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有或无物质使用障碍病史的病态赌徒与健康对照者冲动性的行为评估。

Behavioral assessment of impulsivity in pathological gamblers with and without substance use disorder histories versus healthy controls.

作者信息

Ledgerwood David M, Alessi Sheila M, Phoenix Natalie, Petry Nancy M

机构信息

Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Ave., Farmington, CT 06030-3944, USA.

出版信息

Drug Alcohol Depend. 2009 Nov 1;105(1-2):89-96. doi: 10.1016/j.drugalcdep.2009.06.011. Epub 2009 Jul 16.

Abstract

Pathological gamblers (PGs) may have high levels of impulsivity, and a correlation between substance use disorders (SUDs) and impulsivity is well established. However, only a handful of studies have attempted to assess impulsivity and other impulse-spectrum traits (e.g., sensation seeking) using a variety of behavioral and self-report measures in PGs and few examined the independent impact of SUDs. We compared 30 PGs without SUD histories, 31 PGs with SUD histories and 40 control participants on self-reported impulsivity, delayed discounting, attention/memory, response inhibition, risk taking, sensation seeking and distress tolerance measures. PGs, regardless of SUD history, discounted delayed rewards at greater rates than controls. PGs also reported acting on the spur of the moment, experienced trouble planning and thinking carefully, and noted greater attention difficulties than controls. PGs with SUD took greater risks on a risk-taking task than did PGs without SUD histories, but the two groups did not differ on any other measures of impulsivity. We conclude that PGs are more impulsive than non-problem gamblers in fairly specific ways, but PGs with and without SUD histories differ on few measures. More research should focus on specific ways in which PGs exhibit impulsivity to better address impulsive behaviors in treatment.

摘要

病态赌徒(PGs)可能具有较高的冲动性,而且物质使用障碍(SUDs)与冲动性之间的关联已得到充分证实。然而,只有少数研究尝试使用多种行为和自我报告测量方法来评估PGs的冲动性及其他冲动谱系特征(如寻求刺激),并且很少有研究考察SUDs的独立影响。我们比较了30名无SUD病史的PGs、31名有SUD病史的PGs和40名对照参与者在自我报告的冲动性、延迟折扣、注意力/记忆力、反应抑制、冒险、寻求刺激和痛苦耐受力测量方面的表现。无论有无SUD病史,PGs对延迟奖励的折扣率都高于对照组。PGs还报告说会一时冲动行事,在规划和仔细思考方面存在困难,并且指出他们比对照组有更大的注意力问题。有SUD病史的PGs在冒险任务上比无SUD病史的PGs承担更大的风险,但两组在其他冲动性测量指标上没有差异。我们得出结论,PGs在相当具体的方面比非问题赌徒更冲动,但有无SUD病史的PGs在少数测量指标上存在差异。更多的研究应关注PGs表现出冲动性的具体方式,以便在治疗中更好地应对冲动行为。

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