Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Institute for Interdisciplinary Addiction and Drug Research, Mailbox 201731, 20207 Hamburg, Germany.
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; Institute for Interdisciplinary Addiction and Drug Research, Mailbox 201731, 20207 Hamburg, Germany.
Addict Behav. 2018 Jun;81:60-69. doi: 10.1016/j.addbeh.2018.01.031. Epub 2018 Feb 2.
Despite of high rates of adverse childhood experiences (ACEs) in pathological gamblers, researchers have rarely studied which types of ACEs often co-occur and how these profiles of ACEs are related to current psychopathology. We aimed to identify profiles of ACEs in pathological gamblers and examined how these profiles were related to gambling-related characteristics and current general psychopathology. In 329 current or lifetime pathological gamblers, diagnosed with the Composite Diagnostic Interview for DSM-IV, 10 types of ACEs were measured using the Adverse Childhood Experiences Questionnaire. Global psychopathology was assessed using the Symptom Checklist SCL-27. ACE profiles were identified using latent class analysis. Differences between ACE profiles in gambling-related characteristics and global psychopathology were analyzed using MANOVA. We found that four out of five gamblers (n=257, 78.1%) reported at least one ACE. Four distinct ACE profiles were identified: 'Low ACE', 'High ACE', 'Physical and emotional abuse', and 'Neglect'. The number of the fulfilled pathological gambling criteria and the severity of current global psychopathology differed between the ACE profiles: Gamblers with a 'High ACE' profile fulfilled more pathological gambling criteria and showed a more severe current psychopathology than gamblers of the 'Low ACE' profile. Gamblers with a 'Physical and emotional abuse' or an 'Emotion neglect' profile showed an intermediate severity of psychopathology. Our findings indicate that four different ACE profiles can be distinguished in pathological gamblers that differed in their gambling-related characteristics and current psychopathology. Systematic assessment of profiles of ACEs in pathological gamblers may inform about the severity of current global psychopathology that might be important to be addressed in addition to gambling-specific treatment.
尽管病态赌博者的童年逆境经历（ACE）发生率很高，但研究人员很少研究哪些类型的 ACE 经常同时发生，以及这些 ACE 特征与当前精神病理学有何关联。我们旨在确定病态赌博者 ACE 的特征，并研究这些特征与赌博相关特征和当前一般精神病理学的关系。在 329 名当前或终身病态赌博者中，使用 DSM-IV 综合诊断访谈进行诊断，使用不良童年经历问卷测量了 10 种 ACE。使用症状清单 SCL-27 评估整体心理病理学。使用潜在类别分析确定 ACE 特征。使用 MANOVA 分析 ACE 特征与赌博相关特征和整体精神病理学之间的差异。我们发现，五分之四的赌徒（n=257，78.1%）报告至少有一种 ACE。确定了四个不同的 ACE 特征：“低 ACE”、“高 ACE”、“身体和情感虐待”和“忽视”。符合病态赌博标准的数量和当前整体心理病理学的严重程度在 ACE 特征之间存在差异：具有“高 ACE”特征的赌徒符合更多的病态赌博标准，表现出比“低 ACE”特征的赌徒更严重的当前心理病理学。具有“身体和情感虐待”或“情感忽视”特征的赌徒表现出中等严重程度的心理病理学。我们的研究结果表明，病态赌博者可以区分出四种不同的 ACE 特征，它们在赌博相关特征和当前心理病理学方面存在差异。系统评估病态赌博者的 ACE 特征可以了解当前整体心理病理学的严重程度，这可能除了针对赌博的治疗之外，还需要加以关注。
