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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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Troup LJ. Editorial: Individual differences in addictive behaviors. Front Psychol 2024; 15:1386489. [PMID: 38840736 PMCID: PMC11150761 DOI: 10.3389/fpsyg.2024.1386489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/13/2024] [Indexed: 06/07/2024] Open
Affiliation(s)
- Lucy J. Troup
- Division of Psychology, University of the West of Scotland, Paisley, United Kingdom
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Baenas I, Mora-Maltas B, 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. Cluster analysis in gambling disorder based on sociodemographic, neuropsychological, and neuroendocrine features regulating energy homeostasis. Compr Psychiatry 2024; 128:152435. [PMID: 37976998 DOI: 10.1016/j.comppsych.2023.152435] [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: 07/26/2023] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far. AIMS This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features. METHODS 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ2) for categorical variables, and analysis of variance (ANOVA) for quantitative measures. RESULTS Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2. CONCLUSIONS To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision.
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Affiliation(s)
- Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Mikel Etxandi
- Doctoral Program in Medicine and Translational Research, 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, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, 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 (IDIS), Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), 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 (IDIS), 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, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Stanković M, Bjekić J, Filipović SR. Effects of Transcranial Electrical Stimulation on Gambling and Gaming: A Systematic Review of Studies on Healthy Controls, Participants with Gambling/Gaming Disorder, and Substance Use Disorder. J Clin Med 2023; 12:jcm12103407. [PMID: 37240512 DOI: 10.3390/jcm12103407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 05/28/2023] Open
Abstract
Gambling disorder (GD) and internet gaming disorder (IGD) are formally recognized behavioral addictions with a rapidly growing prevalence and limited treatment options. Recently, transcranial electrical stimulation (tES) techniques have emerged as potentially promising interventions for improving treatment outcomes by ameliorating cognitive functions implicated in addictive behaviors. To systematize the current state of evidence and better understand whether and how tES can influence gambling and gaming-related cognitive processes, we conducted a PRISMA-guided systematic review of the literature, focusing on tES effects on gaming and gambling in a diverse range of population samples, including healthy participants, participants with GD and IGD, as well as participants with substance abuse addictions. Following the literature search in three bibliographic databases (PubMed, Web of Science, and Scopus), 40 publications were included in this review, with 26 conducted on healthy participants, 6 focusing on GD and IGD patients, and 8 including participants with other addictions. Most of the studies targeted the dorsolateral prefrontal cortex, using transcranial direct current stimulation (tDCS), and assessed the effects on cognition, using gaming and gambling computerized cognitive tasks measuring risk taking and decision making, e.g., balloon analogue risk task, Iowa gambling task, Cambridge gambling task, etc. The results indicated that tES could change gambling and gaming task performances and positively influence GD and IGD symptoms, with 70% of studies showing neuromodulatory effects. However, the results varied considerably depending on the stimulation parameters, sample characteristics, as well as outcome measures used. We discuss the sources of this variability and provide further directions for the use of tES in the context of GD and IGD treatment.
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Affiliation(s)
- Marija Stanković
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
| | - Jovana Bjekić
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
| | - Saša R Filipović
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, 11000 Belgrade, Serbia
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Tjernström N, Li TQ, Holst S, Roman E. Functional connectivity in reward-related networks is associated with individual differences in gambling strategies in male Lister hooded rats. Addict Biol 2022; 27:e13131. [PMID: 35229946 DOI: 10.1111/adb.13131] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Abstract
Individuals with gambling disorder display deficits in decision-making in the Iowa Gambling Task. The rat Gambling Task (rGT) is a rodent analogue that can be used to investigate the neurobiological mechanisms underlying gambling behaviour. The aim of this explorative study was to examine individual strategies in the rGT and investigate possible behavioural and neural correlates associated with gambling strategies. Thirty-two adult male Lister hooded rats underwent behavioural testing in the multivariate concentric square field™ (MCSF) and the novel cage tests, were trained on and performed the rGT and subsequently underwent resting-state functional magnetic resonance imaging (R-fMRI). In the rGT, stable gambling strategies were found with subgroups of rats that preferred the suboptimal safest choice as well as the disadvantageous choice, that is, the riskiest gambling strategy. R-fMRI results revealed associations between gambling strategies and brain regions central for reward networks. Moreover, rats with risky gambling strategies differed from those with strategic and intermediate strategies in brain functional connectivity. No differences in behavioural profiles, as assessed with the MCSF and novel cage tests, were observed between the gambling strategy groups. In conclusion, stable individual differences in gambling strategies were found. Intrinsic functional connectivity using R-fMRI provides novel evidence to support the notion that individual differences in gambling strategies are associated with functional connectivity in brain regions important for reward networks.
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Affiliation(s)
- Nikita Tjernström
- Research Group Neuropharmacology, Addiction and Behavior, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Tie-Qiang Li
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Radiation and Nuclear Medicine, Karolinska University Hospital, Solna, Sweden
| | - Sarah Holst
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erika Roman
- Research Group Neuropharmacology, Addiction and Behavior, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
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6
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Huneke NTM, Chamberlain SR, Baldwin DS, Grant JE. Diverse predictors of treatment response to active medication and placebo in gambling disorder. J Psychiatr Res 2021; 144:96-101. [PMID: 34607088 DOI: 10.1016/j.jpsychires.2021.09.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 01/11/2023]
Abstract
Gambling disorder creates a significant public health burden. Despite decades of clinical trials, there are no licensed pharmacological treatments for gambling disorder. Contributing factors to this are the high placebo response rates seen in clinical trials, the heterogeneity of the disorder and high rates of psychiatric comorbidities. Indeed, a number of demographic and clinical variables have previously been associated with altered responses to pharmacotherapy, psychotherapy and placebo. Which variables are likely to predict response to one modality over another remains uncertain. We carried out multiple linear regression analyses in a pooled dataset from six treatment studies in gambling disorder with the aim of identifying predictors of treatment response. Potential predictors were identified a priori through hypothesis and entered into models including all patients, and subsequently for those randomized to active medication or placebo separately. We found that baseline severity of gambling symptoms and number of weeks completed in a trial were predictors of active medication response, while decreased baseline symptoms of anxiety, increased baseline symptoms of depression, and non-Caucasian ethnicity were associated with placebo response. Sensitivity analyses showed that these associations were robust to choices made during the analysis. Further research is required to understand whether controlling for these variables, or using enriched samples, improves assay sensitivity in placebo-controlled clinical trials for gambling disorder.
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Affiliation(s)
- Nathan T M Huneke
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK; University Department of Psychiatry, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK.
| | - Samuel R Chamberlain
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK; University Department of Psychiatry, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK; Department of Psychiatry, University of Cambridge, UK
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, UK; University Department of Psychiatry, University of Southampton, UK; Southern Health National Health Service Foundation Trust, Southampton, UK; University Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
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Heaney D, Baxendale S. Epilepsy & gambling: Risk factors for problem gambling behaviors in people with epilepsy. Epilepsy Behav 2021; 122:108082. [PMID: 34147882 DOI: 10.1016/j.yebeh.2021.108082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Problem gambling results from the complex interaction of neurological factors with psychological, demographic, and socioeconomical influences. The vulnerabilities of people with epilepsy to many of these influences may increase their susceptibility to developing problematic gambling behaviors. The aim of this study was to establish the frequency of gambling participation and the clinical correlates of problem gambling behaviors in people with epilepsy. METHODS Lifestyle questions, including the Lie/Bet screening questionnaire were administered to 250 consecutive attendees at a neurology clinic. Valid data were available for 174 adults with epilepsy and 65 adults with other neurological conditions. RESULTS With the exception of people with frontal lobe epilepsy (FLE), gambling participation rates in people with epilepsy and those with other neurological conditions were lower than those reported in the general population. While the overall levels of gambling participation were relatively low in this sample, the number of gamblers who responded positively to the lie/bet questionnaire was ten times higher than that seen in the general population, with one in three gamblers in our series reporting signs of escalation. All had epilepsy and were more likely to be taking Levetiracetam or Brivaracetam than the other gamblers in our series. While epilepsy classification was not related to gambling escalation, patients with FLE were overrepresented in this group due to their significantly higher baseline levels of participation in gambling. CONCLUSIONS People with FLE may have a heightened vulnerability to developing problem gambling behaviors. The role of the neurological consultation in managing these risks is discussed.
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Affiliation(s)
| | - Sallie Baxendale
- University College Hospital, London, United Kingdom; Department of Clinical and Experimental Epilepsy, UCL, Queen Square, Institute of Neurology, London, United Kingdom.
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8
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Bouchard AE, Dickler M, Renauld E, Lenglos C, Ferland F, Rouillard C, Leblond J, Fecteau S. Brain morphometry in adults with gambling disorder. J Psychiatr Res 2021; 141:66-73. [PMID: 34175744 DOI: 10.1016/j.jpsychires.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/20/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
Little is known regarding the brain substrates of Gambling Disorder, including surface brain morphometry, and whether these are linked to the clinical profile. A better understanding of the brain substrates will likely help determine targets to treat patients. Hence, the aim of this study was two-fold, that is to examine surface-based morphometry in 17 patients with gambling disorder as compared to norms of healthy individuals (2713 and 2790 subjects for cortical and subcortical anatomical scans, respectively) and to assess the clinical relevance of morphometry in patients with Gambling Disorder. This study measured brain volume, surface and thickness in Gambling Disorder. We compared these measures to those of a normative database that controlled for factors such as age and sex. We also tested for correlations with gambling-related behaviors, such as gambling severity and duration, impulsivity, and depressive symptoms (assessed using the South Oaks Gambling Screen, years of gambling, Barratt Impulsiveness Scale, and Beck Depression Inventory, respectively). Patients displayed thinner prefrontal and parietal cortices, greater volume and thickness of the occipital and the entorhinal cortices, and greater volume of subcortical regions as compared to the norms of healthy individuals. There were positive correlations between surface area of occipital regions and depressive symptoms. This work contributes to better characterize the brain substrates of Gambling Disorder, which appear to resemble those of substance use disorders and Internet Gaming Disorder.
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Affiliation(s)
- Amy E Bouchard
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 2325 rue de l'Université, Quebec City, Quebec, G1V 0A6, Canada; CERVO Brain Research Centre, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2301 avenue D'Estimauville, Quebec City, Quebec, G1E 1T2, Canada.
| | - Maya Dickler
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 2325 rue de l'Université, Quebec City, Quebec, G1V 0A6, Canada; CERVO Brain Research Centre, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2301 avenue D'Estimauville, Quebec City, Quebec, G1E 1T2, Canada.
| | - Emmanuelle Renauld
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 2325 rue de l'Université, Quebec City, Quebec, G1V 0A6, Canada; CERVO Brain Research Centre, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2301 avenue D'Estimauville, Quebec City, Quebec, G1E 1T2, Canada.
| | - Christophe Lenglos
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 2325 rue de l'Université, Quebec City, Quebec, G1V 0A6, Canada; CERVO Brain Research Centre, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2301 avenue D'Estimauville, Quebec City, Quebec, G1E 1T2, Canada.
| | - Francine Ferland
- Centre de réadaptation en dépendance du CIUSSS de la Capitale-Nationale, 2525 chemin de la Canardière, Quebec City, Quebec, G1J 2G3, Canada.
| | - Claude Rouillard
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 2325 rue de l'Université, Quebec City, Quebec, G1V 0A6, Canada; Axe Neurosciences, Centre de recherche du CHU de Québec, 2705 boul. Laurier, Quebec City, Quebec, G1V 4G2, Canada.
| | - Jean Leblond
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, 525 boul. Wilfrid-Hamel, Quebec City, Quebec, G1M 2S8, Canada.
| | - Shirley Fecteau
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 2325 rue de l'Université, Quebec City, Quebec, G1V 0A6, Canada; CERVO Brain Research Centre, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2301 avenue D'Estimauville, Quebec City, Quebec, G1E 1T2, Canada.
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Popescu A, Marian M, Drăgoi AM, Costea RV. Understanding the genetics and neurobiological pathways behind addiction (Review). Exp Ther Med 2021; 21:544. [PMID: 33815617 PMCID: PMC8014976 DOI: 10.3892/etm.2021.9976] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/15/2021] [Indexed: 12/20/2022] Open
Abstract
The hypothesis issued by modern medicine states that many diseases known to humans are genetically determined, influenced or not by environmental factors, which is applicable to most psychiatric disorders as well. This article focuses on two pending questions regarding addiction: Why do some individuals become addicted while others do not? along with Is it a learned behavior or is it genetically predefined? Recent data suggest that addiction is more than repeated exposure, it is the synchronicity between intrinsic factors (genotype, sex, age, preexisting addictive disorder, or other mental illness), extrinsic factors (childhood, level of education, socioeconomic status, social support, entourage, drug availability) and the nature of the addictive agent (pharmacokinetics, path of administration, psychoactive properties). The dopamine-mesolimbic motivation-reward-reinforcement cycle remains the most coherent physiological theory in addiction. While the common property of addictive substances is that they are dopamine-agonists, each class has individual mechanisms, pharmacokinetics and psychoactive potentials.
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Affiliation(s)
- Alexandra Popescu
- Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Maria Marian
- Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Ana Miruna Drăgoi
- Department of Psychiatry, 'Prof. Dr. Alex. Obregia' Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Radu-Virgil Costea
- Department of General Surgery, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Chowdhury NS, Livesey EJ, Blaszczynski A, Harris JA. Motor cortex dysfunction in problem gamblers. Addict Biol 2021; 26:e12871. [PMID: 31927792 DOI: 10.1111/adb.12871] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023]
Abstract
Impairments in response inhibition have been implicated in gambling psychopathology. This behavioral impairment may suggest that the neural mechanisms involved in response inhibition, such as GABAA -mediated neurotransmission in the primary motor cortex (M1), are also impaired. The present study obtained paired-pulse transcranial magnetic stimulation markers of GABAA and glutamate receptor activity from the left M1 of three groups-problem gamblers (n = 17, 12 males), at-risk gamblers (n = 29, 19 males), and controls (n = 23, six males)-with each group matched for alcohol use, substance use, and attention-deficit hyperactivity disorder (ADHD) symptomology. Response inhibition was measured using the stop signal task. Results showed that problem gamblers had weaker M1 GABAA receptor activity relative to controls and elevated M1 glutamate receptor activity relative to at-risk gamblers and controls. Although there were no differences in response inhibition between the groups, poorer response inhibition was correlated with weaker M1 GABAA receptor activity. These findings are the first to show that problem gambling is associated with alterations in M1 GABAA and glutamate-mediated neurotransmission.
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Affiliation(s)
- Nahian S. Chowdhury
- School of Psychology The University of Sydney Camperdown New South Wales Australia
| | - Evan J. Livesey
- School of Psychology The University of Sydney Camperdown New South Wales Australia
| | - Alex Blaszczynski
- School of Psychology The University of Sydney Camperdown New South Wales Australia
| | - Justin A. Harris
- School of Psychology The University of Sydney Camperdown New South Wales Australia
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Houghton S, Moss M. Comparing football bettors' response to social media marketing differing in bet complexity and account type - An experimental study. J Behav Addict 2020; 10:388-395. [PMID: 32980826 PMCID: PMC8997207 DOI: 10.1556/2006.2020.00056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/04/2020] [Accepted: 08/19/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS The current study aimed to assess how sports bettors respond to advertised bets on social media and whether this differs dependent upon bet complexity and social media account type. METHODS Employing a 3 × 2 repeated measures design, 145 regular football bettors were recruited to take part in an online study requiring them to rate bets advertised upon social media, providing indications of their likelihood to bet, confidence in the bet and how much they would stake on the bet. Advertised bets differed in terms of complexity (low, medium and high) and each bet was presented separately on both an operator account and an affiliate account. RESULTS Data analysis highlighted a significant interaction between bet complexity and account type, with bettors rating themselves as being more likely to bet and more confident in bets which were presented on an affiliate account for medium complexity bets but not for low or high complexity bets. DISCUSSION AND CONCLUSIONS This study provides initial evidence that affiliate marketing of sports betting increases bettor's confidence in certain types of bets. This heightens previously addressed concerns around affiliate marketing, given that affiliates are financially incentivised to attract custom toward gambling operators. Future research should explore risk factors for increased uptake of affiliate marketing, and the impact on gambling behaviour.
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Affiliation(s)
- Scott Houghton
- NB155, Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
| | - Mark Moss
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
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12
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The Role of Narcissism, Hyper-competitiveness and Maladaptive Coping Strategies on Male Adolescent Regular Gamblers: Two Mediation Models. J Gambl Stud 2020; 37:571-582. [DOI: 10.1007/s10899-020-09980-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
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13
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Wölfling K, Duven E, Wejbera M, Beutel ME, Müller KW. Discounting delayed monetary rewards and decision making in behavioral addictions - A comparison between patients with gambling disorder and internet gaming disorder. Addict Behav 2020; 108:106446. [PMID: 32408114 DOI: 10.1016/j.addbeh.2020.106446] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022]
Abstract
Behavior addictions, such as Gambling Disorder and Internet Gaming Disorder, have been demonstrated to have severe negative impact. Heightened impulsivity, deficits in decision making, and cognitive biases in the preference of immediate rewards have been shown to be crucial aspects in addictive disorders. While for Gambling Disorder (GD), dysfunctional decision making has been documented before, data for Internet Gaming Disorder (IGD) are still underrepresented. In order to allow for a direct comparison of both disorders, we assessed different measures of impulsivity (trait, impulsive choice, and decision making) in a clinical sample. N = 31 patients meeting criteria for GD and n = 30 patients with IGD were recruited from an outpatient clinic and compared regarding their performance in a Delay Discounting Task (DDT), the Iowa Gambling Task (IGT), and self-report data on impulsivity (Barratt Impulsiveness Scale). Healthy controls (n = 27) were included as a reference group. In the DDT, the area under the curve was associated with the severity of GD only. No correlations were found for the impulsivity subscales and the area under the curve which, however, was similar between the two patient groups in contrast to controls. The GD-group performed poorer then the other groups in the IGT while IGD-patients performed poorer only at the beginning of the experiment. Although only few significant differences occurred, similarities between GD and IGD regarding the DDT point towards a tendency on discounting rewards faster. Likewise, both patient groups were performing worse in the IGT than healthy controls which indicates deficiencies in decision making. Interestingly, the IGD-group was able to shift towards more advantageous decision making, which might have important implications for therapeutic interventions.
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Affiliation(s)
- K Wölfling
- Outpatient Clinic for Behavioural Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - E Duven
- Praxengemeinschaft Gonsenheim, Kapellenstraße 7, 55124 Mainz, Germany
| | - M Wejbera
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - M E Beutel
- Outpatient Clinic for Behavioural Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - K W Müller
- Outpatient Clinic for Behavioural Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany.
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14
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Torrado M, Bacelar-Nicolau L, Skryabin V, Teixeira M, Eusébio S, Ouakinin S. Emotional dysregulation features and problem gambling in university students: a pilot study. J Addict Dis 2020; 38:550-566. [PMID: 32762419 DOI: 10.1080/10550887.2020.1800889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Undergraduate students typically cope with various changes in their lives and experience many stressors associated with academic issues. Distress can make them more vulnerable to particular behavioral patterns in order to cope with negative affect. The association of problematic gambling with particular emotion regulation characteristics-some of which are developmentally dependent-becomes a recent focus of research with clinical and preventive implications. We carried out a pilot study enrolling voluntarily young adults of a public university in the Lisbon area, and 117 Portuguese-speaking individuals were interviewed. Participants, mainly female (M = 20.6; SD = 3.9), were investigated taking into consideration their gambling practices, characteristics of impulsivity and alexithymia, along with the symptoms of depression and anxiety. Portuguese versions of the South Oaks Gambling Scale (SOGS) and Short-Version of Impulsive Behavior Scale (S-UPPSP) were prepared (i.e., translation and back-translation of the original versions were performed). The prevalence of gambling problems in this sample is modest, although they were associated with negative urgency and sensation-seeking, as well as with depression symptoms. Multiple correspondence analysis, a particular multivariate model associating gambling problems with socio-demographic and psychological variables, allowed identifying different profiles of individuals. Trace and state emotional dysregulation features are selectively associated with distinctive gambling patterns, according to some previous findings in studies with other groups. Results may address new findings in terms of morbidity, risk factors and the design of future preventive strategies among such individuals.
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Affiliation(s)
- Marco Torrado
- Faculty of Medicine, ISAMB (Instituto de Saúde Ambiental), University of Lisbon, Lisbon, Portugal
| | - Leonor Bacelar-Nicolau
- Faculty of Medicine, ISAMB (Instituto de Saúde Ambiental), University of Lisbon, Lisbon, Portugal
| | - Valentin Skryabin
- Department of Healthcare, Moscow Research and Practical Centre on Addictions of the Moscow, Moscow, Russia
| | - Mariana Teixeira
- Faculty of Medicine, ISAMB (Instituto de Saúde Ambiental), University of Lisbon, Lisbon, Portugal
| | - Susana Eusébio
- Faculty of Medicine, ISAMB (Instituto de Saúde Ambiental), University of Lisbon, Lisbon, Portugal
| | - Silvia Ouakinin
- Faculty of Medicine, ISAMB (Instituto de Saúde Ambiental), University of Lisbon, Lisbon, Portugal
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15
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Antons S, Brand M, Potenza MN. Neurobiology of cue-reactivity, craving, and inhibitory control in non-substance addictive behaviors. J Neurol Sci 2020; 415:116952. [DOI: 10.1016/j.jns.2020.116952] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/19/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022]
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16
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Passanisi A, D’Urso G, Schimmenti A, Ruggieri S, Pace U. Coping Strategies, Creativity, Social Self-Efficacy, and Hypercompetitiveness in Gambling Behaviors: A Study on Male Adolescent Regular Gamblers. Front Psychol 2020; 11:1722. [PMID: 32793061 PMCID: PMC7385227 DOI: 10.3389/fpsyg.2020.01722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 06/23/2020] [Indexed: 01/11/2023] Open
Abstract
The purpose of this research was to explore the cognitive and personality characteristics of male adolescent gamblers. Participants were 273 teenage males (M = 18.04, SD = 2.10) attending betting centers in Sicily, who completed self-report questionnaires on gambling, creativity, perceived social self-efficacy, hypercompetitiveness, and coping strategies. Pathological gamblers reported higher levels of avoidant coping strategies than occasional gamblers. They also scored higher on hypercompetitiveness than both occasional and problem gamblers. Further, problem gamblers scored higher than occasional gamblers on the complexity domain of creative personality. Finally, poor perceived social self-efficacy, higher levels of avoidant coping, and hypercompetitiveness predicted pathological gambling. Theoretical, psycho-educational, and clinical implications are discussed.
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Affiliation(s)
- Alessia Passanisi
- Faculty of Human and Social Science, UKE – Kore University of Enna, Enna, Italy
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17
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Grant JE, Chamberlain SR. Autistic traits in young adults who gamble. CNS Spectr 2020; 21:1-6. [PMID: 32641183 PMCID: PMC7612193 DOI: 10.1017/s1092852920001571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND. Little is known about the relationship between autistic traits and addictive behaviors such as problem gambling. Thus, the present study examined clinical characteristics and multiple facets of cognition in young adults who gamble and have autistic traits. METHODS. A total of 102 young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Autistic traits were examined using the brief Autism-Spectrum Quotient (AQ-10). Clinician rating scales, questionnaires, and cognitive tests were completed. Relationships between AQ10 scores and demographic, gambling symptom, and neurocognitive measures were evaluated. RESULTS. Autistic traits were correlated with disordered gambling symptoms, attention-deficit/hyperactivity disorder (ADHD) symptoms, trait impulsivity, and some types of obsessive-compulsive symptoms. In regression, ADHD no longer significantly related to autistic traits once disordered gambling symptoms were accounted for; whereas the link between autistic traits and disordered gambling symptoms was robust even controlling for ADHD. CONCLUSIONS. These data suggest a particularly strong relationship between autistic traits and problem gambling symptoms, as well as certain aspects of impulsivity and compulsivity. The link between ADHD and autistic traits in some prior studies may have been attributable to disordered gambling symptoms, which was likely not screened for, and since individuals may endorse ADHD instruments due to other impulsive/compulsive symptom types (eg, gambling). The contribution of autistic traits to the emergence and chronicity of disordered gambling now requires further scrutiny, not only in community samples (such as this) but also in clinical settings.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
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18
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Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder. CNS Spectr 2020; 25:392-401. [PMID: 31106718 PMCID: PMC6864250 DOI: 10.1017/s1092852919000993] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Several studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients. METHODS Forty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors. RESULTS Both OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms. CONCLUSION OCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.
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19
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Flack M, Buckby B. Impulsivity and Problem Gambling: Can the Anticipated Emotional Rewards Explain the Relationship? Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-018-9950-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Grant JE, Chamberlain SR. Gambling and substance use: Comorbidity and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109852. [PMID: 31881248 DOI: 10.1016/j.pnpbp.2019.109852] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
Gambling disorder is a common condition that was previously listed as an impulse control disorder, but is now considered a substance-related and addictive disorder. Gambling disorder has been associated with various untoward long-term outcomes including impaired quality of life, relationship break-ups, debt and mortgage foreclosure, and elevated risk of suicidality. This paper provides a concise primer on gambling disorder, with a special focus on its parallels with substance use disorders. We consider clinical presentations, comorbid expression, heritability, and treatment approaches (psychological and pharmacological). Lastly, we highlight new treatment directions suggested by the literature.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge; & Cambridge and Peterborough NHS Foundation Trust (CPFT), UK
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21
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Fugariu V, Zack MH, Nobrega JN, Fletcher PJ, Zeeb FD. Effects of exposure to chronic uncertainty and a sensitizing regimen of amphetamine injections on locomotion, decision-making, and dopamine receptors in rats. Neuropsychopharmacology 2020; 45:811-822. [PMID: 31905371 PMCID: PMC7076035 DOI: 10.1038/s41386-020-0599-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/22/2019] [Accepted: 12/30/2019] [Indexed: 02/06/2023]
Abstract
Gambling disorder (GD) is a behavioral addiction that may be linked to alterations in dopamine (DA) systems. Gambling involves chronic exposure to uncertain reward, which can sensitize the activity of DA systems. Here we explored how combinations of Pavlovian and instrumental uncertainty impact DA sensitization and risky decision-making. Experiment 1: 40 rats underwent 66 uncertainty exposure (UE) sessions during which they responded for saccharin. Animal responding was reinforced according to a fixed or variable (FR/VR) ratio schedule that turned on a conditioned stimulus (CS; light), which predicted saccharin on 50% or 100% of trials. Animals responded under one of the four conditions: FR-CS100% (no uncertainty), VR-CS100%, FR-CS50%, and VR-CS50% (maximal uncertainty). DA sensitization was inferred from an enhanced locomotor response to d-amphetamine (d-AMPH; 0.5 mg/kg) challenge. The rat gambling task (rGT) was used to assess decision-making. Experiment 2: 24 rats received 5 weeks of sensitizing d-AMPH or saline doses, followed by locomotor activity and rGT testing. Experiment 3: Effects of UE and a sensitizing d-AMPH regimen on DA D1, D2, and D3 receptor binding were assessed in 44 rats using autoradiography. Compared to FR-CS100%, VR-CS100% and VR-CS50% rats displayed a greater locomotor response to d-AMPH, and VR-CS50% rats demonstrated riskier decision-making. Chronic d-AMPH-treated rats mirrored the effects of VR-CS50% groups on these two indices. Both VR-CS50% and d-AMPH-treated groups had increased striatal DA D2 receptor binding. These results suggest that chronic uncertainty exposure, similar to exposure to a sensitizing d-AMPH regimen, sensitized the function of DA systems and increased risky decision-making.
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Affiliation(s)
- Victoria Fugariu
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada.
- Section of Biopsychology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Martin H Zack
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Molecular Brain Sciences Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - José N Nobrega
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Section of Behavioral Neurobiology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Paul J Fletcher
- Section of Biopsychology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Fiona D Zeeb
- Section of Biopsychology Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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22
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Sani G, Gualtieri I, Paolini M, Bonanni L, Spinazzola E, Maggiora M, Pinzone V, Brugnoli R, Angeletti G, Girardi P, Rapinesi C, Kotzalidis GD. Drug Treatment of Trichotillomania (Hair-Pulling Disorder), Excoriation (Skin-picking) Disorder, and Nail-biting (Onychophagia). Curr Neuropharmacol 2020; 17:775-786. [PMID: 30892151 PMCID: PMC7059154 DOI: 10.2174/1570159x17666190320164223] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Trichotillomania (TTM), excoriation (or skin-picking) disorder and some severe forms of onychophagia are classified under obsessive-compulsive and related disorders. There are different interacting neurotransmitter systems involved in the pathophysiology of impulse-control disorders, implicating noradrenaline, serotonin, dopamine, opioid peptides and glutamate, hence investigators focused on drugs able to act on these transmitters. Our aim was to critically review the efficacy of the drugs employed in impulse-control disorders. METHODS We searched for controlled drug trials to treat TTM, excoriation, and/or nail-biting six databases (PubMed, Cochrane, Scopus, CINAHL, PsycINFO/PsycARTICLES, and Web of Science), using the search strategy: (trichotillomania OR "excoriation disorder" OR "face picking" OR "skin picking" OR "hair pulling" OR onychophagia OR "nail-biting") AND drug treatment on 12 March 2018 for all databases. We followed in our method of identifying relevant literature the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS SSRIs and clomipramine are considered first-line in TTM. In addition, family members of TTM patients are often affected by obsessive-compulsive spectrum disorders. Other drugs used in the treatment of TTM are lamotrigine, olanzapine, N-Acetylcysteine, inositol, and naltrexone. CONCLUSION The treatment of TTM, excoriation disorder and nail-biting is still rather disappointing. Conjectures made from preclinical studies and the relative pathophysiological hypotheses found poor confirmations at a clinical level. There is a need for further studies and the integration of pharmacological and psychotherapeutic. Our results point to the need of integrating personalised medicine principles in the treatment of these patients.
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Affiliation(s)
- Gabriele Sani
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Centro "Lucio Bini", Rome, Italy.,Tufts University School of Medicine, Boston, United States
| | - Ida Gualtieri
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Marco Paolini
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Luca Bonanni
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Edoardo Spinazzola
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Matteo Maggiora
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Vito Pinzone
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Gloria Angeletti
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
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23
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Cavicchioli M, Vassena G, Movalli M, Maffei C. Addictive behaviors in alcohol use disorder: dysregulation of reward processing systems and maladaptive coping strategies. J Addict Dis 2019; 37:173-184. [PMID: 31496396 DOI: 10.1080/10550887.2019.1643211] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
DSM-5 has included within the substance-related and addictive disorders diagnostic category behavioral addictions, such as gambling disorder. Some scholars also considered ICD-11 compulsive sex as a behavioral addiction. Furthermore, an addiction model of dysfunctional eating behaviors has been proposed. Consistently, the existence of common addiction mechanisms related to substance and non-substance related disorders has been hypothesized. Nevertheless, this approach was called into question, especially considering alternative processes which might be implicated in such conditions. This study aims to compare these opposite theoretical positions concerning substance- and nonsubstance related disorders, investigating the latent structure of addictive behaviors among alcohol use disorder (AUD) individuals. Addictive behaviors were self-reported assessed using the Shorter PROMIS Questionnaire (SPQ). We recruited 456 (59.2% male; 40.8% female) AUD treatment-seeking patients. Two latent structures were tested using a confirmatory factor analytic approach. We compared a one-factor (i.e., common addiction mechanisms) with a two-factor solution (i.e., dysregulation of reward processing systems and maladaptive coping strategies). The two-factor solution showed adequate goodness-of-fit indexes. Specifically, dysregulation of the reward processing systems dimension predicted the SPQ illicit and prescription drugs, gambling, and sex subscales. Conversely, the maladaptive coping strategies dimension predicted the SPQ compulsive buying, binge eating and food restriction subscales. The latent dimensions significantly correlated with each other. Compulsive sex might be preliminarily considered as a behavioral addiction. AUD individuals might show complex patterns of maladaptive behaviors functionally related to different latent processes. Differential treatment approaches are suggested to treat these conditions.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Giulia Vassena
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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24
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Zack M, Lobo D, Biback C, Fang T, Smart K, Tatone D, Kalia A, Digiacomo D, Kennedy JL. Impulsivity moderates the effects of dopamine D2 and mixed D1-D2 antagonists in individuals with gambling disorder. J Psychopharmacol 2019; 33:1015-1029. [PMID: 31219367 DOI: 10.1177/0269881119855972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The functional role of dopamine D1 and D2 receptors in gambling disorder (GD) remains unclear. AIMS This study aimed to investigate the role of D1 activation and the moderating effects of impulsivity, a trait linked with weaker D2-mediated inhibition of dopamine release, in GD subjects. METHODS Thirty (nine female) non-comorbid GD subjects with low (LI), moderate (MI), or high impulsivity (HI) received the preferential D2 antagonist haloperidol (HAL; 3 mg) or the mixed D1-D2 antagonist fluphenazine (FLU; 3 mg), on separate sessions before a 15-minute slot machine game or amphetamine (AMPH; 20 mg), in a placebo-controlled, double-blind, counterbalanced design. RESULTS On their own, HAL and FLU led to linear increases and decreases, respectively, in desire to gamble across increasing levels of impulsivity. The slot machine and AMPH each evoked an inverted-U pattern of desire to gamble across increasing impulsivity. HAL reversed this effect of the game, whereas FLU did not alter post-game desire. HAL and FLU decreased and increased psychostimulant-like effects of the game, respectively, in LI and MI subjects, but consistently reduced these effects in HI subjects. HAL also altered the salience of negative affective words on a reading task, such that greater salience of negative words coincided with lower post-game desire to gamble. CONCLUSIONS D1 receptors appear to gauge the incentive value of gambling in GD subjects. D1 activation has negative reinforcing effects in HI gamblers and positive reinforcing effects in LI gamblers. Medications that activate D1 could curtail chasing in HI gamblers. D1 blockade could benefit HI gamblers whose main concern is craving.
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Affiliation(s)
- Martin Zack
- 1 Molecular Brain Sciences Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniela Lobo
- 1 Molecular Brain Sciences Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Candice Biback
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,4 Leslie Dan School of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Tim Fang
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Kelly Smart
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniel Tatone
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Aditi Kalia
- 2 Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Daniel Digiacomo
- 3 Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- 1 Molecular Brain Sciences Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,3 Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,5 Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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Del Casale A, Kotzalidis GD, Rapinesi C, Girardi P. Current Psychopharmacology of Obsessive-Compulsive Spectrum Disorders. Curr Neuropharmacol 2019; 17:668-671. [PMID: 31393238 PMCID: PMC7059163 DOI: 10.2174/1570159x1708190709144820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Georgios D. Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University; Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
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Widinghoff C, Berge J, Wallinius M, Billstedt E, Hofvander B, Håkansson A. Gambling Disorder in Male Violent Offenders in the Prison System: Psychiatric and Substance-Related Comorbidity. J Gambl Stud 2019; 35:485-500. [PMID: 29971589 PMCID: PMC6517603 DOI: 10.1007/s10899-018-9785-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Gambling disorder is an addiction that can cause major suffering, and some populations seem to be more vulnerable than others. Offender populations have a remarkably high prevalence of gambling problems and they are also over-represented in a number of diagnoses related to gambling disorder, like substance use disorders and antisocial personality disorder. Yet, there are few studies investigating gambling disorder prevalence and related psychiatric comorbidity in this group. This study aims to investigate the prevalence of, and association between, gambling disorder and other psychiatric diagnoses in a sample of young, male violent offenders. Two hundred and sixty-four male offenders, all serving sentences for violent crimes (recruited between 2010 and 2012) participated in this study and went through comprehensive psychiatric evaluation, including assessment for Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria. Sixteen percent of the participants met criteria for gambling disorder. Antisocial personality disorder, cannabis, cocaine and anabolic steroids abuse were significantly more common among participants with gambling disorder. The gambling disorder group also showed significantly lower educational attainment. Cocaine abuse and failure to graduate elementary and middle school in expected time were independently associated with gambling disorder in a regression analysis. This study confirms the previously described high prevalence of gambling disorder in offenders. The psychiatric comorbidity was high and the problems had started early, with lower educational attainment in the gambling disorder group. The findings stress the importance of increased awareness of gambling problems among convicted offenders and of gambling research on young people with delinquent behavior. There is a need of more research to investigate this further, in order to develop preventive strategies and treatment.
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Affiliation(s)
- Carolina Widinghoff
- Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Clinical Research Unit/Gambling Disorder Unit, Malmö Addiction Center, 205 02 Malmö, Region Skåne Sweden
| | - Jonas Berge
- Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Clinical Research Unit/Gambling Disorder Unit, Malmö Addiction Center, 205 02 Malmö, Region Skåne Sweden
| | - Märta Wallinius
- Faculty of Medicine, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Regional Forensic Psychiatric Clinic, Växjö, Sweden
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Eva Billstedt
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Björn Hofvander
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Division of Forensic Psychiatry, Faculty of Medicine, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Lund University, Lund, Region Skåne Sweden
| | - Anders Håkansson
- Faculty of Medicine, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Clinical Research Unit/Gambling Disorder Unit, Malmö Addiction Center, 205 02 Malmö, Region Skåne Sweden
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27
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Mallorquí-Bagué N, Vintró-Alcaraz C, Verdejo-García A, Granero R, Fernández-Aranda F, Magaña P, Mena-Moreno T, Aymamí N, Gómez-Peña M, Del Pino-Gutiérrez A, Mestre-Bach G, Menchón JM, Jiménez-Murcia S. Impulsivity and cognitive distortions in different clinical phenotypes of gambling disorder: Profiles and longitudinal prediction of treatment outcomes. Eur Psychiatry 2019; 61:9-16. [PMID: 31255958 DOI: 10.1016/j.eurpsy.2019.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Impulsivity and cognitive distortions are hallmarks of gambling disorder (GD) but it remains unclear how they contribute to clinical phenotypes. This study aimed to (1) compare impulsive traits and gambling-related distortions in strategic versus non-strategic gamblers and online versus offline gamblers; (2) examine the longitudinal association between impulsivity/cognitive distortions and treatment retention and relapse. METHODS Participants seeking treatment for GD (n = 245) were assessed for gambling modality (clinical interview), impulsive traits (Urgency, Premeditation, Perseverance and Sensation Seeking [UPPS] scale) and cognitive distortions (Gambling Related Cognitions Scale) at treatment onset, and for retention and relapse (as indicated by the clinical team) at the end of treatment. Treatment consisted of 12-week standardized cognitive behavioral therapy, conducted in a public specialized clinic within a general public hospital. RESULTS Strategic gamblers had higher lack of perseverance and gambling-related expectancies and illusion of control than non-strategic gamblers, and online gamblers had generally higher distortions but similar impulsivity to offline gamblers. Lack of perseverance predicted treatment dropout, whereas negative urgency and distortions of inability to stop gambling and interpretative bias predicted number of relapses during treatment. CONCLUSIONS Individuals with online and strategic GD phenotypes have heightened gambling related biases associated with premature treatment cessation and relapse. Findings suggest that these GD phenotypes may need tailored treatment approaches to reduce specific distortions and impulsive facets.
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Affiliation(s)
- Núria Mallorquí-Bagué
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Antonio Verdejo-García
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, 18 Innovation Walk, 3800 Melbourne, VIC, Australia
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Pablo Magaña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Salud Mental (CIBERsam), Instituto de Salud Carlos III (ISCIII), Madrid, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain.
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28
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Rider GN, McMorris BJ, Gower AL, Coleman E, Eisenberg ME. Gambling Behaviors and Problem Gambling: A Population-Based Comparison of Transgender/Gender Diverse and Cisgender Adolescents. J Gambl Stud 2019; 35:79-92. [PMID: 30343416 DOI: 10.1007/s10899-018-9806-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Most gambling research utilizes general youth samples and focuses on binary gender categories; few studies examine and compare gambling behaviors between transgender and gender diverse (TGD) youth and their cisgender peers. The current study used population-based data from the 2016 Minnesota Student Survey to compare the prevalence of gambling behaviors and problem gambling among TGD versus cisgender adolescents, in addition to examining differences by birth-assigned sex. The analytic sample consisted of 80,929 students (including, n = 2168 [2.7%] TGD) in 9th and 11th grades. Chi-square tests and Cohen's d effect sizes were used for all comparisons. TGD youth reported greater involvement in most gambling behaviors and problem gambling compared to cisgender youth. In comparisons by birth-assigned sex, TGD youth assigned male at birth were particularly at risk for gambling involvement and problem gambling. TGD youth assigned female at birth also reported higher rates of problem gambling than both cisgender youth assigned male and female at birth. Results suggest that examining rates of gambling behavior and problem gambling as well as identifying disparities in vulnerable youth populations is crucial in order to develop culturally responsive and gender inclusive prevention, intervention, and outreach programs.
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Affiliation(s)
- G Nic Rider
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 S. 2nd St., Suite 180, Minneapolis, MN, 55454, USA.
| | - Barbara J McMorris
- School of Nursing, University of Minnesota, 308 Harvard St. SE, Minneapolis, MN, 55455, USA
| | - Amy L Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| | - Eli Coleman
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 S. 2nd St., Suite 180, Minneapolis, MN, 55454, USA
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
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29
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Ucheagwu V, Okoli P, Ugokwe-Ossai R. Some Neuropsychological Profiles and Personality Traits of Undergraduate Regular Online Football Gamblers (a New Online Gambling Game) in Nigeria. J Gambl Stud 2019; 35:171-180. [PMID: 30465149 DOI: 10.1007/s10899-018-9812-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Online football (soccer) gambling is among the relatively new sports betting games in Nigeria that use internet connections. Like other gambling games, some psychological profiles either propel or sustain the behavior. We tested some neuropsychological profiles and personality traits that distinguish the regular online football gamblers from non-gamblers. Using a between group design, we tested 140 (60: online football gamblers; 80: non-gamblers) university undergraduate students between the ages of 18-26 years on specific neuropsychological domains (i.e., attention, inhibition and executive function) and personality traits. The neuropsychological tasks used were the Series Addition Task (a modified version of Paced Auditory Serial Addition Task), Stroop-Word Color Test and Trail Making Test (TMT), Parts A and B. The personality traits were assessed using the Big Five Personality Inventory. The findings showed significant differences between the online football gamblers and non-gamblers, reflecting greater agreeableness, conscientiousness, neuroticism and openness to experience for the football gamblers. However, on the attention tasks, the non-gamblers made significantly fewer errors on forward addition and backward subtraction tasks, but did take more time to complete the backward counting task as compared to gamblers. On the other hand, online football gamblers took significantly less time to complete the Stroop congruence task and made significantly fewer errors on Stroop incongruence task. Similarly, the online football gamblers took less time to complete the TMT B and made fewer errors on TMT A. University undergraduate regular online football gamblers, as compared to non-gamblers, demonstrate stronger personality traits of ambition and gregariousness, and perform better on tasks of executive function, though they had more difficulty on tasks of divided and sustained attention.
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Affiliation(s)
- Valentine Ucheagwu
- Department of Psychology, Madonna University, Okija Campus, Okija, Nigeria. .,Department of Psychology, Chukwuemeka Odumegwu Ojukwu University, Igbariam, Nigeria.
| | - Paul Okoli
- Department of Clinical Psychology, Neuropsychiatric Hospital, Enugu, Nigeria
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Clark L, Boileau I, Zack M. Neuroimaging of reward mechanisms in Gambling disorder: an integrative review. Mol Psychiatry 2019; 24:674-693. [PMID: 30214041 DOI: 10.1038/s41380-018-0230-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/28/2018] [Accepted: 08/02/2018] [Indexed: 12/14/2022]
Abstract
Gambling disorder (GD) was reclassified as a behavioral addiction in the DSM-5 and shares clinical and behavioral features with substance use disorders (SUDs). Neuroimaging studies of GD hold promise in isolating core features of the addiction syndrome, avoiding confounding effects of drug neurotoxicity. At the same time, a neurobiologically-grounded theory of how behaviors like gambling can become addictive remains lacking, posing a significant hurdle for ongoing decisions in addiction nosology. This article integrates research on reward-related brain activity (functional MRI) and neurotransmitter function (PET) in GD, alongside the consideration of structural MRI data as to whether these signals more likely reflect pre-existing vulnerability or neuroadaptive change. Where possible, we point to qualitative similarities and differences with established markers for SUDs. Structural MRI studies indicate modest changes in regional gray matter volume and diffuse reductions in white matter integrity in GD, contrasting with clear structural deterioration in SUDs. Functional MRI studies consistently identify dysregulation in reward-related circuitry (primarily ventral striatum and medial prefrontal cortex), but evidence is mixed as to the direction of these effects. The need for further parsing of reward sub-processes is emphasized, including anticipation vs outcome, gains vs. losses, and disorder-relevant cues vs natural rewards. Neurotransmitter PET studies indicate amplified dopamine (DA) release in GD, in the context of minimal differences in baseline DA D2 receptor binding, highlighting a distinct profile from SUDs. Preliminary work has investigated further contributions of opioids, GABA and serotonin. Neuroimaging data increasingly highlight divergent profiles in GD vs. SUDs. The ability of gambling to perpetually activate DA (via maximal uncertainty) may contribute to neuroimaging similarities between GD and SUDs, whereas the supra-physiological DA effects of drugs may partly explain differences in the neuroimaging profile of the two syndromes. Coupled with consistent observations of correlations with gambling severity and related clinical variables within GD samples, the overall pattern of effects is interpreted as a likely combination of shared vulnerability markers across GD and SUDs, but with further experience-dependent neuroadaptive processes in GD.
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Affiliation(s)
- Luke Clark
- Centre for Gambling Research, University of British Columbia (UBC), Vancouver, BC, Canada.,Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Isabelle Boileau
- Addiction Imaging Research Group, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,Vivian M. Rakoff PET Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Schizophrenia Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Martin Zack
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Clinical Neuroscience Program, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON, Canada. .,Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada.
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31
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Ejova A, Ohtsuka K. Erroneous gambling-related beliefs emerge from broader beliefs during problem-solving: a critical review and classification scheme. THINKING & REASONING 2019. [DOI: 10.1080/13546783.2019.1590233] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Anastasia Ejova
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
- LEVYNA Laboratory for the Experimental Research of Religion, Masaryk University, Brno, Czech Republic
| | - Keis Ohtsuka
- Institute for Health and Sport (iHeS), College of Health and Biomedicine – Psychology, Victoria University, Melbourne, VIC, Australia
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32
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Quintero Garzola GC. Review: brain neurobiology of gambling disorder based on rodent models. Neuropsychiatr Dis Treat 2019; 15:1751-1770. [PMID: 31308669 PMCID: PMC6612953 DOI: 10.2147/ndt.s192746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/16/2019] [Indexed: 11/23/2022] Open
Abstract
Different literature reviews of gambling disorder (GD) neurobiology have been focused on human studies, others have focused on rodents, and others combined human and rodent studies. The main question of this review was: which are the main neurotransmitters systems and brain structures relevant for GD based on recent rodent studies? This work aims to review the experimental findings regarding the rodent´s neurobiology of GD. A search in the Pub Med database was set (October 2012-October 2017) and 162 references were obtained. After screening, 121 references were excluded, and only 41 references remained from the initial output. More, other 25 references were added to complement (introduction section, neuroanatomical descriptions) the principal part of the work. At the end, a total of 66 references remained for the review. The main conclusions are: 1) according to studies that used noninvasive methods for drug administration, some of the neurotransmitters and receptors involved in behaviors related to GD are: muscarinic, N-methyl-D-aspartate (NMDA), cannabinoid receptor 1 (CB1), cannabinoid receptor 2 (CB2), dopamine 2 receptor (D2), dopamine 3 receptor (D3), and dopamine 4 receptor (D4); 2) moreover, there are other neurotransmitters and receptors involved in GD based on studies that use invasive methods of drug administration (eg, brain microinjection); example of these are: serotonin 1A receptor (5-HT1A), noradrenaline receptors, gamma-aminobutyric acid receptor A (GABAA), and gamma-aminobutyric acid receptor B (GABAB); 3) different brain structures are relevant to behaviors linked to GD, like: amygdala (including basolateral amygdala (BLA)), anterior cingulate cortex (ACC), hippocampus, infralimbic area, insular cortex (anterior and rostral agranular), nucleus accumbens (NAc), olfactory tubercle (island of Calleja), orbitofrontal cortex (OFC), medial prefrontal cortex (mPFC), prefrontal cortex (PFC) - subcortical network, striatum (ventral) and the subthalamic nucleus (STN); and 4) the search for GD treatments should consider this diversity of receptor/neurotransmitter systems and brain areas.
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Mestre-Bach G, Steward T, Granero R, Fernández-Aranda F, Del Pino-Gutiérrez A, Mallorquí-Bagué N, Mena-Moreno T, Vintró-Alcaraz C, Moragas L, Aymamí N, Gómez-Peña M, Sánchez-González J, Agüera Z, Lozano-Madrid M, Menchón JM, Jiménez-Murcia S. The predictive capacity of DSM-5 symptom severity and impulsivity on response to cognitive-behavioral therapy for gambling disorder: A 2-year longitudinal study. Eur Psychiatry 2018; 55:67-73. [PMID: 30390474 DOI: 10.1016/j.eurpsy.2018.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND DSM-5 proposed a new operational system by using the number of fulfilled criteria as an indicator of gambling disorder severity. This method has proven to be controversial among researchers and clinicians alike, due to the lack of studies indicating whether severity, as measured by these criteria, is clinically relevant in terms of treatment outcome. Additionally, numerous studies have highlighted the associations between gambling disorder and impulsivity, though few have examined the impact of impulsivity on long-term treatment outcomes. METHODS In this study, we aimed to assess the predictive value of DSM-5 severity levels on response to cognitive-behavioral therapy (CBT) in a sample of male adults seeking treatment for gambling disorder (n = 398). Furthermore, we explored longitudinal predictors of CBT treatment response at a follow-up, considering UPPS-P impulsivity traits. RESULTS Our study failed to identify differences in treatment outcomes between patients categorized by DSM-5 severity levels. Higher baseline scores in negative urgency predicted relapse during CBT treatment, and higher levels of sensation seeking were predictive of drop-out from short-term treatment, as well as of drop-out at 24-months. CONCLUSIONS These noteworthy findings raise questions regarding the clinical utility of DSM-5 severity categories and lend support to the implementation of dimensional approaches for gambling disorder.
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Affiliation(s)
- Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès, 08193 Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Jéssica Sánchez-González
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain.
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Napier TC, Persons AL. Pharmacological insights into impulsive-compulsive spectrum disorders associated with dopaminergic therapy. Eur J Neurosci 2018; 50:2492-2502. [PMID: 30269390 DOI: 10.1111/ejn.14177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 12/31/2022]
Abstract
Impulsive-compulsive spectrum disorders are associated with dopamine agonist therapy in some patients. These untoward outcomes occur with direct-acting, full and partial agonists at D2 dopamine family receptors. The disorders typically emerge during chronic treatment, and exhibit common features that are independent of the neurological or psychiatric pathology for which the initial therapy was indicated. It is well-documented that the brain is 'plastic', changing in response to alterations to internal factors (e.g., disease processes), as well as external factors (e.g., therapies). The complexities of these clinical scenarios have eluded a clear depiction of the neurobiology for impulsive-compulsive spectrum disorders and engendered considerable debate regarding the mechanistic underpinnings of the disorders. In this opinion, we use pharmacological concepts related to homeostatic compensation subsequent to chronic receptor activation to provide a unifying construct. This construct helps explain the occurrence of impulsive-compulsive spectrum disorders across disease states, and during therapy with full and partial agonists.
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Affiliation(s)
- T Celeste Napier
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA.,Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL, USA
| | - Amanda L Persons
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA.,Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL, USA.,Department of Physician Assistant Studies, Rush University Medical Center, Chicago, IL, USA
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Luquiens A, Miranda R, Benyamina A, Carré A, Aubin HJ. Cognitive training: A new avenue in gambling disorder management? Neurosci Biobehav Rev 2018; 106:227-233. [PMID: 30359663 DOI: 10.1016/j.neubiorev.2018.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 09/10/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Cognitive deficits are being robustly documented in gambling disorder. Cognitive training has been increasingly investigated as a treatment of substance use disorders. Four training components have been listed to date: cognitive bias, response inhibition, working memory, and goal-directed. This review aimed at the identification of use and efficacy findings in cognitive training in gambling disorder. METHODS We conducted a systematic search to identify use and efficacy data of cognitive training in gambling disorder. No use or efficacy data was available. DISCUSSION AND PERSPECTIVES Studies assessing cognitive training in gambling disorder are being conducted and first results should be upcoming. Methodological challenges have been identified. Several candidate target cognitive functions of training programs are being investigated, relying on the most documented impairments in gambling disorder, inhibition, reward sensitivity and decision making. Gambling-specific or neutral environments are to be distinguished clearly and do not rely on similar assumptions, i.e. general vulnerability or vulnerability expressed only in the specific context of gambling. Proper control groups with placebo conditions should be implemented. Assessment of efficacy should include clinical and neuropsychological assessments to give information of underlying mechanisms of action.
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Affiliation(s)
- Amandine Luquiens
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
| | - Ruben Miranda
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Amine Benyamina
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
| | - Arnaud Carré
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, LIP/PC2S, 38000, Grenoble, France
| | - Henri-Jean Aubin
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
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Mallorquí-Bagué N, Tolosa-Sola I, Fernández-Aranda F, Granero R, Fagundo AB, Lozano-Madrid M, Mestre-Bach G, Gómez-Peña M, Aymamí N, Borrás-González I, Sánchez-González J, Baño M, Del Pino-Gutiérrez A, Menchón JM, Jiménez-Murcia S. Cognitive Deficits in Executive Functions and Decision-Making Impairments Cluster Gambling Disorder Sub-types. J Gambl Stud 2018; 34:209-223. [PMID: 29058168 DOI: 10.1007/s10899-017-9724-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
To identify Gambling Disorder (GD) subtypes, in a population of men seeking treatment for GD, according to specific executive function domains (i.e., cognitive flexibility, inhibition and working memory as well as decision making) which are usually impaired in addictive behaviors. A total of 145 males ranging from 18 to 65 years diagnosed with GD were included in this study. All participants completed: (a) a set of questionnaires to assess psychopathological symptoms, personality and impulsivity traits, and (b) a battery of neuropsychological measures to test different executive functioning domains. Two clusters were identified based on the individual performance on the neuropsychological assessment. Cluster 1 [n = 106; labeled as Low Impaired Executive Function (LIEF)] was composed by patients with poor results in the neuropsychological assessment; cluster 2 patients [n = 46; labeled as High Impaired Executive Function (HIEF)] presented significantly higher deficits on the assessed domains and performed worse than the ones of LIEF cluster. Regarding the characterization of these two clusters, patients in cluster 2 were significantly older, unemployed and registered higher mean age of GD onset than patients in cluster 1. Additionally, patients in cluster 2 also obtained higher psychopathological symptoms, impulsivity (in both positive and negative urgency as well as sensation seeking) and some specific personality traits (higher harm avoidance as well as lower self-directedness and cooperativeness) than patients in cluster 1. The results of this study describe two different GD subtypes based on different cognitive domains (i.e., executive function performance). These two GD subtypes display different impulsivity and personality traits as well as clinical symptoms. The results provide new insight into the etiology and characterization of GD and have the potential to help improving current treatments.
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Affiliation(s)
- Núria Mallorquí-Bagué
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain. .,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain.
| | - Iris Tolosa-Sola
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - Fernándo Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain.,Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Beatriz Fagundo
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | | | - Marta Baño
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | | | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain. .,Ciber Fisiopatologia Obesidad y Nutrición (CB 06/03), Instituto Salud Carlos III, Madrid, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
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Vieno A, Canale N, Potente R, Scalese M, Griffiths MD, Molinaro S. The multiplicative effect of combining alcohol with energy drinks on adolescent gambling. Addict Behav 2018; 82:7-13. [PMID: 29475135 DOI: 10.1016/j.addbeh.2018.01.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE There has been increased concern about the negative effects of adolescents consuming a combination of alcohol mixed with energy drinks (AmED). To date, few studies have focused on AmED use and gambling. The present study analyzed the multiplicative effect of AmED consumption, compared to alcohol alone, on the likelihood of at-risk or problem gambling during adolescence. METHODS Data from the ESPAD®Italia 2015 study, a cross-sectional survey conducted in a nationally representative sample of students (ages 15 to 19years) were used to examine the association between self-reported AmED use (≥6 times,≥10 times, and ≥20 times during the last month) and self-reported gambling severity. Multivariate models were used to calculate adjusted prevalence ratios to evaluate the association between alcohol use, AmED use, and gambling among a representative sample of adolescents who reported gambling in the last year and completed a gambling severity scale (n=4495). RESULTS Among the 19% students classed as at-risk and problem gamblers, 43.9% were classed as AmED consumers, while 23.6% were classed as alcohol consumers (i.e. did not mix alcohol with energy drinks). In multivariate analyses that controlled for covariates, AmED consumers were three times more likely to be at-risk and problem gamblers (OR=3.05) compared to non-consuming adolescents, while the effect became less pronounced with considering those who consumed alcohol without the addition of energy drinks (OR=1.37). CONCLUSIONS The present study clearly established that consuming AmED might pose a significantly greater risk of experiencing gambling-related problems among adolescents.
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Christensen DR. A review of opioid-based treatments for gambling disorder: an examination of treatment outcomes, cravings, and individual differences. INTERNATIONAL GAMBLING STUDIES 2018. [DOI: 10.1080/14459795.2018.1470662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Darren R. Christensen
- Faculty of Health Sciences, University of Lethbridge, Alberta Gambling Research Institute , Lethbridge, Canada
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Chamberlain SR, A Redden S, Grant JE. Calorie Intake and Gambling: Is Fat and Sugar Consumption 'Impulsive'? J Gambl Stud 2018; 33:783-793. [PMID: 27766464 DOI: 10.1007/s10899-016-9647-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Excessive calorie intake constitutes a global public health concern, due to its associated range of untoward outcomes. Gambling is commonplace and gambling disorder is now considered a behavioral addiction in DSM-5. The relationships between calorie intake, gambling, and other types of putatively addictive and impulsive behaviors have received virtually no research attention. Two-hundred twenty-five young adults who gamble were recruited from two Mid-Western university communities in the United States using media advertisements. Dietary intake over the preceding year was quantified using the Dietary Fat and Free Sugar Short questionnaire (DFS). Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between dietary fat/sugar intake and gambling behaviors, as well as other measures of psychopathology and cognition germane to addiction, were evaluated using correlational analyses controlling for multiple comparisons. Greater dietary fat and sugar intake were associated with lower educational levels and with male gender. Controlling for these variables, higher dietary fat and sugar intake were correlated significantly with worse gambling pathology and anxiety scores. Dietary sugar intake was also significantly associated with higher depressive scores, more alcohol intake, lower self-esteem, and with greater risk of having one or more mental disorders in general. Dietary intake did not correlate significantly with ADHD symptoms, presence of one or more impulse control disorders, Barratt impulsiveness, or cognitive functioning. These data suggest a particularly strong relationship between fat/sugar intake and symptoms of gambling pathology, but not most other forms of impulsivity and behavioral addiction (excepting alcohol intake). Providing education about healthy diet may be especially valuable in gamblers and in community settings where gambling advertisements feature prominently. Future work should explore the mediating mechanisms between calorie intake and gambling symptoms, such as whether this could be driven by environmental factors (e.g. advertising) or common dysfunction of brain reward pathways.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK.,Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
| | - Sarah A Redden
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 3077, Chicago, IL, 60637, USA
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 3077, Chicago, IL, 60637, USA.
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Ruiz de Lara CM, Navas JF, Soriano-Mas C, Sescousse G, Perales JC. Regional grey matter volume correlates of gambling disorder, gambling-related cognitive distortions, and emotion-driven impulsivity. INTERNATIONAL GAMBLING STUDIES 2018. [DOI: 10.1080/14459795.2018.1448427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Cristian M. Ruiz de Lara
- Department of Experimental Psychology, University of Granada , Granada, Spain
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada , Granada, Spain
| | - Juan F. Navas
- Department of Experimental Psychology, University of Granada , Granada, Spain
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada , Granada, Spain
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL , Barcelona, Spain
- CIBERSAM, Carlos III Health Institute , Barcelona, Spain
- Department of Psychobiology and Methodology in Health Sciences, Universitat Autònoma de Barcelona , Barcelona, Spain
| | - Guillaume Sescousse
- Donders Institute for Brain, Cognition and Behaviour, Radboud University , Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre , Nijmegen, The Netherlands
| | - José C. Perales
- Department of Experimental Psychology, University of Granada , Granada, Spain
- Mind, Brain, and Behaviour Research Centre (CIMCYC), University of Granada , Granada, Spain
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Narcissistic Implications in Gambling Disorder: The Mediating Role of Emotion Dysregulation. J Gambl Stud 2018; 34:1241-1260. [DOI: 10.1007/s10899-018-9759-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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42
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In Search of Executive Impairment in Pathological Gambling: A Neuropsychological Study on Non-treatment Seeking Gamblers. J Gambl Stud 2018; 34:1327-1340. [DOI: 10.1007/s10899-018-9758-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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43
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Personality biomarkers of pathological gambling: A machine learning study. J Neurosci Methods 2018; 294:7-14. [DOI: 10.1016/j.jneumeth.2017.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/02/2017] [Accepted: 10/24/2017] [Indexed: 02/02/2023]
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Grant JE, Chamberlain SR. Caffeine's influence on gambling behavior and other types of impulsivity. Addict Behav 2018; 76:156-160. [PMID: 28822322 DOI: 10.1016/j.addbeh.2017.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/05/2017] [Accepted: 08/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Young adulthood is a developmental period frequently associated with occurrence of impulsive behaviors including gambling. It is estimated that 73% of children and 87% of adults in the United States regularly use caffeine. Questions remain, however, concerning the role of caffeine in the development and maintenance of impulsive behaviors such as gambling. METHODS Sixty-one young adults with at least some degree of disordered gambling were recruited from two Mid-Western university communities in the United States using media advertisements. Caffeine intake over the preceding month was quantified using the Caffeine Use Questionnaire. Clinician rating scales, questionnaires, and cognitive tests germane to impulsivity were completed. Relationships between caffeine intake and demographic, gambling symptom, and neurocognitive measures were evaluated using the statistical technique of partial least squares (PLS). RESULTS Average weekly caffeine intake in the gamblers was 1218.5mg (a figure higher than previously reported in the general population). PLS yielded an optimal model with one latent factor, which explained 14.8% of variation in demographic/clinical/cognitive measures and 32.3% of variation in caffeine intake. In this model, higher caffeine intake was significantly associated with earlier age at first gambling, higher personality-related impulsiveness, more nicotine consumption, older age, and more impulsive decision-making. CONCLUSIONS These data suggest a particularly strong relationship between caffeine intake, earlier age of first gambling, and certain types of impulsivity in gamblers. Providing education about healthy caffeine use may be especially valuable in gamblers. Future work should explore whether the relationship between caffeine use and gambling is due to a common predisposing factor (impulsive tendencies) or, rather, constitutes a form of self-medication in gamblers (or a means of sustaining gambling habits for longer).
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Online effects of transcranial direct current stimulation on prefrontal metabolites in gambling disorder. Neuropharmacology 2017; 131:51-57. [PMID: 29221791 DOI: 10.1016/j.neuropharm.2017.12.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 11/28/2017] [Accepted: 12/03/2017] [Indexed: 02/07/2023]
Abstract
Gambling disorder is characterized by persistent maladaptive gambling behaviors and is now considered among substance-related and addictive disorders. There is still unmet therapeutic need for these clinical populations, however recent advances indicate that interventions targeting the Glutamatergic/GABAergic system hold promise in reducing symptoms in substance-related and addictive disorders, including gambling disorder. There is some data indicating that transcranial direct current stimulation may hold clinical benefits in substance use disorders and modulate levels of brain metabolites including glutamate and GABA. The goal of the present work was to test whether this non-invasive neurostimulation method modulates key metabolites in gambling disorder. We conducted a sham-controlled, crossover, randomized study, blinded at two levels in order to characterize the effects of transcranial direct current stimulation over the dorsolateral prefrontal cortex on neural metabolites levels in sixteen patients with gambling disorder. Metabolite levels were measured with magnetic resonance spectroscopy from the right dorsolateral prefrontal cortex and the right striatum during active and sham stimulation. Active as compared to sham stimulation elevated prefrontal GABA levels. There were no significant changes between stimulation conditions in prefrontal glutamate + glutamine and N-acetyl Aspartate, or in striatal metabolite levels. Results also indicated positive correlations between metabolite levels during active, but not sham, stimulation and levels of risk taking, impulsivity and craving. Our findings suggest that transcranial direct current stimulation can modulate GABA levels in patients with gambling disorder which may represent an interesting future therapeutic avenue.
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Steward T, Mestre-Bach G, Fernández-Aranda F, Granero R, Perales JC, Navas JF, Soriano-Mas C, Baño M, Fernández-Formoso JA, Martín-Romera V, Menchón JM, Jiménez-Murcia S. Delay discounting and impulsivity traits in young and older gambling disorder patients. Addict Behav 2017; 71:96-103. [PMID: 28288442 DOI: 10.1016/j.addbeh.2017.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/23/2017] [Accepted: 03/04/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Impulsivity is understood to be a multidimensional construct involving aspects such as impulsive choice and impulsive traits. Delay discounting, the tendency to place greater value in immediate rewards over larger, long-term rewards, has been associated with maladaptive choices in gambling disorder (GD). Delay discounting is known to evolve with age; though no study to date has evaluated the interactions between impulsivity, GD severity and age in treatment-seeking patients. OBJECTIVES We aimed to examine whether associations between delay discounting and impulsivity traits differed between younger and older-aged GD patients. Secondly, we sought to untangle the mediating role of impulsivity in determining gambling behavior in these two age groups. METHODS GD patients (N=335) were evaluated using the UPPS-P Impulsive Behavior Scale and a delay discounting task. Structural Equation Modeling (SEM) was used to explore associations between impulsivity measures and gambling severity in young (18-30years) and old (31-70) GD patients. RESULTS No differences in delay discounting were found between young and old GD patients. Significant correlations between delay discounting and urgency levels (the tendency to act rashly under emotional states) were identified only in the young GD group. Path analyses also revealed both positive and negative urgency to be a mediator of GD severity levels in young GD patients. DISCUSSION AND CONCLUSIONS Significant associations between impulsive choice and positive urgency are only present in young gamblers, suggesting that positive urgency influence choice behavior to a greater degree at younger ages. Implications for targeted interventions are discussed.
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Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies. Neurosci Biobehav Rev 2017; 78:104-116. [DOI: 10.1016/j.neubiorev.2017.04.025] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 04/18/2017] [Accepted: 04/22/2017] [Indexed: 12/21/2022]
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Jiménez-Murcia S, Granero R, Wolz I, Baño M, Mestre-Bach G, Steward T, Agüera Z, Hinney A, Diéguez C, Casanueva FF, Gearhardt AN, Hakansson A, Menchón JM, Fernández-Aranda F. Food Addiction in Gambling Disorder: Frequency and Clinical Outcomes. Front Psychol 2017; 8:473. [PMID: 28421009 PMCID: PMC5378803 DOI: 10.3389/fpsyg.2017.00473] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/14/2017] [Indexed: 01/08/2023] Open
Abstract
Background: The food addiction (FA) model is receiving increasing interest from the scientific community. Available empirical evidence suggests that this condition may play an important role in the development and course of physical and mental health conditions such as obesity, eating disorders, and other addictive behaviors. However, no epidemiological data exist on the comorbidity of FA and gambling disorder (GD), or on the phenotype for the co-occurrence of GD+FA. Objectives: To determine the frequency of the comorbid condition GD+FA, to assess whether this comorbidity features a unique clinical profile compared to GD without FA, and to generate predictive models for the presence of FA in a GD sample. Method: Data correspond to N = 458 treatment-seeking patients who met criteria for GD in a hospital unit specialized in behavioral addictions. Results: Point prevalence for FA diagnosis was 9.2%. A higher ratio of FA was found in women (30.5%) compared to men (6.0%). Lower FA prevalence was associated with older age. Patients with high FA scores were characterized by worse psychological state, and the risk of a FA diagnosis was increased in patients with high scores in the personality traits harm avoidance and self-transcendence, and low scores in cooperativeness (R2 = 0.18). Conclusion: The co-occurrence of FA in treatment-seeking GD patients is related to poorer emotional and psychological states. GD treatment interventions and related behavioral addictions should consider potential associations with problematic eating behavior and aim to include techniques that aid patients in better managing this behavior.
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Affiliation(s)
- Susana Jiménez-Murcia
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of BarcelonaBarcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Ines Wolz
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Marta Baño
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
| | - Gemma Mestre-Bach
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Trevor Steward
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Zaida Agüera
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-EssenEssen, Germany
| | - Carlos Diéguez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Physiology, Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas, University of Santiago de Compostela-Instituto de Investigación SanitariaSantiago de Compostela, Spain
| | - Felipe F Casanueva
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Laboratory of Molecular and Cellular Endocrinology, Research Area, Complejo Hospitalario Universitario de Santiago de CompostelaSantiago de Compostela, Spain
| | | | - Anders Hakansson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, PsychiatryLund, Sweden
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of BarcelonaBarcelona, Spain.,Ciber Salud Mental (CIBERSAM), Instituto Carlos IIIBarcelona, Spain
| | - Fernando Fernández-Aranda
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Clinical Sciences, Faculty of Medicine, University of BarcelonaBarcelona, Spain
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49
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Nautiyal KM, Okuda M, Hen R, Blanco C. Gambling disorder: an integrative review of animal and human studies. Ann N Y Acad Sci 2017; 1394:106-127. [PMID: 28486792 PMCID: PMC5466885 DOI: 10.1111/nyas.13356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/29/2022]
Abstract
Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.
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Affiliation(s)
- Katherine M. Nautiyal
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Mayumi Okuda
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Rene Hen
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Departments of Neuroscience and Pharmacology, Columbia University, New York, New York
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
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50
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Maniaci G, Goudriaan AE, Cannizzaro C, van Holst RJ. Impulsivity and Stress Response in Pathological Gamblers During the Trier Social Stress Test. J Gambl Stud 2017; 34:147-160. [PMID: 28316029 PMCID: PMC5846820 DOI: 10.1007/s10899-017-9685-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Gambling has been associated with increased sympathetic nervous system output and stimulation of the hypothalamic–pituitary–adrenal axis. However it is unclear how these systems are affected in pathological gambling. This study aimed to investigate the effect of the Trier Social Stress Test (TSST) on cortisol and on cardiac interbeat intervals in relation to impulsivity, in a sample of male pathological gamblers compared to healthy controls. In addition, we investigated the correlation between the TSST, duration of the disorder and impulsivity. A total of 35 pathological gamblers and 30 healthy controls, ranging from 19 to 58 years old and all male, participated in this study. Stress response was measured during and after the TSST by salivary cortisol and cardiac interbeat intervals; impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). Exposure to the TSST produced a significant increase in salivary cortisol and interbeat intervals in both groups, without differences between groups. We found a negative correlation between baseline cortisol and duration of pathological gambling indicating that the longer the duration of the disorder the lower the baseline cortisol levels. Additionally, we found a main effect of impulsivity across groups on interbeat interval during the TSST, indicating an association between impulsivity and the intensity of the neurovegetative stress response during the TSST. Involvement of the hypothalamic–pituitary–adrenal axis in pathological gambling was confirmed together with evidence of a correlation between length of the disorder and diminished baseline cortisol levels. Impulsivity emerged as a personality trait expressed by pathological gamblers; however the neurovegetative response to the TSST, although associated with impulsivity, appeared to be independent of the presence of pathological gambling.
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Affiliation(s)
- G Maniaci
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.,Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands
| | - A E Goudriaan
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.,Arkin Mental Health Care, Amsterdam, The Netherlands
| | - C Cannizzaro
- Department of Sciences for Health Promotion and Mother and Child Care "Giuseppe D'Alessandro", University of Palermo, Palermo, Italy
| | - R J van Holst
- Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
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