Interplay between alexithymia, emotion regulation, and positive and negative affect as predictors of gambling and gaming disorders in adolescents and young adults

Introduction/Objectives: Gambling and gaming disorder are usually comorbid addictive behaviours in which alexithymia and emotional regulation have been proved to be of relevance. The present study aimed to analyse the relationship between those variables and their differences depending on the presence or absence of gambling and gaming behaviours. Method: The sample consisted of 1,219 people between 12 and 20 years of age (M = 15.55, SD = 2.07; 51.8% females). Results: The results showed significant differences between players and non-players in gambling disorder, alexithymia and emotional regulation. The findings also indicated that there were differences in alexithymia, emotional regulation, negative affect, gambling disorder and gaming disorder among the different profiles of video game players. The comparison of participants with gaming disorder, gambling disorder, both, or neither of them, showed differences in alexithymia, emotional regulation, negative affect, gambling disorder and gaming disorder. Furthermore, correlations between gambling disorder and age, gaming disorder, negative affect, alexithymia and emotional regulation were found. Similarly, gaming dis-order was associated with gambling disorder, negative affect, alexithymia, emotional regulation and age. Conclusions: The hierarchical regression analyses demonstrated the predictive role of alexithymia and age in gambling disorder as well as the predictive role of age, sex and negative affect in gaming disorder.

Introducción/Objetivos: Los trastornos de juego y videojuego son conductas adictivas habitualmente comórbidas en las que se ha demostrado la relevancia de la alexitimia y la regulación emocional. Este estudio analiza la relación entre dichas variables y sus diferencias en función de la presencia o ausencia de conductas de juego y videojuego. Método: La muestra estuvo formada por 1219 personas de entre 12 y 20 años (M = 15.55, SD = 2.07; 51.8 % mujeres). Resultados: Los resultados mostraron diferencias significativas entre jugadores y no jugadores en el juego patológico, la alexitimia y la regulación emocional. Los resultados también indicaron que había diferencias en alexitimia, regulación emocional, afecto negativo, trastorno de juego y videojuego entre los distintos perfiles de jugadores de videojuegos. La comparación de los participantes con trastorno de juego y videojuego, con ambos o con ninguno de ellos, mostró diferencias en la alexitimia, la regulación emocional, el afecto negativo, el trastorno de juego y videojuego. Además, se encontraron correlaciones entre el juego patológico y la edad, el trastorno por videojuego, el afecto negativo, la alexitimia y la regulación emocional. Del mismo modo, el trastorno por videojuego se asoció con el juego patológico, el afecto negativo, la alexitimia, la regulación emocional y la edad. Conclusiones: Los análisis de regresión jerárquica demostraron el papel predictivo de la alexitimia y la edad en el trastorno de juego y el papel predictivo de la edad, el sexo y el afecto negativo en el trastorno por videojuego.

Transtorno de Jogo: contribuição da abordagem psicodinâmica no tratamento / Gambling Disorder: contributions of the psychodynamic approach to treatment / Jeu Pathologique: contributions de l'approche psychodynamique au traitement / Trastorno de Juego: contribución del enfoque psicodinámico al tratamiento

Resumo Jogos de azar podem ser uma atividade de lazer, mas sua prática em excesso pode levar a consequências adversas, como o Transtorno de Jogo. Apesar dos sérios prejuízos provocados por esse quadro, tanto o Transtorno de Jogo em si quanto estratégias de tratamento são pouco conhecidos no Brasil. Este trabalho aborda o Transtorno de Jogo e seu tratamento, tendo como objetivo explicitar a contribuição da abordagem psicodinâmica. São apresentadas as principais hipóteses psicodinâmicas existentes na literatura e tecidas considerações sobre a psicoterapia psicodinâmica realizada em um serviço que atende jogadores em São Paulo, o Programa Ambulatorial do Jogo Patológico (PRO-AMJO) do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IPq HC-FMUSP). Por fim, alguns exemplos de perfis de jogadores patológicos são apresentados.

Abstract Gambling may be a leisure activity, but overdoing it can lead to adverse consequences such as Gambling Disorder. Despite the serious damage caused by the disorder, both Gambling Disorder and its treatment strategies are little known in Brazil. This study investigates Gambling Disorder and its treatment, emphasizing the contributions of the psychodynamic approach. The paper presents the main psychodynamic hypotheses in the literature and comments on the psychodynamic psychotherapy carried out in facilities treating pathological gamblers in São Paulo, such as the Pathological Gambling Outpatient Program (PRO-AMJO) of the Psychiatric Institute of Hospital das Clínicas (IPq HC-FMUSP). Finally, some examples of pathological gambler profiles are discussed.

Résumé Le jeu de hasard peut être un loisir, mais l'excès peut avoir des conséquences néfastes, comme le Jeu Pathologique. Malgré les graves consequences causés par ce trouble, le Jeu Pathologique et ses stratégies de traitement sont peu connus au Brésil. Cettte étude porte sur la Dépendence au jeu et son traitement, en mettant l'accent sur les contributions de l'approche psychodynamique. L'article présente les principales hypothèses psychodynamiques dans la littérature et reflète sur la psychothérapie psychodynamique réalisée dans les services qui s'occupent de joueurs à São Paulo, telles que le Programma ambulatoire sur la dépendance au jeu (PRO-AMJO) del'Institut de psychiatrie de l'Hospital das clínicas (IPq HC-FMUSP). Enfin, quelques exemples de profils de joueurs pathologiques sont discutés.

Resumen Los juegos de azar pueden ser una actividad de diversión, pero su práctica excesiva puede traer consecuencias adversas como el Trastorno de Juego. A pesar de los graves daños causados por este comportamiento, tanto el Trastorno de Juego en sí como las estrategias de tratamiento son poco conocidos en Brasil. Este trabajo aborda el Trastorno de Juego y su tratamiento, con el objetivo de hacer explícito la contribución del enfoque psicodinámico. Se presentan las principales hipótesis psicodinámicas en la literatura y se hacen consideraciones sobre la psicoterapia psicodinámica realizada en un servicio que atiende a jugadores en São Paulo, como el Programa del Hospital das Clínicas de la Facultad de Medicina de la Universidad de São Paulo (IPq HC-FMUSP). Finalmente, se presentan algunos ejemplos de perfiles de jugadores patológicos.

Variables del Sistema Comprehensivo de Rorschach predictivas del proceso de Toma de Decisiones / Comprehensive Rorschach System predictive variables of the decision-making process

RESUMEN Se realizó una investigación aplicada, con enfoque cuantitativo y de diseño no experimental tipo transversal/descriptivo. El estudio tiene como objetivo identificar las variables del Sistema Comprehensivo de Rorschach (SCR), predictivas del proceso de toma de decisiones. La muestra, seleccionada de manera intencional, no probabilística, quedó constituida por 50 adultos. Los métodos empíricos utilizados fueron la entrevista, el Iowa Gambling Task (IGT) o Tarea de apuestas y el Psicodiagnóstico de Rorschach. Los estadígrafos utilizados fueron la prueba de bondad de ajuste de Shapiro-Wilks, el análisis de correlación de Spearman (rho) y la Regresión logística binaria. Se identificó el estilo de lambda como la principal variable predictora, responsable de las variaciones encontradas en la Tarea de apuestas.

ABSTRACT An applied research was carried out, with a quantitative approach, and a non-experimental cross-sectional / descriptive design. The study aims to identify the variables of the Comprehensive Rorschach System (SCR), predictive of the decision-making process. The sample, selected intentionally, not probabilistically, was made up of 50 adults. The empirical methods used were the interview, the Iowa Gambling Task (IGT) or Gambling Task and the Rorschach Psychodiagnosis. The statistics used were the Shapiro-Wilks goodness-of-fit test, Spearman's correlation analysis (rho), and binary logistic regression. LAMBDA was the most important predictive variable of the variations found in the Gambling Task.

Pathological Gambling Due to Aripiprazole: Two Cases

ABSTRACT Aripiprazole is an atypical antipsychotic agent which has a partial agonistic effect on dopamine D2 and D3 receptors. It is effective in the treatment of schizophrenia and bipolar disorder. Owing to its partial agonistic effect, hyperactivity of dopamine may occur in the mesolimbic pathway. In the literature, there are few case reports about pathological gambling due to aripiprazole. In this article, there are two case reports of patients who showed pathological gambling behaviour and alcohol abuse and who were under treatment with aripiprazole. The patient had a history of gambling in the past. With the use of aripiprazole, pathological gambling behaviour occurred quickly and with discontinuation of aripiprazole it ended completely. Aripiprazole causes pathological gambling by forming a hyperdopaminergic condition in the mesolimbic dopaminergic pathway. Aripiprazole should be recommended cautiously and carefully to patients who are impulsive and have a history of alcohol/substance abuse.

Validez de contenido del cuestionario de juego patológico SOGS en el ámbito forense colombiano / The Validity of the SOGS Pathological Gambling Survey's Content in the Colombian Forensic Field / Validade de conteúdo do questionário de jogo patológico SOGS no campo forense colombiano

Resumen Tradicionalmente se ha distinguido el juego como pasatiempo (play) del juego con apuestas (gambling). El juego con apuestas ha facilitado la aparición de conductas problemáticas como el juego patológico, conocido como ludopatía. En Colombia la Ley 1554 de 2012 en el artículo 7° parágrafo I, menciona la importancia de definir guías y protocolos de atención y evaluación de la ludopatía. No obstante, en el contexto colombiano son escasos los estudios que evalúen y atiendan esta problemática. El presente estudio, tuvo como objetivo establecer la validez de contenido del instrumento South Oaks Gambling Screen (SOGS) ampliamente utilizado en el ámbito de la psicología forense. La metodología consistió, en primer lugar, en una etapa de adaptación y ajustes al instrumento, y posteriormente, una etapa de juicio de expertos mediante el método Delphi. Entre los principales resultados del estudio se encuentran: la adaptación de los criterios diagnósticos del cuestionario del DSM-III-R al DSM-5, la adaptación al lenguaje colombiano que permite establecer una mayor comprensión del cuestionario y la incorporación de aspectos relacionados con el juego y las apuestas en línea. El producto de este estudio constituye un instrumento viable para su utilización en el ámbito jurídico y forense, mediante el criterio probatorio del artículo 226 del Código General del Proceso.

Abstract Traditionally, "play" has been distinguished as a hobby within "gambling". Gambling has facilitated the appearance of problematic conducts, such as pathological gambling, also known as compulsive gambling. In Colombia, Law 1554/2020, in article 7, paragraph 1, mentions the importance of defining attention and assessment guides and protocols for compulsive gambling. However, there are few studies in the Colombian context that assess and attend to this issue. This study's objective was to establish the validity of the South Oaks Gambling Screen (SOGS) instrument's content, which is widely used in the field of forensic psychology. The methodology first consisted of a stage adapting to and adjusting the instruments and then a stage of expert judgment through the Delphi method. The study's main results includes: adapting the survey's diagnostic criteria from DSM-III-R to DSM-5, adapting it to Colombian Spanish, which ensures better understanding of the survey and incorporating aspects related to online gambling and betting. This study's product comprises an instrument that may be used in legal and forensic fields through the standard of proof in article 226 of the General Procedural Code.

Resumo Tradicionalmente, tem sido distinguido o jogo como um passatempo (play) do jogo com apostas (gambling). O jogo com apostas facilitou o aparecimento de comportamentos problemáticos, como o jogo patológico, conhecido como jogo compulsivo. Na Colômbia, a Lei 1554 de 2012 em seu artigo 7, parágrafo I, menciona a importância de definir diretrizes e protocolos para o atendimento e avaliação do jogo patológico. Porém, no contexto colombiano, existem poucos estudos que avaliem e abordem esse problema. O presente estudo teve como objetivo estabelecer a validade de conteúdo do instrumento South Oaks Gambling Screen (SOGS) amplamente utilizado na área da psicologia forense. A metodologia consistiu, em primeiro lugar, em uma etapa de adaptação e ajustes do instrumento e, posteriormente, em uma etapa de julgamento de especialistas através método Delphi. Entre os principais resultados do estudo estão: a adaptação dos critérios de diagnóstico do questionário DSM-III-R ao DSM-5, a adaptação à língua colombiana que permite uma maior compreensão do questionário e a incorporação de aspectos relacionados com o jogo e as apostas online. O produto deste estudo constitui um instrumento viável para sua utilização no campo jurídico e forense, através do critério probatório do artigo 226 do Código Geral do Processo.

Juegos de apuestas en estudiantes universitarios: diferencias en impulsividad rasgo, distorsiones cognitivas y severidad en función del tipo de apuestas / Gambling behavior in college students: differences in trait-like impulsivity, cognitive distortions and severity as a function of gambling preference

Resumen El juego patológico se caracteriza por un patrón persistente y excesivo de juego, con interferencias en la vida personal, social, familiar y laboral. Objetivo: Examinar en estudiantes universitarios diferencias en impulsividad rasgo, distorsiones cognitivas y severidad en el involucramiento con los juegos de apuestas en función de los juegos de apuestas de preferencia (estratégicos y no estratégicos); y variaciones en impulsividad en función de los diferentes niveles de severidad en el involucramiento con los juegos de apuestas (sin riesgo, bajo riesgo, alto riesgo). Método: Participaron 295 estudiantes que completaron instrumentos para medir: 1-ocurrencia y preferencia de juegos de apuestas (cuestionario ad-hoc), 2-severidad en el involucramiento con los juegos de apuestas (versión en español del South Oaks Gambling Screen, 3-impulsividad rasgo (versión en español de UPPS-P Impulsive Behavior Scale), 4-distorsiones cognitivas (versión en español del Gamblers' Beliefs Questionnaire). Resultados: Se encontraron diferencias estadísticamente significativas en impulsividad, distorsiones cognitivas y severidad en el involucramiento con los juegos de apuestas en función de la preferencia por determinados tipos de apuestas, y en impulsividad en función del nivel de severidad en el involucramiento con los juegos de apuestas. Conclusión: Los hallazgos describen características psicológicas asociadas a una mayor vulnerabilidad a exhibir modalidades problemáticas de involucramiento con los juegos de apuestas; y sugieren que quienes exhiben preferencias por juegos de apuestas categorizados como estratégicos, o por apuestas estratégicas y no estratégicas combinadas, son quienes parecen estar en mayor riesgo de presentar problemas con el juego de apuestas.

Abstract Pathological gambling is characterized by a persistent and excessive pattern of gambling, with interference in personal, social, family and work life. Objective: To examine, in college students, differences in impulsivity trait, cognitive distortions and severity in gambling involvement as a function gambling preference (strategic and non-strategic); and variations in impulsivity as a function of levels of severity in gambling involvement (no risk, low risk, risk). Method: 295 students completed a survey to measure: 1-occurrence and preference of gambling (ad-hoc questionnaire), 2-severity of gambling involvement (Spanish version of the South Oaks Gambling Screen), 3- impulsivity trait (Spanish version of the UPPS-P Impulsivity Behavior Scale), 4-cognitive distortions (Spanish version of the Gamblers' Beliefs Questionnaire). Results: Analysis of Variance revealed significant differences in impulsivity, cognitive distortions and gambling severity as a function of gambling preference; and significant differences in trait-like impulsivity as a function of gambling severity. Conclusion: These findings describe psychological characteristics associated with increased vulnerability to exhibit gambling problems. The findings also suggest that individuals with a preference for strategic gambling or strategic and no strategic gambling, seem to be at heightened risk for problematic gambling.

Juego online : tratamiento de un caso de adicción a apuestas deportivas / Online gambling: A treatment for sports betting addiction

Resumen Antecedentes : el juego de azar online (apuestas, juegos de casino, póquer, etc.) es una actividad que se está extendiendo mundialmente, incluso en los países en los cuales todavía no está legalizado. A pesar de que la situación en Latinoamérica es de lo más diversa, es probable que conforme se desarrolle y promocione el juego online aparezcan problemas de adicción, de forma similar a lo que está ocurriendo en España desde que este tipo de juegos se legalizó en 2011. De manera que la ciencia psicológica debe ir desarrollando programas de tratamiento que hagan frente a la nueva realidad. Objetivo: el artículo presenta el procedimiento seguido para el tratamiento de un joven con problema de adicción a las apuestas deportivas. Método: la propuesta de tratamiento tiene una orientación conductual-cognitiva, en la que se produjo descondicionamiento de las situaciones de juego, entrenamiento en habilidades para prevenir recaídas y superar situaciones de riesgo, así como información de los riesgos del juego, cambio de actitudes hacia las apuestas y promoción de un estilo de vida saludable incompatible con el juego excesivo. Resultados: se describen tanto las fases del tratamiento como el fundamento teórico de la propuesta de intervención. El paciente, con un diagnóstico de trastorno de juego grave, redujo los criterios de trastorno por juegos de apuesta, así como el Índice de Gravedad de Síntomas clínicos. Conclusiones: se ha desarrollado un protocolo de tratamiento de la adicción al juego online basado en los principios de la motivación y el aprendizaje que ha resultado ser eficaz en la reducción de la conducta de juego y la consolidación de un nuevo estilo de vida saludable.

Abstract Background : Online gambling (bets, casino games, poker, etc.) is an activity that is spreading worldwide, even in countries where it is not yet legalized. Although the situation in Latin America is very heterogeneous, it is possible that, as online gambling is developed and promoted, addiction problems arise. This has already happened in Spain since the legalization of online gambling in 2011. Thus, psychology should be developing intervention programs to face this new scenario. Goal: This paper describes the treatment protocol for a young man with sports betting addiction. Method: The treatment proposal consisted in a cognitive behavioral therapy which focused on deconditioning of gambling situations; training of skills needed to prevent relapses and overcome risky situations; information on gambling risks; change of attitude towards gambling; and promotion of a healthy lifestyle incompatible with gambling addiction. Results: Both the treatment phases and the theoretical basis of the intervention proposal are described. The patient, diagnosed with a severe gambling disorder, showed improvements in the gambling disorder criteria and the Symptom Severity Scale Score. Conclusions: A treatment protocol for online gambling addiction, which is based on the principles of motivation and learning, has been developed. This protocol has demonstrated to be effective in reducing gambling behavior and promoting a new healthy lifestyle.

Comorbid addictive behaviors in disordered gamblers with psychosis

Objective: While it has been shown that disordered gamblers with psychosis are at increased risk for comorbid psychopathology, it is unclear whether this dual-diagnosis population is also at greater risk of problematic engagement with comorbid addictive behaviors. Methods: We tested for association between disordered gambling with psychosis and comorbid addictive behaviors in a sample of 349 treatment-seeking disordered gamblers. Results: Twenty-five (7.2%) disordered gamblers met criteria for psychosis. Disordered gamblers with psychosis were no more likely to meet diagnostic criteria for current alcohol/substance use disorder than disordered gamblers without psychosis. However, this dual-disorder population reported greater misuse of shopping, food bingeing, caffeine, and prescription drugs. When controlling for multiple comparisons, binge eating was the only addictive behavior to remain significant. Conclusion: Given these findings, a comprehensive assessment of addictive behaviors - specifically food bingeing - in this population may be warranted.

O psicodrama no tratamento das dependências do comportamento patológico de jogar e de comprar / The psychodrama in the addiction treatment of pathological gambling and buying behavior / El psicodrama en el tratamiento de las dependencias de la conducta patológica de jugar y de comprar

Partindo dos critérios diagnósticos de dependência segundo o DSM-5, o objetivo deste artigo é mostrar o mecanismo de evolução da dependência do comportamento patológico de jogar e comprar, a psicodinâmica do jogador/comprador a partir dos referenciais teóricos psicodramáticos e a utilização das técnicas psicodramáticas na elucidação dos conteúdos pessoais que motivam o indivíduo ao impulso de jogar e comprar, geralmente desconhecidos e inconscientes. Será exemplificado pelo relato de sessão dramatizada e pelo discurso de pacientes. Este trabalho é importante para dar visibilidade ao psicodrama como uma abordagem terapêutica eficiente no tratamento do comportamento patológico de jogar e comprar, sob um embasamento teórico sólido, o que permite um domínio da intervenção técnica, foco e especificidade no tratamento.

Based on the diagnostic criteria for addiction according to DSM-5, this article aims to show the mechanism of addiction evolution of the pathological gambling and buying behavior, the psychodynamics of the player/buyer in accordance with the psychodramatic theoretical references and the use of the psychodramatic techniques in the elucidation of the personal contents that motivate the individual to the impulse to gamble and buy, usually unknown and unconscious. It will be exemplified through the reports of dramatized sessions and patients' discourses. This work is important to provide visibility of the psychodrama as an efficient therapeutic approach in the treatment of the pathological gambling and buying behavior, under a solid theoretical foundation, which allows a domain of technical intervention, focus and specificity in the treatment.

A partir de los criterios diagnósticos de la dependencia de acuerdo con el DSM-5, el objetivo de este artículo es presentar el mecanismo de la evolución de la dependencia de la conducta patológica de jugar y de comprar, la psicodinámica del jugador/comprador a partir de los referenciales teóricos psicodramáticos y de la utilización de tecnicas psicodramáticas en la elucidación de los contenidos personales que motivan al individuo al impulso de jugar y de comprar, generalmente desconocidos e inconscientes. Será ejemplificado por un relato de sesión dramatizada y por el discursos de pacientes. Este trabajo es importante para dar visibilidad al psicodrama como una práctica terapéutica eficiente en el tratamiento de la conducta patológica de jugar y de comprar, bajo una base teórica sólida, lo que permite un dominio de la intervención tecnica, foco y especificidad en el tratamiento.

Decision Making assessed by the Iowa Gambling Task and Major Depressive Disorder: a systematic review / Tomada de decisão avaliada pela Iowa Gambling Task e pelo Transtorno Depressivo Maior: uma revisão sistemática

Abstract Major Depressive Disorder (MDD) can occur in parallel with cognitive impairment. The search for a neuropsychological profile of depression has been pursued in the last two decades. However, scant research has been done on executive functions and decision-making ability (DM). Objective: To perform a systematic review of the evidence of DM performance evaluated using the Iowa Gambling Task (IGT) in adults with MDD. Methods: A systematic search according to the PRISMA statement was performed on MEDLINE for studies in English using the following keywords: 'depression', 'depressive', 'depressive symptoms' AND 'decision making' OR 'game task'. Results: Five articles that met the inclusion and exclusion criteria were identified. Three reported significant differences between depressed and non-depressed individuals. The results indicated that young adults with MDD exhibited lower performance on all or almost all stages of the IGT. One study that evaluated DM in older adults with MDD showed that depressed non-apathetic participants failed to adopt any advantageous strategy and continued to make risky decisions during the task. Conclusion: Results suggest that performance on the DM task by young and old adults with MDD differed in comparison to non-depressed participants. Given the small number of articles, further studies should be performed.

Resumo O Transtorno Depressivo Maior (TDM) pode ocorrer em paralelo com o comprometimento cognitivo. A busca por um perfil neuropsicológico da depressão tem sido perseguida nas últimas duas décadas. No entanto, poucas pesquisas foram feitas sobre funções executivas e capacidade de decisão (DM). Objetivo: Realizar uma revisão sistemática das evidências do desempenho do DM avaliado pela Iowa Gambling Task (IGT) em adultos com TDM. Métodos: Uma pesquisa sistemática de acordo com a declaração PRISMA foi realizada na MEDLINE para estudos em inglês usando as seguintes palavras-chave: "depressão", "depressivo", "sintomas depressivos" e "tomada de decisão" OU "tarefa de jogo". Resultados: Foram identificados 5 artigos que atenderam aos critérios de inclusão e exclusão. Três relataram diferenças significativas entre indivíduos deprimidos e não deprimidos. Os resultados indicaram que os jovens adultos com TDM exibiram menor desempenho em todos ou quase todos os estágios da IGT. Um estudo que avaliou o DM em idosos com TDM mostrou que os participantes deprimidos não apáticos não adotaram nenhuma estratégia vantajosa e continuaram tomando decisões arriscadas durante a tarefa. Conclusão: Os resultados sugerem que o desempenho na tarefa de DM por jovens e adultos idosos com TDM diferiu em comparação com os participantes não deprimidos. Dado o pequeno número de artigos, mais estudos devem ser realizados.

Magnitude and extent of gambling disorder in the Mexican population / Magnitud y extensión del juego patológico en la población mexicana

Abstract: Introduction: Gambling disorder is characterized by an uncontrollable need to gamble, lack of control over gambling, prioritizing gambling over other activities, and continuing to gamble despite the negative consequences this entails. Worldwide, between .1% and 5% of people show signs of problem gambling and between .1% and 2.2% present a positive result in gambling disorder criteria. Objective: To determine the extent of the problem of gambling disorder in Mexico and to identify and analyze the demographic groups in which it occurs. Method: ENCODAT 2016-2017 is a probabilistic, multi-stage survey with national and state representativeness. The sample comprises 56 877 people who answered a standardized questionnaire that collects information on addictive substance use and other areas such as gambling disorder. Results: A total of 24.5% of the population aged 12 to 65 have played a betting game at lifetime. Men have higher statistically significant prevalences than women in nearly all types of gambling and in six of the nine symptoms of gambling disorder. In Mexico, .3% of the target population meet the criteria for gambling disorder, with adolescents showing the highest percentage (.4%). Discussion and conclusion: It is necessary to reinforce public policies for this issue that include the development of preventive actions targeting the adolescent and youth population in Mexico, and to ensure the adequate monitoring of authorized centers.

Resumen: Introducción: El juego patológico se caracteriza por la necesidad incontrolable de jugar, la falta de control sobre el juego, la prioridad de jugar sobre otras actividades y de continuar jugando a pesar de las consecuencias negativas. A nivel mundial, entre .1% y el 5% de las personas muestra señales de juego problemático y del .1% al 2.2% presenta un resultado positivo en los criterios de juego patológico. Objetivo: Conocer la extensión del problema del juego patológico en México e identificar y analizar los grupos demográficos en los que se presenta. Método: La ENCODAT 2016-2017 es una encuesta probabilística y polietápica con representatividad nacional y estatal. La muestra fue de 56 877 personas, las cuales contestaron un cuestionario estandarizado que recaba información sobre consumo de sustancias adictivas y otras áreas como el juego patológico o ludopatía. Resultados: El 24.5% de la población de 12 a 65 años ha jugado algún juego de azar alguna vez en la vida. Los hombres presentan prevalencias estadísticamente significativas más altas que las mujeres en casi todos los tipos de juegos y en 6 de los 9 síntomas de juego patológico. En el país, el .3% de la población objetivo cumple con los criterios para juego patológico, y los adolescentes muestran el mayor porcentaje (.4%). Discusión y conclusión: Es necesario reforzar políticas públicas sobre el tema que incluyan el desarrollo de acciones preventivas dirigidas a la población adolescente y joven del país, así como incidir en el monitoreo adecuado de los centros autorizados.

Relationship between Horse Racing Addiction and Health Status Indicators

BACKGROUND: The purpose of this study is to investigate relationship between the horse racing addiction and the health status indicators. METHODS: Surveys were conducted with visitors of the Korea Racing Association in Gyeonggi-do, from September 1 to September 24, 2017. We used the questionnaire, which contains questions to assess the horse racing addiction, mood depression, health-related quality of life, smoking amount, alcohol dependency, etc. Survey data were analyzed through t-test, chi-square test, logistic regression analysis, and multiple regression analysis by SPSS program (IBM Corp., Chicago, IL, USA). RESULTS: The pathological gambling group was 47.5% (n=38) of the visitors, and they showed a different racecourse use behavior compared to the normal group. In addition, we found that the pathological gambling group had a significantly different health-related quality of life score and a depression score from the normal group, and that the addiction score and the depression score had a linear correlation. CONCLUSIONS: Among the racecourse visitors, the ratio of the pathological gambler was considerably high, and the pathological gambling group showed different health-related quality of life score and a depression score compared to the normal group; especially, the depression score has a significant correlation with horse racing addiction. Therefore, the horse racing association and the health authorities should recognize the seriousness of the horse racing addiction, make an effort to select high risk users, and prepare a program to prevent pathological gambling.

Mediating Effect of Depression on the Relationship between Gambling Severity and Cognitive Distortion: Secondary Data Analysis of Korea Center on Gambling Problems / 정신간호학회지

PURPOSE: The purpose of this study was to test the mediating effect of depression on the relationship between gambling severity and cognitive distortion in Koreans with a gambling disorder. METHODS: Secondary data from a comprehensive assessment of problematic gambling between 2015 and 2017 on Korea Center on Gambling Problems were used. The subjects in this study were 254 Koreans with that gambling disorder. Data were collected with self-report structured questionnaires which included individual characteristics, the Korean version of Problem Gambling Severity Index, the Center for the Epidemiologic Studies Depression, and the Gambling Related Cognitions Scale. Data were analyzed by using descriptive statistics, independent t-test, one-way ANOVA with the Scheffé test, Pearson's correlation coefficients, and a mediation analysis of the Baron and Kenny method with the SPSS 22.0 program. RESULTS: Significant correlations emerged among the three variables, gambling severity, depression, and cognitive distortion. Depression exerted a partial mediating effect (β=.20, p < .001) on the relationship between gambling severity and cognitive distortion (Sobel test: z=2.33, p=.012). CONCLUSION: Based on this study's findings, nursing intervention programs focused on managing gambling severity and decreasing depression are highly recommended to alleviate cognitive distortion in people with a gambling disorder.

Comparing the Behavioral Patterns and Psychological Characteristics of Web Board Gamers and Gamblers

OBJECTIVE: In Korea, online board games, such as “flower cards,” are played using virtual money. In contrast, Internet-based gambling (ibGambling) concerns the use of real money to gamble online. We hypothesized that online board gamers using virtual money show less risky behaviors than do gamblers who use real money, and that, in regard to psychological aspects, online board gamers are less depressed and more introverted than online gamblers are. METHODS: For this study, 100 online board gamers, 100 ibGamblers, 100 offline gamblers (offGamblers), and 100 age- and sex-matched healthy controls were recruited by an online research company. Gambling behavior and self-efficacy were assessed using the Korean Gambling Behavior Scale-high/low factors (KGBS-H/L) and the Gambling Abstinence Self-efficacy Scale (GASS). Additionally, introversion, depression, and mania tendency were assessed. RESULTS: Online board gamers had good intentions gaming, as evidenced by their higher KGBS-L scores than ibGamblers and offGamblers, and they showed less risky behaviors, as evidenced by their lower KGBS-H scores than offGamblers. Additionally, online board gamers were less introverted than ibGamblers and less depressed than offGamblers. CONCLUSION: Online board gaming could be a gateway to the world of gambling (ibGambling or OffGambling). However, the higher tendency of online board gamers to engage in good intentioned gaming could help prevent online board gaming from progressing to online or offline gambling.

Testing a Model to Predict Problem Gambling in Speculative Game Users

PURPOSE: The purpose of the study was to develop and test a model for predicting problem gambling in speculative game users based on Blaszczynski and Nower's pathways model of problem and pathological gambling. METHODS: The participants were 262 speculative game users recruited from seven speculative gambling places located in Seoul, Gangwon, and Gyeonggi, Korea. They completed a structured self-report questionnaire comprising measures of problem gambling, negative emotions, attentional impulsivity, motor impulsivity, non-planning impulsivity, gambler's fallacy, and gambling self-efficacy. Structural Equation Modeling was used to test the hypothesized model and to examine the direct and indirect effects on problem gambling in speculative game users using SPSS 22.0 and AMOS 20.0 programs. RESULTS: The hypothetical research model provided a reasonable fit to the data. Negative emotions, motor impulsivity, gambler's fallacy, and gambling self-efficacy had direct effects on problem gambling in speculative game users, while indirect effects were reported for negative emotions, motor impulsivity, and gambler's fallacy. These predictors explained 75.2% problem gambling in speculative game users. CONCLUSION: The findings suggest that developing intervention programs to reduce negative emotions, motor impulsivity, and gambler's fallacy, and to increase gambling self-efficacy in speculative game users are needed to prevent their problem gambling.

Latent Class Analysis of Gambling Activities among Korean Adolescents

PURPOSE: The aim of this study is to identify the types of gambling among adolescents and provide basic prevention information regarding adolescents' gambling problems. METHODS: Secondary data from representative national survey on 2015 Youth Gambling Problems of Korea Center on Gambling Problems were used. Using latent class analysis (LCA), 13 gambling types such as offline and online games of 14,011 adolescents were classified, and gambling experiences and characteristics were analyzed. RESULTS: The subgroups of adolescent gambling were identified as four latent classes: a rare group (84.5% of the sample), a risk group (1.0%), an offline group (11.9%), and an expanded group (2.6%). The types and characteristics of gambling among the latent classes differed. In the risk group, adolescents participated in online illegal sports betting and internet casino, and gambling time, gambling expenses, and the number of gambling types were higher than other groups. CONCLUSION: Gambling frequently occur among adolescent, and the subtypes of gambling did not reveal homogeneous characteristics. In order to prevent adolescent gambling problems, it is a necessary to develop tailored prevention intervention in the nursing field, which is appropriate to the characteristics of adolescent gambling group and can help with early identification.

Testing an Explanatory Model for Preventing College Students' Problem Gambling

PURPOSE: A mediated model of Korean college students' problem gambling based on Blaszczynski and Nower's pathway model is developed and tested to explore mediating roles of self-control and irrational gambling beliefs in the association between emotionally vulnerable variables and problem gambling. METHODS: 273 student participants recruited from 4 universities in Seoul and Gyeonggi, Korea responded. Data were collected with a structured self-report questionnaire comprising measures of problem gambling, depression, anxiety, coping styles, irrational gambling belief, and self-control. RESULTS: The modified research model provides a reasonable fit to the data. Depression, anxiety, reflective coping, irrational beliefs, and self-control turned out to have direct effects on problem gambling, while indirect effects were reported in some suppressive and reactive styles. These predictors account for 38% of the college students' problem gambling. CONCLUSION: The findings suggest that developing intervention programs for reducing depression, anxiety, irrational gambling beliefs, and increasing reflective coping and self-control are needed to prevent Korean college students' problem gambling.

Bases neurales de la toma de decisiones e implicación de las emociones en el proceso / The neural basis of the decision-making and emotional processes involved / Bases neurais da tomada de decisão e implicação das emoções neste processo

Este artículo se ha propuesto como una revisión de las investigaciones que han surgido en la última década en el campo de la neurociencia, y que se hayan relacionadas con la actividad neurobiológica y funcional de la toma de decisiones por parte del ser humano. Así, ha sido posible identificar y dar cuenta de las estructuras del sistema nervioso central que son claves en la comprensión de los procesos relacionados con la toma de decisiones, y a su vez han permitido establecer el rol de las emociones como influencia determinante en este proceso. De igual forma, las investigaciones han posibilitado conocer cómo se lleva a cabo la actividad de tomar decisiones en el cerebro, las relaciones entre las diversas regiones y cómo las emociones guían el resultado.Además, se ha llegado a destacar dos sistemas que explicarían el proceso de la toma de decisiones, uno asociado a la intuición (sistema práctico), donde se destaca la actividad metabólica de la amígdala cerebral y sus redes neuronales; otro que corresponde al razonamiento (sistema analítico), en el cual resalta la participación de las conexiones neuronales de la porción ventromedial del córtex prefrontal.

This paper has proposedas a review of the researchthat has been appearing in the last decade in the field of neuroscience, and the relationship with the neurobiological and functional activity of the human decision making. Therefore, it has been possible to identify and inform the key structures of the central nervous system in the comprehension of the related processes, and it has allowed to stablish the important influence of the emotion in this process. Also, the research hasallowed to know how the decision-making process has been referred in the brain, the relationship between the different brain regions and the emotion who led the outcome. Thus, there are two systems involved in the decision makingprocess; one related with the intuition (practical system), where the metabolic activity of the cerebral amygdala is remarked with their neural networks, and other related with reasoning (analytical system), in which, is important to note the involvement of the ventromedial portion of the prefrontal cortex.

Este artigo foi proposto como uma revisão das pesquisas que surgiram na última década no campo da neurociência, e que tem sido relacionada à atividade neurobiológica e funcional da tomada de decisão pelo ser humano. Assim, foi possível identificar e explicar as estruturas do sistema nervoso central que são fundamentais na compreensão dos processos relacionados à tomada de decisões e, por sua vez, permitiram estabelecer o papel das emoções como influência determinante nesse processo. Da mesma forma, a pesquisa permitiu saber como é a atividade de tomada de decisão no cérebro, as relações entre diferentes regiões e como as emoções orientam o resultado. Ademais, foram destacados dois sistemas que explicam o processo de tomada de decisão, um associado à intuição (sistema prático), que enfatiza a atividade metabólica da amígdala cerebral e suas redes neurais; outro correspondente ao raciocínio (sistema analítico), no qual as conexões neuronais da porção ventromedial do córtex pré-frontal são destacadas.

Current psychological therapeutic approaches for gambling disorder with psychiatric comorbidities: A narrative review / Tratamientos psicológicos actuales para el trastorno del juego c on comorbilidad psiquiátrica: una revisión narrativa

Abstract: Background: Although the presence of a gambling disorder (GD) together with another mental disorder poses special treatment challenges, such as relapses, severe outcomes for patients and families, and increased number of hospitalizations, there are only a few critical reviews in the literature. Objective: To review empirical evidence of psychological approaches to cope specifically with these dual disorders. Method: A narrative review of the relevant bibliography on this topic was carried out. A systematic search of original articles (2010-October 2017) was conducted in MEDLINE and PsycInfo. Key terms were: 1. gambling/gamblers, 2. treatment/intervention/therapy/therapeutics, and 3. dual diagnosis/comorbidity. Results: Current treatment for GD involves a number of different options, including inpatient treatments, intensive outpatient therapy, individual and group cognitive-behavioral options (CBT), self-help groups, and pharmacotherapy. Inpatient care is generally limited to patients with severe acute crises, treatment failures, and severe comorbid disorders, particularly depression and attempted suicide. Treatment for GD with other mental disorder needs more research. CBT, motivational enhancement therapy and self-help groups have some empirical support when GD is comorbid with other addiction, mood disorder, or schizophrenia. Programs that combine pharmacotherapy and psychosocial treatments for GD into a single comprehensive package are most likely to have good treatment outcomes, at least with regard to treatment retention. Discussion and conclusion: Interventions should be tailored to the needs of the patients. Future research should be concerned about the statistical power of the studies, implement motivational strategies for patients with poor medication adherence, and design measures to study treatment fidelity in the CBT groups.

Resumen: Antecedentes: La presencia comórbida del juego patológico (JP) con otro trastorno mental plantea diversos desafíos al tratamiento, como las recaídas, las repercusiones negativas para los pacientes y sus familias y un mayor número de hospitalizaciones. Objetivo: Revisar la evidencia empírica existente sobre el papel que cumplen las terapias psicológicas en el tratamiento de estos trastornos duales. Método: Se realizó una revisión narrativa de la bibliografía relevante sobre este tema. Se llevó a cabo una búsqueda sistemática de artículos originales (2010-octubre 2017) en MEDLINE y PsycInfo con las palabras clave: 1. gambling or gamblers, 2. Treatment, intervention, therapy or therapeutics, y 3. dual diagnosis or comorbidity. Resultados: Hay diversas terapias para el JP: tratamiento hospitalario, terapia intensiva ambulatoria, terapia cognitivo-conductual (TCC) individual y en grupo, Jugadores Anónimos y farmacoterapia. La hospitalización se limita a los pacientes con una crisis aguda, fracasos terapéuticos previos y trastornos comórbidos graves, como la depresión y los intentos de suicidio. El tratamiento para el JP comórbido con otro trastorno (depresión, abuso de sustancias o esquizofrenia) requiere más investigación. Las terapias más efectivas en estos casos son al parecer la TCC, la entrevista motivacional y los grupos de autoayuda. Los programas que combinan farmacoterapia con tratamientos psicológicos parecen aumentar la retención del tratamiento. Discusión y conclusión: La intervención debe adaptarse a las necesidades específicas de cada paciente y la investigación debe mejorar las estrategias motivacionales cuando los pacientes muestran una deficiente adherencia a la medicación, así como diseñar medidas para mejorar la fidelidad al tratamiento psicológico.

Cuestionario breve de juego patológico en estudiantes colombianos: propiedades psicométricas / Pathological Gambling Short Questionnaire in Colombian Students: Psychometrics Properties

Resumen Son escasos los estudios sobre instrumentos de evaluación de la ludopatía en población colombiana, así como sobre su prevalencia. El objetivo de este trabajo fue obtener las propiedades psicométricas del Cuestionario Breve de Juego Patológico (CBJP), así como determinar la prevalencia de probable juego patológico en una muestra no aleatoria (n= 5858) de estudiantes de formación superior de todas las ciudades capitales de Colombia. El CBJP mostró una fiabilidad interna (0.74) aceptable y validez convergente con una medida de distorsiones cognitivas sobre los juegos de azar -r(5618)= 0.462, p < 0.001-. La prevalencia de posibles problemas de adicción al juego fue similar a la encontrada con instrumentos más amplios en población análoga (19.2 %), y dicha prevalencia fue más alta en hombres, en personas más jóvenes y de nivel socioeconómico más bajo. De acuerdo con estos resultados, es necesario confirmar con otros instrumentos la prevalencia del juego patológico, impulsar medidas legales y sociosanitarias de prevención para los grupos en riesgo alto, y conocer la utilidad del CBJP en muestras clínicas colombianas.

Abstract There are few studies on pathological gambling (PG) tests and prevalence for Colombian population. The aim of this paper was to obtain both psychometric properties of the Pathological Gambling Short Questionnaire (PGSQ), as well as to calculate the prevalence of pathological gambling (PG) for a non-randomized sample of university and technical courses from all Colombian capital cities. Results showed a PGSQ good internal reliability (0.74) and convergent validity with a cognitive distortions indicator -r(5618)= 0.462, p < 0.001-. The prevalence of possible pathological gamblers was similar to other studies which have used broader measures of pathological gambling (19.2 %). Men, youngest people and members of low social class had higher scores in PG. According to these results, it should be confirmed PG prevalence with other measures, in order to boost legal and socio-health actions for prevention of PG in high risk groups and to know utility of PGSQ for Colombian clinical samples.