Cold pressor pain and gambling disorder: implications for the opioid system

Grant, Jon E.; Chamberlain, Samuel R.

doi:10.1017/s109285291900107x

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…Though, only patients with pain, regardless of the type, reported pathological gambling in our cohort. This finding is consistent with the notion that patients with pain may be more vulnerable to pathological gambling than patients without pain [ 31 , 32 ]. It has been hypothesized that the inability to cope with painful or uncomfortable physical sensations may drive the gambling behavior, due to a general inability to cope with discomfort.…”

Section: Discussionsupporting

confidence: 92%

Central Pain in Parkinson’s Disease: Behavioral and Cognitive Characteristics

Vila‐Chã

Cavaco

Mendes

et al. 2021

Parkinson's Disease

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Introduction. Pain is a major nonmotor symptom of Parkinson’s disease (PD), and central parkinsonian pain is the core feature of the putative Park pain subtype of PD. This study aimed to explore the cognitive and behavioral profile of PD patients with central parkinsonian pain. Material and Methods. A structured interview was used to identify and characterize pain in a cohort of 260 consecutive PD patients. The Ford classification of pain was applied. The Dementia Rating Scale-2 (DRS-2) and the Impulse Control Disorders in Parkinson’s Disease Short Form (QUIP-S) were administered, and patients’ smoking habits were recorded. The Unified Parkinson’s Disease Rating Scale (UPDRS) was used to assess motor and nonmotor symptoms in off and on conditions. Results. One hundred and eighty-eight patients (68%) reported pain; and in 41 (22%) of them, the pain was classified as central parkinsonian pain. PD patients with central parkinsonian pain had better cognitive performance in DRS-2 Initiation/Perseveration and Conceptualization subscales but reported more other compulsive behaviors (e.g., hobbyism, punding, and walkabout) and had more current smoking habits than those without pain or with non-central parkinsonian pain. Multiple logistic regression analyses revealed that the DRS-2 Conceptualization subscale, other compulsive behaviors, and smoking habits remained statistically associated with central parkinsonian pain even when other significant covariates were considered. Only patients with pain, regardless of type, had a gambling disorder. Discussion. The study results provide further evidence that pain revealed that patients with central parkinsonian pain are more likely to present compulsive or addictive behaviors, despite having more preserved cognitive performance. Patients with central parkinsonian pain appear to have a distinct phenotype of PD.

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Section: Discussionsupporting

confidence: 92%

Central Pain in Parkinson’s Disease: Behavioral and Cognitive Characteristics

Vila‐Chã

Cavaco

Mendes

et al. 2021

Parkinson's Disease

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“…There is also increasing evidence about the important role of dysregulation of the endogenous opioid system ( 59 ), the endocannabinoid system ( 1 ), or the nicotinic acetyl-choline receptor (nAChR) system ( 41 ) in the physiopathology of GD. Recent studies indicate that individuals with GD show a relative intolerance to pain that would involve the endogenous opioid system ( 59 , 60 ). The dysfunction of the endogenous endocannabinoid system is known to be implicated in GD ( 61 ).…”

Section: Etiopathogenesis Of Gambling Dual Disordermentioning

confidence: 99%

Gambling Dual Disorder: A Dual Disorder and Clinical Neuroscience Perspective

et al. 2020

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Several behaviors, including compulsive gambling, have been considered non-substance-related addictive disorders. Categorical mental disorders (e.g., DSM-5) are usually accompanied by very different symptomatic expressions (affective, behavioral, cognitive, substance abuse, personality traits). When these mental disorders occur with addictive disorders, either concomitantly or sequentially over the life span, this clinical condition is called a dual disorder. Gambling disorder (GD) has been associated with other categorical psychiatric diagnoses: attention deficit hyperactivity disorder, depression, bipolar disorder, social anxiety, schizophrenia, substance use disorder, antisocial personality disorder; and dimensional symptoms including higher impulsivity, poorer emotional wellbeing, cognitive distortion, psychosis, deficient self-regulation, suicide, poorer family environment, and greater mental distress. We are calling this clinical condition Gambling Dual Disorder. From a clinical perspective, it is clear that Gambling Dual Disorder is not the exception but rather the expectation, and this holds true not just for GD, but also for other mental disorders including other addictions. Mental disorders are viewed as biological disorders that involve brain circuits that implicate specific domains of cognition, emotion, and behavior. This narrative review presents the state of the art with respect to GD in order to address current matters from a dual disorder, precision psychiatry, and clinical neuroscience perspective, rather than the more subjective approach of symptomatology and clinical presentation. This review also presents Gambling Dual Disorder as a brain and neurodevelopmental disorder, including from the perspectives of evolutionary psychiatry, genetics, impulsivity as an endophenotype, the self-medication hypothesis, and sexual biological differences. The wide vision of the disease advances a paradigm shift, highlighting how GD and dual disorders should be conceptualized, diagnosed, and treated. Rethinking GD as part of a dual disorder is crucial for its appropriate conceptualization from the perspective of clinical neuroscience and precision psychiatry.

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“…We aim to investigate this by fitting a Hybrid-RL 7-parameter computational model to the behavioral data obtained from Two-step Markov task, a novel approach which remains unexplored in this line of research. Acute stress will be induced with the Socially Evaluated Cold Pressor Task (SECPT) that requires participants to immerse one arm into cold water while being socially observed and videorecorded, a method that robustly increases laboratory stress reactivity (Schwabe et al, 2008), including among PG (Grant & Chamberlain, 2019). Based on previous findings we hypothesized that PG will repeat previously rewarded choices without accounting for the task structure (Wyckmans et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

The modulation of acute stress on Model-Free and Model-Based reinforcement learning in Gambling Disorder

Wyckmans

Banerjee

Saeremans

et al. 2022

Preprint

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Background and aims: Experiencing acute stress is common in behavioral addictions such as gambling disorder. Additionally, like most substance-induced addictions, aberrant decision-making wherein a reactive habit-induced response (conceptualized as a Model-free [MF] in reinforcement learning) suppresses a flexible goal-directed response (conceptualized as a Model-based [MB]) is also common in gambling disorder. In the current study we investigated the influence of acute stress on the balance between habitual response and the goal-directed system. Methods: A sample of N = 116 pathological gamblers (PG) and healthy controls (HC) performed an acute stress task - the Socially Evaluated Cold pressure task (SECPT) - or a control task. Self-reported stress and salivary cortisol were collected as measures of acute stress. Following the SECPT, participants performed the Two-Step Markov Task to account for the relative contribution of MB and MF strategies. Additionally, verbal working-memory and IQ measures were collected to account for their mediating effects on the orchestration between MB/MF and the impact of stress. Results: Both groups had comparable baseline and stress-induced cortisol response to the SECPT. Non-stressed PG displayed lower MB learning than HC. MANOVA and regression analyses showed a deleterious effect of stress-induced cortisol response on the orchestration between MB and MF learning in HC but not in PG. Neither working memory nor IQ mediated these effects. Discussion and Conclusions: Despite normal cortisol response to stress, we found an abnormal pattern of modulation of stress on the orchestration between MB and MF learning among PG.

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Cold pressor pain and gambling disorder: implications for the opioid system

Cited by 4 publications

References 40 publications

Central Pain in Parkinson’s Disease: Behavioral and Cognitive Characteristics

Central Pain in Parkinson’s Disease: Behavioral and Cognitive Characteristics

Gambling Dual Disorder: A Dual Disorder and Clinical Neuroscience Perspective

The modulation of acute stress on Model-Free and Model-Based reinforcement learning in Gambling Disorder

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