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Mood states and personality traits in Pathological
Gamblers sample and their family members
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Gianni Savron*,Paolo Pitti**,Rolando De
Luca***
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*Affective Disorders Center - Pavanello,
Ponte di Brenta, Padova, Italy; **Lahuén, Center, Psychotherapy
and Work, Morrano, Orvieto, Italy; ***Pathological Gamblers
Treatment Center, Campoformido, Udine, Italy
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| Introduction |
Gambling represents a serious problem due to the psychological,
social and financial repercussions it brings about. Pathological
Gambling (PG) compromises seriously the relationship within
a family, because it determines severe conflicts with repercussions
upon the psychophysical integrity of both the gambler and his/her
family.
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| Methodology |
Eighty-one consecutive Pathological Gamblers, 28 gamblers'
wives and 26 gamblers' parents, referred to the Pathological
Gamblers Treatment Center of Campoformido (Udine), were evaluated
with the previous consent of all subjects.
In PG group inclusion criteria were:
a) primary diagnosis of DSM-IV criteria for Pathological Gambling;
b) a minimal duration of PG at least one year;
c) age between 18- 65.
The exclusion criteria were:
d) presence of psychopathology (psychosis, major depression);
e) neurological disorders;
f) alcohol and drug abuse.
All subjects were assessed before treatment with an Italian
translation of psychometric battery that were found to be valid
and sensitive instruments.
The aim of this study was that of:
1) evaluating the psychological differences in states and traits
between a sample of pathological male gamblers (n=81), and a
control group (n=81) matched for social-demographic variables;
2) investigating the same dimensions between the gamblers' wives
(n=28) and the female control group (n=28);
3) assessing the parents' psychological characteristics (n=26).
assessing differences between all 3 groups.
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| Instruments |
Brief Psychiatric Rating Scale (BPRS) (Overall & Gorham,
1962): this is a clinical interview that consists of 18 items,
each of 4 point scale, that allow to explore the presence of
psychopathology (major depression and psychosis).
South Oaks Gambling Screen (SOGS) (Lasieur & Blume, 1987):
this is a valid and reliable instrument employed to assess pathological
gambling behavior. Twenty questions are counted and 5 or more
indicate a probable gambling problem. A score of 9 or more indicates
a severe gambling problem.
Anxiety Sensitivity Index (ASI) (Peterson & Reiss, 1986).
this is a 16-item self-report questionnaire that measures fear
of anxiety. For each item, individuals rate their degree of
concern on a Likert-type scale ranging from 0 (very little)
to 4 (very much).
Symptom Questionnaire (SQ) (Kellner, 1987): this is a yes/no
questionnaire, with 92 brief and simple items, that covers scales
of anxiety, depression, anger-hostility, and somatic symptoms.
Emotional Inhibition Scale ( EIS) (Kellner, 1986): this is a
self-rating scale of a person's beliefs measuring the extent
to which he can express his feelings and emotions. The EIS consists
of 16 items, each on a 5-point scale (1-no, 5-always), that
explore verbal inhibition, timidity, disguise of feelings, and
self control. Range 16 to 80.
Tridimensional Personality Questionnaire (TPQ) (Cloninger, 1985):
this is a true/false self-report questionnaire that consists
of 100 questions and provides three major dimensions of personality:
novelty seeking (ns), harm avoidance (ha), and reward dependence
(rd).
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| Statistical methods |
| For the comparison between PG and control groups, independent
two-tailed t-test were used. Person's product moment method
was used to compute the correlations. For the comparison of
all groups a non parametric statistic Kruskal-Wallis test was
used. |
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| Results |
Compared to the control group the gamblers result to present
more distress (anxiety, depression, hostility, somatic symptoms),
fear of anxiety symptoms, verbal inhibition, disguise of feeling,
along with high scores in novelty seeking and low scores in
reward dependence TPQ scales (Table I). Thus they present personality
traits of excitability, impulsiveness, eccentricity, rigidity,
practicality and emotional detachment.
The group of wives compared with the control group of women
results to have higher distress (anxiety, depression, hostility,
somatic symptoms) and higher anxiety sensitivity, verbal inhibition
and timidity (Table II). They also present higher scores in
the TPQ traits of harm avoidance and reward dependence, then
traits of chronic anticipatory anxiety, timidity, inhibition
and characteristics of persistence, dependence and sentimentalism.
Wives differ from their husbands in their higher reward dependence
and lower novelty seeking and from their husbands' parents in
their higher scores in harm avoidance and reward dependence
(Table II).
A further comparison between gamblers and their parents revealed
higher somatic symptoms and lower scores in novelty seeking
(Table II).
The specific differences are defined by a comparison between
all groups. (Table III).
In the Gamblers' group, the ASI was negatively related to TPQrd,
and positively related to emotional inhibition. The TPQns was
significantly related to the anxiety, depression and hostility
scores, instead the TPQha score with distress (anxiety, depression,
somatic symptoms, hostility).
TPQrd score was negatively related with depression and verbal
inhibition (Table IV).
In the control group (Table V), ASI and TPQns scores were positively
related with distress.
Personality trait of TPQrd was positively correlated with depression,
and TPQns had not any correlation.
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| Discussion |
Cloninger (1987) pointed out that personality features could
represent risk factors for the development of specific mental
disorders and could be predictive of the pattern of comorbidity.
The same author postulates three genetically independent temperamental
traits: harm avoidance (ha), reward dependence (rd) and novelty
seeking (ns).
Individuals with higher than average scores on ns tend to be
curious, impulsive, excitable, extravagant and disorderly; those
low in ns are reflective, stoical, reserved and orderly.
Individuals with high scores on ha tend to be characterized
by anticipatory worry, fear of uncertainty, shyness of strangers
and fatigability; those low in ha are optimistic, confident,
sociable and energetic.
Individuals with high scores on rd tend to be sentimental, socially
sensitive, persistent and dependent on approval of others; those
low in rd are insensitive, practical irresolute and detached.
Ha and anxiety sensitivity (fear of anxiety, based on the belief
that anxiety sensations have harmful physical, psychological,
or social consequences) may be risk factors to developing agoraphobia
and panic disorder (Saviotti, et al., 1991; Mc Nally, 1999).
Cognitive anxiety and somatic anxiety are most striking characterized
by elevated score in ha and ha are a state -dependent phenomenon
(Starcevic et al., 1992). In contrast, ns and rd seem independent
of current mood.
High ha is present in patients suffering from panic and depression
(Mulder et al., 1994), and Ampollini et al. (1999) reported
high score in ha and rd which might represent a stable temperamental
trait of patients with depressive and anxiety disorders.
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| Conclusion |
The study identified and defined the psychopathological characteristics
of state and trait in both the gamblers and their family members.
The three groups present higher distress, sensitivity to anxiety,
emotional inhibition as compared to the control groups. The
trait anxiety (harm avoidance), higher anxiety sensitivity,
altruism, persistence and dependence specifically characterize
the gamblers' wives. Gamblers, instead, are characterized by
higher impulsiveness, inconstancy, eccentricity, novelty seeking,
emotional detachment (insensitive, practical, tough-minded)
and lower chronic anxiety. The group of parents differentiates
itself from the group of wives for a lower trait-anxiety, pessimism
and lower dependence, however, both present higher levels of
somatic anxiety than the gamblers. The group of wives, due to
their characteristics of state and trait, seems to have the
risk of developing cases of severe depression. Each group presents
a specific personality and psychological model along with peculiar
clinical manifestations, different from the control groups
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