1
|
Stefanovics EA, Potenza MN, Tsai J, Pietrzak RH. Gambling and Substance Use Disorders in U.S. Military Veterans: Prevalence, Clinical Characteristics, and Suicide Risk. J Gambl Stud 2024:10.1007/s10899-024-10359-7. [PMID: 39342537 DOI: 10.1007/s10899-024-10359-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 10/01/2024]
Abstract
Gambling and substance use disorders (SUDs) are prevalent among U.S. military veterans and often co-occur. However, little is known about the clinical and behavioral correlates and suicidal risk of SUDs and gambling among veterans that can help inform targeted interventions for their co-occurrence. In the current study, we analyzed data from a nationally representative sample of 4069 veterans who participated in the National Health and Resilience in Veterans Study. Self-reported measures of lifetime SUDs and past-year gambling (Brief Problem Gambling Screen) were administered. A multinomial logistic regression analysis was conducted to examine differences between four groups: non-SUD/non-gambling, 40.3%; SUD-only 27.3%; Gambling-only 16.3%; and SUD + Gambling, 16.1%. The Gambling-only, SUD-only, and SUD + Gambling groups reported more adverse childhood experiences relative to the non-SUD/non-gambling group. The SUD-only and SUD + Gambling groups had higher odds for all lifetime and current clinical and trauma variables relative to the non-SUD/non-gambling group. The SUD + Gambling group had higher odds of suicidality, non-suicidal self-injury, nicotine dependence and mental health treatment relative to the SUD-only group and all assessed clinical measures relative to the Gambling-only group. Results suggest that SUDs and gambling are associated with substantial trauma and mental health burden among U.S. veterans, with co-occurring SUDs and gambling linked particularly to suicidality/self-harm and mental health treatment. The findings underscore the importance of multicomponent assessments and interventions targeting SUDs, gambling, and related concerns, such as trauma-related mental health difficulties, in this population.
Collapse
Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell Avenue, Build 36, West Haven, CT, 06516, USA.
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council On Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Jack Tsai
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| |
Collapse
|
2
|
Carbonneau R, Vitaro F, Brendgen M, Boivin M, Côté SM, Tremblay RE. Differential Association of Preadolescent Risk Factors Across Developmental Patterns of Adolescent Concurrent Gambling Participation and Substance Use. J Gambl Stud 2024:10.1007/s10899-024-10358-8. [PMID: 39316244 DOI: 10.1007/s10899-024-10358-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2024] [Indexed: 09/25/2024]
Abstract
Early risk factors for gambling participation (GP) and substance use (SU) in adolescents have usually been studied separately, although these disorders were integrated into the same clinical category over a decade ago. This exploratory study aimed to investigate the early individual, parental, familial and social risk factors associated with developmental patterns of adolescent GP and SU in a population-representative cohort (N = 1594, 51.2% boys). Using a person-centered strategy and multiple assessments from age 12 to 17, six developmental patterns describing joint GP and SU courses were revealed. Non-substance users/non-gamblers served as the reference class in an integrated longitudinal-multivariate analysis framework examining 15 distinct risk factors. Results showed that a core of risk factors were common to all trajectory-classes of substance users with or without GP. For a similar level of SU, most of the risk factors associated with non-gambling users also affected their gambling peers. However, additional risk factors were specifically related to GP. Thus, substance users who also gamble were affected by a greater number of risk factors than non-gambling substance users. Findings are consistent with a developmental syndrome of addiction, which posits a shared etiology between different expressions of addiction as well as differences in risk factors that lead to distinct trajectories of addictive behaviors. They highlight the importance of considering both GP and SU for a comprehensive assessment of adolescents' level of risk with regard to addictive behaviors.
Collapse
Affiliation(s)
- Rene Carbonneau
- Department of Pediatrics, Faculty of Medicine, University of Montreal, 3050 Edouard-Montpetit, Suite 225, Montreal, QC, H3T 1J7, Canada.
- Sainte-Justine Hospital Research Center, Montreal, Canada.
- Research Unit On Children's Psychosocial Maladjustment, University of Montreal, Montreal, Canada.
| | - Frank Vitaro
- Sainte-Justine Hospital Research Center, Montreal, Canada
- Research Unit On Children's Psychosocial Maladjustment, University of Montreal, Montreal, Canada
- School of Psychoeducation, University of Montreal, Montreal, Canada
| | - Mara Brendgen
- Sainte-Justine Hospital Research Center, Montreal, Canada
- Research Unit On Children's Psychosocial Maladjustment, University of Montreal, Montreal, Canada
- Department of Psychology, University of Quebec in Montreal, Quebec, Canada
| | - Michel Boivin
- Research Unit On Children's Psychosocial Maladjustment, University of Montreal, Montreal, Canada
- Department of Psychology, Laval University, Quebec, Canada
| | - Sylvana M Côté
- Sainte-Justine Hospital Research Center, Montreal, Canada
- Research Unit On Children's Psychosocial Maladjustment, University of Montreal, Montreal, Canada
- Department of Social and Preventive Medecine, School of Public Health, University of Montreal, Montreal, Canada
| | - Richard E Tremblay
- Department of Pediatrics, Faculty of Medicine, University of Montreal, 3050 Edouard-Montpetit, Suite 225, Montreal, QC, H3T 1J7, Canada
- Sainte-Justine Hospital Research Center, Montreal, Canada
- Research Unit On Children's Psychosocial Maladjustment, University of Montreal, Montreal, Canada
- Department of Psychology, University of Montreal, Montreal, Canada
| |
Collapse
|
3
|
Deriu V, Altavilla D, Adornetti I, Chiera A, Ferretti F. Narrative identity in addictive disorders: a conceptual review. Front Psychol 2024; 15:1409217. [PMID: 38952822 PMCID: PMC11215194 DOI: 10.3389/fpsyg.2024.1409217] [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: 03/29/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
Narrative identity allows individuals to integrate their personal experiences into a coherent and meaningful life story. Addictive disorders appear to be associated with a disturbed sense of self, reflected in problematic and disorganized self-narratives. In recent literature, a growing body of research has highlighted how narrative approaches can make a dual contribution to the understanding of addiction: on the one hand, by revealing crucial aspects of self structure, and, on the other, by supporting the idea that addiction is a disorder related to unintegrated self-states in which dissociative phenomena and the resulting sense of 'loss of self' are maladaptive strategies for coping with distress. This conceptual review identified the main measures of narrative identity, i.e., narrative coherence and complexity, agency, and emotions, and critically examines 9 quantitative and qualitative studies (out of 18 identified in literature), that have investigated the narrative dimension in people with an addictive disorder in order to provide a synthesis of the relationship between self, narrative and addiction. These studies revealed a difficulty in the organization of narrative identity of people with an addictive disorder, which is reflected in less coherent and less complex autobiographical narratives, in a prevalence of passivity and negative emotions, and in a widespread presence of themes related to a lack of self-efficacy. This review points out important conceptual, methodological and clinical implications encouraging further investigation of narrative dimension in addiction.
Collapse
Affiliation(s)
| | - Daniela Altavilla
- Cosmic Lab, Department of Philosophy, Communication and Performing Arts, Roma Tre University, Rome, Italy
| | | | | | | |
Collapse
|
4
|
Romero P, Czakó A, van den Brink W, Demetrovics Z. Psychedelic-assisted therapy for people with gambling disorder? J Behav Addict 2024; 13:6-11. [PMID: 38421388 PMCID: PMC10988418 DOI: 10.1556/2006.2024.00004] [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] [Received: 09/07/2023] [Revised: 12/16/2023] [Accepted: 01/12/2024] [Indexed: 03/02/2024] Open
Abstract
Gambling disorder is a severe mental health and behavioural problem with harmful consequences, including financial, relationship and mental health problems. The present paper initiates discussion on the use of psychedelics combined with psychotherapeutic support as a potential treatment option for people living with a gambling disorder. Recent studies have shown promising results using psychedelic-assisted therapy (PAT) to treat anxiety, depression, post-traumatic stress disorder, and various substance use disorders. Considering the similarities in the underlying psychosocial and neurobiological mechanisms of gambling disorder and other addictive disorders, the authors suggest that psychedelic-assisted therapy could be effective in treating gambling disorder. The paper also underscores the need for further research into the viability and effectiveness of psychedelic-assisted therapy for gambling disorder.
Collapse
Affiliation(s)
- Pedro Romero
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - Andrea Czakó
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Wim van den Brink
- Amsterdam University Medical Centers, Department of Psychiatry, Amsterdam, The Netherlands
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| |
Collapse
|
5
|
Developmental Patterns of Gambling Participation and Substance use Throughout Adolescence in a Population Birth Cohort. J Gambl Stud 2023; 39:137-157. [PMID: 35211846 DOI: 10.1007/s10899-022-10107-9] [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: 10/13/2021] [Revised: 10/13/2021] [Accepted: 01/29/2022] [Indexed: 10/19/2022]
Abstract
This study investigated adolescents' single and co-occurring developmental patterns of gambling participation and substance use and their association with gambling and substance use-related issues at age 17, controlling for confounders. Multiple assessments from age 12 to 17 were conducted in a population-based cohort (N=1594, 51.2% boys). Latent growth modeling was used to analyze developmental patterns and Generalized linear models to examine their association with age-17 gambling and substance use-related problems, types and variety of activities, and substance abuse. Results revealed six developmental patterns, including Low- or Non-substance Users or Gamblers (24.2% sample), two trajectory-classes of Later-Onset Increasing (to a moderate level) substance users, either with or without gambling participation (7.8% and 45.5%, respectively), two trajectory-classes of Early-Onset Increasing (to a higher level) substance users, either with or without gambling participation (6.2% and 12.7%, respectively), and a smaller trajectory-class of Slow-Increasing Substance Users and Early-Onset Gamblers, declining to non-gambling after age 13 (3.6%). Gambling participation and substance use did not appear to influence each other with regard to their onset and course throughout adolescence, and to age-17 types and variety of gambling activities or substances used, problems related to gambling participation or substance use, or substance abuse. These findings are consistent with the addictive syndrome model and with both common and individualized approaches to prevention and treatment for adolescent gamblers or substance users.
Collapse
|
6
|
Merkouris SS, Rodda SN, Aarsman SR, Hodgins DC, Dowling NA. Effective behaviour change techniques for family and close friends: A systematic review and meta-analysis across the addictions. Clin Psychol Rev 2023; 100:102251. [PMID: 36716584 DOI: 10.1016/j.cpr.2023.102251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023]
Abstract
This systematic review aimed to determine whether the use of specific behaviour change technique (BCT) groups are associated with greater effectiveness for psychosocial interventions delivered to family and close friends (FCFs) impacted by addiction. A systematic search of peer-reviewed and grey literature published until August 2021 identified 32 studies in 38 articles. An established BCT taxonomy (93 BCTs clustered into 16 groups) was adapted (inclusion of seven additional BCT groups) and applied to 57 interventions. The meta-analyses indicated that some, but not all, FCF outcomes were improved by the exclusion of BCTs within several groups (Reward and Threat, Scheduled Consequences, Confrontation of the Addicted Person to Engage in Treatment, and Goals and Planning) and inclusion of BCTs within the Restoring a Balanced Lifestyle group. Addicted person outcomes were improved by the inclusion of some BCTs within several groups (Repetition and Substitution, Reward and Threat, Scheduled Consequences, and Restoring a Balanced Lifestyle). Relationship functioning outcomes were improved by the inclusion of BCTs within the Confrontation of the Addicted Person to Engage in Treatment group. Future research involving the development and evaluation of numerous interventions or comprehensive multi-component interventions that can address the various needs of FCFs, without counteracting them, is required.
Collapse
Affiliation(s)
- S S Merkouris
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia.
| | - S N Rodda
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia; Department of Psychology and Neuroscience, Auckland University of Technology, Auckland 1010, New Zealand
| | - S R Aarsman
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia
| | - D C Hodgins
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - N A Dowling
- School of Psychology, Deakin University, Geelong, Victoria 3220, Australia; Melbourne Graduate School of Education, University of Melbourne, Parkville, Victoria 3010, Australia
| |
Collapse
|
7
|
The Prevalence of Problem Gambling and Gambling Disorder Among Homeless People: A Systematic Review And Meta-Analysis. J Gambl Stud 2022; 39:467-482. [PMID: 35851824 PMCID: PMC10175321 DOI: 10.1007/s10899-022-10140-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 10/17/2022]
Abstract
AbstractGambling problems are often associated with homelessness and linked to elevated psychiatric morbidity and homelessness chronicity. We performed a systematic review and meta-analysis on prevalence rates of problem gambling (PG) and gambling disorder (GD) in homeless people. Following PRISMA guidelines, we searched databases Medline, Embase and PsycINFO from inception of databases to 4th may 2021. We included studies reporting prevalence estimates on clinical gambling problems in representative samples of homeless people based on standardized diagnostics. Risk of bias was assessed. A random effects meta-analysis was performed, and subgroup analyses based on methodological characteristics of primary studies were conducted. We identified eight studies from five countries, reporting information on 1938 participants. Prevalence rates of clinically significant PG and GD ranged from 11.3 to 31.3%. There was evidence for substantial heterogeneity with I2 = 86% (95% CI 63–97%). A subgroup of four low risk of bias studies displayed a significantly lower results ranging from 11.3 to 23.6%. Additionally, high rates of subclinical problem gambling were reported (11.6–56.4%). At least one in ten homeless persons experiences clinically significant PG or GD. Social support and health care services for the homeless should address this problem by implementing models for early detection and treatment.
Collapse
|
8
|
Gao L, Zhao W, Chu X, Chen H, Li W. A Network Analysis of the Relationships Between Behavioral Inhibition/Activation Systems and Problematic Mobile Phone Use. Front Psychiatry 2022; 13:832933. [PMID: 35432049 PMCID: PMC9011098 DOI: 10.3389/fpsyt.2022.832933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/23/2022] [Indexed: 11/15/2022] Open
Abstract
Background It is of great concern to society that individuals can be vulnerable to problematic mobile phone use (PMPU). However, there are a few studies in the field evaluating associations between behavioral inhibition/activation systems (BIS/BAS) and PMPU, and the results have been inconsistent. This study aimed to explore the relationships between BIS/BAS and PMPU by network analysis. Methods A total of 891 young adults participated in the study. BIS/BAS and PMPU were assessed by using the behavioral inhibition and activation systems scale and smartphone application-based addiction scale, respectively. The structure of the BIS/BAS-PMPU network was characterized using "strength," "closeness" and "betweenness" as centrality indices. Edge-weight accuracy and centrality stability were tested using a bootstrap procedure. Results The network analysis showed that "mood modification," "tolerance" and "withdrawal symptoms" had high centrality. In addition, the positive connection between BIS and "mood modification" or "tolerance" and between BAS-fun seeking and "mood modification" or "conflict" were also shown in the BIS/BAS-PMPU network. Conclusion These findings shed light on the central and bridge components between the BIS/BAS and PMPU communities, providing new evidence relevant to potential mechanisms that account for how high-BIS or high-BAS individuals develop PMPU, and inspiring component-based PMPU prevention or interventions.
Collapse
Affiliation(s)
- Lingfeng Gao
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, China
- School of Psychology, Central China Normal University, Wuhan, China
| | - Wan Zhao
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, China
| | - Xiaowei Chu
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, China
| | - Haide Chen
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, China
| | - Weijian Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, China
| |
Collapse
|
9
|
Tjernström N, Li TQ, Holst S, Roman E. Functional connectivity in reward-related networks is associated with individual differences in gambling strategies in male Lister hooded rats. Addict Biol 2022; 27:e13131. [PMID: 35229946 DOI: 10.1111/adb.13131] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 11/30/2022]
Abstract
Individuals with gambling disorder display deficits in decision-making in the Iowa Gambling Task. The rat Gambling Task (rGT) is a rodent analogue that can be used to investigate the neurobiological mechanisms underlying gambling behaviour. The aim of this explorative study was to examine individual strategies in the rGT and investigate possible behavioural and neural correlates associated with gambling strategies. Thirty-two adult male Lister hooded rats underwent behavioural testing in the multivariate concentric square field™ (MCSF) and the novel cage tests, were trained on and performed the rGT and subsequently underwent resting-state functional magnetic resonance imaging (R-fMRI). In the rGT, stable gambling strategies were found with subgroups of rats that preferred the suboptimal safest choice as well as the disadvantageous choice, that is, the riskiest gambling strategy. R-fMRI results revealed associations between gambling strategies and brain regions central for reward networks. Moreover, rats with risky gambling strategies differed from those with strategic and intermediate strategies in brain functional connectivity. No differences in behavioural profiles, as assessed with the MCSF and novel cage tests, were observed between the gambling strategy groups. In conclusion, stable individual differences in gambling strategies were found. Intrinsic functional connectivity using R-fMRI provides novel evidence to support the notion that individual differences in gambling strategies are associated with functional connectivity in brain regions important for reward networks.
Collapse
Affiliation(s)
- Nikita Tjernström
- Research Group Neuropharmacology, Addiction and Behavior, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Tie-Qiang Li
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Radiation and Nuclear Medicine, Karolinska University Hospital, Solna, Sweden
| | - Sarah Holst
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erika Roman
- Research Group Neuropharmacology, Addiction and Behavior, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| |
Collapse
|
10
|
Allami Y, Hodgins DC, Young M, Brunelle N, Currie S, Dufour M, Flores‐Pajot M, Nadeau L. A meta-analysis of problem gambling risk factors in the general adult population. Addiction 2021; 116:2968-2977. [PMID: 33620735 PMCID: PMC8518930 DOI: 10.1111/add.15449] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/21/2020] [Accepted: 02/02/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Few meta-analyses have been conducted to pool the most constant risk factors for problem gambling. The present meta-analysis summarizes effect sizes of the most frequently assessed problem gambling risk factors, ranks them according to effect size strength and identifies any differences in effects across genders. METHOD A random-effects meta-analysis was conducted on jurisdiction-wide gambling prevalence surveys on the general adult population published until March 2019. One hundred and four studies were eligible for meta-analysis. The number of participants varied depending on the risk factor analyzed, and ranged from 5327 to 273 946 (52% female). Weighted mean odds ratios were calculated for 57 risk factors (socio-demographic, psychosocial, gambling activity and substance use correlates), allowing them to be ranked from largest to smallest with regard to their association with problem gambling. RESULTS The highest odds ratio (OR) was for internet gambling [OR = 7.59, 95% confidence interval (CI) = 5.24, 10.99, P < 0.000] and the lowest was for employment status (OR = 1.03, 95% CI = 0.87, 1.22, P = 0.718). The largest effect sizes were generally in the gambling activity category and the smallest were in the socio-demographic category. No differences were found across genders for age-associated risk. CONCLUSIONS A meta-analysis of 104 studies of gambling prevalence indicated that the most frequently assessed problem gambling risk factors with the highest effect sizes are associated with continuous-play format gambling products.
Collapse
Affiliation(s)
- Youssef Allami
- ALLY Addiction ConsultingMontréalQCCanada,Centre de Réadaptation en Dépendance de Montréal, Institut UniversitaireCIUSSS du Centre‐Sud‐de‐l'Ile‐de‐MontréalMontréalQCCanada
| | | | - Matthew Young
- Canadian Centre on Substance Use and AddictionOttawaONCanada,Department of PsychologyCarleton UniversityOttawaONCanada
| | - Natacha Brunelle
- Département de psychoéducationUniversité du Québec à Trois‐RivièresTrois‐RivièresQC
| | - Shawn Currie
- Department of PsychologyUniversity of CalgaryCalgaryABCanada
| | - Magali Dufour
- Département de psychologieUniversité du Québec à MontréalMontréalQCCanada
| | | | - Louise Nadeau
- Département de psychologieUniversité de MontréalMontréalQCCanada
| |
Collapse
|
11
|
Prevalence of Suicidal Behavior and Associated Clinical Correlates in Patients with Behavioral Addictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111085. [PMID: 34769603 PMCID: PMC8583661 DOI: 10.3390/ijerph182111085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/17/2022]
Abstract
Addictive disorders are characterized by severe consequences, including suicidal events, but most studies investigating the association between addiction and suicidal risk have focused on substance use disorders and gambling disorder at the expense of the rest of behavioral addictions. This study examined the prevalence and the associated clinical correlates of suicidal ideation and suicide attempts in a sample of patients with a diagnosis of behavioral addiction. The total sample consisted of 4404 individuals: 4103 of these patients with gambling disorder, 99 with gaming disorder, 44 with sex addiction, and 158 with buying–shopping disorder. All of them were assessed consecutively at a specialized hospital unit for the treatment of behavioral addictions. Participants attended two clinical interviews and completed self-reported questionnaires to explore clinical features of behavioral addictions, personality traits, psychopathological symptomatology, suicidal behavior, and sociodemographic variables. The highest prevalence of suicidal ideation was found in patients with gambling disorder (22.9%), followed by buying–shopping disorder (18.4%), sex addiction (18.2%), and gaming disorder (6.1%). The highest prevalence of suicide attempts was registered for sex addiction (9.1%), followed by buying–shopping disorder (7.6%), gambling disorder (6.7%), and gaming disorder (3.0%). Female gender and unemployment constituted two relevant sociodemographic factors associated with suicidal risk in gambling disorder, gaming disorder, and buying–shopping disorder. Lack of family support appeared as a relevant risk factor, except for gaming disorder. These results pointed out that suicide is a prevalent behavior in behavioral addictions, and clinicians and researchers need to pay particular attention to the specificities of each behavioral addiction when assessing suicidal risk.
Collapse
|
12
|
Cuppone D, Gómez Pérez LJ, Cardullo S, Cellini N, Sarlo M, Soldatesca S, Chindamo S, Madeo G, Gallimberti L. The role of repetitive transcranial magnetic stimulation (rTMS) in the treatment of behavioral addictions: Two case reports and review of the literature. J Behav Addict 2021; 10:361-370. [PMID: 34232905 PMCID: PMC8996794 DOI: 10.1556/2006.2021.00032] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/14/2021] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Several behaviors, besides consumption of psychoactive substances, produce short-term reward that may lead to persistent aberrant behavior despite adverse consequences. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions, such as pathological gambling, internet gaming disorder and internet addiction. CASE PRESENTATION Here, we report two cases of behavioral addictions (BA), compulsive sexual behavior disorder for online porn use and internet gaming disorder. A 57-years-old male referred a loss of control over his online pornography use, started 15 years before, while a 21-years-old male university student reported an excessive online gaming activity undermining his academic productivity and social life. Both patients underwent a high-frequency repetitive transcranial magnetic stimulation (rTMS) protocol over the left dorsolateral prefrontal cortex (l-DLPFC) in a multidisciplinary therapeutic setting. A decrease of addictive symptoms and an improvement of executive control were observed in both cases. DISCUSSION Starting from these clinical observations, we provide a systematic review of the literature suggesting that BAs share similar neurobiological mechanisms to those underlying substance use disorders (SUD). Moreover, we discuss whether neurocircuit-based interventions, such as rTMS, might represent a potential effective treatment for BAs.
Collapse
Affiliation(s)
- Diego Cuppone
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | | | - Stefano Cardullo
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Nicola Cellini
- Department of General Psychology, University of Padua
,
Padova
,
Italy,Department of Biomedical Sciences, University of Padova
,
Padova
,
Italy,Padova Neuroscience Center, University of Padova
,
Padova
,
Italy,Human Inspired Technology Center, University of Padova
,
Padova
,
Italy
| | - Michela Sarlo
- Department of Communication Sciences, Humanities and International Studies, University of Urbino Carlo Bo
,
Urbino
,
Italy
| | - Silvia Soldatesca
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Sonia Chindamo
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Graziella Madeo
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy
| | - Luigi Gallimberti
- Novella Fronda Foundation
,
Piazza Castello, 16 - 35141
,
Padua
,
Italy,
Corresponding author. E-mail:
| |
Collapse
|
13
|
Jiménez-Murcia S, Giménez M, Granero R, Masuet-Aumatell C, Ramón JM, Agüero F, Morchón S, Moragas L, Baenas I, del Pino-Gutierrez A, Codina E, Valenciano-Mendoza E, Mora-Maltas B, Valero-Solís S, Etxandi M, Guillen-Guzmán E, Menchón JM, Fernández-Aranda F. Gambling disorder seeking treatment patients and tobacco use in relation to clinical profiles. Addict Behav 2021; 114:106723. [PMID: 33203595 DOI: 10.1016/j.addbeh.2020.106723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/05/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Tobacco smoking and gambling disorder (GD) often co-occur. However, few studies have assessed the extent to which cigarette smoking may serve to classify and/or better define GD behaviour profiles. METHODS Among a large sample of n = 3,652 consecutive treatment-seeking patients with GD (91% men). Smokers were compared to non-smokers across different sociodemographic, clinical, psychopathological and personality variables. The effect sizes for the means and the proportion differences between the groups were estimated. An evaluation of the smoking changes over the last 15 years was also performed. RESULTS From the total sample, 62.4% of gamblers reported tobacco use. A decreasing linear trend in tobacco use was observed within the studied period, women having a more irregular pattern. The use of tobacco was linked to the use of alcohol and other illegal drugs. Gamblers who smoke, as compared to those who don't, presented lower education levels, lower social position indexes and active employment. They were younger, with an earlier age of onset, shorter duration of the gambling behavior, higher GD severity, more psychological symptoms, higher scores in novelty seeking and lower scores in reward dependence, self-directedness and self-transcendence. CONCLUSIONS Gamblers seeking treatment who smoke display particular social, clinical, psychological, temperamental and character features different from non-smoking gamblers, suggesting that the presence or absence of comorbid smoking condition in GD should always be considered when developing an optimal treatment, as gamblers who smoke might need treatment strategies different from non-smoking gamblers.
Collapse
|
14
|
Roozen HG, Tsuji Y, Meyers RJ. CRAFT: Treatment integrity is imperative for understanding research findings. Addiction 2021; 116:205-206. [PMID: 32687614 DOI: 10.1111/add.15195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Hendrik G Roozen
- Substance Abuse, and Addictions (CASAA), The University of New Mexico (UNM) - Center on Alcoholism, MSC11 6280, 2650 Yale Blvd. SE, Albuquerque, NM, 87106, USA
| | - Yui Tsuji
- Graduate School of Psychological Science, Health Sciences University of Hokkaido, Sapporo, Japan.,Sapporo Gakuin University, Ebetsu, Hokkaido, Japan
| | - Robert J Meyers
- Substance Abuse, and Addictions (CASAA), The University of New Mexico (UNM) - Center on Alcoholism, MSC11 6280, 2650 Yale Blvd. SE, Albuquerque, NM, 87106, USA
| |
Collapse
|
15
|
Pallanti S, Marras A, Makris N. A Research Domain Criteria Approach to Gambling Disorder and Behavioral Addictions: Decision-Making, Response Inhibition, and the Role of Cannabidiol. Front Psychiatry 2021; 12:634418. [PMID: 34603091 PMCID: PMC8484302 DOI: 10.3389/fpsyt.2021.634418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Gambling Disorder (GD) has been recently re-classified in the DSM-5 under the "substance-related and addictive disorders," in light of its genetic, endophenotypic, and phenotypic resemblances to substance dependence. Diminished control is a core defining concept of psychoactive substance dependence or addiction and has given rise to the concept of "behavioral" addictions, which are syndromes analogous to substance addiction, but with a behavioral focus other than ingestion of a psychoactive substance. The main symptom clusters are represented by loss of control, craving/withdrawal, and neglect of other areas of life, whereas in a Research Domain Criteria (RDoC) perspective, GD patients exhibit deficits in the domain of "Positive valence systems," particularly in the "Approach motivation" and "Reward learning" constructs, as well as in the "Cognitive systems," primarily in the "Cognitive control" construct. In the Addictions Neuroclinical Assessment (ANA), three relevant domains for addictions emerge: "Incentive salience," "Negative Emotionality," and "Executive Function." The endocannabinoid system (ECS) may largely modulate these circuits, presenting a promising pharmaceutical avenue for treating addictions. Up to now, research on cannabidiol has shown some efficacy in Attention Deficit/Hyperactivity Disorder (ADHD), whereas in behavioral addictions its role has not been fully elucidated, as well as its precise action on RDoC domains. Herein, we review available evidence on RDoC domains affected in GD and behavioral addictions and summarize insights on the use of cannabidiol in those disorders and its potential mechanisms of action on reward, decisional, and sensorimotor processes.
Collapse
Affiliation(s)
- Stefano Pallanti
- Institute of Neurosciences, Florence, Italy.,Albert Einstein College of Medicine and Montefiore Medical Center, New York, NY, United States
| | - Anna Marras
- Institute of Neurosciences, Florence, Italy.,Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Nikolaos Makris
- Departments of Psychiatry and Neurology, Center for Morphometric Analysis, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| |
Collapse
|
16
|
|
17
|
Estévez A, Jáuregui P, Lopez-Gonzalez H, Macia L, Granero R, Mestre-Bach G, Fernández-Aranda F, Gómez-Peña M, Moragas L, Mena-Moreno T, Lozano-Madrid M, Del Pino-Gutierrez A, Codina E, Testa G, Vintró-Alcaraz C, Agüera Z, Munguía L, Baenas I, Valenciano-Mendoza E, Mora-Maltas B, Menchón JM, Jiménez-Murcia S. Comorbid behavioral and substance-related addictions in young population with and without gambling disorder. INTERNATIONAL GAMBLING STUDIES 2020. [DOI: 10.1080/14459795.2020.1836250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Ana Estévez
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Paula Jáuregui
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Hibai Lopez-Gonzalez
- Psychology Department, University of Deusto, Bilbao, Spain
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Macia
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Roser Granero
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Universidad Internacional de La Rioja, Logroño, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical SciencesSchool of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Teresa Mena-Moreno
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - María Lozano-Madrid
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Amparo Del Pino-Gutierrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Giulia Testa
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Lucero Munguía
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | | | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical SciencesSchool of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Clinical SciencesSchool of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
18
|
Li Y, Ramoz N, Derrington E, Dreher JC. Hormonal responses in gambling versus alcohol abuse: A review of human studies. Prog Neuropsychopharmacol Biol Psychiatry 2020; 100:109880. [PMID: 32004637 DOI: 10.1016/j.pnpbp.2020.109880] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/01/2020] [Accepted: 01/27/2020] [Indexed: 01/23/2023]
Abstract
The endocrine system plays an essential role in communication between various organs of the body to maintain homeostasis. Both substance use disorders (SUDs) and non-substance abuse disrupt this system and lead to hormonal dysregulations. Here, we focus on the comparison between the function of the endocrine system in gambling disorders and alcohol addiction to understand the commonalities and differences in their neurobiological and psychological underpinnings. We review human research to compare findings on gambling addiction and alcohol dependence pertaining to the dynamic interplay between testosterone and cortisol. Understanding and classifying similarities in hormonal responses between behavioural addiction and SUDs may facilitate development of treatments and therapeutic interventions across different types of addictive disorders, while describing differences may shed light on therapeutic interventions for specific disorders. Although research on gambling addiction is in its infancy, such evaluation may still have a positive effect for addiction research, thereby stimulating discovery of "crossover" pharmacotherapies with benefits for both SUDs and nonsubstance addictions.
Collapse
Affiliation(s)
- Yansong Li
- Competition, Addiction and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, China; Institute for Brain Sciences, Nanjing University, Nanjing, China.
| | - Nicolas Ramoz
- Vulnerability of Psychiatric and Addictive Disorders, Institute of Psychiatry and Neuroscience of Paris, INSERM UMRS1266, Paris, France.
| | - Edmund Derrington
- Neuroeconomics Laboratory, Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Bron, France
| | - Jean-Claude Dreher
- Neuroeconomics Laboratory, Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Bron, France.
| |
Collapse
|
19
|
Abstract
The aim of this study was to determine the moderating effects of sociodemographic characteristics, substance use, and psychosocial problems on the relationship between perceived gambling availability and problem gambling severity. Bivariate and multivariate regression analyses of the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta surveys found problem gambling severity was 1.25-1.39 times higher for those reporting gambling opportunities were 'too widely available'. Factors such as age, gender, place of residence, and psychosocial problems had significant moderating effects. Our findings indicate that the perception of gambling availability has a statistically significant impact on problem gambling severity.
Collapse
|
20
|
Hellberg SN, Russell TI, Robinson MJF. Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:737-758. [PMID: 30357661 PMCID: PMC6482104 DOI: 10.3758/s13415-018-00662-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gambling disorder is an impairing condition confounded by psychiatric co-morbidity, particularly with substance use and anxiety disorders. Yet, our knowledge of the mechanisms that cause these disorders to coalesce remains limited. The Incentive Sensitization Theory suggests that sensitization of neural "wanting" pathways, which attribute incentive salience to rewards and their cues, is responsible for the excessive desire for drugs and cue-triggered craving. The resulting hyper-reactivity of the "wanting' system is believed to heavily influence compulsive drug use and relapse. Notably, evidence for sensitization of the mesolimbic dopamine pathway has been seen across gambling and substance use, as well as anxiety and stress-related pathology, with stress playing a major role in relapse. Together, this evidence highlights a phenomenon known as cross-sensitization, whereby sensitization to stress, drugs, or gambling behaviors enhance the sensitivity and dopaminergic response to any of those stimuli. Here, we review the literature on how cue attraction and reward uncertainty may underlie gambling pathology, and examine how this framework may advance our understanding of co-mordidity with substance-use disorders (e.g., alcohol, nicotine) and anxiety disorders. We argue that reward uncertainty, as seen in slot machines and games of chance, increases dopaminergic activity in the mesolimbic pathway and enhances the incentive value of reward cues. We propose that incentive sensitization by reward uncertainty may interact with and predispose individuals to drug abuse and stress, creating a mechanism through which co-mordidity of these disorders may emerge.
Collapse
Affiliation(s)
- Samantha N Hellberg
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA
- University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Trinity I Russell
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA
- National Institutes on Drug Abuse, Baltimore, MD, USA
| | - Mike J F Robinson
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA.
| |
Collapse
|
21
|
Cardullo S, Gomez Perez LJ, Marconi L, Terraneo A, Gallimberti L, Bonci A, Madeo G. Clinical Improvements in Comorbid Gambling/Cocaine Use Disorder (GD/CUD) Patients Undergoing Repetitive Transcranial Magnetic Stimulation (rTMS). J Clin Med 2019; 8:jcm8060768. [PMID: 31151221 PMCID: PMC6616893 DOI: 10.3390/jcm8060768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Pathological gambling behaviors may coexist with cocaine use disorder (CUD), underlying common pathogenic mechanisms. Repetitive transcranial magnetic stimulation (rTMS) has shown promise as a therapeutic intervention for CUD. In this case series, we evaluated the clinical effects of rTMS protocol stimulating the left dorsolateral prefrontal cortex (DLPFC) on the pattern of gambling and cocaine use. (2) Methods: Gambling severity, craving for cocaine, sleep, and other negative affect symptoms were recorded in seven patients with a diagnosis of gambling disorder (South Oaks Gambling Screen (SOGS) >5), in comorbidity with CUD, using the following scales: Gambling-Symptom Assessment Scale (G-SAS), Cocaine Craving Questionnaire (CCQ), Beck Depression Inventory-II (BDI-II), Self-rating Anxiety Scale (SAS), and Symptoms checklist-90 (SCL-90). The measures were assessed before the rTMS treatment and after 5, 30, and 60 days of treatment. Patterns of gambling and cocaine use were assessed by self-report and regular urine screens. (3) Results: Gambling severity at baseline ranged from mild to severe (mean ± Standard Error of the Mean (SEM), G-SAS score baseline: 24.42 ± 2.79). G-SAS scores significantly improved after treatment (G-SAS score Day 60: 2.66 ± 1.08). Compared to baseline, consistent improvements were significantly seen in craving for cocaine and in negative-affect symptoms. (4) Conclusions: The present findings provide unprecedent insights into the potential role of rTMS as a therapeutic intervention for reducing both gambling and cocaine use in patients with a dual diagnosis.
Collapse
Affiliation(s)
- Stefano Cardullo
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Luis Javier Gomez Perez
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Linda Marconi
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Alberto Terraneo
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Luigi Gallimberti
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
| | - Antonello Bonci
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Graziella Madeo
- Human Science and Brain Research, Novella Fronda Foundation, Piazza Castello, 35141 Padua, Italy.
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
| |
Collapse
|
22
|
Sharif-Razi M, Hodgins DC, Goghari VM. Reactive and proactive control mechanisms of response inhibition in gambling disorder. Psychiatry Res 2019; 272:114-121. [PMID: 30580134 DOI: 10.1016/j.psychres.2018.12.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/28/2018] [Accepted: 12/06/2018] [Indexed: 12/15/2022]
Abstract
Response inhibition, one component of cognitive control, refers to the ability to inhibit automatic responses and has been found to be impaired in gambling disorder. Recent models of cognitive control distinguish between two mechanisms: reactive control, the ability to stop in response to a stop-stimulus, and proactive control, the ability to anticipate and prepare for a stop. Previous studies have primarily focused on reactive modes of control in gambling disorder. The aim of the current study was to assess both reactive and proactive modes of response inhibition in individuals with gambling disorder (n = 27) and community controls (n = 21) using a variant of the stop-signal task. Second, the relationship between trait impulsivity, and reactive and proactive control was examined. No group differences in reactive or proactive control were found. However, premeditation, one domain of trait impulsivity, was associated with worse proactive control in the gambling group. These results suggest that difficulties with response inhibition may not be a core deficit in all forms of gambling disorder. Future research should continue to develop and test tasks that involve cognitive control processes in different presentations of gambling disorder.
Collapse
Affiliation(s)
- Maryam Sharif-Razi
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| | - David C Hodgins
- Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Calgary, Alberta, T2N 1N4, Canada.
| | - Vina M Goghari
- Clinical Neuroscience of Schizophrenia (CNS) Laboratory, Department of Psychology, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
23
|
Fineberg NA, Demetrovics Z, Stein DJ, Ioannidis K, Potenza MN, Grünblatt E, Brand M, Billieux J, Carmi L, King DL, Grant JE, Yücel M, Dell'Osso B, Rumpf HJ, Hall N, Hollander E, Goudriaan A, Menchon J, Zohar J, Burkauskas J, Martinotti G, Van Ameringen M, Corazza O, Pallanti S, Chamberlain SR. Manifesto for a European research network into Problematic Usage of the Internet. Eur Neuropsychopharmacol 2018; 28:1232-1246. [PMID: 30509450 PMCID: PMC6276981 DOI: 10.1016/j.euroneuro.2018.08.004] [Citation(s) in RCA: 167] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/18/2018] [Accepted: 08/07/2018] [Indexed: 12/24/2022]
Abstract
The Internet is now all-pervasive across much of the globe. While it has positive uses (e.g. prompt access to information, rapid news dissemination), many individuals develop Problematic Use of the Internet (PUI), an umbrella term incorporating a range of repetitive impairing behaviours. The Internet can act as a conduit for, and may contribute to, functionally impairing behaviours including excessive and compulsive video gaming, compulsive sexual behaviour, buying, gambling, streaming or social networks use. There is growing public and National health authority concern about the health and societal costs of PUI across the lifespan. Gaming Disorder is being considered for inclusion as a mental disorder in diagnostic classification systems, and was listed in the ICD-11 version released for consideration by Member States (http://www.who.int/classifications/icd/revision/timeline/en/). More research is needed into disorder definitions, validation of clinical tools, prevalence, clinical parameters, brain-based biology, socio-health-economic impact, and empirically validated intervention and policy approaches. Potential cultural differences in the magnitudes and natures of types and patterns of PUI need to be better understood, to inform optimal health policy and service development. To this end, the EU under Horizon 2020 has launched a new four-year European Cooperation in Science and Technology (COST) Action Programme (CA 16207), bringing together scientists and clinicians from across the fields of impulsive, compulsive, and addictive disorders, to advance networked interdisciplinary research into PUI across Europe and beyond, ultimately seeking to inform regulatory policies and clinical practice. This paper describes nine critical and achievable research priorities identified by the Network, needed in order to advance understanding of PUI, with a view towards identifying vulnerable individuals for early intervention. The network shall enable collaborative research networks, shared multinational databases, multicentre studies and joint publications.
Collapse
Affiliation(s)
- N A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK; Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - Z Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - D J Stein
- Department of Psychiatry and Mental Health at the University of Cape Town and South African MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - K Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
| | - M N Potenza
- Connecticut Mental Health Center and Departments of Psychiatry, Neuroscience and Child Study Center, Yale School of Medicine, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - E Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - M Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), Department of Computer Science and Applied Cognitive Science Faculty of Engineering, University of Duisburg-Essen, Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - J Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - L Carmi
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - D L King
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - J E Grant
- Department of Psychiatry, University of Chicago, Chicago, USA
| | - M Yücel
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - B Dell'Osso
- Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda and CRC "Aldo Ravelli" for neurotechnology and experimental brain therapeutics, Milan, Italy; Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan, Italy
| | - H J Rumpf
- University of Lübeck, Department of Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, Lübeck, Germany
| | - N Hall
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - E Hollander
- Department of Psychiatry and Compulsive, Impulsive and Autism Spectrum Program, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - A Goudriaan
- Department of Psychiatry, Academisch Medisch Centrum (AMC), University of Amsterdam, Amsterdam, Netherlands; Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Meibergdreef 9, Amsterdam, Netherlands; Arkin, Amsterdam, The Netherlands
| | - J Menchon
- Department of Psychiatry, Bellvitge University, Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - J Zohar
- Sackler Medical School, Tel Aviv University, and Chaim Sheba Medical Center Tel Hashomer, Tel Aviv, Israel
| | - J Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Palanga, Lithuania
| | - G Martinotti
- Department of Neuroscience, Imaging, Clinical Science, University G.d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - M Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada
| | - O Corazza
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - S Pallanti
- Albert Einstein College of Medicine, New York, USA; University of Florence, Italy
| | - S R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
24
|
Jacob L, Haro JM, Koyanagi A. Relationship between attention-deficit hyperactivity disorder symptoms and problem gambling: A mediation analysis of influential factors among 7,403 individuals from the UK. J Behav Addict 2018; 7:781-791. [PMID: 30238788 PMCID: PMC6426384 DOI: 10.1556/2006.7.2018.72] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND AIMS Our goal was to examine the association between attention-deficit hyperactivity disorder (ADHD) symptoms and gambling problems, and to identify potential mediating factors of this association. METHODS This study used cross-sectional, community-based data from 7,403 people aged ≥16 years who participated in the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed using the Adult ADHD Self-Report Scale (ASRS) Screener. Problem gambling was assessed using a questionnaire based on the 10 DSM-IV diagnostic criteria for pathological gambling. Respondents were classified as having no problem, at-risk, or problem gambling. Logistic regression and mediation analyses were conducted to analyze the association between ADHD symptoms (i.e., ASRS score ≥14) and problem gambling and the role of several variables in this association. RESULTS The prevalence of at-risk (5.3% vs. 2.4%) and problem gambling (2.4% vs. 0.6%) was higher in individuals with ADHD symptoms than in those without ADHD symptoms. ADHD symptoms were significantly associated with both at-risk (OR = 2.15; 95% CI = 1.22-3.79) and problem gambling (OR = 3.57; 95% CI = 1.53-8.31) when adjusted for age, sex, and ethnicity. Common mental disorders (CMDs; i.e., depression and anxiety disorders) (mediated percentage = 22.4%), borderline personality disorder (BPD) traits (22.1%), stressful life events (13.2%), stress at work or home (12.6%), alcohol dependence (11.8%), and impulsivity (11.2%) were significant mediators in the ADHD-gambling association. DISCUSSION AND CONCLUSIONS Overall, ADHD symptoms were positively associated with problem gambling. CMDs, BPD traits, and stressful life events were important mediators in this relationship.
Collapse
Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, Paris, France,Corresponding author: Dr. Louis Jacob; Faculty of Medicine, University of Paris 5, 15 rue de l’École de Médecine, Paris 75006, France; Phone: +33 6 27 88 37 06; E-mail:
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| |
Collapse
|
25
|
Bergamini A, Turrina C, Bettini F, Toccagni A, Valsecchi P, Sacchetti E, Vita A. At-risk gambling in patients with severe mental illness: Prevalence and associated features. J Behav Addict 2018; 7:348-354. [PMID: 29865864 PMCID: PMC6174579 DOI: 10.1556/2006.7.2018.47] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background and aims The primary objective of this study was to investigate the prevalence of at-risk gambling in a large, unselected sample of outpatients attending two community mental health centers, to estimate rates according to the main diagnosis, and to evaluate risk factors for gambling. Methods All patients attending the centers were evaluated with the Canadian Problem Gambling Index and the Mini International Neuropsychiatric Interview. Diagnoses were checked with the treating psychiatrists and after a chart review of the university hospital discharge diagnoses. Results The rate of at-risk gambling in 900 patients was 5.3%. In those who gambled over the last year, 10.1% were at-risk gamblers. The rates in the main diagnostic groups were: 4.7% schizophrenia and related disorders, 4.9% bipolar disorder, 5.6% unipolar depression, and 6.6% cluster B personality disorder. In 52.1% of the cases, at-risk gambling preceded the onset of a major psychiatric disorder. In a linear regression analysis, a family history of gambling disorder, psychiatric comorbidities, drug abuse/dependence, and tobacco smoking were significantly associated with at-risk gambling. Discussion and conclusion The results of this study evidenced a higher rate of at-risk gambling compared to community estimates and call for a careful screening for gambling in the general psychiatric population.
Collapse
Affiliation(s)
- Annalisa Bergamini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Cesare Turrina
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,Department of Mental Health, ASST Spedali Civili, Brescia, Italy,Corresponding author: Prof. Cesare Turrina; Department of Mental Health, ASST Spedali Civili 1, 25100 Brescia, Italy; Phone: +39 030 3995233; Fax: +39 030 3384089; E-mail:
| | - Francesca Bettini
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Anna Toccagni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Valsecchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Emilio Sacchetti
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy,Department of Mental Health, ASST Spedali Civili, Brescia, Italy
| |
Collapse
|
26
|
Christensen DR, Witcher CSG, Leighton T, Hudson-Breen R, Ofori-Dei S. Piloting the addition of contingency management to best practice counselling as an adjunct treatment for rural and remote disordered gamblers: study protocol. BMJ Open 2018; 8:e018804. [PMID: 29615445 PMCID: PMC5892741 DOI: 10.1136/bmjopen-2017-018804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/05/2017] [Accepted: 11/16/2017] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Problematic gambling is a significant Canadian public health concern that causes harm to the gambler, their families, and society. However, a significant minority of gambling treatment seekers drop out prior to the issue being resolved; those with higher impulsivity scores have the highest drop-out rates. Consequently, retention is a major concern for treatment providers. The aim of this study is to investigate the efficacy of internet-delivered cognitive behavioural therapy (CBT) and internet-delivered CBT and contingency management (CM+) as treatments for gambling disorder in rural Albertan populations. Contingency management (CM) is a successful treatment approach for substance dependence that uses small incentives to reinforce abstinence. This approach may be suitable for the treatment of gambling disorder. Furthermore, internet-delivered CM may hold particular promise in rural contexts, as these communities typically struggle to access traditional clinic-based counselling opportunities. METHODS AND ANALYSIS 54 adults with gambling disorder will be randomised into one of two conditions: CM and CBT (CM+) or CBT alone (CBT). Gambling will be assessed at intake, every treatment session, post-treatment, and follow-up. The primary outcome measures are treatment attendance, gambling abstinence, gambling, gambling symptomatology, and gambling urge. In addition, qualitative interviews assessing study experiences will be conducted with the supervising counsellor, graduate student counsellors, study affiliates, and a subset of treatment seekers. This is the first study to use CM as a treatment for gambling disorder in rural and remote populations. ETHICS AND DISSEMINATION This study was approved by the University of Lethbridge's Human Subject Research Committee (#2016-080). The investigators plan to publish the results from this study in academic peer-reviewed journals. Summary information will be provided to the funder. TRIAL REGISTRATION NUMBER NCT02953899; Pre-results.
Collapse
Affiliation(s)
- Darren R Christensen
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Chad S G Witcher
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, Hampshire, United Kingdom
| | - Trent Leighton
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | | | - Samuel Ofori-Dei
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| |
Collapse
|
27
|
Chamberlain SR, Stochl J, Redden SA, Grant JE. Latent traits of impulsivity and compulsivity: toward dimensional psychiatry. Psychol Med 2018; 48:810-821. [PMID: 28805173 PMCID: PMC5699644 DOI: 10.1017/s0033291717002185] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/07/2017] [Accepted: 07/11/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND The concepts of impulsivity and compulsivity are commonly used in psychiatry. Little is known about whether different manifest measures of impulsivity and compulsivity (behavior, personality, and cognition) map onto underlying latent traits; and if so, their inter-relationship. METHODS A total of 576 adults were recruited using media advertisements. Psychopathological, personality, and cognitive measures of impulsivity and compulsivity were completed. Confirmatory factor analysis was used to identify the optimal model. RESULTS The data were best explained by a two-factor model, corresponding to latent traits of impulsivity and compulsivity, respectively, which were positively correlated with each other. This model was statistically superior to the alternative models of their being one underlying factor ('disinhibition') or two anticorrelated factors. Higher scores on the impulsive and compulsive latent factors were each significantly associated with worse quality of life (both p < 0.0001). CONCLUSIONS This study supports the existence of latent functionally impairing dimensional forms of impulsivity and compulsivity, which are positively correlated. Future work should examine the neurobiological and neurochemical underpinnings of these latent traits; and explore whether they can be used as candidate treatment targets. The findings have implications for diagnostic classification systems, suggesting that combining categorical and dimensional approaches may be valuable and clinically relevant.
Collapse
Affiliation(s)
- S. R. Chamberlain
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
- Cambridge and Peterborough NHS Foundation
Trust, Cambridge, UK
| | - J. Stochl
- Department of Psychiatry,
University of Cambridge, Cambridge,
UK
- Cambridge and Peterborough NHS Foundation
Trust, Cambridge, UK
- Department of Kinanthropology,
Charles University in Prague, Prague,
Czech Republic
| | - S. A. Redden
- Department of Psychiatry & Behavioral
Neuroscience, University of Chicago,
Chicago, USA
| | - J. E. Grant
- Department of Psychiatry & Behavioral
Neuroscience, University of Chicago,
Chicago, USA
| |
Collapse
|
28
|
Davis AK, Bonar EE, Goldstick JE, Walton MA, Winters J, Chermack ST. Binge-drinking and non-partner aggression are associated with gambling among Veterans with recent substance use in VA outpatient treatment. Addict Behav 2017; 74:27-32. [PMID: 28570911 DOI: 10.1016/j.addbeh.2017.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND Gambling is relatively under-assessed in Veterans Affairs (VA) substance use disorder (SUD) treatment settings, yet shared characteristics with substance addiction suggest the importance of understanding how gambling behaviors present in Veterans seeking SUD care. METHOD We evaluated substance use, mental health, and violence-related correlates of past 30-day gambling among 833 Veterans (93% male, M age 48years, 72% Caucasian) seeking treatment in VA outpatient mental health and SUD clinics who completed screening for a randomized clinical trial. RESULTS A total of 288 (35%) Veterans reported past 30-day gambling. Among those who gambled, 79% had cravings/urges to gamble, whereas between 20%-27% of gamblers reported perceived relationship, legal, and daily life problems related to gambling, as well as difficulty controlling gambling. A logistic regression analysis revealed that age, recent binge-drinking, and non-partner physical aggression were associated with recent gambling. CONCLUSIONS Gambling was associated with binge-drinking and non-partner physical aggression, supporting potential shared characteristics among these behaviors such as impulsivity and risk-taking, which may complicate SUD treatment engagement and effectiveness. Findings support the need to screen for gambling in the VA, and to adapt treatments to include gambling as a potential behavioral target or relapse trigger, particularly among heavy drinking patients.
Collapse
Affiliation(s)
- Alan K Davis
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA.
| | - Erin E Bonar
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Jason E Goldstick
- Injury Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA; Department of Emergency Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Bldg 10-G080, Ann Arbor, MI 48109-2800, USA
| | - Maureen A Walton
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; Injury Center, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 10, Ann Arbor, MI 48109, USA
| | - Jamie Winters
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; VA Ann Arbor Healthcare System, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| | - Stephen T Chermack
- Addiction Center, Department of Psychiatry, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA; VA Ann Arbor Healthcare System, North Campus Research Complex, 2800 Plymouth Rd. Building 16, Ann Arbor, MI 48109, USA
| |
Collapse
|
29
|
Lole L, Gonsalvez CJ. Does size matter? An examination of problem gamblers’ skin conductance responses to large and small magnitude rewards. Psychophysiology 2017; 54:1541-1548. [DOI: 10.1111/psyp.12897] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 04/04/2017] [Accepted: 04/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Lisa Lole
- School of Health; Medical, and Applied Sciences, Central Queensland University; Bundaberg Queensland Australia
| | - Craig J. Gonsalvez
- School of Psychology; Western Sydney University; Penrith New South Wales Australia
| |
Collapse
|
30
|
Raghavan V. Prevalence of pathological gambling in patients with alcohol dependence syndrome attending a tertiary care center in South India. Asian J Psychiatr 2017; 26:92-93. [PMID: 28483101 DOI: 10.1016/j.ajp.2017.01.007] [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: 01/11/2017] [Accepted: 01/16/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Vijaya Raghavan
- Schizophrenia Research Foundation, R/7A, North Main Road, Anna Nagar West Extension, Chennai, Tamil Nadu 600101, India.
| |
Collapse
|
31
|
Goulet-Kennedy J, Labbe S, Fecteau S. The involvement of the striatum in decision making. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 27069380 PMCID: PMC4826771 DOI: 10.31887/dcns.2016.18.1/sfecteau] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives.
Collapse
Affiliation(s)
- Julie Goulet-Kennedy
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| | - Sara Labbe
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| | - Shirley Fecteau
- Centre interdisciplinaire de recherche en réadaptation et en intégration sociale. Centre de recherche de l'Institut universitaire en santé mentale de Québec; Faculté de médecine, Université Laval, Québec, Canada
| |
Collapse
|
32
|
Lemeshow A, Gearhardt A, Genkinger J, Corbin WR. Assessing the psychometric properties of two food addiction scales. Eat Behav 2016; 23:110-114. [PMID: 27623221 PMCID: PMC5124537 DOI: 10.1016/j.eatbeh.2016.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. METHODS We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach's alphas and 95% confidence intervals (CIs) for internal reliability and Cohen's Kappa coefficients and 95% CIs for test-retest reliability. RESULTS Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48-0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66-1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale's sensitivity was 92.3% (95% CI, 64%-99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%-100%). CONCLUSIONS Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction.
Collapse
Affiliation(s)
- Adina Lemeshow
- Department of Epidemiology, Columbia University, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, United States of America;
| | - Ashley Gearhardt
- Department of Psychology, University of Michigan, 2268 East Hall, 530 Church Street, Ann Arbor, MI 48109-1043, United States of America;
| | - Jeanine Genkinger
- Department of Epidemiology, Columbia University, Mailman School of Public Health, Herbert Irving Comprehensive Cancer Center, 722 West 168th St, Rm 803, New York, NY 10032, United States of America;
| | - William R. Corbin
- Department of Psychology, University of Arizona, 950 S McAllister, Arizona State University, Tempe, AZ 85287-1104;
| |
Collapse
|
33
|
Abstract
Problem gambling is a significant mental health problem that creates a multitude of intrapersonal, interpersonal, and social difficulties. Recent empirical evidence suggests that personality disorders, and in particular borderline personality disorder (BPD), are commonly co-morbid with problem gambling. Despite this finding there has been very little research examining overlapping factors between these two disorders. The aim of this review is to summarise the literature exploring the relationship between problem gambling and personality disorders. The co-morbidity of personality disorders, particularly BPD, is reviewed and the characteristics of problem gamblers with co-morbid personality disorders are explored. An etiological model from the more advanced BPD literature-the biosocial developmental model of BPD-is used to review the similarities between problem gambling and BPD across four domains: early parent-child interactions, emotion regulation, co-morbid psychopathology and negative outcomes. It was concluded that personality disorders, in particular BPD are commonly co-morbid among problem gamblers and the presence of a personality disorder complicates the clinical picture. Furthermore BPD and problem gambling share similarities across the biosocial developmental model of BPD. Therefore clinicians working with problem gamblers should incorporate routine screening for personality disorders and pay careful attention to the therapeutic alliance, client motivations and therapeutic boundaries. Furthermore adjustments to therapy structure, goals and outcomes may be required. Directions for future research include further research into the applicability of the biosocial developmental model of BPD to problem gambling.
Collapse
|
34
|
Jauregui P, Estévez A, Urbiola I. Pathological Gambling and Associated Drug and Alcohol Abuse, Emotion Regulation, and Anxious-Depressive Symptomatology. J Behav Addict 2016; 5:251-60. [PMID: 27348555 PMCID: PMC5387776 DOI: 10.1556/2006.5.2016.038] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background and aims Pathological gambling is associated with comorbid disorders, such as anxiety, depression, and drug and alcohol abuse. Difficulties of emotion regulation may be one of the factors related to the presence of addictive disorders, along with comorbid symptomatology in pathological gamblers. Therefore, the aim of this study was to evaluate the difficulties of emotion regulation, drug and alcohol abuse, and anxious and depressive symptomatology in pathological gamblers, and the mediating role of difficulties of emotion regulation between anxiety and pathological gambling. Methods The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Pathological gambling (SOGS), difficulties of emotion regulation (DERS), drug and alcohol abuse (MUTICAGE CAD-4), and anxious and depressive symptomatology (SA-45) were measured. Student's t, Pearson's r, stepwise multiple linear regression and multiple mediation analyses were conducted. The study was approved by an Investigational Review Board. Results Relative to non-gamblers, pathological gamblers exhibited greater difficulties of emotion regulation, as well as more anxiety, depression, and drug abuse. Moreover, pathological gambling correlated with emotion regulation difficulties, anxiety, depression, and drug abuse. Besides, emotion regulation difficulties correlated with and predicted pathological gambling, drug and alcohol abuse, and anxious and depressive symptomatology. Finally, emotion regulation difficulties mediated the relationship between anxiety and pathological gambling controlling the effect of age, both when controlling and not controlling for the effect of other abuses. Discussion and conclusions These results suggest that difficulties of emotion regulation may provide new keys to understanding and treating pathological gambling and comorbid disorders.
Collapse
Affiliation(s)
- Paula Jauregui
- Corresponding author: Paula Jauregui; Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain; Phone: (+34) 944 139 000, Fax: +34 944 139 085; E-mail:
| | | | | |
Collapse
|
35
|
Kim HS, Salmon M, Wohl MJA, Young M. A dangerous cocktail: Alcohol consumption increases suicidal ideations among problem gamblers in the general population. Addict Behav 2016; 55:50-5. [PMID: 26790140 DOI: 10.1016/j.addbeh.2015.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 12/21/2015] [Accepted: 12/31/2015] [Indexed: 12/12/2022]
Abstract
The current research examined whether alcohol consumption exacerbates suicidal ideations among gamblers in the general population. While prior research suggests problem gambling severity and excessive alcohol consumption are unique predictors of suicidal behaviors, the extant literature as almost exclusively focused on gamblers in treatment. This represents a significant gap in the literature as less than 10% of gamblers seek treatment. Furthermore, gamblers in treatment are not representative of gamblers in the general population, precluding a simple generalization of research findings. We address this gap using data obtained from the Canadian Community Health Survey (Cycle 4.1)--a cross-sectional national survey that assesses health-related information among the Canadian population. To this end, we conducted a moderation analysis with problem gambling severity as the independent variable, weekly alcohol consumption as the moderator variable and suicidal ideations (in the past 12 months) as the dependent variable. The results found that alcohol consumption alone did not reliably predict suicidal ideation among gamblers who did not gamble problematically. However, as predicted, the odds of suicidal ideation were greatest among problem gamblers who frequently consumed alcohol. Thus, it may behoove policy makers to re-visit the availability of alcohol in gambling venues. Moreover, responsible gambling-oriented education initiatives may be advanced by informing gamblers about the increased risk of suicidal ideations when problematic gambling is combined with frequent alcohol consumption.
Collapse
|
36
|
Dixon MR, Wilson AN, Habib R. Neurological evidence of acceptance and commitment therapy effectiveness in college-age gamblers. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2016. [DOI: 10.1016/j.jcbs.2016.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Denis C, Fatséas M, Beltran V, Serre F, Alexandre JM, Debrabant R, Daulouède JP, Auriacombe M. Usefulness and validity of the modified Addiction Severity Index: A focus on alcohol, drugs, tobacco, and gambling. Subst Abus 2015; 37:168-75. [DOI: 10.1080/08897077.2015.1036334] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
38
|
Deleuze J, Rochat L, Romo L, Van der Linden M, Achab S, Thorens G, Khazaal Y, Zullino D, Maurage P, Rothen S, Billieux J. Prevalence and characteristics of addictive behaviors in a community sample: A latent class analysis. Addict Behav Rep 2015. [PMID: 29531979 PMCID: PMC5845955 DOI: 10.1016/j.abrep.2015.04.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
While addictions to substances such as alcohol, tobacco, and other drugs have been extensively investigated, interest has been growing in potential non-substance-related addictive behaviors (e.g., excessive gambling, buying or playing video games). In the current study, we sought to determine the prevalence and characteristics of a wide range of addictive behaviors in a general population sample and to identify reliable subgroups of individuals displaying addictive behaviors. Seven hundred seventy participants completed an online survey. The survey screened for the presence and characteristics of the main recognized substance and behavioral addictions (alcohol, tobacco, cannabis, other drugs, gambling, compulsive shopping, intensive exercise, Internet and mobile phone overuse, intensive work involvement, and overeating) in a three-month period. Key aspects of addiction were measured for each reported behavior, including negative outcomes, emotional triggers (positive and negative emotional contexts), search for stimulation or pleasure, loss of control, and cognitive salience. Latent class analysis allowed us to identify three theoretically and clinically relevant subgroups of individuals. The first class groups problematic users, i.e., addiction-prone individuals. The second class groups at-risk users who frequently engage in potentially addictive behaviors to regulate emotional states (especially overinvolvement in common behaviors such as eating, working, or buying). The third class groups individuals who are not prone to addictive behaviors. The existence of different groups in the population sheds new light on the distinction between problematic and non-problematic addiction-like behaviors. The study screened for addictive behaviors in a large community sample. Three-month prevalence was established for substance and behavioral addictions. Subgroups of individuals were identified based on addictive behavior prevalence. Substance use/excessive behaviors are most often not related to addiction symptoms. A subgroup of addiction-prone individuals was identified.
Collapse
Affiliation(s)
- Jory Deleuze
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Lucien Rochat
- Cognitive Psychopathology and Neuropsychology Unit, University of Geneva, Geneva, Switzerland
| | - Lucia Romo
- Clinique Psychanalyse Développement (CLIPSYD), University Paris Ouest-Nanterre la Défense, Paris, France
| | - Martial Van der Linden
- Cognitive Psychopathology and Neuropsychology Unit, University of Geneva, Geneva, Switzerland
| | - Sophia Achab
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Gabriel Thorens
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Yasser Khazaal
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Daniele Zullino
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Stéphane Rothen
- Addictology Division, Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Joël Billieux
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| |
Collapse
|
39
|
Di Nicola M, Tedeschi D, De Risio L, Pettorruso M, Martinotti G, Ruggeri F, Swierkosz-Lenart K, Guglielmo R, Callea A, Ruggeri G, Pozzi G, Di Giannantonio M, Janiri L. Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving. Drug Alcohol Depend 2015; 148:118-25. [PMID: 25630963 DOI: 10.1016/j.drugalcdep.2014.12.028] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 12/20/2014] [Accepted: 12/22/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving. METHODS 95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample. RESULTS 28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p<.01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p<.003), were found. BIS-11 (t=-2.36; p=.020), OCDS obsessive (Z=-4.13; p<.001), OCDS compulsive (Z=-2.12; p=.034) and VASc (Z=-4.94; p<.001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p=.012) and higher craving levels (VASc scores; OR=2.48; p<.001). CONCLUSIONS Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.
Collapse
Affiliation(s)
- Marco Di Nicola
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy.
| | - Daniela Tedeschi
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Luisa De Risio
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Mauro Pettorruso
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Filippo Ruggeri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Kevin Swierkosz-Lenart
- Centre Neuchâtelois de Psychiatrie, République et Canton de Neuchâtel, Site de Préfargier, 2074 Marin-Epagnier, Switzerland
| | - Riccardo Guglielmo
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Antonino Callea
- Science of Education, LUMSA University, Borgo Sant'Angelo, 13, 00193 Rome, Italy
| | - Giuseppe Ruggeri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Gino Pozzi
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience and Imaging, Institute of Psychiatry, "G. d'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
| | - Luigi Janiri
- Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, L.go A. Gemelli 8, 00168 Rome, Italy; University Consortium Humanitas, Via della Conciliazione 22, 00193 Rome, Italy
| |
Collapse
|
40
|
Leavens E, Marotta J, Weinstock J. Disordered gambling in residential substance use treatment centers: an unmet need. J Addict Dis 2015; 33:163-73. [PMID: 24735187 DOI: 10.1080/10550887.2014.909697] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined prevalence and potential impact of disordered gambling in a sample of individuals (N = 684) undergoing residential treatment for substance use disorders at 13 facilities. Lifetime disordered gambling prevalence was 20.2%, as identified by South Oaks Gambling Screen. Within individuals who screened positive for disordered gambling, few had sought help for gambling (15.9%) and only 14.3% reported having gambling addressed in their current substance use disorder treatment. Meanwhile, 30.4% identified gambling as a concern in their recovery efforts. The presence of a gambling problem, either historical or current, potentially affects residential treatment outcomes and warrants clinical attention within these programs.
Collapse
|
41
|
Abstract
Addiction professionals and the public are recognizing that certain nonsubstance behaviors--such as gambling, Internet use, video-game playing, sex, eating, and shopping--bear resemblance to alcohol and drug dependence. Growing evidence suggests that these behaviors warrant consideration as nonsubstance or "behavioral" addictions and has led to the newly introduced diagnostic category "Substance-Related and Addictive Disorders" in DSM-5. At present, only gambling disorder has been placed in this category, with insufficient data for other proposed behavioral addictions to justify their inclusion. This review summarizes recent advances in our understanding of behavioral addictions, describes treatment considerations, and addresses future directions. Current evidence points to overlaps between behavioral and substance-related addictions in phenomenology, epidemiology, comorbidity, neurobiological mechanisms, genetic contributions, responses to treatments, and prevention efforts. Differences also exist. Recognizing behavioral addictions and developing appropriate diagnostic criteria are important in order to increase awareness of these disorders and to further prevention and treatment strategies.
Collapse
|
42
|
|
43
|
Obsessive-compulsive aspects and pathological gambling in an Italian sample. BIOMED RESEARCH INTERNATIONAL 2014; 2014:167438. [PMID: 25057479 PMCID: PMC4095731 DOI: 10.1155/2014/167438] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 05/22/2014] [Accepted: 06/03/2014] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Gambling behaviour appears as repetitive and difficult to resist and seems to be aimed at neutralizing or reducing negative feelings such as anxiety and tension, confirming its similarities with the obsessive-compulsive spectrum. Aims. Estimating the prevalence of gambling behaviour in an Italian sample and assessing the effects of sociodemographic variables and the correlations between gambling behaviour and obsessive-compulsive features. METHODS A sample of 300 Italian subjects was evaluated based on gambling behaviours and obsessive-compulsive attitudes. The assessment was carried out in small centers in Italy, mainly in coffee and tobacco shops, where slot machines are located, using the South Oaks Gambling Screen (SOGS) and the MOCQ-R, a reduced form of Maudsley Obsessional-Compulsive Questionnaire. RESULTS A negative correlation between SOGS and MOPQ-R, with reference to the control and cleaning subscales, was evidenced in the majority of the examined subjects. Both evaluating instruments showed reliability and a good discriminative capacity. CONCLUSIONS Our study evidenced that the sample of gamblers we analysed did not belong to the obsessive-compulsive disorders area, supporting the validity of the model proposed by DSM-5 for the classification of PG. These data confirm the importance of investing in treatments similar to those used for substance use disorders.
Collapse
|
44
|
Li Y, Sescousse G, Dreher JC. Endogenous cortisol levels are associated with an imbalanced striatal sensitivity to monetary versus non-monetary cues in pathological gamblers. Front Behav Neurosci 2014; 8:83. [PMID: 24723862 PMCID: PMC3971166 DOI: 10.3389/fnbeh.2014.00083] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 02/25/2014] [Indexed: 11/13/2022] Open
Abstract
Pathological gambling is a behavioral addiction characterized by a chronic failure to resist the urge to gamble. It shares many similarities with drug addiction. Glucocorticoid hormones including cortisol are thought to play a key role in the vulnerability to addictive behaviors, by acting on the mesolimbic reward pathway. Based on our previous report of an imbalanced sensitivity to monetary versus non-monetary incentives in the ventral striatum of pathological gamblers (PGs), we investigated whether this imbalance was mediated by individual differences in endogenous cortisol levels. We used functional magnetic resonance imaging (fMRI) and examined the relationship between cortisol levels and the neural responses to monetary versus non-monetary cues, while PGs and healthy controls were engaged in an incentive delay task manipulating both monetary and erotic rewards. We found a positive correlation between cortisol levels and ventral striatal responses to monetary versus erotic cues in PGs, but not in healthy controls. This indicates that the ventral striatum is a key region where cortisol modulates incentive motivation for gambling versus non-gambling related stimuli in PGs. Our results extend the proposed role of glucocorticoid hormones in drug addiction to behavioral addiction, and help understand the impact of cortisol on reward incentive processing in PGs.
Collapse
Affiliation(s)
- Yansong Li
- Reward and Decision Making Team, Centre de Neurosciences Cognitives, CNRS, UMR 5229 Lyon, France ; Neuroscience Department, Université Claude Bernard Lyon 1 Lyon, France
| | - Guillaume Sescousse
- Reward and Decision Making Team, Centre de Neurosciences Cognitives, CNRS, UMR 5229 Lyon, France
| | - Jean-Claude Dreher
- Reward and Decision Making Team, Centre de Neurosciences Cognitives, CNRS, UMR 5229 Lyon, France ; Neuroscience Department, Université Claude Bernard Lyon 1 Lyon, France
| |
Collapse
|
45
|
Ricquebourg M, Bernède-Bauduin C, Mété D, Dafreville C, Stojcic I, Vauthier M, Galland MC. [Internet and video games among students of Reunion Island in 2010: uses, misuses, perceptions and associated factors]. Rev Epidemiol Sante Publique 2013; 61:503-12. [PMID: 24210787 DOI: 10.1016/j.respe.2013.07.685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 03/28/2013] [Accepted: 07/03/2013] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Describe the uses of Internet and video games and quantify associated problematic uses. METHODS Information on student practices concerning the use of the Internet and video games was collected with a self-administered questionnaire. Problematic uses were identified with specific tools (Young criteria and Tejeiro criteria) and with self-evaluative questions. Information on life events with traumatic potential and use of psychoactive substances was also collected. Logistic regression models were applied to identify possible associated factors. RESULTS Based on a sample of 1119 subjects, this study showed that students in Reunion Island are very concerned by the uses of the Internet and video games (98% and 46% of respondents). The prevalence of problematic use of the Internet accounted for 6% of respondents. Problematic uses of video games involved 8% of students (18% of gamers). Young people seemed unaware of their problematic practices and were seeking informations. The public respondent was also characterized by vulnerable situations (traumatic events induring their lives, consumption of psychoactive substances). Significant associations (with no identified causality) were examined, in particular between problematic uses of Internet and video games, and life events with traumatic potential. CONCLUSION These first estimates of the prevalence of problematic use of Internet and video games on Reunion Island are important to promote locally collective awareness about these modern addictions. These results will be used to guide local actions of prevention and care, especially among younger generations. But it is necessary to conduct further work to better identify the factors associated with these problematic uses (determinants, comorbidities addictive…).
Collapse
Affiliation(s)
- M Ricquebourg
- Observatoire régional de la santé (ORS), 12, rue Colbert, 97400 Saint-Denis, Réunion.
| | | | | | | | | | | | | |
Collapse
|
46
|
Parhami I, Siani A, Rosenthal RJ, Fong TW. Pathological gambling, problem gambling and sleep complaints: an analysis of the National Comorbidity Survey: Replication (NCS-R). J Gambl Stud 2013; 29:241-53. [PMID: 22396174 DOI: 10.1007/s10899-012-9299-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study is to investigate the relationship between sleep disturbances and gambling behavior. Data from the National Comorbidity Survey-Replication (NCS-R) was used to examine the relationship between three specific sleep complaints (difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], and early morning awakening [EMA]) and gambling behavior. Bivariate logistic regression models were used to control for potentially confounding psychiatric disorders and age. Almost half of respondents with problem gambling behavior (45.9%) and two thirds (67.7%) of respondents with pathological gambling behavior reported at least one sleep compliant. Compared to respondents with no gambling pathology, respondents with pathological gambling were significantly more likely to report at least one sleep complaint (Adjusted Odds Ratio [AOR] = 3.444, 95% CI = 1.538-7.713), to report all sleep complaints (AOR = 3.449, 95% CI = 1.503-7.914), and to report any individual complaint (DIS: OR = 2.300, 95% CI = 1.069-4.946; DMS: AOR = 4.604, 95% CI = 2.093-10.129; EMA: AOR = 3.968, 95% CI = 1.856-8.481). The relationship between problem gambling and sleep complaints were more modest (any sleep complaint: AOR = 1.794, 95% CI = 1.142-2.818; all three sleep complaints: AOR = 2.144, 95% CI = 1.169-3.931; DIS: AOR = 1.961, 95% CI = 1.204-3.194; DMS: AOR = 1.551, 95% CI = 0.951-2.529; EMA: AOR = 1.796, 95% CI = 1.099-2.935). Given the individual and societal ramifications linked with the presence of sleep problems, this study presents another health-related repercussion associated with gambling pathology rarely discussed in the literature.
Collapse
Affiliation(s)
- Iman Parhami
- UCLA Gambling Studies, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA.
| | | | | | | |
Collapse
|
47
|
Berlin HA, Braun A, Simeon D, Koran LM, Potenza MN, McElroy SL, Fong T, Pallanti S, Hollander E. A double-blind, placebo-controlled trial of topiramate for pathological gambling. World J Biol Psychiatry 2013; 14:121-8. [PMID: 21486110 DOI: 10.3109/15622975.2011.560964] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Pathological gambling (PG) is an impulse control disorder characterized by recurrent gambling thoughts and behaviours that impair social functioning. Earlier studies suggested that topiramate may be effective in treating some impulse control disorders. We conducted the first randomized, controlled trial of topiramate in PG. METHODS PG patients were randomized to topiramate (N = 20) or placebo (N = 22) in this 14-week, double-blind, placebo-controlled, parallel-group trial. The primary outcome measure was change in the obsessions subscale of the Yale-Brown Obsessive-Compulsive Scale Modified for Pathological Gambling. RESULTS Mixed regression models (time [weeks] × treatment) revealed no significant treatment effect of topiramate on the primary or secondary outcome measures. The most statistically robust findings involved reducing the Barratt Impulsiveness Scale (BIS) total score and Motor and Non-Planning subscale scores, for which topiramate outperformed placebo at merely a trend level (P < 0.1). CONCLUSIONS The observed trend in BIS score reductions may warrant further investigation to study whether topiramate reduces clinically important impulsivity in PG. Treatment studies with larger samples and less stringent exclusion criteria are needed to produce results that can be generalized to pathological gamblers in the community.
Collapse
Affiliation(s)
- Heather A Berlin
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
De Wilde B, Goudriaan A, Sabbe B, Hulstijn W, Dom G. Relapse in pathological gamblers: A pilot study on the predictive value of different impulsivity measures. J Behav Addict 2013; 2:23-30. [PMID: 26165768 DOI: 10.1556/jba.2.2013.1.4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Backgrounds and aims Pathological gambling, a common psychiatric disorder, has many similarities with substance use disorders. Relapse, an important element in addictive disorders, however, has seldom been studied in pathological gambling. Hence, in analogy with previous research studies examining the role of self-report and neurocognitive measures on relapse in substance dependent patients, the present pilot study was executed. Methods Twenty-two pathological gamblers and 31 healthy controls took part in this research. They filled in self-report questionnaires measuring impulsive personality (Barratt Impulsiveness Scale, Sensitivity to Punishment and Sensitivity to Reward Questionnaires) and performed neurocognitive tasks measuring impulsivity, decision-making and attentional bias (Iowa Gambling Task, Delay Discounting Task, Stroop Gambling Task). Twelve months later gambling activity was re-examined. Results Analyses showed that PGs who relapsed (n = 13) did not differ on self-report and neurocognitive measures of impulsivity with PGs who did not relapse (n = 9). However, both groups did differ in age at onset. Finally, healthy controls and PGs differed in some (Barratt Impulsiveness Scale, Stroop Gambling Task), but not all impulsivity measures (Delay Discounting Task, Iowa Gambling Task, Sensitivity to Punishment and Sensitivity to Reward Questionnaires). Conclusions One-year relapse in pathological gamblers is not predicted by self-report and or neurocognitive measures of impulsivity and decision-making. The similarities in performances between pathological gamblers and healthy controls illustrate the relative health of the examined pathological gamblers. This last finding supports the idea that subtypes of pathological gamblers exist so that different treatment strategies might be necessary.
Collapse
|
49
|
Potenza MN, Walderhaug E, Henry S, Gallezot JD, Planeta-Wilson B, Ropchan J, Neumeister A. Serotonin 1B receptor imaging in pathological gambling. World J Biol Psychiatry 2013; 14:139-45. [PMID: 21936763 PMCID: PMC3595502 DOI: 10.3109/15622975.2011.598559] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Objectives. Although serotonergic mechanisms have been implicated in pathological gambling (PG), no ligand-based imaging studies have assessed serotonin receptors in individuals with PG. Given its role in substance addictions and its abundance in brain regions implicated in PG, we evaluated serotonin 1B receptors (5-HT1BRs) in PG. Methods. Ten medication-free subjects with PG (mean ± SD age = 36.3 ± 9.4 years, nine men) and ten control comparison (CC) subjects (mean ± SD age = 35.8 ± 9.9 years, nine men) underwent [(11)C]P943 positron emission scanning on a high resolution research tomograph. Results. 5-HT1BR BPND values were similar in PG and CC subjects (P > 0.1). Among PG subjects, scores on the South Oaks Gambling Screen (SOGS) correlated positively with 5-HT1BR BPND values in the ventral striatum (r = 0.66; P = 0.04), putamen (r = 0.67; P = 0.03) and anterior cingulate cortex (r = 0.73; P = 0.02). Conclusions. These findings provide the first evidence that PG severity in humans is linked to increased levels of 5-HT1BRs in regions previously implicated in functional neuroimaging studies of PG. These findings indicate a potential role for serotonergic function in the ventral striatum and anterior cingulate cortex contributing to problem gambling severity and warrant further studies to investigate whether numbers of available 5-HT1BRs might represent a vulnerability factor for PG or develop in relationship to problem gambling.
Collapse
Affiliation(s)
- Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Neurobiology, Yale University School of Medicine, New Haven, CT, USA,Department of Child Study Center Yale University School of Medicine, New Haven, CT, USA
| | - Espen Walderhaug
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Addiction Treatment – Youth, Oslo University Hospital, Oslo, Norway
| | - Shannan Henry
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | | | - Beata Planeta-Wilson
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | - Jim Ropchan
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
| | | |
Collapse
|
50
|
Potenza MN. Biological contributions to addictions in adolescents and adults: prevention, treatment, and policy implications. J Adolesc Health 2013; 52:S22-32. [PMID: 23332567 PMCID: PMC3935152 DOI: 10.1016/j.jadohealth.2012.05.007] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Revised: 05/22/2012] [Accepted: 05/22/2012] [Indexed: 01/23/2023]
Abstract
PURPOSE Despite significant advances in our understanding of the biological bases of addictions, these disorders continue to represent a huge public health burden that is associated with substantial personal suffering. Efforts to target addictions require consideration of how the improved biological understanding of addictions may lead to improved prevention, treatment, and policy initiatives. METHOD In this article, we provide a narrative review of current biological models for addictions with a goal of placing existing data and theories within a translational and developmental framework targeting the advancement of prevention, treatment, and policy strategies. RESULTS Data regarding individual differences, intermediary phenotypes, and main and interactive influences of genetic and environmental contributions in the setting of developmental trajectories that may be influenced by addictive drugs or behavior indicate complex underpinnings of addictions. CONCLUSIONS Consideration and further elucidation of the biological etiologies of addictions hold significant potential for making important gains and reducing the public health impact of addictions.
Collapse
Affiliation(s)
- Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut; Child Study Center, Yale University School of Medicine, New Haven, Connecticut.
| |
Collapse
|