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Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study

DOI:10.1007/s10899-018-9764-0
Authors:
Vittorio Lutri at Università degli Studi di Milano-Bicocca
Vittorio Lutri
Emiliano Soldini at University of Applied Sciences and Arts of Southern Switzerland
Emiliano Soldini
Silvia Ronzitti at Yale University - VA Hospital
Silvia Ronzitti
  • Yale University - VA Hospital
Neil Smith at Central and North West London NHS Foundation Trust
Neil Smith
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Abstract

Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes—rather than high-stakes—gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.
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J Gambl Stud (2018) 34:1341–1354
https://doi.org/10.1007/s10899-018-9764-0
1 3
ORIGINAL PAPER
Impulsivity andGambling Type Among
Treatment‑Seeking Disordered Gamblers:
AnExplorative Study
VittorioLutri1 · EmilianoSoldini2· SilviaRonzitti1· NeilSmith3·
MassimoClerici1· AlexBlaszczynski4· HenriettaBowden‑Jones3
Published online: 3 March 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract Several studies have found that certain traits of impulsivity are associated with
gambling disorder, and influence its severity. Furthermore, it has been suggested that some
forms of gambling, particularly electronic gambling machines, are particularly widespread
among pathological gamblers. In the present, exploratory study, we aim to clarify the role
played by impulsivity in influencing the choice of specific gambling activities, by examin-
ing the relation between individual dimensions of impulsivity, and the choice of specific
gambling activities in a clinical population. 100 consecutively admitted pathological gam-
blers at the National Problem Gambling Clinic in London (UK) in 2014 were administered
the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index,
and underwent a structured interview concerning their gambling activities in the month
and year prior to assessment. The correlation between individual gambling activities and
impulsivity dimensions was analyzed both at a bivariate level, and using logistic regres-
sion. We found a significant correlation between Negative Urgency, Motor impulsivity and
low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency
to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash
action and restlessness) might be mediating factors in the choice of electronic gambling
machines, particularly among patients whose gambling is escape-oriented. Structural and
situational characteristics of gambling machines, particularly the widespread availability of
low-stakes—rather than high-stakes—gaming machines, might concur to the choice of this
form of gambling among individuals who present higher negative urgency and restlessness.
* Vittorio Lutri
Vittorio.Lutri@chuv.ch
1 Department ofMedicine andSurgery, Università degli Studi di Milano – Bicocca, Milan, Italy
2 Methodology andStatistics Laboratory, Department ofBusiness Economics, Health andSocial
Care, University ofApplied Sciences andArts ofSouthern Switzerland, Manno, Switzerland
3 National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London,
UK
4 School ofPsychiatry, University ofNew South Wales, Sydney, Australia
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
... One of the facets of emotion dysregulation is difficulties in controlling impulses, highly related to GD [19,37,80]. Specifically, Positive urgency, Negative urgency, and Lack of premeditation are the dimensions of the UPPS-P model more strongly associated with GD [26,32]. ...
... These results are in accordance with some studies that analyzed differences between different types of games. Slot machine gamblers seem to score higher in Positive urgency compared to other types of gamblers, including online gamblers [80]. The fact that 70% of land-based GD patients in our sample showed a preference for slot machines could explain the finding of a higher Positive urgency score for this group. ...
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... One of the facets of emotion dysregulation is difficulties in controlling impulses, highly related to GD [19,37,80]. Specifically, Positive urgency, Negative urgency, and Lack of premeditation are the dimensions of the UPPS-P model more strongly associated with GD [26,32]. ...
... These results are in accordance with some studies that analyzed differences between different types of games. Slot machine gamblers seem to score higher in Positive urgency compared to other types of gamblers, including online gamblers [80]. The fact that 70% of land-based GD patients in our sample showed a preference for slot machines could explain the finding of a higher Positive urgency score for this group. ...
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... This may reflect impulsivity-driven characteristics and a certain easily bored mindset, which both frequent offending and fast-paced EGM gambling could potentially feed. Gambling with fast-paced EGMs may be used to relieve tension or boredom (Clarke 2004;Sundqvist et al. 2016, Lutri et al. 2018. It is possible that difficulties in emotion regulation (see, e.g. ...
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... Based on the Diagnostic and Statistical Manual Fifth Edition, gambling disorder (GD) is an addictive condition characterized by persistent and recurrent problematic gambling behavior that generates clinically significant levels of distress and impairments in functioning (American Psychiatric Association, 2013). Although the DSM-5 disorder does not specify types of gambling activities, there is evidence suggesting that certain forms of gambling may be associated with greater risks for the development of GD (Lutri et al., 2018;Stevens & Young, 2010;Williams et al., 2021). Due to sports betting in both online and offline forms increasing in popularity, it is essential to identify demographic and clinical characteristics associated with the risk for the development of GD associated with sports betting. ...
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... Although impulsive tendencies may be shared across both disorders, the dimensions may be related differently. For example, attentional impulsivity (AI) has been closely related to MAUD (Su et al., 2014), whereas motor impulsivity (MI) and non-planning impulsivity (NPI) have been closely related to GD (Lutri et al., 2018). Thus, there may be differences in the predictive properties of impulsive tendencies with respect to different types of addictive disorders (Leeman & Potenza, 2012). ...
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Methamphetamine use disorder (MAUD) and gambling disorder (GD) frequently co-occur. Individuals with both conditions are typically more difficult to treat than those with either disorder alone. This study aimed to investigate the co-occurrence and clinical characteristics of people with MAUD and GD. Between March 2018 and August 2020, 350 men with methamphetamine use entering a compulsory drug rehabilitation center in Changsha, Hunan Province received semi-structured interviews. Participants completed the Barratt Impulsiveness Scale-11 and provided information on childhood upbringings and drug use characteristics. Independent sample t-tests compared differences between individuals with MAUD and with and without co-occurring GD. Dichotomous logistic regression was used to statistically predict co-occurring GD. The prevalence of GD was 45.1%. Most individuals (39.1% overall) had post-onset methamphetamine use (PoMAU-GD). The number of MAUD symptoms, history of gambling by family members, age of first sexual activity, and non-planning impulsivity statistically predicted PoMAU-GD, jointly explaining 24.0% of the total variance. The regression model fit well (HLχ2 = 5.503, p = 0.70), in which the specificity was 0.80, the sensitivity was 0.64, and the area under the curve was 0.79 (95%CI: 0.75-0.84). This study clarifies the prevalence of and potential risk factors for GD among individuals engaging in compulsory MAUD treatment in China. The high prevalence and associated clinical features of GD in the MAUD group highlight the importance of screening for GD in this population and intervening accordingly.
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... Trait impulsivity is typically measured through selfreport questionnaires, with two of the most widely used measures being the Barratt Impulsiveness Scale-11 (BIS-11; Patton, Stanford, & Barratt, 1995) and the UPPS-P (Lynam, Smith, Whiteside, & Cyders, 2006). Several studies have documented a relationship between scores on the BIS-11 and gambling (e.g., Marazziti et al., 2014), and in particular, a robust association between the motor aspect of the BIS-11 and disordered gambling (Lutri et al., 2018). A meta-analysis of motor-impulsivity and gambling found a large weighted mean effect size (0.96) for the BIS-motor subscale, suggesting motor impulsivity is important for understanding gambling disorder (Chowdhury, Livesey, Blaszczynski, & Harris, 2017). ...
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