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      Gambling disorder: Association between duration of illness, clinical, and neurocognitive variables

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          Abstract

          Background and aims

          Gambling disorder (GD) may have its onset in a wide range of ages, from adolescents to old adults. In addition, individuals with GD tend to seek treatment at different moments in their lives. As a result of these characteristics (variable age at onset and variable age at treatment seeking), we find subjects with diverse duration of illness (DOI) in clinical practice. DOI is an important but relatively understudied factor in GD. Our objective was to investigate clinical and neurocognitive characteristics associated with different DOI.

          Methods

          This study evaluated 448 adults diagnosed with GD. All assessments were completed prior to treatments being commenced.

          Results

          Our main results were: (a) there is a negative correlation between DOI and lag between first gambling and onset of GD; (b) lifetime history of alcohol use disorder (AUD) is associated with a longer duration of GD; (c) the presence of a first-degree relative with history of AUD is associated with a more extended course of GD; and (d) there is a negative correlation between DOI and quality of life.

          Discussion

          This study suggests that some important variables are associated with different DOI. Increasing treatment-seeking behavior, providing customized psychological interventions, and effectively managing AUD may decrease the high levels of chronicity in GD. Furthermore, research on GD such as phenomenological studies and clinical trials may consider the duration of GD in their methodology. DOI might be an important variable when analyzing treatment outcome and avoiding confounders.

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          Most cited references58

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          The neural basis of financial risk taking.

          Investors systematically deviate from rationality when making financial decisions, yet the mechanisms responsible for these deviations have not been identified. Using event-related fMRI, we examined whether anticipatory neural activity would predict optimal and suboptimal choices in a financial decision-making task. We characterized two types of deviations from the optimal investment strategy of a rational risk-neutral agent as risk-seeking mistakes and risk-aversion mistakes. Nucleus accumbens activation preceded risky choices as well as risk-seeking mistakes, while anterior insula activation preceded riskless choices as well as risk-aversion mistakes. These findings suggest that distinct neural circuits linked to anticipatory affect promote different types of financial choices and indicate that excessive activation of these circuits may lead to investing mistakes. Thus, consideration of anticipatory neural mechanisms may add predictive power to the rational actor model of economic decision making.
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            Neurogenetic adaptive mechanisms in alcoholism.

            Clinical, genetic, and neuropsychopharmacological studies of developmental factors in alcoholism are providing a better understanding of the neurobiological bases of personality and learning. Studies of the adopted-away children of alcoholics show that the predisposition to initiate alcohol-seeking behavior is genetically different from susceptibility to loss of control after drinking begins. Alcohol-seeking behavior is a special case of exploratory appetitive behavior and involves different neurogenetic processes than do susceptibility to behavioral tolerance and dependence on the antianxiety or sedative effects of alcohol. Three dimensions of personality have been described that may reflect individual differences in brain systems modulating the activation, maintenance, and inhibition of behavioral responses to the effects of alcohol and other environmental stimuli. These personality traits distinguish alcoholics with different patterns of behavioral, neurophysiological, and neuropharmacological responses to alcohol.
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              • Article: not found

              Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis.

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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
                31 May 2017
                June 2017
                : 6
                : 2
                : 194-202
                Affiliations
                [ 1 ]Department of Psychiatry and Behavioral Neuroscience, The University of Chicago , Chicago, IL, USA
                [ 2 ]Department of Psychiatry, University of Cambridge , Cambridge, UK
                Author notes
                [* ]Corresponding author: Gustavo Costa Medeiros; The University of Chicago, 5841 S. Maryland Ave., Office B-344, Chicago, IL 60637, USA; Phone: +1 773 702 9066; Fax: +1 773 834 3778; E-mail: gcmedeiros@ 123456live.com
                Article
                10.1556/2006.6.2017.029
                5520126
                28560882
                806a0496-5fd6-421d-bb19-7cf9bf18cd27
                © 2017 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                History
                : 01 March 2017
                : 01 May 2017
                : 02 May 2017
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 59, Pages: 9
                Funding
                Funding sources: The clinical trials gathered in this study were funded by different grants received by Dr. JEG. The research grants were provided by the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA) (grant number: RC1-DA028279-01), the National Center for Responsible Gaming, Forest, Transcept, Roche, and Psyadon Pharmaceuticals.
                Categories
                FULL-LENGTH REPORT

                Evolutionary Biology,Medicine,Psychology,Educational research & Statistics,Social & Behavioral Sciences
                clinical presentation,gambling disorder,psychopathology,duration of illness,clinical aspects

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