
- Psychology Department, Croatian Studies, University of Zagreb, Croatia.,Psychology Department, San Diego State University, San Diego, USA
| | - Ksenija Marinković
- Psychology Department, San Diego State University, San Diego, USA.,Radiology Department, University of California, San Diego, USA
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70
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The unique and common contributions of impulsivity and decision-making strategies among young adult Italian regular gamblers. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.09.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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71
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Ioannidis K, Hook R, Wickham K, Grant JE, Chamberlain SR. Meta-analyses of clinical neuropsychological tests of executive dysfunction and impulsivity in alcohol use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2017; 43:24-43. [PMID: 27712350 PMCID: PMC6462408 DOI: 10.1080/00952990.2016.1206113] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 06/01/2016] [Accepted: 06/22/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Promising models for cognitive rehabilitation in alcohol treatment rest on a more nuanced understanding of the associated impairments in the multifaceted domains of executive functioning (EF) and impulsivity. OBJECTIVES This meta-analysis examined the effects of alcohol on the individual subcomponents of EF and impulsivity in recently detoxified participants, including 1) Inhibition & Self-Regulation, 2) Flexibility & Set Shifting, 3) Planning & Problem Solving, 4) Reasoning & Abstraction, and 5) Verbal Fluency. Impulsivity was further examined through an analysis of motor, cognitive, and decisional subcategories. METHOD Investigators searched, coded, and calculated effect sizes of impairments demonstrated in a broad range of neuropsychological tests for EF. A total of 77 studies were selected covering 48 years of research with a sample size of 5140. RESULTS Findings ranged from a Hedges' g effect size of 0.803 for Inhibition to a Hedges' g of 0.359 for Verbal Fluency. Results also varied for the individual subcategories of Inhibition, including a large effect size for decisional impulsivity (g = 0.817) and cognitive impulsivity (0.860), and a moderate effect size for motor impulsivity (g = 0.529). The Hayling Test, Wisconsin Card Sorting Test, and Iowa Gambling Task were the measures most sensitive for alcohol effects. CONCLUSION Planning, problem solving, and inhibitory abilities are significantly affected by alcohol abuse, with decisional and cognitive forms of impulsivity most impacted. Cognitive remediation targeting these deficits might increase the related functions that mediate the ability to moderate or abstain from alcohol, and so lead to improved treatment results.
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Affiliation(s)
- Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, UK
- Cambridge and Peterborough NHS Foundation Trust, UK
| | - Roxanne Hook
- Department of Psychiatry, University of Cambridge, UK
| | - Katie Wickham
- Department of Psychiatry, University of Cambridge, UK
| | - Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, USA
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, UK
- Cambridge and Peterborough NHS Foundation Trust, UK
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72
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Gori A, Craparo G, Caretti V, Giannini M, Iraci-Sareri G, Bruschi A, Janiri L, Ponti L, Tani F. Impulsivity, alexithymia and dissociation among pathological gamblers in different therapeutic settings: A multisample comparison study. Psychiatry Res 2016; 246:789-795. [PMID: 28029440 DOI: 10.1016/j.psychres.2016.10.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 10/19/2016] [Accepted: 10/22/2016] [Indexed: 11/15/2022]
Abstract
Since many psychopathological traits seem to be related to Gambling Disorder (GD), impulsivity, alexithymia and dissociation could play a central role in gambling behaviors, particularly in pathological gambling. We test this hypothesis in four distinct samples of gamblers, three undergoing different types of treatments and a control group. The study sample consists of 204 subjects (males 87.3%, mean age=47.75 years, SD=12.08) divided into four groups: (1) 59 subjects belonging to an Outpatients Treatment Program in the National Health System (NHS); (2) 60 subjects of an Outpatients Self-Help Group Program; (3) 35 subjects belonging to a Residential Treatment Program (Inpatients Program); and (4) 50 subjects without gambling problems (Control Group). Results show a positive relationship between gambling behaviors, impulsivity and alexithymia, and a negligible link between gambling behaviors and dissociation. Findings also display the presence of higher levels of all these features in pathological gamblers with higher scores on the SOGS, and particularly, in participants attending a Residential Treatment Program (Inpatients Program). This study confirms the hypothesis of the presence of higher levels of impulsivity, alexithymia and dissociation in pathological gamblers with a greater severity and seems to indicate a significant importance of impulsivity and alexithymia in predicting gambling behaviors.
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Affiliation(s)
- Alessio Gori
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy; Department of Education and Psychology, University of Florence, Florence, Italy; New Social Pathologies Research Unit, University of Florence, Florence, Italy; Italian Society of Psychological Assessment (SIPDC), Italy.
| | - Giuseppe Craparo
- Italian Society of Psychological Assessment (SIPDC), Italy; University of Enna "Kore", Enna, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Rome, Italy; Italian Society of Psychological Assessment (SIPDC), Italy
| | - Marco Giannini
- Italian Society of Psychological Assessment (SIPDC), Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Angelo Bruschi
- Institute of Psychiatry and Clinical Psychology, Catholic University of the Sacred Heart, Rome, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Clinical Psychology, Catholic University of the Sacred Heart, Rome, Italy
| | - Lucia Ponti
- New Social Pathologies Research Unit, University of Florence, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
| | - Franca Tani
- New Social Pathologies Research Unit, University of Florence, Florence, Italy; Department of Health Sciences, University of Florence, Florence, Italy
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Comparison of impulsivity in non-problem, at-risk and problem gamblers. Sci Rep 2016; 6:39233. [PMID: 27976705 PMCID: PMC5156948 DOI: 10.1038/srep39233] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/21/2016] [Indexed: 01/15/2023] Open
Abstract
As a non-substance addiction, gambling disorder represents the model for studying the neurobiology of addiction without toxic consequences of chronic drug use. From a neuropsychological perspective, impulsivity is deemed as a potential construct responsible in the onset and development of drug addiction. The objective of this study was to investigate the associations between impulsivity and gambling status in young adults with varying severity of gambling. A sample of 1120 college students, equally divided into non-problem, at-risk and problem gamblers, were administered multiple measures of impulsivity including the UPPSP Impulsive Behaviors Scale (UPPSP), the Barratt Impulsiveness Scale-11 (BIS-11), and the Delay-discounting Test (DDT). Compared with non-problem gamblers, both at-risk gamblers and problem gamblers displayed elevated scores on Negative Urgency, Positive Urgency, Motor Impulsiveness, and Attentional Impulsiveness. Problem gamblers showed higher scores than at-risk gamblers on Positive Urgency. Logistic regression models revealed that only Negative Urgency positively predicted both at-risk gambling and problem gambling compared to non-problem gambling. These results suggest that dimensions of impulsivity may be differentially linked to gambling behavior in young adults, with Negative Urgency putatively identified as an important impulsivity-related marker for the development of gambling disorder, which may provide a better understanding of the pathogenesis.
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