Relationship between pathological gambling, alexithymia, and gambling type

Cluster analysis based on gambling variables and mental health in a clinical population of gamblers

BACKGROUND

Interest in characterizing individuals involved in addictive behaviors has been growing, which allows tailoring prevention and intervention strategies to the gambler's needs. The study aimed to 1) identify clusters of gamblers according to gambling-related characteristics and mental health; and 2) analyze differences in psychological variables between the clusters.

METHODS

A total of 83 participants undergoing treatment for gambling disorder (Mage = 45.52, 51.8 % female) completed a set of questionnaires. Hierarchical cluster analysis was performed to classify gambling based on gambling variables (i.e., gambling severity and gambling motives) and mental health (i.e., depression, anxiety, and hostility). Several ANOVAs were conducted to illustrate the distinguishing features of each cluster, encompassing both the variables included in the cluster analysis and other relevant psychological variables.

RESULTS

Findings suggest that gamblers can be classified into three clusters based on these variables: 1) "high gambling severity and good mental health," 2) "high gambling severity and poor mental health," and 3) "low gambling severity and good mental health." These clusters were differentiated as a function of psychological variables, such as emotional dependence, alexithymia, and stressful life events.

CONCLUSIONS

Classifying gamblers according to their profile provides a better understanding of their needs and problems, allowing for a more tailored approach in terms of prevention and intervention strategies.

Alexithymia in gaming addiction and engagement

BACKGROUND

It has been suggested that alexithymia plays a significant role in substance and behavioral addictions. However, only a handful of studies investigated this construct in relation to gaming addiction, and no study analyzed its differential effect on gaming engagement and addiction.

METHODS

A total of u adult gamers (Mage = 26.04, SD = 5.78, 94 % male) completed a questionnaire that included the Toronto Alexithymia Scale (and its subscales of difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking), the Addiction-Engagement Questionnaire, and additional questions about gender, age, and time spent gaming. Structural equation modeling was used as the main analytical strategy.

RESULTS

Difficulty identifying feelings (β = 0.28) and externally oriented thinking (β = 0.19) showed a significant positive effect on gaming addiction. Contrary to addiction, externally oriented thinking showed a significant negative effect (β = -0.21) on gaming engagement. No other alexithymia subscales were significant. The model with alexithymia explained 32.7 % of the variance in gaming addiction while only 10.4 % of gaming engagement.

CONCLUSIONS

Alexithymia is a strong predictor of gaming addiction. Gaming engagement seems to be a qualitatively different phenomenon that shows an opposite association with alexithymia than gaming addiction. However, both are related to increased time spent gaming. This suggests a need to distinguish between problematic vs. non-problematic excessive gaming as they have different associations with affect dysregulation.

Individual risk factors and prediction of gambling disorder in online sports bettors - the longitudinal RIGAB study

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.

Moderating effect of alexithymia between problem gambling and psychotic experiences in university students

BACKGROUND

Most of the young individuals with problem gambling (PG) or psychotic experiences (PEs) are less prone to seek medical help. Therefore, community-based studies investigating the relationship between these entities in non-clinical young people across a continuum of severity are warranted. To this end, the present study proposes to advance knowledge on the mechanisms that potentially underlie the association between PG and PEs, by examining the role of a potential moderator, i.e. alexithymia, in this relationship.

METHODS

A total of 399 participants enrolled in this study (mean age = 21.58 ± 3.20 years) participated in an online cross-sectional survey. The South Oaks Gambling Screen (SOGS), the Prodromal Questionnaire-Brief (PQ-B), and the Toronto alexithymia scale (TAS-20) were used.

RESULTS

Thirty-three (8.3%) participants had problem-gambling, whereas 13 (3.3%) were probable pathological gamblers. Moderation analysis results adjusted over confounders (age, household crowding index, marital status, personal history of mental disorder, other illegal drug use) showed that the interaction PG by alexithymia (p = .018) was significantly associated with PEs scores. At moderate (Beta = 1.93) and high (Beta = 3.38) levels of alexithymia, more PG was significantly associated with more PEs scores.

CONCLUSION

Findings suggest that GP may have a different impact on PEs depending on the individual's level of alexithymia. As such, both alexithymia and gambling behavior should be considered in the clinical assessment of young people who present with PEs, which can help in implementing more tailored and individualized treatment plans.

Looking at Sex Differences in Gambling Disorder: The Predictive Role of the Early Abandonment Schema, Gambling Motives and Alexithymia in Depression

A growing body of research indicates differences between men and women with gambling disorder. However, although alexithymia, gambling motives or abandonment have been associated with GD, women's clinical profile remains unexplored. This study aims, firstly, to explore mean differences in gambling motives (i.e. enhancement, coping and social [SOC]), the early maladaptive abandonment schema, alexithymia and depression in women and men with GD. Secondly, to analyse the correlation between the aforementioned variables as a function of sex. Thirdly, to examine the predictive role of gambling motives, early abandonment schema and alexithymia in depression as a function of sex. Lastly, to analyse the mediating role of COP between the early maladaptive abandonment schema and depression in women with GD, and the mediating role of ENH and the early maladaptive abandonment schema between alexithymia and depression in men with GD. The sample comprised 108 adults with GD diagnosis, of whom 60 were women and 48 were men. Regression and mediation analyses were carried out to explore possible sex differences in GD, through the SPSS programme. Results showed that depressive symptoms are predicted by alexithymia in men with GD and by the early maladaptive abandonment schema in women with GD. Regarding mediation analyses, the results suggest that COP mediated the relationship between early abandonment schema and depressive symptoms in females; and ENH and abandonment schema mediated the relationship between alexithymia and depressive symptoms in males. These results provide evidence of the relevance of considering sex differences when establishing therapeutic strategies in GD rehabilitation.

Sex-comparative study of gambling disorder regarding alexithymia and symptoms of depression, anxiety and hostility

BACKGROUND AND AIMS

Alexithymia and psychological symptomatology have been closely associated with gambling disorder (GD). However, sex differences remain underexplored. This study aims, firstly, to explore the differences between groups (GD and no-GD) and sexes (women vs. men) in alexithymia and psychological symptomatology (depression, anxiety and hostility). Secondly, the relationship between alexithymia and psychological symptomatology was analysed by gambling and sex groups. Thirdly, it examines the moderation role of sex and gambling in the relationship between alexithymia and each psychological symptom.

METHOD

The sample was composed of 80 people with GD diagnosis and 80 without GD (40 women and 40 men in each group).

RESULTS

The results showed that alexithymia is positively related to depression, anxiety and hostility, with significantly higher scores in people with GD. Moderation analyses showed a threefold interaction, in which higher alexithymia was related to higher depression for men with GD but not for GD-women. However, in women with GD, depression levels are higher than in people without GD and tend to be more stable over time, despite the lack of effect of alexithymia.

CONCLUSIONS

These results provide evidence indicating that dysfunctional psychological symptomatology affects people with GD to a greater extent than people without GD, but also that the aetiology and effect of underlying vulnerability factors on gambling is different according to sex. The need of prevention and treatment programmes that consider different psychological aspects depending on sex is reinforced.

Gambling disorder duration and cognitive behavioural therapy outcome considering gambling preference and sex

Gambling Disorder (GD) is a behavioural addiction that leads to high level of clinical distress and, in general, it is characterized by enduring symptomatology that presents high rates of chronicity. However, there is high variability of illness duration among patients who seek treatment for GD. Previous studies reported mixed results about the relevance of illness duration in GD treatment outcome. However, there are different profiles of patients who are diagnosed with GD. For this reason, this study aimed to evaluate the effect of illness duration in the treatment outcome of different profiles of GD patients according to their gambling preference and sex. The sample were 1699 patients diagnosed with GD. All patients received cognitive-behavioural therapy in a group format. Treatment outcome was evaluated in terms of relapsing to gambling behaviours and dropout from treatment. Results showed higher probability of poor outcome in the first years of the disorder for strategic gambling compared to non-strategic or mixed forms of gambling. Moreover, women also showed higher probability of poor outcomes than men since the first stages of the disorder. This study draws attention to the relevance of illness duration in the treatment outcome of specific profiles of GD patients. In particular, patients who presented a preference for strategic forms of gambling and women who are diagnosed with GD would have a higher risk of poor treatment outcomes since the first stages of the disorder. These results highlight the importance of an early intervention in these patients in order to prevent the chronicity of the disorder.

The Mediating Roles of Self-compassion and Emotion Regulation in the Relationship among Alexithymia, Gambling Frequency, Risky Decision-Making, and Gambling Severity in Online Gamblers

BACKGROUND

The research literature about the relationship between alexithymia, risky decision-making, and gambling severity has been contradictory and limited. Besides, there is no study on the mediating roles of self-compassion and emotion regulation in online gambling. Moreover, the role of these mediators in gambling frequency has not been studied. Thus, the present study aimed to investigate the relationship between alexithymia, risky decision-making, and gambling frequency by considering the mediating role of self-compassion and emotion regulation in online gamblers.

METHODS

A total of 319 Iranians who gambled online at least once a week in the past three months were investigated using an online survey including Farsi Toronto Alexithymia Scale-20 (FTAS-20), Difficulties in Emotion Regulation Scale (DERS), and Gambling Disorder Screening Questionnaire-Persian (GDSQ-P). Statistical analyses were conducted by SPSS 26.0 for Windows. The relationships between the variables were analyzed using correlation analysis. In cases where significant relationships were observed, the hypotheses of the regression model were tested.

FINDINGS

The mean age of the participants was 24.6±6.06 and 253 participants (73.9%) were male. Furthermore, no significant differences were observed between men and women in terms of risky decision-making (P=0.051), gambling severity (P=0.59), and age (P=0.293).

CONCLUSION

Alexithymia had both a direct and indirect relationship with gambling severity through the mediating roles of emotion regulation and self-compassion. Moreover, alexithymia was significantly associated with risky decision-making and gambling frequency, through the mediating role of difficulties in emotion regulation, both directly and indirectly.

Experiencing a significant win and its sociodemographic and motivational predictors: A comparative analysis of pure-chance gamblers from Poland and France

Research on the relationship between wins and gambling behavior often focuses on winning considerably large amounts of money. It seems, however, that it is not the amount of the win, but the significance that the player assigns to the win, that exerts a decisive influence on gambling behavior. Therefore, in this study we adopted the concept of significant win: a win perceived by gamblers as important to them. The research aimed to discover what kind of wins are experienced as significant and what factors explain experiencing wins as significant. This study, conducted in Poland (N = 3,143) and France (N = 5,692), also had a comparative goal: discovering intercultural differences in experiencing significant wins. A computer-assisted web survey was administered to gamblers who engaged in pure-chance gambling, where the participant does not influence the outcome of the gamble after the initial bet is placed-selected from representative samples in both countries. We used logistic regression models to examine predictors of significant win experience in both countries and the differences between the countries. The results demonstrated that Polish gamblers more frequently considered a win significant when it was accompanied by strong, often negative emotions and was higher in monetary value normalized in terms of average monthly personal income, than French gamblers. French gamblers more frequently associated a significant win with a positive experience. The common predictors of a significant win experience in both countries were: being in debt, experiencing the win of a close person, gambling in a game of pure chance other than lotteries, more systematic pursuit of gambling, self-enhancement motivation, and coping motivation to gamble. Age at initiation into gambling was a significant predictor only in the French sample, whereas a financial motivation was a significant predictor in the Polish one. The results confirmed that the subjective perception of gambling wins is only partially related to the amounts of wins, which has practical implications for planning prevention strategies.

An empirical investigation of the Pathways Model of problem gambling through the conjoint use of self-reports and behavioural tasks

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.

The Association Between Internet Gaming Disorder and Sensation Seeking Among Arab Adolescents

Research on internet gaming disorder (IGD) has increased considerably over the last decade. Although most IGD research has focused on Western or South Asian samples, it is critical to understand and assess this disorder among other populations. The present study investigated the association between IGD and sensation seeking among Arab adolescents. An online survey consisting of the short internet gaming disorder short scale (IGDSS) and brief sensation seeking scale (B-SSS) was completed by 260 participants (mean age = 14.61, SD = 2.43). The results showed that sensation seeking behaviours were associated with higher gaming hours and greater chances of exhibiting IGD. The findings support the current perspective of understanding this disorder from a disease framework as it highlights the relevance of behavioural components in gaming addiction. Importantly, the results will further aid the development of reliable diagnosis and efficacious treatments within clinical practices.

Do emotion regulation and impulsivity differ according to gambling preferences in clinical samples of gamblers?

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.

Alexithymia, Dissociation, and Family Functioning in a Sample of Online Gamblers: A Moderated Mediation Study

The diffusion of the internet and technological progress have made gambling on online platforms possible, also making it more anonymous, convenient, and available, increasing the risk of pathological outcomes for vulnerable individuals. Given this context, the present study explores the role of some protective and risk factors for problematic gambling in online gamblers by focusing on the interaction between alexithymia, dissociation, and family functioning. A sample of 193 online gamblers (Mage = 28.8 years, SD = 10.59; 17% females, 83% males) completed the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Family Adaptability and Cohesion Evaluation Scales-IV through an online survey. MANOVA, ANOVA and moderated mediation analyses were carried out to analyse the data. Significant differences in cohesive family functioning, alexithymia and dissociation have been found between online gamblers with problematic, at-risk or absent levels of gambling disease. Furthermore, the results showed a significant and positive association between alexithymia and problematic online gambling, partially mediated by dissociation, with the moderation of cohesive family functioning. Such data may have relevant clinical implications, highlighting the interaction of some core personal and environmental variables that may be involved in the etiology of online pathological gambling and could be kept in mind to tailor preventive interventions.

Alexithymia and Emotion Regulation Strategies in Adolescent Gamblers with and Without At-Risk Profiles

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.

Impulsivity, Emotion Regulation, Cognitive Distortions and Attentional Bias in a Spanish Sample of Gambling Disorder Patients: Comparison between Online and Land-Based Gambling

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.

Emotional regulation in eating disorders and gambling disorder: A transdiagnostic approach

BACKGROUND AND AIMS

Difficulties in Emotion Regulation (ER) are related to the etiology and maintenance of several psychological disorders, including Eating Disorders (ED) and Gambling Disorder (GD). This study explored the existence of latent empirical groups between both disorders, based on ER difficulties and considering a set of indicators of personality traits, the severity of the disorder, and psychopathological distress.

METHODS

The sample included 1,288 female and male participants, diagnosed with ED (n = 906) and GD (n = 382). Two-step clustering was used for the empirical classification, while analysis of variance and chi-square tests were used for the comparison between the latent groups.

RESULTS

Three empirical groups were identified, from the most disturbed ER profile (Subgroup 1) to the most functional (Subgroup 3). The ER state showed a linear relationship with the severity of each disorder and the psychopathological state. Different personality traits were found to be related to the level of emotion dysregulation.

DISCUSSION AND CONCLUSION

In this study, three distinct empirical groups based on ER were identified across ED and GD, suggesting that ER is a transdiagnostic construct. These findings may lead to the development of common treatment strategies and more tailored approaches.

The role of gambling type on gambling motives, cognitive distortions, and gambling severity in gamblers recruited online

The recent literature shows that the type of gambling practiced influences problem gambling. This study was aimed at investigating the factors associated with gambling type, including gambling severity, gambling motives, and cognitive distortions. A total of 291 regular male gamblers (229 skill gamblers and 62 mixed gamblers, i.e., those who play at least one game of chance and one skill game) were recruited online and assessed for gambling severity (South Oaks Gambling Screen), gambling motives (Gambling Motives Questionnaire-Financial), cognitive distortions (Gambling-Related Cognition Scale), and psychological distress (Hospital Anxiety and Depression Scale). After controlling for the number of games played and psychological distress, we found that gambling type was significantly associated with gambling severity. Moreover, controlling for psychological distress showed that gambling type was also significantly associated with coping motives and interpretative bias. First, mixed gamblers had higher severity scores and higher coping motivation than skill gamblers; second, skill gamblers seemed more at risk of developing interpretative bias. Thus, the gamblers presented different psychological, motivational, and cognitive profiles according to gambling type, indicating that different clinical interventions may be relevant. Working on coping motives and anxiety and depression symptoms with an abstinence purpose would be more suitable for mixed gamblers. Indeed, working on these points could lead to the gambler reducing or eventually ceasing gambling, as the need to regulate negative emotions through gambling behavior would fade in parallel. Gambling type, psychological distress, gambling motives, and cognitive distortions should be taken into consideration systematically in clinical interventions of patients with plural and mixed practice of games.

Maladaptive Personality Functioning and Psychopathological Symptoms in Problematic Video Game Players: A Person-Centered Approach

BACKGROUND

A need exists to increase our understanding of the association between maladaptive personality traits, psychopathological symptoms, game preference, and different types of video game use. In the present study, we used a person-centered approach to identify different subtypes of video game players and we explored how they differ in personality profiles, clinical symptoms, and video game usage.

METHODS

We assessed problematic gaming via the nine-item Internet Gaming Disorder Scale and self-reported screen time playing video games in a sample of 366 adolescents and young adult gamers. Participants also completed measures on maladaptive personality domains (Personality Inventory for DSM-5 Brief Form), alexithymia (Toronto Alexithymia Scale-20 items), and psychopathological symptoms (DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure) and reported which genre of video games they preferred.

RESULTS

Using a person-centered, cluster-analytic approach, we identified four clusters of video game players (Occasional, Passionate, Preoccupied, and Disordered) presenting peculiar combinations of problematic gaming scores and time spent online playing video games. Non-problematic gamers (Occasional and Passionate) represented the majority of the sample (62.3% of the participants). Highly involved gamers who exhibited excessive screen time playing video games (Disordered gamers) presented the highest level of maladaptive personality traits and psychopathological symptoms, and were characterized by the greatest use of Multiplayer Online Battle Arena (MOBA) games.

CONCLUSION

These results have clinical implications on suggesting the importance to determining whether or not problematic gaming activities reflect a dysfunctional emotion-focused coping strategy to avoid inner unpleasant emotional or a more generally compromised emotional and social functioning.

Gambling Problems and Alexithymia: A Systematic Review

Among the factors that are thought to underlie gambling problems, alexithymia has been recognized to contribute to their development. For the first time, we reviewed the literature on the relationship between alexithymia and gambling. A systematic search of literature was run in the major reference databases including PubMed, Cochrane Database for Systematic Review, PsycINFO, Web of Science, Scopus until April 2019. The search produced 182 articles that produced 20 papers included in the review. Fourteen studies were conducted with community samples of pathological gamblers while six studies with clinical samples of disordered gamblers. All studies assessed alexithymia with the Toronto Alexithymia Scale while gambling problems were assessed mostly with the South Oaks Gambling Screen. Alexithymic features were significantly more prevalent in pathological gamblers both at the community and clinical levels, increased symptom severity, and showed interactive mechanisms with personality, psychiatric, and cognitive factors. Alexithymia is likely to associate with gambling as a coping behavior to increase emotional arousal and avoid negative emotions, according to the affect dysregulation model. Further studies are needed to widen the knowledge on this association.

Impulsivity and cognitive distortions in different clinical phenotypes of gambling disorder: Profiles and longitudinal prediction of treatment outcomes

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.

Internet gaming disorder in male and female young adults: The role of alexithymia, depression, anxiety and gaming type

The aim of this study is to investigate the relationship between alexithymia and Internet Gaming Disorder (IGD) (while controlling for depression and anxiety), explore the presence of gender differences, and the potential differences between MOBA and MMORPG gamers. A total of 429 young adults (mean age 20.7 years) recruited from different forums dedicated to video games took part in the study and filled a questionnaire including type of video game use, the Game Addiction Scale, the TAS-20 (evaluating alexithymia) and the HADS (evaluation anxiety and depression). In the whole sample, being alexithymic, depression scores, and anxiety scores were associated with IGD. Nevertheless, results differed depending on gender and type of games played. In male gamers, being alexithymic, being young, and having high anxiety and depression scores was associated with IGD. In female gamers, having less than a high school education and a high depression score was associated with IGD. In MOBA gamers, only the difficulty describing feelings factor was associated with IGD while in MMORPGs gamers, graduation from high school and anxiety scores were associated with IGD. Playing MOBA games could be a strategy to regulate emotions while playing MMORPG appears to be a maladaptive coping strategy to deal with negative affective disturbances. Gender and gaming type are important factors in the relationship between alexithymia, depression, anxiety and IGD. These results have some interesting clinical implications, which are discussed.

Differences in Emotion Regulation Considering Gender, Age, and Gambling Preferences in a Sample of Gambling Disorder Patients

Introduction: Impairments in emotion regulation are understood to be a transdiagnostic risk factor of suffering from compulsive and addictive behaviors. The aim of this study was to investigate the role of emotion regulation deficits in gambling disorder and to analyze these differences taking gender, age, and gambling activity preferences into account.

METHODS

The sample included n = 484 patients seeking treatment for gambling disorder at a specialized outpatient service. Main outcomes were sociodemographic variables, emotion regulation, and gambling severity.

RESULTS

Differences between sexes were found in non-acceptance of emotions. Older patients obtained higher levels in non-acceptance of emotions, lack of emotion regulation strategies, emotional clarity, and global emotion regulation scores. No differences were found in emotion scores considering gambling preferences (non-strategic versus strategic). Path analysis showed that emotion regulation scores and age had a direct effect on gambling disorder severity, while emotion regulation and gambling preference were not mediational variables in the relationships of gender and age with gambling severity.

CONCLUSIONS

Emotion regulation impairments differ in patients seeking treatment for gambling problems. Early prevention and intervention programs should incorporate the different dimensions of this process, taking into account clinical phenotypes.

Alexithymia predicts loss chasing for people at risk for problem gambling

Background and aims The aim of this research was to investigate the relationship between alexithymia and loss-chasing behavior in people at risk and not at risk for problem gambling. Methods An opportunity sample of 58 (50 males and 8 females) participants completed the Problem Gambling Severity Index and the Toronto Alexithymia Scale (TAS-20). They then completed the Cambridge Gambling Task from which a measure of loss-chasing behavior was derived. Results Alexithymia and problem gambling risk were significantly positively correlated. Subgroups of non-alexithymic and at or near caseness for alexithymia by low risk and at risk for problem gambling were identified. The results show a clear difference for loss-chasing behavior for the two alexithymia conditions, but there was no evidence that low and at-risk problem gamblers were more likely to loss chase. The emotion-processing components of the TAS-20 were shown to correlate with loss chasing. Discussion and conclusion These findings suggest that loss-chasing behavior may be particularly prevalent in a subgroup of problem gamblers those who are high in alexithymia.