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Seel CJ, Jones M, Christensen DR, May R, Hoon AE, Dymond S. Treatment of harmful gambling: a scoping review of United Kingdom-based intervention research. BMC Psychiatry 2024; 24:392. [PMID: 38783231 PMCID: PMC11112764 DOI: 10.1186/s12888-024-05843-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Understanding and treating the harm caused by gambling is a growing international psychiatric and public health challenge. Treatment of gambling harm may involve psychological and pharmacological intervention, in conjunction with peer support. This scoping review was conducted to identify, for the first time, the characteristics and extent of United Kingdom (UK) based gambling treatment research. We reviewed studies conducted among people seeking treatment for disordered or harmful gambling in the UK, the settings, research designs, and outcome measures used, and to identify any treatment research gaps. METHODS Systematic searches of PsycInfo, PsycArticles, Scopus, PubMed, and Web of Science databases were carried out for gambling treatment research or evaluation studies conducted in the UK. Studies were included if they evaluated the effectiveness of an intervention or treatment designed to improve symptoms of harmful or problematic gambling, reported outcomes of interventions on treatment adherence, gambling symptoms, or behaviours using standardised measures, were conducted in the UK, and were published since 2000. RESULTS Eight studies met the inclusion criteria. Four were retrospective chart reviews, two were single-participant case reports, one described a retrospective case series, and one employed a cross-sectional design. None used an experimental design. CONCLUSION The limited number of studies included in this review highlights a relative paucity of gambling treatment research conducted in UK settings. Further work should seek to identify potential barriers and obstacles to conducting gambling treatment research in the UK.
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Affiliation(s)
- Christopher J Seel
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK
| | - Matthew Jones
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK
| | | | - Richard May
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, CF371DL, UK
| | - Alice E Hoon
- Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK
| | - Simon Dymond
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK.
- Department of Psychology, Reykjavík University, Menntavegur 1, Nauthólsvík, 101 Reykjavík, Reykjavik, Iceland.
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Månsson V, Pettersson E, Mittendorfer-Rutz E, Guterstam J, Berman AH, Jayaram-Lindström N, Molero Y. The risk and development of work disability among individuals with gambling disorder: a longitudinal case-cohort study in Sweden. Psychol Med 2024; 54:1391-1402. [PMID: 37980927 DOI: 10.1017/s0033291723003288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND This longitudinal register study aimed to investigate the association between gambling disorder (GD) and work disability and to map work disability in subgroups of individuals with GD, three years before and three years after diagnosis. METHODS We included individuals aged 19-62 with GD between 2005 and 2018 (n = 2830; 71.1% men, mean age: 35.1) and a matched comparison cohort (n = 28 300). Work disability was operationalized as the aggregated net days of sickness absence and disability pension. Generalized estimating equation models were used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the risk of long-term work disability (>90 days of work disability/year). Secondly, we conducted Group-based Trajectory Models on days of work disability. RESULTS Individuals with GD showed a four-year increased risk of long-term work disability compared to the matched cohort, peaking at the time of diagnosis (AOR = 1.89; CI 1.67-2.13). Four trajectory groups of work disability days were identified: constant low (60.3%, 5.6-11.2 days), low and increasing (11.4%, 11.8-152.5 days), medium-high and decreasing (11.1%, 65.1-110 days), and constant high (17.1%, 264-331 days). Individuals who were females, older, with prior psychiatric diagnosis, and had been dispensed a psychotropic medication, particularly antidepressants, were more likely to be assigned to groups other than the constant low. CONCLUSION Individuals with GD have an increased risk of work disability which may add financial and social pressure and is an additional incentive for earlier detection and prevention of GD.
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Affiliation(s)
- Viktor Månsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Division of Psychiatry, Health Care Dalarna, Region of Dalarna, Sweden
| | - Emma Pettersson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Joar Guterstam
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anne H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Yasmina Molero
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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3
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Fannin M, Collard S, Davies S. Power, intersectionality and stigma: Informing a gender- and spatially-sensitive public health approach to women and gambling in Great Britain. Health Place 2024; 86:103186. [PMID: 38428064 DOI: 10.1016/j.healthplace.2024.103186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/04/2024] [Accepted: 01/27/2024] [Indexed: 03/03/2024]
Abstract
In Britain more men participate in gambling than women, although the gender gap is narrowing; and online gambling is increasing among women and men. Gambling practices differ between men and women but also between different groups of women, with evidence that younger women are diversifying to gamble in different ways from older women. Complex and powerful spatial, socio-cultural and economic forces shape women's experiences of gambling, the problems gambling may cause, and wider societal efforts to minimise these harms. This paper presents the findings of a Rapid Evidence Assessment (REA) of research on women and gambling and conceptual reflections on these findings to argue for greater attention to the gendered and spatial dimensions of gambling in three ways. First, we discuss the geographical focus and scope of the research we reviewed on women and gambling; second, we analyse the changing geographies of where women gamble; and finally, we consider how qualitative notions of space as experiential and co-constitutive can offer a more nuanced conceptual framework for understanding women's lived experience of gambling and gambling harm. We identify areas for further research on gambling and gambling harm that attends to gendered and spatial dimensions of gambling, including online spaces; the intersectional dynamics that shape gambling practice and gambling harms; and the experiences of those affected by others' gambling.
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Affiliation(s)
- Maria Fannin
- School of Geographical Sciences, University of Bristol, Bristol, BS8 1SS, UK.
| | - Sharon Collard
- Personal Finance Research Centre, School of Geographical Sciences, University Road, Bristol, BS8 1SS, UK.
| | - Sara Davies
- Personal Finance Research Centre, School of Geographical Sciences, University Road, Bristol, BS8 1SS, UK.
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4
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Dowson M, Wohl MJA. The Long Shadow of Addiction-Related Nostalgia: Nostalgia Predicts Ambivalence and Undermines the Benefits of Optimism in Recovery. Subst Use Misuse 2024; 59:989-998. [PMID: 38353636 DOI: 10.1080/10826084.2024.2310502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Background: Previous research has shown that nostalgia for the pre-addicted self can motivate people living with addiction to engage in behavior change. Objective: Herein, we explored nostalgia for the addictive behavior-labeled addiction-related nostalgia (ARN)-among people in recovery from engaging in addictive behavior. We tested the novel idea that ARN is positively associated with ambivalence about recovery. We also hypothesized that ARN may counteract the positive influence of optimism on individuals' commitment to recovery. Results: In two studies involving individuals in recovery from a gambling (Study 1; N=301) or alcohol use disorder (Study 2; N=604), ARN was linked to increased ambivalence about recovery, while optimism was associated with decreased ambivalence. As expected, the interaction between optimism and ARN revealed that nostalgia either eliminated (Study 1) or reduced (Study 2) the negative relation between optimism and ambivalence. Conclusions: These findings underscore the challenges posed by ARN in the recovery process and emphasize the importance of interventions that address and mitigate its impact while considering the moderating role of optimism.
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Affiliation(s)
- Mackenzie Dowson
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Michael J A Wohl
- Department of Psychology, Carleton University, Ottawa, ON, Canada
- Mental Health and Well-Being Research and Training Hub, Ottawa, ON, Canada
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5
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Grant JE, Chamberlain SR. Duration of untreated illness in gambling disorder. CNS Spectr 2024; 29:54-59. [PMID: 37694344 PMCID: PMC7615660 DOI: 10.1017/s1092852923002444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Gambling disorder is common, affects 0.5-2% of the population, and is under-treated. Duration of untreated illness (DUI) has emerged as a clinically important concept in the context of other mental disorders, but DUI in gambling disorder, has received little research scrutiny. METHODS Data were aggregated from previous clinical trials in gambling disorder with people who had never previously received any treatment. DUI was quantified, and clinical characteristics were compared as a function of DUI status. RESULTS A total of 298 individuals were included, and the mean DUI (standard deviation) was 8.9 (8.4) years, and the median DUI was 6 years. Longer DUI was significantly associated with male gender, older age, earlier age when the person first started to gamble, and family history of alcohol use disorder. Longer DUI was not significantly associated with racial-ethnic status, gambling symptom severity, current depressive or anxiety severity, comorbidities, or disability/functioning. The two groups did not differ in their propensity to drop out of the clinical trials, nor in overall symptom improvement associated with participation in those trials. CONCLUSIONS These data suggest that gambling disorder has a relatively long DUI and highlight the need to raise awareness and foster early intervention for affected and at-risk individuals. Because earlier age at first gambling in any form was strongly linked to longer DUI, this highlights the need for more rigorous legislation and education to reduce exposure of younger people to gambling.
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Affiliation(s)
- Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; and Southern Health NHS Foundation Trust, Southampton, UK
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Williams BD, Lee K, Ewah SO, Neelam K. Aripiprazole and Other Third-Generation Antipsychotics as a Risk Factor for Impulse Control Disorders: A Systematic Review and Meta-Analysis. J Clin Psychopharmacol 2024; 44:39-48. [PMID: 38011021 DOI: 10.1097/jcp.0000000000001773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Increasing evidence suggests an association between third-generation antipsychotics (TGAs) and impulse control disorders (ICDs). This is thought to be due to their partial agonism of dopamine receptors. However, neither the relative nor absolute risks of ICDs in those prescribed TGAs are well established. To inform clinical practice, this systematic review and meta-analysis summarizes and quantifies the current evidence for an association. METHODS An electronic search of Medline, PsychINFO, EMBASE, and the Cochrane Clinical Trials Database was undertaken from database inception to November 2022. Three reviewers screened abstracts and reviewed full texts for inclusion. A random-effects meta-analysis was conducted with eligible studies. RESULTS A total of 392 abstracts were retrieved, 214 remained after duplicates were removed. Fifteen full texts were reviewed, of which 8 were included. All 8 studies found that TGAs were associated with increased probability of ICDs. Risk of bias was high or critical in 7 of 8 studies. Three studies were included in the pooled analysis for the primary outcome, 2 with data on each of aripiprazole, cariprazine, and brexpiprazole. Exposure to TGAs versus other antipsychotics was associated with an increase in ICDs (pooled odds ratio, 5.54; 2.24-13.68). Cariprazine and brexpiprazole were significantly associated with ICDs when analyzed individually. Aripiprazole trended toward increased risk, but very wide confidence intervals included no effect. CONCLUSIONS Third-generation antipsychotics were associated with increased risk of ICDs in all studies included and pooled analysis. However, the risk of bias is high, confidence intervals are wide, and the quality of evidence is very low for all TGAs examined.
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Affiliation(s)
- Benjamin David Williams
- From the Inpatient Services, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Kenn Lee
- Liaison Mental Health Service, Royal Oldham Hospital, Oldham, Pennine Care NHS Foundation Trust
| | - Silas Okey Ewah
- From the Inpatient Services, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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7
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Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review. Eur J Psychotraumatol 2023; 14:2178203. [PMID: 37052089 PMCID: PMC9970237 DOI: 10.1080/20008066.2023.2178203] [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: 02/26/2023] Open
Abstract
Background: PTSD and gambling disorder (GD) are frequently comorbid. Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and GD outcomes, yet research into the potential effectiveness of ACT for PTSD and/GD in veterans is scarce.Objective: This review aimed to systematically assess and describe the evidence relating to the use of ACT and acceptance-based therapy for military populations with PTSD and/or GD.Method: Six databases were searched. Selection criteria included studies that featured the armed forces/military, delivered ACT/acceptance-based therapy, and aimed to improve PTSD and/or GD outcomes. A narrative synthesis approach was adopted.Results: From 1,117 results, 39 studies were fully screened and 14 met inclusion criteria. All studies originated from the USA and 9 were associated with United States Department of Veterans Affairs. Therapy use within each study produced an improvement in PTSD and/or GD, yet only one study examined GD and no studies considered comorbid PTSD/GD. The broad range of study designs made it difficult to compare the findings or make generalisations from the collective results. It is unclear which method of ACT delivery is superior (app-based, telehealth, face-to-face, groups, one-to-one, manualised, or unstructured), or what the true effect size is of ACT for PTSD and/or GD.Conclusions: These preliminary findings are promising, yet more research is needed on the delivery format and content of ACT sessions, and whether findings generalise beyond USA-recruited military samples. The cost-effectiveness of remote-based ACT also warrants investigation.HIGHLIGHTS Among veterans, psychological interventions such as Acceptance and Commitment Therapy (ACT) may be effective for Post-Traumatic Stress Disorder (PTSD) and/or Gambling Disorder (GD).There is a paucity of evidence on ACT approaches for treating PTSD and GD in veterans.Further work is needed on context-specific delivery (in-person vs. group), method of ACT intervention (manualised vs unstructured, digital therapeutics) with non-US samples.
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Saunders M, Rogers J, Roberts A, Gavens L, Huntley P, Midgley S. Using geospatial mapping to predict and compare gambling harm hotspots in urban, rural and coastal areas of a large county in England. J Public Health (Oxf) 2023; 45:847-853. [PMID: 37391365 PMCID: PMC10788837 DOI: 10.1093/pubmed/fdad096] [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: 11/04/2022] [Revised: 04/24/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Disordered gambling is a public health problem with interconnections with health and social inequality, and adverse impacts on physical and mental health. Mapping technologies have been used to explore gambling in the UK, though most were based in urban locations. METHODS We used routine data sources and geospatial mapping software to predict where gambling related harm would be most prevalent within a large English county, host to urban, rural and coastal communities. RESULTS Licensed gambling premises were most concentrated in areas of deprivation, and in urban and coastal areas. The aggregate prevalence of disordered gambling associated characteristics was also greatest in these areas. CONCLUSIONS This mapping study links the number of gambling premises, deprivation, and risk factors for disordered gambling, and highlights that coastal areas see particularly high density of gambling premises. Findings can be applied to target resources to where they are most needed.
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Affiliation(s)
- Mike Saunders
- Department of Public Health, Nottingham City Council, Nottingham NG3 3NG, UK
| | - Jim Rogers
- College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
| | - Amanda Roberts
- College of Social Science, University of Lincoln, Lincoln LN6 7TS, UK
| | - Lucy Gavens
- Public Health Division, Lincolnshire County Council, County Offices, Lincoln LN1 1YL, UK
| | - Phil Huntley
- Public Health Division, Lincolnshire County Council, County Offices, Lincoln LN1 1YL, UK
| | - Sarah Midgley
- Public Health Division, Lincolnshire County Council, County Offices, Lincoln LN1 1YL, UK
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Thomas SA, Browning CJ, Charchar FJ, Klein B, Ory MG, Bowden-Jones H, Chamberlain SR. Transforming global approaches to chronic disease prevention and management across the lifespan: integrating genomics, behavior change, and digital health solutions. Front Public Health 2023; 11:1248254. [PMID: 37905238 PMCID: PMC10613497 DOI: 10.3389/fpubh.2023.1248254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
Chronic illnesses are a major threat to global population health through the lifespan into older age. Despite world-wide public health goals, there has been a steady increase in chronic and non-communicable diseases (e.g., cancer, cardiovascular and metabolic disorders) and strong growth in mental health disorders. In 2010, 67% of deaths worldwide were due to chronic diseases and this increased to 74% in 2019, with accelerated growth in the COVID-19 era and its aftermath. Aging and wellbeing across the lifespan are positively impacted by the presence of effective prevention and management of chronic illness that can enhance population health. This paper provides a short overview of the journey to this current situation followed by discussion of how we may better address what the World Health Organization has termed the "tsunami of chronic diseases." In this paper we advocate for the development, validation, and subsequent deployment of integrated: 1. Polygenic and multifactorial risk prediction tools to screen for those at future risk of chronic disease and those with undiagnosed chronic disease. 2. Advanced preventive, behavior change and chronic disease management to maximize population health and wellbeing. 3. Digital health systems to support greater efficiencies in population-scale health prevention and intervention programs. It is argued that each of these actions individually has an emerging evidence base. However, there has been limited research to date concerning the combined population-level health effects of their integration. We outline the conceptual framework within which we are planning and currently conducting studies to investigate the effects of their integration.
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Affiliation(s)
- Shane A Thomas
- Vice Chancellor’s Office, Federation University, Ballarat, VIC, Australia
| | - Colette J Browning
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC, Australia
- Health Innovation and Transformation Centre (HITC), Federation University, Ballarat, VIC, Australia
| | - Fadi J Charchar
- Health Innovation and Transformation Centre (HITC), Federation University, Ballarat, VIC, Australia
| | - Britt Klein
- Health Innovation and Transformation Centre (HITC), Federation University, Ballarat, VIC, Australia
| | - Marcia G. Ory
- Center for Community Health and Aging, Texas A&M University, School of Public Health, College Station, TX, United States
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Southern Gambling Service, and Southern Health NHS Foundation Trust, Southampton, United Kingdom
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Chamberlain SR, Ioannidis K, Bowden-Jones H. The UK Gambling White Paper: comments on implementation and timing. Compr Psychiatry 2023; 126:152410. [PMID: 37619283 DOI: 10.1016/j.comppsych.2023.152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, UK; NHS Southern Gambling Service, Southern Health NHS Foundation Trust, Southampton, UK.
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Southampton, UK; NHS Southern Gambling Service, Southern Health NHS Foundation Trust, Southampton, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic & National Centre for Gaming Disorders, London, UK; Department of Psychiatry, University of Cambridge, UK
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Chamberlain SR, Aslan B, Quinn A, Anilkumar A, Robinson J, Grant JE, Sinclair J. Autism and gambling: A systematic review, focusing on neurocognition. Neurosci Biobehav Rev 2023; 147:105071. [PMID: 36738812 DOI: 10.1016/j.neubiorev.2023.105071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/20/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
Autism spectrum disorders (hereafter autism) are prevalent and often associated with elevated rates of substance use disorders. A subset of people who gamble develop gambling disorder, which is functionally impairing. Characterization of relationships between autism and gambling, particularly as relates to cognition, may have important implications. We conducted a systematic review of the literature. Nine out of 343 publications were found eligible for inclusion. Most studies examined decision-making using cognitive tasks, showing mixed results (less, equivalent or superior performance in autistic people compared to non-autistic people). The most consistent cognitive finding was relatively slower responses in autistic people on gambling tasks, compared to non-autistic people. One study reported a link between problem gambling and autism scores, in people who gamble at least occasionally. This systematic review highlights a profound lack of research on the potential neurocognitive overlap between autism and gambling. Future work should address the link between autism and behavioral addictions in adequately powered samples, using validated tools.
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Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Betul Aslan
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK
| | - Anthony Quinn
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK
| | - Amith Anilkumar
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK
| | - Janine Robinson
- Chitra Sethia Autism Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridge, UK; NHS, UK
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Julia Sinclair
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK.
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12
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The effect of the 7R allele at the DRD4 locus on risk tolerance is independent of background risk in Senegalese fishermen. Sci Rep 2023; 13:622. [PMID: 36635358 PMCID: PMC9837182 DOI: 10.1038/s41598-022-27002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
It has been shown that living in risky environments, as well as having a risky occupation, can moderate risk-tolerance. Despite the involvement of dopamine in the expectation of reward described by neurobiologists, a GWAS study was not able to demonstrate a genetic contribution of genes involved in the dopaminergic pathway in risk attitudes and gene candidate studies gave contrasting results. We test the possibility that a genetic effect of the DRD4-7R allele in risk-taking behavior could be modulated by environmental factors. We show that the increase in risk-tolerance due to the 7R allele is independent of the environmental risk in two populations in Northern Senegal, one of which is exposed to a very high risk due to dangerous fishing.
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13
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Grant JE, Chamberlain SR. Illegal behaviors as a consequence of gambling disorder. Am J Addict 2023; 32:40-46. [PMID: 36398436 PMCID: PMC10098700 DOI: 10.1111/ajad.13360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/03/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Gambling disorder has been associated with illegal behaviors; however, research using validated scales and in-person assessments has been less common. METHODS Four hundred and twenty-seven people with gambling disorders taking part in clinical trials completed multiple instruments and select cognitive tasks. Two groups were identified: those with illegal behaviors linked to gambling disorder and those without. Differences between the groups were examined. RESULTS 43.3% of people with gambling disorders reported gambling-related illegal behaviors. Illegal behaviors were associated with earlier gambling symptom onset, higher levels of depressive symptoms, worse quality of life, and higher non-planning impulsivity. In those with illegal behaviors, the most common activities reported were writing bad checks/paying bills from accounts that no longer had funds (75.1%), and theft (9.6%). People with illegal gambling-related behaviors did not differ from those without, in terms of levels of symptom severity, or likelihood of responding to treatment in the subsequent clinical trials. DISCUSSION AND CONCLUSIONS Illegal behaviors are commonplace in people with gambling disorders and linked to worse quality of life, but people with gambling-related illegal behaviors respond to core treatments to the same extent as people without these behaviors. SCIENTIFIC SIGNIFICANCE The findings from this study extend previous research and support the novel notion that rather than more intensive treatment being indicated for gambling disorders linked to illegal activities, it may be prudent to consider illegal behaviors as part of a wider profile of gambling-related harms that merit interventions in their own right.
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Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK.,Southern Health NHS Foundation Trust, Southampton, UK
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Szerman N, Basurte-Villamor I, Vega P, Mesías B, Martínez-Raga J, Ferre F, Arango C. Is there such a thing as gambling dual disorder? Preliminary evidence and clinical profiles. Eur Neuropsychopharmacol 2023; 66:78-91. [PMID: 36516511 DOI: 10.1016/j.euroneuro.2022.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022]
Abstract
Patients with gambling disorder (GD) frequently present other mental disorders, such as substance use disorder (SUDs), attention deficit/hyperactivity disorder (ADHD), mood disorders, and impulse-control disorders. We propose that GD should not be conceptualized as a single nosological entity, but rather as a gambling dual disorder (GDD). This study aims to provide further evidence of the co-occurrence of GD and other mental disorders in routine clinical practice and to identify different clinical profiles of severity. This descriptive, cross-sectional, and observational study included 116 patients with GD who were undergoing treatment in a specialized center. The MULTICAGE-CAD 4 and South Oaks gambling screen questionnaires confirmed the presence of GD in 97.4% and 100% of the patients, respectively. Other addictive behaviors such as compulsive spending, Internet, video games, or SUD (59.5%, 27.6%, 11.2%, and 13.8%, respectively) were also identified. The most used substances were tobacco (42.2%) and alcohol (5.2%). Half of the patients suffered from ADHD, 30.2% showed moderate or severe depression, and 17.2% suffered from a social anxiety problem. The majority (76.7%) also presented a phenotype with high impulsiveness. The cluster analysis identified two different clinical profiles of severity in patients with GDD. One profile showed higher severity of other mental disorders (ADHD, depression, anxiety, SUD, or insomnia), impulsivity, general psychopathological burden, and disability. In conclusion, our study provides further evidence on the co-occurrence of GD and other mental disorders supporting the GDD existence, shows impulsiveness as a vulnerability factor for GD, and identifies two clinical severity profiles.
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Affiliation(s)
- Néstor Szerman
- WADD and WPA Section Dual Disorders, Mental Health and Psychiatric Institute, Gregorio Marañon University Hospital, Madrid, Spain.
| | - Ignacio Basurte-Villamor
- Department of Psychiatry and Behavioral Health, Clínica López Ibor, Madrid, Spain; School of Medicine, Universidad Europea de Madrid, Spain.
| | - Pablo Vega
- Institute for Addictions, Madrid Salud, Madrid City Council, Madrid, Spain
| | - Beatriz Mesías
- Institute for Addictions, Madrid Salud, Madrid City Council, Madrid, Spain
| | - José Martínez-Raga
- Department of Psychiatry and Clinical Psychology, Hospital Universitario Doctor Peset & University of Valencia
| | - Francisco Ferre
- Institute of Psychiatry and Mental Health, Gregorio Marañón University Hospital, Madrid, School of Medicine, Universidad Complutense de Madrid, CIBERSAM, Spain
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Gregorio Marañón University Hospital, Madrid, School of Medicine, Universidad Complutense de Madrid, CIBERSAM, Spain
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15
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Tzagarakis C. Editorial: Neural mechanisms of impulsivity and compulsivity and their clinical and therapeutic corollaries. Front Behav Neurosci 2022; 16:991267. [PMID: 36035020 PMCID: PMC9403887 DOI: 10.3389/fnbeh.2022.991267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/15/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Charidimos Tzagarakis
- Department of Neuroscience, University of Minnesota, Minneapolis, MN, United States
- Organization Against Drugs (OKANA), Athens, Greece
- *Correspondence: Charidimos Tzagarakis
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16
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Griffiths SM. Gambling harms and gambling disorder research funding. Lancet Psychiatry 2022; 9:e30. [PMID: 35717967 DOI: 10.1016/s2215-0366(22)00191-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Sian M Griffiths
- Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
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17
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Suanes PN, Alberto NRI, Alberto IRI, Eala MAB. Gambling disorder. Lancet Psychiatry 2022; 9:429-430. [PMID: 35569497 DOI: 10.1016/s2215-0366(22)00105-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Patricia N Suanes
- College of Medicine, University of the Philippines, Manila 1000, Philippines
| | | | | | - Michelle Ann B Eala
- College of Medicine, University of the Philippines, Manila 1000, Philippines.
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18
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Gambling disorder - Authors' reply. Lancet Psychiatry 2022; 9:430. [PMID: 35569498 DOI: 10.1016/s2215-0366(22)00144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/23/2022]
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19
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van Schalkwyk MCI, McKee M, Cassidy R, Petticrew M, Blythe J. Gambling disorder. Lancet Psychiatry 2022; 9:429. [PMID: 35569496 DOI: 10.1016/s2215-0366(22)00068-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 01/26/2023]
Affiliation(s)
- May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK.
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | | | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK; SPECTRUM Consortium, UK
| | - Jenny Blythe
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
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20
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Dorey L, Christensen DR, May R, Hoon AE, Dymond S. Gambling treatment service providers' views about contingency management: a thematic analysis. Harm Reduct J 2022; 19:19. [PMID: 35216604 PMCID: PMC8876078 DOI: 10.1186/s12954-022-00600-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background There is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners’ perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers’ views of CM for treatment of problem gambling and gambling disorder. Methods We conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings. Results Participants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives. Conclusions UK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling. Supplementary Information The online version contains supplementary material available at 10.1186/s12954-022-00600-0.
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Affiliation(s)
- Lucy Dorey
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK
| | - Darren R Christensen
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.,University of Melbourne, Parkville, VIC, 3010, Australia
| | - Richard May
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, CF371DL, UK
| | - Alice E Hoon
- Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK
| | - Simon Dymond
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK. .,Department of Psychology, Reykjavík University, Menntavegur 1, Nauthólsvík, 101, Reykjavík, Iceland.
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