Silvia Ronzitti1, Shane W Kraus2, Rani A Hoff3, Massimo Clerici4, Marc N Potenza5. 1. Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA; Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. Electronic address: silvia.ronzitti@yale.edu. 2. VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, 200 Spring Road, Building 5, Room 135B, Bedford, MA 01730, USA. Electronic address: shane.kraus@va.gov. 3. Northeast Program Evaluation Center, Evaluation Division, National Center for PTSD, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. Electronic address: rani.desai@yale.edu. 4. Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Department of Mental Health, San Gerardo Hospital, Monza, Italy. Electronic address: massimo.clerici@unimib.it. 5. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Child Study Center, Connecticut Mental Health Center, Yale School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA. Electronic address: marc.potenza@yale.edu.
Abstract
BACKGROUND: Despite the strong associations between personality disorders and problem/pathological gambling, few studies have investigated the relationships between personality disorders, problem-gambling severity and suicidal thoughts/behaviors. OBJECTIVES: We examined the relationships between problem-gambling severity and personality disorders among individuals with differing levels of suicidality (none, thoughts alone, attempts). METHODS: We analyzed data from 13,543 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) study. First, differences in sociodemographic characteristics and prevalence of personality disorders were analyzed according to problem-gambling severity and suicidality status. Second, we performed a logistic regression to assess among the relationship between problem-gambling severity and DSM-IV Axis II psychopathology according to suicidality level. RESULTS: At-risk or problem/pathological gambling groups showed higher rates of a wide range of personality disorders compared to non-gamblers. Logistic regression showed that at-risk pathological gamblers had a higher odds ratio for any personality disorder in the group with no history of suicidality, particularly for cluster-B personality disorders. Odds ratio interaction analysis identified the relationship between problem-gambling severity and personality disorders, particularly those in cluster B, differ according to suicidality status. CONCLUSIONS: Our findings suggest a complex relationship between suicidality, problem-gambling severity and personality disorders. The stronger relationship between problem-gambling severity and personality disorders in people with no suicidality as compared to some suicidality suggests that some of the relationship between greater problem-gambling severity and Axis II psychopathology is accounted for by increased suicidality. The findings have implications for clinical interventions targeting suicidality in individuals with gambling disorders. Published by Elsevier Ltd.
BACKGROUND: Despite the strong associations between personality disorders and problem/pathological gambling, few studies have investigated the relationships between personality disorders, problem-gambling severity and suicidal thoughts/behaviors. OBJECTIVES: We examined the relationships between problem-gambling severity and personality disorders among individuals with differing levels of suicidality (none, thoughts alone, attempts). METHODS: We analyzed data from 13,543 participants of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) study. First, differences in sociodemographic characteristics and prevalence of personality disorders were analyzed according to problem-gambling severity and suicidality status. Second, we performed a logistic regression to assess among the relationship between problem-gambling severity and DSM-IV Axis II psychopathology according to suicidality level. RESULTS: At-risk or problem/pathological gambling groups showed higher rates of a wide range of personality disorders compared to non-gamblers. Logistic regression showed that at-risk pathological gamblers had a higher odds ratio for any personality disorder in the group with no history of suicidality, particularly for cluster-B personality disorders. Odds ratio interaction analysis identified the relationship between problem-gambling severity and personality disorders, particularly those in cluster B, differ according to suicidality status. CONCLUSIONS: Our findings suggest a complex relationship between suicidality, problem-gambling severity and personality disorders. The stronger relationship between problem-gambling severity and personality disorders in people with no suicidality as compared to some suicidality suggests that some of the relationship between greater problem-gambling severity and Axis II psychopathology is accounted for by increased suicidality. The findings have implications for clinical interventions targeting suicidality in individuals with gambling disorders. Published by Elsevier Ltd.
Authors: Christopher J Hammond; Steven D Shirk; Dawn W Foster; Nicolas B Potenza; Shane W Kraus; Linda C Mayes; Rani A Hoff; Marc N Potenza Journal: Psychol Addict Behav Date: 2019-06-27