Pathological gamblers discount probabilistic rewards less steeply than matched controls.

Nineteen treatment-seeking men meeting Diagnostic and Statistical Manual for Mental Disorders (4th ed.) criteria for pathological gambling and 19 demographically matched controls participated. Participants provided demographic information, information about their recent drug use and gambling activities, and biological samples (to confirm drug abstinence). They also completed the Eysenck Personality Questionnaire, the South Oaks Gambling Screen (SOGS), and 2 questionnaires designed to separately quantify probability and delay discounting. Pathological gamblers discounted probabilistic rewards significantly less steeply than matched controls. A significant correlation revealed that more shallow probability discounting was associated with higher SOGS scores. Across groups, there was no significant difference in delay discounting, although this difference approached significance when education and ethnicity were included as covariates. These findings, collected for the 1st time with pathological gamblers, are consistent with previous reports that problem-gambling college students discount probabilistic rewards less steeply than controls. The nature of the relation between probability discounting and severity of problem gambling is deserving of further study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of pathological gamblers with and without substance abuse treatment histories.

This study evaluated the prevalence and correlates of substance abuse histories in 341 consecutive admissions to gambling treatment programs. After controlling for gender, income, and site, gamblers with substance abuse treatment histories (SATH; 31%) had more severe problems than gamblers with no substance abuse treatment histories (NSATH) on the Gambling, Alcohol, Drug, Psychiatric, and Employment scales of the Addiction Severity Index. The SATH group had more years of gambling problems and gambled more days in the month prior to initiating gambling treatment. The SATH gamblers were also more likely to be receiving treatment for mental health problems and reported greater lifetime psychiatric distress than NSATH gamblers. These data suggest that pathological gamblers with substance abuse treatment histories may present more persistent and severe gambling dysfunction and psychiatric problems than those without such histories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subtyping pathological gamblers based on impulsivity, depression, and anxiety.

This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index—Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity scores. They were also most likely to have a history of substance abuse treatment, history of inpatient psychiatric treatment, and a parent with a substance use or gambling problem. AI and EV gamblers experienced greater gambling severity throughout treatment than BC gamblers, but all three subtypes demonstrated similar patterns of treatment response. Thus, the three Pathways subtypes differ on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Inventory of Gambling Situations in problem and pathological gamblers seeking alcohol and drug abuse treatment.

Identifying situations in which individuals gamble may be important for developing or improving treatments, but few instruments exist for examining high-risk gambling situations. This study evaluated the factor structure of the Inventory of Gambling Situations (IGS), an instrument that assesses situations that may lead to gambling episodes. Individuals seeking alcohol and drug abuse treatment who were identified as problem or pathological gamblers (N = 283) completed the IGS, and principal component analysis revealed a 4-factor solution best fit the data; the factors represented items related to Negative Affect, Positive Affect, Gambling Cues, and Social Situations. Across the whole scale, Cronbach's alpha was 0.97, ranging from 0.83 to 0.96 for the four factors. IGS total scores correlated with other indices of gambling problems, including number of pathological gambling criteria endorsed and frequency and intensity of gambling. Race, education, and severity of psychiatric, drug, and alcohol problems were significantly predictive of some factor scores. Specifically, African Americans were more likely to gamble in response to Negative Affect situations than Caucasians, and education was inversely associated with wagering in response to Gambling Cues. Psychiatric symptoms were predictive of gambling in response to both Positive and Negative Affect situations and Gambling Cues. Severity of drug and alcohol problems were related to gambling in Social Situations. Results from this study indicate that the IGS has good psychometric properties and suggest areas in which intervention efforts may be tailored to prevent or treat gambling problems among individuals seeking substance abuse treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impulsivity and rapid discounting of delayed hypothetical rewards in cocaine-dependent individuals.

In this study, crack/cocaine-dependent (CD) and non-drug-using matched control (MC) participants were presented with hypothetical immediate and delayed rewards, with 16 delay conditions ranging from 5 min to 25 years. All participants were presented with hypothetical monetary rewards; however, the CD group was also presented with hypothetical crack/ cocaine rewards. The objective value of the rewards ranged from $1 to $1,000. Hyperbolic discounting functions provided a good fit of the data. The CD group discounted monetary rewards at a higher rate than the MC group did, and the CD group discounted crack/cocaine rewards at a higher rate than it did monetary rewards. Moreover, scores on self-report measures indicated greater impulsivity in the CD group when compared with the MC group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of methylphenidate on discounting of delayed rewards in attention deficit/hyperactivity disorder.

Impulsivity is a central component of attention deficit/hyperactivity disorder (ADHD). Delay discounting, or a preference for smaller, immediate rewards over larger, delayed rewards, is considered an important aspect of impulsivity, and delay-related impulsivity has been emphasized in etiological models of ADHD. In this study, we examined whether stimulant medication, an effective treatment for ADHD, reduced discounting of delayed experiential and hypothetical rewards among 49 children (ages 9–12 years) with ADHD. After a practice day, participants completed a 3-day double-blind placebo-controlled acute medication assessment. Active doses were long-acting methylphenidate (Concerta), with the nearest equivalents of 0.3 and 0.6 mg/kg TID immediate-release methylphenidate. On each testing day, participants completed experiential (real-world money in real time) and hypothetical discounting tasks. Relative to placebo, methylphenidate reduced discounting of delayed experiential rewards but not hypothetical rewards. Broadly consistent with etiological models that emphasize delay-related impulsivity among children with ADHD, these findings provide initial evidence that stimulant medication reduces delay discounting among those with the disorder. The results also draw attention to task parameters that may influence the sensitivity of various delay discounting measures to medication effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concave utility, transaction costs, and risk in measuring discounting of delayed rewards.

Research has consistently found that the decline in the present values of delayed rewards as delay increases is better fit by hyperbolic than by exponential delay-discounting functions. However, concave utility, transaction costs, and risk each could produce hyperbolic-looking data, even when the underlying discounting function is exponential. In Experiments 1 (N=45) and 2 (N=103), participants placed bids indicating their present values of real future monetary rewards in computer-based 2nd-price auctions. Both experiments suggest that utility is not sufficiently concave to account for the superior fit of hyperbolic functions. Experiment 2 provided no evidence that the effects of transaction costs and risk are large enough to account for the superior fit of hyperbolic functions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Alcohol and substance abuse in adolescence.

Reviews the book, Alcohol and substance abuse in adolescence edited by J. S. Brock, D. J. Lettieri, D. W. Brook, and Barry Stimmell (1985). The introductory "editorial" in this volume sets three goals which sound more like a handbook: elucidate the reasons why youth turn to drugs, how to manage those afflicted and how to educate for prevention. The papers focus largely on the first, and leave the latter two for the readers to infer. Most of the usual themes of adolescent drug use are covered: the influence of peer groups, the influence (or lack thereof) of parents, psychological development of identity and individuation. Drug use is discussed in relation to social influences, personality dynamics and adolescent development and maturation. However, the authors seem to equate any adolescent drug use (particularly marijuana) with excessive involvement. Surely it is important to examine the variations in why and how various drugs are used by that age group. It remains for others to explore the boundaries between drug use and abuse, to identify high risk patterns and to develop strategies to promote normal, healthy maturation of adolescents in a drug-drenched society. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood Maltreatment in Male and Female Treatment-Seeking Pathological Gamblers.

Little empirical research has evaluated childhood abuse in pathological gamblers. This study describes results of an analysis of childhood maltreatment histories among 149 pathological gamblers being treated at 1 of 7 gambling treatment programs. Measurements included instruments assessing gambling behavior and the Childhood Trauma Questionnaire (CTQ; D. P. Bernstein et al., 1994). Women scored higher than men on the overall CTQ scale and subscales measuring childhood physical neglect, emotional abuse, and sexual abuse. Severity of childhood maltreatment was significantly and independently associated with lower age of onset of gambling and increased severity of gambling problems. This study suggests that childhood maltreatment is prevalent in pathological gamblers, especially female gamblers. These results warrant further investigation of the role of childhood maltreatment in the etiology of pathological gambling and its treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls.

This prospective study tested whether early menarche partially accounts for the increases in depression, eating pathology, substance abuse, and comorbid psychopathology that occur among adolescent girls, with structured interview data from a community sample (N?=?496). Early menarche (prior to 11.6 years) was associated with elevated depression, substance abuse, and "any" disorder but did not confer increased risk for anorexia nervosa, bulimia nervosa, or binge eating disorder. Although there was significant comorbidity across all three classes of pathology, early menarche was associated only with comorbid depression and substance abuse. Results provide partial support for the assertion that early menarche is a general risk factor for psychopathology among adolescent girls but suggest that this risk may not apply to certain disorders and that the effects are modest in size. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problem gambling and violence among community-recruited female substance abusers.

Problem gambling (PG) may be associated with depression, victimization, and violence characterizing a substance-abusing lifestyle. The study explored associations of PG with these correlates among heavy-drinking and drug-using out-of-treatment women recently enrolled in 2 National Institutes of Health-funded, community-based HIV prevention trials. Female substance abusers with PG (n = 180) and without PG (NPG; n = 425) were examined according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994). Whereas PGs had higher rates of each correlate than did NPGs, significant associations existed for antisocial personality disorder, specifically for violent tendencies. Logistic regression indicated that substance abusers with violent tendencies were about 3 times as likely as those without such tendencies to be PGs, after controlling for sociodemographics. Future research addressing whether underlying constructs, confounding variables, or interactions exist will further specify PG risk and inform prevention and intervention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief screening for psychological and substance abuse disorders in veterans with long-term spinal cord injury.

Objective: To determine rates of positive screens for psychological and substance use disorders in persons with long-term spinal cord injury (SCI). Study Design: A naturalistic cohort design wherein consecutive admissions during an 8-month period completed the screening battery. Setting: Veterans Affairs SCI Center. Participants: One hundred fifteen men, 2 women, mean age 57.4 years, injured an average of 20 years, readmitted for various reasons. Main Outcome Measures: The Alcohol Use Disorders Identification Test (AUDIT) and screening items for depression and anxiety disorders. Results: Rates of positive screens ranged from 6.2% for alcohol problems to over 40% for anxiety disorders. Positive screens for depression and anxiety correlated positively with the number of recent hospital admissions. Conclusions: Systematic brief screening for psychological and substance abuse disorders in this population revealed rates of positive screens at least equal to those in other medical patient populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How treatments for pathological gambling can be informed by treatments for substance use disorders.

Substance use disorders and pathological gambling share similarities in terms of diagnostic criteria, epidemiology, and clinical course. However, relatively few studies have evaluated the efficacy of treatments for gambling disorders. As interest in pathological gambling grows, adaptation of effective treatments from the field of substance abuse may advance the study of treatment for pathological gambling. This article reviews the similarities and differences between pathological gambling and substance use disorders. It describes psychotherapeutic and pharmacological treatments for substance use disorders and their translation to pathological gambling. Future research should consider investigating the onset and course of pathological gambling within the context of other psychiatric disorders, biological abnormalities associated with gambling, and combined effects of psychotherapy and pharmacotherapy in the treatment of this disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Treating substance abuse: Theory and technique.

Reviews the book, Treating substance abuse: Theory and technique edited by Frederick Rotgers, Daniel S. Keller, and Jon Morgenstern (see record 1995-99052-000). The authors initially postulate the question of "why we produced this book": They indicated that it is "a response to forces of change." Their answers are a reflection of "the increasing uneasiness among substance abuse treatment providers, the unstable, and often poor outcomes that result from mainstream treatments." Those who suffer from psychoactive substance use disorders, (PSUD's) constitute a staggering population; and many fail to benefit from treatment over a period of time. The authors organized the book into five major approaches to treatment theory and techniques. (1) 12-step, (2) Psychodynamic, (3) Marital-Family therapy, (4) Behavioral, and (5) Motivational enhancement. This book is essential for the beginning practitioner in the field of substance abuse, but it also serves as a valuable adjunct for those of us who have been in the field for a period of time. The authors were thorough, organized, and clear in their presentations. The text is well written and certainly a valued, up-to-date, adjunct to the field of substance abuse theory and treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Preventing substance abuse among children and adolescents.

Reviews the book, Preventing substance abuse among children and adolescents by Jean E. Rhodes and Leonard Jason (see record 1988-98428-000). This text is a recent volume in Pergamon Press's Psychology Practitioner Guidebooks series. The volumes in the series are reflective of the current trend to "manualize" various intervention approaches to specific behavior problems. The present volume is potentially valuable in that the content and implementation of various school-based prevention programs carried out in recent years (primarily in the context of research protocols) have not been disseminated widely to psychologists through the traditional means of professional texts. When the results of these investigations are presented in scholarly journal articles and chapters, the focus is usually on research aspects (e.g., methodological issues and outcome) and not the "nuts-and-bolts" of actually developing and implementing interventions. Furthermore, the need for materials of this type appears to be increasing. Many local organizations are actively attempting to develop substance abuse prevention programs and recently there have been major increases in federal funding for these activities. Thus, the publication of the text is clearly timely. Despite the shortcomings, the present text certainly fills an existing need. For the professional interested in educating him or herself in substance abuse prevention in adolescence, it is a good place to start. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Victimization and substance abuse among women: Contributing factors, interventions, and implications.

Although the literature indicates that there is an association of victimization with substance abuse, there has been limited research focused on understanding and synthesizing the factors that have been identified as contributing to victimization and substance abuse and on interventions designed to address these contributing factors. The purposes of this article are to (a) review the literature on factors related to victimization and substance abuse, (b) review interventions and outcomes, and (c) discuss clinical implications for interventions and research. Results suggest that there is a high rate of co-occurrence of victimization and substance abuse among women, that the factors contributing to victimization and substance abuse are complex, and that there is a lack of treatment models addressing victimization and substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subtyping pathological gamblers on the basis of affective motivations for gambling: Relations to gambling problems, drinking problems, and affective motivations for drinking.

Pathological gamblers who drink when gambling (n=158; 77% men; mean age=36.0 years) completed the Inventory of Gambling Situations (IGS) and gambling and drinking criterion measures. Principal components analysis on the IGS subscales revealed negative (e.g., Unpleasant Emotions) and positive (e.g., Pleasant Emotions) gambling situation factors. Subjecting IGS factor scores to cluster analysis revealed three clusters: (a) enhancement gamblers, with low negative and high positive factor scores; (b) coping gamblers, with very high negative and high positive factor scores; and (c) low emotion regulation gamblers, with low negative and positive factor scores (59%, 23%, and 18% of the sample, respectively). Clusters were validated with a direct measure of gambling motives. Additional validity analyses showed that coping gamblers scored higher than the other groups on a variety of different gambling activities, gambling problems, drinking frequency, drinking problems, and coping drinking motives, whereas low emotion regulation gamblers scored lower than the other groups on gambling frequency, gambling problems, drinking quantity, and enhancement drinking motives. The findings validate this empirical approach to subtyping gamblers and suggest consistency of motives across addictive behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family therapy, substance abuse, and adolescents: Moving from isolated cultures to related components.

Reviews the books The family context of adolescent drug abuse, by R. H. Coombs (1988); Practical approaches in treating adolescent chemical dependency: A guide to clinical intervention and assessment, by P. B. Henry (1989); Consequences of adolescent drug abuse, by M. D. Newcomb and P. M. Bentler (1989); Adolescent drug abuse: Analyses of treatment research, by E. R. Rahdert and J. Grabowski (1988); Breakthroughs in family therapy with drug-abusing and problem youth, by J. I. Szapocznik and W. M. Kurtines (see record 1989-98115-000); and Family therapy approaches with adolescent substance abusers, by T. C. Todd and M. Selekman (in press). This spate of books includes representatives of three "cultures" interested in family therapy with substance-abusing adolescents: developmentally oriented research on substance abuse (Combs; Newcomb & Bentler; Rahdert & Grabowski), family therapy applied to substance abuse (Szapocznik et al.; Todd & Selekman), and the addiction/self-help approach (Henry). The coincidental publication of this large number of writings on families and adolescent substance abuse is encouraging. It suggests that all three cultures are vital and contributing. There are important well-written contributions in volumes from each culture. The disjointed status of the field may be a prelude to a significant integrative shift from the isolated cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of change in adolescent substance use and symptomatology: Impact of paternal and maternal substance use disorders.

The effects of paternal and maternal substance use disorders (SUDs) on trajectories of change in adolescent offspring nicotine, alcohol, and drug use and symptomatology were investigated in a population-based sample of adolescent twins (N = 1,514). Adolescent and parental substance phenotypes were assessed when most adolescents were 11 years old, with 2 assessments of adolescents approximately every 3 years thereafter. Growth curves were fit using hierarchical linear modeling. Results indicated acceleration of substance involvement during adolescence, particularly for boys. Paternal and maternal SUD were each associated with more extreme trajectories. There was evidence for an additive, rather than interactive, combined parental effect. Findings help clarify the impact of paternal and maternal SUD on the development of substance involvement during adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity.

A literature review on community studies of adolescent substance use, abuse, or dependence (SU/A/D) and psychiatric comorbidity yielded 22 articles from 15 studies with information on rates, specificity, timing, and differential patterns of comorbidity by gender, race/ethnicity, and other factors. Results revealed that 60% of youths with SU/A/D had a comorbid diagnosis, and conduct disorder (CD) and oppositional defiant disorder (not attention-deficit/hyperactivity disorder) were most commonly associated with SU/A/D, followed by depression. Child psychopathology (particularly CD) was associated with early onset of substance use and abuse in later adolescence. The authors suggest that available data relevant to SU/A/D and psychiatric comorbidity can be used to better address such questions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)