Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.
Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
J Gambl Stud. 2018 Mar;34(1):147-160. doi: 10.1007/s10899-017-9685-3.
Gambling has been associated with increased sympathetic nervous system output and stimulation of the hypothalamic-pituitary-adrenal axis. However it is unclear how these systems are affected in pathological gambling. This study aimed to investigate the effect of the Trier Social Stress Test (TSST) on cortisol and on cardiac interbeat intervals in relation to impulsivity, in a sample of male pathological gamblers compared to healthy controls. In addition, we investigated the correlation between the TSST, duration of the disorder and impulsivity. A total of 35 pathological gamblers and 30 healthy controls, ranging from 19 to 58 years old and all male, participated in this study. Stress response was measured during and after the TSST by salivary cortisol and cardiac interbeat intervals; impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). Exposure to the TSST produced a significant increase in salivary cortisol and interbeat intervals in both groups, without differences between groups. We found a negative correlation between baseline cortisol and duration of pathological gambling indicating that the longer the duration of the disorder the lower the baseline cortisol levels. Additionally, we found a main effect of impulsivity across groups on interbeat interval during the TSST, indicating an association between impulsivity and the intensity of the neurovegetative stress response during the TSST. Involvement of the hypothalamic-pituitary-adrenal axis in pathological gambling was confirmed together with evidence of a correlation between length of the disorder and diminished baseline cortisol levels. Impulsivity emerged as a personality trait expressed by pathological gamblers; however the neurovegetative response to the TSST, although associated with impulsivity, appeared to be independent of the presence of pathological gambling.
赌博与交感神经系统输出增加和下丘脑-垂体-肾上腺轴兴奋有关。然而，病理性赌博如何影响这些系统尚不清楚。本研究旨在探讨在男性病理性赌博者和健康对照组中，三重社会应激测试（TSST）对皮质醇和心脏间搏动间隔的影响，以及与冲动性的关系。共有 35 名病理性赌博者和 30 名健康对照组，年龄在 19 至 58 岁之间，均为男性，参加了这项研究。通过唾液皮质醇和心脏间搏动间隔来测量 TSST 期间和之后的应激反应；采用巴瑞特冲动量表（BIS-11）评估冲动性。两组在 TSST 后唾液皮质醇和间搏动间隔均显著增加，两组间无差异。我们发现基线皮质醇与病理性赌博持续时间呈负相关，表明疾病持续时间越长，基线皮质醇水平越低。此外，我们发现冲动性在两组间对 TSST 期间的间搏动间隔有主要影响，表明冲动性与 TSST 期间神经植物性应激反应的强度有关。确认了病理性赌博症患者的下丘脑-垂体-肾上腺轴的参与，并证实了疾病持续时间与基线皮质醇水平降低之间的相关性。冲动性是病理性赌博者表现出的一种人格特征；然而，对 TSST 的神经植物性反应虽然与冲动性有关，但似乎与病理性赌博的存在无关。
