CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Spain; Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
J Psychiatry Neurosci. 2011 May;36(3):165-75. doi: 10.1503/jpn.090095.
Impairments in self-regulatory behaviour reflect a deficit in executive functioning and decision-making, as well as higher levels of self-reported impulsivity, and may be involved in the development and maintenance of addictive disorders. We sought to explore the association between self-reported impulsivity and neurocognitive measures, and their association with treatment outcome in pathologic gambling.
We assessed patients with pathologic gambling using executive functioning and decision-making tests and self-report measures of impulsivity. Patients underwent cognitive-behavioural therapy (CBT) for pathologic gambling.
We included 88 patients (8% women) in our study. High self-reported extravagance was associated with poor performance in the Iowa Gambling Task (IGT)-ABCD version. High impulsiveness, low disorderliness, high exploratory excitability (trend), poor backward block span and poor IGT-EFGH scores (trend) predicted dropout. We observed no self-reported or neurocognitive predictors of relapse or number of treatment sessions attended.
Most participants were slot-machine gamblers seeking treatment. No follow-up data and no control group were included in the study. The missing sample (i.e., individuals who were recruited and assessed in the pretreatment stage but who chose not to begin treatment) had higher extravagance scores than the final sample.
Neurocognitive reward sensitivity was related to self-reported overspending behaviour. Self-regulatory impairments (especially rash impulsiveness and punishment sensitivity) and executive dysfunction predicted only dropout of CBT in participants with pathologic gambling. Different neurocognitive processes and personality traits might mediate treatment response to psychological therapy of pathologic gambling according to the specific target variable assessed.
自我调节行为的损害反映了执行功能和决策的缺陷，以及更高水平的自我报告冲动性，并且可能与成瘾障碍的发展和维持有关。我们试图探讨自我报告的冲动性与神经认知测量之间的关系，以及它们与病理性赌博治疗结果的关系。
我们使用执行功能和决策测试以及自我报告的冲动性测量来评估病理性赌博患者。患者接受了病理性赌博的认知行为治疗（CBT）。
我们的研究纳入了 88 名患者（8%为女性）。高自我报告的奢侈与爱荷华赌博任务（IGT）-ABCD 版本的表现不佳有关。高冲动性、低无序性、高探索性兴奋性（趋势）、差的回溯块跨度和差的 IGT-EFGH 分数（趋势）预测了辍学。我们没有观察到自我报告或神经认知预测复发或治疗次数的因素。
大多数参与者是寻求治疗的老虎机赌徒。研究中没有包括随访数据和对照组。缺失样本（即，在治疗前阶段被招募和评估但选择不开始治疗的个体）的奢侈分数高于最终样本。
神经认知奖励敏感性与自我报告的过度消费行为有关。自我调节损伤（特别是轻率冲动和惩罚敏感性）和执行功能仅预测了病理性赌博患者 CBT 的辍学。根据评估的特定目标变量，不同的神经认知过程和人格特质可能会影响病理性赌博心理治疗的治疗反应。
