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Rogier G, Roberti A, Garofalo C, Velotti P. An investigation of spitefulness in violent offenders: Associations with the dark triad and emotion dysregulation. Personal Ment Health 2021; 15:89-99. [PMID: 33047517 DOI: 10.1002/pmh.1495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 08/10/2020] [Accepted: 08/23/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND Spitefulness is the inclination to inflict harm to someone else even at one's own expenses. The development of a self-report measure (the Spitefulness Scale [SS]) has fostered the investigation of the relationships between spitefulness and aggression-related variables. OBJECTIVE The present study aims to investigate the construct of spitefulness in violent offenders. Through a translation/back-translation procedure, the SS was translated into Italian, and its psychometric properties were examined. METHOD A sample of 249 male violent offenders and 172 male community participants filled out the SS, the Self-Report Psychopathy Scale-IV, the Difficulties in Emotion Regulation Scale and the Dirty Dozen Scale. RESULTS Confirmatory factor analysis results supported the unidimensional factor structure of the SS. Further results indicated that the scale had good internal consistency and met criteria for configural invariance, partial weak invariance and partial strong invariance across samples. Correlational analyses evidenced positive and significant associations between the SS scores and measures of the dark triad and emotion dysregulation. The offender sample scored significantly higher than the community sample on the SS. CONCLUSION Results support the internal structure and construct validity of the SS, suggesting its potential utility for the study of the construct of spitefulness in violent offenders. © 2020 John Wiley & Sons, Ltd.
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Affiliation(s)
- Guyonne Rogier
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Alessandra Roberti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Carlo Garofalo
- Department of Developmental Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Patrizia Velotti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Terrone G, Gori A, Topino E, Musetti A, Scarinci A, Guccione C, Caretti V. The Link between Attachment and Gambling in Adolescence: A Multiple Mediation Analysis with Developmental Perspective, Theory of Mind (Friend) and Adaptive Response. J Pers Med 2021; 11:228. [PMID: 33810022 PMCID: PMC8005040 DOI: 10.3390/jpm11030228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: Several studies have supported the evidence that attachment styles are a central factor in adolescent gambling problems. On this theoretical basis, the aim of the present study is to analyze a hypothesized mediation model exploring both the direct and indirect effects of insecure attachment on gambling disorder by investigating the role of the developmental perspective, theory of mind (friend) and adaptive response in that relationship. Method: The sample consists of 178 adolescents who underwent the Measures: South Oaks Gambling Screen-Revised for Adolescents and Friends and Family Interview. Result: The mediation analysis was conducted following Hayes' (2018) procedure, using Model 6. The results showed a significant association between insecure attachment and gambling disorder (β = 0.669; p < 0.001). The findings also highlighted a significant chained mediation model in which insecure attachment negatively influenced the developmental perspective (β = -0.742; p < 0.001), which affected the theory of mind toward one's own best friend (β = 0.352; p < 0.001). Conclusions: The results highlighted a significant role of insecure attachment in predicting the symptomatic expression of gambling among adolescents, specifically impacting the development perspective, theory of mind toward one's best friend and adaptive response to stress, which were linked to each other by a sequential influence. Therefore, our results showed that a poor developmental self-vision predicted a dysfunctional theory of mind toward the best friend. This could hinder the formation of positive peer relationships, which are crucial for the development of one's identity.
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Affiliation(s)
- Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Alessio Gori
- Department of Human Sciences, University of Florence, 50100 Florence, Italy;
| | - Eleonora Topino
- Department of Human Sciences, Lumsa University of Rome, 00185 Rome, Italy; (E.T.); (C.G.); (V.C.)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43121 Parma, Italy;
| | - Alessia Scarinci
- Department of Education Sciences, Psychology, Communication, University of Bari, 70121 Bari, Italy;
| | - Camilla Guccione
- Department of Human Sciences, Lumsa University of Rome, 00185 Rome, Italy; (E.T.); (C.G.); (V.C.)
| | - Vincenzo Caretti
- Department of Human Sciences, Lumsa University of Rome, 00185 Rome, Italy; (E.T.); (C.G.); (V.C.)
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Ünal-Aydın P, Obuća F, Aydın O, Spada MM. The role of metacognitions and emotion recognition in problematic SNS use among adolescents. J Affect Disord 2021; 282:1-8. [PMID: 33387741 DOI: 10.1016/j.jad.2020.12.103] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Problematic social networking sites (SNS) use is associated with important psychological problems among adolescents. Nevertheless, research on the aetiology of problematic SNS use is limited. Our aim was to investigate the role of metacognitions and emotion recognition in predicting problematic SNS use during the late adolescence period. METHODS Eight hundred and sixty-one high school students were recruited for the study. Participants completed the Bergen Social Media Addiction Scale (BSMAS), the Metacognitions Questionnaire for Children (MCQ-C), and the Children's Version of Reading the Mind in the Eyes Test (RMET). RESULTS A stepwise multiple linear regression analysis showed that all subdimensions of metacognitions (positive meta-worry, negative meta-worry, superstition, punishment, and responsibility beliefs, and cognitive monitoring), but not emotion recognition, independently predicted the BSMAS total score controlling for daily SNS use. CONCLUSIONS Our findings indicate that maladaptive metacognitions are associated, independently frequency of daily SNS use, to problematic SNS use among late adolescents. Interventions targeting dysfunctional metacognitions may aid adolescents who suffer from the detrimental effects of problematic SNS use.
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Affiliation(s)
- Pınar Ünal-Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Faruk Obuća
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Orkun Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK.
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Giordano C, Lo Coco G, Salerno L, Di Blasi M. The role of emotion dysregulation in adolescents’ problematic smartphone use: A study on adolescent/parents triads. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2020.106632] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Velotti P, Rogier G, Beomonte Zobel S, Castellano R, Tambelli R. Loneliness, Emotion Dysregulation, and Internalizing Symptoms During Coronavirus Disease 2019: A Structural Equation Modeling Approach. Front Psychiatry 2021; 11:581494. [PMID: 33488417 PMCID: PMC7819957 DOI: 10.3389/fpsyt.2020.581494] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Our study aimed to test the hypotheses that an increased level of loneliness experienced during coronavirus disease 2019 (COVID-19) confinement was predictive of internalizing symptoms and that this pathway was mediated by emotion dysregulation levels. Methods: To reach this aim, we performed an online longitudinal survey recruiting 1,330 participants at Time 1 (at the beginning of the lockdown) and 308 participants at Time 2 (few days before the end of the lockdown). All filled out a set of questionnaires: demographic data, University of California, Los Angeles Loneliness scale, Difficulties in Emotion Regulation Scale-18 items, and Depression Anxiety and Stress Scale-21 items. Hypotheses were tested using structural equation modeling in two steps and controlling for age. First, hypotheses were tested on cross-sectional data. Then, a cross-lagged panel analysis was performed on longitudinal data. Results: Models obtained a good fit and evidenced the predictive role of loneliness levels on the three outcomes (i.e., depression, anxiety, and stress). Moreover, we found that emotion dysregulation levels partially mediated the longitudinal relationship between loneliness and both depression and stress but not between loneliness and anxiety levels. Conclusions: This study points out that a central goal of clinical intervention could be the ability to regulate negative emotional states.
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Affiliation(s)
- Patrizia Velotti
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Rogier G, Beomonte Zobel S, Morganti W, Ponzoni S, Velotti P. Metacognition in gambling disorder: A systematic review and meta-analysis. Addict Behav 2021; 112:106600. [PMID: 32861990 DOI: 10.1016/j.addbeh.2020.106600] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 07/31/2020] [Accepted: 08/01/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In recent literature, abnormalities in the metacognitive domain have been pointed out as psychological variables that may account for a wide range of psychopathologies, including gambling disorder (GD). Considering the growing but scattered nature of the research concerning the relationship between metacognition and GD, a systematic review and meta-analysis of the existing results are required. METHODS We performed a systematic search through five scientific databases for research published till December 10, 2019, following PRISMA guidelines. We also searched grey literature. After removing the redundancy, 16.855 records were screened. RESULTS Unanimously, authors selected 10 articles based on the inclusion criteria. Four of the selected studies evaluated metacognitive abilities towards cognitive performances, mostly considering metacognitive deficits about decision-making, while metacognitive beliefs were assessed by six of the selected articles. Only one study examined metacognitive functioning regarding GD. The meta-analytic procedure was performed on 10 identified studies based on the criteria adopted, which comprised 1.655 individuals. Results showed that the average effect size linking metacognitive dysfunctions and GD was significant and moderated by the instrument used to measure metacognition. CONCLUSIONS The examined line of research is highly heterogeneous owing to the type of operationalization adopted for metacognition. The systematic review also showed a grey area, evidencing the lack of research on metacognitive functions. Results demonstrated by this meta-analysis call for future studies examining the role of metacognitive deficits in GD in order to delineate useful clinical indications.
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Affiliation(s)
- Guyonne Rogier
- Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | | | | | - Sara Ponzoni
- School of Social Sciences, University of Genoa, Italy
| | - Patrizia Velotti
- Faculty of Medicine and Psychology, Sapienza University of Rome, Italy.
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Neophytou K, Theodorou M, Theodorou C, Artemi TF, Panayiotou G. Population Screening of Gambling Behavior: Playing to Escape From Problems May Be a Key Characteristic of At-Risk Players. Front Psychiatry 2021; 12:690210. [PMID: 34539459 PMCID: PMC8440894 DOI: 10.3389/fpsyt.2021.690210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/30/2021] [Indexed: 12/02/2022] Open
Abstract
The increase in gambling availability and the inclusion of gambling disorder as an addiction in DSM-5 highlight the importance of brief screening measures aiming to identify at-risk gamblers. The current study, using a brief telephone survey, assessed demographic characteristics and gambling behaviors in 2,118 adults. Questions were developed based on DSM-5 criteria for Gambling Disorder and common assessment tools. A 7% prevalence of as at-risk gamblers was identified. Male gender, low monthly income, high frequency of gambling behavior, large amounts of money spent, and gambling to escape from everyday problems or for amusement, specifically for men, were found to be the characteristics that can help in the early identification of at-risk gamblers. Gambling for financial gain and as a way to socialize, age, and employment status were not significant predictors of gambling severity. This study shows that the above characteristics can be assessed easily through phone screening of large populations, aiding in prevention practices to reduce the problematic use of gambling activities.
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Affiliation(s)
- Klavdia Neophytou
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Marios Theodorou
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Christiana Theodorou
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Tonia-Flery Artemi
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Georgia Panayiotou
- Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
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Quintero MJ, Navas JF, Perales JC. The associative underpinnings of negative urgency and its role in problematic gambling behavior. Addict Behav 2020; 111:106533. [PMID: 32771795 DOI: 10.1016/j.addbeh.2020.106533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 06/01/2020] [Accepted: 06/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Negative urgency -the tendency to lose control under the influence of strong negative emotions- has been proposed to be a sign of malfunctioning emotion regulation mechanisms, and to contribute to severity and complications of gambling disorder and other externalizing behaviors. AIMS AND METHOD This study is aimed at (1) testing whether negative urgency is linked to resistance to extinction in an emotional associative learning task in a sample of 70 participants, 65 of whom were active gamblers (with emotional pictures as unconditioned stimuli, and color patches as conditioned stimuli [CS]); and (b) exploring the link between these two variables (negative urgency and resistance to emotional extinction) and clinical manifestations of gambling (severity and craving). Mixed-effects generalized models were used to analyze trial-by-trial predictive responses during acquisition and extinction for erotic, disgusting, and gambling-related pictures. RESULTS AND CONCLUSIONS Acquisition of CS-elicited responses remained unaffected by negative urgency, whereas extinction was hampered in individuals with high negative urgency, especially for CSs associated with erotic and gambling-related pictures. Moreover, negative urgency predicted higher craving scores, and these predicted more severe gambling-related symptoms. This finding resonates with the well-known involvement of emotion regulation processes in craving control. However, extinction was not independently related to craving. This lacking effect suggests that negative urgency is a broad construct, and although some of its components are directly related to faulty extinction (and generalized emotion dysregulation), such components are not the same negative urgency shares with difficulties of craving control.
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Linguistic Analysis of Self-Narratives of Patients With Gambling Disorder. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
Abstract
Older subjects are susceptible to develop gambling problems, and researchers have attempted to assess the mechanisms underlying the gambling profile in later life. The objective of this study was to identify the main stressful life events (SLE) across the lifespan which have discriminative capacity for detecting the presence of gambling disorder (GD) in older adults. Data from two independent samples of individuals aged 50+ were analysed: N = 47 patients seeking treatment at a Pathological Gambling Outpatient Unit and N = 361 participants recruited from the general population. Sexual problems (p < 0.001), exposure to domestic violent behaviour (p < 0.001), severe financial problems (p = 0.002), alcohol or drug-related problems (p = 0.004) and extramarital sex (p < 0.001) were related to a higher risk of GD, while getting married (p = 0.005), moving to a new home (p = 0.003) and moving to a new city (p = 0.006) decreased the likelihood of disordered gambling. The accumulated number of SLE was not a predictor of the presence of GD (p = 0.732), but patients who met clinical criteria for GD reported higher concurrence of SLE in time than control individuals (p < 0.001). Empirical research highlights the need to include older age groups in evidence-based policies for gambling prevention, because these individuals are at high risk of onset and/or progression of behavioural addiction-related problems such as GD. The results of this study may be useful for developing reliable screening/diagnostic tools and for planning effective early intervention programmes aimed to reduce the harm related to the onset and evolution of problem gambling in older adults.
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Kildahl N, Hansen S, Brevers D, Skewes J. Individual differences in learning during decision-making may predict specific harms associated with gambling. Addict Behav 2020; 110:106496. [PMID: 32563860 DOI: 10.1016/j.addbeh.2020.106496] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 04/30/2020] [Accepted: 06/01/2020] [Indexed: 01/06/2023]
Abstract
Problem gambling has been linked to impairments in decision-making under uncertainty. Problem gamblers are more likely to favor high-risk, high-reward, and short-term gains over more advantageous choice alternatives, and this preference has been linked to impaired learning about decision outcomes. In this paper we link specific learning processes in decision-making to specific harms related to problem gambling. We asked a group of 140 casual gamblers to 1) perform a canonical decision-making task (the Iowa Gambling Task) online, and 2) to complete a self-report survey (the GamTest) designed to measure self-perceived harm caused by their gambling. We used a reinforcement learning model to explain individual differences in the decision task, and related individuals' model parameters to the specific problem areas reported using the questionnaire. We found that people who learned more from gains than from losses on the task were more likely to report overall gambling problems, and problems specifically related to money. We also found that people whose learning was more driven by the frequency of rewards were more likely to report problems related to the amount of time spent gambling, as well as social problems. We discuss possible psychological and neural processes mediating learning and gambling related harms, and we discuss the relevance of our approach to the diagnosis of problem gambling and its consequences.
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The role of gambling type on gambling motives, cognitive distortions, and gambling severity in gamblers recruited online. PLoS One 2020; 15:e0238978. [PMID: 33022001 PMCID: PMC7537860 DOI: 10.1371/journal.pone.0238978] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 08/27/2020] [Indexed: 11/20/2022] Open
Abstract
The recent literature shows that the type of gambling practiced influences problem gambling. This study was aimed at investigating the factors associated with gambling type, including gambling severity, gambling motives, and cognitive distortions. A total of 291 regular male gamblers (229 skill gamblers and 62 mixed gamblers, i.e., those who play at least one game of chance and one skill game) were recruited online and assessed for gambling severity (South Oaks Gambling Screen), gambling motives (Gambling Motives Questionnaire-Financial), cognitive distortions (Gambling-Related Cognition Scale), and psychological distress (Hospital Anxiety and Depression Scale). After controlling for the number of games played and psychological distress, we found that gambling type was significantly associated with gambling severity. Moreover, controlling for psychological distress showed that gambling type was also significantly associated with coping motives and interpretative bias. First, mixed gamblers had higher severity scores and higher coping motivation than skill gamblers; second, skill gamblers seemed more at risk of developing interpretative bias. Thus, the gamblers presented different psychological, motivational, and cognitive profiles according to gambling type, indicating that different clinical interventions may be relevant. Working on coping motives and anxiety and depression symptoms with an abstinence purpose would be more suitable for mixed gamblers. Indeed, working on these points could lead to the gambler reducing or eventually ceasing gambling, as the need to regulate negative emotions through gambling behavior would fade in parallel. Gambling type, psychological distress, gambling motives, and cognitive distortions should be taken into consideration systematically in clinical interventions of patients with plural and mixed practice of games.
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Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. WITHDRAWN: Emotional regulation in gambling disorder. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Problematic Internet use (PIU), personality profiles and emotion dysregulation in a cohort of young adults: trajectories from risky behaviors to addiction. Psychiatry Res 2020; 289:113036. [PMID: 32450451 DOI: 10.1016/j.psychres.2020.113036] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/03/2023]
Abstract
Problematic Internet Use (PIU) encloses excessive online activities (like video gaming, social media use, web-streaming, pornography viewing, buying). Despite its psychological burden, risk factors related to PIU remain still unclear. In the present study we explored the role of personality traits and emotion dysregulation as potential vulnerability factors for PIU. In a sample of American young adults with different PIU risk levels (established through the Internet Addiction Diagnostic Questionnaire), we administered the Tridimensional Personality Questionnaire (TPQ), the Difficulties in Emotion Regulation Scale (DERS), the Barratt Impulsiveness Scale, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale. PIU participants were more likely to report lower TPQ scores in novelty seeking, harm avoidance and reward dependence. Moreover, DERS total scores significantly differed across PIU-risk groups, along with a progressively higher occurrence of depression, anxiety and impulsivity. These results preliminarily support the hypothesis of PIU as a mainly behavior aimed at 'escaping' from negative affects. Besides confirming the role of some personality traits and emotional dysregulation, we propose the concept of risk-trajectories to monitor and prevent the emergence of PIU. Gaining more insight into PIU vulnerability factors may allow us to establish targeted interventions to cope with emotion dysregulation and negative affects.
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A compensatory model to understand dysfunctional personality traits in problematic gaming: The role of vulnerable narcissism. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109921] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Velotti P, Rogier G. An exploratory study of the role played by hedonic dysregulation in gambling disorder. INTERNATIONAL GAMBLING STUDIES 2020. [DOI: 10.1080/14459795.2020.1784977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Patrizia Velotti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Guyonne Rogier
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
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Abstract
Gambling addiction (GA) is now considered a worldwide health issue. Although the topic of disorder awareness is a central issue in clinical practice, there are few studies examining this dimension in relation to GA. To bridge this gap, we conducted a qualitative study, administering interviews focused on awareness of GA and eliciting narratives of both the disorder and the whole life of participants. We adopted both qualitative and quantitative methods of research, using computer-aided content analysis. We administered to a sample of 15 treatment-seeking gamblers the Psychiatric Interview for Gambling Addiction and performed a qualitative analysis of the text using the T-Lab software. Five main thematic domains and four factors emerged, shedding light on specific aspects underlying the development of and recovery from GA. Specifically, the results suggested that dissociation processes, materialistic thinking and difficulties in social achievement underlie the subjective experience of GA. Moreover, closeness in interpersonal relationships and awareness of the disorder emerged as core features in the process of change. As a whole, the results highlight the specificities of disorder awareness in addicted gamblers. We discuss these results within the context of previous research and suggest clinical implications for the treatment of GA.
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A brief report on dysregulation of positive emotions and impulsivity: Their roles in gambling disorder. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00638-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Mestre-Bach G, Fernández-Aranda F, Jiménez-Murcia S, Potenza MN. Emotional regulation in gambling disorder. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2020.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Orsolini L. Unable to Describe My Feelings and Emotions Without an Addiction: The Interdependency Between Alexithymia and Addictions. Front Psychiatry 2020; 11:543346. [PMID: 33192657 PMCID: PMC7644516 DOI: 10.3389/fpsyt.2020.543346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/21/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy.,Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Decision-making among the narcissistic subtypes: If I can’t benefit, then who should? CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Emotion regulation in emerging adult gamblers and its mediating role with depressive symptomology. J Affect Disord 2019; 258:74-82. [PMID: 31398594 DOI: 10.1016/j.jad.2019.07.078] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/08/2019] [Accepted: 07/29/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in emotion regulation explain the association between problem gambling severity and depression. METHODS A sample of 820 emerging adult gamblers (Mage = 21.14 years-old, SD = 2.90, 50.9% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, levels of anxious/depressive symptomology, and difficulties in emotion regulation. In total, 15.6% and 8.2% of this sample were at moderate or high risk for gambling disorder. RESULTS Results from a linear regression model revealed that difficulties with impulse control positively contributed to problem gambling scores and engagement in goal-directed behavior positively contributed to problem gambling scores, even after accounting for symptoms of depression. Moreover, results from a mediation model revealed that the association between problem gambling and depression was explained by participants' deficits in non-acceptance, goals, strategies, and clarity. LIMITATIONS Limitations include the use of self-report and cross-sectional data making it difficult to infer causality. CONCLUSIONS These findings add to our understanding of the mechanisms that appear to explain for the first time the affective consequences of problem gambling. Enhancing specific dimensions of emotion regulation will allow for tailored interventions among gamblers with depression, ultimately achieving better mental health outcomes.
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Rogier G, Beomonte Zobel S, Velotti P. Pathological personality facets and emotion (dys)regulation in gambling disorder. Scand J Psychol 2019; 61:262-270. [PMID: 31625173 DOI: 10.1111/sjop.12579] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/02/2019] [Indexed: 12/15/2022]
Abstract
A number of researches showed high prevalence of personality disorders among addicted gamblers. However, there are still few studies investigating the role of pathological personality facets in Gambling Disorder (GD). Moreover, the nature of the relationship between GD and pathological personality is not clear. We administered to a group of addicted gamblers (N = 79) and a group of healthy participants (N = 101) a battery of self-report questionnaires encompassing the South Oaks Gambling Screen (SOGS), The Personality Inventory for DSM-V (PID-5), the Difficulties in Emotion Regulation Scale (DERS) and the Emotion Regulation Questionnaire (ERQ). Analyses of variance showed that addicted gamblers, compared to healthy participants, scored higher on most of the subscales of the DERS, on the Suppression Dimension of the ERQ and on the five main domains of the PID-5 whereas they obtained lower scores on the Reappraisal subscale of the ERQ. Moreover, multiple regression analyses indicated that some specific facets of pathological personality, emotion dysregulation and lack of cognitive reappraisal, significantly predict GD's severity. Finally, emotion dysregulation levels and lack of cognitive reappraisal partially mediated the relationship between these and GD's severity. Our results confirmed the central roles played by both pathological personality and deficit in emotion regulation capacities in GD. Specifically, Impulsivity, Lack of Perseverance and Suspiciousness may be important predictors of GD severity. Moreover, emotion dysregulation and lack of adaptive emotion regulation strategies partially explained such relationship. As such, training for emotion regulation abilities appears strategically useful in the treatment of addicted gamblers with pathological personality traits.
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Affiliation(s)
- Guyonne Rogier
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Roma, Italy
| | - Sara Beomonte Zobel
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Roma, Italy
| | - Patrizia Velotti
- Department of Educational Sciences, University of Genoa, Genova, Italy
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Gambling Problems and Alexithymia: A Systematic Review. Brain Sci 2019; 9:brainsci9080191. [PMID: 31394857 PMCID: PMC6721389 DOI: 10.3390/brainsci9080191] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022] Open
Abstract
Among the factors that are thought to underlie gambling problems, alexithymia has been recognized to contribute to their development. For the first time, we reviewed the literature on the relationship between alexithymia and gambling. A systematic search of literature was run in the major reference databases including PubMed, Cochrane Database for Systematic Review, PsycINFO, Web of Science, Scopus until April 2019. The search produced 182 articles that produced 20 papers included in the review. Fourteen studies were conducted with community samples of pathological gamblers while six studies with clinical samples of disordered gamblers. All studies assessed alexithymia with the Toronto Alexithymia Scale while gambling problems were assessed mostly with the South Oaks Gambling Screen. Alexithymic features were significantly more prevalent in pathological gamblers both at the community and clinical levels, increased symptom severity, and showed interactive mechanisms with personality, psychiatric, and cognitive factors. Alexithymia is likely to associate with gambling as a coping behavior to increase emotional arousal and avoid negative emotions, according to the affect dysregulation model. Further studies are needed to widen the knowledge on this association.
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75
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The paradoxical relationship between emotion regulation and gambling-related cognitive biases. PLoS One 2019; 14:e0220668. [PMID: 31381598 PMCID: PMC6681951 DOI: 10.1371/journal.pone.0220668] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background Gambling behavior presents substantial individual variability regarding its severity, manifestations, and psychological correlates. Specifically, differences in emotion regulation, impulsivity, and cognitive distortions have been identified as crucial to describe individual profiles with implications for the prevention, prognosis, and treatment of gambling disorder (GD). Aims and method The aim of the present study was to investigate the associations of gambling-related cognitions (measured according to the GRCS model) with impulsivity (UPPS-P model) and emotion regulation (CERQ model), in a sample of 246 gamblers with different levels of gambling involvement, using mixed-effects modelling to isolate theoretically relevant associations while controlling for the potentially confounding effects of sociodemographic and clinical covariates. Results Affective/motivational dimensions of UPPS-P impulsivity positive urgency and sensation seeking, on the one hand, and CERQ emotion regulation strategies reappraisal, rumination and blaming others, on the other, independently and significantly predicted distorted gambling-related cognitions. Conclusions These results (a) reinforce the ones of previous studies stressing the relevance of emotional and motivational processes in the emergence of gambling-related cognitive distortions; and (b) replicate the seemingly paradoxical finding that gamblers use emotion regulation strategies customarily considered as adaptive (i.e. reappraisal) to strengthen and justify their biased beliefs about gambling outcomes and controllability.
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76
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Abstract
A number of studies have suggested that depressive mood might lead to the development and/or maintenance of a gambling disorder (GD). The pathways by which such relationships are fostered may involve deficits in emotional regulation capacity and dysfunctional coping styles. This study aims to explore the role played by depressive symptomatology and the regulation of positive emotion in GD. We administered the South Oaks Gambling Inventory (SOGS, Lesieur and Blume in Am J Psychiatry 144(9):1184-1188, 1987), the 21-item Depression Anxiety Stress Scale (DASS-21, Lovibond and Lovibond in Manual for the depression anxiety stress scales. Psychology Foundation, Sydney, 1995) and the Kill-joy Thinking subscale of the Ways of Savouring Checklist (WOSC, Bryant and Veroff in Savoring: a new model of positive experience. Lawrence Erlbaum, Mahwah, 2007) to a sample of pathological gamblers (n = 91) and a sample of community participants (n = 105). The pathological gamblers scored higher on the DASS-21 subscales and obtained higher scores on the Kill-joy Thinking subscale of the WOSC compared to the controls. Moreover, the SOGS scores positively correlate with the DASS-21 subscales, and with the Kill-Joy Thinking measure. Finally, it is evident that Kill-joy Thinking fully mediates the relationship between depressive symptomatology and GD severity. Our results further confirm the roles of depression, anxiety and stress in GD. Moreover, this is the first study to explore the mediating role of dampening processes in the relationship between depression and GD. Future lines of research are also discussed.
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77
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Kökönyei G, Kocsel N, Király O, Griffiths MD, Galambos A, Magi A, Paksi B, Demetrovics Z. The Role of Cognitive Emotion Regulation Strategies in Problem Gaming Among Adolescents: A Nationally Representative Survey Study. Front Psychiatry 2019; 10:273. [PMID: 31110482 PMCID: PMC6501698 DOI: 10.3389/fpsyt.2019.00273] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 04/10/2019] [Indexed: 12/18/2022] Open
Abstract
Explanatory theoretical models have proposed an association between problematic online gaming and abilities or strategies in alleviating distress or negative emotions in times of stress as proximal non-gaming-related personality factors. However, there is little research that has targeted how emotion regulation relates to problematic online gaming-especially during adolescence when gaming behavior is most prevalent. In emotion regulation research, there has been a particular emphasis on rumination because it is strongly associated with overall psychopathology. However, it is unknown whether this putatively maladaptive strategy relates to problematic online gaming and whether it is a gender-dependent association. Consequently, the present study examined how emotion regulation strategies, and particularly rumination, related to problem gaming and tested whether gender moderated this relationship in adolescents. In a national representative adolescent sample, 46.9% of the participants (N = 1,646) reported online gaming in the past 12 months and provided information on problematic gaming, and it was these data that were used for further analysis. Their data concerning problematic online gaming and emotion regulation strategies were analyzed, including rumination along with other putatively maladaptive (e.g., catastrophizing) and adaptive (e.g., positive reappraisal) strategies, while controlling for age, gender, and game genre preference. Results of linear regression analyses showed that all the putatively maladaptive emotion regulation strategies (including self-blame, other blame, catastrophizing, and rumination) were positively related to problematic online gaming. Positive reappraisal proved to be a protective factor; it was inversely related to problematic online gaming. In addition, the relationship between rumination and online gaming was moderated by gender (i.e., the relationship was stronger among boys). Based on the results, it is argued that emotion regulation is a useful framework to study problematic online gaming. The present study highlighted that the relative predictive value of rumination for problematic online gaming varied for boys and girls, suggesting that trait rumination might be a gender-specific vulnerability factor for problematic online gaming, but this requires further investigation and replication.
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Affiliation(s)
- Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Natália Kocsel
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mark D. Griffiths
- Psychology Department, Nottingham Trent University, Nottingham, United Kingdom
| | - Attila Galambos
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Anna Magi
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Borbála Paksi
- Institute of Education, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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78
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Barrada JR, Navas JF, Ruiz de Lara CM, Billieux J, Devos G, Perales JC. Reconsidering the roots, structure, and implications of gambling motives: An integrative approach. PLoS One 2019; 14:e0212695. [PMID: 30794642 PMCID: PMC6386301 DOI: 10.1371/journal.pone.0212695] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/07/2019] [Indexed: 11/19/2022] Open
Abstract
Rationale and method Accurately identifying motives to gamble is crucial in the functional analysis of gambling behavior. In this study, a data-driven approach was followed to clarify the factor structure underlying a pool of motives for gambling, selected from the Gambling Motives Questionnaire–Financial (GMQ-F), and the Reasons for Gambling Questionnaire (RGQ), in a sample of regular problem and non-problem gamblers. Additionally, the role of gambling motives in the relationship between root behavioral activation/inhibition systems (BIS/BAS) and gambling severity, frequency, and preferences was explored using structural equation modelling (SEM). Results and conclusions The present study identified Social, Financial, and Fun/thrill-related gambling motives factors, but also a fourth factor in which some positive and negative reinforcement-based motives were grouped into a single and broader Affect regulation factor. This Affect regulation factor shared variance both with BIS and BAS-related measures, and was the only direct predictor of disordered gambling symptoms. The Fun/thrill factor was directly related to frequency of participation in high-arousal, skill-based games, and all factors were related to participation in lower-arousal, chance games (with Social motives negatively predicting both participation in the latter and total severity). In the SEM model, measures of BIS/BAS sensitivity were connected to gambling behavior only through gambling motives. Based on measures of items’ specificity, a shortened Spanish scale (the brief Gambling Motives Inventory, bGMI) is proposed to assess gambling motives in accordance with the observed 4-factor structure.
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Affiliation(s)
- Juan R. Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
| | - Juan F. Navas
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- * E-mail:
| | | | - Joël Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Centre for Excessive Gambling, Lausanne University Hospital, Lausanne, Switzerland
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Gaëtan Devos
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Scientific Research and Publication Cell (CRPS), Le Beau Vallon, Namur, Belgium
| | - José C. Perales
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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79
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Sancho M, de Gracia M, Granero R, González-Simarro S, Sánchez I, Fernández-Aranda F, Trujols J, Mallorquí-Bagué N, Mestre-Bach G, Del Pino-Gutiérrez A, Mena-Moreno T, Vintró-Alcaraz C, Steward T, Aymamí N, Gómez-Peña M, Menchón JM, Jiménez-Murcia S. Differences in Emotion Regulation Considering Gender, Age, and Gambling Preferences in a Sample of Gambling Disorder Patients. Front Psychiatry 2019; 10:625. [PMID: 31572231 PMCID: PMC6749049 DOI: 10.3389/fpsyt.2019.00625] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/05/2019] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED Introduction: Impairments in emotion regulation are understood to be a transdiagnostic risk factor of suffering from compulsive and addictive behaviors. The aim of this study was to investigate the role of emotion regulation deficits in gambling disorder and to analyze these differences taking gender, age, and gambling activity preferences into account. METHODS The sample included n = 484 patients seeking treatment for gambling disorder at a specialized outpatient service. Main outcomes were sociodemographic variables, emotion regulation, and gambling severity. RESULTS Differences between sexes were found in non-acceptance of emotions. Older patients obtained higher levels in non-acceptance of emotions, lack of emotion regulation strategies, emotional clarity, and global emotion regulation scores. No differences were found in emotion scores considering gambling preferences (non-strategic versus strategic). Path analysis showed that emotion regulation scores and age had a direct effect on gambling disorder severity, while emotion regulation and gambling preference were not mediational variables in the relationships of gender and age with gambling severity. CONCLUSIONS Emotion regulation impairments differ in patients seeking treatment for gambling problems. Early prevention and intervention programs should incorporate the different dimensions of this process, taking into account clinical phenotypes.
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Affiliation(s)
- Marta Sancho
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Marta de Gracia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Joan Trujols
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBER Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School of the University of Barcelona, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,CIBER Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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