Exploring the influence of circulating endocannabinoids and nucleus accumbens functional connectivity on anorexia nervosa severity.

Anorexia nervosa (AN) is a severe psychiatric disorder characterized by a harmful persistence of self-imposed starvation resulting in significant weight loss. Research suggests that alterations in the nucleus accumbens (NAcc) and circulating endocannabinoids (eCBs), such as anandamide (AEA) and 2-arachidonoylglycerol (2-AG), may contribute to increased severity and maladaptive behaviors in AN, warranting an examination of the interplay between central reward circuitry and eCBs. For this purpose, we assessed NAcc functional connectivity and circulating AEA and 2-AG concentrations in 18 individuals with AN and 18 healthy controls (HC) to test associations between circulating eCBs, NAcc functional connectivity, and AN severity, as defined by body mass index (BMI). Decreased connectivity was observed between the NAcc and the right insula (NAcc-insula; pFWE < 0.001) and the left supplementary motor area (NAcc-SMA; pFWE < 0.001) in the AN group compared to HC. Reduced NAcc-insula functional connectivity mediated the association between AEA concentrations and BMI in the AN group. However, in HC, NAcc-SMA functional connectivity had a mediating role between AEA concentrations and BMI. Although no significant differences in eCBs concentrations were observed between the groups, our findings provide insights into how the interaction between eCBs and NAcc functional connectivity influences AN severity. Altered NAcc-insula and NAcc-SMA connectivity in AN may impair the integration of interoceptive, somatosensory, and motor planning information related to reward stimuli. Furthermore, the distinct associations between eCBs concentrations and NAcc functional connectivity in AN and HC could have clinical implications for weight maintenance, with eCBs being a potential target for AN treatment.

Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents.

Although 1-14% of adolescents may experience problematic pornography use (PPU), psychometrically sound instruments for assessing PPU in Spanish-speaking adolescents are scarce. Given the advantages of the different forms of the Problematic Pornography Consumption Scale (PPCS), the aim of the present study was to assess the psychometric properties of the PPCS and PPCS-6, and to examine associations between PPU and age among boys and girls. Two school-based adolescent samples were recruited in Spain (n = 650; Mage = 16.0 [SD = 1.1]; 50% girls and 50% boys) and Mexico (n1, 160; Mage = 15.8 [SD = 1.1]; 68% girls) to assess the psychometric properties of the PPCS and PPCS-6. Confirmatory factor analysis was applied and convergent and discriminant validity with other measures related to PPU was also tested. The results provided empirical support for the six-factor structure of the PPCS and the one-factor structure of the PPCS-6. Boys with older age showed higher levels of tolerance than girls on the PPCS in both countries. Both the PPCS and the PPCS-6 may be considered valid psychometric instruments for the assessment of PPU in Spanish-speaking adolescents from Spain and Mexico.

Do attention-deficit/hyperactivity symptoms influence treatment outcome in gambling disorder?

BACKGROUND AND AIMS: Numerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD. Therefore, we aimed to explore differences between patients with GD with and without self-reported ADHD symptoms regarding psychopathology, personality, sociodemographic and treatment outcome measures. METHOD: This longitudinal study included 170 patients with GD receiving cognitive behavioral therapy. Multiple self-reported instruments were used to assess clinical variables and sociodemographic measures prior to treatment. RESULTS: A clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were observed between the two groups. However, patients with self-reported ADHD symptoms experienced more severe relapses (i.e., gambled more money) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention. CONCLUSION: Individuals with GD and self-reported symptoms of ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity.

Cluster analysis in gambling disorder based on sociodemographic, neuropsychological, and neuroendocrine features regulating energy homeostasis.

BACKGROUND: The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far. AIMS: This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features. METHODS: 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ2) for categorical variables, and analysis of variance (ANOVA) for quantitative measures. RESULTS: Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2. CONCLUSIONS: To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision.

How to assess eating disorder severity in males?The DSM-5 severity index versus severity based on drive for thinness.

Using a male eating disorder (ED) sample, this study assessed the clinical utility of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) severity indices for males with anorexia nervosa (AN) and bulimia nervosa (BN) and compared it to an alternative transdiagnostic severity categorisation based on drive for thinness (DT). The participants included 143 males with an ED (60 [42.0%] AN and 83 [58.0%] BN) diagnosis, who were classified using these two severity classifications. The different severity categories were then compared based on ED symptoms, general psychopathology, and personality traits. Our results revealed that the DSM-5 "mild" and DT "low" severity categories were most prevalent in the AN and BN male patients. Clinically significant findings were strongest for the DT categorisation for both AN and BN. The current findings provide initial support for an alternative transdiagnostic DT severity classification for males that may be more clinically meaningful than the DSM-5 severity indices.

Roles for Alexithymia, Emotion Dysregulation and Personality Features in Gambling Disorder: A Network Analysis.

Although there is a growing interest in exploring the specific role of both emotional regulation processes and alexithymia in gambling disorder (GD), evidence remains scarce. In order to delve deeper into the complex interactions between these factors, the present study aimed at exploring a network of the core GD-related features, including GD symptomatology and severity, emotion dysregulation, alexithymia, and personality features. The sample included N = 739 treatment-seeking patients with GD (691 men and 48 women), aged 18-78 years (mean age = 39.2, SD = 13.2). The DSM-5 diagnostic criteria were assessed in, and the South Oaks Gambling Screen, Difficulties in Emotion Regulation Scale (DERS), and Temperament and Character Inventory-Revised were administered to, participants. A network analysis was conducted to reveal inter-relationships between these elements. Three nodes related to emotion dysregulation showed the most critical position in the whole network of the present study: "lack of emotional awareness", "non-acceptance of emotional responses", and "difficulties engaging in goal-directed behaviors". When analyzing emotional dysregulation using the different DERS subscales, two independent clusters were identified. One cluster encompassed alexithymia dimensions ("lack of awareness" and "lack of clarity"), while the other cluster included all other emotion-dysregulation dimensions. Identification of the emotion-dysregulation- and GD-related features with the highest centrality/linkage may be particularly useful for developing valid measurement tools and precise management plans for individuals with GD.

Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors.

The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile.

Cyberbullying and Gambling Disorder: Associations with Emotion Regulation and Coping Strategies.

The presence of unsuitable coping and emotion regulation strategies in young populations with gambling disorder (GD) and in those who have experienced cyberbullying victimization has been suggested. However, this association has not been explored in depth. In this study, our aim was to analyze individual differences in emotion regulation, coping strategies, and substance abuse in a clinical sample of adolescents and young adult patients with GD (n = 31) and in a community sample (n = 250). Furthermore, we aimed to examine the association between cyberbullying and GD. Participants were evaluated using the Cyberbullying Questionnaire-Victimization, the Canadian Adolescent Gambling Inventory, the Coping Strategies Inventory, the Difficulties in Emotion Regulation Scale, the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test. Structural Equation Modeling was used to explore associations between these factors in a community sample and in a clinical group. In both groups, exposure to cyberbullying behaviors was positively associated with higher emotion dysregulation and the use of maladaptative coping styles. Our findings uphold that adolescents and young adults who were victims of cyberbullying show difficulties in emotion regulation and maladaptive coping strategies when trying to solve problems. The specific contribution of sex, age, gambling severity, emotion regulation, and coping strategies on cyberbullying severity is also discussed. Populations at vulnerable ages could potentially benefit from public prevention policies that target these risk factors.

The usefulness of an intervention with a serious video game as a complementary approach to cognitive behavioural therapy in eating disorders: A pilot randomized clinical trial for impulsivity management.

OBJECTIVE: The aim of the present study was to test the usefulness of an add-on serious video game approach (i.e., Playmancer) to treatment as usual (TAU) on reducing impulsive behaviours and psychopathology in individuals diagnosed with an eating disorder (ED). METHOD: Thirty-seven patients diagnosed with an ED according to the DSM-5 were included in the present randomized clinical trial (RCT; study record 35,405 in ClinicalTrials.gov) and were randomly assigned to either the TAU or TAU + Playmancer group. All participants completed a clinical interview. Impulsivity (UPPS-P self reported questionnaire and Stroop task) and general psychopathology (SCL-90-R) measures were assessed at: baseline, 4 weeks into treatment, at the end of TAU (after 16 weeks), and follow-up (2 years). In addition, patients in the experimental group underwent a total of nine sessions with Playmancer over the span of 3 weeks. RESULTS: Patients in both treatment groups (TAU + Playmancer or TAU) improved on Stroop task performance and psychological distress. Additionally, patients in TAU-Playmancer improved on the impulsive trait domain of lack of perseverance. No statistical differences were found regarding treatment outcomes (i.e., treatment adherence and remission of eating symptomatology) when comparing the two treatment groups. CONCLUSION: Our results suggest that the impulsivity associated with EDs should be addressed and could be modified, as some facets of trait impulsivity improved after Playmancer add-on treatment. Yet, there were no significant differences in treatment outcomes when comparing the two groups and further research needs to be conducted.

Cognitive and clinical gender-related differences among binge-spectrum eating disorders: Analysis of therapy response predictors.

OBJECTIVE: This study assessed gender-related differences in executive functions (decision-making, inhibitory control and cognitive flexibility), personality traits and psychopathological symptoms in binge-spectrum eating disorders (EDs). Secondly, we aimed to separately explore the predictive value of gender and executive functions in treatment outcome. METHOD: A battery of self-reported and neurocognitive measures were answered by a sample of 85 patients (64 females) diagnosed with a binge-spectrum ED (41 BN; 44 binge eating disorder). RESULTS: Data showed gender-related differences in executive functioning, displaying women lower inhibitory control and lower cognitive flexibility than men. Regarding personality traits and psychopathology symptoms, women presented higher reward dependence and cooperativeness, as well as more drive for thinness, body dissatisfaction, bulimia, and somatisation symptoms than men. Finally, worse executive functioning, particularly having lower ability in concept formation seems to predict worse treatment outcomes and dropout in these patients. CONCLUSIONS: We described gender specific neuropsychological, personality and psychopathological impairments in patients with binge-spectrum EDs. Moreover, difficulties in executive functioning might have an impact on treatment response, since patients with a lower ability in concept formation are less likely to benefit from treatment. The present results can help improving current treatment approaches by tackling gender and individual differences.

Profile of Treatment-Seeking Gaming Disorder Patients: A Network Perspective.

The increasing presence of gaming disorder in recent years has led to major efforts to identify the specific predictors that have a high impact on the profile of people seeking treatment for this mental condition. The purpose of this study was to explore the network structure of the correlates of gaming disorder considering sociodemographic features and other clinical symptoms. Network analysis was applied to a sample of patients who met clinical criteria for gaming disorder (n = 117, of ages ranging from 15 to 70 yrs-old). Variables considered in the network included sex, age, socioeconomic position, global emotional distress, age of onset and duration of the gaming disorder, personality traits and the presence of other addictive behaviors (tobacco, alcohol and behavioral addictions). The central nodes in the network were global psychological distress, chronological age, and age of onset of gaming related problems. Linkage analysis also identified psychopathological status and age as the variables with the most valuable information in the model. The poorest relevance in the analysis was for the duration of gaming problems and socioeconomic levels. Modularity analysis grouped the nodes within four clusters. Identification of the variables with the highest centrality/linkage can be particularly useful for developing precise management plans to prevent and treat gaming disorder related problems.

Identifying Associated Factors for Illegal Acts among Patients with Gambling Disorder and ADHD.

Illegal behaviors have been reported in gambling disorder (GD) as well as in individuals with attention deficit hyperactivity disorder (ADHD). Likewise, ADHD symptomatology has been observed in patients with GD. We aimed to examine the association between ADHD symptomatology, personality traits and impulsivity in a sample of treatment-seeking patients with GD (n = 204) with and without a criminal report. The subjects were evaluated before starting treatment using different self-administered instruments. Among those who had committed an illegal act, two groups were made depending on whether or not the criminal conduct had legal repercussions (n = 64 without legal consequences; n = 32 with legal consequences). Structural equation modeling (SEM) was used to explore the interrelationships between personality traits, ADHD, impulsivity levels, gambling-related criminal behavior and other gambling-related factors. Greater ADHD symptomatology was found in patients with reported illegal behaviors, as well as higher impulsivity levels. Those individuals who presented legal consequences due to the criminal behavior showed higher impulsivity levels and harm avoidance and lower persistence and cooperativeness. Our findings uphold that patients with GD and ADHD symptomatology have greater impulsivity and are more vulnerable to committing an illegal act. Therefore, specific harm-prevention interventions and treatment approaches are needed for this population.

Clinical Features of Gambling Disorder Patients with and Without Food Addiction: Gender-Related Considerations.

Although food addiction (FA) is a debated condition and it is not currently recognized as a formal diagnosis, it shares features with other addictions, such as gambling disorder (GD). However, the prevalence of FA in GD and the clinical correlates are incompletely understood, especially within women versus men. To investigate FA in patients presenting with GD. The sample included 867 patients diagnosed with GD (798 males and 69 females) attending a specialized behavioral addictions unit. FA was observed in 8.3% of GD patients (18.8% of women, 7.4% of men). More psychopathology and harm avoidance, greater body mass indices and less self-directedness and cooperativeness were associated with FA. In women, FA was associated with a longer GD duration. In men, FA was associated with earlier GD onset, greater GD and problematic alcohol use severities. Among patients with GD, FA was associated with more psychopathology and gambling patterns suggestive of more protracted or severe GD. Screening for and addressing FA condition in patients with GD may help optimize preventive and therapeutic approaches. Future studies should consider testing guidelines to improve healthy eating habits, increase physical exercise and better manage stress and other negative emotions in order to target FA in GD.

Clustering Treatment Outcomes in Women with Gambling Disorder.

The rising prevalence of gambling disorder (GD) among women has awakened considerable interest in the study of therapeutic outcomes in females. This study aimed to explore profiles of women seeking treatment for GD based on a set of indicators including sociodemographic features, personality traits, clinical state at baseline, and cognitive behavioral therapy (CBT) outcomes. Two-step clustering, an agglomerative hierarchical classification system, was applied to a sample of n = 163 women of ages ranging from 20 to 73 years-old, consecutively attended to by a clinical unit specialized in the treatment of G. Three mutually exclusive clusters were identified. Cluster C1 (n = 67, 41.1%) included the highest proportion of married, occupationally active patients within the highest social status index. This cluster was characterized by medium GD severity levels, the best psychopathological functioning, and the highest mean in the self-directedness trait. C1 registered 0% dropouts and only 14.9% relapse. Cluster C2 (n = 63; 38.7%) was characterized by the lowest GD severity, medium scores for psychopathological measures and a high risk of dropout during CBT. Cluster C3 (n = 33; 20.2%) registered the highest GD severity, the worst psychopathological state, the lowest self-directedness level and the highest harm-avoidance level, as well as the highest risk of relapse. These results provide new evidence regarding the heterogeneity of women diagnosed with GD and treated with CBT, based on the profile at pre- and post-treatment. Person-centered treatments should include specific strategies aimed at increasing self-esteem, emotional regulation capacities and self-control of GD women.

Where does purging disorder lie on the symptomatologic and personality continuum when compared to other eating disorder subtypes? Implications for the DSM.

OBJECTIVES: To assess the clinical significance and distinctiveness of purging disorder (PD) from other eating disorder (ED) diagnoses. METHOD: Participants included 3127 women consecutively admitted to an ED treatment centre (246 PD, 465 anorexia nervosa restrictive [AN-R], 327 AN-binge purging [AN-BP], 1436 bulimia nervosa [BN], 360 binge eating disorder [BED], 177 atypical AN and 116 unspecified feeding or eating disorder [UFED]) who were diagnosed according to DSM-5 criteria. Additionally, 822 control participants were recruited from the community. All participants completed measures assessing ED symptoms (EDI-2), general psychopathology (SCL-90-R) and personality (TCI-R). RESULTS: Patients with PD, when compared to controls, scored significantly higher on the EDI-2 and SCL-90-R, and most TCI-R dimensions. Most of the significant differences between PD and the other ED diagnoses emerged between PD and AN-R, followed by Atypical-AN, UFED, AN-BP and BED, with patients with PD typically reporting higher scores on the EDI-2 and SCL-90-R subscales. Significant differences between PD and BN were also present, but to a lesser extent. The findings for personality varied amongst the different ED diagnoses. CONCLUSIONS: PD is a clinically significant disorder, which seems to be more similar to BN than it is to AN and the other ED subtypes.

Food addiction in anorexia nervosa: Implications for the understanding of crossover diagnosis.

OBJECTIVE: Food addiction (FA) construct was introduced to reflect abnormal eating patterns that resemble behavioural ones found in substance use disorders. FA has been barely explored in anorexia nervosa (AN). This study evaluated FA occurrence and associated factors in a sample of patients with AN, distinguishing between restrictive and binge-purging subtypes and focussing on the influence of FA in the crossover diagnosis between them. METHOD: A sample of 116 patients with AN admitted for treatment seeking at an Bellvitge Hospital Eating Disorders Unit were included (72 restrictive [AN-R]; 44 binge-purge AN [AN-BP]), and eating-related, personality and psychopathological variables were assessed. Most participants were women (92.2%), mean age 27.1 years old (SD = 10.5). RESULTS: FA was more prevalent in patients with AN-BP compared to the AN-R group (75.0% and 54.2%, respectively). The patients with AN-R FA+, presented more similar ED symptomatology, general psychopathology and personality traits, with the AN-BP patients, than with the AN-R FA-. CONCLUSIONS: Patients with AN-R FA+, exhibit more similarities with the AN-BP subgroup than with the AN-R FA-. Thus, it is possible to hypothesise that the presence of FA might be an indicator of the possible crossover from AN-R to AN-BP.

Risk patterns in food addiction: a Mexican population approach.

BACKGROUND: Food addiction (FA) is a construct that has gained interest in recent years but its relevance in Mexican population is still unexplored. AIMS: The present study has the aims of explore FA in a community of Mexican population, as well as identifying the risk patterns associated with it, in relation to the different etiological factors that have been described such as impulsivity, emotional regulation and eating styles. Furthermore, to identify a predictive model of FA severity. METHODS: The sample consisted of 160 female and male university students of Pachuca city in México, who volunteered to participate in the study. Assessment included multidimensional measures for FA, eating disorder severity, eating disorder styles, emotional regulation and impulsivity. RESULTS: A screening of FA-probable was registered for 13.8% of the sample, while 8.1% met criteria for FA-present. The FA-present group differed from FA-absent in the impulsivity levels and in emotional eating style. Patients with FA-present differed from FA-probable in the impulsivity levels. Differences between FA-probable versus FA-absent were found in the restrained eating style. Path analysis evidenced that FA severity was directly associated with older age, worse eating style profile and higher impulsivity levels, and indirectly related with the ED symptom levels. CONCLUSIONS: Our findings suggest that it is possible to establish a specific predictive model of the development of FA and its severity in Mexican population to implement adequate prevention and treatment strategies. EVIDENCE LEVEL: Level III: evidence obtained from well-designed cohort or case-control analytic studies.

A Comparison of Gambling-Related Cognitions and Behaviors in Gamblers from the United States and Spain.

Few studies have compared the clinical characteristics of gambling disorder (GD) from a cross-cultural perspective. In the present study, we aimed to examine differences in gambling-related cognitions, gambling preferences, GD severity and other clinical and sociodemographic variables in individuals with GD in the United States and Spain. Two groups of participants with GD (from the United States of America (US; n = 109) and Spain (n = 243) were compared using the South Oaks gambling screen and the gambling-related cognitions scale. In Spain, the prevalence of participants who reported only non-strategic gambling preferences was higher, whereas in the US, participants tended to engage in a wider breadth of gambling activities. Moreover, Spanish participants reported higher GD severity, while participants in the US endorsed greater gambling-related cognitions. Our findings suggest that there may jurisdictional or cultural differences in terms of gambling-related cognitions, gambling preferences, and GD severity levels among individuals in the US versus Spain. These differences, which may reflect cultural regulatory or other factors, should be investigated further, and considered when developing and implementing interventions for GD.

Explicit and Implicit Emotional Expression in Gambling Disorder Measured by a Serious Game: A Pilot Study.

Behavioral addictions have been related with biased emotional reactions to risky choices. However, few studies have analyzed the role of both explicit and implicit emotional expression in gambling disorder (GD). This pilot study aims to examine emotion regulation in treatment-seeking patients with GD. The sample included n = 35 participants classified into three groups: patients with current GD, patients with GD in remission, and a control group without GD. Implicit emotional expressions were evaluated through a serious videogame (Playmancer) and explicit emotions were measured through self-reports. Patients in the current GD group had, compared to the remission and control groups, lower levels of implicit emotion expression and higher levels of explicit emotion expression. The patients in GD remission group endorsed better emotion regulation capacity in comparison to patients with current GD. We conclude that differences in emotion expression profiles (such as anger and anxiety) should be considered both in the development of screening and diagnostic measures and in the planning of prevention and treatment programs.

The Severity of Gambling and Gambling Related Cognitions as Predictors of Emotional Regulation and Coping Strategies in Adolescents.

People with gambling disorder (GD) exhibit distorted cognitions and superstitious beliefs more often than the general population. Similarly, difficulties in coping and emotion dysregulation are more prevalent among those with GD, and could determine the onset of GD in particularly vulnerable groups such as adolescents. This study examines the relationship between gambling severity and gambling-related cognitions with coping strategies and emotion regulation. Also, it explores how accurately gambling severity and gambling-related cognitions were able to predict emotion regulation and coping strategies. Two groups were recruited and analyzed: a community sample comprising 250 adolescents and young adults from secondary education schools, and a clinical sample of 31 patients with similar age characteristics seeking treatment for GD. The participants from the clinical sample scored higher on gambling severity, emotion dysregulation, cognitive biases, and maladaptive coping strategies. In the community sample, cognitive biases mediated the relationship between sex and emotion dysregulation and disengagement. People with GD use more often than controls maladaptive emotion regulation strategies to manage negative emotional states. This perspective emphasizes the need to focus on coping with emotions, as opposed to coping with problems, as the best approach to tackle gambling problems.