Brown Meredith, Allen J Sabura, Dowling Nicki A
School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.
School of Psychology, Deakin University, Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
J Gambl Stud. 2015 Dec;31(4):1179-99. doi: 10.1007/s10899-014-9504-z.
Problem gambling is a significant mental health problem that creates a multitude of intrapersonal, interpersonal, and social difficulties. Recent empirical evidence suggests that personality disorders, and in particular borderline personality disorder (BPD), are commonly co-morbid with problem gambling. Despite this finding there has been very little research examining overlapping factors between these two disorders. The aim of this review is to summarise the literature exploring the relationship between problem gambling and personality disorders. The co-morbidity of personality disorders, particularly BPD, is reviewed and the characteristics of problem gamblers with co-morbid personality disorders are explored. An etiological model from the more advanced BPD literature-the biosocial developmental model of BPD-is used to review the similarities between problem gambling and BPD across four domains: early parent-child interactions, emotion regulation, co-morbid psychopathology and negative outcomes. It was concluded that personality disorders, in particular BPD are commonly co-morbid among problem gamblers and the presence of a personality disorder complicates the clinical picture. Furthermore BPD and problem gambling share similarities across the biosocial developmental model of BPD. Therefore clinicians working with problem gamblers should incorporate routine screening for personality disorders and pay careful attention to the therapeutic alliance, client motivations and therapeutic boundaries. Furthermore adjustments to therapy structure, goals and outcomes may be required. Directions for future research include further research into the applicability of the biosocial developmental model of BPD to problem gambling.
问题赌博是一个严重的心理健康问题，会引发大量个人、人际和社会层面的困难。近期的实证证据表明，人格障碍，尤其是边缘型人格障碍（BPD），常与问题赌博共病。尽管有这一发现，但针对这两种障碍之间重叠因素的研究却非常少。本综述的目的是总结探索问题赌博与人格障碍之间关系的文献。对人格障碍，尤其是BPD的共病情况进行了综述，并探讨了患有共病性人格障碍的问题赌徒的特征。运用来自更先进的BPD文献中的一个病因模型——BPD的生物社会发展模型，从四个领域审视问题赌博与BPD之间的相似性：早期亲子互动、情绪调节、共病精神病理学和负面结果。研究得出结论，人格障碍，尤其是BPD，在问题赌徒中普遍共病，且人格障碍的存在使临床情况变得复杂。此外，BPD和问题赌博在BPD的生物社会发展模型中存在相似之处。因此，治疗问题赌徒的临床医生应纳入对人格障碍的常规筛查，并密切关注治疗联盟、来访者动机和治疗界限。此外，可能需要对治疗结构、目标和结果进行调整。未来研究的方向包括进一步研究BPD的生物社会发展模型对问题赌博的适用性。
