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The aim of this study was to measure the reliability, validity, and classification accuracy of a Spanish translation of a measure of DSM-IV diagnostic criteria for Pathological Gambling (PG). Participants were 263 male and 23 female patients seeking treatment for PG and a matched non-psychiatric control sample of 259 men and 24 women. A Spanish translation of a 19-item measure of DSM-IV diagnostic criteria for PG (Stinchfield 2003) was administered along with other validity measures. The DSM-IV diagnostic criteria were found to be internally consistent with a coefficient alpha of .95 in the combined sample. Evidence of satisfactory convergent validity included moderate to high correlations with other measures of problem gambling. Using the standard DSM-IV cut-score of five, the ten criteria were found to yield satisfactory classification accuracy results with a high hit rate (.95), high sensitivity (.92), high specificity (.99), low false positive (.01), and low false negative rate (.08). Lowering the cut score to four resulted in modest improvements in classification accuracy and reduced the false negative rate from .08 to .05. The Spanish translation of a measure of DSM-IV diagnostic criteria for PG demonstrated satisfactory psychometric properties and a cut score of four improved diagnostic precision.

Objective:to examine short and middle-term effectiveness of a group cognitive-behavioral intervention (CBT) in pathological gambling (PG) and to analyze predictors of therapy outcome.Method:Two hundred and ninety PG patients consecutively admitted to our Unit participated in the current study. All participants were diagnosed according to DSM-IV-criteria. Manualized outpatient group CBT [16 weekly sessions] was given. Specific assessment before and after the therapy and at 1, 3 and 6 months follow-up was conducted. Logistic regression analyses and survival analysis were applied.Results:outpatient group CBT was effective with abstinence rates by the end of therapy of 76.1%, and 81.5% at 6 months follow-up. The dropout rate during treatment decreased significantly after the fifth treatment session. Psychopathological distress (p = 0.040) and obsessive-compulsive symptoms were identified as factors predicting relapses and drop-outs respectively.Conclusions:our findings suggest that group CBT is effective for treating PG individuals. Several psychopathological and personality traits were identified as outcome predictors.

Background: Impairments in self-regulatory behaviour reflect a deficit in executive functioning and decision-making, as well as higher levels of self-reported impulsivity, and may be involved in the development and maintenance of addictive disorders. We sought to explore the association between self-reported impulsivity and neurocognitive measures, and their association with treatment outcome in pathologic gambling. Methods: We assessed patients with pathologic gambling using executive functioning and decision -making tests and self-report measures of impulsivity. Patients underwent cognitive-behavioural therapy (CBT) for pathologic gambling. Results: We included 88 patients (8% women) in our study. High self-reported extravagance was associated with poor performance in the Iowa Gambling Task (IGT)-ABCD version. High impulsiveness, low disorderliness, high exploratory excitability (trend), poor backward block span and poor IGT-EFGH scores (trend) predicted dropout. We observed no self-reported or neurocognitive predictors of relapse or number of treatment sessions attended. Limitations: Most participants were slot-machine gamblers seeking treatment. No follow-up data and no control group were included in the study. The missing sample (i.e., individuals who were recruited and assessed in the pretreatment stage but who chose not to begin treatment) had higher extravagance scores than the final sample. Conclusion: Neurocognitive reward sensitivity was related to self-reported overspending behaviour. Self-regulatory impairments (especially rash impulsiveness and punishment sensitivity) and executive dysfunction predicted only dropout of CBT in participants with pathologic gambling. Different neurocognitive processes and personality traits might mediate treatment response to psychological therapy of pathologic gambling according to the specific target variable assessed. Research Paper Effect of executive functioning, decision-making IntroductionImpairments in self-regulatory behaviour seem to be involved in the development and maintenance of pathologic gambling and other addictive disorders.1,2 From a neuropsychological point of view, this impairment reflects a deficit in executive functioning and decision-making. 3,4 Executive functioning includes functions such as cognitive flexibility (set-shifting), which is associated with orbitofrontal functioning, and working memory, planning and abstract thinking, which are associated with dorsolateral prefrontal functioning. [5][6][7] However, decision-making seems to be mainly associated with activation of the ventromedial prefrontal cortex. 5,8 People with pathologic gambling have shown impaired performance in tasks measuring both concepts. Specifically, studies report deficits in cognitive inhibition, complex executive functions and attention. [9][10][11] This population also shows impairments in decision-making.12-14 Decision-making impairments are observed in impulsive individuals in general. Specifically, impulsive individuals show an insensitivity to variations in re...

At least 4 types of PG patients may be identified. Two types showed a response modulation deficit, but only one of them had severe psychopathological disturbances. Two other types showed no impulsiveness or sensation seeking and one of them even exhibited good general functioning. The different personality and clinical configuration of these clusters might be linked to different therapeutic approaches.

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Aims: The aim of this study was to evaluate posttreatment changes of individuals with a diagnosis of gambling disorder (GD) treated with group cognitive behavioral therapy (CBT), to assess the potential moderator effect of sex on CBT outcome, and to explore the best predictors of posttreatment changes, relapse, and dropout rates. Methods: A cohort design was applied with a prospective follow-up. The sample comprised 440 patients and the CBT intervention consisted of 16 weekly outpatient group sessions and a 3-month follow-up period. Results: Patients showed significant improvements in both the level of psychopathology and the severity of the gambling behavior. High self-transcendence and the involvement of the spouse or partner in the therapy predicted a higher risk of relapse. Younger age and low education predicted a higher risk of dropout. Conclusion: Many patients with GD can be treated with strategies to improve self-control and emotional regulation, but other techniques should be incorporated to address the individual characteristics of each patient. This is particularly important in group therapy, in which the same treatment is applied to several patients simultaneously. The involvement of a family member needs to be carefully considered since it may have a negative effect on the response to treatment if not adequately managed.

Shared vulnerabilities have been described across disorders of impulse control, including pathological gambling (PG) and bulimia nervosa (BN). Our aim was to compare the executive functioning of PG and BN females in order to confirm their similarity at a neurocognitive level. A total of 15 BN females, 15 PG females, and 15 healthy control (HC) females were administered the Wisconsin Card Sorting Test (WCST) and the Stroop Color and Word Test. Analysis of covariance adjusted for age and education was conducted to compare groups. PG showed the greatest impairment, that is, the highest percentage of WCST perseverative errors (p = .023), the lowest percentage of conceptual-level responses (p = .034), and the highest number of total trials administered (p = .021), while BN showed the highest percentage of WCST nonperseverative errors (p = .003). Both BN and PG females demonstrated executive dysfunction relative to HCs but different specific correlates (i.e., greater vulnerability to distraction in BN, but more cognitive inflexibility in PG).