The association between gambling pathology and personality disorders

• Published in: Journal of psychiatric research 2008-10, Vol.42 (13), p.1122-1130
• Main Authors: Sacco, Paul, Cunningham-Williams, Renee M, Ostmann, Emily, Spitznagel, Edward L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Biological and medical sciences; Borderline personality disorder; C-GAM; Comorbidity; Depression; Depression - etiology; Diagnostic and Statistical Manual of Mental Disorders; DSM-IV; Female; Gambling - psychology; Humans; Likelihood Functions; Male; Medical sciences; Middle Aged; Miscellaneous; Multivariate Analysis; Pathological gambling; Pathological gambling disorder; Personality disorders; Personality Disorders - complications; Personality Disorders - epidemiology; Personality Disorders - psychology; Personality Inventory; Problem gambling; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; SCID-II; Substance abuse
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2007.11.007

Abstract Research supports increased risk of problem gambling (PG) and pathological gambling disorder (PGD) among individuals with substance abuse/dependence and psychiatric disorders, but studies considering personality disorder comorbidity have not adjusted for confounding relationships with other Axis I disorders. Using targeted advertising, we enrolled 153 gamblers (55% female; 32% minority; Mean age = 47; SD = 18.2) in a clinical validation study of the newly developed computerized gambling assessment module (C-GAM© ). For these analyses, we classified gamblers into three groups based on their endorsement of DSM-IV PGD: Non-gamblers (0 criteria; n = 64; 44%); PG (1–4 criteria; n = 60; 41%); and PGD (5–10 criteria; n = 22; 15%). We evaluated PG and PGD risk associated with personality disorder pathology using the computerized structured clinical interview of DSM-IV Axis II (SCID-II). Using multinomial logistic regression, we found increased odds of PGD among individuals with greater symptoms of borderline personality disorder after adjusting for socio-demographics, substance abuse/dependence and other personality disorders significant at the bivariate level. Yet after adjusting for depressive symptoms, borderline personality disorder criteria were nonsignificant, suggesting a complex relationship between personality pathology, depression, and gambling. These findings bolster the position that further investigation is needed regarding the association of gambling pathology with personality disorders and depressive symptoms.