Cognitive emotion regulation strategies and psychological distress during lockdown due to COVID-19.

Several governments have implemented strict measures to reduce the spread of COVID-19, such as lockdown measures. However, these measures have brought negative consequences at an individual level by exacerbating the psychological distress caused by the pandemic. We evaluated the role of cognitive emotion regulation strategies (CERS) on the levels of anxiety and depression during the lockdown in a sample of 663 Spanish-speaking adults, while controlling for variables related to social support, hobbies, seeking information related to COVID-19, perceived risk of infection, time of assessment, number of deaths and contagions during the assessment and age. Using multiple regression analyses with a stepwise model selection procedure, 29% of the variance in anxiety and 38% of the variance of depression were found to be predicted by specific CERS. The impact of CERS on anxiety and depression was moderated by the sex of participants and the time of assessment, indicating that CERS did not have the same protective or harmful effects in all participants and situations. Based on our results, recommendations are provided for improving coping with stressful events where lockdown measures are taken.

Decision-making inflexibility in a reversal learning task is associated with severity of problem gambling symptoms but not with a diagnosis of substance use disorder.

BACKGROUND: Decisions made by individuals with disordered gambling are markedly inflexible. However, whether anomalies in learning from feedback are gambling-specific, or extend beyond gambling contexts, remains an open question. More generally, addictive disorders-including gambling disorder-have been proposed to be facilitated by individual differences in feedback-driven decision-making inflexibility, which has been studied in the lab with the Probabilistic Reversal Learning Task (PRLT). In this task, participants are first asked to learn which of two choice options is more advantageous, on the basis of trial-by-trial feedback, but, once preferences are established, reward contingencies are reversed, so that the advantageous option becomes disadvantageous and vice versa. Inflexibility is revealed by a less effective reacquisition of preferences after reversal, which can be distinguished from more generalized learning deficits. METHODS: In the present study, we compared PRLT performance across two groups of 25 treatment-seeking patients diagnosed with an addictive disorder and who reported gambling problems, and 25 matched controls [18 Males/7 Females in both groups, Mage(SDage) = 25.24 (8.42) and 24.96 (7.90), for patients and controls, respectively]. Beyond testing for differences in the shape of PRLT learning curves across groups, the specific effect of problematic gambling symptoms' severity was also assessed independently of group assignment. In order to surpass previous methodological problems, full acquisition and reacquisition curves were fitted using generalized mixed-effect models. RESULTS: Results showed that (1) controls did not significantly differ from patients in global PRLT performance nor showed specific signs of decision-making inflexibility; and (2) regardless of whether group affiliation was controlled for or not, gambling severity was specifically associated with more inefficient learning in phases with reversed contingencies. CONCLUSION: Decision-making inflexibility, as revealed by difficulty to reacquire decisional preferences based on feedback after contingency reversals, seems to be associated with gambling problems, but not necessarily with a substance-use disorder diagnosis. This result aligns with gambling disorder models in which domain-general compulsivity is linked to vulnerability to develop gambling-specific problems with exposure to gambling opportunities.

Types of Emotion Regulation and Their Associations with Gambling: A Cross-Sectional Study with Disordered and Non-problem Ecuadorian Gamblers.

This cross-sectional study was aimed at investigating the role of emotional regulation in regular gambling in a sample of 197 disordered and non-problem gamblers from Ecuador. Two proxies were used as measures of behavioral signs of generalized emotion dysregulation (UPPS-P emotion-driven impulsivity) and intentional emotion regulation strategies (ERQ), and their associations with gambling cognitions (as measured by the GRCS questionnaire), gambling behavior (SOGS), and comorbid alcohol and drug misuse (MultiCAGE), were explored. For analyses, impulsivity traits, including emotion-driven impulsivity scores, were used as inputs to predict dispositional variables (ERQ strategies and GRCS cognitions), and clinically relevant behavioral outputs, while controlling for gambling severity. Hypotheses were based on previously published work, although the analysis has been improved (using hierarchical linear mixed-effects modelling), and homogenized in covariate control, and decision threshold stringency. Results were as follows: (1) After controlling for relevant covariates, UPPS-P sensation seeking was positively associated with gambling cognitions, whereas positive urgency was positively associated with cognitive biases (interpretative bias, control illusion, and predictive control) but not with other gambling cognitions. (2) Among emotion regulation strategies, reappraisal, but not suppression, was associated with gambling cognitions. (3) Negative urgency was distinctively associated with suppression, but not with reappraisal. And (4), no impulsivity dimensions significantly predicted drug or alcohol misuse, although negative urgency fell just below the decision threshold. These results reinforce the importance of emotion regulation processes in the cognitive and behavioral manifestations of gambling. Most importantly, they suggest a dissociation between the role of model-free dysregulation of negative emotions (as measured by UPPS-P negative urgency), as a key contributor to gambling complication and general psychopathology; and the one of strategic emotion regulation, in fueling gambling-related cognitive distortions.

Impulsivity and problem awareness predict therapy compliance and dropout from treatment for gambling disorder. / Impulsividad y conciencia del problema predicen la adherencia terapéutica y el abandono del tratamiento en el trastorno por juego de azar.

This study investigates the predictive value of impulsivity traits (as measured by the UPPS-P impulsive behaviour scale) and relevant covariates (sociodemographics, gambling severity, dysphoric mood, other potentially addictive behaviours, and non-verbal intelligence) with regard to treatment dropout and level of adherence to therapy guidelines and instructions in patients with gambling disorder. Sixty-six patients seeking treatment for gambling disorder, and recruited to participate in a larger protocol (G-Brain), were initially assessed in impulsivity traits and relevant covariates in the first six months after admission. Of these, 24 patients dropped out (DO) and 42 patients remained in therapy (NDO) during the subsequent 6-month follow-up period. A multivariate analysis of impulsivity subscales suggested prospective differences between DO and NDO, with affect-driven dimensions (positive and negative urgency) seemingly driving these differences. Among these, only positive urgency independently predicted a slight increase in the drop-out probability. In the NDO group, a higher degree of adherence to therapy was independently predicted by lower sensation-seeking scores and stronger awareness of gambling-related problems. Results suggest the presence of affect-driven impulsivity traits as dropout predictors in patients with gambling disorder. Awareness of gambling-related problems and lower sensation-seeking enhanced compliance with therapeutic guidelines and instructions.

Este estudio investiga el valor predictivo de la impulsividad como rasgo (evaluada con la escala de conducta impulsiva UPPS-P) y de covariados relevantes (variables sociodemográficas, severidad del juego de azar, estado de ánimo disfórico, otras conductas adictivas e inteligencia no verbal), con respecto al abandono del tratamiento y los niveles de cumplimiento de las prescripciones terapéuticas en pacientes con trastorno por juego de azar. Sesenta y seis pacientes con este trastorno, participantes del proyecto G-Brain, fueron evaluados inicialmente en impulsividad rasgo y en los covariados mencionados. Dicha evaluación se realizó durante los seis primeros meses desde el inicio de su tratamiento. En el seguimiento realizado a los 6 meses, 24 pacientes habían abandonado (grupo ABD) y 42 continuaban el tratamiento (grupo NABD). Los análisis multivariados con las subescalas de impulsividad mostraron diferencias prospectivas entre ambos grupos. Aparentemente, estas diferencias son atribuibles a las dimensiones afectivas de impulsividad (urgencias positiva y negativa). Entre ambas dimensiones, solo la urgencia positiva fue un predictor independiente de un ligero incremento en la probabilidad de abandono. Dentro del grupo NABD, un mayor grado de adherencia terapéutica vino predicho, de manera independiente, tanto por una baja búsqueda de sensaciones como por una mayor conciencia de los problemas vinculados al juego. Estos resultados sugieren que los rasgos de impulsividad de origen afectivo son predictores de abandono del tratamiento en pacientes con trastorno por juego. La conciencia de problemas asociados al juego de azar y una baja búsqueda de sensaciones predisponen a una mayor adherencia a las prescripciones terapéuticas.

Impulsividad y conciencia del problema predicen la adherencia terapéutica y el abandono del tratamiento en el trastorno por juego de azar / Impulsivity and problem awareness predict therapy compliance and dropout from treatment for gambling disorder

Este estudio investiga el valor predictivo de la impulsividad como rasgo (evaluada con la escala de conducta impulsiva UPPS-P) y de covariados relevantes (variables sociodemográficas, severidad del juego de azar, estado de ánimo disfórico, otras conductas adictivas e inteligencia no verbal), con respecto al abandono del tratamiento y los niveles de cumplimiento de las prescripciones terapéuticas en pacientes con trastorno por juego de azar. Sesenta y seis pacientes con este trastorno, participantes del proyecto G-Brain, fueron evaluados inicialmente en impulsividad rasgo y en los covariados mencionados. Dicha evaluación se realizó durante los seis primeros meses desde el inicio de su tratamiento. En el seguimiento realizado a los 6 meses, 24 pacientes habían abandonado (grupo ABD) y 42 continuaban el tratamiento (grupo NABD). Los análisis multivariados con las subescalas de impulsividad mostraron diferencias prospectivas entre ambos grupos. Aparentemente, estas diferencias son atribuibles a las dimensiones afectivas de impulsividad (urgencias positiva y negativa). Entre ambas dimensiones, solo la urgencia positiva fue un predictor independiente de un ligero incremento en la probabilidad de abandono. Dentro del grupo NABD, un mayor grado de adherencia terapéutica vino predicho, de manera independiente, tanto por una baja búsqueda de sensaciones como por una mayor conciencia de los problemas vinculados al juego. Estos resultados sugieren que los rasgos de impulsividad de origen afectivo son predictores de abandono del tratamiento en pacientes con trastorno por juego. La conciencia de problemas asociados al juego de azar y una baja búsqueda de sensaciones predisponen a una mayor adherencia a las prescripciones terapéuticas

This study investigates the predictive value of impulsivity traits (as measured by the UPPS-P impulsive behaviour scale) and relevant covariates (sociodemographics, gambling severity, dysphoric mood, other potentially addictive behaviours, and non-verbal intelligence) with regard to treatment dropout and level of adherence to therapy guidelines and instructions in patients with gambling disorder. Sixtysix patients seeking treatment for gambling disorder, and recruited to participate in a larger protocol (G-Brain), were initially assessed in impulsivity traits and relevant covariates in the first six months after admission. 24 patients dropped out (DO) and 42 patients remained in therapy (NDO) during the subsequent 6-month follow-up period. A multivariate analysis of impulsivity subscales suggested prospective differences between DO and NDO, with affect-driven dimensions (positive and negative urgency) seemingly driving these differences. Among these, only positive urgency independently predicted a slight increase in the drop-out probability. In the NDO group, a higher degree of adherence to therapy was independently predicted by lower sensation-seeking scores and stronger awareness of gambling-related problems. Results suggest the presence of affect-driven impulsivity traits as dropout predictors in patients with gambling disorder. Awareness of gambling-related problems and lower sensation-seeking enhanced compliance with therapeutic guidelines and instructions