Pathological gamblers and a non-psychiatric control group taking gender differences into account

Impulsivity Moderates the Association Between Anxiety and Problem Gambling Among Canadian Undergraduates

Tension reduction theory suggests anxious people gamble to cope with negative affect. Literature demonstrates mixed associations between anxiety and gambling behaviours, hence, the important of examining moderators. This study examined how impulsivity moderated anxiety and problem gambling as well as gambling to cope. Given key gender differences, moderation was examined across genders. A sample of 484 undergraduate students who endorsed gambling behaviours completed anxiety, impulsivity, and problem gambling measures. Results showed men with higher levels of anxiety scored higher on problem gambling at both high (B = 0.706, SE = 0.073, p < 0.0001, f2 = 0.20) and low (B = 0.262, SE = 0.103, p = 0.01, f2 = 0.01) impulsivity, though the effect sizes were much larger for men with high impulsivity. This moderation effect was not found in women (B = 0.000, SE = 0.009, p = 0.959). Results showed men with higher levels of anxiety scored higher on coping motives for gambling at both high (B = 0.253, SE = 0.046, p < 0.0001, f2 = 0.06) and low B = 0.141, SE = 0.063, p = 0.026, f2 = 0.01) impulsivity, though the effect sizes were larger for men with high impulsivity. Again, this moderation effect was not found in women (B = - 0.101, SE = 0.006, p = 0.100). Findings from this may help inform impulsivity-focused interventions, such as strengthening impulse control and instilling more adaptive coping strategies to lower gambling risk among university men.

Differences in problem and pathological gambling: A narrative review considering sex and gender

Background and aim

A wide range of studies indicates that men and women with Problem (PrG) and Pathological Gambling (PG) differ in several clinical and sociodemographic characteristics. However, evidence for sex differences, such as the telescoping effect, is contradictory, and it is still unclear whether sex differences observed in offline gambling can also be found for online gambling. Furthermore, reviews have so far focused on binary sex differences but neglect gender aspects. In this study, an updated literature survey of sex- and gender-related differences in PrG and PG was conducted.

Methods

We searched PsyInfo, Medline/Pubmed, and the Web of Science databases from 2005 to 2020 for studies investigating sex and gender differences in gambling. A total of 126 papers were included in the literature survey.

Results

We are presenting our findings according to the categories 'prevalence' (offline, online, LGBTQI*), 'sociodemographic factors', 'preferred gambling type', 'gambling motives', 'severity', 'progression of gambling problems', 'use of professional help/motivation for treatment', 'comorbidity', 'trauma', 'violence and criminality/delinquency'. The studies indicate that, despite some robust sex differences (e.g., concerning prevalence rates), results for most areas were mixed or suggest no sex differences (e.g., violence, gambling motives).

Discussion and conclusion

To date, there is a lack of studies assessing gender, and not only sex, warranting further research in this area.

Clinical differences between men and women in a Swedish treatment-seeking population with gambling disorder

INTRODUCTION

The purpose of this study was to explore clinical differences in Swedish treatment-seeking men and women with gambling disorder (GD). As the prevalence of GD is increasing among women, even though men are still highly overrepresented, the characteristic differences between men and women seeking treatment become increasingly important.

METHOD

A sample of 204 patients with GD (26.5% women and 73.5% men) at an outpatient clinic were diagnosed using the SCI-GD, screened for comorbid diagnoses using the MINI, and further completed a range of self-report questionnaires measuring demographics, GD, alcohol and other drug problems, symptoms of depression and anxiety, and pathways into gambling problems.

RESULTS

Several characteristics differed between treatment-seeking men and women in our sample. Examples of differences between genders included age, onset age, living situation, duration, alcohol and drug problems, comorbidity, and pathways leading to gambling problems.

DISCUSSION

The most evident difference was that women, in addition to GD, showed more symptoms of anxiety and depression than men, while men had a higher degree of substance use problems compared to women. The differences in clinical features between men and women are important to consider in treatment planning and possibly for future gender-based interventions.

Primary and Secondary Diagnoses of Gambling Disorder and Psychiatric Comorbidity in the Swedish Health Care System-A Nationwide Register Study

Background: Psychiatric comorbidity is common in gambling disorder, a condition with low rates of treatment seeking. There is a paucity of documented nationwide data on gambling disorder and its co-occurring psychiatric comorbidities in the health care system. Methods: This is a nationwide register-based study of all patients aged above 18 years who were diagnosed with gambling disorder (corresponding to pathological gambling, code F63.0, in the ICD-10) in Swedish specialized out-patient health care or in-patient care, from 2005 through 2016. All psychiatric disorders co-occurring with the diagnoses were recorded, along with age, gender and the type of medical specialty. Results: A total of 2,099 patients were included (1,784 in out-patient care and 629 patients in in-patient care), among whom 77 percent were men. Treatment uptake during the study period increased significantly in out-patient care, with an increasing uptake of younger individuals, whereas in-patient treatment uptake remained stable. A co-occurring psychiatric diagnosis was registered in 73 percent of patients, more commonly in females (77 vs. 71 percent, p < 0.01). Several diagnostic subgroups were more common in women, with anxiety and affective disorders being the most common subgroups. Prevalence of substance use disorders did not differ with respect to gender. Conclusions: Despite a large gap between probable population prevalence of gambling disorder and the number of treated patients, the number of patients treated in out-patient health care with a gambling disorder diagnosis increased over time, with an increasing treatment uptake in younger individuals. Psychiatric comorbidity is common in gambling disorder patients in the health care system, with a higher prevalence in women.

Clinical Profile and Psychiatric Comorbidity of Treatment-Seeking Individuals with Pathological Gambling in South-Africa

Pathological gambling is a prevalent and disabling mental illness, which is frequently associated with mood, anxiety, and substance use disorders. However, there is relatively little data on comorbidity in individuals with pathological gambling from low and middle income countries such as South-Africa. The Mini-International Neuropsychiatric Interview was used to assess the frequency of DSM-IV-TR disorders among 100 male and 100 female treatment-seeking individuals with pathological gambling in South-Africa. The Sheehan Disability Scale was used to assess functional impairment. In a South-African sample of individuals with pathological gambling, the most frequent current comorbid psychiatric disorders were major depressive disorder (28%), anxiety disorders (25.5%) and substance use disorders (10.5 %). Almost half of the individuals had a lifetime diagnosis of major depressive disorder (46%). Female pathological gamblers were significantly more likely to be diagnosed with a comorbid major depressive disorder or generalised anxiety disorder than their male counterparts. Data from South-Africa are consistent with previously published data from high income countries. Psychiatric comorbidity is common among individuals with pathological gambling.

[Sociodemographic Traits and Comorbidities in Pathological Gamblers With a Suicide Attempt in Spain]

OBJECTIVE

Suicide is the first cause of non-natural death in Spain. Among addictive disorders, pathological gambling is one the most significant independent risk factors for suicidal behavior. The objective of this study is to describe and compare the sociodemographic traits, comorbidity and attempt characteristics, between suicide attempters who fulfill diagnostic criteria for pathological gambling and those who do not.

METHODS

A total of 345 patients admitted to the emergency department of a University Hospital in Madrid between 1999 and 2004 were interviewed for this study. To describe and compare the demographic characteristics, comorbidity and those related to attempted suicide, using logistic regression models adjusted for sex and age were used.

RESULTS

Suicide attempters who fulfilled diagnostic criteria for pathological gambling were predominantly male, with a low education level, and had more offspring. Furthermore, these patients had more comorbidities, such as: global substance dependence, nicotine, cocaine and opioid dependence.

CONCLUSIONS

The present study suggests that pathological gamblers represent a distinct subgroup among suicide attempters, with particular characteristics, similar to those found in pathological gamblers in the general population.

Personality traits of problem gamblers with and without alcohol dependence

INTRODUCTION

A large proportion of individuals with gambling disorder also present with a history of alcohol dependence, but few studies have directly examined the relationship between these two conditions. This study's primary and secondary aims were to 1) examine the relationship of personality traits to co-occurring lifetime (current/past) alcohol dependence status, while 2) accounting for differences in gambling characteristics and co-occurring psychiatric disorders among problem/pathological gamblers recruited from the community.

METHODS

Problem/pathological gamblers (N=150) completed measures of personality traits and gambling characteristics (e.g., gambling severity, gambling involvement, delayed discounting of monetary rewards), and were clinically interviewed for co-occurring psychiatric disorders.

RESULTS

A co-occurring lifetime diagnosis of alcohol dependence (n=61, 40.7%) was associated with lower personality scores for Control, Well-Being, Achievement, Traditionalism, and Harm Avoidance, as well as higher scores for Alienation (Tellegen & Waller, 1994) in bivariate analyses. Problem/pathological gamblers with lifetime alcohol dependence reported greater lifetime gambling severity, greater past-year gambling involvement, steeper delayed discounting, and a greater likelihood of current and lifetime substance dependence, lifetime antisocial personality disorder, and current unipolar mood disorders. Multivariate analyses indicated that lower Control, Traditionalism, and Well-Being and a co-occurring lifetime substance dependence diagnosis best accounted for a co-occurring lifetime alcohol dependence diagnosis in problem/pathological gamblers.

CONCLUSIONS

Problem/pathological gamblers with co-occurring lifetime alcohol dependence demonstrate addictive behavior across multiple domains and report a personality style characterized by hopelessness, impaired control, and resistance to externally-motivated treatment approaches. Implications for the treatment of these complex cases are discussed.