1
|
Christensen E, Albertella L, Chamberlain SR, Brydevall M, Suo C, Grant JE, Yücel M, Lee RSC. The neurocognitive correlates of non-substance addictive behaviors. Addict Behav 2024; 150:107904. [PMID: 37984220 DOI: 10.1016/j.addbeh.2023.107904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/19/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Neurocognitive deficits have been implicated as transdiagnostic risk markers of substance use disorders. However, these have yet to be comprehensively evaluated in other, non-substance addictions. In a large, general community sample (N = 475) the present study evaluated the neurocognitive correlates of problem alcohol use and three non-substance-related addictive behaviors: addictive eating (AE), problematic pornography use (PPU), and problematic use of the internet (PUI), to identify potential shared and distinct neurocognitive correlates. A sample of Australian residents (54.4 % female M[SD] age = 32.4[11.9] years) completed a comprehensive online assessment of neurocognitive tasks tapping into eight distinct expert-endorsed domains purportedly associated with addiction. Multiple linear regressions with bootstrapping were used to examine associations among each addictive behavior of interest and neurocognition, trait impulsivity, and compulsivity, as well as key covariates. Neurocognition was differentially associated with each addictive behavior. None of the neurocognitive domains were significantly associated with problematic alcohol use or AE (p >.05), poorer performance monitoring was significantly associated with higher levels of PPU and PUI (β = -0.10, p =.049; β = -0.09, p =.028), and a preference for delayed gratification was associated with more severe PUI (β = -0.10, p =.025). Our findings have theoretical implications for how we understand non-substance addiction and suggest the need for a more nuanced approach to studying addictive behaviors that take into account the underlying neurocognitive mechanisms associated with each type of addiction.
Collapse
Affiliation(s)
- Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, the United Kingdom of Great Britain and Northern Ireland; Southern Health NHS Foundation Trust, Southampton, the United Kingdom of Great Britain and Northern Ireland
| | - Maja Brydevall
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Chao Suo
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia; QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Rico Sze Chun Lee
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
2
|
Baenas I, Mora-Maltas B, Etxandi M, Lucas I, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Gómez-Peña M, Moragas L, Del Pino-Gutiérrez A, Tapia J, Diéguez C, Goudriaan AE, Jiménez-Murcia S. Cluster analysis in gambling disorder based on sociodemographic, neuropsychological, and neuroendocrine features regulating energy homeostasis. Compr Psychiatry 2024; 128:152435. [PMID: 37976998 DOI: 10.1016/j.comppsych.2023.152435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far. AIMS This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features. METHODS 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ2) for categorical variables, and analysis of variance (ANOVA) for quantitative measures. RESULTS Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2. CONCLUSIONS To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision.
Collapse
Affiliation(s)
- Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Mikel Etxandi
- Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sulay Tovar
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain; Medical Direction of Ambulatory Processes, South Metropolitan Territorial Management, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Diéguez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Anna E Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
3
|
Berta K, Pesthy ZV, Vékony T, Farkas BC, Németh D, Kun B. The neuropsychological profile of work addiction. Sci Rep 2023; 13:20090. [PMID: 37973989 PMCID: PMC10654659 DOI: 10.1038/s41598-023-47515-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
The objective of this study was to examine, for the first time, the neuropsychological aspects of work addiction, with a specific emphasis on the cognitive factors identified by theoretical models. While previous research has highlighted self-reported obsessiveness and impulsiveness in work addiction, this study sought to go beyond self-report measures by employing also neuropsychological reaction time tasks to assess executive functions. A total of 101 participants were categorized into two groups based on their Work Addiction Risk Test scores: a high-risk group (HWA; n = 39) and a low-risk group (LWA; n = 62) for work addiction. Executive functions were assessed using Go/No-Go, Digit Span, Counting Span, N-back, and Card Sorting Tasks. The findings revealed that the HWA group had poorer inhibitory control and achieved lower scores on the more complex working memory task involving updating (2-back). However, they exhibited unaltered cognitive flexibility and outperformed the LWA group on the 1-back task associated with maintenance and storage of information and sustained attention. Higher levels of impulsiveness and compulsiveness were observed in the HWA group, consistent with previous studies. These findings highlight the role of inhibition and working memory in work addiction, potentially contributing to challenges such as inefficient working strategies and impaired social functioning. This study offers valuable insights into the neurocognitive aspects of work addiction, deepening our understanding of this phenomenon.
Collapse
Affiliation(s)
- Krisztina Berta
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | - Teodóra Vékony
- Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, INSERM, CNRS, Université Claude Bernard Lyon 1, Bron, France
| | - Bence C Farkas
- Université Paris-Saclay, UVSQ, INSERM, CESP, Villejuif, France
- Institut du Psychotraumatisme de l'Enfant et de l'Adolescent, Conseil Départemental Yvelines et Hauts-de-Seine et Centre Hospitalier des Versailles, Versailles, France
- Centre de Recherche en Épidémiologie et en Santé des Populations, INSERM U1018, Université Paris-Saclay, Université Versailles Saint-Quentin, Paris, France
| | - Dezső Németh
- Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, INSERM, CNRS, Université Claude Bernard Lyon 1, Bron, France
- BML-NAP Research Group, Institute of Psychology, Institute of Cognitive Neuroscience and Psychology, HUN-REN Research Centre for Natural Sciences, Eötvös Loránd University, Budapest, Hungary
| | - Bernadette Kun
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| |
Collapse
|
4
|
Impact of social media use on executive function. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
5
|
Age and Gender Considerations with Respect to Gambling-Disorder Severity and Impulsivity and Self-control. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00794-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
6
|
Weidacker K, Johnston SJ, Mullins PG, Boy F, Dymond S. Neurochemistry of response inhibition and interference in gambling disorder: a preliminary study of γ-aminobutyric acid (GABA+) and glutamate-glutamine (Glx). CNS Spectr 2021:1-11. [PMID: 33752778 DOI: 10.1017/s1092852921000316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Neurobehavioral research on the role of impulsivity in gambling disorder (GD) has produced heterogeneous findings. Impulsivity is multifaceted with different experimental tasks measuring different subprocesses, such as response inhibition and distractor interference. Little is known about the neurochemistry of inhibition and interference in GD. METHODS We investigated inhibition with the stop signal task (SST) and interference with the Eriksen Flanker task, and related performance to metabolite levels in individuals with and without GD. We employed magnetic resonance spectroscopy (MRS) to record glutamate-glutamine (Glx/Cr) and inhibitory, γ-aminobutyric acid (GABA+/Cr) levels in the dorsal ACC (dACC), right dorsolateral prefrontal cortex (dlPFC), and an occipital control voxel. RESULTS We found slower processing of complex stimuli in the Flanker task in GD (P < .001, η2p = 0.78), and no group differences in SST performance. Levels of dACC Glx/Cr and frequency of incongruent errors were correlated positively in GD only (r = 0.92, P = .001). Larger positive correlations were found for those with GD between dACC GABA+/Cr and SST Go error response times (z = 2.83, P = .004), as well as between dACC Glx/Cr and frequency of Go errors (z = 2.23, P = .03), indicating general Glx-related error processing deficits. Both groups expressed equivalent positive correlations between posterror slowing and Glx/Cr in the right dlPFC (GD: r = 0.74, P = .02; non-GD: r = .71, P = .01). CONCLUSION Inhibition and interference impairments are reflected in dACC baseline metabolite levels and error processing deficits in GD.
Collapse
Affiliation(s)
| | | | - Paul G Mullins
- School of Psychology, Bangor University, Bangor, United Kingdom
| | - Frederic Boy
- School of Psychology, Swansea University, Swansea, United Kingdom
- School of Management, Swansea University, Swansea, United Kingdom
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, United Kingdom
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
| |
Collapse
|
7
|
UYGUR AB. KUMAR OYNAMA BOZUKLUĞUNUN DAVRANIŞSAL İNHİBİSYON-AKTİVASYON SİSTEMLERİ ve SOSYODEMOGRAFiK ETKENLER ile İLİŞKİSİ. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.862992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
8
|
Harris A, Gous G, de Wet B, Griffiths MD. The Relationship Between Gambling Event Frequency, Motor Response Inhibition, Arousal, and Dissociative Experience. J Gambl Stud 2021; 37:241-268. [PMID: 32537726 PMCID: PMC7882578 DOI: 10.1007/s10899-020-09955-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Speed of play has been identified as a key structural characteristic in gambling behaviour, where games involving higher playing speeds enhance the experience of gambling. Of interest in the present study is the consistent finding that games with higher event frequencies are preferred by problem gamblers and are associated with more negative gambling outcomes, such as difficulty quitting the game and increased monetary loss. The present study investigated the impact of gambling speed of play on executive control functioning, focusing on how increased speeds of play impact motor response inhibition, and the potential mediating role arousal and dissociative experience play in this relationship. Fifty regular non-problem gamblers took part in a repeated-measures experiment where they gambled with real money on a simulated slot machine across five speed of play conditions. Response inhibition was measured using an embedded Go/No-Go task, where participants had to withhold motor responses, rather than operating the spin button on the slot machine when a specific colour cue was present. Results indicated that response inhibition performance was significantly worse during faster speeds of play, and that the role of arousal in this relationship was independent of any motor priming affect. The implications of these findings for gambling legislation and gambling harm-minimisation approaches are discussed.
Collapse
Affiliation(s)
- Andrew Harris
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK.
| | - Georgina Gous
- Psychology Department, University of Lincoln, Lincoln, UK
| | - Bobbie de Wet
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| |
Collapse
|
9
|
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
|
10
|
Brevers D, King DL, Billieux J. Delineating adaptive esports involvement from maladaptive gaming: a self-regulation perspective. Curr Opin Psychol 2020; 36:141-146. [PMID: 32795945 DOI: 10.1016/j.copsyc.2020.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 12/26/2022]
Abstract
The last decade has witnessed the rise of electronic sports (esports), yet little is known about how involvement in intensive esports relates to self-regulatory processes, such as executive functioning (EF). In this paper, we review the evidence on EF in problematic and non-problematic video-game use. We also consider research on EF in traditional sports athletes, as well as in 'exercise addiction'. The focus of the review is on two core components of EF, namely response inhibition and cognitive flexibility. The available evidence suggests that EF is a reliable marker for indexing specific types of sport and video-gaming expertise, but does not appear to consistently delineate maladaptive from adaptive video-game involvement. Future research avenues on EF that characterize esport players are suggested to advance this area.
Collapse
Affiliation(s)
- Damien Brevers
- Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg.
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Australia
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| |
Collapse
|
11
|
Aydın O, Obuća F, Boz C, Ünal-Aydın P. Associations between executive functions and problematic social networking sites use. J Clin Exp Neuropsychol 2020; 42:634-645. [DOI: 10.1080/13803395.2020.1798358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Orkun Aydın
- Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Faruk Obuća
- Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Canahmet Boz
- Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Pınar Ünal-Aydın
- Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| |
Collapse
|
12
|
Quoilin C, Grandjean J, Duque J. Considering Motor Excitability During Action Preparation in Gambling Disorder: A Transcranial Magnetic Stimulation Study. Front Psychiatry 2020; 11:639. [PMID: 32695036 PMCID: PMC7339919 DOI: 10.3389/fpsyt.2020.00639] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/19/2020] [Indexed: 11/13/2022] Open
Abstract
A lack of inhibitory control appears to contribute to the development and maintenance of addictive disorders. Among the mechanisms thought to assist inhibitory control, an increasing focus has been drawn on the so-called preparatory suppression, which refers to the drastic suppression observed in the motor system during action preparation. Interestingly, deficient preparatory suppression has been reported in alcohol use disorders. However, it is currently unknown whether this deficit also concerns behavioral, substance-free, addictions, and thus whether it might represent a vulnerability factor common to both substance and behavioral addictive disorders. To address this question, neural measures of preparatory suppression were obtained in gambling disorder patients (GDPs) and matched healthy control subjects. To do so, single-pulse transcranial magnetic stimulation was applied over the left and the right motor cortex to elicit motor-evoked potentials (MEPs) in both hands when participants were performing a choice reaction time task. In addition, choice and rapid response impulsivity were evaluated in all participants, using self-report measures and neuropsychological tasks. Consistent with a large body of literature, the MEP data revealed that the activity of the motor system was drastically reduced during action preparation in healthy subjects. Surprisingly, though, a similar MEP suppression was observed in GDPs, indicating that those subjects do not globally suffer from a deficit in preparatory suppression. By contrast, choice impulsivity was higher in GDPs than healthy subjects, and a higher rapid response impulsivity was found in the more severe forms of GD. Altogether, those results demonstrated that although some aspects of inhibitory control are impaired in GDPs, these alterations do not seem to concern preparatory suppression. Yet, the profile of individuals suffering of a GD is very heterogeneous, with only part of them presenting an impulsive disposition, such as in patients with alcohol use disorders. Hence, a lack of preparatory suppression may be only shared by this sub-type of addicts, an interesting issue for future investigation.
Collapse
Affiliation(s)
- Caroline Quoilin
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | | | | |
Collapse
|
13
|
Challet-Bouju G, Hurel E, Thiabaud E, Leboucher J, Leroy M, Quibel AL, Grall-Bronnec M. Inhibitory control in poker: Do experienced non-pathological poker gamblers exhibit better performance than healthy controls on motor, verbal and emotional expression inhibition? J Behav Addict 2020; 9:347-362. [PMID: 32516118 PMCID: PMC8939416 DOI: 10.1556/2006.2020.00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/15/2020] [Accepted: 04/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Strategic games, such as poker, require gamblers to develop several skills to perform better than others and to expect a potential gain. Players must remain as unpredictable and unreadable as possible by inhibiting the expression of their emotions in response to both good and bad poker events. The aim of the present study was to compare several aspects of the inhibition process in experienced poker gamblers and controls to better understand how inhibitory control is involved in poker performance. METHODS Thirty experienced non-pathological poker gamblers (EG) and thirty healthy controls with no or limited poker experience (HC) completed 3 cognitive tasks. Each task measured a specific type of inhibition: motor inhibition [Go/No-Go task], verbal inhibition [Hayling Sentence Completion Task] and expressive inhibition [expressive suppression task, which combines subjective, expressive (facial EMG) and physiological (skin conductance, heart interbeat interval, cardiovascular and respiratory activation) measures of emotional experience]. Linear mixed models with random effects were performed. RESULTS Inhibitory control skills were similar between the two groups, regardless of the form of inhibition tested. The only difference observed in EG was a higher ability to partially suppress the physiological expression of emotion. However, this difference was only present for negative and positive emotional induction and was not maintained for emotional induction related to poker situations. DISCUSSION AND CONCLUSIONS The development of specific inhibition skills in experienced poker gamblers was not supported and raises questions about the transferability of poker skills previously discussed in the literature.
Collapse
Affiliation(s)
- G. Challet-Bouju
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France,Université de Nantes, Université de Tours, INSERM, SPHERE U1246 “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes, France,Corresponding author. CHU de Nantes, Service d’Addictologie et de Psychiatrie de Liaison, Hôpital Saint Jacques, 85, rue Saint Jacques, 44093 Nantes Cedex 1, France. Tel.: +33 253482532 E-mail:
| | - E. Hurel
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France,Université de Nantes, Université de Tours, INSERM, SPHERE U1246 “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes, France
| | - E. Thiabaud
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France
| | - J. Leboucher
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France
| | - M. Leroy
- CHU Nantes, Biostatistics and Methodology Unit, Department of Clinical Research and Innovation, Nantes, France
| | - A. L. Quibel
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France,Université de Nantes, Université de Tours, INSERM, SPHERE U1246 “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes, France
| | - M. Grall-Bronnec
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France,Université de Nantes, Université de Tours, INSERM, SPHERE U1246 “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes, France
| |
Collapse
|
14
|
Grant JE, Chamberlain SR. Gambling and substance use: Comorbidity and treatment implications. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109852. [PMID: 31881248 DOI: 10.1016/j.pnpbp.2019.109852] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
Gambling disorder is a common condition that was previously listed as an impulse control disorder, but is now considered a substance-related and addictive disorder. Gambling disorder has been associated with various untoward long-term outcomes including impaired quality of life, relationship break-ups, debt and mortgage foreclosure, and elevated risk of suicidality. This paper provides a concise primer on gambling disorder, with a special focus on its parallels with substance use disorders. We consider clinical presentations, comorbid expression, heritability, and treatment approaches (psychological and pharmacological). Lastly, we highlight new treatment directions suggested by the literature.
Collapse
Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge; & Cambridge and Peterborough NHS Foundation Trust (CPFT), UK
| |
Collapse
|
15
|
Seok JW, Sohn JH. Response inhibition during processing of sexual stimuli in males with problematic hypersexual behavior. J Behav Addict 2020; 9:71-82. [PMID: 32359232 PMCID: PMC8935199 DOI: 10.1556/2006.2020.00003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND AIMS Individuals with problematic hypersexual behavior (PHB) are unable to control their sexual cravings, regardless of other situational factors. This inability to control cravings is a common trait in patients with neurological pathologies related to response inhibition. Until recently, however, it was unclear whether individuals with PHB have decreased inhibition and altered neural responses in the brain regions associated with inhibition compared to healthy control individuals, especially in the presence of distracting sexual stimuli. In this study, we examined the neural and psychological underpinnings of inhibition in individuals with PHB. METHODS Thirty individuals with PHB and 30 healthy subjects underwent functional magnetic resonance imaging while performing a modified go/no-go task with neutral or sexual backgrounds used as distractors. RESULTS Individuals with PHB showed poorer response inhibition than healthy subjects, especially when sexual distractors were present. Further, compared to healthy control subjects, individuals with PHB showed decreased activation in the right inferior frontal gyrus (IFG) and reduced functional connectivity between the IFG and the pre-supplementary motor area (preSMA) when response inhibition was required. Finally, the reduced activation and connectivity were more pronounced in the presence of sexual distractors than in the presence of neutral distractors. DISCUSSION These findings suggest that individuals with PHB show reduced ability to inhibit responses that might be related to lower IFG activation and IFG-preSMA connectivity during response inhibition. Our results provide insights into the neurobiological underpinnings of poor response inhibition in individuals with PHB.
Collapse
Affiliation(s)
- Ji-woo Seok
- Department of Psychology, Chungnam National University, Daejeon, 305-764, South Korea,Department of Rehabilitation Counseling Psychology, Seoul Hanyoung University, Seoul, 08274, South Korea
| | - Jin-Hun Sohn
- Department of Psychology, Chungnam National University, Daejeon, 305-764, South Korea,Corresponding author. Tel.: +82 42 821 7404; fax: +82 42 821 8875. E-mail:
| |
Collapse
|
16
|
Zhang K, Clark L. Loss-chasing in gambling behaviour: neurocognitive and behavioural economic perspectives. Curr Opin Behav Sci 2020. [DOI: 10.1016/j.cobeha.2019.10.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
17
|
Abstract
Impulsivity is a multidimensional construct. Although gambling disorder (GD) has been associated with high impulsivity, impulsivity across multiple domains has not been thoroughly investigated in this population. We first aimed to examine whether associations between three facets of impulsivity (response impulsivity, choice impulsivity and impulsive tendency) varied between GD patients and healthy controls (HC). We next aimed to evaluate relationships between these three types of impulsivity, as proposed by theoretical models of impulsivity, and their associations with GD severity. The sample included 97 treatment-seeking adult men with GD, diagnosed according to DSM-5 criteria, and 32 male HCs recruited from the general population. Greater impulsivity in all three domains was found in men with GD in comparison to men without GD. Associations between impulsivity facets were found in both groups, with response impulsivity being the only domain associated with GD severity. Our findings confirm that multiple domains of impulsivity are relevant in GD. Future studies should examine the extent to which treatments aimed at targeting specific aspects of impulsivity improve outcomes.
Collapse
|
18
|
Abstract
OBJECTIVE The clinical phenotype of gambling disorder (GD) is suggestive of changes in brain regions involved in reward and impulse suppression, notably the striatum. Studies have yet to characterize striatal morphology (shape) in GD and whether this may be a vulnerability marker. AIMS To characterize the morphology of the striatum in those with disordered gambling (at-risk gambling and GD) versus controls. METHOD Individuals aged 18-29 years were classified a priori into those with some degree of GD symptoms (at-risk gambling and GD) or controls. Exclusion criteria were a current mental disorder (apart from GD), history of brain injury, or taking psychoactive medication within 6 weeks of enrollment. History of any substance use disorder was exclusionary. Participants completed an impulsivity questionnaire and structural brain scan. Group differences in volumes and morphology were characterized in subcortical regions of interest, focusing on the striatum. RESULTS Thirty-two people with GD symptoms (14 at-risk and 18 GD participants) and 22 controls completed the study. GD symptoms were significantly associated with higher impulsivity and morphological alterations in the bilateral pallidum and left putamen. Localized contraction in the right pallidum strongly correlated with trait impulsivity in those with GD symptoms. CONCLUSIONS Morphologic abnormalities of the striatum appear to exist early in the disease trajectory from subsyndromal gambling to GD and thus constitute candidate biological vulnerability markers, which may reflect differences in brain development associated with trait impulsivity. Striatal morphology and associated impulsivity might predispose to a range of problematic repetitive behaviors.
Collapse
|
19
|
Zheng Y, Mei S, Yi W, Li Q, Liu X. Abnormal performance monitoring but intact response inhibition in sensation seeking. Psychophysiology 2019; 56:e13373. [PMID: 30932201 DOI: 10.1111/psyp.13373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 11/26/2022]
Abstract
The sensation-seeking trait is a potential endophenotype for various addictive behaviors. Using a nonclinical sample, the current ERP study examined the effects of sensation seeking on performance monitoring and response inhibition. Twenty high sensation seekers and 21 low sensation seekers were selected from a large sample based on their sensation-seeking score and performed a stop-signal task while their EEG was recorded. High relative to low sensation seekers displayed similar response inhibition in terms of performance measure and stop-P3 amplitudes. Compared to low sensation seekers, however, high sensation seekers exhibited a reduced stop-N2 for unsuccessful, but not successful, inhibition. Moreover, an enhanced go-N2 in response to go signals was observed for high versus low sensation seekers, irrespective of whether the go signals were followed by a stop signal or not. Together, our findings suggest that sensation seeking in nonclinical populations is related to individual variability in performance monitoring rather than response inhibition, which provides important implications for the prevention and intervention of addictive behaviors that are driven by trait sensation seeking.
Collapse
Affiliation(s)
- Ya Zheng
- Department of Psychology, Dalian Medical University, Dalian, China
| | - Shuting Mei
- Department of Psychology, Dalian Medical University, Dalian, China
| | - Wei Yi
- Department of Psychology, Dalian Medical University, Dalian, China
| | - Qi Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xun Liu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
20
|
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
|
21
|
Trait impulsivity and cognitive domains involving impulsivity and compulsivity as predictors of gambling disorder treatment response. Addict Behav 2018; 87:169-176. [PMID: 30048796 DOI: 10.1016/j.addbeh.2018.07.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) is a highly heterogeneous condition with high rates of chronicity, relapses and treatment dropout. The aim of this study was to longitudinally explore the associations between trait impulsivity, impulsivity-compulsivity related cognitive domains, and treatment outcome in an outpatient sample of adult patients with GD. METHODS 144 adult male participants diagnosed with GD undergoing cognitive-behavioural treatment (CBT) at a specialized outpatient service completed a series of neuropsychological tests to assess executive functioning (including cognitive flexibility, inhibition control and decision making) and psychometric questionnaires. RESULTS Trait impulsivity predicted low compliance [UPPS-P negative urgency (B = 0.113; p = 0.019)] and relapse [UPPS-P negative urgency (B = 0.140; p = 0.015)] at 5 weeks of treatment and dropout at the end of treatment [(UPPS-P sensation seeking B = 0.056; p = 0.045)]. Cognitive flexibility performance predicted: dropout rates at the end of treatment [WCST perseverative errors (B = 0.043; p = 0.042)]; dropout [WCST categories completed (B = -1.827; p = 0.020)] and low compliance or relapses at follow-up [WCST perseverative errors (B = 0.128; p = 0.020)]; and time to first relapse [WCST failure to maintain set (B = -0.374; p = 0.048)] and time to dropout [WCST perseverative errors (B = 0.0198; p = 0.019)]. CONCLUSIONS Our findings indicate impulsivity-compulsivity levels may influence response to GD treatment (i.e.: low compliance and dropout or relapse rates) thus representing a potential target for improving treatment outcomes.
Collapse
|
22
|
Banks PJ, Tata MS, Bennett PJ, Sekuler AB, Gruber AJ. Implicit Valuation of the Near-Miss is Dependent on Outcome Context. J Gambl Stud 2018; 34:181-197. [PMID: 28668981 DOI: 10.1007/s10899-017-9705-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Gambling studies have described a "near-miss effect" wherein the experience of almost winning increases gambling persistence. The near-miss has been proposed to inflate the value of preceding actions through its perceptual similarity to wins. We demonstrate here, however, that it acts as a conditioned stimulus to positively or negatively influence valuation, dependent on reward expectation and cognitive engagement. When subjects are asked to choose between two simulated slot machines, near-misses increase valuation of machines with a low payout rate, whereas they decrease valuation of high payout machines. This contextual effect impairs decisions and persists regardless of manipulations to outcome feedback or financial incentive provided for good performance. It is consistent with proposals that near-misses cause frustration when wins are expected, and we propose that it increases choice stochasticity and overrides avoidance of low-valued options. Intriguingly, the near-miss effect disappears when subjects are required to explicitly value machines by placing bets, rather than choosing between them. We propose that this task increases cognitive engagement and recruits participation of brain regions involved in cognitive processing, causing inhibition of otherwise dominant systems of decision-making. Our results reveal that only implicit, rather than explicit strategies of decision-making are affected by near-misses, and that the brain can fluidly shift between these strategies according to task demands.
Collapse
Affiliation(s)
- Parker J Banks
- Department of Neuroscience, University of Lethbridge, EP 1219, 4401 University Drive W, Lethbridge, AB, T1K 6T5, Canada.,Vision and Cognitive Neuroscience Lab, Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Matthew S Tata
- Department of Neuroscience, University of Lethbridge, EP 1219, 4401 University Drive W, Lethbridge, AB, T1K 6T5, Canada
| | - Patrick J Bennett
- Vision and Cognitive Neuroscience Lab, Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Allison B Sekuler
- Vision and Cognitive Neuroscience Lab, Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Aaron J Gruber
- Department of Neuroscience, University of Lethbridge, EP 1219, 4401 University Drive W, Lethbridge, AB, T1K 6T5, Canada.
| |
Collapse
|
23
|
In Search of Executive Impairment in Pathological Gambling: A Neuropsychological Study on Non-treatment Seeking Gamblers. J Gambl Stud 2018; 34:1327-1340. [DOI: 10.1007/s10899-018-9758-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
24
|
Compulsivity-related neurocognitive performance deficits in gambling disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2018; 84:204-217. [DOI: 10.1016/j.neubiorev.2017.11.022] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 12/11/2022]
|
25
|
Fineberg NA, Apergis-Schoute AM, Vaghi MM, Banca P, Gillan CM, Voon V, Chamberlain SR, Cinosi E, Reid J, Shahper S, Bullmore ET, Sahakian BJ, Robbins TW. Mapping Compulsivity in the DSM-5 Obsessive Compulsive and Related Disorders: Cognitive Domains, Neural Circuitry, and Treatment. Int J Neuropsychopharmacol 2018; 21:42-58. [PMID: 29036632 PMCID: PMC5795357 DOI: 10.1093/ijnp/pyx088] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Compulsions are repetitive, stereotyped thoughts and behaviors designed to reduce harm. Growing evidence suggests that the neurocognitive mechanisms mediating behavioral inhibition (motor inhibition, cognitive inflexibility) reversal learning and habit formation (shift from goal-directed to habitual responding) contribute toward compulsive activity in a broad range of disorders. In obsessive compulsive disorder, distributed network perturbation appears focused around the prefrontal cortex, caudate, putamen, and associated neuro-circuitry. Obsessive compulsive disorder-related attentional set-shifting deficits correlated with reduced resting state functional connectivity between the dorsal caudate and the ventrolateral prefrontal cortex on neuroimaging. In contrast, experimental provocation of obsessive compulsive disorder symptoms reduced neural activation in brain regions implicated in goal-directed behavioral control (ventromedial prefrontal cortex, caudate) with concordant increased activation in regions implicated in habit learning (presupplementary motor area, putamen). The ventromedial prefrontal cortex plays a multifaceted role, integrating affective evaluative processes, flexible behavior, and fear learning. Findings from a neuroimaging study of Pavlovian fear reversal, in which obsessive compulsive disorder patients failed to flexibly update fear responses despite normal initial fear conditioning, suggest there is an absence of ventromedial prefrontal cortex safety signaling in obsessive compulsive disorder, which potentially undermines explicit contingency knowledge and may help to explain the link between cognitive inflexibility, fear, and anxiety processing in compulsive disorders such as obsessive compulsive disorder.
Collapse
Affiliation(s)
- Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire, United Kingdom
- University of Hertfordshire, Department of Postgraduate Medicine, College Lane Hatfield, United Kingdom
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Annemieke M Apergis-Schoute
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Matilde M Vaghi
- Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Paula Banca
- Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Claire M Gillan
- School of Psychology, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Valerie Voon
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Samuel R Chamberlain
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
- Cambridge and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Eduardo Cinosi
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire, United Kingdom
- University of Hertfordshire, Department of Postgraduate Medicine, College Lane Hatfield, United Kingdom
| | - Jemma Reid
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire, United Kingdom
- University of Hertfordshire, Department of Postgraduate Medicine, College Lane Hatfield, United Kingdom
| | - Sonia Shahper
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire, United Kingdom
| | - Edward T Bullmore
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Barbara J Sahakian
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Trevor W Robbins
- Behavioral and Clinical Neurosciences Institute, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
26
|
Castrén S, Kontto J, Alho H, Salonen AH. The relationship between gambling expenditure, socio-demographics, health-related correlates and gambling behaviour-a cross-sectional population-based survey in Finland. Addiction 2018; 113:91-106. [PMID: 28667828 PMCID: PMC5763410 DOI: 10.1111/add.13929] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/25/2017] [Accepted: 06/26/2017] [Indexed: 12/11/2022]
Abstract
AIMS To investigate gambling expenditure and its relationship with socio-demographics, health-related correlates and past-year gambling behaviour. DESIGN Cross-sectional population survey. SETTING Population-based survey in Finland. PARTICIPANTS Finnish people aged 15-74 years drawn randomly from the Population Information System. The participants in this study were past-year gamblers with gambling expenditure data available (n = 3251, 1418 women and 1833 men). MEASUREMENTS Expenditure shares, means of weekly gambling expenditure (WGE, €) and monthly gambling expenditure as a percentage of net income (MGE/NI, %) were calculated. The correlates used were perceived health, smoking, mental health [Mental Health Inventory (MHI)-5], alcohol use [Alcohol Use Disorders Identification Test (AUDIT)-C], game types, gambling frequency, gambling mode and gambling severity [South Oaks Gambling Screen (SOGS)]. FINDINGS Gender (men versus women) was found to be associated significantly with gambling expenditure, with exp(β) = 1.40, 95% confidence interval (CI) = 1.29, 1.52 and P < 0.005 for WGE, and exp(β) = 1.39, 95% CI = 1.27, 1.51 and P < 0.005 for MGE/NI. All gambling behaviour correlates were associated significantly with WGE and MGE/NI: gambling frequency (several times a week versus once a month/less than monthly, exp(β) = 30.75, 95% CI = 26.89, 35.17 and P < 0.005 for WGE, and exp(β) = 31.43, 95% CI = 27.41, 36.03 and P < 0.005 for MGE/NI), gambling severity (probable pathological gamblers versus non-problem gamblers, exp(β) = 2.83, 95% CI = 2.12, 3.77 and P < 0.005 for WGE, and exp(β) = 2.67, 95% CI = 2.00, 3.57 and P < 0.005 for MGE/NI) and on-line gambling (on-line and land-based versus land-based only, exp(β) = 1.35, 95% CI = 1.24, 1.47 and P < 0.005 for WGE, and exp(β) = 1.35, 95% CI = 1.24, 1.47 and P < 0.005 for MGE/NI). CONCLUSIONS In Finland, male gender is associated significantly with both weekly gambling expenditure and monthly gambling expenditure related to net income. People in Finland with lower incomes contribute proportionally more of their income to gambling compared with middle- and high-income groups.
Collapse
Affiliation(s)
- Sari Castrén
- Department of Public Health Solutions, Alcohol, Drugs and Addictions UnitNational Institute for Health and WelfareHelsinkiFinland
- Institute of Clinical MedicineUniversity and University Hospital of HelsinkiHelsinkiFinland
- Faculty of Social Sciences, Department of Psychology and Speech‐Language PathologyUniversity of TurkuTurkuFinland
| | - Jukka Kontto
- Department of Public Health Solutions, Health Monitoring UnitNational Institute for Health and WelfareHelsinkiFinland
| | - Hannu Alho
- Department of Public Health Solutions, Alcohol, Drugs and Addictions UnitNational Institute for Health and WelfareHelsinkiFinland
- Abdominal CenterUniversity of HelsinkiHelsinkiFinland
| | - Anne H. Salonen
- Department of Public Health Solutions, Alcohol, Drugs and Addictions UnitNational Institute for Health and WelfareHelsinkiFinland
- Institute of Clinical MedicineUniversity and University Hospital of HelsinkiHelsinkiFinland
| |
Collapse
|
27
|
Harries MD, Redden SA, Leppink EW, Chamberlain SR, Grant JE. Sub-clinical Alcohol Consumption and Gambling Disorder. J Gambl Stud 2017; 33:473-486. [PMID: 27826730 DOI: 10.1007/s10899-016-9649-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
While it is well established that gambling disorder is associated with alcohol use disorder, less is known regarding whether sub-clinical alcohol consumption increases gambling behavior. This study examined the effects of varying levels of alcohol consumption on clinical and cognitive measures. The sample consisted of 572 non-treatment seeking gamblers age 18-29 who were divided into three groups: non-current drinkers, current drinkers who did not qualify for an alcohol use disorder, and those with an alcohol use disorder (AUD). All subjects were assessed on gambling pathology, severity and impulsivity using the Structured Clinical Interview for Gambling Disorder, Yale Brown Obsessive Compulsive Scale for Pathologic Gambling and the Barratt Impulsive Scale-11 and select cognitive tests. In all of the clinical measures, controlling for age, gender and education, the AUD group was significantly more likely than the non-current and current drinkers to be a pathologic gambler and to be impulsive, compulsive and depressed. On cognitive tasks, controlling for age, gender and education, the AUD group had significantly worse strategy use on a spatial working memory task than both other groups. This study suggests that the relationship between alcohol and gambling may only exist when pathology in both alcohol consumption and gambling behavior is present. Examining this relationship with alcohol consumption as a continuous variable would provide additional insight into the potential effects alcohol consumption has on gambling behavior.
Collapse
Affiliation(s)
- Michael D Harries
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States.
| | - Sarah A Redden
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States
| | - Eric W Leppink
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States
| | | | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, United States
| |
Collapse
|
28
|
Challet-Bouju G, Bruneau M, Victorri-Vigneau C, Grall-Bronnec M. Cognitive Remediation Interventions for Gambling Disorder: A Systematic Review. Front Psychol 2017; 8:1961. [PMID: 29255433 PMCID: PMC5723090 DOI: 10.3389/fpsyg.2017.01961] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/25/2017] [Indexed: 11/18/2022] Open
Abstract
Various therapeutic approaches are available for the treatment of gambling disorder (GD), especially cognitive behavioral therapy (CBT; the most widely used treatment). However, CBT has high dropout and relapse rates as well as non-compliance issues, which may be partly due to resistance to changing core characteristics, such as executive functioning, attention, and emotional regulation abnormalities. Finding new therapeutic approaches to treat GD is thus a key challenge. Cognitive remediation (CR) interventions represent a promising approach to GD management, which has recently been demonstrated to have efficacy for treating other addictive disorders. The objective of this review is to describe the possible benefits of CR interventions for GD management. Two systematic searches in MEDLINE and ScienceDirect databases were conducted up until January 2017. Potential neurocognitive targets of CR interventions for GD were reviewed, as is the use and efficacy of such interventions for GD. While there is evidence of several neurocognitive deficits in individuals with GD in terms of impulsive, reflective, and interoceptive processes, the literature on CR interventions is virtually absent. No clinical studies were found in the literature, apart from a trial of a very specific program using Playmancer, a serious videogame, which was tested in cases of bulimia nervosa and GD. However, neurocognitive impairments in individuals with addictive disorders are highly significant, not only affecting quality of life, but also making abstinence and recovery more difficult. Given that CR interventions represent a relatively novel therapeutic approach to addiction and that there is currently a scarcity of studies on clinical populations suffering from GD, further research is needed to examine the potential targets of such interventions and the effectiveness of different training approaches. So far, no consensus has been reached on the optimal parameters of CR interventions (duration, intensity, frequency, group vs. individual, pencil-and-paper vs. computerized delivery, etc.). Although no firm conclusions can be drawn, CR interventions represent a promising adjunct treatment for GD. Such a novel therapy could be associated with common interventions, such as CBT and educational and motivational interventions, in order to make therapies more effective and longer-lasting and to decrease the risk of relapse.
Collapse
Affiliation(s)
- Gaëlle Challet-Bouju
- Clinical Investigation Unit "Behavioral Addictions/Complex Affective Disorders", Department of Addictology and Psychiatry, CHU Nantes, Nantes, France.,Université de Nantes, Université de Tours, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1246 SHERE, Nantes, France
| | - Mélanie Bruneau
- Clinical Investigation Unit "Behavioral Addictions/Complex Affective Disorders", Department of Addictology and Psychiatry, CHU Nantes, Nantes, France
| | | | - Caroline Victorri-Vigneau
- Université de Nantes, Université de Tours, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1246 SHERE, Nantes, France.,Department of Pharmacology, Center for Evaluation and Information on Pharmacodependence, CHU Nantes, Nantes, France
| | - Marie Grall-Bronnec
- Clinical Investigation Unit "Behavioral Addictions/Complex Affective Disorders", Department of Addictology and Psychiatry, CHU Nantes, Nantes, France.,Université de Nantes, Université de Tours, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1246 SHERE, Nantes, France
| |
Collapse
|
29
|
A Comparison of Online Versus Offline Gambling Harm in Portuguese Pathological Gamblers: An Empirical Study. Int J Ment Health Addict 2017; 16:1219-1237. [PMID: 30416402 PMCID: PMC6208709 DOI: 10.1007/s11469-017-9846-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Over the past decade, gambling has become a very popular activity across Europe including the growth of Internet gambling. Portugal is one of the few European countries where little research has been carried out. Given the lack of studies, a Portuguese sample (N = 1,599) was surveyed concerning their online and offline gambling habits. More specifically, the aim of this study was to identify and compare from the total sample, online pathological gamblers (PGON) (n = 171) and offline pathological gamblers’ (PGOF) (n = 171) characteristics, and eventual risk factors for the development of problem gambling. Results demonstrated that PGON had different profiles compared to PGOF, although there were also similarities. Situational characteristics were much more significant for PGON than PGOF (e.g., availability, accessibility, affordability), but PGOF had higher scores than PGON on factors concerning individual characteristics (e.g., intensity of feelings while gambling, depression, suicidal ideation, etc.). Findings also showed differences concerning attitudes toward responsible gambling measures. The fact that situational characteristics are more attractive to online gamblers confirms differences between PGON and PGOF and suggests that this preferred attractiveness may enhance problem gambling potential. Further research is needed to better understand the interaction between Internet situational characteristics and the individual characteristics of gamblers, as well as the profile of the growing population of gamblers that uses both online and offline modes to gamble.
Collapse
|
30
|
Harries MD, Redden SA, Grant JE. An Analysis of Treatment-Seeking Behavior in Individuals with Gambling Disorder. J Gambl Stud 2017; 34:999-1012. [PMID: 29134496 DOI: 10.1007/s10899-017-9730-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Gambling disorder affects approximately 1.1-3.5% of the population, with the rates being higher in young adults. Despite this high prevalence, little is known regarding which pathological gamblers decide to seek treatment. This study sought to examine the differences in three groups of pathological gamblers: those who did not seek treatment (n = 94), those who sought therapy (n = 106) and those who sought medication therapy (n = 680). All subjects were assessed on a variety of measures including demographics, family history, gambling history, comorbid psychiatric disorders and an assortment of clinical variables such as the Quality of Life Inventory, Hamilton Depression and Anxiety Rating Scales, Yale Brown Obsessive Compulsive Scale for Pathologic Gambling (PG-YBOCS), Barratt Impulsiveness Scale, Eysenck Impulsiveness Questionnaire and select cognitive tasks. Those seeking treatment were more likely to be Caucasian, have lost more money in the past year due to gambling, and were more likely to have legal and social problems as a result of their gambling. Those seeking therapy or medical treatment also scored significantly higher on the PG-YBOCS. This study suggests that pathologic gamblers seeking treatment were more likely to exhibit obsessive-compulsive tendencies likely leading to the increased legal and social problems that exist in this group.
Collapse
Affiliation(s)
- Michael D Harries
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, USA.
| | - Sarah A Redden
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, USA
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Avenue, MC3077, Chicago, IL, 60637, USA
| |
Collapse
|
31
|
van Timmeren T, Jansen JM, Caan MWA, Goudriaan AE, van Holst RJ. White matter integrity between left basal ganglia and left prefrontal cortex is compromised in gambling disorder. Addict Biol 2017; 22:1590-1600. [PMID: 27612435 DOI: 10.1111/adb.12447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 08/02/2016] [Accepted: 08/09/2016] [Indexed: 12/17/2022]
Abstract
Pathological gambling (PG) is a behavioral addiction characterized by an inability to stop gambling despite the negative consequences, which may be mediated by cognitive flexibility deficits. Indeed, impaired cognitive flexibility has previously been linked to PG and also to reduced integrity of white matter connections between the basal ganglia and the prefrontal cortex. It remains unclear, however, how white matter integrity problems relate to cognitive inflexibility seen in PG. We used a cognitive switch paradigm during functional magnetic resonance imaging in pathological gamblers (PGs; n = 26) and healthy controls (HCs; n = 26). Cognitive flexibility performance was measured behaviorally by accuracy and reaction time on the switch task, while brain activity was measured in terms of blood oxygen level-dependent responses. We also used diffusion tensor imaging on a subset of data (PGs = 21; HCs = 21) in combination with tract-based spatial statistics and probabilistic fiber tracking to assess white matter integrity between the basal ganglia and the dorsolateral prefrontal cortex. Although there were no significant group differences in either task performance, related neural activity or tract-based spatial statistics, PGs did show decreased white matter integrity between the left basal ganglia and prefrontal cortex. Our results complement and expand similar findings from a previous study in alcohol-dependent patients. Although we found no association between white matter integrity and task performance here, decreased white matter connections may contribute to a diminished ability to recruit prefrontal networks needed for regulating behavior in PG. Hence, our findings could resonate an underlying risk factor for PG, and we speculate that these findings may extend to addiction in general.
Collapse
Affiliation(s)
- Tim van Timmeren
- Department of Psychiatry, Academic Medical Center; Amsterdam Brain and Cognition Center, University of Amsterdam; The Netherlands
| | - Jochem M. Jansen
- Department of Psychiatry, Academic Medical Center; Amsterdam Brain and Cognition Center, University of Amsterdam; The Netherlands
- Institute for Criminal Law and Criminology; Leiden University; The Netherlands
| | - Matthan W. A. Caan
- Department of Radiology, Academic Medical Center; University of Amsterdam; The Netherlands
| | - Anna E. Goudriaan
- Department of Psychiatry, Academic Medical Center; Amsterdam Brain and Cognition Center, University of Amsterdam; The Netherlands
- Arkin Institute of Mental Health; The Netherlands
| | - Ruth J. van Holst
- Department of Psychiatry, Academic Medical Center; Amsterdam Brain and Cognition Center, University of Amsterdam; The Netherlands
- Donders Institute for Cognition, Brain and Behaviour; Radboud University; The Netherlands
- Department of Neurology; Radboud University Medical Center; The Netherlands
| |
Collapse
|
32
|
Chamberlain SR, Stochl J, Redden SA, Odlaug BL, Grant JE. Latent class analysis of gambling subtypes and impulsive/compulsive associations: Time to rethink diagnostic boundaries for gambling disorder? Addict Behav 2017; 72:79-85. [PMID: 28384607 PMCID: PMC5457805 DOI: 10.1016/j.addbeh.2017.03.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 03/22/2017] [Accepted: 03/27/2017] [Indexed: 12/26/2022]
Abstract
Background Gambling disorder has been associated with cognitive dysfunction and impaired quality of life. The current definition of non-pathological, problem, and pathological types of gambling is based on total symptom scores, which may overlook nuanced underlying presentations of gambling symptoms. The aims of the current study were (i) to identify subtypes of gambling in young adults, using latent class analysis, based on individual responses from the Structured Clinical Interview for Gambling Disorder (SCI-GD); and (ii) to explore relationships between these gambling subtypes, and clinical/cognitive measures. Methods Total 582 non-treatment seeking young adults were recruited from two US cities, on the basis of gambling five or more times per year. Participants undertook clinical and neurocognitive assessment, including stop-signal, decision-making, and set-shifting tasks. Data from individual items of the Structured Clinical Interview for Gambling Disorder (SCI-GD) were entered into latent class analysis. Optimal number of classes representing gambling subtypes was identified using Bayesian Information Criterion and differences between them were explored using multivariate analysis of variance. Results Three subtypes of gambling were identified, termed recreational gamblers (60.2% of the sample; reference group), problem gamblers (29.2%), and pathological gamblers (10.5%). Common quality of life impairment, elevated Barratt Impulsivity scores, occurrence of mainstream mental disorders, having a first degree relative with an addiction, and impaired decision-making were evident in both problem and pathological gambling groups. The diagnostic item ‘chasing losses’ most discriminated recreational from problem gamblers, while endorsement of ‘social, financial, or occupational losses due to gambling’ most discriminated pathological gambling from both other groups. Significantly higher rates of impulse control disorders occurred in the pathological group, versus the problem group, who in turn showed significantly higher rates than the reference group. The pathological group also had higher set-shifting errors and nicotine consumption. Conclusions Even problem gamblers who had a relatively low total SCI-PG scores (mean endorsement of two items) exhibited impaired quality of life, objective cognitive impairment on decision-making, and occurrence of other mental disorders that did not differ significantly from those seen in the pathological gamblers. Furthermore, problem/pathological gambling was associated with other impulse control disorders, but not increased alcohol use. Groups differed on quality of life when classified using the data-driven approach, but not when classified using DSM cut-offs. Thus, the current DSM-5 approach will fail to discriminate a significant fraction of patients with biologically plausible, functionally impairing illness, and may not be ideal in terms of diagnostic classification. Cognitive distortions related to ‘chasing losses’ represent a particularly important candidate treatment target for early intervention. Current classification of gambling pathology relies on total number of criteria met for gambling disorder (DSM-5) This approach can be seen as somewhat arbitrary and may overlook meaningful gambling subtypes Latent class analysis (LCA) was used to identify candidate subtypes of gambling in 582 gamblers. Compared to the reference class, both problem gamblers and gambling disorder classes showed relatively impaired quality of life, and more psychiatric morbidity. Both problem gamblers and gambling disorder classes also showed higher impulsivity scores and impaired decision-making. LCA classification was sensitive to group quality of life differences, whereas DSM-5 classification was not.
Collapse
Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, UK
| | - Jan Stochl
- Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, UK
| | - Sarah A Redden
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, United States
| | - Brian L Odlaug
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, United States.
| |
Collapse
|
33
|
Steward T, Mestre-Bach G, Fernández-Aranda F, Granero R, Perales JC, Navas JF, Soriano-Mas C, Baño M, Fernández-Formoso JA, Martín-Romera V, Menchón JM, Jiménez-Murcia S. Delay discounting and impulsivity traits in young and older gambling disorder patients. Addict Behav 2017; 71:96-103. [PMID: 28288442 DOI: 10.1016/j.addbeh.2017.03.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/23/2017] [Accepted: 03/04/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Impulsivity is understood to be a multidimensional construct involving aspects such as impulsive choice and impulsive traits. Delay discounting, the tendency to place greater value in immediate rewards over larger, long-term rewards, has been associated with maladaptive choices in gambling disorder (GD). Delay discounting is known to evolve with age; though no study to date has evaluated the interactions between impulsivity, GD severity and age in treatment-seeking patients. OBJECTIVES We aimed to examine whether associations between delay discounting and impulsivity traits differed between younger and older-aged GD patients. Secondly, we sought to untangle the mediating role of impulsivity in determining gambling behavior in these two age groups. METHODS GD patients (N=335) were evaluated using the UPPS-P Impulsive Behavior Scale and a delay discounting task. Structural Equation Modeling (SEM) was used to explore associations between impulsivity measures and gambling severity in young (18-30years) and old (31-70) GD patients. RESULTS No differences in delay discounting were found between young and old GD patients. Significant correlations between delay discounting and urgency levels (the tendency to act rashly under emotional states) were identified only in the young GD group. Path analyses also revealed both positive and negative urgency to be a mediator of GD severity levels in young GD patients. DISCUSSION AND CONCLUSIONS Significant associations between impulsive choice and positive urgency are only present in young gamblers, suggesting that positive urgency influence choice behavior to a greater degree at younger ages. Implications for targeted interventions are discussed.
Collapse
|
34
|
Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies. Neurosci Biobehav Rev 2017; 78:104-116. [DOI: 10.1016/j.neubiorev.2017.04.025] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 04/18/2017] [Accepted: 04/22/2017] [Indexed: 12/21/2022]
|
35
|
Fauth-Bühler M, Mann K, Potenza MN. Pathological gambling: a review of the neurobiological evidence relevant for its classification as an addictive disorder. Addict Biol 2017; 22:885-897. [PMID: 26935000 DOI: 10.1111/adb.12378] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/09/2015] [Accepted: 01/26/2016] [Indexed: 01/13/2023]
Abstract
In light of the upcoming eleventh edition of the International Classification of Diseases (ICD-11), the question arises as to the most appropriate classification of 'Pathological Gambling' ('PG'). Some academic opinion favors leaving PG in the 'Impulse Control Disorder' ('ICD') category, as in ICD-10, whereas others argue that new data especially from the neurobiological area favor allocating it to the category of 'Substance-related and Addictive Disorders' ('SADs'), following the decision in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders. The current review examines important findings in relation to PG, with the aim of enabling a well-informed decision to be made with respect to the classification of PG as a SAD or ICD in ICD-11. Particular attention is given to cognitive deficits and underlying neurobiological mechanisms that play a role in SADs and ICDs. These processes are impulsivity, compulsivity, reward/punishment processing and decision-making. In summary, the strongest arguments for subsuming PG under a larger SAD category relate to the existence of similar diagnostic characteristics; the high co-morbidity rates between the disorders; their common core features including reward-related aspects (positive reinforcement: behaviors are pleasurable at the beginning which is not the case for ICDs); the findings that the same brain structures are involved in PG and SADs, including the ventral striatum. Research on compulsivity suggests a relationship with PG and SAD, particularly in later stages of the disorders. Although research is limited for ICDs, current data do not support continuing to classify PG as an ICD.
Collapse
Affiliation(s)
- Mira Fauth-Bühler
- Department of Addictive Behavior and Addiction Medicine; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine; Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University; Mannheim Germany
| | - Marc N. Potenza
- Departments of Psychiatry, Neurobiology and Child Study Center and CASAColumbia; Yale University School of Medicine; New Haven CT USA
| |
Collapse
|
36
|
Nautiyal KM, Okuda M, Hen R, Blanco C. Gambling disorder: an integrative review of animal and human studies. Ann N Y Acad Sci 2017; 1394:106-127. [PMID: 28486792 PMCID: PMC5466885 DOI: 10.1111/nyas.13356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/29/2022]
Abstract
Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.
Collapse
Affiliation(s)
- Katherine M. Nautiyal
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Mayumi Okuda
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Rene Hen
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Departments of Neuroscience and Pharmacology, Columbia University, New York, New York
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
| |
Collapse
|
37
|
Abstract
The present review is an overview of previous experimental work on biopsychological aspects of gambling disorder. It includes the topics 1) gambling disorder from the neuroimaging and electroencephalography (EEG) perspective, 2) cognitive, executive functioning, and neuropsychological aspects of gambling disorder, and 3) rodent models of gambling disorder. Penalties and losses in gambling can differ in terms of brain activity. Also, specific patterns of brain activity, brain anatomical traits, EEG responses, and cognitive and executive performance can discriminate pathological gamblers from nonpathological gamblers. Also, pathological gamblers can display dysfunction in such brain areas as the insula, frontal lobe, and orbitofrontal cortex. Pathological gambling is a heterogeneous disorder that can vary depending on the severity of cognition, the style of gambling (strategic or not), the prospect of recovery, proneness to relapse, and proneness to treatment withdrawal. Finally, based on rodent models of gambling, the appropriateness of gambling decision is influenced by the presence of cues, the activity of dopamine receptors, and the activity of some brain areas (infralimbic, prelimbic, or rostral agranular insular cortex). Pathological gamblers differed in terms of frontoparietal brain activation compared to nonpathological gamblers (if winning or losing a game). Pathological gamblers had dysfunctional EEG activity. The severity of gambling was linked to the magnification and content of cognitive distortions. The insula was fundamental in the distortion of cognitions linked to result analysis during gambling activity.
Collapse
|
38
|
Leppink EW, Fridberg DJ, Redden SA, Grant JE. The intersection of obesity and the longitudinal course of problem gambling. Psychiatry Res 2016; 246:707-711. [PMID: 27817903 DOI: 10.1016/j.psychres.2016.10.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/20/2016] [Accepted: 10/27/2016] [Indexed: 11/19/2022]
Abstract
The purpose of this analysis was to assess the potential association between body mass index (BMI) and change in gambling symptom severity in a sample of non-treatment-seeking problem gamblers over a one year period. One-hundred sixty problem gamblers age 18-29 were recruited from the surrounding community and completed assessments of gambling behavior and related variables at baseline and one-year visits. Hierarchical multiple regression was used to examine the association between BMI and symptom change, while accounting for nicotine use, gender, age, and baseline gambling severity. The sample included 102 normal weight, 35 overweight, and 23 obese gamblers. Groups differed in sex, age, gambling risk level, and current nicotine use. There was a significant obesity x baseline gambling risk level interaction for the model predicting changes in GD-YBOCS scores over the 1-year follow-up. Obese participants with gambling disorder showed significantly smaller improvements in symptoms over one year than normal weight participants. Results suggest that obesity predicts smaller improvements in gambling symptoms over time in those meeting criteria for gambling disorder. Future research should clarify the possible influence of impulsivity on this association, and assess the clinical utility of weight management programs in treatments for gambling disorder.
Collapse
Affiliation(s)
- Eric W Leppink
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Daniel J Fridberg
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Sarah A Redden
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| |
Collapse
|
39
|
Comparison of impulsivity in non-problem, at-risk and problem gamblers. Sci Rep 2016; 6:39233. [PMID: 27976705 PMCID: PMC5156948 DOI: 10.1038/srep39233] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/21/2016] [Indexed: 01/15/2023] Open
Abstract
As a non-substance addiction, gambling disorder represents the model for studying the neurobiology of addiction without toxic consequences of chronic drug use. From a neuropsychological perspective, impulsivity is deemed as a potential construct responsible in the onset and development of drug addiction. The objective of this study was to investigate the associations between impulsivity and gambling status in young adults with varying severity of gambling. A sample of 1120 college students, equally divided into non-problem, at-risk and problem gamblers, were administered multiple measures of impulsivity including the UPPSP Impulsive Behaviors Scale (UPPSP), the Barratt Impulsiveness Scale-11 (BIS-11), and the Delay-discounting Test (DDT). Compared with non-problem gamblers, both at-risk gamblers and problem gamblers displayed elevated scores on Negative Urgency, Positive Urgency, Motor Impulsiveness, and Attentional Impulsiveness. Problem gamblers showed higher scores than at-risk gamblers on Positive Urgency. Logistic regression models revealed that only Negative Urgency positively predicted both at-risk gambling and problem gambling compared to non-problem gambling. These results suggest that dimensions of impulsivity may be differentially linked to gambling behavior in young adults, with Negative Urgency putatively identified as an important impulsivity-related marker for the development of gambling disorder, which may provide a better understanding of the pathogenesis.
Collapse
|
40
|
|
41
|
Leppink EW, Redden SA, Chamberlain SR, Grant JE. Cognitive flexibility correlates with gambling severity in young adults. J Psychiatr Res 2016; 81:9-15. [PMID: 27355427 PMCID: PMC5330432 DOI: 10.1016/j.jpsychires.2016.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 06/02/2016] [Accepted: 06/10/2016] [Indexed: 01/30/2023]
Abstract
Although gambling disorder (GD) is often characterized as a problem of impulsivity, compulsivity has recently been proposed as a potentially important feature of addictive disorders. The present analysis assessed the neurocognitive and clinical relationship between compulsivity on gambling behavior. A sample of 552 non-treatment seeking gamblers age 18-29 was recruited from the community for a study on gambling in young adults. Gambling severity levels included both casual and disordered gamblers. All participants completed the Intra/Extra-Dimensional Set Shift (IED) task, from which the total adjusted errors were correlated with gambling severity measures, and linear regression modeling was used to assess three error measures from the task. The present analysis found significant positive correlations between problems with cognitive flexibility and gambling severity (reflected by the number of DSM-5 criteria, gambling frequency, amount of money lost in the past year, and gambling urge/behavior severity). IED errors also showed a positive correlation with self-reported compulsive behavior scores. A significant correlation was also found between IED errors and non-planning impulsivity from the BIS. Linear regression models based on total IED errors, extra-dimensional (ED) shift errors, or pre-ED shift errors indicated that these factors accounted for a significant portion of the variance noted in several variables. These findings suggest that cognitive flexibility may be an important consideration in the assessment of gamblers. Results from correlational and linear regression analyses support this possibility, but the exact contributions of both impulsivity and cognitive flexibility remain entangled. Future studies will ideally be able to assess the longitudinal relationships between gambling, compulsivity, and impulsivity, helping to clarify the relative contributions of both impulsive and compulsive features.
Collapse
Affiliation(s)
- Eric W. Leppink
- University of Chicago, Department of Psychiatry & Behavioral
Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA,Corresponding author (E.W.
Leppink)
| | - Sarah A. Redden
- University of Chicago, Department of Psychiatry & Behavioral
Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Herchel Smith
Building, Robinson Way, Cambridge, CB2 0SZ, UK,Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge
Road, Fulbourne, Cambridge, CB21 5HH, UK
| | - Jon E. Grant
- University of Chicago, Department of Psychiatry & Behavioral
Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA
| |
Collapse
|
42
|
Racial-ethnic related clinical and neurocognitive differences in adults with gambling disorder. Psychiatry Res 2016; 242:82-87. [PMID: 27262266 PMCID: PMC5328399 DOI: 10.1016/j.psychres.2016.05.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 04/23/2016] [Accepted: 05/26/2016] [Indexed: 12/22/2022]
Abstract
Recent epidemiological data suggest that the lifetime prevalence of gambling problems differs depending on race-ethnicity. Understanding variations in disease presentation in blacks and whites, and relationships with biological and sociocultural factors, may have implications for selecting appropriate prevention strategies. 62 non-treatment seeking volunteers (18-29 years, n=18 [29.0%] female) with gambling disorder were recruited from the general community. Black (n=36) and White (n=26) participants were compared on demographic, clinical and cognitive measures. Young black adults with gambling disorder reported more symptoms of gambling disorder and greater scores on a measure of compulsivity. In addition they exhibited significantly higher total errors on a set-shifting task, less risk adjustment on a gambling task, greater delay aversion on a gambling task, and more total errors on a working memory task. These findings suggest that the clinical and neurocognitive presentation of gambling disorder different between racial-ethnic groups.
Collapse
|
43
|
Zack M, Cho SS, Parlee J, Jacobs M, Li C, Boileau I, Strafella A. Effects of High Frequency Repeated Transcranial Magnetic Stimulation and Continuous Theta Burst Stimulation on Gambling Reinforcement, Delay Discounting, and Stroop Interference in Men with Pathological Gambling. Brain Stimul 2016; 9:867-875. [PMID: 27350401 DOI: 10.1016/j.brs.2016.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 05/30/2016] [Accepted: 06/11/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Repeated transcranial magnetic stimulation (rTMS) can reduce cravings and improve cognitive function in substance dependent individuals. Whether these benefits extend to individuals with pathological gambling (PG) is unclear. High-frequency rTMS of the medial prefrontal cortex (PFC) and continuous theta burst stimulation (cTBS) of the right dorsolateral PFC can reduce impulsive choice in healthy volunteers. OBJECTIVE This study aimed to assess the effects of these two protocols on gambling reinforcement and related responses in otherwise healthy men with PG. METHODS Participants (n = 9) underwent active or sham treatments at weekly intervals in a repeated-measures, Latin square design. Subjective and physiological responses were assessed before and after a 15-min slot machine game on each session. Delay discounting and Stroop tasks measured post-game impulsive choice and attentional control. RESULTS Multivariate analysis of covariance, controlling for winnings on the slot machine under each treatment, found that rTMS reduced the post-game increase in Desire to Gamble; cTBS reduced amphetamine-like effects, and decreased diastolic blood pressure. Treatment had no significant univariate effects on bet size or speed of play in the game; however, a multivariate effect for the two indices suggested that treatment decreased behavioral activation. Neither treatment reduced impulsive choice, while both treatments increased Stroop interference. CONCLUSIONS rTMS and cTBS can reduce gambling reinforcement in non-comorbid men with PG. Separate processes appear to mediate gambling reinforcement and betting behavior as against delay discounting and Stroop interference. Interventions that modify risky as opposed to temporal aspects of decision making may better predict therapeutic response in PG.
Collapse
Affiliation(s)
- Martin Zack
- Neuroscience Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Sang Soo Cho
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Jennifer Parlee
- Neuroscience Research Department, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada
| | - Mark Jacobs
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Crystal Li
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Isabelle Boileau
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Antonio Strafella
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| |
Collapse
|
44
|
Figee M, Pattij T, Willuhn I, Luigjes J, van den Brink W, Goudriaan A, Potenza MN, Robbins TW, Denys D. Compulsivity in obsessive-compulsive disorder and addictions. Eur Neuropsychopharmacol 2016; 26:856-68. [PMID: 26774279 DOI: 10.1016/j.euroneuro.2015.12.003] [Citation(s) in RCA: 113] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 08/17/2015] [Accepted: 12/01/2015] [Indexed: 01/05/2023]
Abstract
Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets.
Collapse
Affiliation(s)
- Martijn Figee
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
| | - Tommy Pattij
- Neuroscience Campus Amsterdam, Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Ingo Willuhn
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; The Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Judy Luigjes
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
| | - Wim van den Brink
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Anneke Goudriaan
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Trevor W Robbins
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Damiaan Denys
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands; The Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
| |
Collapse
|
45
|
Chamberlain SR, Lochner C, Stein DJ, Goudriaan AE, van Holst RJ, Zohar J, Grant JE. Behavioural addiction-A rising tide? Eur Neuropsychopharmacol 2016; 26:841-55. [PMID: 26585600 DOI: 10.1016/j.euroneuro.2015.08.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/17/2015] [Accepted: 08/15/2015] [Indexed: 01/21/2023]
Abstract
The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambling disorder. Could other disorders characterised by repetitive behaviours, besides gambling disorder, also be considered 'addictions'? Potential examples include kleptomania, compulsive sexual behaviour, 'Internet addiction', trichotillomania (hair pulling disorder), and skin-picking disorder. This paper seeks to define what is meant by 'behavioural addiction', and critically considers the evidence for and against this conceptualisation in respect of the above conditions, from perspectives of aetiology, phenomenology, co-morbidity, neurobiology, and treatment. Research in this area has important implications for future diagnostic classification systems, neurobiological models, and novel treatment directions.
Collapse
Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust (CPFT), UK.
| | - Christine Lochner
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Dan J Stein
- MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Anna E Goudriaan
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, The Netherlands and Arkin Mental Health, Amsterdam, The Netherlands
| | - Ruth Janke van Holst
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, The Netherlands and Arkin Mental Health, Amsterdam, The Netherlands
| | - Joseph Zohar
- Division of Psychiatry, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| |
Collapse
|
46
|
Li Q, Nan W, Taxer J, Dai W, Zheng Y, Liu X. Problematic Internet Users Show Impaired Inhibitory Control and Risk Taking with Losses: Evidence from Stop Signal and Mixed Gambles Tasks. Front Psychol 2016; 7:370. [PMID: 27014170 PMCID: PMC4794503 DOI: 10.3389/fpsyg.2016.00370] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/29/2016] [Indexed: 11/13/2022] Open
Abstract
According to the balance model of self-regulation, dysfunction of the inhibitory control and reward processing might be a behavioral marker for addiction and problematic behaviors. Although several studies have separately examined the inhibitory control or reward processing of individuals exhibiting problematic Internet use (PIU), no study has explored these two functions simultaneously to examine the potential imbalance of these functions. This study aimed to investigate whether the self-regulatory failure of PIU individuals results from deficits in both inhibitory control [indexed with the stop signal reaction time (SSRT) in a stop signal task] and risk taking with losses (measured as the acceptance rates of risky gables or the ratio of win/loss in a mixed gambles task). The results revealed that PIU individuals, compared with controls, showed decreased SSRT and increased error rates as well as reduced risk taking with losses. Correlational analyses revealed a significant positive relationship between the SSRT and risk taking with losses. These findings suggest that both the inhibitory control and reward functions are impaired in PIU individuals and reveal an association between these two systems. These results strengthen the balance model of self-regulation theory's argument that deficits in inhibitory control and risk taking with losses may assist in identifying risk markers for early diagnosis, progression, and prediction of PIU.
Collapse
Affiliation(s)
- Qi Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences Beijing, China
| | - Weizhi Nan
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of SciencesBeijing, China; University of Chinese Academy of SciencesBeijing, China
| | - Jamie Taxer
- Stanford Psychophysiology Laboratory, Department of Psychology, Stanford University Stanford, CA, USA
| | - Weine Dai
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of SciencesBeijing, China; University of Chinese Academy of SciencesBeijing, China
| | - Ya Zheng
- Department of Psychology, Dalian Medical University Dalian, China
| | - Xun Liu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences Beijing, China
| |
Collapse
|
47
|
Abstract
Cognitive constructs provide conceptual frameworks for transpathological characterization and improved phenotyping of apparently disparate psychiatric groups. This dimensional approach can be applied to the examination of individuals with behavioral addictions, for example, towards gambling, video-games, the internet, food, and sex, allowing operationalization of core deficits. We use this approach to review constructs such as impulsivity, compulsivity, and attention regulation, which may be most relevant, applicable, and successful for the understanding and subsequent treatment of the addictions.
Collapse
|
48
|
Leppink EW, Redden SA, Grant JE. Impulsivity and gambling: A complex clinical association across three measures. Am J Addict 2016; 25:138-44. [PMID: 26848551 DOI: 10.1111/ajad.12341] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/03/2015] [Accepted: 01/18/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Gambling disorder (GD) is often characterized as an impulsive condition, but results to date have varied substantially by the measure used to assess impulsivity and the modality of the assessment. The purpose of this analysis was to assess the clinical associations between three measures of impulsivity (Eysenck impulsiveness questionnaire [EIQ], Barratt impulsiveness scale [BIS], and stop-signal task [SST]) and GD symptom severity. METHODS One hundred and fifty-four participants with a current GD diagnosis were assessed on at least one of the three measures of impulsivity and additional clinical measures of gambling severity. Groups within each domain of the measures were divided using a mean split to compare high and low impulsivity (HI and LI) across clinical and demographic variables. RESULTS Of the included domains, the motor impulsivity domain of the BIS showed multiple clinical differences between the HI and LI groups. The attentional impulsivity domain of the BIS showed limited clinical associations. Surprisingly, HI and LI groups from the SST and EIQ domains did not show any differences in symptom severity. DISCUSSION AND CONCLUSIONS These findings emphasize the complex nature of impulsivity, particularly as it relates to GD. With disparate results between different measures, it will be important to clarify the specific features assessed by each measure, and their optimal use clinically. SCIENTIFIC SIGNIFICANCE This analysis suggests that the motor impulsivity feature of the BIS shows the strongest clinical utility for predicting gambling severity. It also emphasizes the importance of sub-typing impulsivity, rather than considering it a single neurocognitive feature.
Collapse
Affiliation(s)
- Eric W Leppink
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Sarah A Redden
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| |
Collapse
|
49
|
Grant JE, Odlaug BL, Chamberlain SR. Neural and psychological underpinnings of gambling disorder: A review. Prog Neuropsychopharmacol Biol Psychiatry 2016; 65:188-93. [PMID: 26497079 DOI: 10.1016/j.pnpbp.2015.10.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 10/17/2015] [Accepted: 10/20/2015] [Indexed: 01/14/2023]
Abstract
Gambling disorder affects 0.4 to 1.6% of adults worldwide, and is highly comorbid with other mental health disorders. This article provides a concise primer on the neural and psychological underpinnings of gambling disorder based on a selective review of the literature. Gambling disorder is associated with dysfunction across multiple cognitive domains which can be considered in terms of impulsivity and compulsivity. Neuroimaging data suggest structural and functional abnormalities of networks involved in reward processing and top-down control. Gambling disorder shows 50-60% heritability and it is likely that various neurochemical systems are implicated in the pathophysiology (including dopaminergic, glutamatergic, serotonergic, noradrenergic, and opioidergic). Elevated rates of certain personality traits (e.g. negative urgency, disinhibition), and personality disorders, are found. More research is required to evaluate whether cognitive dysfunction and personality aspects influence the longitudinal course and treatment outcome for gambling disorder. It is hoped that improved understanding of the biological and psychological components of gambling disorder, and their interactions, may lead to improved treatment approaches and raise the profile of this neglected condition.
Collapse
Affiliation(s)
- Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Brian L Odlaug
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Samuel R Chamberlain
- Department of Psychiatry, University of UK, & Cambridge and Peterborough NHS Foundation Trust, United Kingdom
| |
Collapse
|
50
|
Ability to use the wait-and-see strategy in pathological gamblers. Psychiatry Res 2015; 230:472-8. [PMID: 26500070 DOI: 10.1016/j.psychres.2015.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 08/03/2015] [Accepted: 09/24/2015] [Indexed: 11/20/2022]
Abstract
Pathological gamblers (PGs) perform differently on neurocognitive tests than do healthy controls (HC). The aim of this study was to assess "waiting ability" - a major components of inhibition control-using a modified Stop Signal Task (SST) in a population of male PGs (N=55), and HCs (N=53). Results indicated no differences between PGs and HCs in reaction times, intra-individual response variability, or number of false alarms and misses. In conclusion, PGs were not impaired in their ability to manipulate their on-line response strategy during the experimental task and were instead able to change their strategy to decrease the number of false alarms. However, much more empirical and theoretical work needs to be carried out in order to understand the key neural basis of impulsivity among PGs.
Collapse
|