Metacognition in Pathological Gambling and Its Relationship with Anxious and Depressive Symptomatology.

Gambling disorder is associated with elevated comorbidity with depressive and anxious disorders, and one variable that might help in the understanding of this association is metacognition. In the present study, the relationship between gambling and metacognition and the mediating role of metacognition in the relationship between gambling and depressive and anxious symptomatology were assessed. The sample comprised 124 pathological gamblers from centers that assist pathological gamblers and 204 participants from the general population. The results showed that pathological gamblers had higher levels of depressive and anxious symptomatology. Additionally, pathological gamblers had higher scores for positive beliefs about worry, negative beliefs of uncontrollability and danger, and beliefs about the need to control thoughts; these factors were also positively correlated with depressive and anxious symptomatology. Metacognition also fully mediated the association between gambling and depressive and anxious symptomatology. These results suggest that metacognition could contribute to explaining gambling disorder and the symptomatology associated with it.

Pathological Gambling and Associated Drug and Alcohol Abuse, Emotion Regulation, and Anxious-Depressive Symptomatology.

Background and aims Pathological gambling is associated with comorbid disorders, such as anxiety, depression, and drug and alcohol abuse. Difficulties of emotion regulation may be one of the factors related to the presence of addictive disorders, along with comorbid symptomatology in pathological gamblers. Therefore, the aim of this study was to evaluate the difficulties of emotion regulation, drug and alcohol abuse, and anxious and depressive symptomatology in pathological gamblers, and the mediating role of difficulties of emotion regulation between anxiety and pathological gambling. Methods The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Pathological gambling (SOGS), difficulties of emotion regulation (DERS), drug and alcohol abuse (MUTICAGE CAD-4), and anxious and depressive symptomatology (SA-45) were measured. Student's t, Pearson's r, stepwise multiple linear regression and multiple mediation analyses were conducted. The study was approved by an Investigational Review Board. Results Relative to non-gamblers, pathological gamblers exhibited greater difficulties of emotion regulation, as well as more anxiety, depression, and drug abuse. Moreover, pathological gambling correlated with emotion regulation difficulties, anxiety, depression, and drug abuse. Besides, emotion regulation difficulties correlated with and predicted pathological gambling, drug and alcohol abuse, and anxious and depressive symptomatology. Finally, emotion regulation difficulties mediated the relationship between anxiety and pathological gambling controlling the effect of age, both when controlling and not controlling for the effect of other abuses. Discussion and conclusions These results suggest that difficulties of emotion regulation may provide new keys to understanding and treating pathological gambling and comorbid disorders.