Individuals with a score of 5 or higher are probable pathological gamblers 5 was the cut-off score adopted in the current study. It is based on 10 questions concerning information about involve- ment with drugs, excluding alcohol and tobacco. In Italy, it has been validated by Piccinelli et al. A cut-off score of 5 was associated with sensitivity of 0. The Italian validation of the scale used in this study, by Sica and Ghisi , showed excellent psychometric properties with an internal consistency of.
The BIS is composed of 30 items describing common impulsive or non-impulsive behaviours. The Italian validation of the scale used in this study, by Fossati et al. It was developed to measure different aspects of hostility and guilt. The dimensions are assault, indirect hostility, verbal hostility, irritability, negativism, suspicious, resentment, and guilt. The revised and validated Italian version by Castrogiovanni et al.
The Italian validation by Fossati et al. The IGT was developed to investigate cognitive symptoms that occur after prefrontal lesions e. The task consists of a card game in which participants select a card from one of four available decks for trials. Each deck is associated with a gain, and some decks are associated with a penalty. The penalty is higher in card decks A or B and lower in decks C or D.
The quantitative outcome consists of the net score computed for the four blocks of 25 cards each 1—25, 26—50, and so on. This outcome was computed to quantify the progressive change in selection across the task. An IGT net score of o 0 indicates more frequent selection from disadvantageous decks. Participants start with 1,h and are instructed to maximize their winnings.
The probability of winning or losing is associated with each of 18 trials throughout the GDT. Participants are instructed to choose between one dice or two-, three-, and four-dice combinations. The options with a single number yield a 1,h gain or loss probability of winning is , two-dice combinations yield a h gain or loss probability is , three-dice combinations yield a h gain or loss probability is , and four-dice combi- nations yield a h gain or loss probability is The choices of one dice or two-dice combinations can be considered risky decisions, whereas the choices of three- or four-dice combinations are relatively safe decisions.
Data Analysis The participants were divided into three groups and compared across clinical and cognitive measures. Statistical analyses showed that the groups did not differ in relation to education levels and age see Table 2. GD SDG SDG 2. Personality Traits A one-way between-participant ANOVA was conducted to investigate group differences in personality traits, including temperaments and character traits, and scores on each subscale were calculated for each of the seven dimensions.
Regarding the HA1 subscale, the GD group had higher scores than did the HC group, whereas no differences were reported between the experimental groups.
SDG 6. SDG 4. Post hoc comparisons revealed that the HC group had higher scores on each of these subscales than did the experimental groups, with the exception of the ST3 subscale, on which the SDG group had higher scores than did the HC group see Table 3. In the groups and in the whole sample, we found no association with age or education as a covariate in the analysis of the IGT and GDT variables.
An interesting result was found regarding the severity of GD evaluated by the SOGS ; in contrast to what was expected, the pure gamblers showed higher mean scores than did those with GD and SUD, probably because the gamblers with SUD experience GD as a disorder that is secondary to drug addiction.
However, there were no conclusive results on the effects of prolonged drug abstinence in individuals with GD and SUD, and further studies should clarify the impact of both prolonged abstinence and the type of treatment received on the severity of GD.
On the other hand, the higher scores provided from the trait-anxiety measure only in the pure gamblers were in accordance with the literature, which shows a high prevalence of mood disorders in GD Kim et al. Substance use can in turn maintain an underlying mechanism, especially in situations involving unpleasant internal states such as resentment, irritability, anger, and guilt, resulting in an inability to inhibit aggressive responses and behaviour.
With regard to personality traits, we found differences between the experimental groups compared with the HC group. In contrast, we found no clear differences between pure gamblers and those with both GD and SUD with respect to personality aspects. However, we hypothesize that these differences may be mainly the result of the different addictions experienced and different psychological and pharmacological treatments.
Grant et al. Indeed, tasks in which explicit rules are provided seem to recruit more cognitive processes e. The lack of performance on the IGT was reported as a measure of compromised decision making in several neurological and psychiatric conditions Bechara, ; ; Bechara et al. Our study did not replicate the results reported in the growing literature on decision-making impairments e.
No differences were detected concerning performances on the IGT; moreover, selecting a sample of pure gamblers without comorbid substance abuse and other psychiatric disorders should have avoided confounding effects on IGT performance.
This evidence means that SDGs preferred risky choices, whereby they have a low probability of winning but potentially higher gains, resulting in a worsening overall score based on both the total number of risky choices and the risky choices after a loss trial i. Negative feedback i. The primary aim of our study was to investigate the presence of exclusive char- acteristics in pure GD that could differentiate this condition from GD with SUD.
A growing body of literature, especially from neuroimaging studies, has reported both similarities and differences with SUD, creating the premises for moving GD to the addictions section of the DSM-5; however, few studies have investigated the pure GD condition from a behavioural and personological perspective. The importance of detecting differences in pure GD lies in understanding the characteristics result- ing from behavioural dependence without the effect of neurotoxic substances.
It seems that pure GD differs only in characteristics related to mood disorders e. Furthermore, our results showed comparable personality character- istics. Nevertheless, these results cannot be generalized because of several limitations of our study. Despite its small size, our sample yielded good levels of reliability and usability of the measures administered; however, the measures examined self-report and behavioural tasks may be sensitive to contextual factors, irrational aspects, and the residential time of the individual, affecting the ecological validity of the study, which would require further investigation.
Indeed, even the presence of any residual symptoms of disorders e. It is also possible that the sample used in this study is not representative of the types and level of comorbidity in the general population of gamblers, leading to incorrect inferences about the relationship between GD, comorbidity, and clinical variables.
In addition, the present study did not measure or control for the IQ scores of each participant. Despite these limitations, our study suggests the need to further investigate the comparison of gamblers with pure GD with gamblers with SUD; focusing on pure GD could provide a better understanding of the underlying factors involved in maintaining pathological behaviour without the confounding effects of substances.
Pure GD may therefore represent a less complicated group of behaviourally dependent individuals. Subtyping study of a pathological gamblers sample. The Canadian Journal of Psychiatry, 55 8 , — Diagnostic and statistical manual of mental disorders DSM-5s. American Psychiatric Pub. American Psychiatric Association. Manuale Diagnostico e Statistico dei Disturbi Mentali [Diagnostic and statistical manual of mental disorders] 5th ed.
Raffaello Cortina Editore. Personality and Individual Differences, 43 4 , — The role of emotion in decision-making: Evidence from neurological patients with orbitofrontal damage. Brain and Cognition, 55 1 , 30— Decision making, impulse control and loss of willpower to resist drugs: A neurocognitive perspective. Nature Neuroscience, 8 11 , — Insensitivity to future consequences following damage to human prefrontal cortex.
Cognition, 50 1—3 , 7— Deciding advantageously before knowing the advantageous strategy. Science, , — APA PsycTests. Psychological Medicine, 36 7 , — A pathways model of problem and pathological gambling.
Addiction, 97 5 , — Decision-making impairments in patients with pathological gambling. Psychiatry Research, 1 , 91— Executive functions and risky decision-making in patients with opiate dependence. Drug and Alcohol Dependence, 97 1—2 , 64— Frontiers in Psychology, 4, Decision making under ambiguity but not under risk is related to problem gambling severity. Psychiatry Research, 2—3 , — Addiction, 8 , — An inventory for assessing different kinds of hostility.
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