Subtyping pathological gamblers based on impulsivity, depression, and anxiety

• Published in: Psychology of addictive behaviors Vol. 24; no. 4; p. 680
• Main Authors: Ledgerwood, David M, Petry, Nancy M
• Format: Journal Article
• Language: English
• Published: United States 01.12.2010
• Subjects: Adult; Analysis of Variance; Anxiety - psychology; Behavior Therapy; Behavior, Addictive - classification; Behavior, Addictive - psychology; Behavior, Addictive - therapy; Depression - psychology; Gambling - classification; Gambling - psychology; Gambling - therapy; Humans; Impulsive Behavior - psychology; Interviews as Topic; Male; Models, Psychological; Patient Acceptance of Health Care - psychology; Psychiatric Status Rating Scales; Psychotherapy, Group; Severity of Illness Index; Statistics, Nonparametric; Surveys and Questionnaires; Treatment Outcome
• ISSN: 1939-1501
• DOI: 10.1037/a0019906

This study examined putative subtypes of pathological gamblers (PGs) based on the Pathways model, and it also evaluated whether the subtypes would benefit differentially from treatment. Treatment-seeking PGs (N = 229) were categorized into Pathways subtypes based on scores from questionnaires assessing anxiety, depression, and impulsivity. The Addiction Severity Index-Gambling assessed severity of gambling problems at baseline, posttreatment, and 12-month follow-up. Compared with behaviorally conditioned (BC) gamblers, emotionally vulnerable (EV) gamblers had higher psychiatric and gambling severity, and were more likely to have a parent with a psychiatric history. Antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity relative to BC gamblers. They were more likely to have antisocial personality disorder and had the highest legal and family/social severity scores. They were also most likely to have a history of substance abuse treatment, history of inpatient psychiatric treatment, and a parent with a substance use or gambling problem. AI and EV gamblers experienced greater gambling severity throughout treatment than BC gamblers, but all three subtypes demonstrated similar patterns of treatment response. Thus, the three Pathways subtypes differ on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity.