Cognitive Distortions in Gamblers and Non-gamblers of a Representative Spanish Sample.

Cognitive biases or distortions related to gambling, present in all people, are considered a relevant factor in the development of gambling-related problems. OBJECTIVE: to establish whether the presence of these biases or cognitive distortions, in gamblers and non-gamblers, is related to the presence of gambling problems. METHOD: 3000 people aged 18-81 years, representative of the Spanish adult population, underwent a structured survey. RESULTS: the presence of distortions was relevant to distinguish gamblers according to their level of gambling engagement and problems. There is a constant and significant tendency to have more cognitive distortions as gambling problems increase. But not all distortions have the same ability to distinguish between the different groups of gamblers. The results seem to group gamblers into three groups according to the presence of cognitive distortions, from less to more: (1) non-gamblers, (2) low-risk and at-risk gamblers, and (3) problem and pathological gamblers. The relevance of this research and its practical implications for both treatment and prevention work is discussed.

Measurement instruments of online gaming disorder in adolescents and young people according to DSM-5 criteria: a systematic review. / Instrumentos de medida del trastorno de juego en internet en adolescentes y jóvenes según criterios DSM-5: una revisión sistemática.

The inclusion of Internet Gaming Disorder (IGD) in the DSM-5 has generated controversy over its diagnosis, and it therefore seems necessary to establish a clear cut-off point to identify when excessive gaming becomes problematic. Such identification is especially difficult in adolescents and young people, who frequently dedicate a great deal of time to online games. The goal of this systematic review was to analyze the instruments developed to assess IGD in adolescents and young people since its inclusion in the DSM-5. We identified 13 studies which included validations of seven assessment instruments for IGD in adolescents and young people. Each instrument and its validations in different languages are described. In comparison to previous reviews, a lower diversity of assessment instruments, a reduction in the number of items and a more uniform form of measurement was observed, maintaining high internal consistency and good criterion validity. However, problems related to sample selection, the lack of sensitivity and specificity studies, and the establishment of cut points and profiles of gamers remain. Advances in the analysis of the psychometric qualities of the instruments and their validation in different countries are needed, and cultural differences should be considered in order to allow the prevalence of this problem to be compared.

La inclusión del Trastorno de Juego en Internet (TJI) en el DSM-5 ha generado polémica sobre su diagnóstico, no obstante parece necesario establecer un punto de corte claro para identificar cuando este juego excesivo se convierte en problemático. Esta identificación se hace especialmente difícil en adolescentes y jóvenes, entre los que suele ser frecuente la dedicación a este tipo de juegos. El objetivo de esta revisión sistemática fue analizar los instrumentos que desarrollados para la evaluación del TJI en adolescentes y jóvenes desde su inclusión en el DSM-5. Se identificaron 13 estudios que incluían validaciones de 7 instrumentos de evaluación del TJI en adolescentes y jóvenes. Se describió cada instrumento y sus validaciones en distintos idiomas. En relación con revisiones previas, se observó una menor diversidad de instrumentos de evaluación, una reducción en el número de ítems y una forma de medida más uniforme, manteniéndose una alta consistencia interna y una buena validez de criterio. Sin embargo, siguen presentes los problemas referidos a la selección de muestras, la falta de estudios de sensibilidad y especificidad, y el establecimiento de puntos de corte y perfiles de jugadores. Se recomienda avanzar en el análisis de las cualidades psicométricas de los instrumentos, y su validación en distintos países para considerar las diferencias culturales y poder comparar la presencia de este problema.

Video Game Playing and Internet Gaming Disorder: A Profile of Young Adolescents.

In recent times, growing concern has arisen regarding the utilization of technology, video games, and the emergence of internet gaming disorder (IGD), particularly among young adolescents. This worry arises from the ambiguity in distinguishing between "normal" and "problematic" video game behavior, despite efforts to establish clear criteria for defining both. The goal of this study is to outline distinct profiles of adolescent video game players and identify variables associated with their gaming practices that correlate with problematic gaming. The study utilizes a substantial sample of adolescents drawn from a representative cross-section of educational institutions in the city of Madrid, ranging in age from 12 to 16 years. In total, 1516 participants (75%) acknowledged engaging in video game activities. The research delves into characterizing prevailing profiles of video game participants within this cohort and scrutinizes the profile that aligns with issues of IGD. In summary, approximately three-quarters of young adolescents participate in video gaming, with males constituting the majority. Typically, participants immerse themselves in action genre games for over three days per week, with males exhibiting a higher frequency than their female counterparts. Elevated gaming frequency correlates with heightened IGD scores, particularly among females. Young adolescents show a preference for game consoles (males) and mobile phones (females) and often play alone at home. Specific factors such as the device used, online mode, company, and gaming location impact the IGD scores. These profiles aim to assist families and educators in recognizing potential risk behaviors and IGD concerns; however, it is crucial to emphasize the necessity for case-specific screening and evaluation before deliberating on such behaviors.

Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis.

BACKGROUND: Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse. METHOD: A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference. RESULTS: The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP. CONCLUSIONS: The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.

Spanish Validation and Scoring of the Internet Gaming Disorder Scale - Short-Form (IGDS9-SF).

Since the inclusion of the Internet Gaming Disorder (IGD) in the Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), a short nine items test, has become one of the most used standardized instruments for its psychometric evaluation. This study presents a validation and psychometric evaluation of the Spanish version of the IGDS9-SF. A sample of 2173 videogame players between 12 and 22 years old, comprising both genders, was employed, achieved with a randomized selection process from educational institutions in the city of Madrid. Participants completed the adapted version of the IGDS9-SF, the General Health Questionnaire (GHQ-12) and a negative cognitions scale associated with videogame use, as well as sociodemographic data and frequency of videogame play. A unifactorial structure with sufficient reliability and internal consistency was found through exploratory and confirmatory analyses. In addition, the instrument was found to have good construct validity; the scoring of the IGDS9-SF were found to show a positive association with gaming frequency, with general health problems, and to a greater extent, with problematic cognitions with regard to videogames. Factorial invariance was found concerning the age of participants. However, even though the factorial structure was consistent across genders, neither metric nor scalar invariance were found; for this reason, we present a scale for the whole sample and a different one for gender. These results suggest that this Spanish version of the IGDS9-SF is a reliable and valid instrument, useful to evaluate the severity of IGD in Spanish students, and we provide a scoring scale for measurement purposes.

Psychometric properties of a brief on-line screening instrument to detect at-risk gamblers.

BACKGROUND: Gambling facilitates the development of psychopathological problems in some gamblers. Rapid and easy detection of the presence of these problems, or the risk of their development, will allow early action at the beginning of the problem, including preventive action. For this purpose, we developed the “Sistema de Cribado de Riesgo de Problemas de Juegos” (SCRI-PJ [Risk of Gambling Problems Screening System]), an on-line instrument for the detection of people who have, or may develop, gambling problems. The goal of this work is to present and validate the SCRI-PJ. METHOD: 85 people with gambling problems undergoing treatment and 119 people from the general population were assessed with the SCRI-PJ and the DSM-RT Diagnostic Criteria for Pathological Gambling questionnaire. RESULTS: the SCRI-PJ showed high internal consistency (α= .96), sensitivity (94.2%) specificity (91.4%), with a negative predictive value of 98.6%. CONCLUSION: the SCRI-PJ is a brief and effective screening instrument to detect people with gambling problems or who are at risk of developing them.

Evaluation of a group cue-exposure treatment for opiate addicts.

Twenty-four detoxified opiate addicts were randomized to an experimental group and a control group to evaluate efficacy of a group cue-exposure treatment to reduce or extinguish classically conditioned responses to drug-related stimuli. Assessment included psychophysiological responses (skin temperature, skin conductance level--SCL--, and heart rate) to a videotape and subjective measures (subjective craving, positive and negative affect) before and after the videotape. The experimental group received a group cue-exposure program to drug-related stimuli that comprised twelve treatment sessions administered three times weekly. The treatment program significantly reduced conditioned responses to drug-related stimuli, as measured by SCL and positive affect.

Treatment of Anxiety Disorders in a Psychology Clinic.

People with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around €840. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders.

Factors associated with prolonging psychological treatment for anxiety disorders.

BACKGROUND: Anxiety disorders are one of the disorders most frequently requested for psychological attention. The purpose of this study is to identify the factors that can explain a longer duration of psychological treatment for anxiety disorders. METHOD: 202 patients from the University Psychology Clinic of the Complutense University of Madrid were analyzed. RESULTS: Multivariate regression analysis showed that the presence of obsessive-compulsive disorder and the application of arousal control techniques followed by modeling and other specific techniques were the best predictors of treatment duration. CONCLUSION: Reducing as much as possible the number of techniques applied without reducing intervention efficacy is suggested. In some disorders that produce a greater life disorganization, it may be useful to try to organize the patient´s life either as a first goal or at the same time as the intervention program, so as to increase its effectiveness and reduce the number of sessions.

Blood pressure variability and stress management training for essential hypertension.

The purpose of this study was to determine whether stress management training reduces blood pressure (BP) variability in hypertensive patients. Previous literature suggests that cardiovascular risk is not only a function of BP levels, but also of BP variability, and this partially depends on changes induced by the stress of everyday life. The authors reanalyzed data from a previous study of 43 male patients with essential hypertension who were randomly assigned to 2 groups (stress management training and waiting list). Patients in the stress management group lowered their self-measured BP variability significantly from pretreatment to the 4-month follow-up examination, showing a mean reduction of 2.6/1.5 mm Hg in the standard deviation of systolic/diastolic BP (SBP/DBP), and a mean decrease of 1.84/1.59% in the coefficient of variation of SBP/DBP. For SBP, these reductions were significantly greater than those showed by the control group. These results suggest that stress management training is effective in reducing day-to-day BP variability, providing an additional reduction in cardiovascular risk for hypertensive patients.

Empirically supported treatments for panic disorder with agoraphobia in a Spanish psychology clinic.

The aim of this work is to study the sociodemographic and clinical characteristics of patients diagnosed with Panic Disorder with Agoraphobia (PD/Ag), as well as the characteristics of the treatment and its results and cost in a University Psychology Clinic. Fifty patients demanded psychological assistance for PD/Ag; 80% were women, with an average age of 29.22 years (SD = 9.03). Mean number of evaluation sessions was 3.26 (SD = 1.03), and of treatment sessions, 13.39 (SD = 9.237). Of the patients, 83.33% were discharged (that is, questionnaire scores were below the cut-off point indicated by the authors, and no PD/Ag was observed at readministration of the semistructured interview), 5.5% refused treatment, and 11% were dropouts. The average number of treatment sessions of patients who achieved therapeutic success was 15.13 (SD = 8.98). Effect sizes (d) greater than 1 were obtained in all the scales. Changes in all scales were significant (p < .05). The estimated cost of treatment for patients who achieved therapeutic success was 945.12€. The treatment results are at least similar to those of studies of efficacy and effectiveness for PD/Ag. The utility of generalizing treatments developed in research settings to a welfare clinic is discussed.

Norms for the Spanish version of the Eating Disorders Examination Questionnaire (S-EDE-Q).

BACKGROUND: This study presents normative data on the Spanish Version of the Eating Disorders Examination Questionnaire (S-EDE-Q) for adolescents and young adults in Spain. METHOD: A sample of 1,543 men and women, aged 12 - 21 years, completed the S-EDE-Q as part of a larger assessment battery. RESULTS: Means, standard deviations, clinical significance and percentile ranks for the raw Restraint, Eating Concern, Shape Concern, and Weight Concern subscales and the Global Score by age group and gender are presented. Data on any and regular occurrences of dieting, bingeing and compensatory behaviors by age group and gender are reported. Compared with men, women scored higher on all the subscales and reported more key eating disorders (ED) and compensatory behavior. Compared with adolescents, young adults scored higher on the Restraint and Shape Concern subscales and reported more dietary restraint (DR), objective binge episodes (OBE) and diuretic misuse (DIUR). CONCLUSIONS: These results can help researchers and clinicians interpret the S-EDE-Q scores of adolescents and young adults in Spanish-speaking countries.

Does adding pharmaceutical medication contribute to empirically supported psychological treatment for anxiety disorders?

BACKGROUND: The goal of this work is to determine whether the combined use of empirically supported psychological treatments (ESTs) and pharmacological therapy (PT) achieves better results than the isolated use of ESTs in the treatment of Anxiety Disorders (AD) in a welfare clinical setting. METHOD: A quasi-experimental study was designed, with a sample of 287 patients with primary diagnosis of AD. Of the patients, 25.1% (n = 72) received ESTs+PT and 74.9% (n = 216), only ESTs. At pretreatment, no intergroup differences were observed in anxiety and depressive symptoms, duration of the problem and comorbidity, but there were differences for previous treatments (they were fewer in the EST group). RESULTS: After the intervention, both groups showed similar degree of completion, compliance with treatment, task performance and similar effectiveness at post treatment but EST+PT was significantly longer (16.58 sessions vs. 13.04 sessions). CONCLUSIONS: It is concluded that adding PT to EST does not improve the results but it does increase the cost and duration of treatment, thereby reducing the efficiency of the intervention.

[Sociodemographic, clinical and outcome differences among anxiety disorders]. / Diferencias sociodemográfi cas, clínicas y de resultados del tratamientoentre los trastornos de ansiedad.

The aims of this paper are to analyze differences in sociodemographic and clinical characteristics among the various anxiety disorders treated in a Psychology Clinic, and the results of treatment in each anxiety disorder. Data from 282 patients of University Psychology Clinic at the Complutense University of Madrid, who had at least one diagnosis of anxiety according to DMS-IV-TR criteria, were analyzed. The most frequent anxiety disorders were nonspecific anxiety disorder (19.1%) and social phobia (18.8%). Significant differences were observed according to sex (in all disorders, the percentage of women was significantly higher than that of men, except for obsessive-compulsive disorder). Unspecific anxiety disorder required a smaller number of assessment and treatment sessions, whereas obsessive-compulsive disorder required a greater number of sessions. There were no significant differences between the percentage of patients who completed treatment and dropout rates in specific phobia, general anxiety disorder and obsessive-compulsive disorder. Differences between epidemiological and clinical data are discussed.

[Why are psychological treatments prolonged? Predictors of a longer duration of treatment and analysis of the differences between long- and short-term cases]. / Por qué se alargan los tratamientos psicológicos? Predictores de una mayor duración del tratamiento y diferencias entre los casos de corta y larga duración.

The purpose of this study was to identify variables that may explain a longer psychological treatment and to analyze differences between short- and long-term cases. Data from 419 patients of the University Clinic of Psychology at the Complutense University of Madrid were analyzed. Number of intervention techniques, comorbidity, previous treatments, and a primary diagnosis of mood disorder or eating disorder were the factors that explained longer treatment duration. Significant differences were observed between short- and long-term cases in number of intervention techniques, number of therapeutic objectives, and also in some clinical variables (diagnostic group, comorbidity, previous treatment) and demographics (age and educational level). Results are discussed and some lines of intervention and/ or reflection are proposed.

Organización vital de una muestra clínica que demanda atención psicológica / Life Functioning among a Clinical Sample Demanding Psychological Treatment

La asociación entre trastornos psicopatológicos y variables de funcionamiento psicosocial ha sido documentada, pero son escasos los estudios que evalúan su impacto sobre la eficacia de los tratamientos psicológicos. El objetivo de este estudio fue evaluar la organización vital de 78 pacientes de un servicio de atención psicológica y examinar la relación con variables clínicas y con el éxito del tratamiento. Esta organización se evaluó mediante una escala confeccionada ad hoc para este estudio. El área de pareja resultó la menos organizada frente a la familiar y personal, con las mayores puntuaciones. La organización vital se relacionó de forma significativa con distintos ejes del DSM-IV-TR. Se confirmó que pacientes con baja organización vital requieren un mayor número de objetivos terapéuticos.

The association between psychological disorders and psychosocial functioning variables has been previously documented, but relatively few studies have examined the impact of these variables on psychological treatment outcomes. The aim of this study was to assess the life functioning of 78 patients from a psychological service centre, and to examine its relationship with clinical variables and treatment success. Life functioning was evaluated with a scale elaborated ad hoc for this study. The partner area of functioning was the most impaired while family and personal areas obtained the highest functioning scores. Patient's life functioning was significantly associated with several axis of DSM-IV-TR. It was confirmed that patients with poorer life functioning required a greater number of treatment objectives.

Uso de técnicas de exposición en una clínica de psicología / Use of Exposure Techniques in a Psychology Clinic

El objetivo del artículo es indagar el uso de las técnicas de exposición en la práctica de la psicología clínica asistencial. Se analiza el tipo de técnicas de exposición, su frecuencia de uso, tanto en general como en función del diagnóstico, y su relación con los resultados del tratamiento. De los 880 pacientes de la Clínica Universitaria de Psicología de la Universidad Complutense, con todo tipo de diagnóstico, el 67.2% son mujeres y su edad media es de 32.79 años. Los resultados señalan que el 39.5% de los casos ha utilizado alguna técnica de exposición, siendo la Exposición Gradual la más frecuente (31.6%). Predomina el uso de las técnicas de exposición en trastornos de ansiedad (70.8%), somatomorfos (47.4%) y sexuales (47.1%). Se observa un incremento en el uso de técnicas de exposición en los casos con comorbilidad (55.4% frente a 36.3%). De los casos que han recibido alguna técnica de exposición, el 74.1% ha finalizado con éxito el tratamiento, frente al 61.9% de los que no han utilizado ninguna técnica de exposición. Se discuten los resultados, destacando el valor de usar técnicas de exposición para reducir la evitación o las respuestas de miedo con independencia del diagnóstico.

The aim of this work is to explore the use of exposure techniques at the health care context of a clinical psychology facility. Different modalities of exposure techniques, their frequency of usage - both across the entire sample and considering different diagnostic groups - and their relationship to the treatment results, were analysed. From the 880 patients with diverse diagnosis treated at the University Psychology Clinic of the Universidad Complutense of Madrid, 67.2% were women, with a mean of32.79 years. Results show that exposure techniques were used in 39.5% of total cases, being gradual exposure the most frequent (31.6%). Exposure techniques were employed foremost on anxiety disorders (70.8%), somatoform disorders (47.4%), and sexual disorders (47.1%). Also, it was observed that exposure techniques were used more often in cases with one or more comorbid diagnosis (55.4 vs. 36.3%). 74.1% of the patients treated with exposure techniques received therapeutic discharge, while 61.9% of patients not treated with exposure techniques were discharged. The results are discussed, emphasizing the utility of exposure techniques to treat avoidant or fearful behaviour regardless of the diagnosis.

Orienting-defense responses and psychophysiological reactivity in isolated clinic versus sustained hypertension.

This study sought to determine whether patients with white-coat or isolated clinic hypertension (ICH) show, in comparison to patients with sustained hypertension (SH), a defense response pattern to novel stimuli and an enhanced psychophysiological reactivity to stress. Forty-three patients with essential hypertension were divided into two groups after 16 days of self-monitoring blood pressure (BP): ICH (24 men; self-measured BP < 135/85 mmHg) and SH (19 men; self-measured BP >or= 135/85 mmHg). Defense responses were measured as the cardiac changes to phasic non-aversive auditory stimuli. Psychophysiological reactivity (heart and breath rate, blood volume pulse, electromyography, and skin conductance) was measured during mental arithmetic and video game tasks. The standard deviation of self-measured BPs and the difference between mean BPs at work and at home were used as indicators of cardiovascular reactivity to daily stress. No significant differences were seen in defense responses or psychophysiological reactivity to laboratory or naturally occurring stressors. These results do not support the hypothesis that ICH can be explained in terms of a generalized hyperreactivity to novel or stressful stimuli.

Distorsiones cognitivas durante el juego en máquinas recreativas con premio en jugadores patológicos y no jugadores / Cognitive distortions during gambling on slot machines with prizes in pathologicalgamblers and non-gamblers

Se comparan las distorsiones cognitivas referidas al azar en jugadores patológicos,antes del tratamiento, versus un grupo de no jugadores o jugadores sin problema.La muestra está compuesta por 160 varones, 80 jugadores patológicos (DSM-IVTR;A.P.A. ), cuya actividad principal de juego eran las máquinas recreativas, y 80varones sin problemas de juego. El objetivo es constatar si los sesgos cognitivos,respecto al juego, difieren en frecuencia e intensidad entre ambas muestras.Se evaluaron los sesgos cognitivos mediante: (a) observación sistemática enlaboratorio (método de pensar en voz alta durante el juego) y (b) autoinforme(escalas Likert de estimación de probabilidades de ganar y atribución de losresultados). Existen diferencias significativas entre los jugadores patológicosy los no jugadores en las medidas más relevantes: (a) porcentaje de frasesirracionales (30.31% versus. 8.28%); (b) tasa de irracionalidad en frases sobreestrategias (97 por ciento versus 82 por ciento), (c) estimación de posibilidades de ganar (38.46 por cientovs. 26.92 por ciento), y (d) el porcentaje de los resultados atribuido a la suerte (44.30 por cientovs. 19.74 por ciento). Los elevados valores de distorsiones cognitivas en los jugadoresparecen un factor etiológico destacado en el desarrollo de las conductas de juegopatológico. En consecuencia, al menos una parte del tratamiento debe dirigirse amodificar estas distorsiones.

Cognitive distortions presented in pathological gamblers before treatment, andthose of a group of non-players or players with no problems, are compared. Theparticipants are 160 men, 80 pathological gamblers according to DSM-IV-TRcriteria, whose main gambling activity was slot machines; and 80 men with nogambling problems. The objective is to establish whether there is a difference ingambling-related cognitive distortions between the two samples. The cognitivedistortions were evaluated by: (a) systematic observation in laboratory (the‘thinking aloud’ method while playing) and (b) self-statements (two Likertscales for the estimation of the probabilities of winning and the attribution ofthe results). Significant differences between the pathological gamblers and thenon problem gamblers, in the main related to gambling measures, are presented:(a) percentage of irrational phrases (30,31 per cent versus. 8.28 per cent); (b) percentage ofirrationality in phrases on gambling strategies (97 per cent versus 82 per cent), (c) estimationof winning possibilities (38,46 per cent versus. 26,92 per cent) and (d) the percentage of theresults attributed to luck (44,30 per cent versus. 19.74 per cent). The high score of cognitivedistortions in the players seems to be a strong etiological factor in the conductdevelopment of pathological gambling, consequently, at least a part of thetreatment should be focused on modifying these distortions.

Se analisam as distorções cognitivas referidas ao acaso em jogadores patológicos,antes do tratamento, versus um grupo de não-jogadores ou jogadores sem problema.A mostra está composta por 160 varões, 80 jogadores patológicos (DSM-IVTR),cuja atividade principal de jogo eram as máquinas recreativas e 80 varõessem problemas de jogo. O objetivo é constatar se os sesgos cognitivos respeito aojogo diferem em freqüência e intensidade entre ambas amostras. Se avaliaram ossesgos cognitivos mediante: (a) observação sistemática em laboratório (método depensar em voz alta durante o jogo) e (b) autoinforme (escala Likert de estimativade probabilidades de ganhar e atribuição dos resultados). Existem diferençassignificativas entre os jogadores patológicos e os não jogadores nas medidasmais relevantes: (a) porcentagem de frases irracionais (30.31 por cento versus. 8.28 por cento);(b) taxa de irracionalidade em frases sobre estratégias (97 por cento versus 82 por cento), (c)estimativa de possibilidades de ganhar (38.46 por cento vs. 26.92 por cento) e (d) a porcentagemdos resultados atribuído à sorte (44.30 por cento vs. 19.74 por cento). Os elevados valores dedistorções cognitivas nos jogadores parecem um fator etiológico destacado no desenvolvimento das condutas de jogo patológico. Em conseqüência, pelo menosuma parte do tratamento deve dirigirse a modificar estas distorções.