Do patients with OCD and pathological gambling have similar dysfunctional cognitions?

The obsessive-compulsive spectrum disorder (OCSD) theory postulates that a wide range of disorders is closely related to OCD. Current cognitive models ascertain that certain beliefs leading to misinterpretation of the significance of intrusions are important in the etiology and maintenance of OCD. This study examined whether pathological gambling, a disorder belonging to the OC spectrum, is characterized by similar dysfunctional cognitions as OCD. Dysfunctional beliefs of OCD patients were compared to those of patients with pathological gambling, panic disorder and normal controls. These beliefs were measured by the Obsessive-compulsive Beliefs Questionnaire-87 (OBQ-87), which was developed by a group of leading OCD researchers [Behav. Res. Ther. 35 (1997) 667]. It was hypothesized that according to the OCSD theory, pathological gamblers would exhibit similar cognitions to OCD patients, as well as increased levels of OCD symptoms. Analysis showed that OCD patients exhibited higher OBQ-87 scores than both panic patients and normal controls, but equal to pathological gambling patients. Pathological gamblers exhibited, however, no increase in OCD symptoms. These mixed results do not seem to support the OC spectrum theory for pathological gambling, moreover being contradictory to contemporary cognitive OCD models.     

Internet‐based CBT intervention for gamblers in Finland: Experiences from the field

From September 2007 to May 2011 a total of 471 participants (325 males and 146 females) signed up for an 8‐week Internet‐based cognitive behavioral therapy offered for gamblers in Finland. Sixty‐four percent of the participants were pathological gamblers (PGs) (NODS 5> points), 14% were problem gamblers (NODS 3–4 points) and 10% were at risk of gambling problems (NODS 1–2 points). Two hundred and twenty four participants completed the treatment and after the treatment period significant changes were found in the following variables: gambling related problems (NODS), gambling urge, impaired control of gambling, alcohol consumption (AUDIT‐C), social consequences, gambling‐related cognitive erroneous thoughts and depression (MARD‐S). In this sample co‐morbid alcohol consumption was stronger among males. The main finding of this study was that the onset age of gambling was associated with a greater amount of gambling‐related cognitive erroneous thoughts.     

Characterization of controlled gamblers and pathological gamblers using the social representation theory

Introduction

In industrialized countries, gambling disorder tends to become a major issue. The use of the social representation theory provides clues for a better understanding of pathological gamblers.

Association of pathological gambling with depression in Scotland

Is most research concerning gambling and depression has been conducted on clinical populations, the present study examined the relationship between gambling and depression across a large sample in Scotland in higher education and the community. A questionnaire-based cluster design involved the distribution of the South Oaks Gambling Screen and the Centre for Epidemiologic Studies Depression Scale mainly to students and staff of higher educational establishments, with small community and gambling samples also included. Thirty-seven colleges and universities across Scotland participated in the research, with a sample of 2259 people aged sixteen years of age or over (M = 28.9 yr., SD = 13.4) being obtained. It was found that past-year probable pathological gamblers had significantly higher depression than problem gamblers, nonproblem gamblers, and nongamblers. However, when probable pathological gamblers who had sought treatment were omitted from the analysis, the nontreatment-seeking probable pathological gambling group no longer had significantly higher depression than the problem gambling group. Female problem and probable pathological gamblers had particularly high depressive symptomatology, suggesting co-morbid depression may be a prominent feature of problematic female gambling.     

DIMENSIONS COGNITIVES ET COMPORTEMENTALES CHEZ LES JOUEURS RÉGULIERS ET OCCASIONNELS AU BLACKJACK

Empirical studies in the psychology of gambling have revealed at least two well supported findings: (1) irrational cognitions outnumber rational cognitions during gambling (Gaboury and Ladouceur, 1987; Ladouceur, Gaboury, Dumont and Rochette 1988); (2) risk-taking behavior increases as a function to exposure to gambling activities (Ladouceur, Mayrand and Tourigny 1987; Ladouceur, Tourigny and Mayrand 1986). The present study compared regular and occasional gamblers on cognitive and behavioral measures during a blackjack session using the thinking aloud method. The results confirmed that regular players emitted more irrational thoughts than occasional gamblers. The theoretical and practical implications of those results are discussed within the general context of the psychology of gambling.     

Impulsivity facets and cognitive distortions associated with problem gambling: Differences between ADHD and non-ADHD gamblers

ObjectiveTo compare the association between (1) impulsivity facets or cognitive distortions, and (2) problem gambling between male gamblers with versus without self-reported Attention-Deficit/Hyperactivity Disorder (ADHD).MethodIn 287 male gamblers recruited online, we assessed problem gambling (South Oaks Gambling Screen; cut-off ≥ 3), Adult ADHD Self-report Scale-V1.1 (ADHD), impulsivity facets (UPPS Impulsive Behavior Scale-short version) and gambling-related cognitions (Gambling-Related Cognitions Scale).ResultsThe prevalence of self-reported ADHD was 21.6%. In both ADHD and non-ADHD groups, problem gambling was associated with negative urgency, positive urgency and the same cognitive distortions. Sensation seeking and lack of premeditation were associated with problem gambling, but only in non-ADHD gamblers (significant interaction effect).ConclusionDifferent impulsivity facets, but not different cognitive distortions, are associated with problem gambling in male gamblers with or without ADHD. Emotion dysregulation (positive and negative urgency) and cognitive distortions are involved in both groups, but sensation seeking and lack of premeditation may be specific to non-ADHD problem gamblers.     

Pathological Women Gamblers: Gender-Related Aspects of Control

This study examines the control exhibited by pathological women gamblers over their lives and their surroundings, and how this is governed by their perception of their gender role and socio-cultural expectations of them as women. Seventeen pathological women gamblers (13 of whom were mothers) were recruited from three addiction treatment centers in Israel, and participated in semi-structured interviews. Three central themes emerged during analysis: maintaining control over the gender roles—putting child raising and housekeeping duties first despite their gambling habits; control over the choice of gambling venue—gambling far from their home, or where they knew the owners; and moral control—steering clear of immoral behaviors in spite of their addiction to gambling. Further analysis reveals how pathological women gamblers who are also mothers make rational choices that help them juggle between their gender roles and gambling, to minimize the social costs that might be incurred by their gambling habit. Moreover, presenting the gambling behavior as more moral than theft or prostitution enabled them to normalize their behavior. The study’s findings show how the decisions and choices made by the women in this study are shaped by the socio-cultural context in which they are made.     

Cognitive treatment of pathological gamblers

This study evaluates the efficacy of a cognitive treatment for pathological gambling. Five pathological gamblers were treated in a multiple baseline across subjects design. Cognitive correction targeted the erroneous perceptions towards the notion of randomness. Four subjects reported a clinically significant decrease in the urge to gamble, an increase in their perception of control, and no longer met the DSM-IV criteria for pathological gambling. Therapeutic gains were maintained at the 6 month follow-up. Results suggest that cognitive therapy targeting the misconception of the notion of randomness is a promising treatment for pathological gambling, a refractory disorder to most therapeutic interventions.     

Trauma history and severity of gambling involvement among horse-race gamblers in a South African gambling setting

The purpose of this study was to ascertain the frequency of gambling involvement and the prevalence of problem gambling among horse race gamblers and to discover whether problem gambling in this sample is associated with a history of trauma. Among a sample of 266 South African horse-race gamblers (94% men and 6% women, Mage 46.8 yr., SD = 13.9, range 18-85 years), 31.2% were classified as probable pathological gamblers and 19.9% with problem gambling. Major weekly gambling activities included racetrack betting (82%), purchase of lottery tickets or scratch tickets (35%), purchase of sports lottery tickets (23%), and using casino type games (18%). Trauma history was significantly associated with gambling severity.     

Modeling Potential Psychological Risk Factors of Pathological Gambling

This paper proposes a model of potential psychological risk factors antecedent to pathological gambling. Proposed relationships are tested using a structural equations methodology for 2 samples: (a) gamblers composed of members of Gamblers Anonymous and individuals clinically diagnosed and in treatment for pathological gambling. and (b) a demographically matched sample drawn from the general population of a 3-state area from which the gamblers were recruited. Results show both intriguing similarities and differences in relationships among the risk factors. Specifically. for these 2 samples, relationships among the constructs of neurotic/obsessive thoughts, self-esteem, impulsiveness, and anxiety/nervousness are generally similar, but relationships between model constructs and a measure of probable pathological gambling varies across the samples.     

A comparison of individual and group cognitive-behavioural treatment for female pathological gambling

The current study aimed to determine the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered in individual and group format. Fifty-six female pathological gamblers with electronic gaming machine gambling problems were randomly assigned to the control (waiting list) group or one of the treatment groups (individual or group treatment). Treatment comprised a 12-session program including financial limit setting, alternative activity planning, cognitive correction, problem solving, communication training, relapse prevention, and imaginal desensitisation. Treatment outcome was evaluated with conceptually related measures within the areas of gambling behaviour and psychological functioning. While individual and group treatment formats generally produced comparable outcomes in terms of gambling behaviour and psychological functioning, group treatment failed to produce superior outcomes to the control group in relation to several measures of psychological functioning. Moreover, by the completion of the six-month follow-up, 92% of the gamblers allocated to individual treatment compared with 60% allocated to group treatment no longer satisfied the diagnostic criteria for pathological gambling. These findings suggest that some caution should be employed when delivering cognitive-behavioural treatment in a group format until further research is conducted to establish its efficacy.     

Discounting of probabilistic rewards is associated with gambling abstinence in treatment-seeking pathological gamblers

Individuals with addictive disorders, including substance abusers and pathological gamblers, discount or devalue rewards delayed in time more than controls. Theoretically, preference for probabilistic rewards is directly related to gambling, but limited empirical research has examined probabilistic discounting in individuals with pathological gambling. This study evaluated probability and delay discounting in treatment-seeking pathological gamblers and their association with gambling treatment outcomes during and after treatment. At time of treatment entry, 226 pathological gamblers completed probability and delay discounting tasks. They were then randomized to one of three treatment conditions, and gambling behavior was measured throughout treatment and at a 1-year follow-up assessment. After controlling for possibly confounding variables and treatment condition, more shallow probability discounting was associated with greater reductions in amounts wagered during treatment and likelihood of gambling abstinence at the end of treatment and throughout the follow-up period. No associations were noted between delay discounting and gambling treatment outcomes. These data suggest that probability discounting may be an important construct in understanding pathological gambling and its treatment.     

Cognitive biases and decision making in gambling

Heuristics and cognitive biases can occur in reasoning and decision making. Some of them are very common in gamblers (illusion of control, representativeness, availability, etc.). Structural characteristics and functioning of games of chance favor the appearance of these biases. Two experiments were conducted with nonpathological gamblers. The first experiment was a game of dice with wagers. In the second experiment, the participants played two bingo games. Specific rules of the games favored the appearance of cognitive bias (illusion of control) and heuristics (representativeness and availability) and influence on the bets. Results and implications for gambling are discussed.     

Évolution du traitement attentionnel de l’information émotionnelle de joueurs pathologiques anxieux et non anxieux : une étude préliminaire

The aim of this study was to estimate, outside a context of game, the attentional behavior (selection and focus) of pathological gamblers in front of the emotional information, and in various stages of its treatment. More exactly, anxious pathological gamblers (14), not anxious pathological gamblers (10), anxious not gamblers (14) and not anxious not gamblers (15) were subjected to a task of selection spatial attentional (task modified by detection of probes, Mogg and Bradley, 2004) and in a task of focus attentional (task of distractors, Fox, 1993, Fox, 1996). The results reveal an effect combined by the pathological gambling and by the anxiety Trait, on the processing of emotional information, in the first stages of its treatment (subliminal condition and automatic).     

Psychobiology of the near-miss in fruit machine gambling

Explanations involving the etiology of pathological gambling have tended to emphasize psychosocial factors. However, the possibility that psychobiological factors may be important in the development of pathological gambling behavior should not be ruled out. Psychobiological approaches are becoming ever more prominent with the three main lines of research being (a) a search for a physiological disposition and/or underlying biological substrate in pathological gamblers, (b) an examination of the role of arousal in gambling, and (c) speculation about endorphin-related explanations. The data from questionnaires and interviews with fruit machine gamblers suggest that both physiological and cognitive factors (e.g., the psychology of the near-miss) may be important in the explanation of excessive fruit machine gambling. Thus, if a gambler becomes physiologically aroused when he or she wins or nearly wins, it will stimulate further play, here termed the psychobiology of the near-miss.     

Psychological Factors that Promote and Inhibit Pathological Gambling

This paper describes qualitative data regarding psychological factors that may affect gambling behavior among treatment-seeking pathological gamblers. Participants (n = 84) diagnosed with pathological gambling were treated in a clinical trial examining the efficacy of cognitive behavioral therapy (CBT). Qualitative data were collected from participants during each of 8 structured CBT sessions. Specific gambling-related psychological factors that were assessed include triggers, consequences, high-risk situations, craving experiences, assertiveness skills, cognitive distortions, and coping strategies. The most commonly reported triggers for gambling were lack of structured time and negative emotional state, which were similar to the high-risk times for gambling. The most frequently listed positive consequences of gambling were enjoyment associated with winning and use of gambling as an escape. Negative consequences of gambling included depressed mood, financial problems, and conflict with family. Coping strategies changed during treatment, as participants reported relying less upon avoidance and distraction, and became better able to utilize support networks and cognitive coping skills. These data are important to better understand the factors associated with the development, maintenance, and cessation of pathological gambling.     

The reasoning skills and thinking dispositions of problem gamblers: a dual‐process taxonomy

We present a taxonomy that categorizes the types of cognitive failure that might result in persistent gambling. The taxonomy subsumes most previous theories of gambling behavior, and it defines three categories of cognitive difficulties that might lead to gambling problems: The autonomous set of systems (TASS) override failure, missing TASS output, and mindware problems. TASS refers to the autonomous set of systems in the brain (which are executed rapidly and without volition, are not under conscious control, and are not dependent on analytic system output). Mindware consists of rules, procedures, and strategies available for explicit retrieval. Seven of the eight tasks administered to pathological gamblers, gamblers with subclinical symptoms, and control participants were associated with problem gambling, and five of the eight were significant predictors in analyses that statistically controlled for age and cognitive competence. In a commonality analysis, an indicator from each of the three categories of cognitive difficulties explained significant unique variance in problem gambling, indicating that each of the categories had some degree of predictive specificity. Copyright © 2006 John Wiley & Sons, Ltd.     

Distorsions cognitives et pratique de jeu de hasard et d’argent : état de la question

Cognitive distorsions are inherent to any gambling situation whatever the level of commitment of the gambler. Irrational beliefs lead the subject to overestimate his share of control over the game's outcome to the detriment of chance. Knowing the objective probability to win and having good numeric capacities of reasoning does not prevent the gamblers from developing these false beliefs. According to the concept of double switching proposed by Ladouceur and Sévigny (2005), irrational beliefs would coexist with objective knowledges on the game and would bustle in situation of gambling. The progress and the outcome of the game influence the development and the maintenance of cognitive distorsions, which influences the subject's practice of gambling. Pathological gambling, repeated and persistent gambling behavior, is characterized in particular by the presence of cognitive distortions, leading the subject to maintain, even to increase his gambling practice. Indeed, if cognitive distorsions are present in any situation of gambling, it seems nevertheless that it is more frequent and more intense in problem and pathological gamblers. Cognitive distorsions, in particular illusion of control, thus lead to a more important practice of gambling and a financial risk-taking, favoring the installation and the preservation of problem gambling. Certain factors seem to influence cognitive distorsions. There is a gender effect: women would present fewer irrational beliefs than men. Depression, anxiety and stress would also favor the development of these beliefs in situation of gambling. Several methods exist to estimate cognitive distorsions in gamblers. The first researches are based on assessment made by others (observation and analysis of gambler's verbalizations). Afterward, several self-report scales were created. At the moment, none of these scales has been validated in French language. The identification of gambling related cognitive distortions permit to elaborate adapted modes of treatment. So, the cognitive therapy suggests identifying and restructuring the beliefs to bring the subject to change his gambling behavior. In spite of the current knowledge on cognitive distorsions, certain questions remain open, in particular about the implication of theses beliefs in games implying a part of strategy, in which the subject has effectively a certain control over the game.     

Group therapy for pathological gamblers: a cognitive approach

This study evaluated the efficacy of a group cognitive treatment for pathological gambling. Gamblers, meeting DSM-IV criteria for pathological gambling, were randomly assigned to treatment (N=34) or wait-list control (N=24) conditions. Cognitive correction techniques were used first to target gamblers' erroneous perceptions about randomness, and then to address issues of relapse prevention. The dependent measures used were the DSM-IV criteria for pathological gambling, perceived self-efficacy, gamblers' perception of control, desire to gamble, and frequency of gambling. Post-treatment results indicated that 88% of the treated gamblers no longer met the DSM-IV criteria for pathological gambling compared to only 20% in the control group. Similar changes were observed on all outcome measures. Analysis of data from 6-, 12- and 24-month follow-ups revealed maintenance of therapeutic gains. Recommendations for group interventions are discussed, focusing on the cognitive correction of erroneous perceptions toward the notion of randomness.