Effect of genes, environment, and lifetime co-occurring disorders on health-related quality of life in problem and pathological gamblers.

Research Service, St Louis Veterans Affairs Medical Center, St Louis, Missouri 63106, USA.
Archives of General Psychiatry (Impact Factor: 13.75). 07/2005; 62(6):677-83. DOI: 10.1001/archpsyc.62.6.677
Source: PubMed

ABSTRACT Problem and pathological gambling are associated with many impairments in quality of life, including financial, family, legal, and social problems. Gambling disorders commonly co-occur with other psychiatric disorders, such as alcoholism and depression. Although these consequences and correlates have been reported, little is known about the health-related functional impairment associated with gambling.
To model differences in the health-related quality of life (HRQoL) among non-problem gamblers, problem gamblers, and pathological gamblers after controlling for lifetime co-occurring substance use disorders, psychiatric disorders, sociodemographics, and genetic and family environmental influences.
Cohort and co-twin studies.
Nationally distributed community sample.
Male twin members of the Vietnam Era Twin Registry: 53 pathological gamblers, 270 subclinical problem gamblers, and 1346 non-problem gamblers (controls).
We obtained HRQoL data, via the 8-Item Short-Form Health Survey, from all participants. Data from a subset of twin pairs discordant for gambling behavior was used to control for genetic and family environmental effects on HRQoL and problem gambling. Main Outcome Measure Health-related quality of life.
Results from adjusted logistic regression analyses suggest little difference across groups in the physical domains of the health survey; however, for each mental health domain, pathological gamblers had lower HRQoL scores than problem gamblers (P<.05), who in turn had lower scores than non-problem gamblers (P<.05). After controlling for genes and family environment, no significant differences existed between the non-problem gambling twins and their problem or pathological gambling brothers, but adjusted co-twin analyses resulted in statistically significant differences in 4 of 8 subscales.
Pathological and problem gambling are associated with significant decrements in HRQoL. This association is partly explained by genetic and family environmental effects and by lifetime co-occurring substance use disorders. Implications for clinicians, health care utilization, and public health issues are discussed.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Past research suggests that sleep problems are associated with increased risky decision-making. Similarly, gambling disorder and alcohol use disorder are also associated with increased risky decision-making. Individuals with gambling disorder or alcohol use disorder have also reported higher rates of sleep problems compared to normal healthy controls. As such, we sought to examine whether sleep problems play a role in the development of alcohol use disorder or gambling disorder.
    Journal of Behavioural Addictions 09/2014; 3(3):166-72. DOI:10.1556/JBA.3.2014.014
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Like in the case of drugs, gambling hijacks reward circuits in a brain which is not prepared to receive such intense stimulation. Dopamine is normally released in response to reward and uncertainty in order to allow animals to stay alive in their environment – where rewards are relatively unpredictable. In this case, behavior is regulated by environmental feedbacks, leading animals to persevere or to give up. In contrast, drugs provide a direct, intense pharmacological stimulation of the dopamine system that operates independently of environmental feedbacks, and hence causes “motivational runaways”. With respect to gambling, the confined environment experienced by gamblers favors the emergence of excitatory conditioned cues, so that positive feedbacks take over negative feedbacks. Although drugs and gambling may act differently, their abnormal activation of reward circuitry generates an underestimation of negative consequences and promotes the development of addictive/compulsive behavior. In Parkinson’s and Huntington’s disease, dopamine-related therapies may disrupt these feedbacks on dopamine signalling, potentially leading to various addictions, including pathological gambling. The goal of this Research Topic is to further our understanding of the neurobiological mechanisms underlying the development of pathological gambling. This eBook contains a cross-disciplinary collection of research and review articles, ranging in scope from animal behavioral models to human imaging studies.
    11/2014; Frontiers Media SA.., ISBN: 978-2-88919-320-2
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract This is a book review. In this book review, the author explored gambling motivations and the impact of gambling on quality of life of the gamblers and families, communities and societies of the gamblers. In the review, the author addressed cultural components like cultural values and acculturations influence adolescents and young adult gamblers initiation and maintenance of gambling and problem gambling. In the review, the researcher also addressed that adolescents and young adults are motivated to gamble for various reasons like entertainment, excitement, amusement, learning and accomplishing, and also, serious cognitive bias, risk-prone attitudes, and higher levels of stress and anxiety. Researches also indicated that there is gender difference on what motivate gamblers to initiate and maintain gambling and problem gambling. Finally, the author addressed that with respect to the impact of gambling on the quality of life, public health position recognizes that gambling yields both potential costs (like a wide range of difficulties on the individuals, families, and communities either indirectly or directly but also negative consequences of gambling like disorders) and benefits (like sense of connectedness and socialization through discretionary leisure time entertainment, enhancing the income of the individuals, strengthening memory, coping strategies and etc) that affect all aspects of the community, including health and socioeconomic dimensions. Keywords: Culture; Gambling; Motivation; Quality of life