Impact of ADHD symptoms on clinical and cognitive aspects of problem gambling.

BACKGROUND: Problem gambling is common across cultures, and has been conceptualized in terms of impulsivity. While elevated rates of attention deficit hyperactivity disorder (ADHD) have been observed in problem gamblers, the relationship between these two conditions, and other dissociable forms of impulsivity, has received little research attention. METHODS: N=126 non-treatment seeking young adults with problem gambling were recruited from the community, and were grouped according to the presence or absence of probable current ADHD. Clinical and cognitive measures pertaining to impulsivity were collected via detailed psychiatric assessment, questionnaires, and computerized neuropsychological tests. These variables were compared between groups. RESULTS: Probable current ADHD was identified in 21.4% of the sample, and was associated with earlier age at onset of gambling behaviors, higher Barratt impulsivity scores (all three subscales), greater caffeine intake, worse response inhibition (Stop-Signal Test), and impaired decision-making (greater proportion of points gambled, Cambridge Gamble Test). Problem gamblers with and without ADHD did not differ on demographic characteristics or the rate of other psychiatric disorders, depression scores, nicotine and alcohol consumption, and body mass index. No significant group differences were found for general response speed, working memory, or executive planning. CONCLUSIONS: ADHD is common in young adults with dysfunctional gambling behaviors and is associated with elevated questionnaire and cognitive based measures of impulsivity, along with heightened caffeine use. Future work should study the causal nature between these factors and the treatment implications of these findings.This work was supported by a Center of Excellence in Gambling Research grant from the National Center for Responsible Gaming (USA) to Dr. Grant. Dr. Chamberlain's involvement in this research was supported by a grant from the Academy of Medical Sciences (AMS, UK).This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.comppsych.2014.10.01

A preliminary comparison of cannabis use in subsyndromal gamblers: select neurocognitive and behavioral differences based on use.

OBJECTIVES: Cannabis and gambling are 2 common forms of impulsive behavior among young adults. Although both cannabis use and gambling have been associated with specific cognitive deficits on tasks related to decision making, no studies to date have examined the possible effects on neurocognition in those who simultaneously gamble and use cannabis. METHODS: To address this question, the present study analyzed 214 subsyndromal gamblers from a larger study on impulsivity. Of these subjects, 64 (29.9%) were current cannabis users (last use within the last 3 months) and 150 (70.1%) had no history of cannabis use in the last 3 months, along with 163 healthy controls. Participants were assessed on various cognitive and clinical measures, including measures for gambling severity and impulsivity. RESULTS: Subjects using cannabis had higher rates of current alcohol use disorders and more frequent gambling behavior per week. Gamblers who used cannabis also exhibited significantly greater scores on one measure of attentional impulsivity. Both gambling groups differed from healthy controls on all clinical and select neurocognitive variables, consistent with previous research. CONCLUSIONS: These results indicate that cannabis use in young adults who gamble is associated with nuanced behavioral differences, although causality could not be determined. Longitudinal research should examine cannabis use in subsyndromal gamblers over time to characterize whether these findings are causative.Dr. Grant has received research grants from NIMH, NIDA, National Center for Responsible Gaming, Forest, Transcept, Roche, and Psyadon Pharmaceuticals, and the University of South Florida. He receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. Dr. Chamberlain has consulted for Cambridge Cognition, P1Vital, and Shire Pharmaceuticals; and has received speaker honoraria from Lilly. Mr. Leppink and Ms. Derbyshire report no financial relationships with commercial interests.This is the author accepted manuscript. The final version is available from Wolters Kluwer via http://dx.doi.org/10.1097/ADM.000000000000007

Obesity and dissociable forms of impulsivity in young adults.

OBJECTIVE: Obesity is one of the leading causes of preventable morbidity and mortality, and young people are increasingly affected. The aim of this study was to examine relationships between obesity and dissociable forms of impulsivity in young adults. METHODS: A group of young adults (511) was recruited from city areas in the United States using media advertisements. These young adults were administered careful and extensive clinical and neurocognitive assessment in order to quantify different aspects of impulsivity (behavioral/phenomenological-, cognitive-, and personality-related measures). Associations between obesity and impulsivity were explored using multivariate analysis of variance and discriminant function analysis. RESULTS: 10.8% of the sample was obese, and 21.5% was overweight. Compared to controls, subjects with obesity showed significantly elevated rates of maladaptive gambling behaviors, monetary amounts lost to gambling, nicotine consumption, impulsive action (prolonged stop-signal reaction times in the Stop-Signal Test), and impulsive decision-making (reduced modulation of behavior as a function of risk in the Cambridge Gamble Test). Even accounting for potential confounding variables, obesity was significantly predicted by female gender, older age, more maladaptive gambling behaviors, and worse inhibitory control (stop-signal reaction times). CONCLUSION: Obesity is associated with several dissociable forms of impulsivity in young people, especially gambling and impulse dyscontrol. Family doctors should screen for gambling problems in obese young adults. Successful treatment of nicotine dependence in young obese people is likely to require intensive weight management support. Neuropsychological deficits relating to impulsivity occur in obese people in early adulthood, and may represent vulnerability markers rather than being due to chronic untoward metabolic effects on brain function.This research was supported by a Center for Excellence in Gambling Research grant to Dr. Grant from the National Center for Responsible Gaming (USA) and by the Academy of Medical Sciences (UK; grant to Dr. Chamberlain).This is the author accepted manuscript. The final version is available from CUP at http://dx.doi.org/10.1017/S109285291400062

Sleepiness and cognition in young adults who gamble and use alcohol

Abstract Background and aims Past research suggests that sleep problems are associated with increased risky decision-making. Similarly, gambling disorder and alcohol use disorder are also associated with increased risky decision-making. Individuals with gambling disorder or alcohol use disorder have also reported higher rates of sleep problems compared to normal healthy controls. As such, we sought to examine whether sleep problems play a role in the development of alcohol use disorder or gambling disorder. Methods One hundred and forty-one individuals who gamble and use alcohol, yet do not meet criteria for gambling disorder or alcohol use disorder, were assessed to determine the correlation between sleepiness, amount of sleep obtained, decision-making, and alcohol or gambling behaviors. Results Our results suggest that inconsistent sleep patterns may be associated with increased frequency of alcohol use and gambling. We did not, however, find a significant correlation between sleep factors and decision-making. Discussion Further research is needed to examine the specific relationship between sleep patterns and alcohol use and gambling frequency. Overall these data suggest that sleepiness or sleep and risky decision-making is not a significant factor in gambling and alcohol use behaviors in individuals not meeting criteria for alcohol use disorder or gambling disorder

White matter tract integrity in treatment-resistant gambling disorder.

BACKGROUND: Gambling disorder is a relatively common psychiatric disorder recently re-classified within the DSM-5 under the category of 'substance-related and addictive disorders'. AIMS: To compare white matter integrity in patients with gambling disorder with healthy controls; to explore relationships between white matter integrity and disease severity in gambling disorder. METHOD: In total, 16 participants with treatment-resistant gambling disorder and 15 healthy controls underwent magnetic resonance imaging (MRI). White matter integrity was analysed using tract-based spatial statistics. RESULTS: Gambling disorder was associated with reduced fractional anisotropy in the corpus callosum and superior longitudinal fasciculus. Fractional anisotropy in distributed white matter tracts elsewhere correlated positively with disease severity. CONCLUSIONS: Reduced corpus callosum fractional anisotropy is suggestive of disorganised/damaged tracts in patients with gambling disorder, and this may represent a trait/vulnerability marker for the disorder. Future research should explore these measures in a larger sample, ideally incorporating a range of imaging markers (for example functional MRI) and enrolling unaffected first-degree relatives of patients.This research was supported by a grant from the National Center for Responsible Gaming to Dr. Grant, and by a grant from the Academy of Medical Sciences to Dr. Chamberlain (UK). Dr. Grant has received research grants from NIMH, National Center for Responsible Gaming, and Forest and Roche Pharmaceuticals Dr. Grant receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. Dr. Chamberlain consults for Cambridge Cognition. Mr. Odlaug has received a research grant from the Trichotillomania Learning Center, consults for H. Lundbeck A/S, and has received royalties from Oxford University Press. Mr. Leppink and Ms. Derbyshire report no conflicts of interest.This is the author accepted manuscript. The final version is available from the Royal College of Psychiatrists via http://dx.doi.org/10.1192/bjp.bp.115.16550

Impaired response inhibition and excess cortical thickness as candidate endophenotypes for trichotillomania.

This is the author accepted manuscript. the final version is available via Elsevier at http://www.sciencedirect.com/science/article/pii/S0022395614002465.Trichotillomania is characterized by repetitive pulling out of one's own hair. Impaired response inhibition has been identified in patients with trichotillomania, along with gray matter density changes in distributed neural regions including frontal cortex. The objective of this study was to evaluate impaired response inhibition and abnormal cortical morphology as candidate endophenotypes for the disorder. Subjects with trichotillomania (N = 12), unaffected first-degree relatives of these patients (N = 10), and healthy controls (N = 14), completed the Stop Signal Task (SST), a measure of response inhibition, and structural magnetic resonance imaging scans. Group differences in SST performance and cortical thickness were explored using permutation testing. Groups differed significantly in response inhibition, with patients demonstrating impaired performance versus controls, and relatives occupying an intermediate position. Permutation cluster analysis revealed significant excesses of cortical thickness in patients and their relatives compared to controls, in right inferior/middle frontal gyri (Brodmann Area, BA 47 & 11), right lingual gyrus (BA 18), left superior temporal cortex (BA 21), and left precuneus (BA 7). No significant differences emerged between groups for striatum or cerebellar volumes. Impaired response inhibition and an excess of cortical thickness in neural regions germane to inhibitory control, and action monitoring, represent vulnerability markers for trichotillomania. Future work should explore genetic and environmental associations with these biological markers.This research was supported by a grant from the Trichotillomania Learning Center, USA, to Mr. Odlaug; and by a grant from the Academy of Medical Sciences, UK, to Dr. Chamberlain. Neither of these entities had any further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication

A combined SAXS/WAXS investigation of the phase behaviour of di-polyenoic membrane lipids

AbstractReal-time measurements of the SAXS/WAXS diffraction patterns of aqueous dispersions (1:1 wt/wt) of the di-polyenoic lipids di-18:2 PC, di-18:3 PC, di-18:2 PE and di-18:3 PE were made over the temperature range 10° to about −80°C. The results of these measurements were compared to similar measurements performed on the corresponding di-18:0 and di-18:1 derivatives. SAXS measurements of the temperature dependence of lamellar repeat distances show that the di-polyenoic lipids undergo broad second-order transitions between their gel and liquid-crystal lamellar phases spanning 30–40°C. The di-18:1 and di-18:0 derivatives, in contrast, undergo abrupt first-order transitions. The gel phases of the di-18:0 derivatives are characterised by two-component WAXS patterns with a sharp component close to 0.42 nm and a broader component at narrower spacings. On cooling, these lipids appear to undergo an initial transition to an Lβ, phase followed by a conversion to an Lc phase. The gel phases of the di-18:1 derivatives also show two-component patterns but with the sharp component centred closer to 0.44 nm. The di-polyenoic lipids, in contrast, are characterised by a single broad peak centred at a spacing of about 0.42 nm, close to that of conventional Lβ, phases. The changes in lamellar repeat distance accompanying the transitions in the di-monoenoic and di-polyenoic lipids, all of which occur in the frozen state, are very similar, indicating that the acyl chains of the polyenoic lipids are close to their maximum extension in the gel state. The WAXS patterns of the polyenoic lipids suggest that the saturated upper parts of the acyl chains are packed on a regular hexagonal lattice while their polyunsaturated termini remain relatively disordered

System for MR image-guided prostate interventions: canine study

Cataloged from PDF version of article.The purpose of this study was to demonstrate the use of a transrectal system that enables precise magnetic resonance (MR) image guidance and monitoring of prostate interventions. The system used a closed-bore 1.5-T MR imaging unit and enables one to take advantage of the higher signal-to-noise ratio achieved with traditional magnet designs, which is crucial for accurate targeting and monitoring of prostate interventions. In the first of the four canine studies, reliable needle placement, with all needles placed within 2 mm of the desired target site, was achieved. In two other studies, MR imaging was used to monitor distribution of injected contrast agent solution (gadopentetate dimeglumine mixed with trypan blue dye) in and around the prostate, thereby confirming that solution had been delivered to the desired tissue and also detecting faulty injections. In the final study, accurate placement and MR imaging of brachytherapy seeds in the prostate were demonstrated. The described system provides a flexible platform for a variety of minimally invasive MR image-guided therapeutic and diagnostic prostate interventions