A pilot study of impulsivity and compulsivity in pathological gambling

We examined the relationship between gambling severity, impulsivity and obsessionality/compulsivity in 38 pathological gamblers, representing the complete Minnesota sample of a randomized, placebo-controlled clinical trial of paroxetine for the treatment of pathological gambling (PG), using Pearson correlations and linear regression models at baseline and treatment endpoint. At baseline, Pathological Gambling Modification of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS) scores correlated significantly with those of the Eysenck Impulsiveness Questionnaire (EIQ) Impulsiveness subscale and Padua Inventory (PI) factors I and IV (corresponding to impaired control over mental and motor activities, respectively). None of the associations between PI factors and the PG-YBOCS were significant after adjusting for Impulsiveness scores. There were no differences in changes in the PG-YBOCS between the paroxetine and placebo group. Changes in PG-YBOCS scores after treatment correlated with changes in Impulsiveness scores. These changes appeared independent of paroxetine treatment. The results suggest that, although PG exhibits features of both obsessionality/compulsivity and impulsivity and elements of both decrease with treatment, impulsivity predominates and changes in gambling severity are most associated with changes in impulsivity.

[1]  Eric Hollander,et al.  Reliability and Validity of the Pathological Gambling Adaptation of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS) , 2005, Journal of Gambling Studies.

[2]  Suck-Won Kim,et al.  An open naltrexone treatment study in pathological gambling disorder , 2001, International clinical psychopharmacology.

[3]  A. V. van Balkom,et al.  Cognitive and behavioral therapies alone versus in combination with fluvoxamine in the treatment of obsessive compulsive disorder. , 1998, The Journal of nervous and mental disease.

[4]  E. Hollander,et al.  Short-term single-blind fluvoxamine treatment of pathological gambling. , 1998, The American journal of psychiatry.

[5]  Sybil B. G. Eysenck,et al.  Impulsiveness and Venturesomeness in a Detention Center Population , 1980, Psychological reports.

[6]  C. Blanco,et al.  A Pilot Placebo-Controlled Study of Fluvoxamine for Pathological Gambling , 2002, Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists.

[7]  M. Potenza,et al.  Advances in the Pharmacological Treatment of Pathological Gambling , 2004, Journal of Gambling Studies.

[8]  D. Clarke.  Impulsiveness, Locus of Control, Motivation and Problem Gambling , 2004, Journal of Gambling Studies.

[9]  C. Blanco,et al.  Psychiatric comorbidity in pathological gamblers seeking treatment. , 2001, The American journal of psychiatry.

[10]  E. Barratt,et al.  Psychiatric aspects of impulsivity. , 2001, The American journal of psychiatry.

[11]  S. Dickman,et al.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Functional and Dysfunctional Impulsivity: Personality and Cognitive Correlates , 1990 .

[12]  E. Sanavio.  Obsessions and compulsions: the Padua Inventory. , 1988, Behaviour research and therapy.

[13]  P. R. Pearson,et al.  Age norms for impulsiveness, venturesomeness and empathy in adults , 1985 .

[14]  E. Hollander,et al.  Lithium and valproate treatment of pathological gambling: a randomized single-blind study. , 2002, The Journal of clinical psychiatry.

[15]  F. Downton,et al.  Introduction to Mathematical Statistics , 1959 .

[16]  F. Mancini,et al.  Obsessions and compulsions and intolerance for uncertainty in a non-clinical sample. , 2002, Journal of anxiety disorders.

[17]  D. Black,et al.  Clinical features and psychiatric comorbidity of subjects with pathological gambling behavior. , 1998, Psychiatric services.

[18]  D. Dougherty,et al.  Laboratory measured behavioral impulsivity relates to suicide attempt history. , 2004, Suicide & life-threatening behavior.

[19]  H. Eysenck,et al.  Impulsiveness and Venturesomeness: Their Position in a Dimensional System of Personality Description , 1978, Psychological reports.

[20]  M. Potenza,et al.  Preliminary validity and reliability testing of a structured clinical interview for pathological gambling , 2004, Psychiatry Research.

[21]  Suck-Won Kim,et al.  A double-blind placebo-controlled study of the efficacy and safety of paroxetine in the treatment of pathological gambling. , 2002, The Journal of clinical psychiatry.

[22]  B. Grant,et al.  Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. , 2005, The Journal of clinical psychiatry.

[23]  John C Gore,et al.  Gambling urges in pathological gambling: a functional magnetic resonance imaging study. , 2003, Archives of general psychiatry.

[24]  E. Hollander,et al.  Impact of trait impulsivity and state aggression on divalproex versus placebo response in borderline personality disorder. , 2005, The American journal of psychiatry.

[25]  P. Skudlarski,et al.  An Fmri Stroop Task Study of Ventromedial Prefrontal Cortical Function in Pathological Gamblers Image Acquisition , 2022 .

[26]  N. Petry,et al.  Excessive discounting of delayed rewards in substance abusers with gambling problems. , 1999, Drug and alcohol dependence.

[27]  N. Petry.  Psychosocial Treatments for Pathological Gambling: Current Status and Future Directions , 2002 .

[28]  R. Ladouceur,et al.  Cognitive and behavioral treatment of pathological gambling: a controlled study. , 1997, Journal of consulting and clinical psychology.

[29]  J. Neter,et al.  Applied Linear Regression Models , 1983 .

[30]  N. Petry.  Pathological gamblers, with and without substance use disorders, discount delayed rewards at high rates. , 2001, Journal of abnormal psychology.

[31]  E. Hollander,et al.  Does sustained-release lithium reduce impulsive gambling and affective instability versus placebo in pathological gamblers with bipolar spectrum disorders? , 2005, The American journal of psychiatry.

[32]  J. Hektner,et al.  Paroxetine treatment of pathological gambling: a multi‐centre randomized controlled trial , 2003, International clinical psychopharmacology.

[33]  A. Blaszczynski.  Pathological Gambling and Obsessive-Compulsive Spectrum Disorders , 1999, Psychological reports.

[34]  Suck-Won Kim,et al.  Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling , 2001, Biological Psychiatry.

[35]  A. Blaszczynski,et al.  Sensation seeking and pathological gambling. , 1986, British journal of addiction.

[36]  Z. Steel,et al.  Impulsivity in pathological gambling: the antisocial impulsivist. , 1997, Addiction.

[37]  N. Petry,et al.  Substance abuse, pathological gambling, and impulsiveness. , 2001, Drug and alcohol dependence.

[38]  R. Stinchfield.  Reliability, validity, and classification accuracy of a measure of DSM-IV diagnostic criteria for pathological gambling. , 2003, The American journal of psychiatry.

[39]  M. Potenza,et al.  Pathological gambling. , 2001, Journal of the American Medical Association (JAMA).

[40]  H. Sumnall,et al.  Self-Reported Psychopathology in Polydrug Users , 2004, Journal of psychopharmacology.

[41]  C. Blanco,et al.  Pathological gambling and platelet MAO activity: a psychobiological study. , 1996, The American journal of psychiatry.