The predictive capacity of DSM-5 symptom severity and impulsivity on response to cognitive-behavioral therapy for gambling disorder: A 2-year longitudinal study

Mestre‐Bach, Gemma; Steward, Trevor; Granero, Roser; Fernández‐Aranda, Fernando; Pino-Gutiérrez, Amparo del; Mallorquí‐Bagué, Núria; Mena-Moreno, Teresa; Vintró-Alcáraz, Cristina; Moragas, Laura; Aymamí, Neus; Gómez-Peña, Mònica; Sánchez‐González, Jéssica; Agüera, Zaida; Lozano‐Madrid, María; Menchón, José M.; Jiménez‐Murcia, Susana

doi:10.1016/j.eurpsy.2018.09.002

Cited by 28 publications

(36 citation statements)

References 63 publications

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“…Finally, a significant association was found between GD severity and two of the impulsivity facets, impulsive tendencies and choice impulsivity, which is consistent with other findings 24,40 . Even though a recent meta-analysis identified associations between motor impulsivity and GD 9 , our study failed to identify a significant association between response inhibition and GD severity among GD patients.…”

Section: Discussionsupporting

confidence: 90%

“…It also remains unclear whether impulsivity levels are associated with treatment outcome. Some research has found high levels of impulsive traits to be associated with relapse and dropout from treatment 40 , whereas other studies have found greater awareness of gambling-related problems to be associated with positive outcomes 44 . Finally, another study found GD to be associated with response impulsivity and choice impulsivity, although only the latter was linked with GD severity 13 .…”

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confidence: 99%

“…Similarly, lack of premeditation is positively associated with poor decision-making and an inability to identify the possible negative financial outcomes that might stem from taking risks, a relevant feature in patients with GD 20,39 . Other studies highlight that urgency levels, characterized by the tendency to act rashly when experiencing extreme moods, are linked with GD severity and other impulsive behaviors 40,41 . It should also be noted that impulsivity stemming from enduring personality characteristics that lead gamblers to focus on short-term gains (i.e.…”

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Dimensions of Impulsivity in Gambling Disorder

Mestre‐Bach

Steward

Granero

et al. 2020

Sci Rep

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Impulsivity is a multidimensional construct. Although gambling disorder (GD) has been associated with high impulsivity, impulsivity across multiple domains has not been thoroughly investigated in this population. We first aimed to examine whether associations between three facets of impulsivity (response impulsivity, choice impulsivity and impulsive tendency) varied between GD patients and healthy controls (HC). We next aimed to evaluate relationships between these three types of impulsivity, as proposed by theoretical models of impulsivity, and their associations with GD severity. The sample included 97 treatment-seeking adult men with GD, diagnosed according to DSM-5 criteria, and 32 male HCs recruited from the general population. Greater impulsivity in all three domains was found in men with GD in comparison to men without GD. Associations between impulsivity facets were found in both groups, with response impulsivity being the only domain associated with GD severity. Our findings confirm that multiple domains of impulsivity are relevant in GD. Future studies should examine the extent to which treatments aimed at targeting specific aspects of impulsivity improve outcomes. Although impulsivity has been proposed as a multifactorial construct 1 , there is still a lack of consensus regarding its definition and the independence of impulsivity domains 2. Impulsivity has been defined as a tendency to respond with little forethought, often with disregard to the negative consequences to the impulsive individual or others 3. Impulsivity has been found to factor into multiple forms, including response and choice forms, that can be measured across species 4-7. While multiple theoretical models have been proposed different types of impulsivity, the proposal by MacKillop et al. 8 is widely used and validated in different populations. This model posits that impulsivity can be partitioned into three main domains: response impulsivity, choice impulsivity and impulsive tendencies. Response impulsivity, also termed impulsive action or motor impulsivity, involves impairments in delaying, withholding or interrupting inappropriate responses 4,9. High levels of this type of impulsivity have been associated with gambling disorder (GD), with GD participants demonstrating differences in response impulsivity in comparison with healthy control (HC) participants 10 , including within treatment-seeking samples 11. Multiple studies suggest gambling severity is positively correlated with motor impulsivity 9,12,13 and one recent meta-analysis found GD to be associated with significant impairments in motor and attentional inhibition 14. Delay discounting relates to impulsive choice and the extent to which an individual prefers a smaller-sooner over a larger-later reward 5,15. In the case of GD, cognitive disturbances related to risk-reward decision making have been reported 16,17 , and individuals with GD tend to discount rewards more steeply than controls 18-21. Increasing evidence supports that people with gambling problems prefer to obtain ...

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

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Dimensions of Impulsivity in Gambling Disorder

Mestre‐Bach

Steward

Granero

et al. 2020

Sci Rep

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“…4 Overall, research demonstrates that CBT can have robust short-term and long-term effects on problem gambling, and related harms (e.g., quality of life, emotional wellbeing) 5,6 across gambling types 5 and severity levels. 7 Research comparing outcomes from routine clinical CBT with the results of randomised control trials (RCTs) demonstrate that CBT is as effective at addressing gambling problems and related harms in real clinical contexts, as it is in research contexts. 8…”

Section: Overall Efficacy Of Cbt For Treating Gambling Problemsmentioning

confidence: 99%

“…› A study of adult men seeking treatment for gambling disorder did not find differences in CBT outcomes between patients categorised by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) severity levels. 7 Primary Gambling Activity › A 2009 systematic review and meta-analysis found that CBT was effective at reducing problem gambling (assessed using various screening tools, SOGS most frequently used) across primary gambling activities (at three and six-month windows, excluding scratch cards at the three-month window). 5 › A 2018 study of treatment-seeking adults in London (UK) found significant differences in dropout rates depending on gambling activity.…”

Section: Severity Levelmentioning

confidence: 99%

Effective Treatment and Support for Problem Gambling

Kalbfleisch¹,

Baxter²,

McKnight³

et al. 2020

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The National Strategy to Reduce Gambling Harms has identified the need to make significant progress towards truly national treatment and support options as one of its priority actions. This priority area is shared by GambleAware, another key stakeholder in the Great Britain's (GB) gambling treatment and support landscape. The evidence upon which GB's current gambling treatment strategy is based is outdated, and GambleAware has begun the planning process towards an update to the current treatment strategy. A rapid evidence review was commissioned to provide an updated evidence base on treatment and support for problem gambling in order to inform future growth, improvement, and evaluation of problem gambling treatment services across GB. The report covers ten key treatment topics including:

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