The personality profile of chronic alcohol dependent patients with comorbid gambling disorder symptoms [open access article]

Abstract
Background and aims: The importance of personality characteristics in the diagnostics and treatment of gambling disorder (GD) and alcohol use disorder (AUD) is often highlighted in scientific literature. This study aimed to test predictions about the associations of temperament and character in chronic AUD patients with comorbid GD symptoms and without them.

Methods: Chronic AUD patients enrolled from an inpatient clinic were divided in two groups based on cluster analysis, AUD patients with (AUD+GD groups: N = 30) and without (AUD groups: N = 68) GD symptoms. Severity of GD symptoms and personality dimensions (Cloninger’s Temperament and Character Inventory Revised, TCI-R) were assessed. Associations of tested variables were analysed with analysis of covariance, one-sample and independent sample t-tests.

Results: GD symptoms proved to be a clustering factor in terms of personality, where AUD+GD groups expressed a more maladaptive personality profile. Compared to Hungarian normative TCI-R scores, both patient groups showed elevated levels of Harm Avoidance and Novelty Seeking with lower scores of Self-directedness, while the AUD+GD group scored lower on Persistence and Cooperation as well. The AUD+GD group reported significantly higher levels of Harm Avoidance, with lower scores of Reward Dependence compared to the AUD group.

Discussion: Comorbid GD symptom severity is an important factor in chronic AUD, where AUD patients with comorbid GD symptoms exhibited more maladaptive personality constellation than singular AUD patients. These emphasize the need of special attention for comorbid GD symptoms in AUD, since treatment recommendations and prognosis for them may also differ. Link to the article

Citation: I. Kovács, I.K. Pribék, I. Demeter, et al., The personality profile of chronic alcohol dependent patients with comorbid gambling disorder symptoms, Comprehensive Psychiatry (2020), https://doi.org/10.1016/j.comppsych.2020.152183

Response trajectories of gambling severity after cognitive behavioral therapy in young-adult pathological gamblers [open access article]

Abstract
Background and aims: The significant increase in the prevalence of gambling disorder (GD) among young adults in recent years has attracted interest in determining therapeutic efficiency in this sector of the population. The aim of this work was to estimate the response trajectories of gambling severity during the six-month follow-up after a cognitive behavioral therapy (CBT) program in young adult patients and to identify the main variables associated with each trajectory.

Methods: The sample included n 5 192 patients, aged 19–35 years old, seeking treatment for GD. Response trajectories were identified through latent class growth analysis.

Results: Three trajectories emerged: T1 (n 5 118, 61.5%), composed of patients with severe GD at pre-treatment and good evolution to recovery; T2 (n 5 62, 32.3%), with patients with moderate-high GD affectation at baseline and good evolution to recovery; and T3 (n 5 12, 6.3%), with participants with severe baseline GD severity and poor evolution after CBT (Abbott, 2019). The highest risk of poor therapeutic outcomes was related to lower social index positions, high emotional distress, high scores in harm avoidance and low scores in self-directedness.

Discussion and conclusions: Differences in the response trajectories at short-term follow-up after CBT reveal heterogeneity in the samples including young and young-adult GD patients. Patients’ phenotype at baseline should be considered when developing efficient, person-centered intervention programs, which should comprise strategies aimed at increasing emotional regulation capacities, self-esteem and self-efficacy, with the aim of avoiding relapses in the medium-long term after therapy. Link to the article

Citation: Granero, R., Valero-Solis, S., Fernández-Aranda, F., Gómez-Peña, M., Moragas, L., Mena-Moreno. & Murcia, S.J. (2020). Response trajectories of gambling severity after cognitive behavioral therapy in young-adult pathological gamblers. Journal of Behavioral Addiction, 9(1), 140-152. Retrieved from https://akjournals.com

Psychological Vulnerability and Problem Gambling: The Mediational Role of Cognitive Distortions

By Lévesque, D., Sévigny, S., Giroux, I., & Jacques, C.

Abstract: Despite numerous studies demonstrating the influence of cognitive distortions on gambling problem severity, empirical data regarding the role of psychological vulnerability on the latter is limited. Hence, this study assesses the mediating effect of cognitive distortions between psychological vulnerability (personality and mood), and gambling problem severity. It also verifies whether the relationships between these variables differs according to the preferred gambling activity. The sample is composed of 272 male gamblers [191 poker players; 81 video lottery terminal (VLT) players] aged between 18 and 82 years (M = 35.2). Bootstrap analysis results revealed that cognitive distortions mediate the effect of narcissism on gambling problem severity for both groups. The level of depression for VLT players significantly predicted gambling problem severity, both directly and indirectly via the mediating effect of cognitive distortions. Mediation analyses also indicated that narcissism had an indirect impact on problem gambling through cognitive distortions for both groups. These findings suggest that certain vulnerabilities related to personality and mood may influence cognitive distortion intensity and gambling problem severity. In addition, psychological vulnerabilities could differ based on preferred gambling activity. These results may be useful for prevention policies, identifying high risk gamblers and planning psychological interventions.

Lévesque, D., Sévigny, S., Giroux, I., & Jacques, C. (2018). Psychological Vulnerability and Problem Gambling: The Mediational Role of Cognitive Distortions. Journal of Gambling Studies. https://doi.org/10.1007/s10899-017-9740-0

 

Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study

K.W. Müller, K. Wölfling, U. Dickenhorst, M.E. Beutel, J. Medenwaldt, A. Koch.

Purpose: Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched.

Materials and methods: Patients (n = 270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter.

Results: At follow-up, three groups were identified: subjects maintaining full abstinence (41.6%), patients still meeting criteria for gambling disorder (29.2%), and subjects still participating in gambling without meeting the diagnostic criteria for gambling disorder (29.2%). Every group had improvements in functional impairment, abstinent subjects showed the lowest psychopathology. Significant decreases in neuroticism and increases in both extraversion and conscientiousness were found among abstinent subjects but not in patients still meeting criteria for gambling disorder.

Discussion: One year after treatment, a considerable percentage of patients kept on gambling but not all of them were classified with gambling disorder leading to the question if abstinence is a necessary goal for every patient.

Conclusions: The changes of personality in abstinent patients indicate that after surmounting gambling disorder a subsequent maturing of personality might be a protective factor against relapse.

Müller, K. W., Wölfling, K., Dickenhorst, U., Beutel, M. E., Medenwaldt, J., & Koch, A. (n.d.). Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study. European Psychiatry. https://doi.org/10.1016/j.eurpsy.2017.01.326

Relations of Five-Factor Personality Domains to Gambling Motives in Emerging Adult Gamblers: A Longitudinal Study (full text)

Sean P. Mackinnon, Laura Lambe, & Sherry H. Stewart
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.

Gambling, Risk-Taking, and Antisocial Behavior: A Replication Study Supporting the Generality of Deviance

Research suggests that high frequency gambling is a component of the “generality of deviance”, which describes the observation that various forms of risky and antisocial behavior tend to co-occur among individuals. Furthermore, risky and antisocial behaviors have been associated with such personality traits as low self-control, and impulsivity, and sensation-seeking. We conducted a replication (and extension) of two previous studies examining whether high frequency gambling is part of the generality of deviance using a large and diverse community sample (n = 328). This study was conducted as a response to calls for more replication studies in the behavioral and psychological sciences (recent systematic efforts suggest that a significant proportion of psychology studies do not replicate). The results of the present study largely replicate those previously found, and in many cases, we observed stronger associations among measures of gambling, risk-taking, and antisocial behavior in this diverse sample. Together, this study provides evidence for the generality of deviance inclusive of gambling (and, some evidence for the replicability of research relating to gambling and individual differences).

Impact of alcohol consumption on clinical aspects of gambling disorder

Similarities between gambling disorder and substance use disorders have been extensively described. To date, however, few studies using large clinical samples have been carried out that reliably assess the relationship between different levels of alcohol consumption and gambling disorders. The present study aimed to assess the impact of baseline alcohol consumption levels on the clinical profile in a large sample of treatment-seeking individuals. Nine hundred and fifty-one consecutive outpatients diagnosed with gambling disorder according to DSM-IV criteria were compared after being included in three alcohol consumption groups (low risk, abuse and risk of dependence) based on their total raw scores on the AUDIT questionnaire. Results showed a high prevalence of risk of alcohol dependence in GD patients who were immigrants, unemployed, and had a low level of education. A positive linear trend was also found between alcohol consumption level and the prevalence of other current and life-time comorbid mental disorders, and for the presence of drug abuse. Statistically significant differences were found between the three alcohol consumption groups in terms of the evolution and severity of the gambling disorder, self-directedness personality trait, and levels of general psychopathology, hostility and paranoid ideation. In conclusion, the results showed an association between increased alcohol consumption and greater dysfunction.