Trait impulsivity and cognitive domains involving impulsivity and compulsivity as predictors of gambling disorder treatment response

2018 ◽  
Vol 87 ◽  
pp. 169-176 ◽  
Author(s):  
Nuria Mallorquí-Bagué ◽  
Gemma Mestre-Bach ◽  
María Lozano-Madrid ◽  
Fernando Fernandez-Aranda ◽  
Roser Granero ◽  
...  
Author(s):  
Theodore P. Beauchaine ◽  
Aimee R. Zisner ◽  
Elizabeth P. Hayden

In recent years, it has become increasingly clear that common forms of psychopathology derive from complex interactions among neurobiological vulnerabilities and environmental adversities. These interactions can alter neurobehavioral development to yield progressively intractable forms of psychopathology across childhood and adolescence. This chapter focuses on neurobiological mechanisms of trait impulsivity, trait anxiety, stress reactivity, and emotion regulation/executive function. How these traits confer vulnerability to externalizing disorders, internalizing disorders, heterotypic comorbidity, and heterotypic continuity is described. Next, neurobiological mechanisms of treatment response are considered. Trait impulsivity and trait anxiety are highly heritable and derive initially from subcortical structures that mature early in life. In contrast, emotion regulation and executive function, which modulate trait impulsivity and trait anxiety, are more sensitive to environmental influence and derive from cortical structures that mature into young adulthood. Neurobiological mechanisms of psychosocial treatment response are represented largely in the cortex and its neuromodulatory connections with the subcortex.


2019 ◽  
Author(s):  
Joshua Grubbs ◽  
Heather Chapman

Gambling disorder and symptoms of post-traumatic stress are highly comorbid. Numerous studies suggest that the presence of one (either disordered gambling or post-traumatic stress) substantially increases the odds of later developing the other. However, little is known about the etiological links between these two domains or the nuances of the comorbidity. Past research has suggested that symptoms of post-traumatic stress might be related to unique motivations for and beliefs about gambling. The present work sought to examine whether or not symptoms of post-traumatic stress might also be related to specific situational vulnerabilities to gambling behaviors. Using a large cross-sectional sample of internet-using adults in the U.S. who were primarily recreational gamblers (N = 589; 43% men, Mage = 36.1, SD = 11.0), as well as an inpatient sample of U.S. Armed Forces veterans seeking treatment for gambling disorder (N = 332, 80% men, Mage = 53.5, SD = 11.5), the present work tested whether or not symptoms of post-traumatic stress were uniquely related to a variety of gambling situations. Results in both samples revealed that, even when controlling for potentially confounding variables (e.g., substance use and trait impulsivity), symptoms of post-traumatic stress were uniquely related to gambling in response to negative affect, gambling in response to social pressure, and gambling due to a need for excitement. These findings are consistent with recent work suggesting that individuals with post-traumatic stress symptoms are more likely to engage in gambling behaviors for unique reasons that differ from gamblers without such symptoms.


CNS Spectrums ◽  
2019 ◽  
Vol 24 (6) ◽  
pp. 609-615 ◽  
Author(s):  
Jon E. Grant ◽  
Masanori Isobe ◽  
Samuel R. Chamberlain

ObjectiveThe clinical phenotype of gambling disorder (GD) is suggestive of changes in brain regions involved in reward and impulse suppression, notably the striatum. Studies have yet to characterize striatal morphology (shape) in GD and whether this may be a vulnerability marker.AimsTo characterize the morphology of the striatum in those with disordered gambling (at-risk gambling and GD) versus controls.MethodIndividuals aged 18–29 years were classified a priori into those with some degree of GD symptoms (at-risk gambling and GD) or controls. Exclusion criteria were a current mental disorder (apart from GD), history of brain injury, or taking psychoactive medication within 6 weeks of enrollment. History of any substance use disorder was exclusionary. Participants completed an impulsivity questionnaire and structural brain scan. Group differences in volumes and morphology were characterized in subcortical regions of interest, focusing on the striatum.ResultsThirty-two people with GD symptoms (14 at-risk and 18 GD participants) and 22 controls completed the study. GD symptoms were significantly associated with higher impulsivity and morphological alterations in the bilateral pallidum and left putamen. Localized contraction in the right pallidum strongly correlated with trait impulsivity in those with GD symptoms.ConclusionsMorphologic abnormalities of the striatum appear to exist early in the disease trajectory from subsyndromal gambling to GD and thus constitute candidate biological vulnerability markers, which may reflect differences in brain development associated with trait impulsivity. Striatal morphology and associated impulsivity might predispose to a range of problematic repetitive behaviors.


2019 ◽  
Vol 31 (04) ◽  
pp. 230-234
Author(s):  
Ole Köhler-Forsberg ◽  
Louisa G. Sylvia ◽  
Charles L. Bowden ◽  
Joseph R. Calabrese ◽  
Michael E. Thase ◽  
...  

AbstractBackground:Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.Methods:Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.Results:Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.Conclusions:An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.


2016 ◽  
Vol 33 (3) ◽  
pp. 937-953 ◽  
Author(s):  
Susana Jiménez-Murcia ◽  
Joël Tremblay ◽  
Randy Stinchfield ◽  
Roser Granero ◽  
Fernando Fernández-Aranda ◽  
...  

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