Metacognition in Pathological Gambling and Its Relationship with Anxious and Depressive Symptomatology

The Mediating Effect of Coping Strategies and Emotion Regulation in the Relationship between Impulsivity, Metacognition, and Eating Disorders

BACKGROUND

Risk factors for eating disorders are multifaceted and complex, so it is crucial to elucidate the role of executive functions, including impulsivity and metacognition, and coping strategies in the severity of eating behaviors. The study aims were threefold: (1) to analyze gender differences in impulsivity, metacognition, coping strategies, emotion regulation, and eating disorders; (2) to examine the correlation between the study variables; and (3) to test the mediating role of coping and emotion-regulation strategies in the relationship between metacognition, impulsivity, and eating disorders.

METHODS

A total of 1076 participants (Mage = 21.78, SD = 5.10; 77.7% women) completed a set of questionnaires. Two mediation analyses were conducted to test the mediating role of coping strategies, including emotion regulation, in the relationship between executive functions (i.e., impulsivity and metacognition) and eating disorders.

RESULTS

Women displayed higher coping strategies, specifically emotional expression, wishful thinking, and social support, whereas men presented greater social withdrawal. Mediational analyses showed a significant association between impulsivity, metacognition, and eating disorders, whose relationship was partially mediated by coping strategies and mainly by emotion regulation.

CONCLUSION

Interventions based on coping strategies and emotion regulation could be a feasible and effective option to deal with eating disorders among the young population.

Problematic Gambling Behavior in a Sample of Gamblers: The Role of Alexithymia, Dissociation Features, and External Locus of Control

Gambling disorder is a severe condition that significantly compromises the lives of those affected. In light of this clinical relevance, the literature on the antecedents of this form of addiction is constant and continually evolving. Consistently with this framework, the present research aimed at investigating the role of some risk factors in gambling disorder, with a specific focus on alexithymia, dissociation, and locus of control. The research involved a sample of 290 participants (183 males and 107 females; Mage = 34.43, SD = 14.65) who practice gambling at least occasionally. They completed an online survey including the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Locus of Control of Behavior. ANOVA and a moderated-mediation model were implemented to analyse the collected data. Results showed that 19.0% of the participants were At Risk and Problem Gamblers, while 27.6% fell into the category of Problematic Gamblers. Problematic Gamblers showed significantly higher levels of alexithymia, dissociation, and external locus of control. Moreover, a significant association between alexithymia and the severity of problematic gambling behaviour was found and was significantly mediated by absorption (a dissociation feature). Furthermore, the external locus of control significantly moderated this indirect effect. The role of gender as a covariate was also investigated. Such findings may offer further insights into the field of clinical research on gambling disorder and may provide useful information for effective clinical practice.

Can you accurately monitor your behaviors while multitasking? The effect of multitasking on metacognition

With the pace of life accelerating, multitasking has become the norm in daily life. According to research, multiple cognitive processes, including numerical reasoning, comprehension, and writing, are negatively affected by multitasking. However, only a few studies have investigated the relationship between multitasking and metacognition. In this study, the effect of multitasking on metacognition was examined using a prospective monitoring paradigm (prediction of subsequent recall performance). In Experiment 1, the participants simultaneously studied word pairs (primary task) and differentiated between different sound pitches (secondary task) and then predicted their performance in a subsequent memory test for the studied word pairs (prospective metacognitive monitoring). The accuracy of metacognitive evaluation with multitasking was then compared with that without multitasking. In Experiment 2, sounds and icons of real-life applications were used to improve the ecological validity of the experiment in the secondary task. The results indicated that multitasking impaired metacognition in both artificial and real-life simulated scenarios. In addition, the participants who engaged in more media multitasking in their daily lives exhibited poorer metacognitive monitoring abilities in single tasks.

Emotion dysregulation and Internet gaming disorder in young people: Mediating effects of negative affect and metacognitions

BACKGROUND

Recent studies have found that emotion dysregulation, negative affect, and metacognitions about online gaming are risk factors for Internet gaming disorder (IGD). However, few studies investigated the mechanisms underlying these interactions. The present study aimed to explore the relationships between emotion dysregulation and IGD, and the mediating effects of negative affect and metacognitions about online gaming.

METHODS

An online survey was conducted with young people (aged 10-24 years) who played video games. 1768 participants were included in this study. Observed variables, including emotion dysregulation, IGD, depression, anxiety, and metacognitions, were measured with self-report scales. Structural equation modeling (SEM) was used to analyze the relationships among the variables.

RESULTS

The results showed that emotion dysregulation positively predicted IGD through a fully mediated model which included the independent mediating effects of negative affect and metacognitions about online gaming and their sequential mediating effect. The model explained 76.1 % of the variance in IGD.

LIMITATIONS

This was a cross-sectional study which could not infer causality.

CONCLUSIONS

This study emphasizes that negative affect and metacognitions about online gaming mediate the effect of emotion dysregulation on IGD; moreover, metacognition may be a proximal factor of IGD. Thus, improving emotional regulation and modifying maladaptive metacognitions in young people may improve the prevention and treatment of IGD.

Cluster Analysis Algorithm in the Analysis of College Students' Mental Health Education

With the rapid development of curricula, a large number of studies are emerging to assist in the development of curricula. But in an information society, in the face of rapid learning and increased life expectancy, students face the pressure not to forget; the mental health status as a result of our curricula is closely related to our learning. The research and application of the integration algorithm plays an important role in the analysis of the mental health education system. The purpose of this work is to study the application analysis algorithm in the students' context. This work applies the integration analysis algorithm to students' mental health analysis and identifies students' mental health problems using the integration analysis algorithm so that students are well informed and guided. Based on the system engineering method, using the data mining clustering method, a detailed analysis and research on the mental health of college students is done. In this work, a method of student behavior analysis and statistical tools are used to collect mental health data to find common features of different groups of students, in order to better visualize and investigate the mental health of these students on a scientific basis. The results of this study are as follows: a general analysis algorithm application on the analysis of students' mental health education system allows for an effective understanding of scientific data. FCM and FCM algorithms based on the density of information entropy characteristics were used to investigate the effect of mental health factors on the results of the study and the practicality of the algorithm used, which provided an effective method for the prevention of student mental problems. Assisting the school in formulating corresponding new methods of early prevention and intervention of college students' psychological disorders will create a good and healthy atmosphere for college students' study and life. The research results provide a reliable basis for managing and cultivating students.

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

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

Modelling the Contribution of Metacognitions, Impulsiveness, and Thought Suppression to Behavioural Addictions in Adolescents

The most common behavioral addictions in adolescents are Internet Gaming Disorder (IGD), Compulsive Sexual Behavior Disorder (CSBD), and Problematic Social Networks Use (PSNU). In the present study, we investigated whether thought suppression and impulsiveness mediate the relationship between metacognitions and these three behavioral addictions (IGD, CSBD and PSNU). In Study 1 (n = 471), we examined whether online gaming thought suppression and impulsiveness mediate the relationship between metacognitions and IGD. In Study 2 (n = 453), we examined whether sex thought suppression and impulsiveness mediate the relationship between metacognitions and CSBD. In Study 3 (n = 1004), we examined whether social media thought suppression and impulsiveness mediate the relationship between metacognitions and PSNU. Results of path analysis indicated, across the three studies, the importance of both thought suppression and impulsiveness as mediators between metacognitions and the three behavioral addictions (IGD, CSBD and PSNU) being investigated. These findings provide an opportunity for therapists as well as educators to gain a better insight into the link between metacognitions, thought suppression, impulsiveness, and behavioral addictions as part of developmental behavior among adolescents.

A systematic review of metacognitions in Internet Gaming Disorder and problematic Internet, smartphone and social networking sites use

Background

The use of new technologies is growing, and some authors have suggested that frequent use might hide a non‐chemical addiction (i.e., technological addiction). Over the last 5 years, several studies investigating the role of metacognitions in technological addictions have been published. We aim to provide the first systematic review focused on this topic, by updating the initial evidence highlighted by a previous systematic review on metacognitions across addictive behaviours (Hamonniere & Varescon, 2018).

Methods

Electronic literature databases (Pubmed, PsychINFO, SCOPUS and Web of Science) were searched to identify studies that examined the relationship between metacognitions and four different technological addictions (Internet Gaming Disorder, IGD; problematic Internet use, PIU; problematic smartphone use, PSU; and problematic social networking sites use, PSNSU).

Results

We found 13 empirical studies published between 2018 and 2021. Positive low to moderate cross‐sectional associations between the four technological addictions and both generic and specific metacognitions were found, in accordance with the metacognitive model of addictive behaviours. Positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, beliefs about the need to control thoughts and a lack of cognitive confidence were associated with IGD, PIU, PSU and PSNSU.

Conclusions

The absence of longitudinal studies prevents us from providing definitive answers about the role of metacognitions in technological addictions. Despite this limitation, interventions that target metacognitions could be beneficial for people presenting with technological addictions.

A Serious Game to Improve Emotion Regulation in Treatment-Seeking Individuals With Gambling Disorder: A Usability Study

Background: Serious games have shown positive results in increasing motivation, adherence to treatment and strengthening the therapeutic alliance in multiple psychiatric disorders. In particular, patients with impulse control disorders and other disorders in which the patient suffers from inhibitory control deficits (e.g., behavioral addictions) have been shown to benefit from serious games. Aim: The aim of this study was to describe the characteristics and to evaluate the usability of a new serious videogame, e-Estesia. This serious videogame was designed to improve emotion regulation in patients with gambling disorder (GD). Preliminary results from a pilot sample are also reported. Method: A pilot sample of 26 patients undergoing treatment for GD was recruited (ranging from 22 to 74 years, mean = 41.2 and SD = 12.9; 80.8% men). Participants used e-Estesia on a tablet, which was connected to a thoracic band that sent heart rate (HR) and heart rate variability (HRV) data to the videogame platform in order to provide biofeedback. The System Usability Scale was completed by patients to determine the usability of e-Estesia. Results and Discussion: e-Estesia performed comparatively well for all the explored groups (i.e., sex, age, and online vs. offline gambling: mean usability score = 83.8, SD = 13.1). Around 84.6% of the patients endorsed that it was easy to use. Female patients with GD presented higher HRV during the use of the serious videogame compared to men.

The role of metacognitions and emotion recognition in problematic SNS use among adolescents

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.

Metacognition in gambling disorder: A systematic review and meta-analysis

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.

The Relationship Between Family Gambling Problems, Other Family Stressors, and Health Indicators in a Large Population-Representative Sample of Australian Adults

PURPOSE

Harms due to excessive gambling can be experienced by gamblers and those close to them. Family gambling problems (FGPs) are currently under-researched, particularly in population-representative samples. This study aimed to identify prevalence, risk factors, and the complex of stressors and health-related consequences associated with FGPs, as well as isolating the impact of FGPs on physical and psychological health problems.

METHODS

We analysed data from the National Health Survey 2011-13, a large (N = 15,475) nationally representative sample of Australian adults. Participants reported on the presence of 14 family stressors (including FGPs), self-assessed health status, and risky health behaviours. Psychological impact was measured by the Kessler Psychological Distress Scale-10, as well as several indicators of the presence of mental health problems.

RESULTS

Overall, 1.7% of households reported a FGP. Interviewees in these households reported three times the number of other stressors than those without a FGP. In addition, they were around eight times more likely to be experiencing other addictions (drug and alcohol related problems) and stressors associated with socially deviant behaviours (trouble with police, abuse or violent crime, and witness to violence). Once age, gender, socioeconomic disadvantage, and other stressors were controlled for, FGPs significantly predicted lower self-assessed health and higher psychological distress.

CONCLUSIONS

FGPs occur within a complex of other addictions and stressors, impacting the quality of life of people close to problem gambling. The findings are discussed in relation to their support for General Strain Theory (Agnew, Criminology 30:47-87, 1992).

Metacognitions and emotion recognition in Internet Gaming Disorder among adolescents

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Metacognitions and emotion recognition predict IGD in early adolescence.

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Re-parenting, building assertiveness skills and metacognitions modification may protect adolescents from IGD.

Internet Gaming Disorder (IGD) is associated with considerable psychological distress in adolescents. However, studies which strive to shed light on the developmental background of IGD are still sparse. We aimed to examine the role of metacognitions and emotion recognition in predicting IGD during the early adolescence period. Four hundred and seventy-seven secondary school students were recruited for the study. Participants completed the Internet Gaming Disorder Test (IGDT), the Metacognitions Questionnaire for Children (MCQ-C), and the Children’s Version of Reading the Mind in the Eye Test (RMET). Correlation analyses indicated that three factors of the MCQ-C (positive meta-worry, negative meta-worry, and superstition, punishment, and responsibility) and its total score were positively correlated with the majority of factors of the IGDT. The negative factor of the RMET was positively correlated with the salience, tolerance, and relapse factors and total score of the IGDT. Daily internet use was positively correlated with all factors of the IGDT and its total score. Hierarchical regression analyses indicated that daily internet use and metacognitions (in different combinations) were significant independent predictors of IGDT factors and its total score, and that the negative factor of the RMET was a significant independent predictor of the salience and tolerance factors of IGDT and its total score. The implications of these findings are discussed.

Parenting styles and metacognitions as predictors of cannabis use

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First study to investigate metacognitions in cannabis use.

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Negative affect, parenting styles and metacognitions were correlated with cannabis use.

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Coercive authoritarian parenting style and cognitive confidence predicted cannabis use.

Metacognitions, the beliefs held about internal mental processes and the strategies aimed at controlling such processes, are known to play a significant role in the development and maintenance of addictive behaviours. Specifically, lack of cognitive confidence and beliefs about the need to control thoughts have been implicated across addictive behaviours. No research to date, though, has explored the role of metacognitions in cannabis use. Research has also shown that an authoritarian parenting style (where a parent uncompromisingly enforces their own ideas regardless of the will of the child) may be correlated with addictive behaviours. However very limited research has investigated the role of parenting styles in cannabis use. In the current study we aimed to investigate the relative contribution of parenting styles and metacognitions to cannabis use. A sample of 85 participants completed a series of online questionnaires, measuring negative affect, parenting styles, metacognitions and cannabis use. Spearman correlations indicated that cannabis use was positively correlated with each of the metacognitions and both permissive and authoritarian parenting styles. Regression analyses demonstrated that a combination of the physically coercive aspects of the authoritarian parental style and lack of cognitive confidence predicted cannabis use when controlling for negative affect. The implications of the current findings are discussed.

Psychometric properties of the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) in alcohol-dependent individuals

Positive and negative metacognitions regarding alcohol effects are related to drinking problems. This study aimed to validate the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) and to assess the relations of metacognitions about alcohol use to alcohol craving and dependence in a clinical sample of males with a DSM diagnosis of alcohol dependence. Three hundred treatment-seeking males with alcohol dependence completed the Alcohol Use Disorders Identification Test (AUDIT), the Alcohol Outcome Expectancy Questionnaire (AOEQ), the Obsessive Compulsive Drinking Scale (OCDS), the Depression Anxiety Stress Scales (DASS-21), and the Persian-translated versions of the PAMS and NAMS. The results showed that similar to original versions of the PAMS and NAMS, the Persian version of the scales had a two-factor structure. Test-retest coefficients over a four-week interval and internal consistency showed good reliability for the Persian-PAMS and Persian-NAMS and their subscales. Predictive validity showed that positive metacognitions about alcohol use were associated with alcohol craving and dependence independent of outcome expectancies about alcohol use. The findings suggest that the Persian-PAMS and Persian-NAMS have appropriate psychometric properties in Iranian males with alcohol dependence. Results also highlight that positive metacognitions may be more related to alcohol craving and dependence relative to outcome expectancies about alcohol use.

Pathological personality facets and emotion (dys)regulation in gambling disorder

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.

Cognitive factors and addiction

The present paper provides a brief review of cognitive factors related to addiction. Five representative cognitive constructs were selected from the current literature. These include the distinction between implicit and explicit cognitions; metacognitions; expectancies; motives; and social norms. For each of these a general overview is provided along with specific findings from selected recent studies. The intention is to provide the reader with a succinct but reasonable view of how each construct is currently studied in relation to the use of alcohol and other substances and to become aware of some of the strengths and limitations corresponding to the study of these constructs.

Differences in Emotion Regulation Considering Gender, Age, and Gambling Preferences in a Sample of Gambling Disorder Patients

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.

Metacognitive beliefs in addictive behaviours: A systematic review

A wide research base has shown the link between metacognitive beliefs and psychopathology and there is currently evidence that elevated levels of maladaptive metacognitive beliefs are present in the majority of psychological disorders. An increasing body of evidence also suggests that metacognitive beliefs may play a role in alcohol use, nicotine use, gambling, online gaming and problematic internet use. This article provides a systematic review of empirical studies that have examined metacognitive beliefs and addictive behaviours. Thirty-eight studies were included, with results showing a significant positive association between metacognitive beliefs and addictive behaviours. These results are consistent with the metacognitive model of addictive behaviour that supports the central role of metacognitive beliefs in the development and maintenance of addictive behaviours. However, our review highlights the paucity of longitudinal and experimental studies, preventing the determination of the causal status of metacognitive beliefs in addictive behaviours. Despite this limitation, the current evidence has important treatment implications because it suggests that interventions that target metacognitive beliefs could be beneficial for people presenting with addictive behaviours.

Chronic cannabis use and attentional bias: Extended attentional capture to cannabis cues

INTRODUCTION

A significant proportion of chronic cannabis users experience occupational, social, and psychological problems thought to reflect, in part, cannabis-related cognitive and emotional attentional biases. The emotional attentional blink (EAB) is a unique test of attentional bias that assesses automatic responses, cue-detection failures, and rapid and temporally extended biases. Using the EAB, we tested users' and non-users' attentional biases and how cannabis exposure correlates with these attentional biases.

METHODS

Forty-eight regular cannabis users and 51 non-users completed demographic, psychological, and cannabis-use reports and two EAB target-detection experiments. Each experiment comprised 160 trials. Each trial included a rapid serial visual presentation of images with one of four types of distractor images (cannabis, generically positive, neutral, or scrambled) preceding the target image. Distractor images were presented 200ms (Lag 2) or 800ms (Lag 8) before the target in Experiment 1 and 200ms (Lag 2) or 500ms (Lag 5) before the target in Experiment 2.

RESULTS

Chronic cannabis users exhibited exaggerated, immediate attentional bias (Lag 2) and exaggerated, extended attentional bias (Lag 5) compared to non-users. The intensity of cannabis-use (grams per week) correlated with more errors at the extended attentional bias durations (Lags 5 and 8).

CONCLUSIONS

Our results represent novel evidence of automatic attentional capture consistent with an exaggerated "wanting" motive in models of addiction. Our unique evidence of temporally extended attentional biases is consistent with attentional disengagement deficits associated with chronic cannabis use.

Conceptualizing gambling disorder with the process model of emotion regulation

Introduction Nowadays, gambling disorder (GD) is a worldwide health issue and there is a growing need to both improve our understanding of this disorder and to tailor specific interventions for its treatment. Moreover, theoretical models and preliminary empirical results suggest that difficulty in regulating emotional states might be involved in GD. However, literature describing clinical and theoretical aspects of emotional dysregulation among pathological gamblers (PGs) shows a lack of systematic description. Objectives We aimed to provide, within an exhaustive theoretical framework of emotion regulation (ER) processing, empirical evidence supporting a conceptual model of GD as an ER affliction. Methods We commented on empirical evidence on the relationship between ER and GD in the light of two main conceptual models of emotion (dys)regulation. Results The results suggest there are actual deficits of ER processing among PGs, manifesting themselves through different ways and in different steps of the ER timeline. In addition, dysregulation of positive emotions may play a central role in GD. From a clinical point of view, we pointed out that deficits in ER might be multiple in nature and an assessment for GD should be accurate to identify the specific components accounting for the development and maintenance of the disorder. It should also orientate the clinician in selecting therapeutic objectives. Conclusions The nature of emotional states that are difficult to regulate might account for the GD severity and indicate the subtype of PGs the patient belongs to. Treatment programs should be tailored on the specificity of PGs.

Exploring the Relationship between Reward and Punishment Sensitivity and Gambling Disorder in a Clinical Sample: A Path Modeling Analysis

Most individuals will gamble during their lifetime, yet only a select few will develop gambling disorder. Gray's Reinforcement Sensitivity Theory holds promise for providing insight into gambling disorder etiology and symptomatology as it ascertains that neurobiological differences in reward and punishment sensitivity play a crucial role in determining an individual's affect and motives. The aim of the study was to assess a mediational pathway, which included patients' sex, personality traits, reward and punishment sensitivity, and gambling-severity variables. The Sensitivity to Punishment and Sensitivity to Reward Questionnaire, the South Oaks Gambling Screen, the Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were administered to a sample of gambling disorder outpatients (N = 831), diagnosed according to DSM-5 criteria, attending a specialized outpatient unit. Sociodemographic variables were also recorded. A structural equation model found that both reward and punishment sensitivity were positively and directly associated with increased gambling severity, sociodemographic variables, and certain personality traits while also revealing a complex mediational role for these dimensions. To this end, our findings suggest that the Sensitivity to Punishment and Sensitivity to Reward Questionnaire could be a useful tool for gaining a better understanding of different gambling disorder phenotypes and developing tailored interventions.

Problem gambling and substance use in patients attending community mental health services

Background and aims Relatively little is known about co-occurring gambling problems and their overlap with other addictive behaviors among individuals attending mental health services. We aimed to determine rates of gambling and substance use problems in patients accessing mental health services in Victoria, Australia. Methods A total of 837 adult patients were surveyed about their gambling and administered standardized screening tools for problem gambling and harmful tobacco, alcohol, and drug use. Prevalence of gambling problems was estimated and regression models used to determine predictors of problem gambling. Results The gambling participation rate was 41.6% [95% CI = 38.2-44.9]. The Problem Gambling Severity Index identified 19.7% [CI = 17.0-22.4] as "non-problem gamblers," 7.2% [CI = 5.4-8.9] as "low-risk" gamblers, 8.4% [CI = 6.5-10.2] as "moderate-risk" gamblers, and 6.3% [CI = 4.7-8.0] as "problem gamblers." One-fifth (21.9%) of the sample and 52.6% of all gamblers were identified as either low-risk, moderate-risk, or problem gamblers (PGs). Patients classified as problem and moderate-risk gamblers had significantly elevated rates of nicotine and illicit drug dependence (p < .001) according to short screening tools. Current diagnosis of drug use (OR = 4.31 [CI = 1.98-9.37]), borderline personality (OR = 2.59 [CI = 1.13-5.94]), bipolar affective (OR = 2.01 [CI = 1.07-3.80]), and psychotic (OR = 1.83 [CI = 1.03-3.25]) disorders were significant predictors of problem gambling. Discussion and conclusions Patients were less likely to gamble, but eight times as likely to be classified as PG, relative to Victoria's adult general population. Elevated rates of harmful substance use among moderate-risk and PG suggest overlapping vulnerability to addictive behaviors. These findings suggest mental health services should embed routine screening into clinical practice, and train clinicians in the management of problem gambling.