Pathological Gambling Unit, Consorci Sanitari de Terrassa, Barcelona, (Spain); Department of Mental Health, Consorci Sanitari de Terrassa, Barcelona, (Spain).
Quantitative Psychology Unit, Faculty of Psychology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences (Neuro UB), University of Barcelona, Barcelona, Spain.
Compr Psychiatry. 2018 May;83:79-83. doi: 10.1016/j.comppsych.2018.03.008. Epub 2018 Mar 21.
In gambling disorder (GD), impulsivity has been related with severity, treatment outcome and a greater dropout rate. The aim of the study is to obtain an empirical classification of GD patients based on their impulsivity and compare the resulting groups in terms of sociodemographic, clinical and gambling behavior variables.
126 patients with slot machine GD attending the Pathological Gambling Unit between 2013 and 2016 were included. The UPPS-P Impulsive Behavior Scale was used to assess impulsivity, and the severity of past-year gambling behavior was established with the Screen for Gambling problems questionnaire (NODS). Depression and anxiety symptoms and executive function were also assessed. A two-step cluster analysis was carried out to determine impulsivity profiles.
According to the UPPS-P data, two clusters were generated. Cluster 1 showed the highest scores on all the UPPS-P subscales, whereas patients from cluster 2 exhibited only high scores on two UPPS-P subscales: Negative Urgency and Lack of premeditation. Additionally, patients on cluster 1 were younger and showed significantly higher scores on the Beck Depression Inventory and on the State-Trait Anxiety Inventory questionnaires, worse emotional regulation and executive functioning, and reported more psychiatric comorbidity compared to patients in cluster 2. With regard to gambling behavior, cluster 1 patients had significantly higher NODS scores and a higher percentage presented active gambling behavior at treatment start than in cluster 2.
We found two impulsivity subtypes of slot machine gamblers. Patients with high impulsivity showed more severe gambling behavior, more clinical psychopathology and worse emotional regulation and executive functioning than those with lower levels of impulsivity. These two different clinical profiles may require different therapeutic approaches.
在赌博障碍（GD）中，冲动性与严重程度、治疗结果和更高的辍学率有关。本研究的目的是根据 GD 患者的冲动性获得经验分类，并比较这些结果组在人口统计学、临床和赌博行为变量方面的差异。
纳入了 2013 年至 2016 年间在病理性赌博科就诊的 126 名患有老虎机 GD 的患者。使用 UPPS-P 冲动行为量表评估冲动性，使用赌博问题筛选问卷（NODS）评估过去一年的赌博行为严重程度。还评估了抑郁和焦虑症状以及执行功能。进行两步聚类分析以确定冲动性特征。
根据 UPPS-P 数据，生成了两个聚类。聚类 1 在所有 UPPS-P 分量表上的得分最高，而聚类 2 的患者仅在 UPPS-P 的两个分量表上表现出高分：负性冲动和缺乏前摄性。此外，聚类 1 的患者年龄较小，贝克抑郁量表和状态特质焦虑量表的得分显著较高，情绪调节和执行功能较差，与聚类 2 的患者相比，报告的共病精神障碍更多。在赌博行为方面，聚类 1 的患者 NODS 评分显著更高，在治疗开始时表现出活跃赌博行为的比例也明显高于聚类 2。
我们发现了两种老虎机赌徒的冲动性亚型。高冲动性患者的赌博行为更为严重，临床心理病理学更为严重，情绪调节和执行功能较差，而冲动性较低的患者则较差。这两种不同的临床特征可能需要不同的治疗方法。
