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Wu R, Clark L. Impulse and reason? Justifications in problem gambling. Addict Behav 2024; 157:108072. [PMID: 38851143 DOI: 10.1016/j.addbeh.2024.108072] [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: 02/20/2024] [Revised: 04/29/2024] [Accepted: 05/20/2024] [Indexed: 06/10/2024]
Abstract
People often use justifications to make desirable choices, but little is known about these justificatory thoughts in gambling. We conducted an exploratory Study 1 (n = 101) and a confirmatory Study 2 (n = 154) using online surveys, recruiting gamblers with prior and current experience of trying to reduce their gambling. Using justifications recognized in the domains of eating and consumer behavior (e.g., prior use of effort, feelings of achievement), we examined whether justifications were associated with problem gambling severity, and whether they explained additional variance above trait impulsivity and cognitive distortions. In both studies, justifications were positively associated with problem gambling severity, after accounting for trait impulsivity and cognitive distortions. Additionally, justifications were positively correlated with trait urgency and cognitive distortions, indicating that such thinking may not be antithetical to impulsivity. These data provide proof-of-principle evidence that justificatory thinking occurs in the context of gambling, is related to problem gambling severity, and may therefore represent a neglected aspect of gambling-related cognitions.
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Affiliation(s)
- Raymond Wu
- Centre for Gambling Research, Department of Psychology, University of British Columbia, Canada.
| | - Luke Clark
- Centre for Gambling Research, Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
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2
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Grubbs JB, Connolly AJ, Floyd CG, Kim HS, Kraus SW. Impulsivity and diverse forms of sports wagering in the U.S.: An examination of the UPPS-P model. Addict Behav 2024; 156:108058. [PMID: 38733951 DOI: 10.1016/j.addbeh.2024.108058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Center on Alcohol, Substance Use, And Addictions (CASAA), University of New Mexico, Albuquerque, USA.
| | - Alex J Connolly
- Department of Psychology, University of New Mexico, Albuquerque, USA
| | - Christopher G Floyd
- Department of Psychology, Bowling Green State University, Bowling Green, USA
| | - Hyoun S Kim
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, USA
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3
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Bai X, Liu H, Li T, Xu L, Liu X. Enhancing response inhibition behavior through tDCS intervention in college students with smartphone addiction. Sci Rep 2024; 14:19469. [PMID: 39174567 PMCID: PMC11341704 DOI: 10.1038/s41598-024-69175-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024] Open
Abstract
Smartphone addiction, emerging from excessive use of smartphones, poses a challenge to inhibitory control functions within society. This research employed transcranial direct current stimulation (tDCS) as an intervention alongside the stop signal task (SST) to explore behavioral distinctions between individuals with smartphone addiction and a non-addicted control group, focusing on the efficacy of tDCS intervention. The participant cohort comprised 80 individuals, divided into an addiction group (39 participants, with 19 receiving active tDCS and 20 receiving sham tDCS) and a control group (41 participants, with 20 receiving active tDCS and 21 receiving sham tDCS), with anodal stimulation applied over the right dorsolateral prefrontal cortex (dlPFC) and cathodal placement over the left arm. The findings indicate that university students struggling with smartphone addiction exhibit reduced inhibitory control compared to their non-addicted peers, while maintaining similar levels of general cognitive control. Remarkably, tDCS interventions were observed to enhance inhibitory control in both groups. Although the improvement in the addiction group appeared more pronounced numerically than in the control group, no significant interaction with group was noted. However, a higher percentage of participants in the smartphone addiction (SA) group exhibited enhanced response inhibition under active tDCS. This study demonstrates the inhibitory control deficits in individuals addicted to smartphones and underscores the potential of tDCS in enhancing response inhibition. It provides a valuable reference for future tDCS research targeting smartphone addiction and highlights the importance of developing healthier smartphone usage habits.
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Affiliation(s)
- Xue Bai
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
| | - Huafang Liu
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
| | - Tongshu Li
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China
| | - Lei Xu
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China.
| | - Xiaolong Liu
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, 610066, China.
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4
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Li S, Feng N, Cui L. Network analysis of social anxiety and problematic mobile phone use in Chinese adolescents: A longitudinal study. Addict Behav 2024; 155:108026. [PMID: 38593598 DOI: 10.1016/j.addbeh.2024.108026] [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: 11/01/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/11/2024]
Abstract
Social anxiety is a common comorbid factor of problematic mobile phone use, but the relationship between them from the inside structure has been underexplored. This two-wave longitudinal study aims to identify the central symptoms of problematic mobile phone use and social anxiety, respectively, as well as the bridge symptoms between the two disorders. Furthermore, this study examined the time and gender differences. A total of 3,294 Chinese adolescents were recruited during two waves (T1: January 2023; T2: August 2023), and completed the questionnaires of social anxiety and problematic mobile phone use. Through network analysis, the results showed that 1) the central symptom of problematic mobile phone use was "loss of control" both at T1 and T2, 2) the central symptom of social anxiety was "fear of negative evaluation" both at T1 and T2, and 3) the bridge symptom between social anxiety and problematic mobile phone use was "withdrawal" both at T1 and T2. Moreover, the network comparison test indicated that the nodes of social anxiety were more strongly associated with "craving", "loss of control", and "negative life consequences" of problematic mobile phone use at T2 than at T1. The nodes of social anxiety were more strongly associated with "negative life consequences" of problematic mobile phone use for boys than for girls, while the "fear of negative evaluation" was more strongly associated with "loss of control" for girls than for boys. These findings provide new scientific basis for interventions targeting adolescents who are susceptible to social anxiety and problematic mobile phone use.
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Affiliation(s)
- Shuang Li
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Institute of Brain and Education Innovation, The School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ningning Feng
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Institute of Brain and Education Innovation, The School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Shanghai Centre for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Lijuan Cui
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Institute of Brain and Education Innovation, The School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Shanghai Centre for Brain Science and Brain-Inspired Technology, Shanghai, China.
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5
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Mora-Maltas B, Baenas I, Etxandi M, Lucas I, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Gómez-Peña M, Moragas L, Del Pino-Gutiérrez A, Tapia J, Diéguez C, Goudriaan AE, Jiménez-Murcia S. Association between endocrine and neuropsychological endophenotypes and gambling disorder severity. Addict Behav 2024; 153:107968. [PMID: 38447412 DOI: 10.1016/j.addbeh.2024.107968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/07/2024] [Accepted: 01/22/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Neurobiological characteristics have been identified regarding the severity of gambling disorder (GD). The aims of this study were: (1) to examine, through a path analysis, whether there was a relationship between neuroendocrine features, potentially mediational GD variables, and GD severity, and (2) to associate neuroendocrine variables, with GD severity-related variables according to gambling preferences. METHODS The sample included 297 outpatients with GD. We analyzed endocrine concentrations of different appetite-related hormones (ghrelin, liver antimicrobial peptide 2 [LEAP-2], leptin, adiponectin), and neuropsychological performance (working memory, cognitive flexibility, inhibition, decision making, premorbid intelligence). Path analysis assessed mechanisms between neuroendocrine features and GD severity, including mediational GD variables (impulsivity traits and gambling-related cognitive distortions). Partial correlations evaluated the associations between neuroendocrine variables, including impulsivity traits, and variables related to GD severity (DSM-5, South Oaks Gambling Screen, illness duration, and gambling-related cognitive distortions). RESULTS Lower adiponectin concentrations predicted greater GD severity, while higher LEAP-2 concentrations predicted more gambling-related cognitive distortions. Likewise, better neuropsychological performance directly predicted GD severity, but worse neuropsychological performance was associated with GD severity through the mediational variables of impulsivity traits and gambling-related cognitive distortions. Also, in non-strategic individuals with GD, poor working memory was associated with gambling expectancies and predictive control. In strategic individuals with GD, poor cognitive flexibility was associated with illusion of control, predictive control, and inability to stop gambling. CONCLUSIONS These results provide updated information about the comprehension of the interaction between neuroendocrine features, clinical variables, and severity of GD. Thus, neurobiological functions seem to be strongly related to GD severity.
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Affiliation(s)
- Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain
| | - Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mikel Etxandi
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Roser Granero
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sulay Tovar
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Doctorate in Medicine and Traslational Research Programme, University of Barcelona (UB), Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Medical Direction of Ambulatory Processes, South Metropolitan Territorial Management, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Diéguez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria, Santiago de Compostela, Spain
| | - Anna E Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Centre for Psychological Services, University of Barcelona, Spain.
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Wirkus T, Czernecka R, Bühringer G, Kräplin A. Individual risk factors and prediction of gambling disorder in online sports bettors - the longitudinal RIGAB study. Front Psychiatry 2024; 15:1320592. [PMID: 38476615 PMCID: PMC10929711 DOI: 10.3389/fpsyt.2024.1320592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction While research in online sports betting is dominated by studies using objective player tracking data from providers to identify risky gambling behavior, basicresearch has identified various putative individual risk factors assumed to underlie the development of gambling disorder across all types of gambling. This study aims to examine individual risk factors and their longitudinal clinical relevance in online sports bettors. Methods German online sports bettors (N = 607, Mage = 34, 92% male) from a provider based sample took part in an online survey. The study team randomly preselected customers to be invited. N = 325 (53,45%) of the participants also took part in an online follow-up survey one year later. Crosssectional and longitudinal associations of putative risk factors and DSM-5 gambling disorder in online sports bettors were analyzed. These risk factors include alcohol and tobacco use, impulsivity, difficulties in emotion identification, emotion regulation strategies, comorbid mental disorders and stress. Results We found more pronounced impulsivity, difficulties in emotion identification, emotion suppression, comorbid mental disorders and stress were cross-sectionally associated with gambling disorder, and longitudinally predicted gambling disorder in online sports bettors (with the exception of emotion suppression). In an overall model only lack of premeditation and perceived helplessness remained significant as predictors for gambling disorder. Online sports bettors with gambling disorder predominantly showed more pronounced risk factors, which were also confirmed longitudinally as relevant for the maintenance of gambling disorder. Discussion Risk factors such as impulsivity and stress and appropriate coping mechanisms should consequently be integrated not only into prevention efforts to identify individuals at risk early, but also into intervention efforts to tailor treatment.
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Affiliation(s)
- Theresa Wirkus
- Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Robert Czernecka
- Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Institut für Therapieforschung IFT, Prävention und betriebliche Gesundheitsförderung GmbH, München, Germany
| | - Gerhard Bühringer
- Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Institut für Therapieforschung IFT, Prävention und betriebliche Gesundheitsförderung GmbH, München, Germany
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Anja Kräplin
- Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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7
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Elliott MV, Johnson SL, Pearlstein JG, Muñoz Lopez DE, Keren H. Emotion-related impulsivity and risky decision-making: A systematic review and meta-regression. Clin Psychol Rev 2023; 100:102232. [PMID: 36512906 PMCID: PMC9974869 DOI: 10.1016/j.cpr.2022.102232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/12/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022]
Abstract
Emotion-related impulsivity, the trait-like tendency toward regrettable behavior during states of high emotion, is a robust predictor of internalizing and externalizing psychopathology. Despite substantial evidence that emotion-related impulsivity is important transdiagnostically, relatively little is known about its cognitive correlates. This systematic review and meta-regression investigates one such candidate, risky decision-making. We analyzed 195 effect sizes from 51 studies of 14,957 total participants, including 105 newly calculated effect sizes that were not reported in the original publications. The meta-regression demonstrated evidence for a small, positive relationship of emotion-related impulsivity with behavioral indices of risky decision-making (ß = 0.086). Effects generalized across sample age, gender, Positive versus Negative Urgency, and clinical versus nonclinical samples. The average effect size varied by task type, with stronger effects for the Iowa Gambling Task and Delay Discounting Task. Experimental arousal manipulation was nearly a significant moderator, with stress and pharmacological manipulations yielding significant effect sizes. Analyses indicated that publication bias did not skew the current findings. Notwithstanding limitations, the data suggest that risky decision-making is a cognitive domain that relates to emotion-related impulsivity. We conclude with recommendations regarding the specific types of tasks and arousal inductions that will best capture emotion-related impulsivity in future experimental research.
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Affiliation(s)
- Matthew V Elliott
- University of California, Berkeley, Berkeley, CA, United States of America.
| | - Sheri L Johnson
- University of California, Berkeley, Berkeley, CA, United States of America
| | | | | | - Hanna Keren
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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8
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Awo LO, Amazue LO, Eze VC, Ekwe CN. Mediating Role of Impulsivity in the Contributory Roles of Upward Versus Downward Counterfactual Thinking in Youth Gambling Intention. J Gambl Stud 2023; 39:33-48. [PMID: 35246753 DOI: 10.1007/s10899-022-10112-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 11/26/2022]
Abstract
The proliferation of gambling shops, and the growing gambling prevalence in Nigeria, youths have constantly engaged in gambling activities even during school period. This has raised concerns among therapists and parents as the trend could degenerate to problem gambling and its associated psychosocial problems if left unchecked. Our study examined the role of impulsivity as a mediator in the association between two types of counterfactual thinking (CFT) and gambling intention in a non-clinical sample. A self-report measure containing South Oaks Gambling Screen: Reversed for Adolescents (SOGS: RA), CFT, and impulsivity scales was completed by 371 Nigerian adolescents who had gambled for money (mean age = 17.37 years; SD = 4.13). After controlling for age, increase in downward CFT was associated with decreased gambling intention, whereas increase in upward CFT and impulsivity were associated with increased gambling intention. Upward CFT contributed more to gambling intention than downward CFT. Mediation result showed that Impulsivity significantly mediated only the association between upward CFT and gambling intention. We concluded that gambling therapies should include treatment packages that enhance impulse control abilities and gambling-related downward CFT and at the same time, attenuate gambling-related upward CFT.
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Affiliation(s)
- Larry O Awo
- School of General Studies, Federal Polytechnic of Oil and Gas, Bonny, Nigeria.
| | | | - Val C Eze
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Catherine N Ekwe
- Department of Educational Foundations and Counselling, Imo State University, Owerri, Nigeria
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Garrett EP, Drummond A, Lowe-Calverley E, de Salas K, Lewis I, Sauer JD. Impulsivity and loot box engagement. TELEMATICS AND INFORMATICS 2023. [DOI: 10.1016/j.tele.2023.101952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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10
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Valenciano-Mendoza E, Fernández-Aranda F, Granero R, Vintró-Alcaraz C, Mora-Maltas B, Valero-Solís S, Sánchez I, Toro JJD, Gómez-Peña M, Moragas L, Jiménez-Murcia S. Common and differential risk factors behind suicidal behavior in patients with impulsivity-related disorders: The case of bulimic spectrum eating disorders and gambling disorder. J Behav Addict 2022; 11:963-978. [PMID: 36287739 PMCID: PMC9881661 DOI: 10.1556/2006.2022.00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/23/2022] [Accepted: 09/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS Mental disorders with high levels of impulsivity such as bulimic spectrum eating disorders (BSED) and gambling disorder (GD) are associated with high risk of suicidal behavior. The aim of the present study was to identify the common and differential vulnerability factors behind suicide attempts in a sample of patients with BSED compared to patients with GD. METHODS A total of 6,077 adults who sought treatment and met criteria either for BSED (n = 2,391) or GD (n = 3,686) were assessed at a specialized hospital unit. Personality traits, psychopathological symptomatology, lifetime history of suicide attempts and socio-demographic variables were evaluated. RESULTS The prevalence of suicide attempts was higher for BSED patients (26.2%) compared to GD patients (7.1%) being anorexia nervosa (Binge/Purge type) and bulimia nervosa the most affected subtypes. In the predictive model, the transdiagnostic vulnerability factors with the highest contribution to the risk of suicidal behavior both in BSED and GD were unemployment, early age of onset of the disorder, worse psychopathological state, and self-transcendence personality trait. However, specific risk factors for suicidal acts were identified in each disorder: longer duration of the disorder, lower education levels and reward dependence were exclusively associated with BSED while female gender, older age, and higher harm avoidance were associated with GD. DISCUSSION Patients with GD and BSED share certain vulnerability factors although certain factors are exclusive to each disorder. CONCLUSIONS Interventions need to pay special attention to both common and specific vulnerability factors to mitigate the risk of suicidal acts in these disorders.
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Affiliation(s)
- Eduardo Valenciano-Mendoza
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Corresponding author. E-mail:
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jessica Jimenez-de Toro
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain,Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), 08908, Barcelona, Spain,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Corresponding author. E-mail:
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Mastropietro S, Favieri F, Forte G, Locuratolo N, Mannarelli D, Pauletti C, Fattapposta F, Casagrande M. Behavioral Addictions Questionnaire (BAQ): Validation of a New Tool for the Screening of Multiple Addictive Behaviors in the Italian Population. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00906-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
AbstractThis study deals with the uncertainty in defining behavioral addictions (BAs). BAs are characterized by specific compulsive behaviors, regardless of potential negative consequences. However, to differentiate a behavior from a leisure activity to an addictive one is still an object of debate in the literature. Accordingly, this study aimed to assess the psychometric properties of the Behavioral Addictions Questionnaire (BAQ) as a possible screening tool for multiple BAs (i.e., shopping, food addiction, gambling, sex, work, exercise, Internet, videogames, and smartphone). BAQ aims to give a dimensional and quantitative assessment of addictive behaviors in a continuum, including both the adaptive and maladaptive features of the behaviors. Five hundred and seventy-six healthy adults (age range: 18–88) participated in the study, completing a survey including the BAQ questionnaire. Considering both exploratory and confirmatory factor analyses, statistical examination suggested good psychometric properties, with adequate validity in all its subscales (i.e., the goodness of fit). Moreover, also higher reliability was confirmed for each dimension detected (i.e., all alpha over 0.65). The BAQ represents a comprehensive screening instrument that benefits from appropriate validity and reliability for assessing BAs. Therefore, it can be used in clinical fields and research. Moreover, the feature of BAs on a continuum, and the severity index adopted by the study, can help from a preventive perspective. However, further validation of the BAQ is needed in other countries and contexts.
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Boussac M, Arbus C, Colin O, Laurencin C, Eusebio A, Hainque E, Corvol JC, Versace N, Rascol O, Rousseau V, Harroch E, Ory-Magne F, Fabbri M, Moreau C, Rolland AS, Jarraya B, Maltête D, Drapier S, Marques AR, Auzou N, Wirth T, Meyer M, Giordana B, Tir M, Rouaud T, Devos D, Brefel-Courbon C. Personality assessment with Temperament and Character Inventory in Parkinson's disease. Parkinsonism Relat Disord 2022; 103:34-41. [PMID: 36030666 DOI: 10.1016/j.parkreldis.2022.08.004] [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: 06/14/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION There is a growing interest in personality evaluation in Parkinson's disease (PD), following observations of specific temperaments in PD patients. Therefore, our objective was to evaluate personality dimensions from the Temperament and Character Inventory (TCI) in a cohort of fluctuating PD patients considered for deep brain stimulation. METHODS Fluctuating PD patients from the PREDISTIM cohort were included. Description of TCI dimensions and comparison with a French normative cohort were performed. Pearson correlations between TCI dimensions and motor, behavioral and cognitive variables were investigated. Structural and internal consistency analysis of the TCI were further assessed. RESULTS The 570 PD patients presented significant higher scores in Harm Avoidance, Reward Dependence, Persistence, Self-Directedness and Cooperativeness and significant lower scores in Self-Transcendence compared to the French normative cohort; only Novelty Seeking scores were not different. Harm Avoidance and Self-directedness scores were correlated with PDQ-39 total, HAMD, HAMA scores, and anxiolytic/antidepressant treatment. Novelty Seeking scores were correlated with impulsivity. Pearson correlations between TCI dimensions, principal component analysis of TCI sub-dimensions and Cronbach's alpha coefficients showed adequate psychometric proprieties. CONCLUSION The TCI seems to be an adequate tool to evaluate personality dimensions in PD with good structural and internal consistencies. These fluctuating PD patients also have specific personality dimensions compared to normative French population. Moreover, Harm Avoidance and Self-Directedness scores are associated with anxio-depressive state or quality of life and, and Novelty Seeking scores with impulsivity.
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Affiliation(s)
- Mathilde Boussac
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France.
| | - Christophe Arbus
- Psychiatry Department of the University Hospital of Toulouse, CHU Purpan, Toulouse, France
| | - Olivier Colin
- Service de neurologie, Centre Hospitalier de Brive-la-Gaillarde, France; Centre Expert Parkinson, CHU de Limoges, France
| | - Chloé Laurencin
- Service de neurologie C - Hôpital Neurologique - 59 boulevard Pinel 69003 Lyon - Hospices Civils de Lyon, France
| | - Alexandre Eusebio
- Aix Marseille Université, AP-HM, Hôpital de La Timone, Service de Neurologie et Pathologie du Mouvement, and UMR CNRS 7289, Institut de Neuroscience de La Timone, NS-PARK/FCRIN Network, Marseille, France
| | - Elodie Hainque
- Département de Neurologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; et Faculté de Médecine de Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau, F-75013, Paris, France
| | - Jean Christophe Corvol
- Département de Neurologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; et Faculté de Médecine de Sorbonne Université, UMR S 1127, Inserm U 1127, and CNRS UMR 7225, and Institut du Cerveau, F-75013, Paris, France
| | - Nathalie Versace
- Department of Neurology, Hôpital Fondation Rothschild, Paris, France
| | - Olivier Rascol
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center CIC1436, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), Toulouse, NS-PARK/FCRIN Network, France
| | - Vanessa Rousseau
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center CIC1436, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), Toulouse, NS-PARK/FCRIN Network, France
| | - Estelle Harroch
- Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center CIC1436, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), Toulouse, NS-PARK/FCRIN Network, France
| | - Fabienne Ory-Magne
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center CIC1436, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), Toulouse, NS-PARK/FCRIN Network, France
| | - Margherita Fabbri
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center CIC1436, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), Toulouse, NS-PARK/FCRIN Network, France
| | - Caroline Moreau
- Department of Medical Pharmacology, Neurology and Movement Disorders Department, Referent Center of Parkinson's disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, Lille, NS-PARK/FCRIN Network, France
| | - Anne-Sophie Rolland
- Department of Medical Pharmacology, Neurology and Movement Disorders Department, Referent Center of Parkinson's disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, Lille, NS-PARK/FCRIN Network, France
| | - Béchir Jarraya
- Service de Neurologie, Unité des Mouvements Anormaux, Foch Hospital, Suresnes, France; Université de Versailles Paris-Saclay, INSERM U992, CEA Neurospin, Saclay, France
| | - David Maltête
- Department of Neurology, Rouen University Hospital and University of Rouen, France; INSERM U1239, Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan, France
| | - Sophie Drapier
- Service de neurologie, CHU Rennes, CIC INSERM, 1414, Rennes, France
| | - Ana-Raquel Marques
- Université Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal, Clermont-Ferrand University Hospital, Neurology department, France
| | - Nicolas Auzou
- Institut des Maladies neurodégénératives, Pôle des neurosciences cliniques, CHU Bordeaux, France; Service de neurophysiologie clinique de l'enfant et de l'adulte, Pôle des neurosciences cliniques, CHU Bordeaux, France
| | - Thomas Wirth
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM-U964/CNRSUMR7104/Université de Strasbourg, Illkirch-Graffenstaden, France; Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Mylène Meyer
- Neurology Department of the University Hospital of Nancy, CHRU de Nancy, Nancy, France
| | - Bruno Giordana
- CHU Nice, Department of Psychiatry and Psychotherapy, Nice, France
| | - Mélissa Tir
- Department of Neurology, Department of Neurosurgery, Expert Centre for Parkinson's disease, Amiens University Hospital, EA 4559 Laboratoire de Neurosciences Fonctionnelles et Pathologie (LNFP) Université de Picardie Jules Verne, University of Picardy Jules Verne (UPJV), NS-PARK/FCRIN Network, Amiens, France
| | - Tiphaine Rouaud
- Department of Neurology, Expert Centre for Parkinson's Disease, University Hospital of Nantes, Nantes, France
| | - David Devos
- Department of Medical Pharmacology, Neurology and Movement Disorders Department, Referent Center of Parkinson's disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, Lille, NS-PARK/FCRIN Network, France
| | - Christine Brefel-Courbon
- Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Clinical Investigation Center CIC1436, University Hospital of Toulouse, NeuroToul COEN (Center of Excellence in Neurodegeneration), Toulouse, NS-PARK/FCRIN Network, France
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Bonnaire C, Devos G, Barrault S, Grall-Bronnec M, Luminet O, Billieux J. An empirical investigation of the Pathways Model of problem gambling through the conjoint use of self-reports and behavioural tasks. J Behav Addict 2022; 11:858-873. [PMID: 35947492 PMCID: PMC9872534 DOI: 10.1556/2006.2022.00055] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/23/2022] [Accepted: 07/14/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIMS Blaszczynski and Nower (2002) conceptualized their Pathways Model by postulating the existence of three subtypes of problem gamblers who share common characteristics, but also present specific ones. METHODS This study investigated how the psychological mechanisms postulated in the Pathways Model predict clinical status in a sample that combined treatment-seeking gamblers (n = 59) and non-problematic community gamblers (n = 107). To test the Pathways Model, we computed a hierarchic logistic regression in which variables associated with each postulated pathway were entered sequentially to predict the status of the treatment-seeking gambler. Self-report questionnaires measured gambling-related cognitions, alexithymia, emotional reactivity, emotion regulation strategies and impulsivity. Behavioural tasks measured gambling persistence (slot machine task), decision-making under uncertainty (Iowa Gambling Task) and decision-making under risk (Game of Dice Task). RESULTS We showed that specific factors theorized as underlying mechanisms for each pathway predicted the status of clinical gambler. For each pathway, significant predictors included gambling-related cognitive distortions and behaviourally measured gambling persistence (behaviourally conditioned pathway), emotional reactivity and emotion regulation strategies (emotionally vulnerable pathway), and lack of premeditation impulsivity facet (impulsivist-antisocial pathway). DISCUSSION AND CONCLUSIONS Our study adds to the body of literature confirming the validity of the Pathways Model and hold important implications in terms of assessment and treatment of problem gambling. In particular, a standardized assessment based on the Pathways Model should promote individualized treatment strategies to allow clinicians to take into account the high heterogeneity that characterizes gambling disorder.
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Affiliation(s)
- Céline Bonnaire
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100Boulogne-Billancourt, France,Centre Pierre Nicole, “Consultation Jeunes Consommateurs”, Croix-Rouge Française, 75005Paris, France
| | - Gaëtan Devos
- UCLouvain, Research Institute for Psychological Sciences, Louvain-la-Neuve, Belgium,Service Universitaire D’Addictologie de Lyon (SUAL), CH le Vinatier, F-69500, Bron, France,Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Servane Barrault
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100Boulogne-Billancourt, France,Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, 3 rue des Tanneurs, 37041Tours, France,Centre de Soins d’Accompagnement et de Prévention en Addictologie (CSAPA 37), CHRU of Tours, 37044Tours Cedex, France
| | - Marie Grall-Bronnec
- CHU Nantes, Psychiatry and Mental Health Department, Nantes, France,Université de Nantes, Université de Tours, Inserm U1246, Nantes, France
| | - Olivier Luminet
- UCLouvain, Research Institute for Psychological Sciences, Louvain-la-Neuve, Belgium,Fund for Scientific Research (FRS-FNRS), Brussels, Belgium
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland,Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland,Corresponding author. E-mail:
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Vintró-Alcaraz C, Mestre-Bach G, Granero R, Gómez-Peña M, Moragas L, Fernández-Aranda F, Jiménez-Murcia S. Do emotion regulation and impulsivity differ according to gambling preferences in clinical samples of gamblers? Addict Behav 2022; 126:107176. [PMID: 34782207 DOI: 10.1016/j.addbeh.2021.107176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/18/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Emotion regulation (ER) and impulsivity impairments have been reported in patients with gambling disorder (GD). However, both constructs have not been studied in depth jointly in clinical samples. Therefore, the aim of this study was to analyze ER and impulsive tendencies/traits in a sample of n = 321 treatment-seeking individuals with GD by differentiating them according to their gambling preference (n = 100 strategic; n = 221 non-strategic). METHODS Our sample was assessed through the DERS (ER), the UPPS-P (impulsivity), and the DSM-5 (GD severity). RESULTS The non-strategic group included a higher proportion of women and reported greater ER impairments, and more impulsive traits/tendencies compared to strategic gamblers. GD severity was associated with all DERS subscale (except for awareness) and with urgency dimensions of the UPPS-P. DISCUSSION AND CONCLUSIONS Our findings confirm that strategic and non-strategic gamblers differ in their ER processes and impulsive tendencies, showing the first clinical group a more adaptive profile. These results suggest the relevance of assessing these ER and impulsivity in order to tailor better treatment approaches.
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Affiliation(s)
- Cristina Vintró-Alcaraz
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.
| | | | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Mónica Gómez-Peña
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
| | - Laura Moragas
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain.
| | - Fernando Fernández-Aranda
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Department of Psychiatry. Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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15
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Desrochers SS, Spring MG, Nautiyal KM. A Role for Serotonin in Modulating Opposing Drive and Brake Circuits of Impulsivity. Front Behav Neurosci 2022; 16:791749. [PMID: 35250501 PMCID: PMC8892181 DOI: 10.3389/fnbeh.2022.791749] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/11/2022] [Indexed: 12/15/2022] Open
Abstract
Impulsivity generally refers to a deficit in inhibition, with a focus on understanding the neural circuits which constitute the “brake” on actions and gratification. It is likely that increased impulsivity can arise not only from reduced inhibition, but also from a heightened or exaggerated excitatory “drive.” For example, an action which has more vigor, or is fueled by either increased incentive salience or a stronger action-outcome association, may be harder to inhibit. From this perspective, this review focuses on impulse control as a competition over behavioral output between an initially learned response-reward outcome association, and a subsequently acquired opposing inhibitory association. Our goal is to present a synthesis of research from humans and animal models that supports this dual-systems approach to understanding the behavioral and neural substrates that contribute to impulsivity, with a focus on the neuromodulatory role of serotonin. We review evidence for the role of serotonin signaling in mediating the balance of the “drive” and “brake” circuits. Additionally, we consider parallels of these competing instrumental systems in impulsivity within classical conditioning processes (e.g., extinction) in order to point us to potential behavioral and neural mechanisms that may modulate the competing instrumental associations. Finally, we consider how the balance of these competing associations might contribute to, or be extracted from, our experimental assessments of impulsivity. A careful understanding of the underlying behavioral and circuit level contributions to impulsivity is important for understanding the pathogenesis of increased impulsivity present in a number of psychiatric disorders. Pathological levels of impulsivity in such disorders are likely subserved by deficits in the balance of motivational and inhibitory processes.
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Alexithymia and Emotion Regulation Strategies in Adolescent Gamblers with and Without At-Risk Profiles. J Gambl Stud 2021; 38:15-29. [PMID: 34250551 PMCID: PMC8866352 DOI: 10.1007/s10899-021-10057-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 11/12/2022]
Abstract
Alexithymia, difficulties in emotion regulation, and negative affect play an important role in adolescents who present pathological gambling. Therefore, the objectives of the present study were, firstly, to analyze the differences between alexithymia, difficulties in emotion regulation, and positive and negative affect in adolescents with and without risk of gambling problems. Secondly, the relationships between all the variables of the study in adolescents with and without risk of problem gambling were analyzed separately. Thirdly, we analyzed the mediating role of positive and negative affect in the relationship between alexithymia and dysfunctional emotion regulation strategies (ERS) in adolescents at risk of gambling problems. The sample was composed of 206 adolescents with ages ranging from 12 to 18 years (M = 15.52; SD = 1.43). They were divided into two groups according to the score obtained in the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA). Thus, 84 were included in the group without risk of gambling problems and 122 in the group at risk of gambling problems. The results obtained revealed higher scores in negative affect and pathological gambling in the group at risk of gambling problems. Likewise, positive relationships between alexithymia, maladaptive emotion regulation strategies (MERS), and affect were found. Mediation analyses showed that difficulties in identifying feelings were indirectly related to greater use of dysfunctional ERS through their relationship with negative affect in at-risk gamblers.
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von der Heiden JM, Egloff B. Associations of the Big Five and locus of control with problem gambling in a large Australian sample. PLoS One 2021; 16:e0253046. [PMID: 34125840 PMCID: PMC8202919 DOI: 10.1371/journal.pone.0253046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 05/27/2021] [Indexed: 11/19/2022] Open
Abstract
Gambling may range from being a recreational leisure activity to a behavioral addiction. A rising number of gamblers experience adverse consequences from gambling, termed problem gambling, which may become a challenge for the individual and society. With the present research, we aimed to investigate the correlates of problem gambling. We used a large sample of more than 12,500 individuals (46% male, Mage = 48, SDage = 18) from the Household, Income, and Labour Dynamics in Australia (HILDA) Survey and analyzed sociodemographic and personality variables (Big Five, locus of control) as well as the extent of problem gambling. Findings showed that male sex and a lower level of education were related to problem gambling, but personality traits were predictive of problem gambling over and above sociodemographic variables. Specifically, a low level of emotional stability, an external locus of control, and, to a lesser extent, a low level of conscientiousness and a high level of extraversion were predictive of problem gambling, whereas openness and agreeableness were not. These results remained constant across various robustness analyses. Our findings reveal the importance of including personality traits when explaining gambling behavior.
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Affiliation(s)
| | - Boris Egloff
- Department of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
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18
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Velotti P, Rogier G, Beomonte Zobel S, Billieux J. Association between gambling disorder and emotion (dys)regulation: A systematic review and meta-analysis. Clin Psychol Rev 2021; 87:102037. [PMID: 34022642 DOI: 10.1016/j.cpr.2021.102037] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
The aim of this systematic review and meta-analysis was to provide a comprehensive evaluation of the role of emotion (dys)regulation in gambling disorder (GD). PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed were systematically searched for articles published until November 3, 2020. Forty-nine studies were considered for the systematic review; of these, 38 comprising 5242 participants met the inclusion criteria for the meta-analysis. Associations were found between GD and specific emotion regulation (ER) deficits, namely (1) nonacceptance of negative emotional states, (2) difficulties in maintaining goal-directed behaviors when faced with intense emotional contexts, (3) lack of clarity about emotional states (poor emotional awareness), (4) low impulse control in reaction to negative emotional states, and (5) difficulties in accessing adaptive ER strategies. We furthermore found that GD is associated with a tendency for emotional suppression, which is known as a maladaptive ER strategy and linked with reduced mindfulness abilities. Additional moderator analyses were conducted regarding age, gender, type of instrument used to measure GD, clinical status of the samples, and quality of the studies. Overall, the data demonstrated consistent and significant associations between GD and ER. This systematic review and meta-analysis mostly supports the conceptualization of GD as an addictive disorder characterized by ER deficits and stresses the need to develop interventions in ER deficits that are tailored to the specificities of GD.
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Affiliation(s)
- P Velotti
- Department of Dynamic and Clinical Psychology, Health Studies, Sapienza University of Rome, Italy.
| | - G Rogier
- Department of Dynamic and Clinical Psychology, Health Studies, Sapienza University of Rome, Italy
| | - S Beomonte Zobel
- Department of Dynamic and Clinical Psychology, Health Studies, Sapienza University of Rome, Italy
| | - J Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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Impulsivity, Emotion Regulation, Cognitive Distortions and Attentional Bias in a Spanish Sample of Gambling Disorder Patients: Comparison between Online and Land-Based Gambling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094869. [PMID: 34063619 PMCID: PMC8124317 DOI: 10.3390/ijerph18094869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 12/02/2022]
Abstract
Several risk factors have been related to the onset and maintenance of gambling disorder (GD). The aim of this study was to explore the differences in emotion dysregulation, impulsivity, cognitive distortions, and attentional bias between online and land-based gamblers. The sample consisted of 88 treatment-seeking patients from the Behavioral Addictions Unit at the Hospital de la Santa Creu i Sant Pau, Barcelona (Spain). Patients were divided into two groups by considering their main type of gambling, i.e., online (n = 26) and land-based gambling (n = 62). Online gamblers were younger, more often employed, with a higher educational level than land-based gamblers. Regarding the rest of the variables, statistically significant differences were only found in Positive Urgency, one of the UPPS-P subscales, in which the land-based gambling group scored higher than the online gambling group. In this exploratory study, individuals with online and land-based GD phenotypes did not differ either in difficulties in emotion regulation or in attentional and cognitive biases. However, land-based GD patients showed a higher tendency to succumb to strong impulses under the influence of positive emotions. These preliminary findings warrant the need to continue investigating GD phenotypes in larger patient samples.
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Legault MCB, Liu HZ, Balodis IM. Neuropsychological Constructs in Gaming Disorders: a Systematic Review. Curr Behav Neurosci Rep 2021. [DOI: 10.1007/s40473-021-00230-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Weidacker K, Johnston SJ, Mullins PG, Boy F, Dymond S. Neurochemistry of response inhibition and interference in gambling disorder: a preliminary study of γ-aminobutyric acid (GABA+) and glutamate-glutamine (Glx). CNS Spectr 2021:1-11. [PMID: 33752778 DOI: 10.1017/s1092852921000316] [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: 11/07/2022]
Abstract
BACKGROUND Neurobehavioral research on the role of impulsivity in gambling disorder (GD) has produced heterogeneous findings. Impulsivity is multifaceted with different experimental tasks measuring different subprocesses, such as response inhibition and distractor interference. Little is known about the neurochemistry of inhibition and interference in GD. METHODS We investigated inhibition with the stop signal task (SST) and interference with the Eriksen Flanker task, and related performance to metabolite levels in individuals with and without GD. We employed magnetic resonance spectroscopy (MRS) to record glutamate-glutamine (Glx/Cr) and inhibitory, γ-aminobutyric acid (GABA+/Cr) levels in the dorsal ACC (dACC), right dorsolateral prefrontal cortex (dlPFC), and an occipital control voxel. RESULTS We found slower processing of complex stimuli in the Flanker task in GD (P < .001, η2p = 0.78), and no group differences in SST performance. Levels of dACC Glx/Cr and frequency of incongruent errors were correlated positively in GD only (r = 0.92, P = .001). Larger positive correlations were found for those with GD between dACC GABA+/Cr and SST Go error response times (z = 2.83, P = .004), as well as between dACC Glx/Cr and frequency of Go errors (z = 2.23, P = .03), indicating general Glx-related error processing deficits. Both groups expressed equivalent positive correlations between posterror slowing and Glx/Cr in the right dlPFC (GD: r = 0.74, P = .02; non-GD: r = .71, P = .01). CONCLUSION Inhibition and interference impairments are reflected in dACC baseline metabolite levels and error processing deficits in GD.
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Affiliation(s)
| | | | - Paul G Mullins
- School of Psychology, Bangor University, Bangor, United Kingdom
| | - Frederic Boy
- School of Psychology, Swansea University, Swansea, United Kingdom
- School of Management, Swansea University, Swansea, United Kingdom
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, United Kingdom
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
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22
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Starosta J, Izydorczyk B, Sitnik-Warchulska K, Lizińczyk S. Impulsivity and Difficulties in Emotional Regulation as Predictors of Binge-Watching Behaviours. Front Psychiatry 2021; 12:743870. [PMID: 34858225 PMCID: PMC8631421 DOI: 10.3389/fpsyt.2021.743870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/18/2021] [Indexed: 12/13/2022] Open
Abstract
Recently, the question about the potentially problematic characteristics of binge-watching behaviours has been raised in the contemporary literature. Binge-watching is a highly popular behaviour that involves watching multiple episodes of TV series in one sitting. Studies show that binge-watching can be both an entertaining, but also a potentially problematic, behaviour. Therefore, this research aimed to answer the question about how impulsivity, difficulties in emotional regulation, and one's motivations around why they want to watch a TV series predict problematic binge-watching among a group of Polish young adults. The research group consisted of 645 participants. The following tools were then used to measure the study variables: the Impulsive Behaviour Scale, the Difficulties in Emotion Regulation Scale, the Viewing Motivation Scale, and the Questionnaire of Excessive Binge-watching. Furthermore, a regression analysis was performed on the responses to each measure in order to answer our research questions. Our results show that a lack of premeditation, impulse control difficulties, and having an escapist motivation are all significant predictors of problematic binge-watching behaviours. Furthermore, one's motivations around dealing with loneliness, their motivations around how to best spend their free time, as well as their informative and entertaining motivations were also found to be significant predictors of problematic binge-watching behaviours.
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Affiliation(s)
- Jolanta Starosta
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Kraków, Poland
| | - Bernadetta Izydorczyk
- Institute of Psychology, Faculty of Philosophy, Jagiellonian University, Kraków, Poland
| | - Katarzyna Sitnik-Warchulska
- Institute of Applied Psychology, Faculty of Management and Social Communication, Jagiellonian University, Kraków, Poland
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23
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Mestre-Bach G, Steward T, Balodis IM, DeVito EE, Yip SW, George TP, Reynolds BA, Granero R, Fernandez-Aranda F, Jimenez-Murcia S, Potenza MN. Discrete Roles for Impulsivity and Compulsivity in Gambling Disorder. Front Psychiatry 2021; 12:789940. [PMID: 34950074 PMCID: PMC8689001 DOI: 10.3389/fpsyt.2021.789940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objective: Complex associations between gambling disorder (GD) and impulsivity have been identified. However, little is known regarding how compulsivity associates with different impulsivity domains in GD. In this study, we examined associations between self-reported and behavioral measures of impulsivity-assessed through the Barratt Impulsiveness Scale (BIS-11) and the Experiential Discounting Task (EDT), respectively- and compulsivity-measured using the Padua Inventory and the Wisconsin Card Sorting Test (WCST), respectively-, in an adult sample with GD (N = 132, 94 men and 38 women, ages ranging from 18 to 69 years). GD severity was assessed using the South Oaks Gambling Screen. Methods: Structural Equation Modeling was used to examine relationships between impulsivity and compulsivity measures, age, and GD severity. Results: BIS-11 non-planning and BIS-11 total scores positively correlated with GD severity. The standardized coefficients for the SEM showed direct positive contributions of BIS-11 non-planning, Padua and EDT scores to GD severity. Only participants' ages directly contributed to WCST perseverative errors, and no direct or indirect effects were found with respect to GD severity. Conclusion: The findings suggest that specific aspects of impulsivity and compulsivity contribute to GD severity. Interventions specifically targeting domains that are most relevant to GD severity may improve treatment outcomes.
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Affiliation(s)
- Gemma Mestre-Bach
- Health Sciences School, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Trevor Steward
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Iris M Balodis
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Elise E DeVito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.,Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Tony P George
- Addictions Division, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Brady A Reynolds
- Department of Behavioral Science, University of Kentucky, Lexington, KY, United States
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Fernandez-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jimenez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.,Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.,Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States.,Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States.,The National Center on Addiction and Substance Abuse, Yale University School of Medicine, New Haven, CT, United States.,Connecticut Mental Health Center, New Haven, CT, United States
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24
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Wu Y, Kennedy D, Goshko CB, Clark L. "Should've known better": Counterfactual processing in disordered gambling. Addict Behav 2021; 112:106622. [PMID: 32905866 DOI: 10.1016/j.addbeh.2020.106622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 10/23/2022]
Abstract
Counterfactual thinking is a component of human decision-making that entails "if only" thinking about unselected choices and outcomes. It is associated with strong emotional responses of regret (when the obtained outcome is inferior to the counterfactual) and relief (vice versa). Counterfactual thinking may play a role in various cognitive phenomena in disordered gambling, such as the effects of near-misses. This study compared individuals with gambling disorder (n = 46) and healthy controls (n = 25) on a behavioural economic choice task that entailed choosing between two gambles, designed to measure counterfactual thinking. Participants provided affect ratings following both the obtained and the non-obtained outcomes. Choices were analyzed using a computational model that derived parameters reflecting sensitivity to expected value, risk variance, and anticipated regret. In the computational choice model, the group with gambling disorder showed increased sensitivity to anticipated regret, reduced sensitivity to expected value, and increased preference for high risk-variance gambles. On the affect ratings, the group with gambling disorder displayed blunted emotional sensitivity to obtained and counterfactual outcomes. Effect sizes of the group differences were modest. Participants with gambling disorder show wide-ranging alterations in decision-making processes and emotional reactivity to choice outcomes. Altered sensitivity to anticipatory regret in gambling disorder may contribute to the development of gambling-related cognitive distortions, and the influences of gambling marketing.
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25
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Brevers D, King DL, Billieux J. Delineating adaptive esports involvement from maladaptive gaming: a self-regulation perspective. Curr Opin Psychol 2020; 36:141-146. [PMID: 32795945 DOI: 10.1016/j.copsyc.2020.07.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 12/26/2022]
Abstract
The last decade has witnessed the rise of electronic sports (esports), yet little is known about how involvement in intensive esports relates to self-regulatory processes, such as executive functioning (EF). In this paper, we review the evidence on EF in problematic and non-problematic video-game use. We also consider research on EF in traditional sports athletes, as well as in 'exercise addiction'. The focus of the review is on two core components of EF, namely response inhibition and cognitive flexibility. The available evidence suggests that EF is a reliable marker for indexing specific types of sport and video-gaming expertise, but does not appear to consistently delineate maladaptive from adaptive video-game involvement. Future research avenues on EF that characterize esport players are suggested to advance this area.
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Affiliation(s)
- Damien Brevers
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Australia
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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26
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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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27
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Kim JH, Choi JY. Influence of childhood trauma and post-traumatic stress symptoms on impulsivity: focusing on differences according to the dimensions of impulsivity. Eur J Psychotraumatol 2020; 11:1796276. [PMID: 33029332 PMCID: PMC7473132 DOI: 10.1080/20008198.2020.1796276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Impulsivity, a trait and multidimensional construct, is associated with a wide range of impulsive behaviours. Although it is well documented that childhood trauma (CT) affects impulsivity, few studies examine whether its effects depend on particular dimensions of impulsivity and the role post-traumatic stress symptoms play in the relationship between childhood trauma and different dimensions of impulsivity. OBJECTIVE This research aims to explore the relationships between CT, PTSD, and impulsivity in a heterogeneous clinical sample. We also sought to examine whether the influence of CT on impulsivity differs across the dimensions of impulsivity. METHOD We investigated the relationships between CT, symptoms of post-traumatic stress disorder (PTSD), and five dimensions of impulsivity using a sample of 162 non-psychotic psychiatric patients without neurocognitive diagnoses. Participants completed the Childhood Trauma Questionnaire (CTQ), Impact of Event Scale - Revised (IES), and the UPPS-P Impulsive Behaviour Scale (UPPS-P). RESULTS The results of structural equation modelling showed that CT is associated with PTSD symptoms, in addition to four of the five dimensions of impulsivity in the UPPS-P:positive urgency, negative urgency, lack of premeditation, and lack of perseverance. The indirect effect of CT through PTSD symptoms was significant only for the two types of urgency. CONCLUSIONS The results of this study suggest that interventions that aim to alleviate impulsive behaviour derived from high urgency should pay particular attention to the presence of CT and PTSD symptoms.
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Affiliation(s)
- Ji Hye Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, Seoul, South Korea
| | - Ji Young Choi
- Department of Child Studies, Inha University, Incheon, South Korea
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28
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Characteristics of Treatment Seeking Problem Gamblers with Adult ADHD. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-018-9986-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Quoilin C, Grandjean J, Duque J. Considering Motor Excitability During Action Preparation in Gambling Disorder: A Transcranial Magnetic Stimulation Study. Front Psychiatry 2020; 11:639. [PMID: 32695036 PMCID: PMC7339919 DOI: 10.3389/fpsyt.2020.00639] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
A lack of inhibitory control appears to contribute to the development and maintenance of addictive disorders. Among the mechanisms thought to assist inhibitory control, an increasing focus has been drawn on the so-called preparatory suppression, which refers to the drastic suppression observed in the motor system during action preparation. Interestingly, deficient preparatory suppression has been reported in alcohol use disorders. However, it is currently unknown whether this deficit also concerns behavioral, substance-free, addictions, and thus whether it might represent a vulnerability factor common to both substance and behavioral addictive disorders. To address this question, neural measures of preparatory suppression were obtained in gambling disorder patients (GDPs) and matched healthy control subjects. To do so, single-pulse transcranial magnetic stimulation was applied over the left and the right motor cortex to elicit motor-evoked potentials (MEPs) in both hands when participants were performing a choice reaction time task. In addition, choice and rapid response impulsivity were evaluated in all participants, using self-report measures and neuropsychological tasks. Consistent with a large body of literature, the MEP data revealed that the activity of the motor system was drastically reduced during action preparation in healthy subjects. Surprisingly, though, a similar MEP suppression was observed in GDPs, indicating that those subjects do not globally suffer from a deficit in preparatory suppression. By contrast, choice impulsivity was higher in GDPs than healthy subjects, and a higher rapid response impulsivity was found in the more severe forms of GD. Altogether, those results demonstrated that although some aspects of inhibitory control are impaired in GDPs, these alterations do not seem to concern preparatory suppression. Yet, the profile of individuals suffering of a GD is very heterogeneous, with only part of them presenting an impulsive disposition, such as in patients with alcohol use disorders. Hence, a lack of preparatory suppression may be only shared by this sub-type of addicts, an interesting issue for future investigation.
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Affiliation(s)
- Caroline Quoilin
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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30
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Flayelle M, Verbruggen F, Schiel J, Vögele C, Maurage P, Billieux J. Non‐problematic and problematic binge‐watchers do not differ on prepotent response inhibition: A preregistered pilot experimental study. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2020. [DOI: 10.1002/hbe2.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maèva Flayelle
- Institute for Health and Behaviour, Department of Behavioural and Cognitive SciencesUniversity of Luxembourg Esch‐sur‐Alzette Luxembourg
- Institute of PsychologyUniversity of Lausanne Lausanne Switzerland
| | | | - Julie Schiel
- Institute for Health and Behaviour, Department of Behavioural and Cognitive SciencesUniversity of Luxembourg Esch‐sur‐Alzette Luxembourg
| | - Claus Vögele
- Institute for Health and Behaviour, Department of Behavioural and Cognitive SciencesUniversity of Luxembourg Esch‐sur‐Alzette Luxembourg
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research InstituteUCLouvain Louvain‐La‐Neuve Belgium
| | - Joël Billieux
- Institute for Health and Behaviour, Department of Behavioural and Cognitive SciencesUniversity of Luxembourg Esch‐sur‐Alzette Luxembourg
- Institute of PsychologyUniversity of Lausanne Lausanne Switzerland
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31
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Balodis IM. Neuropsychology in GD: old and new directions. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Impulsivity is a multidimensional construct. Although gambling disorder (GD) has been associated with high impulsivity, impulsivity across multiple domains has not been thoroughly investigated in this population. We first aimed to examine whether associations between three facets of impulsivity (response impulsivity, choice impulsivity and impulsive tendency) varied between GD patients and healthy controls (HC). We next aimed to evaluate relationships between these three types of impulsivity, as proposed by theoretical models of impulsivity, and their associations with GD severity. The sample included 97 treatment-seeking adult men with GD, diagnosed according to DSM-5 criteria, and 32 male HCs recruited from the general population. Greater impulsivity in all three domains was found in men with GD in comparison to men without GD. Associations between impulsivity facets were found in both groups, with response impulsivity being the only domain associated with GD severity. Our findings confirm that multiple domains of impulsivity are relevant in GD. Future studies should examine the extent to which treatments aimed at targeting specific aspects of impulsivity improve outcomes.
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33
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Lim MSM, Rogers RD. Simulated die-rolling behaviours express illusions of control in regular gamblers. INTERNATIONAL GAMBLING STUDIES 2020. [DOI: 10.1080/14459795.2019.1652668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Matthew S. M. Lim
- Department of Psychology, National University of Singapore, Singapore, Singapore
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34
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Devos MG, Clark L, Bowden-Jones H, Grall-Bronnec M, Challet-Bouju G, Khazaal Y, Maurage P, Billieux J. The joint role of impulsivity and distorted cognitions in recreational and problem gambling: A cluster analytic approach. J Affect Disord 2020; 260:473-482. [PMID: 31539682 DOI: 10.1016/j.jad.2019.08.096] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/27/2019] [Accepted: 08/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS The Pathways Model (Blaszczynski & Nower, 2002) posits that problem gambling is a heterogeneous disorder with distinct subgroups (behaviorally conditioned gamblers, emotionally vulnerable gamblers, and antisocial-impulsivist gamblers). Impulsivity traits and gambling-related cognitions are recognized as two key psychological factors in the onset and maintenance of problem gambling. To date, these constructs have been explored separately, and their joint role in determining problem gambling subtypes has received little attention. The goal of our study was to identify subgroups of gamblers based on impulsivity traits and gambling-related cognitions, and to determine whether this approach is consistent with the Pathways model. METHODS Gamblers from the community (N = 709) and treatment-seeking pathological gamblers (N = 122) completed questionnaires measuring gambling habits, disordered gambling symptoms, gambling-related cognitions, and impulsivity traits. RESULTS Cluster analyses revealed that three clusters globally aligned with the pathways proposed by Blaszczynski & Nower (2002). Two other clusters emerged: (1) impulsive gamblers without cognitive-related cognitions; and (2) gamblers without impulsivity or gambling-related cognitions. Gamblers with both heightened impulsive traits and gambling-related cognitions had more severe problem gambling symptoms. CONCLUSION We successfully identified, based on an a priori theoretical framework, different subtypes of gamblers that varied in terms of problem gambling symptoms and clinical status. The diversity of the cluster profiles supports the development of personalized prevention strategies and psychological interventions.
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Affiliation(s)
- Mr Gaëtan Devos
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, F-69500, Bron, France; Scientific Research and Publication Cell (CRPS), Le Beau Vallon, Namur, Belgium.
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, Canada
| | | | - Marie Grall-Bronnec
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France; Université de Nantes, Université de Tours, UMR INSERM 1246 SHERE, Nantes, France
| | - Gaëlle Challet-Bouju
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France; Université de Nantes, Université de Tours, UMR INSERM 1246 SHERE, Nantes, France
| | - Yasser Khazaal
- Addiction Division, Mental Health and Psychiatry Department, Geneva University Hospitals, Geneva, Switzerland; Addiction medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Switzerland
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland.
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Neural and neurocognitive markers of vulnerability to gambling disorder: a study of unaffected siblings. Neuropsychopharmacology 2020; 45:292-300. [PMID: 31597159 PMCID: PMC6901470 DOI: 10.1038/s41386-019-0534-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 08/26/2019] [Accepted: 09/12/2019] [Indexed: 11/08/2022]
Abstract
Psychological and neurobiological markers in individuals with gambling disorder (GD) could reflect transdiagnostic vulnerability to addiction or neuroadaptive consequences of long-term gambling. Using an endophenotypic approach to identify vulnerability markers, we tested the biological relatives of cases with GD. Male participants seeking treatment for GD (n = 20) were compared with a male control group (n = 18). Biological siblings of cases with GD (n = 17, unrelated to the current GD group) were compared with a separate control group (n = 19) that overlapped partially with the GD control group. Participants completed a comprehensive assessment of clinical scales, neurocognitive functioning, and fMRI of unexpected financial reward. The GD group displayed elevated levels of self-report impulsivity and delay discounting, and increased risk-taking on the Cambridge Gamble Task. We did not observe impaired motor impulsivity on the stop-signal task. Siblings of GD showed some overlapping effects; namely, elevated impulsivity (negative urgency) and increased risk-taking on the Cambridge Gamble Task. We did not observe any differences in the neural response to win outcomes, either in the GD or sibling analysis compared with their control group. Within the GD group, activity in the thalamus and caudate correlated negatively with gambling severity. Increased impulsivity and risk-taking in GD are present in biological relatives of cases with GD, suggesting these markers may represent pre-existing vulnerability to GD.
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36
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Wang Y, Long J, Liu Y, Liu T, Billieux J. Psychometric Properties of the Chinese SUPPS-P Impulsive Behavior Scale: Factor Structure and Measurement Invariance Across Gender and Age. Front Psychiatry 2020; 11:529949. [PMID: 33329077 PMCID: PMC7710909 DOI: 10.3389/fpsyt.2020.529949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/27/2020] [Indexed: 01/27/2023] Open
Abstract
Objective: Impulsivity is widely recognized as a risk factor for a variety of mental disorders and problematic behaviors. The Short UPPS-P Impulsive Behavior Scale (SUPPS-P) is an extensively used instrument to measure impulsivity in research and clinical settings. The current study primarily aimed to evaluate the psychometric properties of the Chinese version of the SUPPS-P (C-SUPPS-P) among Chinese adolescents and emerging adults, and then to test its measurement invariance across gender and age. Methods: Data were collected from three vocational high schools and six colleges in Changsha, China. A total of 2,551 participants (20.1% male and 22.6% adolescents) completed the C-SUPPS-P and scales assessing addictive and problematic smartphone use, as well as emotional symptoms (anxiety, stress, depression). Four alternative models were examined and compared by using confirmatory factor analysis to determine the best factor structure of the C-SUPPS-P. Multigroup confirmatory factor analyses were used to test measurement invariance across gender and age. Results: A theory-driven five-factor structure consistent with the original scale was identified. All of the subscales had good internal consistency. The correlations observed with the other scales supported the construct validity of the C-SUPPS-P. Full measurement invariance was established across gender and age, and significant gender and age differences according to impulsivity facets were identified. Conclusions: The C-SUPPS-P presents a consistent factor structure, as well as reliability and validity that are equivalent to those of the original scale. The full measurement invariance shown across gender and age allows for intergroup comparisons. Overall, the C-SUPPS-P is a promising instrument to measure various impulsivity traits in Chinese adolescents and emerging adults.
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Affiliation(s)
- Yingying Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, The China National Clinical Research Center on Mental Health Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of Central South University, Changsha, China
| | - Jiang Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Yueheng Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, The China National Clinical Research Center on Mental Health Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, The China National Clinical Research Center on Mental Health Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Mental Health Institute of Central South University, Changsha, China
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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Perales JC, King DL, Navas JF, Schimmenti A, Sescousse G, Starcevic V, van Holst RJ, Billieux J. Learning to lose control: A process-based account of behavioral addiction. Neurosci Biobehav Rev 2019; 108:771-780. [PMID: 31846653 DOI: 10.1016/j.neubiorev.2019.12.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/24/2022]
Abstract
Learning psycho(bio)logy has developed a solid corpus of evidence and theory regarding behavior control modes. The present article briefly reviews that literature and its influence on recent models in which the transition from goal-directed to compulsive behavior is identified as the main process underlying substance use disorders. This literature is also relevant to non-substance addictive disorders, and serves as basis to propose a restricted definition of behavioral addiction relying on the presence of behavior-specific compulsivity. Complementarily, we consider whether some activities can become disordered while remaining mostly goal-driven. Based on reinforcement learning models, relative outcome utility computation is proposed as an alternative mechanism through which dysfunctional behaviors (even not qualifying as addictive) can override adaptive ones, causing functional impairment. Beyond issues of conceptual delimitation, recommendations are made regarding the importance of identifying individual etiological pathways to dysregulated behavior, the necessity of accurately profiling at-risk individuals, and the potential hazards of symptom-based diagnosis. In our view, the validity of these recommendations does not depend on the position one takes in the nosological debate.
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Affiliation(s)
- José C Perales
- Department of Experimental Psychology, Mind Brain and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Australia
| | - Juan F Navas
- Department of Basic Psychology, Autonomous University of Madrid, Spain; Universitat Oberta de Catalunya, Spain.
| | | | - Guillaume Sescousse
- Lyon Neuroscience Research Center - INSERM U1028 - CNRS UMR5292, PSYR2 Team, University of Lyon, France
| | - Vladan Starcevic
- University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, Australia
| | - Ruth J van Holst
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Netherlands
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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Rémond JJ, Hernández-Mora M, Marseille C, Mesure G, Romo L. [Feasibility study of therapeutic exposure in virtual reality for pathological gamblers]. Encephale 2019; 46:23-29. [PMID: 31761313 DOI: 10.1016/j.encep.2019.09.002] [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] [Received: 03/06/2019] [Revised: 08/27/2019] [Accepted: 09/02/2019] [Indexed: 11/27/2022]
Abstract
The experiment presented is the result of a partnership between the Paris-Nanterre University (CLIPSYD laboratory, EA 4430) and the CSAPA Imagine (Simone Veil Hospital, GH Eaubonne-Montmorency). Virtual reality immersion exposure for pathological gamblers is beneficial in the context of cognitive and behavioral interventions. It can be used to evoke the desire to play and to have access to automatic thoughts and mistaken beliefs of the players when they find themselves in a gambling context. Exposure is used until the urge to play diminishes and disappears which is the process of desensitization or extinction. OBJECTIVE The objective of the study was to investigate the possibilities implemented by virtual reality in the case of an exhibition for pathological gamers to create a desire to play and work with the patient in an environment identical to the ecological one. Two hypotheses were proposed. On the one hand, the virtual reality exhibition will help to change the desire to play in relation to the game. On the other hand, virtual exhibition sessions associated with cognitive restructuring will have a greater impact on the perception of reality. METHOD After a diagnosis was made, participation in the study was offered to patients (n=10) in routine care and able to participate (exclusion criteria). It consisted of four virtual reality exposure sessions integrated with traditional care. Exposure did not exceed 20minutes. To carry out this study we used the virtual reality headset "Oculus Rift CV1" and the headphones measuring EEG waves, "Emotiv Epoc". A battery of questionnaires were proposed to evaluate gambling-related behaviors (ICJP, GRCS, UPPS), to analyze the interest of the virtual reality exhibition (SIS, CGI, TEI, EVA), and to glimpse the immersion abilities (QEP and QPI). RESULTS Ten participants aged 25 to 60 agreed to participate in the study. The results of this study demonstrated the viability of RV gamers' exposure as a tool that can help reduce pathological gambling symptoms and the severity perceived by therapists (CPI: t=1.6, P=0.001; CGI: t=4.87, P=0.001) between the beginning of the care and the end of the care and at D+1. We were also able to observe significant results (P<0.05) concerning a decrease in cognitive distortions (GRCS tot, Illusion of control, Power of prediction, Favorable interpretation). CONCLUSION The feasibility study shows that the desire to play is very present during the virtual reality exhibition in accordance with literature studies. The results also demonstrate the utility of virtual reality to allow the patient to elaborate on the cognitive distortions associated with the practice of pathological gambling. From a therapeutic point of view, the results suggest that virtual reality can increase the effectiveness of cognitive restructuring and increase understanding of the urge to play related to stimuli in the environment of play.
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Affiliation(s)
- J-J Rémond
- CLIPSYD 4430 EA 4430, université Paris Nanterre, 92, 92000 Nanterre, France.
| | - M Hernández-Mora
- CSAPA Imagine, hospitalier Eaubonne-Montmorency, Ermont, 95, 14, rue de Saint-Prix, 95600 Eaubonne, France
| | - C Marseille
- CSAPA Imagine, hospitalier Eaubonne-Montmorency, Ermont, 95, 14, rue de Saint-Prix, 95600 Eaubonne, France
| | - G Mesure
- CSAPA Imagine, hospitalier Eaubonne-Montmorency, Ermont, 95, 14, rue de Saint-Prix, 95600 Eaubonne, France
| | - L Romo
- CLIPSYD 4430 EA 4430, université Paris Nanterre, 92, 92000 Nanterre, France; Inserm U494 centre hospitalier Sainte-Anne (CMME), 75014 Paris, France
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An Overview of the Neurobiology of Impulsivity in Gambling and Gaming Disorder. Curr Behav Neurosci Rep 2019. [DOI: 10.1007/s40473-019-00190-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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The paradoxical relationship between emotion regulation and gambling-related cognitive biases. PLoS One 2019; 14:e0220668. [PMID: 31381598 PMCID: PMC6681951 DOI: 10.1371/journal.pone.0220668] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/20/2019] [Indexed: 12/14/2022] Open
Abstract
Background Gambling behavior presents substantial individual variability regarding its severity, manifestations, and psychological correlates. Specifically, differences in emotion regulation, impulsivity, and cognitive distortions have been identified as crucial to describe individual profiles with implications for the prevention, prognosis, and treatment of gambling disorder (GD). Aims and method The aim of the present study was to investigate the associations of gambling-related cognitions (measured according to the GRCS model) with impulsivity (UPPS-P model) and emotion regulation (CERQ model), in a sample of 246 gamblers with different levels of gambling involvement, using mixed-effects modelling to isolate theoretically relevant associations while controlling for the potentially confounding effects of sociodemographic and clinical covariates. Results Affective/motivational dimensions of UPPS-P impulsivity positive urgency and sensation seeking, on the one hand, and CERQ emotion regulation strategies reappraisal, rumination and blaming others, on the other, independently and significantly predicted distorted gambling-related cognitions. Conclusions These results (a) reinforce the ones of previous studies stressing the relevance of emotional and motivational processes in the emergence of gambling-related cognitive distortions; and (b) replicate the seemingly paradoxical finding that gamblers use emotion regulation strategies customarily considered as adaptive (i.e. reappraisal) to strengthen and justify their biased beliefs about gambling outcomes and controllability.
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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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Grubbs JB, Chapman H. Predicting Gambling Situations: The Roles of Impulsivity, Substance Use, and Post-Traumatic Stress. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2019; 13:1178221819852641. [PMID: 31258327 PMCID: PMC6591666 DOI: 10.1177/1178221819852641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/02/2019] [Indexed: 12/04/2022]
Abstract
Gambling disorder and symptoms of post-traumatic stress are highly comorbid.
Numerous studies suggest that the presence of one (either disordered gambling or
post-traumatic stress) substantially increases the odds of later developing the
other. However, little is known about the etiological links between these two
domains or the nuances of the comorbidity. Past research has suggested that
symptoms of post-traumatic stress might be related to unique motivations for and
beliefs about gambling. The present work sought to examine whether or not
symptoms of post-traumatic stress might also be related to specific situational
vulnerabilities to gambling behaviors. Using a large cross-sectional sample of
Internet-using adults in the United States who were primarily recreational
gamblers (N = 743; 46% men, Mage = 36.0, SD = 11.1),
as well as an inpatient sample of US Armed Forces veterans seeking treatment for
gambling disorder (N = 332, 80% men, Mage = 53.5,
SD = 11.5), the present work tested whether or not symptoms of post-traumatic
stress were uniquely related to a variety of gambling situations. Results in
both samples revealed that even when controlling for potentially confounding
variables (eg, substance use and trait impulsivity), symptoms of post-traumatic
stress were uniquely related to gambling in response to negative affect,
gambling in response to social pressure, and gambling due to a need for
excitement. These findings are consistent with recent work suggesting that
individuals with post-traumatic stress symptoms are more likely to engage in
gambling behaviors for unique reasons that differ from gamblers without such
symptoms.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Heather Chapman
- Gambling Treatment Program, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
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Jara-Rizzo MF, Navas JF, Catena A, Perales JC. Types of Emotion Regulation and Their Associations with Gambling: A Cross-Sectional Study with Disordered and Non-problem Ecuadorian Gamblers. J Gambl Stud 2019; 35:997-1013. [DOI: 10.1007/s10899-019-09868-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Fernández-Aranda F, Granero R, Mestre-Bach G, Steward T, Müller A, Brand M, Mena-Moreno T, Vintró-Alcaraz C, del Pino-Gutiérrez A, Moragas L, Mallorquí-Bagué N, Aymamí N, Gómez-Peña M, Lozano-Madrid M, Menchón JM, Jiménez-Murcia S. Spanish validation of the pathological buying screener in patients with eating disorder and gambling disorder. J Behav Addict 2019; 8:123-134. [PMID: 30932708 PMCID: PMC7044599 DOI: 10.1556/2006.8.2019.08] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Pathological buying (PB) is a behavioral addiction that presents comorbidity with several psychiatric disorders. Despite the increase in the prevalence estimates of PB, relatively few PB instruments have been developed. Our aim was to assess the psychometric properties of the Spanish version of the pathological buying screener (PBS) and to explore the associations between PB, psychopathology, and personality traits. METHODS A total of 511 participants, including gambling disorder (GD) and eating disorder (ED) patients diagnosed according to DSM-5 criteria, as well as healthy controls (HCs), took part in the study. RESULTS Higher PB prevalence was obtained in ED patients than in the other two study groups (ED 12.5% vs. 1.3% HC and 2.7% GD). Confirmatory factor analysis (CFA) verified the 13-item structure of the PBS, and indexes of convergent and discriminant capacity were estimated. CFA confirmed the structure in two factors (excessive buying behavior and loss of control) with excellent internal consistency (α = .92 and .86, respectively). Good convergent capacity was obtained with external psychopathology and personality measures (positive correlations with novelty seeking and negative associations with self-directedness and harm avoidance were found). Good discriminative capacity to differentiate between the study groups was obtained. DISCUSSION AND CONCLUSIONS This study provides support for the reliability and validity of the Spanish adaptation of the PBS. Female sex, higher impulsivity, and higher psychopathology were associated with PB.
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Affiliation(s)
- Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Head of Gambling Disorder Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Head of ED Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 72 27; Fax: +34 93 260 76 58; E-mail:
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Departament de Psicologia Clínica i Psicobiologia, Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain,Corresponding authors: Susana Jiménez-Murcia, PhD; Head of Gambling Disorder Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: ; Fernando Fernández-Aranda, PhD; Head of ED Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 72 27; Fax: +34 93 260 76 58; E-mail:
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Sharman S, Clark L, Roberts A, Michalczuk R, Cocks R, Bowden-Jones H. Heterogeneity in Disordered Gambling: Decision-Making and Impulsivity in Gamblers Grouped by Preferred Form. Front Psychiatry 2019; 10:588. [PMID: 31481905 PMCID: PMC6709538 DOI: 10.3389/fpsyt.2019.00588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Previous research has indicated that disordered gamblers display deficits in impulsivity and risky decision-making, compared to healthy control groups. However, disordered gamblers are not a homogenous group, and differences in performance on neurocognitive tasks may be related to the form of gambling in which an individual chooses to engage. The present study used neurocognitive tasks and questionnaire measures to ascertain group differences in gamblers grouped by preferred form of gambling. Method: Treatment-seeking pathological gamblers from the National Problem Gambling Clinic, London (n = 101), completed a neurocognitive assessment comprising the Cambridge gamble task (CGT), the stop-signal task (SST), a probabilistic reversal learning task (PRL), and the Kirby Monetary Choice Questionnaire, as well as questionnaire measures of gambling severity, impulsivity, depression, and anxiety. Analyses compared gamblers who favored fixed-odds betting terminals (FOBTs) (the modal form) to gamblers who preferred other forms of gambling (non-FOBT). Results: The FOBT group showed impaired decision-making under risk on the CGT compared to the non-FOBT group, choosing the likely option less on more uncertain decisions. The FOBT group made fewer perseverative errors on the PRL task, had lower depression and anxiety scores, and were less likely to have a family history of problem gambling than the non-FOBT group. Discussion: Decision-making and cognitive flexibility differences between gamblers grouped by gambling type supports preferred form as an important source of heterogeneity in gambling disorder. Decision-making strategies and risk attitudes should be considered when approaching cognition-focused treatment strategies, allowing interventions to be targeted at specific cognitive deficits.
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Affiliation(s)
- Steve Sharman
- School of Psychology, College of Applied Health and Communities, University of East London, London, United Kingdom.,Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Luke Clark
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom.,Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Amanda Roberts
- School of Psychology, College of Social Science, University of Lincoln, Lincoln, United Kingdom
| | - Rosanna Michalczuk
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom.,South London and Maudsley Trust, Bethlem Royal Hospital, London, United Kingdom
| | - Rachel Cocks
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom.,Royal Holloway, University of London, London, United Kingdom
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, United Kingdom.,Faculty of Medicine, Faculty of Medicine Centre, Imperial College London, London, United Kingdom
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Lutri V, Soldini E, Ronzitti S, Smith N, Clerici M, Blaszczynski A, Bowden-Jones H. Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study. J Gambl Stud 2018; 34:1341-1354. [PMID: 29502327 DOI: 10.1007/s10899-018-9764-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes-rather than high-stakes-gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.
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Affiliation(s)
- Vittorio Lutri
- Department of Medicine and Surgery, Università degli Studi di Milano - Bicocca, Milan, Italy.
| | - Emiliano Soldini
- Methodology and Statistics Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Silvia Ronzitti
- Department of Medicine and Surgery, Università degli Studi di Milano - Bicocca, Milan, Italy
| | - Neil Smith
- National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
| | - Massimo Clerici
- Department of Medicine and Surgery, Università degli Studi di Milano - Bicocca, Milan, Italy
| | - Alex Blaszczynski
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
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Trait impulsivity and cognitive domains involving impulsivity and compulsivity as predictors of gambling disorder treatment response. Addict Behav 2018; 87:169-176. [PMID: 30048796 DOI: 10.1016/j.addbeh.2018.07.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) is a highly heterogeneous condition with high rates of chronicity, relapses and treatment dropout. The aim of this study was to longitudinally explore the associations between trait impulsivity, impulsivity-compulsivity related cognitive domains, and treatment outcome in an outpatient sample of adult patients with GD. METHODS 144 adult male participants diagnosed with GD undergoing cognitive-behavioural treatment (CBT) at a specialized outpatient service completed a series of neuropsychological tests to assess executive functioning (including cognitive flexibility, inhibition control and decision making) and psychometric questionnaires. RESULTS Trait impulsivity predicted low compliance [UPPS-P negative urgency (B = 0.113; p = 0.019)] and relapse [UPPS-P negative urgency (B = 0.140; p = 0.015)] at 5 weeks of treatment and dropout at the end of treatment [(UPPS-P sensation seeking B = 0.056; p = 0.045)]. Cognitive flexibility performance predicted: dropout rates at the end of treatment [WCST perseverative errors (B = 0.043; p = 0.042)]; dropout [WCST categories completed (B = -1.827; p = 0.020)] and low compliance or relapses at follow-up [WCST perseverative errors (B = 0.128; p = 0.020)]; and time to first relapse [WCST failure to maintain set (B = -0.374; p = 0.048)] and time to dropout [WCST perseverative errors (B = 0.0198; p = 0.019)]. CONCLUSIONS Our findings indicate impulsivity-compulsivity levels may influence response to GD treatment (i.e.: low compliance and dropout or relapse rates) thus representing a potential target for improving treatment outcomes.
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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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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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50
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Rochat L, Maurage P, Heeren A, Billieux J. Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction. Neuropsychol Rev 2018; 29:27-51. [PMID: 30293096 DOI: 10.1007/s11065-018-9387-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 09/21/2018] [Indexed: 12/17/2022]
Abstract
Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.
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Affiliation(s)
- Lucien Rochat
- Cognitive Psychopathology and Neuropsychology Unit, Department of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
- Clinical Neuroscience Division, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Alexandre Heeren
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
- Clinical Neuroscience Division, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab (ACB-Lab), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
- Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland.
- Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland.
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