Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Farmington, CT 06030, USA.
Psychol Addict Behav. 2010 Dec;24(4):680-8. 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.
本研究依据途径模型检验了病理性赌博者(PGs)的假定亚类,并评估了这些亚类是否会因治疗而产生不同的获益。该研究纳入了 229 名寻求治疗的 PGs,根据评估焦虑、抑郁和冲动的问卷得分将其分为途径模型亚类。基线时、治疗后和 12 个月随访时,使用成瘾严重程度评估量表-赌博评估赌博问题的严重程度。与行为条件反射型(BC)赌博者相比,情绪脆弱型(EV)赌博者的精神和赌博严重程度更高,且更有可能存在有精神病史的父母。反社会冲动型(AI)赌博者与 BC 赌博者相比,赌博和精神严重程度也更高。他们更有可能患有反社会人格障碍,并且在法律、家庭/社会方面的严重程度评分最高。他们也最有可能有药物滥用治疗史、住院精神治疗史,以及存在有药物使用或赌博问题的父母。AI 和 EV 赌博者在整个治疗过程中经历的赌博严重程度都高于 BC 赌博者,但所有三个亚类的治疗反应模式相似。因此,三种途径模型亚类在一些基线特征上存在差异,但除了与赌博问题严重程度的简单关联外,亚类并不能预测治疗结果。