Clinical and Personality Characteristics of Problem and Pathological Gamblers With and Without Symptoms of Adult ADHD.

The study examined the differential clinical and personality characteristics of problem and pathological gamblers (PPGs) with and without clinically significant symptoms of adult attention deficit hyperactive disorder (ADHD). Adults (N = 150, n = 75 women) with PPG were assessed by the SCID-IV, Conners' Adult ADHD Rating Scales, Multidimensional Personality Questionnaire, Gambling Motivation Questionnaire, and the Barratt Impulsiveness Scale. PPGs who reported symptoms of ADHD were more likely to be male, endorse psychiatric comorbidities (i.e., alcohol dependence, anxiety disorders, and antisocial personality disorder), report maladaptive personality traits (i.e., higher negative emotionality and lower positive emotionality), as well as higher impulsivity (attention impulsiveness, motor impulsiveness, and nonplanning impulsiveness). PPGs with symptoms of ADHD reported gambling for social, coping, and enhancement reasons. A multivariate binary logistic regression revealed that sex, higher scores on social reasons for gambling, and lack of premeditation were associated with an increased likelihood of reporting ADHD symptoms. The findings demonstrate important differences of PPGs with symptoms of ADHD and provide information for treatment consideration.

Subtyping Non-treatment-seeking Problem Gamblers Using the Pathways Model.

This study examined whether distinct subgroups could be identified among a sample of non-treatment-seeking problem and pathological/disordered gamblers (PG) using Blaszczynski and Nower's (Addiction 97:487-499, 2002) pathways model (N = 150, 50% female). We examined coping motives for gambling, childhood trauma, boredom proneness, risk-taking, impulsivity, attention-deficit/hyperactivity disorder (ADHD), and antisocial personality disorder as defining variables in a hierarchical cluster analysis to identify subgroups. Subgroup differences in gambling, psychiatric, and demographic variables were also assessed to establish concurrent validity. Consistent with the pathways model, our analyses identified three gambling subgroups: (1) behaviorally conditioned (BC), (2) emotionally vulnerable (EV), and (3) antisocial-impulsivist (AI) gamblers. BC gamblers (n = 47) reported the lowest levels of lifetime depression, anxiety, gambling severity, and interest in problem gambling treatment. EV gamblers (n = 53) reported the highest levels of childhood trauma, motivation to gamble to cope with negative emotions, gambling-related suicidal ideation, and family history of gambling problems. AI gamblers (n = 50) reported the highest levels of antisocial personality disorder and ADHD symptoms, as well as higher rates of impulsivity and risk-taking than EV gamblers. The findings provide evidence for the validity of the pathways model as a framework for conceptualizing PG subtypes in a non-treatment-seeking sample, and underscore the importance of tailoring treatment approaches to meet the respective clinical needs of these subtypes.

Psychological Characteristics of Problem Gamblers With and Without Mood Disorder.

OBJECTIVE: Problem and pathological gamblers are significantly more likely to experience mood disorders, compared with the general population. Our study examined the relation of psychological characteristics (personality, trait impulsiveness, and gambling motives) to current co-occurring mood disorder (major depression and dysthymia) status among problem and pathological gamblers. METHOD: Problem and pathological gamblers (N = 150) underwent a clinical interview to assess current co-occurring mood disorders; participants completed measures of problem gambling severity, personality, impulsiveness, and gambling motives. RESULTS: Problem and pathological gamblers with a current co-occurring mood disorder were more likely to be female, older, and to report higher lifetime and past-year gambling severity. A co-occurring mood disorder was associated with higher personality scores for alienation and stress reaction, lower scores for well-being, social closeness, and control, as well as higher impulsiveness scores for urgency and lack of premeditation, and lower sensation seeking scores. Participants with a co-occurring mood disorder also reported higher coping motives for gambling. Multivariate logistic regression analyses demonstrated that personality factors (lower social closeness and higher alienation) contributed to the greatest likelihood of being diagnosed with a co-occurring mood disorder. CONCLUSIONS: Mood disorders frequently co-occur with problem and pathological gambling, and they are associated with greater gambling severity. These findings highlight that interpersonal facets of personality contribute substantially to co-occurring mood disorder status. Implications for treatment will be discussed.

Clinical and personality characteristics associated with post traumatic stress disorder in problem and pathological gamblers recruited from the community.

Problem and pathological gamblers (PPGs) are more likely than the general population to experience co-occurring psychiatric problems. However, the problem gambling literature has largely overlooked the importance of trauma and post-traumatic stress disorder (PTSD) as a prevalent co-occurring condition among PPGs. This study examined clinical differences between PPGs with and without a history of co-occurring PTSD. Lifetime PPGs (N = 150) recruited from community sources completed clinical assessments including measures of problem gambling severity, co-occurring psychiatric conditions, gambling motivations and personality traits. Over 19% of the participants met criteria for a lifetime diagnosis of PTSD. Those presenting with PTSD histories were more likely to be women, and were more likely to have lifetime substance use disorder (abuse and/or dependence) and substance dependence, lifetime major depressive disorder, current dysthymic disorder, and lifetime and current anxiety disorder. Those with lifetime PTSD also were more likely to use gambling as a way to cope with negative emotions and experienced greater negative emotionality. Few PPGs (16%) had ever sought treatment for their gambling problems. PTSD is a prevalent condition among individuals with lifetime PPG recruited from the community, and is associated with greater psychiatric co-morbidity among these populations. More research is needed to further understand the relationship between gambling and trauma, and better outreach is needed to encourage these individuals to seek treatment.

Executive function in pathological gamblers and healthy controls.

Executive function (EF) deficits may underlie some of the impulse control problems seen in pathological gambling. Pathological gamblers (PGs, n = 45) and controls (n = 45) were compared on several measures of EF (including measures of response inhibition, working memory, cognitive flexibility and perseveration, planning and decision-making), as well as memory and intelligence tests to examine whether PGs evidence EF dysfunction. Compared with controls, PGs exhibited specific deficits on measures of planning and decision-making. PGs also exhibited relative deficits on a measure of perseveration, but this deficit was no longer significant after controlling for group differences in intelligence. These results suggest that PGs may experience deficits on specific components of EF.

Physical health status in relation to self-forgiveness and other-forgiveness in healthy college students.

We extended prior research on the medical health-correlates of forgiving others by examining the relationship between self-forgiveness, other-forgiveness and health. Results derived from a cross-sectional survey of 266 healthy undergraduates showed that these dimensions of forgiveness were positively related to perceived physical health. Regression analysis revealed that self-forgiveness uniquely predicted a significant amount of variance in perceived physical health, and predicted more variance than did other-forgiveness. These results are discussed in light of the limitations of the current study and directions for future research.

Personality traits of problem gamblers with and without alcohol dependence.

INTRODUCTION: A large proportion of individuals with gambling disorder also present with a history of alcohol dependence, but few studies have directly examined the relationship between these two conditions. This study's primary and secondary aims were to 1) examine the relationship of personality traits to co-occurring lifetime (current/past) alcohol dependence status, while 2) accounting for differences in gambling characteristics and co-occurring psychiatric disorders among problem/pathological gamblers recruited from the community. METHODS: Problem/pathological gamblers (N=150) completed measures of personality traits and gambling characteristics (e.g., gambling severity, gambling involvement, delayed discounting of monetary rewards), and were clinically interviewed for co-occurring psychiatric disorders. RESULTS: A co-occurring lifetime diagnosis of alcohol dependence (n=61, 40.7%) was associated with lower personality scores for Control, Well-Being, Achievement, Traditionalism, and Harm Avoidance, as well as higher scores for Alienation (Tellegen & Waller, 1994) in bivariate analyses. Problem/pathological gamblers with lifetime alcohol dependence reported greater lifetime gambling severity, greater past-year gambling involvement, steeper delayed discounting, and a greater likelihood of current and lifetime substance dependence, lifetime antisocial personality disorder, and current unipolar mood disorders. Multivariate analyses indicated that lower Control, Traditionalism, and Well-Being and a co-occurring lifetime substance dependence diagnosis best accounted for a co-occurring lifetime alcohol dependence diagnosis in problem/pathological gamblers. CONCLUSIONS: Problem/pathological gamblers with co-occurring lifetime alcohol dependence demonstrate addictive behavior across multiple domains and report a personality style characterized by hopelessness, impaired control, and resistance to externally-motivated treatment approaches. Implications for the treatment of these complex cases are discussed.

The subtyping of pathological gambling: a comprehensive review.

Pathological gamblers (PGs) present with various forms of psychopathology, maladaptive personality traits, and gambling motivations. Some suggest that this variability supports classification of PGs into distinct subtypes. Subtyping models are thought to have implications for understanding pathological gambling (PG) etiology and treatment outcomes. This review evaluates the existing literature on the subtyping of PGs based on psychopathology, personality, and/or motivation for gambling. We conclude that three PG subtypes consistently emerge from the empirical literature, and should be the focus of future study. These subtypes closely parallel the three types of gamblers presented in Blaszczynski and Nower's (2002) conceptual pathways model. We suggest that future investigations on PG subtypes build upon the theoretical framework of the pathways model, but also address the limitations of prior studies.