Comparative analysis of distinct phenotypes in gambling disorder based on gambling preferences

Background: Studies examining gambling preferences have identified the importance of the type of gambling practiced on distinct individual profiles. The objectives were to compare clinical, psychopathological and personality variables between two different groups of individuals with a gambling disorder (strategic and non-strategic gamblers) and to evaluate the statistical prediction capacity of these preferences with respect to the severity of the disorder. Method: A total sample of 2010 treatment-seeking patients with a gambling disorder participated in this stand-alone study. All were recruited from a single Pathological Gambling Unit in Spain (1709 strategic and 301 non-strategic gamblers). The design of the study was cross-sectional and data were collected at the start of treatment. Data was analysed using logistic regression for binary outcomes and analysis of variance (ANOVA) for quantitative responses. Results: There were significant differences in several socio-demographic and clinical variables, as well as in personality traits (novelty seeking and cooperativeness). Multiple regression analysis showed harm avoidance and self-directedness were the main predictors of gambling severity and psychopathology, while age at assessment and age of onset of gambling behaviour were predictive of gambling severity. Strategic gambling (as opposed to non-strategic) was significantly associated with clinical outcomes, but the effect size of the relationships was small. Conclusions: It is possible to identify distinct phenotypes depending on the preference of gambling. While these phenotypes differ in relation to the severity of the gambling disorder, psychopathology and personality traits, they can be useful from a clinical and therapeutic perspective in enabling risk factors to be identified and prevention programs targeting specific individual profiles to be developed

Demographic Characteristics of the Sample (<i>N</i> = 622).

<p>Demographic Characteristics of the Sample (<i>N</i> = 622).</p

Comparison for clinical variables between countries (China, UK and Spain).

<p>Comparison for clinical variables between countries (China, UK and Spain).</p

Developmental trajectories for ODB in the different instruments, children's age on X-axis and raw score on Y-axis (broken line represents the cut-off of diagnosis for DSM-IV definition and percentile 90 at baseline in the sample for dimensional measures; triangle represents observed empirical values).

<p><i>S = slope (in brackets, p-value)</i>.</p

Means (standard errors) for the UPPS-P dimensions based on the diagnostic group and the NSSI behavior adjusted for age.

<p>NSSI = Non-Suicidal Self-Injury, HC = Healthy Controls, AN-R = Anorexia Nervosa Restrictive Subtype, AN-BP = Anorexia Nervosa Binge-eating/Purging type, BN = Bulimia Nervosa, EDNOS = Eating Disorder Not Otherwise Specified</p><p>Means (standard errors) for the UPPS-P dimensions based on the diagnostic group and the NSSI behavior adjusted for age.</p

Prevalence rates for lifetime NSSI and comparison between diagnostic group.

<p>CI = Confidence Interval, OR = Odds Ratio, HC = Healthy Controls, AN-R = Anorexia Nervosa Restrictive Subtype, AN-BP = Anorexia Nervosa Binge-eating/Purging type, BN = Bulimia Nervosa, EDNOS = Eating Disorder Not Otherwise Specified</p><p>Prevalence rates for lifetime NSSI and comparison between diagnostic group.</p

Predictive capacity of the UPPS-P Impulsivity Facets on the presence of NSSI behavior: logistic regression adjusted by the covariates age and diagnostic group.

<p>Adjusted Nagelkerke’s-<i>R</i>^<i>2</i> =. 115</p><p>OR = Odd Ratio, CI = Confidence Interval</p><p>Predictive capacity of the UPPS-P Impulsivity Facets on the presence of NSSI behavior: logistic regression adjusted by the covariates age and diagnostic group.</p

Comparison for the UPPS-P dimensions based on the NSSI behavior and the diagnostic group.

<p>ANOVA controlled for age. N×G = interaction NSSI × group.</p><p>NSSI = Non-Suicidal Self Injury, HC = Healthy Controls, AN-R = Anorexia Nervosa Restrictive Subtype, AN-BP = Anorexia Nervosa Binge-eating/Purging type, BN = Bulimia Nervosa, EDNOS = Eating Disorder Not Otherwise Specified</p><p>CI = Confidence Interval MD: mean difference.</p><p>Results include Bonferroni-Simes correction for multiple significance tests.</p><p>Comparison for the UPPS-P dimensions based on the NSSI behavior and the diagnostic group.</p

Radar chart for the UPPS-P mean scores and the lifetime prevalence of Non-Suicidal Self-Injury (NSSI), stratified by the diagnostic subtypes [Healthy Controls (HC), Anorexia Nervosa-Restrictive type (AN-R), Anorexia Nervosa-Binge-eating/Purging type (AN-BP), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS)].

<p>Radar chart for the UPPS-P mean scores and the lifetime prevalence of Non-Suicidal Self-Injury (NSSI), stratified by the diagnostic subtypes [Healthy Controls (HC), Anorexia Nervosa-Restrictive type (AN-R), Anorexia Nervosa-Binge-eating/Purging type (AN-BP), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS)].</p

Comparison of neurocognitive measures between diagnosis subtypes.

<p>IGT: Iowa Gambling Task;</p><p>WCST: Wisconsin Card Sorting Test;</p><p>CLR: Conceptual Level Response;</p><p>MD: mean difference (contrast value);</p>*<p>Significant contrast (.05 level).</p