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Lozano-Madrid M, Granero R, Lucas I, Sánchez I, Sánchez-González J, Gómez-Peña M, Moragas L, Mallorquí-Bagué N, Tapia J, Jiménez-Murcia S, Fernández-Aranda F. Impulsivity and compulsivity in gambling disorder and bulimic spectrum eating disorders: Analysis of neuropsychological profiles and sex differences. Eur Psychiatry 2023; 66:e91. [PMID: 37855168 PMCID: PMC10755579 DOI: 10.1192/j.eurpsy.2023.2458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains. METHODS Using self-reported and neurocognitive measures, we assessed different impulsive-compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls. RESULTS We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs. CONCLUSIONS Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.
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Affiliation(s)
- María Lozano-Madrid
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Isabel Sánchez
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jéssica Sánchez-González
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Nuria Mallorquí-Bagué
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Department of Psychiatry, Hospital de Mataró, Consorci Sanitari del Maresme, Mataró, Spain
| | - Javier Tapia
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, University Hospital of Bellvitge – ICS, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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2
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Guerra RF, Batista IR, Kim HS, Hoexter MQ, Shih MC, Bressan RA, Tavares H. Neuroimaging of Dopamine Transporter Density in the Striatum of Disordered Gamblers. J Gambl Stud 2023; 39:119-136. [PMID: 35099670 DOI: 10.1007/s10899-021-10100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 11/28/2022]
Abstract
The aim of the present research was to add to the growing literature on dopamine and gambling disorder (GD) by assessing whether GD is associated with dopamine transporter (DAT) density in the ventral striatum compared to healthy controls and whether DAT density was associated with key characteristics of GD (e.g., abstinence, craving). In a cross-sectional investigation using single-photon emission computed tomography with a technetium-99m-labeled tropane derivative as a radiotracer with SPECT imaging, fifteen participants with GD and 15 controls (non-gambling individuals, matched for age, gender, handedness, and smoking status) were measured. The GD group completed self-reported questionnaires regarding gambling. Striatal DAT density did not differ between the two groups. Conversely, striatal DAT density correlated significantly with various measures of recent gambling, but not with measures of chronic gambling. Multivariate analysis, adjusted for age and smoking status, showed that DAT density in the left striatum correlated positively with time spent gambling and gambling craving in the last month, whereas DAT density in the right striatum correlated negatively with abstinence self-efficacy. The results suggests that DAT density in the striatum is associated with recent gambling activity and gambling expectation.
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Affiliation(s)
- Renata Faro Guerra
- Gambling Outpatient Unit (RFG, HT), Department & Institute of Psychiatry, Universidade de São Paulo, Ovídio Pires de Campos Street, 783, 3rd floor, São Paulo, Brazil.
| | - Ilza Rosa Batista
- Department of Diagnostic Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Hyoun S Kim
- Addictive Behaviours Laboratory, Department of Psychology, Department & Institute of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Marcelo Queiroz Hoexter
- Gambling Outpatient Unit (RFG, HT), Department & Institute of Psychiatry, Universidade de São Paulo, Ovídio Pires de Campos Street, 783, 3rd floor, São Paulo, Brazil
| | - Ming Chi Shih
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Rodrigo Affonseca Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Hermano Tavares
- Gambling Outpatient Unit (RFG, HT), Department & Institute of Psychiatry, Universidade de São Paulo, Ovídio Pires de Campos Street, 783, 3rd floor, São Paulo, Brazil
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3
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Macía L, Momeñe López J, Macía P, Herrero M, Jauregui P, Iruarrizaga I, Estévez A. Latent classes of eating disorders and addictions by sex: Implication of alexithymia and stressful life events in youths. Front Psychol 2023; 14:1088595. [PMID: 36844334 PMCID: PMC9950640 DOI: 10.3389/fpsyg.2023.1088595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/19/2023] [Indexed: 02/12/2023] Open
Abstract
Introduction Eating disorders (EDs) and behavioural addictions show common psychological vulnerability factors such as alexithymia and stressful life events (SLE). This study aims, firstly, to explore the prevalence and latent profiles of participants based on their risk of suffering EDs, gambling disorder (GD), alcohol and/or drug abuse, and compulsive buying (CB) by sex. Secondly, it aimed to test whether alexithymia and having experienced SLE are associated with group membership. Methods The sample was predominantly drawn from university students and social networks. It was composed of 352 young adults between 18 and 35 years old, of whom 77.8% were women and 22.2% men. Results The results showed that the most prevalent disorders of the sample were alcohol, EDs, CB, drugs and GD, respectively. Moreover, latent class analyses were conducted based on the risk of suffering EDs or addictions by sex. Three main profiles were found: 'Men with addictions', 'Healthy women' and 'Women with EDs'. Finally, differences in SLE and alexithymia levels were tested by latent classes. "Men with addictions" and "Women with EDs" had higher scores on alexithymia and SLE than the group of "Healthy women". However, the group of "Women with EDs" (class 3) reported significantly higher levels of SLE and alexithymia than the other two groups. Discussion and conclusion In conclusion, we discuss the possibility that some vulnerability factors operate generally and transdiagnostically in EDs and addictive disorders. The identification of clinical phenotypes could complement and deepen prediction, prevention and treatment research in clinical settings. The need to take sex and gender differences into account is reinforced.
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Affiliation(s)
- Laura Macía
- Psychology Department, School of Health Sciences, University of Deusto, Bilbao, Spain
| | - Janire Momeñe López
- Psychology Department, School of Health Sciences, University of Deusto, Bilbao, Spain
| | - Patricia Macía
- Department of Basic Psychological Processes and their Development, University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), Donostia-San Sebastián, Spain
| | - Marta Herrero
- Psychology Department, School of Health Sciences, University of Deusto, Bilbao, Spain
| | - Paula Jauregui
- Psychology Department, School of Health Sciences, University of Deusto, Bilbao, Spain
| | - Iciar Iruarrizaga
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Social Work, Complutense University of Madrid, Madrid, Spain
| | - Ana Estévez
- Psychology Department, School of Health Sciences, University of Deusto, Bilbao, Spain,*Correspondence: Ana Estévez, ✉
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Underlying Mechanisms Involved in Gambling Disorder Severity: A Pathway Analysis Considering Genetic, Psychosocial, and Clinical Variables. Nutrients 2023; 15:nu15020418. [PMID: 36678289 PMCID: PMC9864492 DOI: 10.3390/nu15020418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/29/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Gambling Disorder (GD) has a complex etiology that involves biological and environmental aspects. From a genetic perspective, neurotrophic factors (NTFs) polymorphisms have been associated with the risk of developing GD. The aim of this study was to assess the underlying mechanisms implicated in GD severity by considering the direct and mediational relationship between different variables including genetic, psychological, socio-demographic, and clinical factors. To do so, we used genetic variants that were significantly associated with an increased risk for GD and evaluated its relationship with GD severity through pathway analysis. We found that the interaction between these genetic variants and other different biopsychological features predicted a higher severity of GD. On the one hand, the presence of haplotype block 2, interrelated with haplotype block 3, was linked to a more dysfunctional personality profile and a worse psychopathological state, which, in turn, had a direct link with GD severity. On the other hand, having rs3763614 predicted higher general psychopathology and therefore, higher GD severity. The current study described the presence of complex interactions between biopsychosocial variables previously associated with the etiopathogenesis and severity of GD, while also supporting the involvement of genetic variants from the NTF family.
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Valenciano-Mendoza E, Fernández-Aranda F, Granero R, Vintró-Alcaraz C, Mora-Maltas B, Valero-Solís S, Sánchez I, Toro JJD, Gómez-Peña M, Moragas L, Jiménez-Murcia S. Common and differential risk factors behind suicidal behavior in patients with impulsivity-related disorders: The case of bulimic spectrum eating disorders and gambling disorder. J Behav Addict 2022; 11:963-978. [PMID: 36287739 PMCID: PMC9881661 DOI: 10.1556/2006.2022.00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/23/2022] [Accepted: 09/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS Mental disorders with high levels of impulsivity such as bulimic spectrum eating disorders (BSED) and gambling disorder (GD) are associated with high risk of suicidal behavior. The aim of the present study was to identify the common and differential vulnerability factors behind suicide attempts in a sample of patients with BSED compared to patients with GD. METHODS A total of 6,077 adults who sought treatment and met criteria either for BSED (n = 2,391) or GD (n = 3,686) were assessed at a specialized hospital unit. Personality traits, psychopathological symptomatology, lifetime history of suicide attempts and socio-demographic variables were evaluated. RESULTS The prevalence of suicide attempts was higher for BSED patients (26.2%) compared to GD patients (7.1%) being anorexia nervosa (Binge/Purge type) and bulimia nervosa the most affected subtypes. In the predictive model, the transdiagnostic vulnerability factors with the highest contribution to the risk of suicidal behavior both in BSED and GD were unemployment, early age of onset of the disorder, worse psychopathological state, and self-transcendence personality trait. However, specific risk factors for suicidal acts were identified in each disorder: longer duration of the disorder, lower education levels and reward dependence were exclusively associated with BSED while female gender, older age, and higher harm avoidance were associated with GD. DISCUSSION Patients with GD and BSED share certain vulnerability factors although certain factors are exclusive to each disorder. CONCLUSIONS Interventions need to pay special attention to both common and specific vulnerability factors to mitigate the risk of suicidal acts in these disorders.
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Affiliation(s)
- Eduardo Valenciano-Mendoza
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Corresponding author. E-mail:
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jessica Jimenez-de Toro
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Corresponding author. E-mail:
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Solé-Morata N, Baenas I, Etxandi M, Granero R, Forcales SV, Gené M, Barrot C, Gómez-Peña M, Menchón JM, Ramoz N, Gorwood P, Fernández-Aranda F, Jiménez-Murcia S. The role of neurotrophin genes involved in the vulnerability to gambling disorder. Sci Rep 2022; 12:6925. [PMID: 35484167 PMCID: PMC9051155 DOI: 10.1038/s41598-022-10391-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/07/2022] [Indexed: 01/16/2023] Open
Abstract
Evidence about the involvement of genetic factors in the development of gambling disorder (GD) has been assessed. Among studies assessing heritability and biological vulnerability for GD, neurotrophin (NTF) genes have emerged as promising targets, since a growing literature showed a possible link between NTF and addiction-related disorders. Thus, we aimed to explore the role of NTF genes and GD with the hypothesis that some NTF gene polymorphisms could constitute biological risk factors. The sample included 166 patients with GD and 191 healthy controls. 36 single nucleotide polymorphisms (SNPs) from NTFs (NGF, NGFR, NTRK1, BDNF, NTRK2, NTF3, NTRK3, NTF4, CNTF and CNTFR) were selected and genotyped. Linkage disequilibrium (LD) and haplotype constructions were analyzed, in relationship with the presence of GD. Finally, regulatory elements overlapping the identified SNPs variants associated with GD were searched. The between groups comparisons of allele frequencies indicated that 6 SNPs were potentially associated with GD. Single and multiple-marker analyses showed a strong association between both NTF3 and NTRK2 genes, and GD. The present study supports the involvement of the NTF family in the aetiopathogenesis of GD. An altered cross-regulation of different NTF members signalling pathways might be considered as a biological vulnerability factor for GD.
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Affiliation(s)
- Neus Solé-Morata
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain.,Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Mikel Etxandi
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain.,Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Bellaterra, Spain
| | - Sonia V Forcales
- Serra Húnter Programme, Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, University of Barcelona, Hospitalet de Llobregat, 08907, Spain
| | - Manel Gené
- Genetic Lab, Forensic and Legal Medicine Unit, Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Carme Barrot
- Genetic Lab, Forensic and Legal Medicine Unit, Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet del Llobregat, Spain.,Ciber of Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain.,Psychiatry and Mental Health Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet del Llobregat, Spain
| | - Nicolás Ramoz
- Psychiatry and Mental Health Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet del Llobregat, Spain.,Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, Université de Paris, 75014, Paris, France
| | - Philip Gorwood
- Psychiatry and Mental Health Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet del Llobregat, Spain.,Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Team Vulnerability of Psychiatric and Addictive Disorders, Université de Paris, 75014, Paris, France
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain.,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain.,Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet del Llobregat, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital, c/Feixa Llarga S/N, Hospitalet de Llobregat, 08907, Barcelona, Spain. .,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain. .,Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Hospitalet del Llobregat, Spain.
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7
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Lemón L, Fernández-Aranda F, Jiménez-Murcia S, Håkansson A. Eating disorder in gambling disorder: A group with increased psychopathology. J Behav Addict 2021; 10:540-545. [PMID: 34587116 PMCID: PMC8997200 DOI: 10.1556/2006.2021.00060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/29/2021] [Accepted: 08/14/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND AIMS Theoretical background and previous data provide some similarities between problematic gambling and eating behaviors, and a theoretically increased clinical severity in individuals suffering from both conditions. However, large datasets are lacking, and therefore, the present study aimed to study, in a nationwide register material, psychiatric comorbidity, age and gender in gambling disorder (GD) patients with or without eating disorder (ED). METHODS Diagnostic data from a nationwide register were used, including all individuals with a GD diagnosis in specialized health care in Sweden, in the years 2005-2016 (N = 2,099). Patients with GD and an ED diagnosis (n = 57) were compared to GD patients without ED. RESULTS Patients with GD+ED were significantly more likely than other GD patients to also have a diagnosis of drug use disorder, depressive disorders, bipolar disorders, other mood disorder, anxiety disorders, personality disorders, and neuropsychiatric disorders, when controlling for gender. In logistic regression, a comorbid ED in GD was associated with female gender, younger age, depressive disorder and personality disorders. DISCUSSION AND CONCLUSION In nationwide register data, despite the low number of GD+ED patients, GD patients with ED appear to have a more severe psychiatric comorbidity than GD patients without ED. The combined GD+ED conditions may require particular screening and clinical attention, as well as further research in larger and longitudinal studies.
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Affiliation(s)
- Linda Lemón
- Region Skåne, Department of Psychiatry Malmö-Trelleborg, Malmö, Sweden
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anders Håkansson
- Region Skåne, Malmö Addiction Center, Malmö, Sweden,Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund, Sweden,Corresponding author. Tel.: +46 703 13 56 77. E-mail:
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8
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Clinical Features of Gambling Disorder Patients with and Without Food Addiction: Gender-Related Considerations. J Gambl Stud 2021; 38:843-862. [PMID: 34585341 DOI: 10.1007/s10899-021-10071-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
Although food addiction (FA) is a debated condition and it is not currently recognized as a formal diagnosis, it shares features with other addictions, such as gambling disorder (GD). However, the prevalence of FA in GD and the clinical correlates are incompletely understood, especially within women versus men. To investigate FA in patients presenting with GD. The sample included 867 patients diagnosed with GD (798 males and 69 females) attending a specialized behavioral addictions unit. FA was observed in 8.3% of GD patients (18.8% of women, 7.4% of men). More psychopathology and harm avoidance, greater body mass indices and less self-directedness and cooperativeness were associated with FA. In women, FA was associated with a longer GD duration. In men, FA was associated with earlier GD onset, greater GD and problematic alcohol use severities. Among patients with GD, FA was associated with more psychopathology and gambling patterns suggestive of more protracted or severe GD. Screening for and addressing FA condition in patients with GD may help optimize preventive and therapeutic approaches. Future studies should consider testing guidelines to improve healthy eating habits, increase physical exercise and better manage stress and other negative emotions in order to target FA in GD.
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Tabri N, Werner KM, Milyavskaya M, Wohl MJA. Perfectionism predicts disordered eating and gambling via focused self-concept among those high in erroneous beliefs about their disordered behavior. J Behav Addict 2021; 10:524-533. [PMID: 34564064 PMCID: PMC8997204 DOI: 10.1556/2006.2021.00068] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/28/2021] [Accepted: 09/01/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND AIMS Perfectionism, a focused self-concept, and erroneous beliefs have been implicated in the development and maintenance of various disordered behaviors. However, researchers have yet to examine how these factors combine to explain different disordered behaviors. Herein, we addressed this gap and hypothesized a moderated-mediation model whereby perfectionism fosters the development of disordered behaviors through a focused self-concept. Critically, the effect of a focused self-concept on disordered behaviors is specific to people with erroneous beliefs about their disordered behaviors. The model was tested in the contexts of disordered gambling and disordered eating, particularly dietary restraint. METHOD In Study 1, participants were community members who gamble (N = 259). In Study 2, participants were university women (N = 219). In both studies, participants completed self-report measures of all constructs that are both reliable and valid. RESULTS In Study 1, as expected, there was a positive association between perfectionism and disordered gambling, which was mediated by financially focused self-concept. This mediation was only observed among participants who scored high on illusion of control and belief in luck. Likewise, in Study 2, there was a positive association between perfectionism and dietary restraint, which was mediated by appearance focused self-concept. The mediation effect was only observed among participants who believed that maladaptive dietary restraint behaviors were safe and efficacious. DISCUSSION AND CONCLUSIONS The findings support the transdiagnostic utility of our model, which may help explain an array of disordered behaviors, including other addictive behaviors as well as behaviors that involve rigid adherence to rules and control.
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Affiliation(s)
- Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, ON, Canada,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, ON, Canada,Corresponding author. E-mail:
| | | | - Marina Milyavskaya
- Department of Psychology, Carleton University, Ottawa, ON, Canada,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, ON, Canada
| | - Michael J. A. Wohl
- Department of Psychology, Carleton University, Ottawa, ON, Canada,Mental Health and Well-being Research and Training Hub, Carleton University, Ottawa, ON, Canada
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10
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Estévez A, Jauregui P, Lopez-Gonzalez H, Macia L, López N, Zamora L, Onaindia J, Granero R, Mestre-Bach G, Steward T, Fernández-Aranda F, Gómez-Peña M, Moragas L, Mena-Moreno T, Lozano-Madrid M, Del Pino-Gutiérrez A, Codina E, Testa G, Vintró-Alcaraz C, Agüera Z, Munguía L, Baenas I, Valenciano-Mendoza E, Mora-Maltas B, Menchón JM, Jiménez-Murcia S. Exploring the Predictive Value of Gambling Motives, Cognitive Distortions, and Materialism on Problem Gambling Severity in Adolescents and Young Adults. J Gambl Stud 2021; 37:643-661. [PMID: 32809101 DOI: 10.1007/s10899-020-09972-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gambling motives and cognitive distortions are thought to be associated because both coping and financial motives to gamble appear to be predictors of gambling related cognitive distortions. Therefore, there is an argument to be made that gambling motives, cognitive distortions, and materialism share common attributes and might be related to problem gambling severity. The present paper aims to examine the relationship between these three variables, both in a clinical and community setting, to see if they can predict gambling severity. A sample of 250 participants from the general population and 31 participants from the clinical population was recruited. The results showed that the clinical sample scored higher on gambling severity, cognitive distortions, materialism, and gambling motives. It also showed that low scores in enhancement motives and higher scores in social motives and gambling related cognitions predicted gambling severity in older gamblers, whereas for younger patients, gambling severity was best predicted by higher scores in materialism and coping motives, and lower scores for enhancement and social motives. In the community sample, gambling severity correlated with gambling related cognitive distortions and with gambling motives (except for social and coping motives within the women subsample). These results testify to the importance of materialism, cognitive distortions, and gambling motives as risk factors for problem gambling both in community and clinical samples.
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Affiliation(s)
- Ana Estévez
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Paula Jauregui
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Hibai Lopez-Gonzalez
- Psychology Department, University of Deusto, Bilbao, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Macia
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Naiara López
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Leire Zamora
- Psychology Department, University of Deusto, Bilbao, Spain
| | | | - Roser Granero
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Universidad Internacional de La Rioja, Logroño, La Rioja, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Departament d'Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d'Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Giulia Testa
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain
- Departament d'Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d'Infermeria, Universitat de Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga S/N, 08907, Hospitalet de Llobregat, Barcelona, Spain.
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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11
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A Comparison of Gambling-Related Cognitions and Behaviors in Gamblers from the United States and Spain. J Gambl Stud 2021; 37:319-333. [PMID: 32772214 DOI: 10.1007/s10899-020-09971-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Few studies have compared the clinical characteristics of gambling disorder (GD) from a cross-cultural perspective. In the present study, we aimed to examine differences in gambling-related cognitions, gambling preferences, GD severity and other clinical and sociodemographic variables in individuals with GD in the United States and Spain. Two groups of participants with GD (from the United States of America (US; n = 109) and Spain (n = 243) were compared using the South Oaks gambling screen and the gambling-related cognitions scale. In Spain, the prevalence of participants who reported only non-strategic gambling preferences was higher, whereas in the US, participants tended to engage in a wider breadth of gambling activities. Moreover, Spanish participants reported higher GD severity, while participants in the US endorsed greater gambling-related cognitions. Our findings suggest that there may jurisdictional or cultural differences in terms of gambling-related cognitions, gambling preferences, and GD severity levels among individuals in the US versus Spain. These differences, which may reflect cultural regulatory or other factors, should be investigated further, and considered when developing and implementing interventions for GD.
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12
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Munguía L, Jiménez-Murcia S, Granero R, Baenas I, Agüera Z, Sánchez I, Codina E, del Pino-Gutiérrez A, Testa G, Treasure J, Fernández-Aranda F. Emotional regulation in eating disorders and gambling disorder: A transdiagnostic approach. J Behav Addict 2021; 10:508-523. [PMID: 33784249 PMCID: PMC8997225 DOI: 10.1556/2006.2021.00017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/04/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Difficulties in Emotion Regulation (ER) are related to the etiology and maintenance of several psychological disorders, including Eating Disorders (ED) and Gambling Disorder (GD). This study explored the existence of latent empirical groups between both disorders, based on ER difficulties and considering a set of indicators of personality traits, the severity of the disorder, and psychopathological distress. METHODS The sample included 1,288 female and male participants, diagnosed with ED (n = 906) and GD (n = 382). Two-step clustering was used for the empirical classification, while analysis of variance and chi-square tests were used for the comparison between the latent groups. RESULTS Three empirical groups were identified, from the most disturbed ER profile (Subgroup 1) to the most functional (Subgroup 3). The ER state showed a linear relationship with the severity of each disorder and the psychopathological state. Different personality traits were found to be related to the level of emotion dysregulation. DISCUSSION AND CONCLUSION In this study, three distinct empirical groups based on ER were identified across ED and GD, suggesting that ER is a transdiagnostic construct. These findings may lead to the development of common treatment strategies and more tailored approaches.
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Affiliation(s)
- Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Roser Granero
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, 08193Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, 08907Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
- Department of Public Health, Mental Health and Maternal-Child Nursing, School of Nursing, University of Barcelona, 08907Barcelona, Spain
| | - Giulia Testa
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 08907Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, 08907Barcelona, Spain
- Ciber Physiopathology, Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, 08907Barcelona, Spain
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13
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Jiménez-Murcia S, Giménez M, Granero R, López-González H, Gómez-Peña M, Moragas L, Baenas I, Del Pino-Gutiérrez A, Codina E, Mena-Moreno T, Valenciano-Mendoza E, Mora-Maltas B, Valero-Solís S, Rivas-Pérez S, Guillén-Guzmán E, Menchón JM, Fernández-Aranda F. Psychopathogical status and personality correlates of problem gambling severity in sports bettors undergoing treatment for gambling disorder. J Behav Addict 2021; 10:422-434. [PMID: 33683220 PMCID: PMC8997230 DOI: 10.1556/2006.2020.00101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/03/2020] [Accepted: 12/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Sports betting has been barely explored independently from other gambling behaviors. Little evidence is available regarding the factors affecting its severity in a clinical sample. The current study explores new determinants for sports betting severity in Spain by the inclusion of psychopathological distress and personality factors. METHODS A sample of 352 Spanish sports bettors undergoing treatment for gambling disorder was recruited. Multiple regression models were used to evaluate the effects of sociodemographic variables, the age of onset of gambling behavior, the global psychopathological distress (SCL-90R GSI) and the personality profile (TCI-R) on sports betting severity and their influence over frequency (bets per episode) and debts due to gambling. RESULTS We found that older age, higher psychopathological distress, lower self-directedness level, and higher novelty seeking level were predictors of gambling severity in Spanish sports bettors. The highest betting frequency was found in men, with the lowest education levels but the highest social status, the highest psychopathological distress, reward dependence score, and self-transcendence trait and the lowest persistence score. Debts were also associated to higher score in cooperativeness as well as older age. DISCUSSION AND CONCLUSIONS Our findings call for further exploration of factors affecting sports betting severity regarded as a separate gambling entity subtype, as some of the traditional factors typically found in gamblers do not apply to sports bettors or apply inversely in our country. Consequently, sports bettors might deserve specific clinical approaches to tackle the singularities of their gambling behavior.
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Affiliation(s)
- Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mónica Giménez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, 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
| | - Hibai López-González
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Isabel Baenas
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Sandra Rivas-Pérez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Elías Guillén-Guzmán
- Departament of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic Barcelona, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Jiménez-Murcia S, Giménez M, Granero R, Masuet-Aumatell C, Ramón JM, Agüero F, Morchón S, Moragas L, Baenas I, del Pino-Gutierrez A, Codina E, Valenciano-Mendoza E, Mora-Maltas B, Valero-Solís S, Etxandi M, Guillen-Guzmán E, Menchón JM, Fernández-Aranda F. Gambling disorder seeking treatment patients and tobacco use in relation to clinical profiles. Addict Behav 2021; 114:106723. [PMID: 33203595 DOI: 10.1016/j.addbeh.2020.106723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/05/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Tobacco smoking and gambling disorder (GD) often co-occur. However, few studies have assessed the extent to which cigarette smoking may serve to classify and/or better define GD behaviour profiles. METHODS Among a large sample of n = 3,652 consecutive treatment-seeking patients with GD (91% men). Smokers were compared to non-smokers across different sociodemographic, clinical, psychopathological and personality variables. The effect sizes for the means and the proportion differences between the groups were estimated. An evaluation of the smoking changes over the last 15 years was also performed. RESULTS From the total sample, 62.4% of gamblers reported tobacco use. A decreasing linear trend in tobacco use was observed within the studied period, women having a more irregular pattern. The use of tobacco was linked to the use of alcohol and other illegal drugs. Gamblers who smoke, as compared to those who don't, presented lower education levels, lower social position indexes and active employment. They were younger, with an earlier age of onset, shorter duration of the gambling behavior, higher GD severity, more psychological symptoms, higher scores in novelty seeking and lower scores in reward dependence, self-directedness and self-transcendence. CONCLUSIONS Gamblers seeking treatment who smoke display particular social, clinical, psychological, temperamental and character features different from non-smoking gamblers, suggesting that the presence or absence of comorbid smoking condition in GD should always be considered when developing an optimal treatment, as gamblers who smoke might need treatment strategies different from non-smoking gamblers.
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Morris J, Anderson S. An update on eating disorders. BJPSYCH ADVANCES 2021. [DOI: 10.1192/bja.2020.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYEating disorders are heterogeneous disorders characterised by a maladaptive drive to lose weight and, for the most part, by extreme fear of weight gain and overvaluation of thin body image. Calorie restriction, overexercise and purging behaviours put some sufferers at high risk of physical morbidity and mortality. Mental preoccupations interfere with social, professional and general quality of life. Patients’ defensive secrecy and compulsivity can make it hard to diagnose and treat such disorders despite the suffering they involve. Integrated medical and psychiatric intervention can save life and safely improve nutrition. Behavioural support – with family and carer involvement when appropriate – can counter the dysregulation that leads to vicious cycles of restriction–binge–purge, helping patients develop new skills to regulate emotion without weight losing. In the future, exciting developments in neuroimaging, neurosurgery and pharmacology may lead to ways to make the brain more responsive to therapy. Insights into risk factors may also improve preventive strategies in a climate of highly sophisticated international electronic communication.
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16
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Estévez A, Jáuregui P, Lopez-Gonzalez H, Macia L, Granero R, Mestre-Bach G, Fernández-Aranda F, Gómez-Peña M, Moragas L, Mena-Moreno T, Lozano-Madrid M, Del Pino-Gutierrez A, Codina E, Testa G, Vintró-Alcaraz C, Agüera Z, Munguía L, Baenas I, Valenciano-Mendoza E, Mora-Maltas B, Menchón JM, Jiménez-Murcia S. Comorbid behavioral and substance-related addictions in young population with and without gambling disorder. INTERNATIONAL GAMBLING STUDIES 2020. [DOI: 10.1080/14459795.2020.1836250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ana Estévez
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Paula Jáuregui
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Hibai Lopez-Gonzalez
- Psychology Department, University of Deusto, Bilbao, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Macia
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Roser Granero
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Universidad Internacional de La Rioja, Logroño, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical SciencesSchool of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Amparo Del Pino-Gutierrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Giulia Testa
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | | | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical SciencesSchool of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical SciencesSchool of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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Tang KTY, Kim HS, Hodgins DC, McGrath DS, Tavares H. Gambling disorder and comorbid behavioral addictions: Demographic, clinical, and personality correlates. Psychiatry Res 2020; 284:112763. [PMID: 31951870 DOI: 10.1016/j.psychres.2020.112763] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/09/2019] [Accepted: 01/04/2020] [Indexed: 11/15/2022]
Abstract
Gambling disorder (GD) frequently co-occurs with substance use disorders. However, the extent to which GD co-occurs with behavioral addictions (BAs) and the demographic, clinical, and personality correlates of comorbid GD and BA is largely unknown. The aims of the present research were to address this gap among people seeking treatment for GD (N = 458) in São Paulo, Brazil. Structured clinical interviews diagnosed individuals with GD and other psychiatric disorders. The Shorter PROMIS questionnaire was used to identify BAs (work, exercise, food bingeing, sex, and shopping). Questionnaires assessed demographic characteristics, gambling behavior, and personality. Of the total sample, 206 (45.0%) participants met the criteria of having at least one behavioral addiction (GD+BA). The most common comorbid BA was food bingeing (8.1%) with the least common being exercise (3.6%). In a multivariate logistic regression, individuals with GD+BA tended to be younger, and had greater rates of comorbid post-traumatic stress disorder and bulimia nervosa compared to participants who did not present with a comorbid BA. Taken together, individuals with GD+BA present with increased psychopathology. These results may have important implications for the assessment and treatment of individuals with GD and comorbid BAs.
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Affiliation(s)
- Karen T Y Tang
- Department of Psychology & Neuroscience, Dalhousie University, Canada.
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, Canada
| | | | | | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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Abstract
Impulsivity is a multidimensional construct. Although gambling disorder (GD) has been associated with high impulsivity, impulsivity across multiple domains has not been thoroughly investigated in this population. We first aimed to examine whether associations between three facets of impulsivity (response impulsivity, choice impulsivity and impulsive tendency) varied between GD patients and healthy controls (HC). We next aimed to evaluate relationships between these three types of impulsivity, as proposed by theoretical models of impulsivity, and their associations with GD severity. The sample included 97 treatment-seeking adult men with GD, diagnosed according to DSM-5 criteria, and 32 male HCs recruited from the general population. Greater impulsivity in all three domains was found in men with GD in comparison to men without GD. Associations between impulsivity facets were found in both groups, with response impulsivity being the only domain associated with GD severity. Our findings confirm that multiple domains of impulsivity are relevant in GD. Future studies should examine the extent to which treatments aimed at targeting specific aspects of impulsivity improve outcomes.
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Fernández-Aranda F, Granero R, Mestre-Bach G, Steward T, Müller A, Brand M, Mena-Moreno T, Vintró-Alcaraz C, del Pino-Gutiérrez A, Moragas L, Mallorquí-Bagué N, Aymamí N, Gómez-Peña M, Lozano-Madrid M, Menchón JM, Jiménez-Murcia S. Spanish validation of the pathological buying screener in patients with eating disorder and gambling disorder. J Behav Addict 2019; 8:123-134. [PMID: 30932708 PMCID: PMC7044599 DOI: 10.1556/2006.8.2019.08] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Pathological buying (PB) is a behavioral addiction that presents comorbidity with several psychiatric disorders. Despite the increase in the prevalence estimates of PB, relatively few PB instruments have been developed. Our aim was to assess the psychometric properties of the Spanish version of the pathological buying screener (PBS) and to explore the associations between PB, psychopathology, and personality traits. METHODS A total of 511 participants, including gambling disorder (GD) and eating disorder (ED) patients diagnosed according to DSM-5 criteria, as well as healthy controls (HCs), took part in the study. RESULTS Higher PB prevalence was obtained in ED patients than in the other two study groups (ED 12.5% vs. 1.3% HC and 2.7% GD). Confirmatory factor analysis (CFA) verified the 13-item structure of the PBS, and indexes of convergent and discriminant capacity were estimated. CFA confirmed the structure in two factors (excessive buying behavior and loss of control) with excellent internal consistency (α = .92 and .86, respectively). Good convergent capacity was obtained with external psychopathology and personality measures (positive correlations with novelty seeking and negative associations with self-directedness and harm avoidance were found). Good discriminative capacity to differentiate between the study groups was obtained. DISCUSSION AND CONCLUSIONS This study provides support for the reliability and validity of the Spanish adaptation of the PBS. Female sex, higher impulsivity, and higher psychopathology were associated with PB.
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Affiliation(s)
- Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, 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,Corresponding authors: Susana Jiménez-Murcia, PhD; Head of Gambling Disorder Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Head of ED Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 72 27; Fax: +34 93 260 76 58; E-mail:
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, 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, Barcelona, Spain,Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, 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, Barcelona, 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,Corresponding authors: Susana Jiménez-Murcia, PhD; Head of Gambling Disorder Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Head of ED Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 72 27; Fax: +34 93 260 76 58; E-mail:
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