Contribution of sex on the underlying mechanism of the gambling disorder severity

Abstract

Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients’ sex. A sample of n = 512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients’ sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care.

Clustering Treatment Outcomes in Women with Gambling Disorder

“…Some studies have observed that at the beginning of treatment GD severity is similar among men and women (number of gambling symptoms, level of urgency related to the gambling behavior or cognitive biases associated with gambling expectations) (Grant, Chamberlain, et al, 2012 ; Grant, Odlaug, et al, 2012 ; G. Mestre-Bach et al, 2016a , b; Smith et al, 2015 ). However, remarkably different results have been obtained in other studies, which suggest the existence of distinct profiles in men and women regarding gambling severity (Susana Jiménez-Murcia et al, 2020 ; Ronzitti, Lutri, et al, 2016 ; Ronzitti, Soldini, et al, 2016 ), as well as in other compulsive-related neurocognitive domains (Mallorquí-Bagué et al, 2021 ), and in the role of the urge to gamble and gambling-related cognitions in the tracking correlations of GD over time (Dunsmuir et al, 2018 ). Empirical evidence has also showed that patients’ sex could modulate the relationships between the multiple variables that can be used to explain gambling severity and the development of the disorder.…”

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

“…Although a higher prevalence of GD is described in men than women (Blanco et al, 2006;Husky et al, 2015), previous studies have reported that women are more likely to engage in FA behaviors (Schulte & Gearhardt, 2018) and experience abnormal eating and weight disorders (Jiménez-Murcia et al, 2019;Romero et al, 2019;Schulte & Gearhardt, 2018), with initial studies suggesting similar relationships in patients with GD Jiménez-Murcia et al, 2017). Lower socioeconomic status has been associated with GD severity among women (Jiménez-Murcia et al, 2020). Higher psychopathology, particularly depressive and anxiety symptoms, and some specific personality features, such as low self-directedness and perseverance or high reward dependence, have been linked to FA in both medical and mental conditions (Brunault et al, 2018;Imperatori, 2014;Wolz et al, 2016).…”

The Relationship between Impulsiveness, Self-Esteem, Irrational Gambling Belief and Problem Gambling Moderating Effects of Gender

“…These results underscore the importance of impulsivity and irrational gambling belief in problem gambling [ 10 ]. Previous studies showed that adults with the characteristics of impulsiveness had more symptoms of problem gambling than those who were less impulsive [ 10 , 11 , 12 , 48 ]. Problem gambling is a mental disorder and is associated with dysfunction in the cognitive domains that control impulsive behavior [ 7 ].…”