OBJECTIVE: While many individuals gamble responsibly, some develop maladaptive symptoms of a gambling disorder. Gambling problems often first occur in young people, yet little is known about the longitudinal course of such symptoms and whether this course can be predicted. The aim of this study was to identify latent subtypes of disordered gambling based on symptom presentation and identify predictors of persisting gambling symptoms over time. METHODS: 575 non-treatment seeking young adults (mean age [SD] = 22.3 [3.6] years; 376 (65.4%) male) were assessed at baseline and annually, over three years, using measures of gambling severity. Latent subtypes of gambling symptoms were identified using latent mixture modeling. Baseline differences were characterized using analysis of variance and binary logistic regression respectively. RESULTS: Three longitudinal phenotypes of disordered gambling were identified: high harm group (N = 5.6%) who had moderate-severe gambling disorder at baseline and remained symptomatic at follow-up; intermediate harm group (19.5%) who had problem gambling reducing over time; and low harm group (75.0%) who were essentially asymptomatic. Compared to the low harm group, the other two groups had worse baseline quality of life, elevated occurrence of other mental disorders and substance use, higher body mass indices, and higher impulsivity, compulsivity, and cognitive deficits. Approximately 5% of the total sample showed worsening of gambling symptoms over time, and this rate did not differ significantly between the groups. CONCLUSIONS: Three subtypes of disordered gambling were found, based on longitudinal symptom data. Even the intermediate gambling group had a profundity of psychopathological and untoward physical health associations. Our data indicate the need for large-scale international collaborations to identify predictors of clinical worsening in people who gamble, across the full range of baseline symptom severity from minimal to full endorsement of current diagnostic criteria for gambling disorder.

Department of Psychiatry and Behavioral Neuroscience University of Chicago United States of America

Department of Psychiatry University of Cambridge UK; Cambridge and Peterborough NHS Foundation Trust UK

Department of Psychiatry University of Cambridge UK; Department of Kinanthropology Charles University Prague Czechia; Cambridge and Peterborough NHS Foundation Trust UK

Zobrazit více v PubMed

American Psychiatric Association . American Psychiatric Publishing; Arlington, VA: 2013. Diagnostic and Statistical Manual of Mental Disorders (5th Ed.) (DSM-5)

Aron A.R., Robbins T.W., Poldrack R.A. Inhibition and the right inferior frontal cortex: one decade on. Trends Cogn. Sci. 2014;18(4):177–185. PubMed

Blanco C., Hanania J., Petry N.M., Wall M.M., Wang S., Jin C.J. Towards a comprehensive developmental model of pathological gambling. Addiction. 2015;110(8):1340–1351. PubMed PMC

Borsboom D., Rhemtulla M., Cramer A.O., van der Maas H.L., Scheffer M., Dolan C.V. Kinds versus continua: a review of psychometric approaches to uncover the structure of psychiatric constructs. Psychol. Med. 2016;46(8):1567–1579. PubMed

Browne M., Greer N., Rawat V., Rockloff M. A population-level metric for gambling related harm. Int. Gambl. Stud. 2017;17(2):163–175.

Chamberlain S.R., Grant J.E. Minnesota impulse disorders interview (MIDI): validation of a structured diagnostic clinical interview for impulse control disorders in an enriched community sample. Psychiatry Res. 2018;265:279–283. PubMed PMC

Chamberlain S.R., Stochl J., Redden S.A., Odlaug B.L., Grant J.E. Latent class analysis of gambling subtypes and impulsive/compulsive associations: time to rethink diagnostic boundaries for gambling disorder? Addict. Behav. 2017;72:79–85. PubMed PMC

Clark L. Decision-making during gambling: an integration of cognitive and psychobiological approaches. Philos. Trans. R. Soc. Lond. Ser. B Biol. Sci. 2010;365(1538):319–330. PubMed PMC

Cohen P., Kasen S., Chen H., Hartmark C., Gordon K. Variations in patterns of developmental transitions in the emerging adulthood period. Dev. Psychol. 2003;39(4):657–669. PubMed

Currie S.R., Hodgins D.C., Casey D.M., el-Guebaly N., Smith G.J., Williams R.J. Examining the predictive validity of low-risk gambling limits with longitudinal data. Addiction. 2012;107(2):400–406. PubMed

Edgerton J.D., Melnyk T.S., Roberts L.W. Problem gambling and the youth-to-adulthood transition: assessing problem gambling severity trajectories in a sample of young adults. J. Gambl. Stud. 2015;31(4):1463–1485. PubMed

Frisch M.B., Cornell J., Michael V. Clinical validation of the quality of life inventory: a measure of life satisfaction for use in treatment planning and outcome assessment. Psychol. Assess. 1993;4(1):92–101.

Grant J.E. WW Norton and Company; New York: 2008. Impulse Control Disorders: A Clinician’s Guide to Understanding and Treating Behavioral Addictions.

Grant J.E., Kim S.W. Demographic and clinical features of 131 adult pathological gamblers. J Clin Psychiatry. 2001;62(12):957–962. PubMed

Grant J.E., Steinberg M.A., Kim S.W., Rounsaville B.J., Potenza M.N. Preliminary validity and reliability testing of a structured clinical interview for pathological gambling. Psychiatry Res. 2004;128(1):79–88. PubMed

Grant J.E., Chamberlain S.R., Schreiber L.R., Odlaug B.L., Kim S.W. Selective decision-making deficits in at-risk gamblers. Psychiatry Res. 2011;189(1):115–120. PubMed PMC

Jung T., Wickrama K.A.S. An introduction to latent class growth analysis and growth mixture modeling. Soc. Personal. Psychol. Compass. 2008;2(1):301–317.

Ledgerwood D.M., Petry N.M. Gambling and suicidality in treatment-seeking pathological gamblers. J. Nerv. Ment. Dis. 2004;192(10):711–714. PubMed

Lorains F.K., Cowlishaw S., Thomas S.A. Prevalence of comorbid disorders in problem and pathological gambling: systematic review and meta-analysis of population surveys. Addiction. 2011;106(3):490–498. PubMed

Morasco B.J., Pietrzak R.H., Blanco C., Grant B.F., Hasin D., Petry N.M. Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on alcohol and related conditions. Psychosom. Med. 2006;68(6):976–984. PubMed

Muthén L., Muthén B. 2016. Mplus User’s Guide. Los Angeles, CA, USA.

Pantelis C., Barber F.Z., Barnes T.R., Nelson H.E., Owen A.M., Robbins T.W. Comparison of set-shifting ability in patients with chronic schizophrenia and frontal lobe damage. Schizophr. Res. 1999;37(3):251–270. PubMed

Patton J.H., Stanford M.S., Barratt E.S. Factor structure of the Barratt impulsiveness scale. J. Clin. Psychol. 1995;51(6):768–774. PubMed

Petry N.M., Stinson F.S., Grant B.F. Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on alcohol and related conditions. J Clin Psychiatry. 2005;66(5):564–574. PubMed

Rogers R.D., Everitt B.J., Baldacchino A., Blackshaw A.J., Swainson R., Wynne K. Dissociable deficits in the decision-making cognition of chronic amphetamine abusers, opiate abusers, patients with focal damage to prefrontal cortex, and tryptophan-depleted normal volunteers: evidence for monoaminergic mechanisms. Neuropsychopharmacology. 1999;20(4):322–339. PubMed

Sagoe D., Pallesen S., Hanss D., Leino T., Molde H., Mentzoni R.A. The relationships between mental health symptoms and gambling behavior in the transition from adolescence to emerging adulthood. Front. Psychol. 2017;8:478. PubMed PMC

Sanavio E. Obsessions and compulsions: the Padua inventory. Behav. Res. Ther. 1988;26(2):169–177. PubMed

Sheehan D.V., Lecrubier Y., Sheehan K.H., Amorim P., Janavs J., Weiller E. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J. Clin. Psychiatry. 1998;59(Suppl. 20):22–33. quiz 4–57. PubMed

Slutske W.S., Jackson K.M., Sher K.J. The natural history of problem gambling from age 18 to 29. J. Abnorm. Psychol. 2003;112(2):263–274. PubMed

Sood E.D., Pallanti S., Hollander E. Diagnosis and treatment of pathologic gambling. Curr Psychiatry Rep. 2003;5(1):9–15. PubMed

Stanford M.S., Mathias C.W., Dougherty D.M., Lake S.L., Anderson N.E., Patton J.H. Fifty years of the Barratt impulsiveness scale: an update and review. Personal. Individ. Differ. 2016;47(5):385–395.

van Holst R.J., van den Brink W., Veltman D.J., Goudriaan A.E. Why gamblers fail to win: a review of cognitive and neuroimaging findings in pathological gambling. Neurosci. Biobehav. Rev. 2010;34(1):87–107. PubMed

Weinstock J., Whelan J.P., Meyers A.W. Behavioral assessment of gambling: an application of the timeline followback method. Psychol. Assess. 2004;16(1):72–80. PubMed

Witkiewitz K., King K., McMahon R.J., Wu J., Luk J., Bierman K.L. Evidence for a multi-dimensional latent structural model of externalizing disorders. J. Abnorm. Child Psychol. 2013;41(2):223–237. PubMed PMC