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      A Serious Videogame as an Additional Therapy Tool for Training Emotional Regulation and Impulsivity Control in Severe Gambling Disorder

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          Abstract

          Background: Gambling disorder (GD) is characterized by a significant lack of self-control and is associated with impulsivity-related personality traits. It is also linked to deficits in emotional regulation and frequently co-occurs with anxiety and depression symptoms. There is also evidence that emotional dysregulation may play a mediatory role between GD and psychopathological symptomatology. Few studies have reported the outcomes of psychological interventions that specifically address these underlying processes.

          Objectives: To assess the utility of the Playmancer platform, a serious video game, as an additional therapy tool in a CBT intervention for GD, and to estimate pre-post changes in measures of impulsivity, anger expression and psychopathological symptomatology.

          Method: The sample comprised a single group of 16 male treatment-seeking individuals with severe GD diagnosis. Therapy intervention consisted of 16 group weekly CBT sessions and, concurrently, 10 additional weekly sessions of a serious video game. Pre-post treatment scores on South Oaks Gambling Screen (SOGS), Barratt Impulsiveness Scale (BIS-11), I7 Impulsiveness Questionnaire (I7), State-Trait Anger Expression Inventory 2 (STAXI-2), Symptom Checklist-Revised (SCL-90-R), State-Trait Anxiety Inventory (STAI-S-T), and Novelty Seeking from the Temperament and Character Inventory-Revised (TCI-R) were compared.

          Results: After the intervention, significant changes were observed in several measures of impulsivity, anger expression and other psychopathological symptoms. Dropout and relapse rates during treatment were similar to those described in the literature for CBT.

          Conclusion: Complementing CBT interventions for GD with a specific therapy approach like a serious video game might be helpful in addressing certain underlying factors which are usually difficult to change, including impulsivity and anger expression.

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          Introduction to behavioral addictions.

          Several behaviors, besides psychoactive substance ingestion, produce short-term reward that may engender persistent behavior, despite knowledge of adverse consequences, i.e., diminished control over the behavior. These disorders have historically been conceptualized in several ways. One view posits these disorders as lying along an impulsive-compulsive spectrum, with some classified as impulse control disorders. An alternate, but not mutually exclusive, conceptualization considers the disorders as non-substance or "behavioral" addictions. Inform the discussion on the relationship between psychoactive substance and behavioral addictions. We review data illustrating similarities and differences between impulse control disorders or behavioral addictions and substance addictions. This topic is particularly relevant to the optimal classification of these disorders in the forthcoming fifth edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Growing evidence suggests that behavioral addictions resemble substance addictions in many domains, including natural history, phenomenology, tolerance, comorbidity, overlapping genetic contribution, neurobiological mechanisms, and response to treatment, supporting the DSM-V Task Force proposed new category of Addiction and Related Disorders encompassing both substance use disorders and non-substance addictions. Current data suggest that this combined category may be appropriate for pathological gambling and a few other better studied behavioral addictions, e.g., Internet addiction. There is currently insufficient data to justify any classification of other proposed behavioral addictions. Proper categorization of behavioral addictions or impulse control disorders has substantial implications for the development of improved prevention and treatment strategies.
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            Emotion regulation and psychopathology.

            Emotional problems figure prominently in many clinical conditions. Recent efforts to explain and treat these conditions have emphasized the role of emotion dysregulation. However, emotional problems are not always the result of emotion dysregulation, and even when emotional problems do arise from emotion dysregulation, it is necessary to specify precisely what type of emotion dysregulation might be operative. In this review, we present an extended process model of emotion regulation, and we use this model to describe key points at which emotion-regulation difficulties can lead to various forms of psychopathology. These difficulties are associated with (a) identification of the need to regulate emotions, (b) selection among available regulatory options, (c) implementation of a selected regulatory tactic, and (d) monitoring of implemented emotion regulation across time. Implications and future directions for basic research, assessment, and intervention are discussed.
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              Age norms for impulsiveness, venturesomeness and empathy in adults

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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                12 November 2015
                2015
                : 6
                : 1721
                Affiliations
                [1] 1Department of Psychobiology and Methodology of Health Science, Universitat Autònoma de Barcelona Barcelona, Spain
                [2] 2Faculty of Health and Life Sciences, Universitat Pompeu Fabra de Barcelona Barcelona, Spain
                [3] 3Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
                [4] 4Ciber Fisiopatologia Obesidad y Nutrición, Instituto Salud Carlos III Barcelona, Spain
                [5] 5Department of Clinical Sciences, School of Medicine, University of Barcelona Barcelona, Spain
                [6] 6CIBERSAM - CIBER Salud Mental, Instituto Salud Carlos III Barcelona, Spain
                Author notes

                Edited by: Federica Scarpina, University of Turin, Italy

                Reviewed by: Shane Andrew Thomas, University of Adelaide, Australia; Yasser Khazaal, Geneva University Hospitals, Switzerland; Riccardo Pignatti, Ente Ospedaliero Cantonale, Switzerland

                *Correspondence: Susana Jiménez-Murcia sjimenez@ 123456bellvitgehospital.cat

                This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2015.01721
                4641919
                26617550
                16257759-5c13-4791-b673-f9fa9ca03a10
                Copyright © 2015 Tárrega, Castro-Carreras, Fernández-Aranda, Granero, Giner-Bartolomé, Aymamí, Gómez-Peña, Santamaría, Forcano, Steward, Menchón and Jiménez-Murcia.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 July 2015
                : 26 October 2015
                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 99, Pages: 12, Words: 9030
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                gambling disorder,video game therapy,impulsivity,emotion regulation,anger

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