Trevor Steward1, Gemma Mestre-Bach1, Fernando Fernández-Aranda2, Roser Granero3, José C Perales4, Juan Francisco Navas4, Carles Soriano-Mas5, Marta Baño6, Jose A Fernández-Formoso7, Virginia Martín-Romera8, José M Menchón9, Susana Jiménez-Murcia10. 1. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain. 2. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain. 3. Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès 08193, Barcelona, Spain. 4. Department of Experimental Psychology, University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain; Brain, Mind and Behaviour Research Center (CIMCYC), University of Granada, Campus de Cartuja s/n, 18071 Granada, Spain. 5. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès 08193, Barcelona, Spain; Ciber de Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain. 6. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain. 7. Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain. 8. Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès 08193, Barcelona, Spain. 9. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain; Ciber de Salud Mental (CIBERSAM), Instituto Salud Carlos III, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain. 10. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain; Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Feixa Llarga s/n, Hospitalet de Llobregat 08907, Barcelona, Spain. Electronic address: sjimenez@bellvitgehospital.cat.
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.
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 GDpatients. Secondly, we sought to untangle the mediating role of impulsivity in determining gambling behavior in these two age groups. METHODS:GDpatients (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) GDpatients. RESULTS: No differences in delay discounting were found between young and old GDpatients. 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 GDpatients. 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.
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