Brown M, Oldenhof E, Allen J S, Dowling N A
School of Psychological Sciences, Monash University, Clayton, Australia.
School of Psychology, Faculty of Health, Deakin University, Melbourne Burwood Campus, Room BC5.116, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
J Gambl Stud. 2016 Dec;32(4):1079-1100. doi: 10.1007/s10899-016-9600-3.
The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impulsivity, distress tolerance, substance use, PTSD symptoms, psychological distress and work/social adjustment) are associated with problem gambling. A secondary aim was to explore the strength of the relationships between these symptoms and problem gambling severity in problem gamblers with and without personality disorder pathology. Participants were 168 consecutively admitted problem gamblers seeking treatment from a specialist outpatient gambling service in Australia. The prevalence of personality disorders using the self-report version of the Iowa Personality Disorders Screen was 43.3 %. Cluster B personality disorders, but not Cluster A or C personality disorders, were associated with problem gambling severity. All psychological symptoms, except alcohol and drug use, were significantly higher among participants with personality disorder pathology compared to those without. Finally, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for problem gamblers with personality disorder pathology, while impulsivity, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for those without personality disorder pathology. High rates of comorbid personality disorders, particularly Cluster B disorders, necessitate routine screening in gambling treatment services. More complex psychological profiles may complicate treatment for problem gamblers with comorbid personality disorders. Future research should examine the applicability of the biosocial developmental model to problem gambling in community studies.
本研究的主要目的是调查问题赌徒中人格障碍的患病率，探讨人格障碍与问题赌博严重程度之间的关系，以及探索边缘型人格障碍的生物社会发展模型中所强调的心理症状（冲动性、痛苦耐受性、物质使用、创伤后应激障碍症状、心理困扰及工作/社会适应）与问题赌博的关联程度。次要目的是探究这些症状与有无人格障碍病理的问题赌徒的问题赌博严重程度之间关系的强度。参与者为168名连续入院、在澳大利亚一家专科门诊赌博服务机构寻求治疗的问题赌徒。使用爱荷华人格障碍筛查自评版得出的人格障碍患病率为43.3%。B类人格障碍而非A类或C类人格障碍与问题赌博严重程度相关。除酒精和药物使用外，有人格障碍病理的参与者的所有心理症状均显著高于无此病理的参与者。最后，对于有人格障碍病理的问题赌徒，心理困扰以及工作和社会适应与问题赌博严重程度显著相关；而对于无人格障碍病理的问题赌徒，冲动性、心理困扰以及工作和社会适应与问题赌博严重程度显著相关。共患人格障碍的比例很高，尤其是B类障碍，因此赌博治疗服务机构有必要进行常规筛查。更复杂的心理状况可能会使共患人格障碍的问题赌徒的治疗复杂化。未来的研究应在社区研究中检验生物社会发展模型对问题赌博的适用性。
