Chamberlain Samuel R, Derbyshire Katherine, Leppink Eric, Grant Jon E
Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK.
Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
Compr Psychiatry. 2015 Feb;57:51-7. doi: 10.1016/j.comppsych.2014.10.013. Epub 2014 Oct 23.
Problem gambling is common across cultures, and has been conceptualized in terms of impulsivity. While elevated rates of attention deficit hyperactivity disorder (ADHD) have been observed in problem gamblers, the relationship between these two conditions, and other dissociable forms of impulsivity, has received little research attention.
N=126 non-treatment seeking young adults with problem gambling were recruited from the community, and were grouped according to the presence or absence of probable current ADHD. Clinical and cognitive measures pertaining to impulsivity were collected via detailed psychiatric assessment, questionnaires, and computerized neuropsychological tests. These variables were compared between groups.
Probable current ADHD was identified in 21.4% of the sample, and was associated with earlier age at onset of gambling behaviors, higher Barratt impulsivity scores (all three subscales), greater caffeine intake, worse response inhibition (Stop-Signal Test), and impaired decision-making (greater proportion of points gambled, Cambridge Gamble Test). Problem gamblers with and without ADHD did not differ on demographic characteristics or the rate of other psychiatric disorders, depression scores, nicotine and alcohol consumption, and body mass index. No significant group differences were found for general response speed, working memory, or executive planning.
ADHD is common in young adults with dysfunctional gambling behaviors and is associated with elevated questionnaire and cognitive based measures of impulsivity, along with heightened caffeine use. Future work should study the causal nature between these factors and the treatment implications of these findings.
问题赌博在不同文化中都很常见，并且已根据冲动性进行概念化。虽然在问题赌徒中观察到注意力缺陷多动障碍（ADHD）的发病率升高，但这两种情况以及其他可分离的冲动形式之间的关系很少受到研究关注。
从社区招募了N = 126名有问题赌博行为且未寻求治疗的年轻成年人，并根据当前是否可能患有ADHD进行分组。通过详细的精神病学评估、问卷和计算机化神经心理学测试收集与冲动性相关的临床和认知指标。对这些变量在组间进行比较。
样本中21.4%的人当前可能患有ADHD，这与赌博行为开始的年龄较早、巴拉特冲动性得分较高（所有三个子量表）、咖啡因摄入量较高、反应抑制较差（停止信号测试）以及决策受损（赌博点数比例较高，剑桥赌博测试）有关。患有和未患有ADHD的问题赌徒在人口统计学特征或其他精神障碍的发生率、抑郁得分、尼古丁和酒精消费以及体重指数方面没有差异。在一般反应速度、工作记忆或执行计划方面未发现显著的组间差异。
ADHD在有功能失调赌博行为的年轻成年人中很常见，并且与基于问卷和认知的冲动性测量升高以及咖啡因使用增加有关。未来的研究应探讨这些因素之间的因果关系以及这些发现的治疗意义。
