Pathological gambling and impulsivity: an Italian study.

AimsTo identify the prevalence of pathological gambling (PG) in patients with Parkinson's disease (PD) from studies using comparable methodology to the best general population estimates. Additionally, to collate case-control based...

Individuals suffering from pathological gambling (PG) show impaired decision making, but it is still not clear how this impairment is related to other traits and neuroanatomical characteristics. In this study, we investigated how the influence of PG on decision making (1) is connected to different impulsivity facets and (2) how it is related to gray matter volume (GMV) in various brain regions. Twenty-eight diagnosed PG patients and 23 healthy controls completed the cups task to measure decision making. In this task, participants had to decide between safe and risky options, which varied in expected value (EV) between risk advantageous, equal EV, and risk disadvantageous choices. A delay discounting task and the Barrant Impulsiveness Scale were applied to assess multiple impulsivity facets. In addition, structural magnetic resonance images were acquired. In comparison to the control group PG patients demonstrated more deficits in decision making, indicated by less EV sensitivity, but there was no significant difference in number of overall risky choices. Also, PG patients showed increased impulsivity in nearly every dimension. Results revealed (1) a positive correlation between decision making impairments and non-planning impulsivity but no significant relation to other impulsivity facets. Although we found no GMV differences between PG patients and controls, (2) a regions of interest analysis showed a correlation between medial orbitofrontal GMV and EV sensitivity in PG patients. Our findings showed that (1) the association between decision making and impulsivity can also be found in PG patients, but only for certain impulsivity facets. This suggests that it is essential to consider measuring different dimensions, when investigating impulsivity in a PG sample. Secondly, our findings revealed that (2) dysfunctional decision making—particularly the component of risk evaluation—is related to decreased GMV in the medial orbitofrontal cortex, a brain region concerned with processing of rewards. Interestingly, we did not find more risky choices for PG patients, and thus, we assume that decision making deficits in PG are primarily related to risk evaluation, not risk seeking, which is in line with our GMV findings.

Gambling severity is associated with both childhood trauma and pathological dissociation in casino gamblers. A mediational model shows that the effect of childhood trauma on gambling severity is entirely mediated by pathological dissociation. From a clinical point of view, our results highlight the importance of assessing, and possibly treating, dissociative symptoms in individuals with gambling disorder.

Veterans are at an elevated risk for suicide, with notably high suicide rates over recent years. Additionally, veterans are also at elevated risk for a variety of psychiatric and mental health comorbidities, one of them being gambling disorder (GD). However, limited research has examined the relationship between GD and suicidality among veteran populations. The present study links suicidality with GD including comorbid diagnoses, gambling preferences, gambling severity, and impulsivity in a sample of military veterans with GD. This study was an archival analysis of data from 603 United States veterans who received inpatient treatment for GD at a Veterans Affairs Hospital between the years of 2010 and 2024. Gambling disorder and comorbid diagnoses were determined at intake through clinician interviews and assessment. The South Oaks Gambling Screen (SOGS) and the Urgency, Premeditation, Perseverance, Sensation Seeking, and Positive Urgency Scale (UPPS-P) assessed gambling severity and impulsivity. Chi-squares, independent t-tests, and logistical regressions were conducted. Additional tests were conducted on a subset of 157 veterans for which suicide attempt reason was reported. Suicide attempt history is extremely common in veterans receiving treatment for gambling disorder, with over 40% reporting such a history. Veterans who reported a past suicide attempt were more likely to be nonstrategic gamblers, to have a current psychiatric diagnosis, and to report greater levels of impulsivity. Women veterans were especially likely to report a suicide attempt history (60% of women in our sample). Lastly, veterans who reported their suicide attempt was related to gambling were more likely to be a strategic gambler, have greater gambling severity, and impulsivity. Veterans with GD are particularly vulnerable to increased risk for suicidality and its associations. Our findings point to the importance of customizing treatment for veterans with GD to target these potential risk profiles (e.g., gambling preferences, heightened impulsivity facets, and comorbidities) and therefore decrease the risks of suicidality.

Background Pathological gambling (PG) is an important public health problem. We assessed the prevalence of PG and problem (at-risk) gambling in a random sample of Iowa adults and compared the results to survey data collected in 1989 and 1995. The goal of this study was to examine whether continued expansion of gambling venues is associated with increased rates of problematic gambling behavior. Methods A random digit dialing telephone screening was conducted in eastern Iowa of men and women age =18. Respondents were administered the South Oaks Gambling Screen (SOGS) to assess lifetime gambling behavior. Demographic and clinical variables were collected. Results A total of 356 respondents (147 men, 209 women) completed the SOGS, and all reported lifetime gambling participation. PG (SOGS =5) was found in 5 (1.4%) and problem gambling (SOGS = 3, 4) in 8 (2.2%) respondents. Disordered gambling (SOGS =3) was found in 13 (3.6%) respondents. Risk factors for disordered gambling included age (odds ratio [OR] = 0.64 per 10-year age increase), income (OR = 0.82 per $10,000 increase), minority group status (OR = 5.75), number of lifetime gambling activities (OR = 1.27), and having ever gambled =$100 (OR = 13.3). Overall gambling participation was significantly less in the current sample, compared with data collected in 1995. Conclusions Recent gambling participation was less than in 1995, despite the continued expansion of gaming opportunities. Disordered gambling was associated with younger age, lower income, and minority group status. The results are consistent with Shaffer's “adaptation” hypothesis, which posits that following an initial increase in gambling participation, problematic gambling stabilizes at a lower level.

Gambling behavior is partly the result of varied motivations leading individuals to participate in gambling activities. Specific motivational profiles are found in gamblers, and gambling motives are closely linked to the development of cognitive distortions. This cross-sectional study aimed to predict cognitive distortions from gambling motives in poker players. The population was recruited in online gambling forums. Participants reported gambling at least once a week. Data included sociodemographic characteristics, the South Oaks Gambling Screen, the Gambling Motives Questionnaire-Financial and the Gambling-Related Cognition Scale. This study was conducted on 259 male poker gamblers (aged 18–69 years, 14.3% probable pathological gamblers). Univariate analyses showed that cognitive distortions were independently predicted by overall gambling motives (34.8%) and problem gambling (22.4%) (p < .05). The multivariate model, including these two variables, explained 39.7% of cognitive distortions (p < .05). The results associated with the literature data highlight that cognitive distortions are a good discriminating factor of gambling problems, showing a close inter-relationship between gambling motives, cognitive distortions and the severity of gambling. These data are consistent with the following theoretical process model: gambling motives lead individuals to practice and repeat the gambling experience, which may lead them to develop cognitive distortions, which in turn favor problem gambling. This study opens up new research perspectives to understand better the mechanisms underlying gambling practice and has clinical implications in terms of prevention and treatment. For example, a coupled motivational and cognitive intervention focused on gambling motives/cognitive distortions could be beneficial for individuals with gambling problems.

Does craving increase gambling severity? The role of attentional bias

This study examines the influence of the selection of screening tests and cut-off scores on the prevalence of gambling disorders by simultaneously administering several tests to the same sample. The survey was conducted online in 2021, with 2,000 respondents distributed equally across two prefectures in Japan. Four screening tests were administered simultaneously: the South Oaks Gambling Screen (SOGS), Problem Gambling Severity Index (PGSI), Lie/Bet questionnaire, and Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). The prevalence at the original cut-off scores was markedly different, with the SOGS (10.3%) showing the highest prevalence and the DSM-5 (3.8%) showing the lowest prevalence. Adjusting the cut-off score from 5 to 4 for the SOGS increased prevalence by 2.9%, while changing the PGSI cut-off score from 8 to 7 only increased it by 0.5%. This is the first study in Japan to simultaneously compare the scores for multiple screening tests and cut-off scores regarding gambling disorders. The SOGS screens more individuals with a possible gambling disorder than other measures, and altering the cut-off score significantly affected its prevalence. Selecting appropriate screening tests and cut-off scores is crucial to accurately assessing the prevalence of possible gambling disorders.

I 1928 Freud published an essay about the pathological gambling of Fyodor Dostoyevsky, the Russian author who wrote a novel called The Gambler based on his personal experience. However, not until 1980 was pathological gambling acknowledged by the American Psychiatric Association as a psychiatric disorder of impulse control. The classification of pathological gambling as a psychiatric disorder was followed by the development of uniform diagnostic criteria, a valid, reliable screening tool—the South Oaks Gambling Screen (SOGS) (1)—and preliminary neurobiological studies that implicated serotonergic dysfunction in pathological gambling (2). However, few psychiatrists have had substantial experience in the prevention, assessment, and treatment of pathological gambling. Moreover, despite rapid increases in gambling opportunities in the last decade, public health, clinical, and social implications of gambling behavior have been understudied, particularly among adolescents. We would like to argue that the current lack of knowledge about and failure to respond to adolescent gambling behavior is similar to the situation that existed 30 years ago in the area of another addiction, substance abuse. We fear that failure to draw attention to the needs of adolescents at high risk for problem and pathological gambling may result in an increase in the number of pathological gamblers in the next generation. Such an increase would be accompanied by emotional and financial damage to these individuals and their families and by legal and financial costs to the community.

Introduction: Previous research has identified a relation between impulsiveness and substance use, as well as performance on certain tests of executive functioning. However, no prior research has investigated these relations in Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn (OEF/OIF/OND) veterans with and without a history of mild traumatic brain injury (mTBI). Method: The present study utilized a sample of 127 veterans (55 controls, 72 mTBI). Relations among health behaviors, cognition, and domain scores (attentional, motor, and nonplanning impulsiveness) of the Barratt Impulsiveness Scale–11 (BIS–11) were examined using regression analyses. Results: Nonplanning impulsiveness was associated with higher Alcohol Use Disorders Identification Test (AUDIT) score. Attentional and motor impulsiveness were not associated with performance on any measures of behavior or cognition. The relationship between nonplanning impulsiveness and alcohol misuse was not influenced by history of mTBI. Conclusions: These results partially support previous findings and indicate that an association between impulsiveness and problematic behaviors exists in OEF/OIF/OND veterans, regardless of TBI history.

The primary aim of this article is to critically review the clinical features and comorbidities, epidemiology, pathophysiology, and treatment of impulse control disorder (ICD) associated with Parkinson disease (PD). References for this review were identified by searches of PubMed from 1980 until January 2008 with the terms "Parkinson disease," "impulse control," "pathologic gambling,""hypersexuality," "levodopa," and "dopamine agonists." Articles were also identified through searches of the authors' own files. Only papers published in English were reviewed. Pathologic gambling has emerged as one of the most prominent ICDs, although hypersexuality, compulsive shopping and other manifestations of obsessive-compulsive disorder may also dominate PD-related behavioral manifestations. Affected patients may demonstrate a pattern of self-escalation of dopaminergic medication dosing which may lead to a state of dependency. Patients most commonly affected by ICD, such as pathologic gambling and hypersexuality, are males who develop PD at a younger age, and those with a previous history of mood disorder, alcohol abuse, or obsessive-compulsive disorder. Dopaminergic drugs, particularly dopamine agonists, play an important role in triggering these nonmotor symptoms.

Pathological gambling was officially defined as a psychiatric illness by APA in 1980. The authors report on the results of a state-wide study in New York that indicated significant differences between problem gamblers in the general population and pathological gamblers entering publicly funded treatment programs. These results, based on telephone interviews using standardized assessment instruments with 1,000 persons, raise serious clinical and programmatic issues regarding the development and organization of appropriate services for pathological gamblers. They also point to the fact that large segments of the general population are not receiving needed services.

This study aimed to describe the 12-month period prevalence and risk factors for suicidal ideation and behaviour in a cohort of patients with pathological gambling attending a treatment service. Seventy-nine people with a diagnosis of pathological gambling received a mail out survey that included questions on postulated risk factors for suicidal ideation and behaviour, the modified Suicide Ideation Scale (SIS), the South Oaks Gambling Screen (SOGS), the Beck Depression Inventory (BDI) and the CAGE. A total of 54.4% of the surveys were returned completed. There were 81.4% who showed some suicidal ideation and 30.2% reported one or more suicide attempts in the preceding 12 months. Suicidal ideation and behaviours were positively correlated with the gambling severity (SOGS scores), the presence of debt attributed to gambling, alcohol dependence and depression (BDI). Suicidal ideation/behaviour was not significantly associated with gender and living arrangements, nor a history of receiving treatment for depression during the preceding 12 months. People with pathological gambling attending a treatment service had higher levels of suicidal ideation and behaviour than previous studies. Pathological gambling should be seen as a chronic condition with a similar risk for suicidal ideation and behaviour as other mental illnesses. Counselling services, general practitioners and mental health services should screen for gambling problems when assessing risk after suicide attempts and for suicide risk in patients presenting with gambling problems and co-morbid depression, alcohol abuse and a previous suicide attempt.

Gambling participation rates among older adults (65+ years) have been increasing in recent years. Very few studies have compared older and younger gamblers on gambling motivation and problem gambling. This study compared 41 male and 63 female older gamblers (66-87 years; median 73) to 20 male and 85 female younger gamblers (17-34 years; median 20) in New Zealand on gambling involvement, gambling motives and number of gambling related problems in the previous 12 months. The questionnaire included the Gambling Motivation Scale (GMS) and the Revised South Oaks Gambling Screen (SOGS-R) of current problem gambling. There were between-group age differences but no significant gender or gender by age interaction effects. While older adults had significantly lower scores on all the measures, except they gambled more frequently, for both groups frequency of gambling, number of activities, largest amount spent in a single session and all motives were correlated with SOGS-R scores. Preferences for electronic gaming machines and bingo were related to SOGS-R scores for both age groups. Hierarchical regression analysis showed that after statistically controlling for age, gambling involvement and other motives, tension release uniquely predicted SOGS-R scores. For both age groups, increasing severity of problem gambling is more likely to be associated with releasing tension than with winning money or seeking sensation.

In this first study on gambling in Brazil, pathological and non-pathological gamblers were surveyed at three bingo clubs, one video poker club, and one horse-racing club in São Paulo. The South Oaks Gambling Screen and a questionnaire were administered to 171 subjects. When compared to nonpathological gamblers, a significantly higher proportion of pathological gamblers played cards, horse races, video poker, and dice in their lifetime. The two groups were similar with respect to socially acceptable games such as lotteries, bingo, sports, and the stock market. No significant differences were observed in drug consumption except for a higher lifetime consumption of tobacco among pathological gamblers. Only 4.9% of the gamblers sought help for gambling-related problems, suggesting that gambling is not generally perceived as a mental health problem by these subjects.