The nation’s leading causes of death are related to alcohol and drug use, tobacco smoke exposure, and behavioral addictions. In addition, the comorbidity of addictions and psychiatric illnesses (ie, dual diagnosis) is… Read More
The number of pathological gamblers seeking treatment has risen continuously till the present, and the trend shows no sign of reversal. Estimates of the number of pathological gamblers in Germany range from 103,000 to 290,000, corresponding to 0.2% to 0.6% of the population. Pathological gambling often accompanies other mental disturbances. Doctors who learn that their patients suffer from such disturbances should ask targeted questions about gambling behavior to increase the chance that this problem will be detected early on.|This article is based on an analysis of secondary data obtained from the German Statutory Pension Insurance Scheme and the Federal Statistical Office and on a selective review of the literature on comorbidities and available interventions.|The rate of inpatient treatment for pathological gambling tripled from 2000 to 2010. Most pathological gamblers are men (70%-80%). More than 90% of the patients suffer from more than one mental disturbance; 40% of them carry
Mental health professionals, policy makers and the general public continue to debate the issue of pathological video gaming. Scholars disagree on the prevalence and diagnostic criteria for this potential new disorder. The current meta-analysis considers existing scholarship to examine how differing measurement methods influence prevalence rates and associations with other mental health problems.|Thirty three published studies and doctoral dissertations were analyzed in meta-analysis. Prevalence rates and comorbidity with other mental health problems were examined according to measurement method.|Prevalence estimates and comorbidity with other problems varied widely between studies. Measurement which attempted to replicate "pathological gambling" approaches produced higher prevalence estimates and lower comorbidity estimates than methods which focused on the interfering nature of pathological gaming. The most precise measures produce an overall prevalence rate of 3.1%.|Diagnostic
This review summarizes studies of pathological gambling and personality. Meta-analyses were conducted on 44 studies that reported personality traits of pathological gamblers (N = 2134) and nonpathological gambling control groups (N = 5321). Effect size estimates were calculated for 128 comparisons and organized according to the factors associated with two integrative accounts of personality. Four of the meta-analyses examined traits that have previously been found to load on the Urgency, Premeditation, Perseverance, and Sensation Seeking aspects of impulsivity (Whiteside & Lynam 2001). Substantial effects were found for traits associated with Negative Urgency (Cohen's d =.99) and Low Premeditation (d =.84), but not for Low Perseverance or Sensation Seeking. A second set of meta-analyses examined broad domains of personality that have previously been found to load on Negative Affect, Positive Affect, Disagreeable Disinhibition, and Unconscientious Disinhibition (Markon, Krueger, &
This paper reviews evidence pertaining to the prevalence of common comorbid disorders, including alcohol use disorder, depression, substance use disorders, nicotine dependence, anxiety disorders and antisocial personality disorder, in population-representative samples of problem and pathological gamblers.|A systematic search was conducted for peer-reviewed and unpublished articles reported between 1 January 1998 and 20 September 2010. Only studies which examined the prevalence of comorbid conditions in problem and/or pathological gamblers from a general population sample using randomized sampling methods and standardized measurement tools were included. Meta-analysis techniques were then performed to synthesize the included studies and estimate the weighted mean effect size and heterogeneity across studies.|Eleven eligible studies were identified from the literature. Results from across the studies indicated that problem and pathological gamblers had high rates of other comorbid
The Stop Signal Task (SST) is a measure that has been used widely to assess response inhibition. We conducted a meta-analysis of studies that examined SST performance in patients with various psychiatric disorders to determine the magnitude and generality of deficient inhibition. A five-item instrument was used to assess the methodological quality of studies. We found medium deficits in stop signal reaction time (SSRT), reflecting the speed of the inhibitory process, for attention-deficit hyperactivity disorder (ADHD) (g = 0.62), obsessive compulsive disorder (OCD) (g = 0.77) and schizophrenia (SCZ) (g = 0.69). SSRT was less impaired or normal for anxiety disorder (ANX), autism, major depressive disorder (MDD), oppositional defiant disorder/conduct disorder (ODD/CD), pathological gambling, reading disability (RD), substance dependence, and Tourette syndrome. We observed a large SSRT deficit for comorbid ADHD + RD (g = 0.82). SSRT was less than moderately impaired for ADHD + ANX and
Individual risk preferences have a large influence on decisions, such as financial investments, career and health choices, or gambling. Decision making under risk has been studied both behaviorally and on a neural level. It remains unclear, however, how risk attitudes are encoded and integrated with choice. Here, we investigate how risk preferences are reflected in neural regions known to process risk. We collected functional magnetic resonance images of 56 human subjects during a gambling task (Preuschoff et al., 2006). Subjects were grouped into risk averters and risk seekers according to the risk preferences they revealed in a separate lottery task. We found that during the anticipation of high-risk gambles, risk averters show stronger responses in ventral striatum and anterior insula compared to risk seekers. In addition, risk prediction error signals in anterior insula, inferior frontal gyrus, and anterior cingulate indicate that risk averters do not dissociate properly between
The course of pathological gambling (PG) in women has been described as having a later age of initiation but a shorter time to problematic gambling ("telescoped"). This study examined evidence for telescoping and its relationship with comorbidities. Seventy-one treatment-seeking individuals with PG underwent a diagnostic interview to examine gambling behaviors, age at initiation of gambling, and time from initiation to meeting criteria for PG. The women had a higher mean age at gambling initiation compared with that of the men (mean [SD] age, 31.3 [13.0] years, compared with 22.4 [7.9] years; p = 0.0003) and a significantly shorter time from initiation of gambling to meeting the criteria for PG (8.33 [8.7] years compared with 11.97 [9.1] years; p = 0.0476) after controlling for demographic and clinical variables. This study presents evidence for a gender-specific course of PG unrelated to psychiatric comorbidities and suggests a need for greater clinical focus on the gender
Pathological gambling (PG) is a behavioural addiction associated with elevated impulsivity and suspected dopamine dysregulation. Reduced striatal dopamine D(2)/D(3) receptor availability has been reported in drug addiction, and may constitute a premorbid vulnerability marker for addictive disorders. The aim of the present study was to assess striatal dopamine D(2)/D(3) receptor availability in PG, and its association with trait impulsivity. Males with PG (n=9) and male healthy controls (n=9) underwent [11C]-raclopride positron emission tomography imaging and completed the UPPS-P impulsivity scale. There was no significant difference between groups in striatal dopamine D(2)/D(3) receptor availability, in contrast to previous reports in drug addiction. However, mood-related impulsivity ('Urgency') was negatively correlated with [11C]-raclopride binding potentials in the PG group. The absence of a group difference in striatal dopamine binding implies a distinction between behavioural
Victoria Sharman travelled to Las Vegas on a scholarship to learn about treatment and support for problem gamblers. She discovered high-quality, accessible services, but was most impressed by the city's attitude to gambling.
22962952 2012 09 11 2013 01 28 1360-0443 107 10 Oct Addiction 1736-7 10.1111/j.1360-0443.2012.03669.x Sociology and Applied Social Science, University of Glasgow, Glasgow, G12 8RT, UK. firstname.lastname@example.org Reith Gerda G eng Comment Journal
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Numeracy and the Medical Students Ability To Interpret Data CONTEXT. Although the ability to work with numbers is important to the practice of medicine, little is known about physician numeracy ( basic skill with numbers). OBJECTIVE. To test
Five Steps to Improving Patient Access Judy Capko, May 21, 2013 Patient access is getting increased attention through reform initiatives. Here are five steps you can take to make sure patients get appropriate access to care in your office.