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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.
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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.
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2
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Wang Y, Zuo J, Hao W, Wu L, Liu F, Wang Q, He L, Peng P, Zhou Y, Li M, Yang Q, Wang X, Liu T, Potenza MN. Relationships Between Impulsivity, Methamphetamine use Disorder and Gambling Disorder. J Gambl Stud 2023; 39:1635-1650. [PMID: 36973505 DOI: 10.1007/s10899-023-10201-6] [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] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
Methamphetamine use disorder (MAUD) and gambling disorder (GD) frequently co-occur. Individuals with both conditions are typically more difficult to treat than those with either disorder alone. This study aimed to investigate the co-occurrence and clinical characteristics of people with MAUD and GD. Between March 2018 and August 2020, 350 men with methamphetamine use entering a compulsory drug rehabilitation center in Changsha, Hunan Province received semi-structured interviews. Participants completed the Barratt Impulsiveness Scale-11 and provided information on childhood upbringings and drug use characteristics. Independent sample t-tests compared differences between individuals with MAUD and with and without co-occurring GD. Dichotomous logistic regression was used to statistically predict co-occurring GD. The prevalence of GD was 45.1%. Most individuals (39.1% overall) had post-onset methamphetamine use (PoMAU-GD). The number of MAUD symptoms, history of gambling by family members, age of first sexual activity, and non-planning impulsivity statistically predicted PoMAU-GD, jointly explaining 24.0% of the total variance. The regression model fit well (HLχ2 = 5.503, p = 0.70), in which the specificity was 0.80, the sensitivity was 0.64, and the area under the curve was 0.79 (95%CI: 0.75-0.84). This study clarifies the prevalence of and potential risk factors for GD among individuals engaging in compulsory MAUD treatment in China. The high prevalence and associated clinical features of GD in the MAUD group highlight the importance of screening for GD in this population and intervening accordingly.
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Affiliation(s)
- Yingying Wang
- School of Physical Education and Health, Hunan University of Technology and Business, Changsha, China
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Jinsong Zuo
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
- School of Life Science and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Wei Hao
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Lingxiang Wu
- School of Science, Shaoyang University, Shaoyang, China
| | - Feng Liu
- Compulsory detoxification center of Changsha Public Security Bureau, Changsha, Hunan, China
| | - Qianjin Wang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Li He
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Pu Peng
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Brain Hospital of Hunan Province (The Second People's Hospital of Hunan Province), Changsha, China
| | - Manyun Li
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Qian Yang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Xin Wang
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya, National Clinical Research Center for Mental Disorders, Hospital of Central South University, Changsha, China.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
- Connecticut Mental Health Center, New Haven, CT, USA.
- Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA.
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3
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Armoon B, Griffiths MD, Mohammadi R, Ahounbar E. Suicidal Behaviors and Associated Factors Among Individuals with Gambling Disorders: A Meta-Analysis. J Gambl Stud 2023; 39:751-777. [PMID: 36693983 DOI: 10.1007/s10899-023-10188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
The risk for suicidal behaviors including suicide ideations and attempts among individuals with gambling disorder (IWGDs) is high compared to the general population. Little is known about the interplay of mood disorders, alcohol use disorders, and suicidal behaviors among IWGDs. The study aimed to determine the prevalence, sociodemographic characteristics, risky behaviors, mental health disorders, and alcohol use disorders associated with suicide behaviors among IWGDs. Studies published between January 1 1995 and September 1 2022 were obtained from following databases: PubMed, Scopus, Web of Science and Cochrane Library databases. PECOS (population, exposures, comparison, outcome, and study design) criteria were used for selecting studies. The Newcastle-Ottawa Scale (NOS) was used for assessing risk of bias and rated each study in terms of exposure, outcome, and comparability. After initial assessment of 10,243 papers, a total of 39 studies met the eligibility criteria. Among IWGDs, the findings indicated a life-time pooled prevalence rate of 31% for suicide ideations (95% CI, 23-39%), 17% for suicide plans (95% CI, 0-34%), and 16% for suicide attempts (95% CI, 12-20%). Generally, suicide ideations among IWGDs were associated with having any financial debt and having chronic physical illnesses, as well as experiencing depression, mood disorders, and alcohol use disorders. Suicide attempts among IWGDs were associated with being older and having a childhood history of sexual abuse, as well as experiencing depression, mood disorders and alcohol use disorders. Interventions can help to facilitate seeking support among IWGDs by de-stigmatizing mental health disorders as well as improving the quality of care presented to individuals with psychiatric conditions.
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Affiliation(s)
- Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran. .,Department of Public Health, Saveh University of Medical Sciences, Saveh, Iran.
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Rasool Mohammadi
- Social Determinants of Health Research Center, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.,Department of Biostatistics and Epidemiology, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Elaheh Ahounbar
- Orygen, The National Center of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.,Center for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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4
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Estévez A, Jauregui P, Momeñe J, Etxaburu N, Lopez-Gonzalez H. Hopelessness in gambling disorder: relationship with affect, alexithymia and gambling motives in young adults. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2152468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Ana Estévez
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Paula Jauregui
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Janire Momeñe
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Nerea Etxaburu
- Psychology Department, University of Deusto, Bilbao, Spain
| | - Hibai Lopez-Gonzalez
- Department of Library, Information, and Communication, University of Barcelona, Barcelona, Spain
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5
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Applying the Revised Illness Perception Questionnaire (IPQ-R) to Gambling Disorder: Its Psychometric Properties in Chinese Adults. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00837-7] [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: 11/25/2022] Open
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6
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Russell AMT, Browne M, Hing N, Rockloff M, Newall P. Are any samples representative or unbiased? reply to Pickering and Blaszczynski. INTERNATIONAL GAMBLING STUDIES 2021. [DOI: 10.1080/14459795.2021.1973535] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alex M. T. Russell
- Experimental Gambling Research Laboratory, CQUniversity, School of Health, Medical and Applied Sciences, Sydney, Australia
| | - Matthew Browne
- Experimental Gambling Research Laboratory, CQUniversity, School of Health, Medical and Applied Sciences, Bundaberg, Australia
| | - Nerilee Hing
- Experimental Gambling Research Laboratory, CQUniversity, School of Health, Medical and Applied Sciences, Bundaberg, Australia
| | - Matthew Rockloff
- Experimental Gambling Research Laboratory, CQUniversity, School of Health, Medical and Applied Sciences, Bundaberg, Australia
| | - Philip Newall
- Experimental Gambling Research Laboratory, CQUniversity, School of Health, Medical and Applied Sciences, Sydney, Australia
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7
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Do Gender Norms Matter? General Strain Theory and a Gendered Analysis of Gambling Disorder among Chinese Married Couples. J Gambl Stud 2021; 38:123-151. [PMID: 34097184 DOI: 10.1007/s10899-021-10021-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
Despite the emergence of literature on gender differences in gambling problems, few empirical studies have explored how gender norms inform the gender dynamics involved in the development of gambling disorder. This study addresses this research gap by applying general strain theory to gambling disorder across genders. The objectives of this study are twofold. First, we examine the role of gender norms in the social strain-gambling disorder relationship across genders. Second, we explore the extent to which males and females who conform to traditional gender norms are likely to express strain-induced negative emotions that result in gambling disorder. These relationships are examined with data from a cross-sectional survey of 1,620 Chinese married couples in Hong Kong. Our results indicate that gender norms function differently between genders. Specifically, gender norms exacerbate the effect of social strain on gambling disorder in males but mitigate the effect of social strain on gambling disorder in females. In addition, gender norms amplify the effect of strain-induced negative emotions on gambling disorder in males only.
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8
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Carmassi C, Bertelloni CA, Cordone A, Dell'Oste V, Pedrinelli V, Barberi FM, Massimetti E, Bui E, Dell'Osso L. Problematic Use of the Internet in Subjects With Bipolar Disorder: Relationship With Posttraumatic Stress Symptoms. Front Psychiatry 2021; 12:646385. [PMID: 33981258 PMCID: PMC8107280 DOI: 10.3389/fpsyt.2021.646385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/02/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Literature shows a high risk for problematic use of the Internet (PUI) in mood disorders, especially in bipolar disorder (BD). In subjects with BD, traumatic events and posttraumatic stress disorder (PTSD) are related to alcohol or substance use disorder, as well as to gambling disorder. However, little is known about the possible association between traumatic exposure and PUI. The present study was aimed at examining the relationship between PUI and trauma exposure, besides PTSD symptoms, in subjects with BD. Methods: A sample of 113 subjects with BD was screened to putative PUI. Furthermore, they completed the Trauma and Loss Spectrum Self-Report (TALS-SR) to assess traumatic events and posttraumatic stress symptoms. Results: Twenty-four subjects (21.2%) reported putative PUI. Subjects with putative PUI presented significantly higher scores in the TALS-SR domains Potentially Traumatic Events, Re-experiencing, Maladaptive coping, and Arousal, as well as in the TALS-SR total score. In a logistic regression model, a positive association emerged between Potentially Traumatic Events and Arousal TALS-SR domains and putative PUI. Conclusion: One in five patients with BD screened positive for PUI. A significant association between PUI and lifetime traumatic events as well as PTSD symptoms emerged, highlighting the relevance of the comorbidity between PTSD and PUI in subjects with BD.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Enrico Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eric Bui
- Caen University Hospital, University of Caen Normandy, Caen, France
| | - Lliliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Mann K, Lemenager T, Zois E, Hoffmann S, Nakovics H, Beutel M, Vogelgesang M, Wölfling K, Kiefer F, Fauth-Bühler M. Comorbidity, family history and personality traits in pathological gamblers compared with healthy controls. Eur Psychiatry 2020; 42:120-128. [DOI: 10.1016/j.eurpsy.2016.12.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 12/02/2016] [Accepted: 12/03/2016] [Indexed: 12/24/2022] Open
Abstract
AbstractBackgroundWhile DSM-5 classified pathological gambling as an addictive disorder, there is debate as to whether ICD-11 should follow suit. The debate hinges on scientific evidence such as neurobiological findings, family history of psychiatric disorders, psychiatric comorbidity, and personality variables.MethodsIn the “Baden-Württemberg Study of Pathological Gambling”, we compared a group of 515 male pathological gamblers receiving treatment with 269 matched healthy controls. We studied differences in sociodemographic characteristics, gambling-related variables, psychiatric comorbidity (lifetime), family history of psychiatric conditions, as well as personality traits such as impulsivity (Barratt Impulsiveness Scale), sensation seeking (Zuckerman's Sensation Seeking Scale) and the NEO-FFI big five. Personality traits were validated in an age- and ethnicity-matched subsample of “pure” gamblers without any psychiatric comorbidity (including nicotine dependence). Data were analyzed using two-sample t-tests, Chi2 analyses, Fisher's exact test and Pearson correlation analysis, as appropriate. Bonferroni correction was applied to correct for multiple comparisons.ResultsOnly 1% of the gamblers had been diagnosed with an impulse control disorder other than gambling (ICD-10). Notably, 88% of the gamblers in our sample had a comorbid diagnosis of substance dependence. The highest axis I comorbidity rate was for nicotine dependence (80%), followed by alcohol dependence (28%). Early age of first gambling experience was correlated with gambling severity. Compared to first-degree relatives of controls, first-degree relatives of pathological gamblers were more likely to suffer from alcohol dependence (27.0% vs. 7.4%), pathological gambling (8.3% vs. 0.7%) and suicide attempts (2.7% vs. 0.4%). Significant group differences were observed for the NEO-FFI factors neuroticism, agreeableness and conscientiousness. Gamblers were also more impulsive than controls, but did not differ from controls in terms of sensation seeking.ConclusionsOur findings support classifying pathological gambling as a behavioural addiction in the ICD-11. This decision will have a significant impact on the approaches available for prevention (e.g. age limits) and treatment.
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10
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Bischof A, Bischof G, Meyer C, John U, Hodgins DC, Rumpf HJ. Untreated pathological gamblers: who recovers and who does not? INTERNATIONAL GAMBLING STUDIES 2019. [DOI: 10.1080/14459795.2019.1703201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Anja Bischof
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
| | - Christian Meyer
- Institute of Social Medicine and Prevention, University Medicine of Greifswald, Greifswald, Germany
| | - Ulrich John
- Institute of Social Medicine and Prevention, University Medicine of Greifswald, Greifswald, Germany
| | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany
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11
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Perales JC, King DL, Navas JF, Schimmenti A, Sescousse G, Starcevic V, van Holst RJ, Billieux J. Learning to lose control: A process-based account of behavioral addiction. Neurosci Biobehav Rev 2019; 108:771-780. [PMID: 31846653 DOI: 10.1016/j.neubiorev.2019.12.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/24/2022]
Abstract
Learning psycho(bio)logy has developed a solid corpus of evidence and theory regarding behavior control modes. The present article briefly reviews that literature and its influence on recent models in which the transition from goal-directed to compulsive behavior is identified as the main process underlying substance use disorders. This literature is also relevant to non-substance addictive disorders, and serves as basis to propose a restricted definition of behavioral addiction relying on the presence of behavior-specific compulsivity. Complementarily, we consider whether some activities can become disordered while remaining mostly goal-driven. Based on reinforcement learning models, relative outcome utility computation is proposed as an alternative mechanism through which dysfunctional behaviors (even not qualifying as addictive) can override adaptive ones, causing functional impairment. Beyond issues of conceptual delimitation, recommendations are made regarding the importance of identifying individual etiological pathways to dysregulated behavior, the necessity of accurately profiling at-risk individuals, and the potential hazards of symptom-based diagnosis. In our view, the validity of these recommendations does not depend on the position one takes in the nosological debate.
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Affiliation(s)
- José C Perales
- Department of Experimental Psychology, Mind Brain and Behavior Research Center (CIMCYC), University of Granada, Spain
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Australia
| | - Juan F Navas
- Department of Basic Psychology, Autonomous University of Madrid, Spain; Universitat Oberta de Catalunya, Spain.
| | | | - Guillaume Sescousse
- Lyon Neuroscience Research Center - INSERM U1028 - CNRS UMR5292, PSYR2 Team, University of Lyon, France
| | - Vladan Starcevic
- University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Discipline of Psychiatry, Australia
| | - Ruth J van Holst
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Institute for Addiction Research, Netherlands
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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12
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Hellberg SN, Russell TI, Robinson MJF. Cued for risk: Evidence for an incentive sensitization framework to explain the interplay between stress and anxiety, substance abuse, and reward uncertainty in disordered gambling behavior. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:737-758. [PMID: 30357661 PMCID: PMC6482104 DOI: 10.3758/s13415-018-00662-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Gambling disorder is an impairing condition confounded by psychiatric co-morbidity, particularly with substance use and anxiety disorders. Yet, our knowledge of the mechanisms that cause these disorders to coalesce remains limited. The Incentive Sensitization Theory suggests that sensitization of neural "wanting" pathways, which attribute incentive salience to rewards and their cues, is responsible for the excessive desire for drugs and cue-triggered craving. The resulting hyper-reactivity of the "wanting' system is believed to heavily influence compulsive drug use and relapse. Notably, evidence for sensitization of the mesolimbic dopamine pathway has been seen across gambling and substance use, as well as anxiety and stress-related pathology, with stress playing a major role in relapse. Together, this evidence highlights a phenomenon known as cross-sensitization, whereby sensitization to stress, drugs, or gambling behaviors enhance the sensitivity and dopaminergic response to any of those stimuli. Here, we review the literature on how cue attraction and reward uncertainty may underlie gambling pathology, and examine how this framework may advance our understanding of co-mordidity with substance-use disorders (e.g., alcohol, nicotine) and anxiety disorders. We argue that reward uncertainty, as seen in slot machines and games of chance, increases dopaminergic activity in the mesolimbic pathway and enhances the incentive value of reward cues. We propose that incentive sensitization by reward uncertainty may interact with and predispose individuals to drug abuse and stress, creating a mechanism through which co-mordidity of these disorders may emerge.
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Affiliation(s)
- Samantha N Hellberg
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA
- University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Trinity I Russell
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA
- National Institutes on Drug Abuse, Baltimore, MD, USA
| | - Mike J F Robinson
- Psychology Department and the Neuroscience and Behavior Program, Wesleyan University, 207 High Street, Middletown, CT, 06457, USA.
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Barrada JR, Navas JF, Ruiz de Lara CM, Billieux J, Devos G, Perales JC. Reconsidering the roots, structure, and implications of gambling motives: An integrative approach. PLoS One 2019; 14:e0212695. [PMID: 30794642 PMCID: PMC6386301 DOI: 10.1371/journal.pone.0212695] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 02/07/2019] [Indexed: 11/19/2022] Open
Abstract
Rationale and method Accurately identifying motives to gamble is crucial in the functional analysis of gambling behavior. In this study, a data-driven approach was followed to clarify the factor structure underlying a pool of motives for gambling, selected from the Gambling Motives Questionnaire–Financial (GMQ-F), and the Reasons for Gambling Questionnaire (RGQ), in a sample of regular problem and non-problem gamblers. Additionally, the role of gambling motives in the relationship between root behavioral activation/inhibition systems (BIS/BAS) and gambling severity, frequency, and preferences was explored using structural equation modelling (SEM). Results and conclusions The present study identified Social, Financial, and Fun/thrill-related gambling motives factors, but also a fourth factor in which some positive and negative reinforcement-based motives were grouped into a single and broader Affect regulation factor. This Affect regulation factor shared variance both with BIS and BAS-related measures, and was the only direct predictor of disordered gambling symptoms. The Fun/thrill factor was directly related to frequency of participation in high-arousal, skill-based games, and all factors were related to participation in lower-arousal, chance games (with Social motives negatively predicting both participation in the latter and total severity). In the SEM model, measures of BIS/BAS sensitivity were connected to gambling behavior only through gambling motives. Based on measures of items’ specificity, a shortened Spanish scale (the brief Gambling Motives Inventory, bGMI) is proposed to assess gambling motives in accordance with the observed 4-factor structure.
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Affiliation(s)
- Juan R. Barrada
- Departamento de Psicología y Sociología, Universidad de Zaragoza, Teruel, Spain
| | - Juan F. Navas
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- * E-mail:
| | | | - Joël Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Centre for Excessive Gambling, Lausanne University Hospital, Lausanne, Switzerland
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Gaëtan Devos
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, Bron, France
- Scientific Research and Publication Cell (CRPS), Le Beau Vallon, Namur, Belgium
| | - José C. Perales
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
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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.
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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.
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Brand E, Rodriguez-Monguio R, Volber R. Gender differences in mental health and substance use disorders and related healthcare services utilization. Am J Addict 2018; 28:9-15. [PMID: 30536669 DOI: 10.1111/ajad.12826] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/08/2018] [Accepted: 11/02/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Pathological gambling often co-occurs with other psychiatric disorders. Gender differences in treatment-seeking behaviors among patients with pathological gambling diagnosis remain poorly understood. This study assessed gender differences in healthcare services utilization in patients seeking treatment for pathological gambling, substance use, and mental health co-occurring conditions. METHODS Study data were derived from a representative sample of the Massachusetts All Payers Claims Database for the period 2009-2013. Descriptive analyses were performed by gender using group t-tests and Pearson's chi-square tests. Bootstrap analysis was used to account for skewed distribution of healthcare services utilization data. Multiple linear regressions were used to evaluate the association between healthcare services utilization and gender while controlling for patient's age, county, and ICD-9-CM diagnosis codes. RESULTS Over two-thirds of the patients were males. Moreover, two in five patients seeking treatment had pathological gambling as principal or primary diagnosis. Females had a significantly greater number of three or more co-occurring psychiatric conditions than males. Having a diagnosis of episodic mood disorder, neurotic disorder, or adjustment reaction significantly increased the utilization of healthcare services for both genders. Females had a greater utilization of healthcare services than males for the same psychiatric diagnosis. DISCUSSION AND CONCLUSIONS Healthcare services utilization significantly varies by gender and type of mental health and substance use diagnosis. There are significant differences by gender in the utilization of healthcare services for the same psychiatric disorders. SCIENTIFIC SIGNIFICANCE There is a need to address gender differences in psychiatric conditions and their related healthcare needs. (Am J Addict 2019;28:9-15).
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Affiliation(s)
- Evelyn Brand
- Mathematica Policy Research, Ann Arbor, Michigan
| | - Rosa Rodriguez-Monguio
- School of Pharmacy, University of California San Francisco, San Francisco, California.,Medication Outcomes Center, University of California San Francisco, San Francisco, California
| | - Rachel Volber
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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Executive Function in Problem Gamblers with and without History of Depression. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-017-9804-5] [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
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Abstract
This study examined whether distinct subgroups could be identified among a sample of non-treatment-seeking problem and pathological/disordered gamblers (PG) using Blaszczynski and Nower's (Addiction 97:487-499, 2002) pathways model (N = 150, 50% female). We examined coping motives for gambling, childhood trauma, boredom proneness, risk-taking, impulsivity, attention-deficit/hyperactivity disorder (ADHD), and antisocial personality disorder as defining variables in a hierarchical cluster analysis to identify subgroups. Subgroup differences in gambling, psychiatric, and demographic variables were also assessed to establish concurrent validity. Consistent with the pathways model, our analyses identified three gambling subgroups: (1) behaviorally conditioned (BC), (2) emotionally vulnerable (EV), and (3) antisocial-impulsivist (AI) gamblers. BC gamblers (n = 47) reported the lowest levels of lifetime depression, anxiety, gambling severity, and interest in problem gambling treatment. EV gamblers (n = 53) reported the highest levels of childhood trauma, motivation to gamble to cope with negative emotions, gambling-related suicidal ideation, and family history of gambling problems. AI gamblers (n = 50) reported the highest levels of antisocial personality disorder and ADHD symptoms, as well as higher rates of impulsivity and risk-taking than EV gamblers. The findings provide evidence for the validity of the pathways model as a framework for conceptualizing PG subtypes in a non-treatment-seeking sample, and underscore the importance of tailoring treatment approaches to meet the respective clinical needs of these subtypes.
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Kim HS, Cassetta BD, Hodgins DC, Tomfohr-Madsen LM, McGrath DS, Tavares H. Assessing the Relationship between Disordered Gamblers with Psychosis and Increased Gambling Severity: The Mediating Role of Impulsivity. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:370-377. [PMID: 28884607 PMCID: PMC5971405 DOI: 10.1177/0706743717730825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Recent research suggests that disordered gambling and psychosis co-occur at higher rates than expected in the general population. Gamblers with psychosis also report greater psychological distress and increased gambling severity. However, the mechanism by which psychosis leads to greater gambling symptomology remains unknown. The objective of the present research was to test whether impulsivity mediated the relationship between comorbid psychosis and gambling severity. METHOD The sample consisted of 394 disordered gamblers voluntarily seeking treatment at a large university hospital in São Paulo, Brazil. A semistructured clinical interview (Mini-International Neuropsychiatric Interview) was used to diagnosis the presence of psychosis by registered psychiatrists. Severity of gambling symptoms was assessed using the Gambling Symptom Assessment Scale, and the Barratt Impulsiveness Scale-11 provided a measure of impulsivity. RESULTS Of the sample, 7.2% met diagnostic criteria for psychosis. Individuals with a dual diagnosis of psychosis did not report greater gambling severity. Conversely, dual diagnoses of psychosis were associated with greater levels of impulsivity. Higher levels of impulsivity were also associated with greater gambling severity. Importantly, support for our hypothesised mediation model was found such that impulsivity mediated the association between disordered gambling and psychosis and gambling severity. CONCLUSION Impulsivity appears to be a transdiagnostic process that may be targeted in treatment among disordered gamblers with a dual diagnosis of psychosis to reduce problematic gambling behaviours.
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Affiliation(s)
- Hyoun S. Kim
- Department of Psychology, University of Calgary, Calgary, Alberta
| | | | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, Alberta
| | | | | | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, Butantã, São Paulo, Brazil
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Kim HS, von Ranson KM, Hodgins DC, McGrath DS, Tavares H. Demographic, psychiatric, and personality correlates of adults seeking treatment for disordered gambling with a comorbid binge/purge type eating disorder. EUROPEAN EATING DISORDERS REVIEW 2018; 26:508-518. [PMID: 29797743 DOI: 10.1002/erv.2606] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/26/2018] [Accepted: 05/06/2018] [Indexed: 02/06/2023]
Abstract
Preliminary evidence suggests that binge/purge type eating disorders and gambling disorder may commonly co-occur. However, this dual-diagnosis population remains understudied. The present research examined the prevalence rates and correlates of binge/purge type eating disorders (i.e., bulimia nervosa, binge-eating disorder, and anorexia nervosa binge/purge type) among adults seeking treatment for their gambling (N = 349). In total, 11.5% of the sample (n = 40) met criteria for a binge/purge type eating disorder, most commonly bulimia nervosa (n = 33). There was a higher preponderance of binge/purge type eating disorders in women. People with a comorbid binge/purge type eating disorder reported more days gambling, gambling-related cognitive distortions, impulsivity, suicidality, and other current psychiatric comorbidities including addictive behaviours. These findings suggest that binge/purge type eating disorders in people seeking treatment for gambling may be more common than previously believed. Furthermore, the increased psychopathology among people with binge/purge type eating disorder and gambling disorder identify vulnerabilities of this dual-diagnosed population that may require clinical attention.
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Affiliation(s)
- Hyoun S Kim
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Hermano Tavares
- Impulse Control Disorders Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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Zois E, Kiefer F, Vollstädt-Klein S, Lemenager T, Mann K, Fauth-Bühler M. Amygdala grey matter volume increase in gambling disorder with depression symptoms of clinical relevance: a voxel-based morphometry study. INTERNATIONAL GAMBLING STUDIES 2018. [DOI: 10.1080/14459795.2018.1452276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Evangelos Zois
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
| | - Tagrid Lemenager
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
| | - Karl Mann
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
| | - Mira Fauth-Bühler
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg , Heidelberg, Germany
- iwp Institute for Economic Psychology, FOM University of Applied Sciences for Economics and Management , Essen, Germany
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Rémond JJ, Romo L. Analysis of Gambling in the Media Related to Screens: Immersion as a Predictor of Excessive Use? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E58. [PMID: 29301311 PMCID: PMC5800157 DOI: 10.3390/ijerph15010058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/25/2017] [Accepted: 12/27/2017] [Indexed: 11/18/2022]
Abstract
This study investigates the intricacies between the player interface proposed by the screens, (in particular on smartphone applications or in video games) and gambling. Recent research indicates connections between "immersion" and excessive screen practice. We want to understand the causal-effects between online gambling and the "immersion" variable and understand their relationship and its contingencies. This article empirically investigates whether and how it is possible to observe immersion with its sub-dimensions in gambling on different screens. The objective of this study was to analyze: (1) the costs and benefits associated with gambling practice on screens (2) the link between gambling practice and screen practice (video game, Internet, mobile screen); (3) to observe the propensity to immersion for individuals practicing gambling on screens; and (4) to examine the comorbidities and cognitive factors associated with the practice of gambling on screen. A total of 432 adults (212 men, 220 women), recruited from Ile-de-France (France), responded to a battery of questionnaires. Our study suggests that immersion variables make it possible to understand the cognitive participation of individuals towards screens in general, the practice of gambling on screens and the excessive practice of screens.
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Affiliation(s)
- Jean-Jacques Rémond
- Psychology Department, Laboratory EA CLIPSYD 4430, Paris Nanterre University, 92000 Nanterre, France.
| | - Lucia Romo
- Psychology Department, Laboratory EA CLIPSYD 4430, Paris Nanterre University, 92000 Nanterre, France.
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Ronzitti S, Kraus SW, Hoff RA, Potenza MN. Stress moderates the relationships between problem-gambling severity and specific psychopathologies. Psychiatry Res 2018; 259:254-261. [PMID: 29091825 PMCID: PMC5742031 DOI: 10.1016/j.psychres.2017.10.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/21/2017] [Accepted: 10/21/2017] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to examine the extent to which stress moderated the relationships between problem-gambling severity and psychopathologies. We analyzed Wave-1 data from 41,869 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Logistic regression showed that as compared to a non-gambling (NG) group, individuals at-risk gambling (ARG) and problem gambling (PPG) demonstrated higher odds of multiple Axis-I and Axis-II disorders in both high- and low-stress groups. Interactions odds ratios were statistically significant for stress moderating the relationships between at-risk gambling (versus non-gambling) and Any Axis-I and Any Axis-II disorder, with substance-use and Cluster-A and Cluster-B disorders contributing significantly. Some similar patterns were observed for pathological gambling (versus non-gambling), with stress moderating relationships with Cluster-B disorders. In all cases, a stronger relationship was observed between problem-gambling severity and psychopathology in the low-stress versus high-stress groups. The findings suggest that perceived stress accounts for some of the variance in the relationship between problem-gambling severity and specific forms of psychopathology, particularly with respect to lower intensity, subsyndromal levels of gambling. Findings suggest that stress may be particularly important to consider in the relationships between problem-gambling severity and substance use and Cluster-B disorders.
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Affiliation(s)
- Silvia Ronzitti
- Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, USA.
| | - Shane W. Kraus
- VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, 200 Spring Road, Building 5, Room 135B, Bedford MA, 01730, United States
| | - Rani A. Hoff
- Northeast Program Evaluation Center; Director, Evaluation Division, National Center for PTSD, West Haven, CT USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Marc N. Potenza
- Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA,Department of Neuroscience, Child Study Center, National Center on Addiction and Substance Abuse, and Connecticut Mental Health Center
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Kovács I, Richman MJ, Janka Z, Maraz A, Andó B. Decision making measured by the Iowa Gambling Task in alcohol use disorder and gambling disorder: a systematic review and meta-analysis. Drug Alcohol Depend 2017; 181:152-161. [PMID: 29055269 DOI: 10.1016/j.drugalcdep.2017.09.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/21/2017] [Accepted: 09/22/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIMS Gambling disorder (GD) and alcohol use disorder (AD) have similar features, such as elevated impulsivity and decision-making deficits, which are directly linked to relapse and poor therapeutic outcomes. Our aim was to assess decision-making characteristics in GD and AD patients compared to healthy controls (HC) based on one of the most frequently used measures of decision-making: the Iowa Gambling Task (IGT). METHODS In our systematic literature search of three databases, we identified 1198 empirical articles that mentioned decision-making deficits with the use of the IGT in patients diagnosed with either AD or GD. Possible effects were calculated using meta-analysis. In the end, 17 studies (including 1360 participants) were suitable for inclusion in the meta-analysis reporting data for 23 group contrasts. RESULTS The random effects estimate indicated impaired IGT performance in both AD patients (N=500; d=-0.581, CI:-89.5<δ<-26.6%) and an even greater deficit in GD patients (N=292; d=-1.034, CI:-156.1<δ<50.7%) compared to HCs. Sampling variances were calculated for both AD (v1=0.0056) and GD groups (v2=0.0061), from which the z-score was calculated (z=-21.0785; p<0.05), which indicates a statistically significant difference between AD and GD groups. No significant moderating effects of age, gender or education were found. CONCLUSIONS There is enough evidence to support that decision-making deficit associated with addictive disorders, and that the deficit is more expressed in gambling disorder than in alcohol use disorder. Impaired decision-making plays an important part in poor therapeutic outcomes, thus provides a promising opportunity for cognitive intervention.
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Affiliation(s)
- Ildikó Kovács
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave. 57, H-6725, Szeged, Hungary.
| | - Mara J Richman
- Institute of Psychology, Eötvös Loránd University, Izabella Str. 46, H-1064, Budapest, Hungary
| | - Zoltán Janka
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave. 57, H-6725, Szeged, Hungary
| | - Aniko Maraz
- Institute of Psychology, Eötvös Loránd University, Izabella Str. 46, H-1064, Budapest, Hungary
| | - Bálint Andó
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave. 57, H-6725, Szeged, Hungary
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Mackinnon SP, Lambe L, Stewart SHSH. Relations of Five-Factor Personality Domains to Gambling Motives in Emerging Adult Gamblers: A Longitudinal Study. JOURNAL OF GAMBLING ISSUES 2017. [DOI: 10.4309/jgi.2016.34.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
At least three types of gambling motives have been proposed: coping motives (gambling to reduce negative affect), enhancement motives (gambling to enhance positive affect), and social motives (gambling to increase social affiliation). Few studies have examined the underlying personality traits that give rise to these different motivations. The present study tests the longitudinal link between changes in five-factor model personality domains and gambling motives among emerging adults. A sample of 679 emerging adults (Mage = 18.90 years; 51.8% female) was recruited as part of the Manitoba Longitudinal Study of Young Adults (MLSYA). Participants completed self-report questionnaires across four measurement occasions, with each measurement 12–18 months apart. The NEO Five Factor Inventory was administered at waves 1 and 3, and the Gambling Motives Questionnaire was administered at wave 4. Data were analyzed using longitudinal structural equation modeling. Emerging adults who experienced increases in neuroticism had higher coping motives at a subsequent wave. Those who experienced increases in extraversion had higher enhancement and social motives. Those who experienced increases in agreeableness had lower social and coping motives. Changes in conscientiousness and openness were unrelated to any of the motives after controlling for all other variables. Extraversion and agreeableness predicting social motives were the most robust findings. A multigroup analysis showed the measurement and structural models did not differ by sex. Longitudinal changes in five-factor model personality domains were linked to specific motives for gambling in a theoretically-expected fashion. Results have implications for personality-targeted interventions for problem gamblers.Au moins trois types de motivations au jeu ont été proposées : l’adaptation (jouer pour atténuer une émotion négative), la stimulation (jouer pour stimuler une émotion positive) et les rapports sociaux (jouer pour accroître ses liens sociaux). Peu d’études ont examiné les traits de personnalité associés à ces différentes motivations. La présente étude met à l’épreuve le lien longitudinal entre des changements touchant les domaines de la personnalité (selon un modèle à cinq facteurs NEO Pi-R) et les motivations au jeu chez les jeunes adultes. Un échantillon de 679 jeunes adultes (Mâge = 18,9 ans; 51,8 % de femmes) a été recruté dans le cadre d’une étude longitudinale sur les jeunes adultes du Manitoba (Manitoba Longitudinal Study of Young Adults [MLSYA]). Les participants ont rempli des questionnaires d’autoévaluation lors de quatre séances de mesure espacées d’un intervalle de 12 à 18 mois entre chacune. Le test de personnalité à cinq facteurs NEO Pi-R a été administré aux participants pendant les séances 1 et 3, et ceux-ci ont répondu au questionnaire sur les motivations au jeu lors de la séance 4. Les données ont été analysées au moyen d’une modélisation par équation structurelle longitudinale. Chez les jeunes adultes dont la personnalité a connu un accroissement du domaine du névrosisme, les motivations relevant de l’adaptation étaient également plus élevées. Ceux chez qui le domaine de l’extraversion s’est accru, les motivations étaient de l’ordre de la stimulation et de la recherche de rapports sociaux, alors que ceux pour qui le domaine de l’agréabilité a augmenté, les motivations relevant de l’adaptation et de la recherche de rapports sociaux étaient moins importantes. Des changements dans les domaines de la conscience et de l’ouverture n’étaient associés à aucun type de motivation, après un rajustement pour toutes les autres variables. La constatation la plus robuste de l’étude consiste dans le fait que les domaines de l’extraversion et de l’agréabilité sont des variables explicatives des motivations d’ordre social. Une analyse de groupes multiples a montré que les mesures et les modèles structuraux ne donnaient lieu à aucune différence quant au sexe. Il existe un lien entre les changements longitudinaux touchant les domaines de la personnalité du modèle à cinq facteurs NEO Pi-R et les motivations propres au jeu, conformément à ce que prévoyait la théorie. Ces résultats ont une incidence sur les interventions auprès des joueurs à problèmes axées sur la personnalité.
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Shensa A, Escobar-Viera CG, Sidani JE, Bowman ND, Marshal MP, Primack BA. Problematic social media use and depressive symptoms among U.S. young adults: A nationally-representative study. Soc Sci Med 2017; 182:150-157. [PMID: 28446367 DOI: 10.1016/j.socscimed.2017.03.061] [Citation(s) in RCA: 181] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/20/2017] [Accepted: 03/31/2017] [Indexed: 02/07/2023]
Abstract
RATIONALE Depression is the leading cause of disability worldwide. The suggested association between social media use (SMU) and depression may be explained by the emerging maladaptive use pattern known as problematic social media use (PSMU), characterized by addictive components. OBJECTIVE We aimed to assess the association between PSMU and depressive symptoms-controlling for overall time and frequency of SMU-among a large sample of U.S. young adults. METHODS In October 2014, participants aged 19-32 (N = 1749) were randomly selected from a nationally-representative U.S. probability-based panel and subsequently invited to participate in an online survey. We assessed depressive symptoms using the validated Patient-Reported Outcomes Measurement Information System (PROMIS) brief depression scale. We measured PSMU using an adapted version of the Bergen Facebook Addiction Scale to encompass broader SMU. Using logistic regression models, we tested the association between PSMU and depressive symptoms, controlling for time and frequency of SMU as well as a comprehensive set of socio-demographic covariates. RESULTS In the multivariable model, PSMU was significantly associated with a 9% increase in odds of depressive symptoms (AOR [adjusted odds ratio] = 1.09; 95% CI [confidence interval]: 1.05, 1.13; p < 0.001.) Increased frequency of SMU was also significantly associated with increased depressive symptoms, whereas SMU time was not (AOR = 1.01; 95% CI: 1.00, 1.01; p = 0.001 and AOR = 1.00; 95% CI: 0.999-1.001; p = 0.43, respectively). CONCLUSION PSMU was strongly and independently associated with increased depressive symptoms in this nationally-representative sample of young adults. PSMU largely explained the association between SMU and depressive symptom, suggesting that it may be how we use social media, not how much, that poses a risk. Intervention efforts aimed at reducing depressive symptoms, such as screenings for maladaptive SMU, may be most successful if they address addictive components and frequency-rather than time-of SMU.
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Affiliation(s)
- Ariel Shensa
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States.
| | - César G Escobar-Viera
- Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States; Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jaime E Sidani
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nicholas D Bowman
- Department of Communication Studies, West Virginia University, Morgantown, WV, United States
| | - Michael P Marshal
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Brian A Primack
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States; Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA, United States
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Ledgerwood DM, Arfken CL. Assessing the Need for Higher Levels of Care Among Problem Gambling Outpatients. J Gambl Stud 2017; 33:1263-1275. [DOI: 10.1007/s10899-017-9677-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lister JJ, Milosevic A, Ledgerwood DM. Personality traits of problem gamblers with and without alcohol dependence. Addict Behav 2015; 47:48-54. [PMID: 25864135 DOI: 10.1016/j.addbeh.2015.02.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/23/2015] [Accepted: 02/27/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A large proportion of individuals with gambling disorder also present with a history of alcohol dependence, but few studies have directly examined the relationship between these two conditions. This study's primary and secondary aims were to 1) examine the relationship of personality traits to co-occurring lifetime (current/past) alcohol dependence status, while 2) accounting for differences in gambling characteristics and co-occurring psychiatric disorders among problem/pathological gamblers recruited from the community. METHODS Problem/pathological gamblers (N=150) completed measures of personality traits and gambling characteristics (e.g., gambling severity, gambling involvement, delayed discounting of monetary rewards), and were clinically interviewed for co-occurring psychiatric disorders. RESULTS A co-occurring lifetime diagnosis of alcohol dependence (n=61, 40.7%) was associated with lower personality scores for Control, Well-Being, Achievement, Traditionalism, and Harm Avoidance, as well as higher scores for Alienation (Tellegen & Waller, 1994) in bivariate analyses. Problem/pathological gamblers with lifetime alcohol dependence reported greater lifetime gambling severity, greater past-year gambling involvement, steeper delayed discounting, and a greater likelihood of current and lifetime substance dependence, lifetime antisocial personality disorder, and current unipolar mood disorders. Multivariate analyses indicated that lower Control, Traditionalism, and Well-Being and a co-occurring lifetime substance dependence diagnosis best accounted for a co-occurring lifetime alcohol dependence diagnosis in problem/pathological gamblers. CONCLUSIONS Problem/pathological gamblers with co-occurring lifetime alcohol dependence demonstrate addictive behavior across multiple domains and report a personality style characterized by hopelessness, impaired control, and resistance to externally-motivated treatment approaches. Implications for the treatment of these complex cases are discussed.
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