Delay Discounting in Gambling Disorder : Implications in Treatment Outcome
Mena Moreno, Teresa (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición)
Testa, Giulia (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición)
Mestre-Bach, Gemma (Universidad Internacional de La Rioja. Facultad de Ciencias de la Salud)
Miranda-Olivos, Romina (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición)
Granero, Roser (Institut d'Investigació Biomèdica de Bellvitge)
Fernández-Aranda, Fernando (Institut d'Investigació Biomèdica de Bellvitge)
Menchón, José M. (Centro de Investigación Biomédica en Red de Salud Mental)
Jiménez-Murcia, Susana (Institut d'Investigació Biomèdica de Bellvitge)

Date:	2022
Abstract:	Impulsive choice, measured by delay discounting (DD) tasks, has been shown in patients with gambling disorders (GD). However, the impact of DD and treatment outcome has been scarcely explored in GD patients. The aims of this study were: (1) to examine the baseline association between DD and clinical variables in GD patients depending on their age and gambling preferences (strategic vs. non-strategic); and (2) to estimate the predictive role of DD on poorer outcomes of cognitive-behavioral therapy (CBT) when considering also the effect of other clinical variables. 133 treatment-seeking male GD patients were evaluated at baseline with a DD task and measures of GD severity, personality traits and psychopathology. Treatment outcome was measured in terms of dropout from CBT and relapses. Results showed baseline associations between DD and GD severity (correlation coefficient R = 0. 408 among strategic gamblers and R = 0. 279 among mixed gamblers) and between DD and positive/negative urgency (R = 0. 330 for the youngest patients, R = 0. 244 for middle age, and around R = 0. 35 for gamblers who reported preferences for strategic games). Other personality traits such as high harm avoidance and low cooperativeness were also related to DD at baseline (R = 0. 606 among strategic gamblers). Regarding treatment outcome, a steeper discount rate predicted a higher risk of relapses in strategic gamblers (odds ratio OR = 3. 01) and middle-age ones (OR = 1. 59), and a higher risk of dropout in younger gamblers (OR = 1. 89), non-strategic gamblers (OR = 1. 70) and mixed gamblers (R = 4. 74). GD severity mediated the associations between age, DD, personality traits and poor CBT outcome. In conclusion, impulsive choice affects treatment response in individuals with GD and may interfere with it to a significant extent. Considering DD in GD, patients seeking treatment could help control its impact on treatment adherence and relapses.
Grants:	Ministerio de Ciencia e Innovación RTI2018-101837-B-100 Ministerio de Educación, Cultura y Deporte FPU16/02087 Instituto de Salud Carlos III PI17/01167
Note:	Altres ajuts: Delegación del Gobierno para el Plan Nacional sobre Drogas: 2017I067 i 2019I47
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Impulsivity ; Delay discounting ; Gambling disorder ; Treatment outcomes ; Gambling preferences
Published in:	Journal of clinical medicine, Vol. 11 (march 2022) , ISSN 2077-0383

DOI: 10.3390/jcm11061611
PMID: 35329937

14 p, 1.2 MB

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