Núria Mallorquí-Bagué1, Cristina Vintró-Alcaraz2, Antonio Verdejo-García3, Roser Granero4, Fernando Fernández-Aranda5, Pablo Magaña6, Teresa Mena-Moreno2, Neus Aymamí6, Mónica Gómez-Peña6, Amparo Del Pino-Gutiérrez7, Gemma Mestre-Bach2, José M Menchón8, Susana Jiménez-Murcia9. 1. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Addictive Behaviours Unit, Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain. Electronic address: nmallorqui@live.com. 2. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain. 3. Monash Institute of Cognitive and Clinical Neurosciences, Monash University, 18 Innovation Walk, 3800 Melbourne, VIC, Australia. 4. Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, C/Fortuna Edificio B, Bellaterra, Cerdanyola del Vallès, 08193 Barcelona, Spain. 5. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain. 6. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. 7. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain. 8. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Salud Mental (CIBERsam), Instituto de Salud Carlos III (ISCIII), Madrid, C/Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain. 9. Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, C/Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, C/Feixa Llarga s/n, Hospitalet de Llobregat, 08907 Barcelona, Spain. Electronic address: sjimenez@bellvitgehospital.cat.
Abstract
BACKGROUND: Impulsivity and cognitive distortions are hallmarks of gambling disorder (GD) but it remains unclear how they contribute to clinical phenotypes. This study aimed to (1) compare impulsive traits and gambling-related distortions in strategic versus non-strategic gamblers and online versus offline gamblers; (2) examine the longitudinal association between impulsivity/cognitive distortions and treatment retention and relapse. METHODS: Participants seeking treatment for GD (n = 245) were assessed for gambling modality (clinical interview), impulsive traits (Urgency, Premeditation, Perseverance and Sensation Seeking [UPPS] scale) and cognitive distortions (Gambling Related Cognitions Scale) at treatment onset, and for retention and relapse (as indicated by the clinical team) at the end of treatment. Treatment consisted of 12-week standardized cognitive behavioral therapy, conducted in a public specialized clinic within a general public hospital. RESULTS: Strategic gamblers had higher lack of perseverance and gambling-related expectancies and illusion of control than non-strategic gamblers, and online gamblers had generally higher distortions but similar impulsivity to offline gamblers. Lack of perseverance predicted treatment dropout, whereas negative urgency and distortions of inability to stop gambling and interpretative bias predicted number of relapses during treatment. CONCLUSIONS: Individuals with online and strategic GD phenotypes have heightened gambling related biases associated with premature treatment cessation and relapse. Findings suggest that these GD phenotypes may need tailored treatment approaches to reduce specific distortions and impulsive facets.
BACKGROUND: Impulsivity and cognitive distortions are hallmarks of gambling disorder (GD) but it remains unclear how they contribute to clinical phenotypes. This study aimed to (1) compare impulsive traits and gambling-related distortions in strategic versus non-strategic gamblers and online versus offline gamblers; (2) examine the longitudinal association between impulsivity/cognitive distortions and treatment retention and relapse. METHODS:Participants seeking treatment for GD (n = 245) were assessed for gambling modality (clinical interview), impulsive traits (Urgency, Premeditation, Perseverance and Sensation Seeking [UPPS] scale) and cognitive distortions (Gambling Related Cognitions Scale) at treatment onset, and for retention and relapse (as indicated by the clinical team) at the end of treatment. Treatment consisted of 12-week standardized cognitive behavioral therapy, conducted in a public specialized clinic within a general public hospital. RESULTS: Strategic gamblers had higher lack of perseverance and gambling-related expectancies and illusion of control than non-strategic gamblers, and online gamblers had generally higher distortions but similar impulsivity to offline gamblers. Lack of perseverance predicted treatment dropout, whereas negative urgency and distortions of inability to stop gambling and interpretative bias predicted number of relapses during treatment. CONCLUSIONS: Individuals with online and strategic GD phenotypes have heightened gambling related biases associated with premature treatment cessation and relapse. Findings suggest that these GD phenotypes may need tailored treatment approaches to reduce specific distortions and impulsive facets.
Authors: Ana Estévez; Paula Jauregui; Janire Momeñe; Laura Macia; Hibai López-González; Iciar Iruarrizaga; Conchi Riquelme-Ortiz; Roser Granero; Fernando Fernández-Aranda; Cristina Vintró-Alcaraz; Gemma Mestre-Bach; Lucero Munguía; Neus Solé-Morata; Susana Jiménez-Murcia Journal: Int J Environ Res Public Health Date: 2021-03-10 Impact factor: 3.390