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      Demographic and psychiatric correlates of compulsive sexual behaviors in gambling disorder

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          Abstract

          Background and aims

          Gambling disorder (GD) and compulsive sexual behavior (CSB) may commonly co-occur. Yet, the psychiatric correlates of these co-occurring disorders are an untapped area of empirical scrutiny, limiting our understanding of appropriate treatment modalities for this dual-diagnosed population. This study examined the demographic and clinical correlates of CSB in a sample of treatment-seeking individuals with GD ( N = 368) in São Paulo, Brazil.

          Methods

          Psychiatrists and psychologists conducted semi-structured clinical interviews to identify rates of CSB and other comorbid psychiatric disorders. The Shorter PROMIS Questionnaire was administered to assess additional addictive behaviors. The TCI and BIS-11 were used to assess facets of personality. Demographic and gambling variables were also assessed.

          Results

          Of the total sample, 24 (6.5%) met diagnostic criteria for comorbid CSB (GD + CSB). Compared to those without compulsive sexual behaviors (GD − CSB), individuals with GD + CSB were more likely to be younger and male. No differences in gambling involvement emerged. Individuals with GD + CSB tended to have higher rates of psychiatric disorders (depression, post-traumatic stress disorder, and bulimia nervosa) and engage in more addictive behaviors (problematic alcohol use, drug use, and exercise) compared to GD − CSB. Those with GD + CSB evidenced less self-directedness, cooperativeness, self-transcendence, and greater motor impulsivity. Logistic regression showed that the predictors of GD + CSB, which remained in the final model, were being male, a diagnosis of bulimia, greater gambling severity, and less self-transcendence.

          Discussion and conclusion

          Given those with GD + CSB evidence greater psychopathology, greater attention should be allocated to this often under studied comorbid condition to ensure adequate treatment opportunities.

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          Most cited references 86

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          Varieties of impulsivity.

           J Evenden (1999)
          The concept of impulsivity covers a wide range of "actions that are poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation and that often result in undesirable outcomes". As such it plays an important role in normal behaviour, as well as, in a pathological form, in many kinds of mental illness such as mania, personality disorders, substance abuse disorders and attention deficit/hyperactivity disorder. Although evidence from psychological studies of human personality suggests that impulsivity may be made up of several independent factors, this has not made a major impact on biological studies of impulsivity. This may be because there is little unanimity as to which these factors are. The present review summarises evidence for varieties of impulsivity from several different areas of research: human psychology, psychiatry and animal behaviour. Recently, a series of psychopharmacological studies has been carried out by the present author and colleagues using methods proposed to measure selectively different aspects of impulsivity. The results of these studies suggest that several neurochemical mechanisms can influence impulsivity, and that impulsive behaviour has no unique neurobiological basis. Consideration of impulsivity as the result of several different, independent factors which interact to modulate behaviour may provide better insight into the pathology than current hypotheses based on serotonergic underactivity.
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            A ‘components’ model of addiction within a biopsychosocial framework

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              Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais

               Tânia Amorim (2000)
              Objetivos: O MINI é uma entrevista diagnóstica padronizada breve (15-30 minutos), compatível com os critérios do DSM-III-R/IV e da CID-10, que é destinada à utilização na prática clínica e na pesquisa em atenção primária e em psiquiatria, e pode ser utilizada por clínicos após um treinamento rápido (de 1 a 3 horas). A versão Plus do MINI, mais detalhada, gera diagnósticos positivos dos principais transtornos psicóticos e do humor do DSM-IV. Este artigo apresenta os resultados de quatro estudos de validação do instrumento, realizados na Europa e nos EUA. Métodos: Os estudos 1 (França) e 2 (EUA) testaram a confiabilidade - entre avaliadores e teste-reteste - da versão DSM-III-R do MINI (n=84, sendo 42 pacientes psiquiátricos de cada centro) e sua validade com relação ao CIDI (n=346, sendo 296 pacientes psiquiátricos e 50 controles) e ao SCID-P (n=370, sendo 308 pacientes psiquiátricos e 62 controles), respectivamente. O estudo 3 testou a validade de diagnósticos gerados por clínicos gerais usando o MINI (DSM-IV) com relação aos diagnósticos clínicos habituais de psiquiatras, em 409 pacientes de centros de atenção primária de quatro países (França, Espanha, Itália e Reino Unido). O estudo 4 testou a confiabilidade entre avaliadores (n=20 pacientes psiquiátricos) e a validade dos módulos Transtornos Psicóticos, Depressão e Mania do MINI Plus - DSM IV (n=104 pacientes psiquiátricos) com relação a dois critérios de referência: diagnósticos do CIDI e diagnósticos clínicos de psiquiatras. Análises quantitativas (índices de concordância e de validade) e qualitativas (razões de discordância) foram realizadas. Resultados: Os índices de confiabilidade do MINI (estudos 1 e 2) e do MINI Plus (estudo 4) foram globalmente satisfatórios. Comparados a vários critérios de referência (CIDI, SCID-P, opinião de peritos), em diferentes contextos (unidades psiquiátricas e centros de atenção primária), o MINI e o MINI Plus mostraram qualidades psicométricas similares às de outras entrevistas diagnósticas padronizadas mais complexas, permitindo uma redução de 50% ou mais no tempo da avaliação. Análises qualitativas identificaram dificuldades e erros diagnósticos ligados aos casos, métodos de avaliação e critérios de diagnósticos estudados. Modificações foram introduzidas para corrigir os problemas identificados e otimizar as propriedades psicométricas do MINI e do MINI Plus. Conclusões: O MINI e sua versão Plus são adaptados ao contexto clínico e à avaliação de pacientes mais graves, e representam uma alternativa econômica para a seleção de pacientes, segundo critérios internacionais, em estudos clínicos e epidemiológicos. O MINI já está disponível em aproximadamente 30 idiomas, incluindo a versão brasileira. As perspectivas atuais de adaptação e aplicação transcultural do instrumento são discutidas.
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                Author and article information

                Journal
                J Behav Addict
                J Behav Addict
                jba
                JBA
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                16 August 2019
                September 2019
                : 8
                : 3
                : 451-462
                Affiliations
                [1 ]Addictive Behaviours Laboratory, Department of Psychology, University of Calgary , Calgary, AB, Canada
                [2 ]Outpatient Unit for Excessive Sexual Drive and Prevention of Negative Outcomes Associated with Sexual Behavior, Institute of Psychiatry, Clinicas’ Hospital, University of São Paulo Medical School , São Paulo, Brazil
                [3 ]Department of Psychiatry, Medical School, University of São Paulo , São Paulo, Brazil
                [4 ]Experimental Pathophysiology, Post-Graduation Program, Medical School, University of São Paulo , São Paulo, Brazil
                [5 ]Impulse Control Disorders and Behavioral Addictions Outpatient Unit, Institute and Department of Psychiatry, University of São Paulo , São Paulo, Brazil
                Author notes
                [* ]Corresponding author: Megan E. Cowie; Addictive Behaviours Laboratory, Department of Psychology, University of Calgary, Room AD 240, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada; Phone: +1 403 210 9580; E-mail: megan.cowie@ 123456ucalgary.ca
                Article
                10.1556/2006.8.2019.35
                7044634
                31416337
                © 2019 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.

                Page count
                Figures: 0, Tables: 6, Equations: 0, References: 89, Pages: 12
                Product
                Funding
                Funding sources: No financial support was received for this study.
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