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Mora-Maltas B, Baenas I, Etxandi M, Lucas I, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Gómez-Peña M, Moragas L, Del Pino-Gutiérrez A, Tapia J, Diéguez C, Goudriaan AE, Jiménez-Murcia S. Association between endocrine and neuropsychological endophenotypes and gambling disorder severity. Addict Behav 2024; 153:107968. [PMID: 38447412 DOI: 10.1016/j.addbeh.2024.107968] [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: 09/25/2023] [Revised: 01/07/2024] [Accepted: 01/22/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Neurobiological characteristics have been identified regarding the severity of gambling disorder (GD). The aims of this study were: (1) to examine, through a path analysis, whether there was a relationship between neuroendocrine features, potentially mediational GD variables, and GD severity, and (2) to associate neuroendocrine variables, with GD severity-related variables according to gambling preferences. METHODS The sample included 297 outpatients with GD. We analyzed endocrine concentrations of different appetite-related hormones (ghrelin, liver antimicrobial peptide 2 [LEAP-2], leptin, adiponectin), and neuropsychological performance (working memory, cognitive flexibility, inhibition, decision making, premorbid intelligence). Path analysis assessed mechanisms between neuroendocrine features and GD severity, including mediational GD variables (impulsivity traits and gambling-related cognitive distortions). Partial correlations evaluated the associations between neuroendocrine variables, including impulsivity traits, and variables related to GD severity (DSM-5, South Oaks Gambling Screen, illness duration, and gambling-related cognitive distortions). RESULTS Lower adiponectin concentrations predicted greater GD severity, while higher LEAP-2 concentrations predicted more gambling-related cognitive distortions. Likewise, better neuropsychological performance directly predicted GD severity, but worse neuropsychological performance was associated with GD severity through the mediational variables of impulsivity traits and gambling-related cognitive distortions. Also, in non-strategic individuals with GD, poor working memory was associated with gambling expectancies and predictive control. In strategic individuals with GD, poor cognitive flexibility was associated with illusion of control, predictive control, and inability to stop gambling. CONCLUSIONS These results provide updated information about the comprehension of the interaction between neuroendocrine features, clinical variables, and severity of GD. Thus, neurobiological functions seem to be strongly related to GD severity.
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Affiliation(s)
- Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain
| | - Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mikel Etxandi
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Roser Granero
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de 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
| | - Sulay Tovar
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Medical Direction of Ambulatory Processes, South Metropolitan Territorial Management, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Diéguez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Anna E Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de 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; Centre for Psychological Services, University of Barcelona, Spain.
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2
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Johannessen DA, Overå S, Arnevik EA. The role of contextual factors in avenues to recover from gambling disorder: a scoping review. Front Psychol 2024; 15:1247152. [PMID: 38410405 PMCID: PMC10894926 DOI: 10.3389/fpsyg.2024.1247152] [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: 06/26/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Recovery from complex conditions such as gambling disorders (GD) often entail considerable change and require a range of adaptable interventions in the health care system. Outcomes from such avenues to change are influenced by multifarious contextual factors, which are less frequently considered in treatment outcome studies. Accordingly, this scoping review aims to map the level of evidence and explore how contextual factors influence the provision and outcomes of GD interventions. Methods A systematic search in selected health and social science research databases yielded a total of 2.464 unique references. The results were screened in three selection steps-titles (n = 2.464), abstracts (n = 284) and full-text (n = 104). The scoping approach was applied to provide a narrative account of the final included references (n = 34). Results and discussion Findings suggest that the research on GD treatment is in the early stages of development. Additionally, studies on GD interventions are characterized by cultural biases (Region and ethnicity and Gender perspectives), while three key elements are described as successful avenues to recover from GD (Competence, Perception and Utilization). In line with these findings, proposals for future research and treatment designs are made.
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Affiliation(s)
- Dagny Adriaenssen Johannessen
- Department of Social Work, Child Welfare and Social Policy, OsloMet—Oslo Metropolitan University, Oslo, Norway
- Blue Cross East, Oslo, Norway
| | - Stian Overå
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Espen Ajo Arnevik
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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3
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Vintró-Alcaraz C, Mestre-Bach G, Granero R, Gómez-Peña M, Moragas L, Fernández-Aranda F, Potenza MN, Jiménez-Murcia S. Do attention-deficit/hyperactivity symptoms influence treatment outcome in gambling disorder? Compr Psychiatry 2024; 128:152433. [PMID: 37924691 DOI: 10.1016/j.comppsych.2023.152433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/29/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND AND AIMS Numerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD. Therefore, we aimed to explore differences between patients with GD with and without self-reported ADHD symptoms regarding psychopathology, personality, sociodemographic and treatment outcome measures. METHOD This longitudinal study included 170 patients with GD receiving cognitive behavioral therapy. Multiple self-reported instruments were used to assess clinical variables and sociodemographic measures prior to treatment. RESULTS A clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were observed between the two groups. However, patients with self-reported ADHD symptoms experienced more severe relapses (i.e., gambled more money) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention. CONCLUSION Individuals with GD and self-reported symptoms of ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity.
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Affiliation(s)
- Cristina Vintró-Alcaraz
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | - Gemma Mestre-Bach
- Instituto de Transferencia e Investigación, Universidad Internacional de La Rioja, La Rioja, Spain.
| | - Roser Granero
- Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; 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.
| | - Mónica Gómez-Peña
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain.
| | - Laura Moragas
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain.
| | - Fernando Fernández-Aranda
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - 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 and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Marc N Potenza
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA; Yale University School of Medicine, Department of Neuroscience, New Haven, CT, USA; Yale University School of Medicine, Yale Child Study Center, New Haven, CT, USA; Yale University School of Medicine, The National Center on Addiction and Substance Abuse, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA.
| | - Susana Jiménez-Murcia
- Department of Clinical Psychology, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - 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 and Health Sciences, University of Barcelona, Barcelona, Spain.
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4
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Grubbs JB, Chapman H, Milner LA, Floyd CG, Kraus SW. Comorbid psychiatric diagnoses and gaming preferences in US armed forces veterans receiving inpatient treatment for gambling disorder. Addict Behav 2023; 147:107840. [PMID: 37643505 DOI: 10.1016/j.addbeh.2023.107840] [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: 06/02/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
Armed Forces Veterans are uniquely vulnerable to problem gambling and gambling disorder. Even so, research regarding the full clinical profile of veterans with gambling problems lags. Gambling activities vary widely from each other, but most gambling activities can be understood as either strategic (i.e., involving some measure of skill and decision-making as a part of the gambling practice) or non-strategic (i.e., gambling activities that are entirely based on chance). Prior works have found that gamblers that prefer strategic gambling activities and those that prefer nonstrategic gambling activities often differ from each other in key ways, with the two preferences being linked to varying motivations for gambling, varying cognitions about gambling, and the course of gambling disorder. The present work sought to examine how preferences for strategic vs. nonstrategic gambling might be related to psychiatric comorbidities among U.S. Armed Forces Veterans receiving inpatient treatment for Gambling Disorder. Data from U.S. Armed Forces Veterans (N = 401) receiving residential treatment for GD between the years of 2010-2016 were analyzed. Results demonstrated that gamblers that preferred strategic gambling, as opposed to non-strategic gambling, were more likely to be younger, more likely to be men, less likely to have a nicotine use disorder, and less likely to have PTSD. Such findings suggest that gamblers with PTSD are likely to prefer nonstrategic games and may imply a unique vulnerability to gambling problems related to non-strategic gambling among armed forces veterans.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Center on Alcohol, Substance use, And Addictions, University of New Mexico, United States.
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5
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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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6
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Weidberg S, González-Roz A, Castaño Y, Secades-Villa R. Emotion dysregulation in relation to cannabis use and mental health among young adults. Addict Behav 2023; 144:107757. [PMID: 37224581 DOI: 10.1016/j.addbeh.2023.107757] [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: 12/06/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Emotion dysregulation (ED) is a transdiagnostic variable that accounts for the onset and maintenance of mental health disorders. The interplay between ED, cannabis use and mental health has not been appraised in the young adult population and whether there are sex-dependent effects has yet to be examined. This study looked at whether ED mediates the association between past-month cannabis use and mental health, while considering sex as a moderator. METHODS 2,762 (64.2% women) undergraduate Spanish students completed an online battery. Among others, they fulfilled the Depression Anxiety Stress Scale-21 (DASS-21) and the Difficulties in Emotion Regulation Scale (DERS-28). A two-way ANOVA assessed the effects of sex and past-month cannabis use on participants' DASS-21 scores. A set of moderated mediations tested whether the indirect effect of past-month cannabis use on DASS-21 through DERS differed by sex. RESULTS Past-month cannabis female users showed higher levels of depression, anxiety and stress (M = 51.10, SD = 26.72) than did men [(M = 33.76, SD = 20.31); F(1, 2758) = 5.119, p =.024, η2p =.002]. In female young adults only, the effect of past-month cannabis use on mental health was mediated by ED (total score), non-acceptance of emotional responses, lack of emotional control, difficulties in engaging in goal-directed behavior, and lack of emotional clarity (all p's < 0.005) CONCLUSIONS: Findings indicate the importance of considering ED in assessment and intervention practices. Interventions targeting ED may be particularly effective for female young adult cannabis users.
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Affiliation(s)
- Sara Weidberg
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain.
| | - Yasmina Castaño
- Department of Psychology. University of the Balearic Islands. Ctra. Valldemossa, km 7.5, 07122, Palma, Spain
| | - Roberto Secades-Villa
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
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Aloi M, Riccelli C, Piterà F, Notaro M, Curcio V, Pullia L, Sorrentino C, Audino MG, Carcione A, Segura-Garcia C, De Fazio P. Impaired Metacognitive Differentiation, High Difficulty in Controlling Impulses and Non-acceptance of Emotions are Associated With the Severity of Gambling Disorder. J Gambl Stud 2023; 39:1-11. [PMID: 35000052 DOI: 10.1007/s10899-021-10099-y] [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: 05/29/2021] [Revised: 12/01/2021] [Accepted: 12/10/2021] [Indexed: 11/25/2022]
Abstract
The role of metacognition in gambling disorder (GD) is underexplored. To date, only two studies have investigated the role of metacognitive functioning, but among the adolescent population. The first aim of the current research was to assess and compare adult male gamblers with healthy controls (HCs) in relation to metacognition, impulsivity and emotional dysregulation. The second aim was to identify the variables among metacognition, impulsivity and emotional dysregulation associated with the severity of GD by means of linear regression.A total of 116 adult males (58 with GD and 58 HCs) completed self-report questionnaires on gambling severity, metacognition, emotional dysregulation and impulsivity. A linear regression analysis was run to assess the variables associated with gambling severity.Patients with GD exhibited more impaired scores than HCs in all the psychopathological dimensions investigated. More interestingly, gambling severity was significantly associated with metacognitive differentiation/decentration, difficulty in controlling impulses and non-acceptance of negative emotions.According to our results, the severity of gambling is associated with impaired metacognitive differentiation, high difficulty in controlling impulses and non-acceptance of negative emotions, and these findings can lead to new treatment implications. Interventions focused on metacognition and emotion regulation could help patients with GD to avoid maladaptive strategies such as behavioural addictions and, more specifically, to manage their own emotions. This type of treatment could help gamblers to become more aware of their internal state and learn strategies for adaptively managing emotions through functional metacognitive differentiation.
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Affiliation(s)
- Matteo Aloi
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Claudia Riccelli
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Francesco Piterà
- Therapeutic Community "Centro Calabrese di Solidarietà", Catanzaro, Italy
| | - Mariarita Notaro
- Addiction Service, Azienda Sanitaria Provinciale, Catanzaro, Italy
| | - Vittoria Curcio
- Therapeutic Community "Progetto Sud - Fandango", Lamezia Terme, Italy
| | - Luigi Pullia
- Addiction Service, Azienda Sanitaria Provinciale, Catanzaro, Italy
| | - Carla Sorrentino
- Addiction Service, Azienda Sanitaria Provinciale, Catanzaro, Italy
| | | | - Antonino Carcione
- Third Centre of Cognitive Psychotherapy - Italian School of Cognitive Psychotherapy (SICC), Rome, Italy
| | - Cristina Segura-Garcia
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Viale Europa, 88100, Catanzaro, Italy.
| | - Pasquale De Fazio
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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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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9
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Etxandi M, Baenas I, Mora-Maltas B, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Lucas I, Casado S, Gómez-Peña M, Moragas L, del Pino-Gutiérrez A, Codina E, Valenciano-Mendoza E, Potenza MN, Diéguez C, Jiménez-Murcia S. Are Signals Regulating Energy Homeostasis Related to Neuropsychological and Clinical Features of Gambling Disorder? A Case-Control Study. Nutrients 2022; 14:nu14235084. [PMID: 36501114 PMCID: PMC9736671 DOI: 10.3390/nu14235084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/04/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
Gambling disorder (GD) is a modestly prevalent and severe condition for which neurobiology is not yet fully understood. Although alterations in signals involved in energy homeostasis have been studied in substance use disorders, they have yet to be examined in detail in GD. The aims of the present study were to compare different endocrine and neuropsychological factors between individuals with GD and healthy controls (HC) and to explore endocrine interactions with neuropsychological and clinical variables. A case−control design was performed in 297 individuals with GD and 41 individuals without (healthy controls; HCs), assessed through a semi-structured clinical interview and a psychometric battery. For the evaluation of endocrine and anthropometric variables, 38 HCs were added to the 41 HCs initially evaluated. Individuals with GD presented higher fasting plasma ghrelin (p < 0.001) and lower LEAP2 and adiponectin concentrations (p < 0.001) than HCs, after adjusting for body mass index (BMI). The GD group reported higher cognitive impairment regarding cognitive flexibility and decision-making strategies, a worse psychological state, higher impulsivity levels, and a more dysfunctional personality profile. Despite failing to find significant associations between endocrine factors and either neuropsychological or clinical aspects in the GD group, some impaired cognitive dimensions (i.e., WAIS Vocabulary test and WCST Perseverative errors) and lower LEAP2 concentrations statistically predicted GD presence. The findings from the present study suggest that distinctive neuropsychological and endocrine dysfunctions may operate in individuals with GD and predict GD presence. Further exploration of endophenotypic vulnerability pathways in GD appear warranted, especially with respect to etiological and therapeutic potentials.
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Affiliation(s)
- Mikel Etxandi
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, 08916 Badalona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
| | - Sulay Tovar
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Sabela Casado
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, 08907 Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
| | - Eduardo Valenciano-Mendoza
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06106, USA
- Department of Neuroscience, Yale University, New Haven, CT 06520, USA
| | - Carlos Diéguez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Physiology, CIMUS, Instituto de Investigación Sanitaria, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Institute for Biomedical Research (IDIBELL), 08907 Barcelona, Spain
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Institute for Biomedical Research (IDIBELL), 08908 Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 08907 Barcelona, Spain
- Correspondence:
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