Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Norra stationsgatan 69, plan 7, 113 64, Stockholm, Sweden.
Stockholm Region Health Services, Stockholm, Sweden.
BMC Psychiatry. 2022 Jul 28;22(1):510. doi: 10.1186/s12888-022-04152-2.
From a clinical perspective, knowledge of the psychological processes involved in maintaining gambling disorder has been lacking. This qualitative study formulated hypotheses on how gambling disorder is maintained by identifying clinically relevant behaviors at an individual level, as a means to guide the development of new cognitive behavioral interventions.
Six individuals from a treatment study, diagnosed with gambling disorder and with diverse symptom profiles of psychiatric comorbidity, were recruited. Participants were interviewed using an in-depth semi-structured functional interview and completed self-report measures assessing gambling behavior.
Functional analysis was used as a theoretical framework for a thematic analysis, which yielded the following categories: 1) antecedents that may increase or decrease gambling; 2) experiences accompanying gambling; 3) control strategies; 4) consequences of gambling behavior; and 5) events terminating gambling behavior. Few differences were identified in relation to symptom profiles of psychiatric comorbidity, although some gamblers did not report experiencing abstinence when not being able to gamble.
Gambling is a secluded activity mainly triggered by access to money. Positive and negative emotions could be both antecedents and functions of gambling behavior. Avoidance-based strategies used to control gambling might result in a failure to learn to control gambling behavior. Anticipation, selective attention, and chasing could be important reinforcers, which should be addressed in new developments in cognitive behavioral treatment for gambling disorder.
从临床角度来看，人们对维持赌博障碍相关的心理过程知之甚少。本定性研究通过确定个体层面上与临床相关的行为，提出了关于如何维持赌博障碍的假设，旨在为新的认知行为干预措施的发展提供指导。
从一项治疗研究中招募了 6 名被诊断患有赌博障碍且伴有不同精神共病症状谱的个体。参与者接受了深入的半结构化功能访谈，并完成了评估赌博行为的自我报告量表。
功能分析被用作主题分析的理论框架，得出以下类别：1）可能增加或减少赌博的诱因；2）伴随赌博的体验；3）控制策略；4）赌博行为的后果；5）终止赌博行为的事件。虽然一些赌徒在无法赌博时没有报告经历戒断，但与精神共病的症状谱相关的差异很少。
赌博是一种孤立的活动，主要由获取资金触发。积极和消极的情绪都可能是赌博行为的诱因和功能。用于控制赌博的基于回避的策略可能导致无法学会控制赌博行为。预期、选择性注意和追逐可能是重要的强化物，应在赌博障碍的认知行为治疗的新发展中加以解决。
