Cognitive-behavioural treatment of pathological gambling in individuals with chronic schizophrenia: a pilot study

The current study aimed to test the clinical effectiveness of a cognitive-behavioural program (CBT) specifically adapted for pathological gamblers with chronic schizophrenia, carried out in a naturalistic setting of community Mental Health Centres. Forty-four pathological gamblers with chronic schizophrenia were assigned either to a standard drug therapy for schizophrenia (control group) or to cognitive-behavioural therapy for pathological gambling plus a standard drug therapy for schizophrenia (experimental group). Psychological treatment comprised a 20-session program including psychoeducation, stimulus control, gradual exposure and relapse prevention. Therapeutic success was defined as abstinence or the occurrence of only 1 or 2 episodes of gambling during the follow-up period. While the patients treated in the experimental group showed a rate of success of 73.9%, only 19% of the participants belonging to the control group gave up gambling at the 3-month follow-up. The CBT group also did better than the control group in the number of gambling episodes and in the amount of money spent on gambling. However, the improvement of the experimental group was weaker at the 6- and 12-month follow-up. These findings support the beneficial effects of CBT as adjunctive therapy for patients with dual diagnoses (schizophrenia and pathological gambling).     

The effects of brief cognitive-behaviour therapy for pathological skin picking: A randomized comparison to wait-list control

Thirty-four college students suffering from pathological skin picking were randomly assigned to a four-session cognitive-behavioural treatment (n = 17) or a waiting-list condition (n = 17). Severity of skin picking, psycho-social impact of skin picking, strength of skin-picking-related dysfunctional cognitions, and severity of skin injury were measured at pre-, post-, and two-months follow-up assessment. Participants in the treatment condition showed a significantly larger reduction on all measured variables in comparison to the waiting-list condition. The obtained effect sizes for the outcome measures were large, ranging from .90 to 1.89. Treatment effects were maintained at follow-up. In conclusion, cognitive-behavioural therapy, even in brief form, constitutes an adequate treatment option for pathological skin-picking behaviour.     

Personality factors as predictors of pathological gambling

The aim of this study was to investigate the relationship between different personality variables and pathological gambling (PG). The NEO-FFI and measures of impulsivity and sensation-seeking were administered to a sample of pathological gamblers (n = 90) and to a contrast group of non-pathological gamblers (n = 66) matched on sex and age. Gender, age, education level and the personality variables were entered into crude and adjusted logistic regression analyses with PG-status as the dependent variable. The results showed that educational level and all personality variables were significant predictors of PG in the crude analyses, however only four of the 12 significant predictor variables (Neuroticism, Openness, Impulsivity, and need for Stimulus Intensity) remained significant in the adjusted analysis. All predictor variables accounted for 71% of the variance in PG-status. Clinical implications of the findings are discussed.     

大学生网络使用动机对其病理性网络使用行为的影响机制

基于以往病理性网络使用行为成因的研究,本研究提出并检验了病理性网络使用行为作用机制的三个假设模型。结果表明：人际关系困扰、自尊、情感型网络使用动机均与病理性网络使用行为有显著相关;其中,人际关系困扰对个体病理性网络使用行为具有直接影响,也通过情感获取型网络动机间接影响病理性网络使用行为;而自尊则主要通过作用于人际关系困扰和情感获取型网络动机间接地影响病理性网络使用行为。情感型网络使用动机是个体病理性网络使用行为形成机制中的关键性因素。     

Using self-esteem to disaggregate psychopathy,narcissism, and aggression

Past research offers conflicting conclusions regarding the associations between self-esteem, psychopathy, narcissism, and aggression. The current study clarified these associations by examining self-esteem level and stability as it relates to the factors of psychopathy and narcissism predicting aggression. Self-report assessments were administered to 118 undergraduates. While self-esteem instability was not related to psychopathy or narcissism, it was positively correlated with aggression. Additionally, those with the healthier aspects of narcissism and Factor 1 features of psychopathy had high self-esteem and less aggression, while those with more pathological narcissism and Factor 2 features of psychopathy had lower self-esteem and more aggression. Specifically, the relationship between psychopathy Factor 1 and aggression was partially mediated by lower self-esteem.     

Inverse association between dopaminergic neurotransmission and Iowa Gambling Task performance in pathological gamblers and healthy controls

Linnet, J., Møller, A., Peterson, E., Gjedde, A. & Doudet, D. (2011). Inverse association between dopaminergic neurotransmission and Iowa Gambling Task performance in pathological gamblers and healthy controls. Scandinavian Journal of Psychology 52, 28–34. The dopamine system is believed to affect gambling behavior in pathological gambling. Particularly, dopamine release in the ventral striatum appears to affect decision‐making in the disorder. This study investigated dopamine release in the ventral striatum in relation to gambling performance on the Iowa Gambling Task (IGT) in 16 Pathological Gamblers (PG) and 14 Healthy Controls (HC). We used Positron Emission Tomography (PET) to measure the binding potential of [¹¹C] raclopride to dopamine D2/3 receptors during a baseline and gambling condition. We hypothesized that decreased raclopride binding potentials in the ventral striatum during gambling (indicating dopamine release) would be associated with higher IGT performance in Healthy Controls, but lower IGT performance in Pathological Gamblers. The results showed that Pathological Gamblers with dopamine release in the ventral striatum had significantly lower IGT performance than Healthy Controls. Furthermore, dopamine release was associated with significantly higher IGT performance in Healthy Controls and significantly lower IGT performance in Pathological Gamblers. The results suggest that dopamine release is involved both in adaptive and maladaptive decision‐making. These findings may contribute to a better understanding of dopaminergic dysfunctions in pathological gambling and substance related addictions.     

Can auditory deviant stimuli temporarily suspend cognitive processing? Evidence from patients with anxiety

While anxiety is typically thought to increase distractibility, this notion mostly derives from studies using emotionally loaded distractors presented in the same modality as the target stimuli and tasks involving crosstalk interference. We examined whether pathological anxiety might also increase distractibility for emotionally neutral irrelevant sounds presented prior to target stimuli in a task where these stimuli do not compete for selection. Patients with anxiety and control participants categorized visual digits preceded by task-irrelevant sounds that changed on rare trials (auditory deviance). Both groups exhibited an equivalent increase in response times following a deviant sound but patients showed a reduction of response accuracy, which was entirely due to an increase in response omissions. We conclude that the involuntary capture of attention by unexpected stimuli may, in patients with anxiety, result in a temporary suspension of cognitive activity.     

Effects of impulsivity, reinforcement sensitivity, and cognitive style on Pathological Gambling symptoms among frequent slot machine players

Pathological Gambling (PG) is the inability to resist recurrent urges to gamble excessively despite harmful consequences to the gambler or others. A cognitive-behavioral Pathways Model of PG (Blaszczynski & Nower, 2002) suggests individual differences in rash impulsivity and reward sensitivity, together with a cognitive style that promotes poor decision making, as risk factors. These individual differences were examined in a community sample of experienced slot machine players (N = 100), who were classified into Low, Moderate, and Problem gambling groups according to the Problem Gambling Severity Index (Ferris & Wynne, 2001). There were significant group differences on rash impulsivity as measured by the Eysenck Impulsivity scale, and on reward sensitivity as measured by the BIS/BAS Drive scale. For cognitive style, there were differences on Actively Openminded Thinking (AOT), but not the Rational Experiential Inventory. Hierarchical regression analyses found that impulsivity and AOT predicted severity of PG, but that AOT mediated the effect of BAS Drive. A thinking style that promotes erroneous cognition may correlate with PG, but individual differences in rash impulsivity and reward-seeking play a more critical role in the etiology of PG. The individual characteristics of Pathological Gamblers are similar to those of people with Substance Use Disorders.     

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.