Compulsive use of games, pornography, phones and gambling.
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201 to 225 of 620Gambling and substance use: Comorbidity and treatment implications.
Gambling disorder is a common condition that was previously listed as an impulse control disorder, but is now considered a substance-related and addictive disorder. Gambling disorder has been associated with various untoward long-term outcomes including impaired quality of life, relationship break-ups, debt and mortgage foreclosure, and elevated risk of suicidality. This paper provides a concise primer on gambling disorder, with a special focus on its parallels with substance use disorders. We consider clinical presentations, comorbid expression, heritability, and treatment approaches (psychological and pharmacological). Lastly, we highlight new treatment directions suggested by the literature.
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Di Nicola M, De Crescenzo F, D'Alò GL, Remondi C, Panaccione I, Moccia L, Molinaro M, Dattoli L, Lauriola A, Martinelli S, Giuseppin G, Maisto F, Crosta ML, Di Pietro S, Amato L, Janiri L (2020)reviewMEDLINE-indexed journal, not yet read by usJournal of addiction medicine42 citations Pharmacological and Psychosocial Treatment of Adults With Gambling Disorder: A Meta-Review.
Background and objectives: Gambling disorder (GD) leads to impaired socioeconomical functioning and increased social costs. Although the research on GD has been rising over the years, approved treatment guidelines are currently not available. The aim of this study was to systematically review the literature on the pharmacological and psychosocial treatment of adults with GD, and to identify possible agreed-upon standards of care.
Methods: MEDLINE, PubMed, Cochrane, Web of Science, Embase, and CINAHL electronic databases were searched up to April 2019 for systematic reviews on pharmacological, psychosocial, and combined treatment of adults with GD. Twenty-six studies were eventually included in this meta-review.
Results: Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in subjects with c…
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Gambling disorder.
Gambling disorder is characterized by a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The prevalence of gambling disorder has been estimated at 0.5% of the adult population in the United States, with comparable or slightly higher estimates in other countries. The aetiology of gambling disorder is complex, with implicated genetic and environmental factors. Neurobiological studies have implicated cortico-striato-limbic structures and circuits in the pathophysiology of this disorder. Individuals with gambling disorder often go unrecognized and untreated, including within clinical settings. Gambling disorder frequently co-occurs with other conditions, particularly other psychiatric disorders. Behavioural interventions, particularly cognitive-behavioural therapy but also motivational interviewing and Gamblers Anonymous, are supported in …
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Long-term effects of internet-supported cognitive behaviour therapy.
Introduction: Internet-supported and therapist-guided cognitive behaviour therapy (ICBT) is effective for a range of problems in the short run, but less is known about the long-term effects with follow-ups of two years or longer. Areas covered: This paper reviews studies in which the long-term effects of guided ICBT were investigated. Following literature searches in PubMed and other sources meta-analytic statistics were calculated for 14 studies involving a total of 902 participants, and an average follow-up period of three years. Studies were from Sweden (n = 11) or the Netherlands (n = 3). Long-term outcome studies were found for panic disorder, social anxiety disorder, generalized anxiety disorder, depression, mixed anxiety and depression, obsessive-compulsive disorder, pathological gambling, stress and chronic fatigue. The duration of the treatments was usually short (8-15 weeks). T…
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Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research.
Despite significant psychiatric comorbidity in problem gambling, there is little evidence on which to base treatment recommendations for subpopulations of problem gamblers with comorbid psychiatric disorders. This mini-review draws on two separate systematic searches to identify possible interventions for comorbid problem gambling and psychiatric disorders, highlight the gaps in the currently available evidence base, and stimulate further research in this area. In this mini-review, only 21 studies that have conducted post-hoc analyses to explore the influence of psychiatric disorders or problem gambling subtypes on gambling outcomes from different types of treatment were identified. The findings of these studies suggest that most gambling treatments are not contraindicated by psychiatric disorders. Moreover, only 6 randomized studies comparing the efficacy of interventions targeted towar…
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Gamblers Anonymous as a Recovery Pathway: A Scoping Review.
Given the preponderance of Gamblers Anonymous (GA), there has been relatively little effort to explore the existing evidence base on its effectiveness as a recovery approach for problem gambling. To remedy this gap in the literature we conducted a scoping review of the literature on mutual aid for individuals experiencing problem gambling published between 2002 and 2015. We searched 13 databases and reviewed reference lists and websites of relevant organizations. We reviewed records for eligibility and extracted relevant data from eligible articles. Three reviewers independently assessed the methodological quality of the included studies using the Mixed Methods Appraisal Tool. We identified 17 studies in 25 publications that were eligible for inclusion. Most studies were conducted in the United States, were cross-sectional in design, and involved both male and female adult participants. …
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Neural and psychological underpinnings of gambling disorder: A review.
Gambling disorder affects 0.4 to 1.6% of adults worldwide, and is highly comorbid with other mental health disorders. This article provides a concise primer on the neural and psychological underpinnings of gambling disorder based on a selective review of the literature. Gambling disorder is associated with dysfunction across multiple cognitive domains which can be considered in terms of impulsivity and compulsivity. Neuroimaging data suggest structural and functional abnormalities of networks involved in reward processing and top-down control. Gambling disorder shows 50-60% heritability and it is likely that various neurochemical systems are implicated in the pathophysiology (including dopaminergic, glutamatergic, serotonergic, noradrenergic, and opioidergic). Elevated rates of certain personality traits (e.g. negative urgency, disinhibition), and personality disorders, are found. More r…
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Gambling disorder and its relationship with substance use disorders: implications for nosological revisions and treatment.
Background: Gambling disorder, recognized by the DSM-5 as a behavioral addiction, affects .4-1.6% of adults worldwide, and is highly comorbid with other mental health disorders, particularly substance use disorders (SUDs).
Objectives: To provide a concise primer on the relationship between gambling disorder and SUDs, focusing on phenomenology/clinical presentation, co-morbidity, familiality, cognition, neuroanatomy/neurochemistry, and treatment.
Methods: Selective review of the literature.
Results: Scientific evidence shows that gambling and SUDs have consistently high rates of comorbidity, similar clinical presentations, and some genetic and physiological overlap. Several treatment approaches show promise for gambling disorder, some of which have previously been effective for SUDs.
Scientific significance: It is hoped that recognition of overlap between gambling disorder and SUDs in ter…
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Irrational beliefs, biases and gambling: exploring the role of animal models in elucidating vulnerabilities for the development of pathological gambling.
Gambling is a heterogeneous and complex disorder. Multiple factors may lead to problem gambling, yet one of the most important appears to be the increased presence of cognitive biases or distortions. These biases are thought to precipitate gambling as they can lead to dysfunctional decision making under risk or ambiguity. Modelling these cognitive perturbations in animals can improve our understanding of their neurobiological bases, and potentially stimulate novel treatment options. The first aim of this review is to give a broad overview of some of the cognitive biases that are most commonly associated with gambling. Secondly, we will discuss several animal models that we have developed in which rodent decision-making appears hallmarked by the same cognitive inconsistencies as human choice. In particular, we will discuss two tasks that capture elements of risk and loss averse decision m…
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Potenza MN (2014)reviewMEDLINE-indexed journal, not yet read by usTrends in cognitive sciences61 citations The neural bases of cognitive processes in gambling disorder.
Functional imaging is offering powerful new tools to investigate the neurobiology of cognitive functioning in people with and without psychiatric conditions like gambling disorder. Based on similarities between gambling and substance-use disorders in neurocognitive and other domains, gambling disorder has recently been classified in the Diagnostic and Statistical Manual of Mental Disorders (5th edn) (DSM-5) as a behavioral addiction. Despite the advances in understanding, there exist multiple unanswered questions about the pathophysiology underlying gambling disorder and the promise for translating the neurobiological understanding into treatment advances remains largely unrealized. Here we review the neurocognitive underpinnings of gambling disorder with a view to improving prevention, treatment, and policy efforts.
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An overview of and rationale for changes proposed for pathological gambling in DSM-5.
The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in 2013. It will include several changes to the diagnosis of pathological gambling: the name of the disorder will be altered, the threshold for diagnosis will decrease, and one criterion will be removed. This paper reviews the rationale for these changes and addresses how they may impact diagnosis and treatment of the disorder, as well as potential for future research in the field.
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Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: emerging evidence.
Delay discounting describes the devaluation of a reinforcer as a function of the delay until its receipt. Although all people discount delayed reinforcers, one consistent finding is that substance-dependent individuals tend to discount delayed reinforcers more rapidly than do healthy controls. Moreover, these higher-than-normal discounting rates have been observed in individuals with other behavioral maladies such as pathological gambling, poor health behavior, and overeating. This suggests that high rates of delay discounting may be a trans-disease process (i.e., a process that occurs across a range of disorders, making findings from one disorder relevant to other disorders). In this paper, we argue that delay discounting is a trans-disease process, undergirded by an imbalance between two competing neurobehavioral decision systems. Implications for our understanding of, and treatment fo…
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Pathological gambling in Parkinson's disease--a review of the literature.
The prevalence of pathological gambling is 3.4% to 6% in treated Parkinson's disease, which is higher than the background population rate. In this review we discuss current evidence to indicate that dopamine agonists are much more likely to trigger this behavior than either L-dopa or selective monoamine oxidase B inhibitor monotherapy. New insights from recent behavioral and functional imaging studies and possible treatment approaches are also covered. A PubMed literature search using the terms "gambling" and "Parkinson's disease," "impulse control disorder," "impulsive compulsive behaviour," "dopamine agonist," of individual dopamine agonists, and of ongoing drug trials, using http://www.clinicaltrials.gov, was carried out for the period up to January 2011.
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Clark L (2010)reviewMEDLINE-indexed journal, not yet read by usPhilosophical transactions of the Royal Society of London. Series B, Biological sciences129 citations Decision-making during gambling: an integration of cognitive and psychobiological approaches.
Gambling is a widespread form of entertainment that may afford unique insights into the interaction between cognition and emotion in human decision-making. It is also a behaviour that can become harmful, and potentially addictive, in a minority of individuals. This article considers the status of two dominant approaches to gambling behaviour. The cognitive approach has identified a number of erroneous beliefs held by gamblers, which cause them to over-estimate their chances of winning. The psychobiological approach has examined case-control differences between groups of pathological gamblers and healthy controls, and has identified dysregulation of brain areas linked to reward and emotion, including the ventromedial prefrontal cortex (vmPFC) and striatum, as well as alterations in dopamine neurotransmission. In integrating these two approaches, recent data are discussed that reveal anoma…
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Brain imaging studies in pathological gambling.
This article reviews the neuroimaging research on pathological gambling (PG). Because of the similarities between substance dependence and PG, PG research has used paradigms similar to those used in substance use disorder research, focusing on reward and punishment sensitivity, cue reactivity, impulsivity, and decision making. This review shows that PG is consistently associated with blunted mesolimbic-prefrontal cortex activation to nonspecific rewards, whereas these areas show increased activation when exposed to gambling-related stimuli in cue exposure paradigms. Very little is known, and hence more research is needed regarding the neural underpinnings of impulsivity and decision making in PG. This review concludes with a discussion regarding the challenges and new developments in the field of neurobiological gambling research and comments on their implications for the treatment of PG…
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Potenza MN (2008)reviewMEDLINE-indexed journal, not yet read by usPhilosophical transactions of the Royal Society of London. Series B, Biological sciences267 citations Review. The neurobiology of pathological gambling and drug addiction: an overview and new findings.
Gambling is a prevalent recreational behaviour. Approximately 5% of adults have been estimated to experience problems with gambling. The most severe form of gambling, pathological gambling (PG), is recognized as a mental health condition. Two alternate non-mutually exclusive conceptualizations of PG have considered it as an obsessive-compulsive spectrum disorder and a 'behavioural' addiction. The most appropriate conceptualization of PG has important theoretical and practical implications. Data suggest a closer relationship between PG and substance use disorders than exists between PG and obsessive-compulsive disorder. This paper will review data on the neurobiology of PG, consider its conceptualization as a behavioural addiction, discuss impulsivity as an underlying construct, and present new brain imaging findings investigating the neural correlates of craving states in PG as compared …
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Seeman P (2015)reviewMEDLINE-indexed journal, not yet read by usSynapse (New York, N.Y.)99 citations Parkinson's disease treatment may cause impulse-control disorder via dopamine D3 receptors.
In treating Parkinson's disease with dopaminergic agonists, such as pramipexole, ropinirole, pergolide, rotigotine, apomorphine, or bromocriptine, it has been observed that a significant number of patients develop impulse-control disorders, such as compulsive shopping, pathological gambling, or hypersexuality. Because the dopamine agonists have high affinities for the dopamine D2 and D3 receptors, the drug dissociation constants of these drugs at the functional high-affinity states of these receptors, namely D2High and D3High, were compared. The data show that, compared to the other dopamine agonist drugs, pramipexole has a relatively high selectivity for the dopamine D3 receptor, as compared to D2, suggesting that the D3 receptor may be a primary target for pramipexole. There is a trend showing that the proportion of impulse-control disorders is related to the selectivity for D3 recepto…
matched on Gambling (keyword), Disruptive, Impulse Control, and Conduct Disorders (mesh)
Cognitive-behavioral approaches to outpatient treatment of internet addiction in children and adolescents.
Excessive and potentially addictive use of the Internet among children and adolescents has emerged as a major concern in recent times. Internet addiction is often conceptualized as an impulse control disorder, with features similar to pathological gambling. However, there remains considerable debate about the core components, etiological processes, course, and maintaining factors of the disorder. This article presents a case study of a 16-year-old male with generalized pathological Internet use. Critical issues relevant to case conceptualization, assessment, and choice of therapy are examined. Although the evidence base is limited in this emerging area of clinical psychology, we provide a summary of empirically supported cognitive-behavioral techniques for Internet addiction.
matched on Video Games (mesh), Behavior, Addictive (mesh)
Pathologic gambling in patients with restless legs syndrome treated with dopaminergic agonists.
Pathologic gambling is an impulse control disorder previously reported to complicate dopamine agonist therapy in patients with Parkinson disease. It has not been described in association with dopamine agonist therapy of other conditions. We report three patients treated in our sleep disorders center who developed pathologic gambling while receiving treatment with dopamine agonists for restless legs syndrome.
matched on Gambling (mesh), Disruptive, Impulse Control, and Conduct Disorders (mesh)
Predictors of Spontaneous Remission of Problematic Internet Use in Adolescence: A One-Year Follow-Up Study.
Problematic use of the Internet is becoming increasingly important and especially for adolescents, high prevalence rates are reported in many countries. Despite the growing international research activities and the reported prevalence estimates, comparatively very few studies have focused on spontaneous remission and its possible causes. In a risk population of 272 adolescents, we used standardized diagnostic instruments to investigate which socio-demographic and psychosocial characteristics at baseline (at t1) predicted spontaneous remission of problematic Internet use one year later (at t2). The predictors were determined by bivariate and multivariate logistic regression analyses. In the bivariate regressions, we found male gender, higher self-efficacy (t1), a lower level of maladaptive emotion regulation strategies (t1), lower depression (t1), lower performance and school anxiety (t1)…
matched on Video Games (mesh), Behavior, Addictive (mesh), problematic internet use (text)
Passion or addiction? Correlates of healthy versus problematic use of videogames in a sample of French-speaking regular players.
A criticism of current diagnostic approaches to gaming disorder is that they fail to take into account that high and repeated engagement is not problematic per se, nor is it necessarily associated with adverse consequences. To tackle this controversy, we used Confirmatory Factor Analysis (CFA) to test, in regular gamers (N = 268), whether high (but healthy) engagement can be distinguished from problematic engagement by using the Addiction-Engagement Questionnaire (Charlton & Danforth, 2007). We then tested whether differential relationships exist between the engagement and addiction constructs, DSM-5 criteria for Internet gaming disorder (IGD), and psychological factors linked to gaming use and misuse (self-reported impulsivity, motives to play, and depression). Results indicated that a model holding engagement and addiction as two distinct, but related, constructs fits the data well. Se…
matched on Video Games (mesh), Behavior, Addictive (mesh), gaming disorder (text)
Aarseth E, Bean AM, Boonen H, Colder Carras M, Coulson M, Das D, Deleuze J, Dunkels E, Edman J, Ferguson CJ, Haagsma MC, Helmersson Bergmark K, Hussain Z, Jansz J, Kardefelt-Winther D, Kutner L, Markey P, Nielsen RKL, Prause N, Przybylski A, Quandt T, Schimmenti A, Starcevic V, Stutman G, Van Looy J, Van Rooij AJ (2017)MEDLINE-indexed journal, not yet read by usJournal of behavioral addictions247 citations Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal.
Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-po…
matched on Video Games (mesh), Behavior, Addictive (mesh), gaming disorder (text)
Risk Factors for Internet Gaming Disorder: Psychological Factors and Internet Gaming Characteristics.
Background: Understanding the risk factors associated with Internet gaming disorder (IGD) is important to predict and diagnose the condition. The purpose of this study is to identify risk factors that predict IGD based on psychological factors and Internet gaming characteristics; Methods: Online surveys were conducted between 26 November and 26 December 2014. There were 3568 Korean Internet game users among a total of 5003 respondents. We identified 481 IGD gamers and 3087 normal Internet gamers, based on Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria. Logistic regression analysis was applied to identify significant risk factors for IGD; Results: The following eight risk factors were found to be significantly associated with IGD: functional and dysfunctional impulsivity (odds ratio: 1.138), belief self-control (1.034), anxiety (1.086), pursuit of desired appetiti…
matched on Video Games (mesh), Behavior, Addictive (mesh), gaming disorder (text)
Altered resting-state functional connectivity of the insula in young adults with Internet gaming disorder.
The insula has been implicated in salience processing, craving, and interoception, all of which are critical to the clinical manifestations of drug and behavioral addiction. In this functional magnetic resonance imaging (fMRI) study, we examined resting-state functional connectivity (rsFC) of the insula and its association with Internet gaming characteristics in 74 young adults with Internet gaming disorder (IGD) and 41 age- and gender-matched healthy control subjects (HCs). In comparison with HCs, IGD subjects (IGDs) exhibited enhanced rsFC between the anterior insula and a network of regions including anterior cingulate cortex (ACC), putamen, angular gyrus, and precuneous, which are involved in salience, craving, self-monitoring, and attention. IGDs also demonstrated significantly stronger rsFC between the posterior insula and postcentral gyrus, precentral gyrus, supplemental motor are…
matched on Video Games (mesh), Behavior, Addictive (mesh), gaming disorder (text)
Delay discounting, risk-taking, and rejection sensitivity among individuals with Internet and Video Gaming Disorders.
Background and aims There is a previous evidence for impulsivity in individuals with Internet and Video Gaming Disorders. The aim of this study was to examine whether Internet and video game addictions are associated with experiential delay discounting, risk-taking, and sensitivity to social rejection using computerized tasks and questionnaires. Methods Twenty participants (mean age 24, SD = 1.55) with high score on the Problematic Online Gaming Questionnaire (POGQ) were compared with 20 participants (mean age 24.8, SD = 1.34) with low score on the POGQ. They performed on computerized Balloon Analog Risk Task and Experiential Delay discounting Task (EDT), and filled in the sensitivity to social rejection questionnaire. Results Participants with high POGQ scores had lower measures of delay discounting, higher measures of risk-taking, and higher measures of sensitivity to social rejection …
matched on Video Games (mesh), Behavior, Addictive (mesh), gaming disorder (text)