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使用途径模型对非治疗寻求问题赌徒进行亚类型划分。

Subtyping Non-treatment-seeking Problem Gamblers Using the Pathways Model.

机构信息

Substance Abuse Research Division, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Tolan Park Medical Building, 3901 Chrysler Service Drive, Suite 2A, Detroit, MI, 48201, USA.

Department of Psychology, University of Windsor, Windsor, ON, Canada.

出版信息

J Gambl Stud. 2017 Sep;33(3):841-853. doi: 10.1007/s10899-016-9658-y.

Abstract

This study examined whether distinct subgroups could be identified among a sample of non-treatment-seeking problem and pathological/disordered gamblers (PG) using Blaszczynski and Nower's (Addiction 97:487-499, 2002) pathways model (N = 150, 50% female). We examined coping motives for gambling, childhood trauma, boredom proneness, risk-taking, impulsivity, attention-deficit/hyperactivity disorder (ADHD), and antisocial personality disorder as defining variables in a hierarchical cluster analysis to identify subgroups. Subgroup differences in gambling, psychiatric, and demographic variables were also assessed to establish concurrent validity. Consistent with the pathways model, our analyses identified three gambling subgroups: (1) behaviorally conditioned (BC), (2) emotionally vulnerable (EV), and (3) antisocial-impulsivist (AI) gamblers. BC gamblers (n = 47) reported the lowest levels of lifetime depression, anxiety, gambling severity, and interest in problem gambling treatment. EV gamblers (n = 53) reported the highest levels of childhood trauma, motivation to gamble to cope with negative emotions, gambling-related suicidal ideation, and family history of gambling problems. AI gamblers (n = 50) reported the highest levels of antisocial personality disorder and ADHD symptoms, as well as higher rates of impulsivity and risk-taking than EV gamblers. The findings provide evidence for the validity of the pathways model as a framework for conceptualizing PG subtypes in a non-treatment-seeking sample, and underscore the importance of tailoring treatment approaches to meet the respective clinical needs of these subtypes.

摘要

本研究旨在通过 Blaszczynski 和 Nower 的(Addiction 97:487-499, 2002)成瘾途径模型,探讨在一个非治疗寻求的问题和病理性/障碍性赌徒样本(N=150,50%为女性)中是否可以识别出不同的亚组。我们检查了赌博的应对动机、儿童期创伤、无聊倾向、冒险倾向、冲动性、注意力缺陷/多动障碍(ADHD)和反社会人格障碍作为分层聚类分析中的定义变量,以确定亚组。还评估了赌博、精神科和人口统计学变量的亚组差异,以建立同时有效性。与途径模型一致,我们的分析确定了三个赌博亚组:(1)行为条件(BC),(2)情感脆弱(EV)和(3)反社会冲动(AI)赌徒。BC 赌徒(n=47)报告的终生抑郁、焦虑、赌博严重程度和对问题赌博治疗的兴趣最低。EV 赌徒(n=53)报告的儿童期创伤、用赌博来应对负面情绪的动机、与赌博相关的自杀意念以及家族赌博问题史最高。AI 赌徒(n=50)报告的反社会人格障碍和 ADHD 症状水平最高,以及冲动性和冒险性比 EV 赌徒更高。这些发现为将途径模型作为一种概念化非治疗寻求样本中 PG 亚组的框架提供了证据,并强调了针对这些亚组各自的临床需求定制治疗方法的重要性。

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