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      Clustering of treatment-seeking women with gambling disorder

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          Abstract

          Background

          The prevalence of gambling disorder (GD) in women has increased, but, to date, few studies have explored the features of clinical GD subtypes in female samples.

          Aims

          The aim of this study is to identify empirical clusters based on clinical/sociodemographic variables in a sample of treatment-seeking women with GD.

          Methods

          Agglomerative hierarchical clustering was applied to a sample of n = 280 patients, using sociodemographic variables, psychopathology, and personality traits as indicators for the grouping procedure.

          Results

          Three mutually exclusive groups were obtained: (a) Cluster 1 (highly dysfunctional; n = 82, 29.3%) endorsed the highest levels in gambling severity, comorbid psychopathology, novelty seeking, harm avoidance, and self-transcendence, and the lowest scores in self-directedness and cooperativeness; (b) Cluster 2 (dysfunctional; n = 142, 50.7%) achieved medium mean scores in gambling severity and psychopathological symptoms; and (c) Cluster 3 (functional; n = 56, 20.0%) obtained the lowest mean scores in gambling severity and in psychopathology, and a personality profile characterized by low levels in novelty seeking, harm avoidance, and self-transcendence, and the highest levels in self-directedness and cooperativeness.

          Discussion and conclusions

          This study sheds light on the clinical heterogeneity of women suffering from GD. Identifying the differing features of women with GD is vital to developing prevention programs and personalized treatment protocols for this overlooked population.

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          Most cited references75

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          Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

          To present nationally representative data on lifetime prevalence and comorbidity of pathological gambling with other psychiatric disorders and to evaluate sex differences in the strength of the comorbid associations. Data were derived from a large national sample of the United States. Some 43,093 household and group quarters residents age 18 years and older participated in the 2001-2002 survey. Prevalence and associations of lifetime pathological gambling and other lifetime psychiatric disorders are presented. The diagnostic interview was the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Fifteen symptom items operationalized the 10 pathological gambling criteria. The lifetime prevalence rate of pathological gambling was 0.42%. Almost three quarters (73.2%) of pathological gamblers had an alcohol use disorder, 38.1% had a drug use disorder, 60.4% had nicotine dependence, 49.6% had a mood disorder, 41.3% had an anxiety disorder, and 60.8% had a personality disorder. A large majority of the associations between pathological gambling and substance use, mood, anxiety, and personality disorders were overwhelmingly positive and significant (p .05). Pathological gambling is highly comorbid with substance use, mood, anxiety, and personality disorders, suggesting that treatment for one condition should involve assessment and possible concomitant treatment for comorbid conditions.
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            Sex differences in subclinical and DSM-IV pathological gambling: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

            To examine sex differences in DSM-IV subclinical and pathological gambling in nationally representative data of the US population. Data come from a large (n = 43093) representative sample of the adult US population. The lifetime prevalence rate of DSM-IV pathological gambling was 0.64% (95% CI 0.50-0.78) for men and 0.23% (95% CI 0.17-0.29) for women, whereas the lifetime prevalence of subclinical pathological gambling was 6.79% (95% CI 6.32-7.26) for men and 3.26% (95% CI 2.93-3.59) for women. For subclinical pathological gambling, men were significantly (p < 0.01) more likely than women to have smoked more than two packs of cigarettes a day, to be classified as heavy drinkers and to have lifetime diagnoses of alcohol and drug use disorders. Women with subclinical and pathological gambling were significantly more likely than men to have lifetime mood and anxiety disorders. With respect to pathological gambling, women had later ages of onset of the disorder, and were significantly more likely than men to report gambling to relieve depressed mood and to prefer casino gambling. Rates of treatment-seeking for DSM-IV pathological gambling were low for both men and women. There are important sex differences in the prevalence, symptom pattern, sociodemographic and clinical correlates and course of DSM-IV subclinical and pathological gambling. Results underscore the need to investigate sex differences in the social determinants, neurobiology and treatment response of DSM-IV subclinical and pathological gambling.
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              • Article: not found

              Reliability, validity, and classification accuracy of a measure of DSM-IV diagnostic criteria for pathological gambling.

              The purpose of this study was to measure the reliability, validity, and classification accuracy of the DSM-IV diagnostic criteria for pathological gambling.
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                Author and article information

                Journal
                jba
                JBA
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                21 September 2018
                September 2018
                : 7
                : 3
                : 770-780
                Affiliations
                [ 1 ]Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III , Barcelona, Spain
                [ 2 ]Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona , Barcelona, Spain
                [ 3 ]Department of Psychiatry, Bellvitge University Hospital/IDIBELL , Barcelona, Spain
                [ 4 ]Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona , Barcelona, Spain
                [ 5 ] National Health System Addictions Clinic , Milan, Italy
                [ 6 ]The Bob Shapell School of Social Work, Tel Aviv University , Tel Aviv, Israel
                [ 7 ]Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona , Barcelona, Spain
                [ 8 ]Ciber de Salud Mental (CIBERSAM), Instituto de Salud Carlos III , Barcelona, Spain
                Author notes
                [* ]Corresponding author: Susana Jiménez-Murcia; Department of Psychiatry, Bellvitge University Hospital/IDIBELL; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, c/ Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain; Phone: +34 93 260 79 88; Fax: +34 93 260 76 58; E-mail: sjimenez@ 123456bellvitgehospital.cat
                Article
                10.1556/2006.7.2018.93
                6426395
                30238785
                57f8eb5a-1564-4d13-8a65-98a75cb66761
                © 2018 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                : 10 May 2018
                : 03 August 2018
                : 16 August 2018
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 80, Pages: 11
                Funding
                Funding sources: Financial support was received through the Ministerio de Economía y Competitividad (grant PSI2011-28349 and PSI2015-68701-R). FIS PI14/00290, FIS PI17/01167, and 18MSP001 – 2017I067 received aid from the Ministerio de Sanidad, Servicios Sociales e Igualdad. CIBER Fisiología Obesidad y Nutrición (CIBERobn) and CIBER Salud Mental (CIBERSAM), both of which are initiatives of ISCIII. GM-B is supported by a predoctoral Grant of AGAUR (2018 FI_B2 00174), co-financed by the European Social Fund, with the support of the Secretaria d’Universitats I Recerca del Departament d’Economia i Coneixement de la Generalitat de Catalunya. TM-M is supported by a predoctoral Grant of the Ministerio de Educación, Cultura y Deporte (FPU16/02087).
                Categories
                FULL-LENGTH REPORT

                Evolutionary Biology,Medicine,Psychology,Educational research & Statistics,Social & Behavioral Sciences
                women,psychopathology,gambling disorder,assessment,personality traits

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