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Compulsivity and Impulsivity in Pathological Gambling: Does a Dimensional–Transdiagnostic Approach Add Clinical Utility to DSM-5 Classification?

Although the phenomenology of Pathological Gambling (PG) is clearly characterized by impulsive features, some of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria for PG are similar to those of Obsessive Compulsive Disorder (OCD). Therefore, the compulsive–impulsive spectrum...

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Published in:Journal of gambling studies 2015-09, Vol.31 (3), p.825-847
Main Authors: Bottesi, Gioia, Ghisi, Marta, Ouimet, Allison J., Tira, Michael D., Sanavio, Ezio
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description Although the phenomenology of Pathological Gambling (PG) is clearly characterized by impulsive features, some of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria for PG are similar to those of Obsessive Compulsive Disorder (OCD). Therefore, the compulsive–impulsive spectrum model may be a better (or complementary) fit with PG phenomenology. The present exploratory research was designed to further investigate the compulsive and impulsive features characterizing PG, by comparing PG individuals, alcohol dependents (ADs), OCD patients, and healthy controls (HCs) on both self-report and cognitive measures of compulsivity and impulsivity. A better understanding of the shared psychological and cognitive mechanisms underlying differently categorized compulsive and impulsive disorders may significantly impact on both clinical assessment and treatment strategies for PG patients. With respect to self-report measures, PG individuals reported more compulsive and impulsive features than did HCs. As regards motor inhibition ability indices, PG individuals and HCs performed similarly on the Go/No-go task and better than AD individuals and OCD patients. Results from the Iowa Gambling Task highlighted that PG, AD, and OCD participants performed worse than did HCs. An in-depth analysis of each group’s learning profile revealed similar patterns of impairment between PG and AD individuals in decision-making processes. Current findings support the utility of adopting a dimensional–transdiagnostic approach to complement the DSM-5 classification when working with PG individuals in clinical practice. Indeed, clinicians are encouraged to assess both compulsivity and impulsivity to provide individualized case conceptualizations and treatment plans focusing on the specific phenomenological features characterizing each PG patient.
doi_str_mv 10.1007/s10899-014-9470-5
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subjects Addictive behaviors
Adult
Alcohol
Behavior
Clinical medicine
Community and Environmental Psychology
Compulsive Behavior - classification
Compulsive Behavior - psychology
Decision Making
Diagnostic and Statistical Manual of Mental Disorders
Economics
Female
Gambling
Gambling - classification
Gambling - psychology
Gaming machines
Humans
Impulsive Behavior
Impulsivity
Inhibition (Psychology)
Internal-External Control
Italy
Legalized gambling
Male
Medicine
Medicine & Public Health
Mental disorders
Middle Aged
Obsessive compulsive disorder
Original Paper
Phenomenology
Physiology
Psychiatry
Social research
Sociology
Studies
Young Adult
title Compulsivity and Impulsivity in Pathological Gambling: Does a Dimensional–Transdiagnostic Approach Add Clinical Utility to DSM-5 Classification?
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