Leppink Eric W, Grant Jon E
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA. E-mail:
Ann Clin Psychiatry. 2015 Feb;27(1):16-24.
Epidemiological research has shown high comorbidity rates between at-risk/problem (ARP) gambling and trauma. However, few studies have assessed the neurocognitive implications of this comorbidity, and even fewer have been conducted with young adults. The present study sought to determine the neurocognitive, clinical, personality types associated with trauma in ARP gamblers.
The present study analyzed young adult gamblers age 18 to 29 drawn from a study investigating impulsivity. Of the 230 gamblers, 52 (22.6%) reported experiencing a traumatic event during their life to which they responded with intense fear, helplessness, or horror. The remaining participants indicated no experience with trauma.
ARP gamblers who had experienced trauma showed significant neurocognitive deficits on tasks related to decision-making, risk adjustment, sustained attention, and spatial working memory. We did not detect significant differences in gambling severity. Trauma was associated with lower perceived quality of life and self-esteem, and higher rates of current comorbid diagnoses, suicidality, substance use disorders, and nicotine use.
This study suggests that trauma may not exacerbate the severity of gambling in ARP gamblers. However, significant differences in supplemental clinical and neurocognitive measures may indicate that trauma is an important consideration when assessing problems beyond those related directly to gambling severity.
流行病学研究表明，高危/问题（ARP）赌博与创伤之间的共病率很高。然而，很少有研究评估这种共病的神经认知影响，针对年轻人开展的研究甚至更少。本研究旨在确定与ARP赌博者创伤相关的神经认知、临床及人格类型。
本研究分析了从一项关于冲动性的研究中选取的18至29岁的年轻赌博者。在230名赌博者中，52人（22.6%）报告在其生活中经历过创伤事件，并对此产生了强烈的恐惧、无助或恐惧反应。其余参与者表示没有创伤经历。
经历过创伤的ARP赌博者在与决策、风险调整、持续注意力和空间工作记忆相关的任务上表现出显著的神经认知缺陷。我们未发现赌博严重程度上的显著差异。创伤与较低的生活质量感知和自尊相关，以及当前共病诊断、自杀倾向、物质使用障碍和尼古丁使用的较高发生率相关。
本研究表明，创伤可能不会加剧ARP赌博者的赌博严重程度。然而，补充临床和神经认知测量的显著差异可能表明，在评估除与赌博严重程度直接相关的问题之外的问题时，创伤是一个重要的考虑因素。
