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Ngetich R, Villalba-García C, Soborun Y, Vékony T, Czakó A, Demetrovics Z, Németh D. Learning and memory processes in behavioural addiction: A systematic review. Neurosci Biobehav Rev 2024; 163:105747. [PMID: 38870547 DOI: 10.1016/j.neubiorev.2024.105747] [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: 02/02/2024] [Revised: 05/28/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
Similar to addictive substances, addictive behaviours such as gambling and gaming are associated with maladaptive modulation of key brain areas and functional networks implicated in learning and memory. Therefore, this review sought to understand how different learning and memory processes relate to behavioural addictions and to unravel their underlying neural mechanisms. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched four databases - PsycINFO, PubMed, Scopus, and Web of Science using the agreed-upon search string. Findings suggest altered executive function-dependent learning processes and enhanced habit learning in behavioural addiction. Whereas the relationship between working memory and behavioural addiction is influenced by addiction type, working memory aspect, and task nature. Additionally, long-term memory is incoherent in individuals with addictive behaviours. Consistently, neurophysiological evidence indicates alterations in brain areas and networks implicated in learning and memory processes in behavioural addictions. Overall, the present review argues that, like substance use disorders, alteration in learning and memory processes may underlie the development and maintenance of behavioural addictions.
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Affiliation(s)
- Ronald Ngetich
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | | | - Yanisha Soborun
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Teodóra Vékony
- Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, INSERM, CNRS, Université Claude Bernard Lyon 1, Bron, France; Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
| | - Andrea Czakó
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia.
| | - Dezső Németh
- Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, INSERM, CNRS, Université Claude Bernard Lyon 1, Bron, France; Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain; BML-NAP Research Group, Institute of Psychology, Eötvös Loránd University & Institute of Cognitive Neuroscience and Psychology, HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
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2
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Gori A, Topino E. Problematic Gambling Behavior in a Sample of Gamblers: The Role of Alexithymia, Dissociation Features, and External Locus of Control. J Gambl Stud 2024:10.1007/s10899-024-10322-6. [PMID: 38831237 DOI: 10.1007/s10899-024-10322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2024] [Indexed: 06/05/2024]
Abstract
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.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, Firenze, 50135, Italy.
- Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, Florence, 50122, Italy.
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina 21, Rome, 00193, Italy
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3
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Mestre-Bach G, Granero R, Fernández-Aranda F, Potenza MN, Jiménez-Murcia S. Roles for Alexithymia, Emotion Dysregulation and Personality Features in Gambling Disorder: A Network Analysis. J Gambl Stud 2023; 39:1207-1223. [PMID: 36434175 DOI: 10.1007/s10899-022-10164-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/26/2022]
Abstract
Although there is a growing interest in exploring the specific role of both emotional regulation processes and alexithymia in gambling disorder (GD), evidence remains scarce. In order to delve deeper into the complex interactions between these factors, the present study aimed at exploring a network of the core GD-related features, including GD symptomatology and severity, emotion dysregulation, alexithymia, and personality features. The sample included N = 739 treatment-seeking patients with GD (691 men and 48 women), aged 18-78 years (mean age = 39.2, SD = 13.2). The DSM-5 diagnostic criteria were assessed in, and the South Oaks Gambling Screen, Difficulties in Emotion Regulation Scale (DERS), and Temperament and Character Inventory-Revised were administered to, participants. A network analysis was conducted to reveal inter-relationships between these elements. Three nodes related to emotion dysregulation showed the most critical position in the whole network of the present study: "lack of emotional awareness", "non-acceptance of emotional responses", and "difficulties engaging in goal-directed behaviors". When analyzing emotional dysregulation using the different DERS subscales, two independent clusters were identified. One cluster encompassed alexithymia dimensions ("lack of awareness" and "lack of clarity"), while the other cluster included all other emotion-dysregulation dimensions. Identification of the emotion-dysregulation- and GD-related features with the highest centrality/linkage may be particularly useful for developing valid measurement tools and precise management plans for individuals with GD.
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Affiliation(s)
- Gemma Mestre-Bach
- Universidad Internacional de La Rioja, La Rioja, Spain
- Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain
| | - Roser Granero
- Departament de Psicobiologia i Metodologia de Les Ciències de La Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Department of Neuroscience, Yale University, New Haven, CT, USA.
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
- Connecticut Mental Health Center, New Haven, CT, USA.
- Wu Tsai Institute, Yale University, New Haven, CT, USA.
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
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Macía L, Jauregui P, Herrero M, Iruarrizaga I, Micó V, Lamas J, Estévez A. Sex-comparative study of gambling disorder regarding alexithymia and symptoms of depression, anxiety and hostility. Compr Psychiatry 2023; 122:152364. [PMID: 36682199 DOI: 10.1016/j.comppsych.2023.152364] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/30/2022] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND AIMS Alexithymia and psychological symptomatology have been closely associated with gambling disorder (GD). However, sex differences remain underexplored. This study aims, firstly, to explore the differences between groups (GD and no-GD) and sexes (women vs. men) in alexithymia and psychological symptomatology (depression, anxiety and hostility). Secondly, the relationship between alexithymia and psychological symptomatology was analysed by gambling and sex groups. Thirdly, it examines the moderation role of sex and gambling in the relationship between alexithymia and each psychological symptom. METHOD The sample was composed of 80 people with GD diagnosis and 80 without GD (40 women and 40 men in each group). RESULTS The results showed that alexithymia is positively related to depression, anxiety and hostility, with significantly higher scores in people with GD. Moderation analyses showed a threefold interaction, in which higher alexithymia was related to higher depression for men with GD but not for GD-women. However, in women with GD, depression levels are higher than in people without GD and tend to be more stable over time, despite the lack of effect of alexithymia. CONCLUSIONS These results provide evidence indicating that dysfunctional psychological symptomatology affects people with GD to a greater extent than people without GD, but also that the aetiology and effect of underlying vulnerability factors on gambling is different according to sex. The need of prevention and treatment programmes that consider different psychological aspects depending on sex is reinforced.
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Affiliation(s)
- Laura Macía
- Faculty of Health Sciences, Psychology Department, University of Deusto, 48007 Bilbao, Spain
| | - Paula Jauregui
- Faculty of Health Sciences, Psychology Department, University of Deusto, 48007 Bilbao, Spain
| | - Marta Herrero
- Faculty of Health Sciences, Psychology Department, University of Deusto, 48007 Bilbao, Spain
| | - Iciar Iruarrizaga
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Social Work, Complutense University of Madrid, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Virtu Micó
- Federación Española de Jugadores de Azar Rehabilitados [FEJAR; Spanish Federation of Rehabilitated Gamblers], 03400 Alicante, Spain
| | - Juan Lamas
- Federación Española de Jugadores de Azar Rehabilitados [FEJAR; Spanish Federation of Rehabilitated Gamblers], 03400 Alicante, Spain
| | - Ana Estévez
- Faculty of Health Sciences, Psychology Department, University of Deusto, 48007 Bilbao, Spain.
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5
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Estévez A, Jauregui P, Momeñe J, Etxaburu N, Lopez-Gonzalez H. Hopelessness in gambling disorder: relationship with affect, alexithymia and gambling motives in young adults. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2152468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Ana Estévez
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Paula Jauregui
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Janire Momeñe
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Nerea Etxaburu
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Hibai Lopez-Gonzalez
- Department of Library, Information, and Communication, University of Barcelona, Barcelona, Spain
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Wyckmans F, Banerjee N, Saeremans M, Otto R, Kornreich C, Vanderijst L, Gruson D, Carbone V, Bechara A, Buchanan T, Noël X. The modulation of acute stress on model-free and model-based reinforcement learning in gambling disorder. J Behav Addict 2022; 11:831-844. [PMID: 36112488 PMCID: PMC9872530 DOI: 10.1556/2006.2022.00059] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Experiencing acute stress is common in behavioral addictions such as gambling disorder. Additionally, like most substance-induced addictions, aberrant decision-making wherein a reactive habit-induced response (conceptualized as a Model-free [MF] in reinforcement learning) suppresses a flexible goal-directed response (conceptualized as a Model-based [MB]) is also common in gambling disorder. In the current study we investigated the influence of acute stress on the balance between habitual response and the goal-directed system. METHODS A sample of N = 116 problem gamblers (PG) and healthy controls (HC) performed an acute stress task - the Socially Evaluated Cold pressure task (SECPT) - or a control task. Self-reported stress and salivary cortisol were collected as measures of acute stress. Following the SECPT, participants performed the Two-Step Markov Task to account for the relative contribution of MB and MF strategies. Additionally, verbal working memory and IQ measures were collected to account for their mediating effects on the orchestration between MB/MF and the impact of stress. RESULTS Both groups had comparable baseline and stress-induced cortisol response to the SECPT. Non-stressed PG displayed lower MB learning than HC. MANOVA and regression analyses showed a deleterious effect of stress-induced cortisol response on the orchestration between MB and MF learning in HC but not in PG. These effects remained when controlling for working memory and IQ. DISCUSSION AND CONCLUSIONS We found an abnormal pattern of modulation of stress on the orchestration between MB and MF learning among PG. Several interpretations and future research directions are discussed.
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Affiliation(s)
- Florent Wyckmans
- Psychological Medicine Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Nilosmita Banerjee
- Psychological Medicine Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Mélanie Saeremans
- Psychiatric Institute, Universitary Hospital Brugmann, Brussels, Belgium
| | - Ross Otto
- Department of Psychology, McGill University, Montréal, Canada
| | - Charles Kornreich
- Psychological Medicine Laboratory, Université Libre de Bruxelles, Brussels, Belgium,Psychiatric Institute, Universitary Hospital Brugmann, Brussels, Belgium
| | - Laetitia Vanderijst
- Psychological Medicine Laboratory, Université Libre de Bruxelles, Brussels, Belgium
| | - Damien Gruson
- Department of Laboratory Medicine, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Vincenzo Carbone
- Department of Laboratory Medicine, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Antoine Bechara
- Faculty of Psychology, University of Southern California, Los Angeles, USA
| | - Tony Buchanan
- Department of Psychology, Saint Louis University, USA
| | - Xavier Noël
- Psychological Medicine Laboratory, Université Libre de Bruxelles, Brussels, Belgium,Corresponding author. E-mail:
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7
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Zou AR, Muñoz Lopez DE, Johnson SL, Collins AGE. Impulsivity Relates to Multi-Trial Choice Strategy in Probabilistic Reversal Learning. Front Psychiatry 2022; 13:800290. [PMID: 35360119 PMCID: PMC8964258 DOI: 10.3389/fpsyt.2022.800290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Impulsivity is defined as a trait-like tendency to engage in rash actions that are poorly thought out or expressed in an untimely manner. Previous research has found that impulsivity relates to deficits in decision making, in particular when it necessitates executive control or reward outcomes. Reinforcement learning (RL) relies on the ability to integrate reward or punishment outcomes to make good decisions, and has recently been shown to often recruit executive function; as such, it is unsurprising that impulsivity has been studied in the context of RL. However, how impulsivity relates to the mechanisms of RL remains unclear. We aimed to investigate the relationship between impulsivity and learning in a reward-driven learning task with probabilistic feedback and reversal known to recruit executive function. Based on prior literature in clinical populations, we predicted that higher impulsivity would be associated with poorer performance on the task, driven by more frequent switching following unrewarded outcomes. Our results did not support this prediction, but more advanced, trial-history dependent analyses revealed specific effects of impulsivity on switching behavior following consecutive unrewarded trials. Computational modeling captured group-level behavior, but not impulsivity results. Our results support previous findings highlighting the importance of sensitivity to negative outcomes in understanding how impulsivity relates to learning, but indicate that this may stem from more complex strategies than usually considered in computational models of learning. This should be an important target for future research.
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Affiliation(s)
- Amy R. Zou
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Daniela E. Muñoz Lopez
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
- Institute of Human Development, University of California, Berkeley, Berkeley, CA, United States
| | - Sheri L. Johnson
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Anne G. E. Collins
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
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8
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Alexithymia and Emotion Regulation Strategies in Adolescent Gamblers with and Without At-Risk Profiles. J Gambl Stud 2021; 38:15-29. [PMID: 34250551 PMCID: PMC8866352 DOI: 10.1007/s10899-021-10057-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 11/12/2022]
Abstract
Alexithymia, difficulties in emotion regulation, and negative affect play an important role in adolescents who present pathological gambling. Therefore, the objectives of the present study were, firstly, to analyze the differences between alexithymia, difficulties in emotion regulation, and positive and negative affect in adolescents with and without risk of gambling problems. Secondly, the relationships between all the variables of the study in adolescents with and without risk of problem gambling were analyzed separately. Thirdly, we analyzed the mediating role of positive and negative affect in the relationship between alexithymia and dysfunctional emotion regulation strategies (ERS) in adolescents at risk of gambling problems. The sample was composed of 206 adolescents with ages ranging from 12 to 18 years (M = 15.52; SD = 1.43). They were divided into two groups according to the score obtained in the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA). Thus, 84 were included in the group without risk of gambling problems and 122 in the group at risk of gambling problems. The results obtained revealed higher scores in negative affect and pathological gambling in the group at risk of gambling problems. Likewise, positive relationships between alexithymia, maladaptive emotion regulation strategies (MERS), and affect were found. Mediation analyses showed that difficulties in identifying feelings were indirectly related to greater use of dysfunctional ERS through their relationship with negative affect in at-risk gamblers.
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Abstract
Attachment and alexithymia play a central role in the appearance and persistence of pathological gambling and related comorbid addictive behaviours among adolescents and young adults. The aim of the present study was to explore the differences between problem gamblers and non-problem gamblers in gambling severity, spending, video gaming, alcohol and drugs use, attachment, and alexithymia, as well as the interaction among these variables. The study sample included 560 participants non-problem gamblers (mean age = 15.49 years) and 54 problem gamblers (mean age = 16.43 years). Gambling disorder (SOGS-RA), drugs, alcohol, video games and spending (MULTICAGE CAD-4), attachment (IPPA), and alexithymia (TAS-20) were measured. Student's t, Pearson's r, and multiple mediation analyses were conducted. Problem gamblers scored significantly higher in all substance and non-substance addictive behaviours and alexithymia; as well as significantly lower scores in mother and father attachment scales. Moreover, gambling was negatively associated to father and mother attachment, and positively associated to alexithymia. Finally, alexithymia was found to mediate between parental attachment and gambling, spending, videogame, drug and alcohol abuse, especially in the case of mother attachment. This study demonstrated that adolescent and young adult problem gamblers show higher comorbid addictions than non-problem gamblers, in the same way as higher levels of alexithymia and poorer father attachment. Given that higher comorbidity in early ages is associated with worse prognosis and higher psychopathology in adult life, early detection and treatment purposes becomes essential.
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10
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Impulsivity, Emotion Regulation, Cognitive Distortions and Attentional Bias in a Spanish Sample of Gambling Disorder Patients: Comparison between Online and Land-Based Gambling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094869. [PMID: 34063619 PMCID: PMC8124317 DOI: 10.3390/ijerph18094869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 12/02/2022]
Abstract
Several risk factors have been related to the onset and maintenance of gambling disorder (GD). The aim of this study was to explore the differences in emotion dysregulation, impulsivity, cognitive distortions, and attentional bias between online and land-based gamblers. The sample consisted of 88 treatment-seeking patients from the Behavioral Addictions Unit at the Hospital de la Santa Creu i Sant Pau, Barcelona (Spain). Patients were divided into two groups by considering their main type of gambling, i.e., online (n = 26) and land-based gambling (n = 62). Online gamblers were younger, more often employed, with a higher educational level than land-based gamblers. Regarding the rest of the variables, statistically significant differences were only found in Positive Urgency, one of the UPPS-P subscales, in which the land-based gambling group scored higher than the online gambling group. In this exploratory study, individuals with online and land-based GD phenotypes did not differ either in difficulties in emotion regulation or in attentional and cognitive biases. However, land-based GD patients showed a higher tendency to succumb to strong impulses under the influence of positive emotions. These preliminary findings warrant the need to continue investigating GD phenotypes in larger patient samples.
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11
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Jiménez-Murcia S, Granero R, Giménez M, Del Pino-Gutiérrez A, Mestre-Bach G, Mena-Moreno T, Moragas L, Baño M, Sánchez-González J, de Gracia M, Baenas-Soto I, Contaldo SF, Valenciano-Mendoza E, Mora-Maltas B, López-González H, Menchón JM, Fernández-Aranda F. Contribution of sex on the underlying mechanism of the gambling disorder severity. Sci Rep 2020; 10:18722. [PMID: 33127941 PMCID: PMC7599246 DOI: 10.1038/s41598-020-73806-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/22/2020] [Indexed: 12/19/2022] Open
Abstract
Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients’ sex. A sample of n = 512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients’ sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care.
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Affiliation(s)
- Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain. .,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Barcelona, Spain. .,Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Mónica Giménez
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain.,Ciber Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain.,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Teresa Mena-Moreno
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Jéssica Sánchez-González
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Marta de Gracia
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Isabel Baenas-Soto
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - S Fabrizio Contaldo
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain.,Ciber Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - Hibai López-González
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Barcelona, Spain.,Ciber Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain.,Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, C/Feixa Llarga S/N, C.P. 08907, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, Universitat de Barcelona - UB, L'Hospitalet de Llobregat, Barcelona, Spain.,Psychiatry and Mental Health Group, Neuroscience Program, Institut D'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
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12
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Gambling Problems and Alexithymia: A Systematic Review. Brain Sci 2019; 9:brainsci9080191. [PMID: 31394857 PMCID: PMC6721389 DOI: 10.3390/brainsci9080191] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 11/20/2022] Open
Abstract
Among the factors that are thought to underlie gambling problems, alexithymia has been recognized to contribute to their development. For the first time, we reviewed the literature on the relationship between alexithymia and gambling. A systematic search of literature was run in the major reference databases including PubMed, Cochrane Database for Systematic Review, PsycINFO, Web of Science, Scopus until April 2019. The search produced 182 articles that produced 20 papers included in the review. Fourteen studies were conducted with community samples of pathological gamblers while six studies with clinical samples of disordered gamblers. All studies assessed alexithymia with the Toronto Alexithymia Scale while gambling problems were assessed mostly with the South Oaks Gambling Screen. Alexithymic features were significantly more prevalent in pathological gamblers both at the community and clinical levels, increased symptom severity, and showed interactive mechanisms with personality, psychiatric, and cognitive factors. Alexithymia is likely to associate with gambling as a coping behavior to increase emotional arousal and avoid negative emotions, according to the affect dysregulation model. Further studies are needed to widen the knowledge on this association.
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13
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Sancho M, de Gracia M, Granero R, González-Simarro S, Sánchez I, Fernández-Aranda F, Trujols J, Mallorquí-Bagué N, Mestre-Bach G, Del Pino-Gutiérrez A, Mena-Moreno T, Vintró-Alcaraz C, Steward T, Aymamí N, Gómez-Peña M, Menchón JM, Jiménez-Murcia S. Differences in Emotion Regulation Considering Gender, Age, and Gambling Preferences in a Sample of Gambling Disorder Patients. Front Psychiatry 2019; 10:625. [PMID: 31572231 PMCID: PMC6749049 DOI: 10.3389/fpsyt.2019.00625] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/05/2019] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED Introduction: Impairments in emotion regulation are understood to be a transdiagnostic risk factor of suffering from compulsive and addictive behaviors. The aim of this study was to investigate the role of emotion regulation deficits in gambling disorder and to analyze these differences taking gender, age, and gambling activity preferences into account. METHODS The sample included n = 484 patients seeking treatment for gambling disorder at a specialized outpatient service. Main outcomes were sociodemographic variables, emotion regulation, and gambling severity. RESULTS Differences between sexes were found in non-acceptance of emotions. Older patients obtained higher levels in non-acceptance of emotions, lack of emotion regulation strategies, emotional clarity, and global emotion regulation scores. No differences were found in emotion scores considering gambling preferences (non-strategic versus strategic). Path analysis showed that emotion regulation scores and age had a direct effect on gambling disorder severity, while emotion regulation and gambling preference were not mediational variables in the relationships of gender and age with gambling severity. CONCLUSIONS Emotion regulation impairments differ in patients seeking treatment for gambling problems. Early prevention and intervention programs should incorporate the different dimensions of this process, taking into account clinical phenotypes.
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Affiliation(s)
- Marta Sancho
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Marta de Gracia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Isabel Sánchez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Joan Trujols
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBER Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School of the University of Barcelona, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - José Manuel Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,CIBER Salud Mental (CIBERsam), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
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14
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Clark L, Goudriaan AE. The neuroscience and neuropsychology of gambling and gambling addiction: an introduction to the special issue. INTERNATIONAL GAMBLING STUDIES 2018. [DOI: 10.1080/14459795.2018.1467946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia , Vancouver, Canada
| | - Anna E. Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
- Arkin Mental Health , The Netherlands
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