Department of Dynamic and Clinical Psychology, Sapienza University of Rome.
Psychol Addict Behav. 2021 May;35(3):247-262. doi: 10.1037/adb0000693. Epub 2021 Mar 1.
Multilevel consequences related to gambling disorder (GD) are glaring enough to make gambling a worldwide public health issue. Dissociation has been pointed out in clinical, empirical, and theoretical contributions as a key variable accounting for the development and maintenance of GD. However, we still lack a systematization of available empirical data that may facilitate further accurate conclusions.
A systematic review and meta-analysis were performed with the goal to answer to open questions. We followed the PRISMA guidelines conducting a systematic search of 5 scientific databases (PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed) including grey literature.
A total of 843 records were screened, and 20 studies were included in the qualitative and quantitative analyses. A systematic review of selected studies outlines the high heterogeneity in the operationalization of the dissociation construct as well as the absence of studies examining the role played by the specific dimensions of the pathological dissociative feature in GD. A significant, positive, and moderate effect size (r = .37) was found linking GD to dissociation. Moreover, this effect appears to not be moderated by the quality of studies, age, and gender of participants nor measures used to evaluate dissociation.
Despite empirical evidences supporting the theoretical assertions toward the relationship between GD and dissociation, few studies have reached an articulated understanding of this topic, mostly failing to identify specific dissociative features involved in GD. Furthermore, the existence of the current gap in the literature are discussed to delineate future lines of research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
与赌博障碍（GD）相关的多层次后果明显到足以使赌博成为全球公共卫生问题。在临床、实证和理论贡献中，分离已被指出是解释和维持 GD 发展的关键变量。然而，我们仍然缺乏对现有实证数据的系统化，这可能会促进更准确的结论。
我们进行了系统审查和荟萃分析，旨在回答开放性问题。我们遵循 PRISMA 指南，对 5 个科学数据库（PsycINFO、PsycARTICLES、MEDLINE、Scopus、Web of Science 和 PubMed）进行了系统搜索，包括灰色文献。
共筛选出 843 条记录，其中 20 项研究纳入定性和定量分析。对选定研究的系统综述概述了分离结构操作性的高度异质性，以及缺乏研究检查病理性分离特征特定维度在 GD 中所扮演的角色。发现 GD 与分离之间存在显著、正相关且中等效应大小（r =.37）。此外，该效应似乎不受研究质量、参与者年龄和性别以及用于评估分离的测量方法的调节。
尽管有实证证据支持 GD 与分离之间的理论假设，但很少有研究对这一主题有明确的认识，主要是未能确定与 GD 相关的特定分离特征。此外，还讨论了目前文献中的这一差距，以描绘未来的研究方向。
