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Abstract

Aim of the present study was to investigate affective and cognitive processes underlying self-narratives of patients with gambling disorder through a verbal language analysis. A semistructured interview was administered to 30 patients with gambling disorder (GD) (24 males and 6 females; mean age: 46.63 ± 9.08) concerning the various thematic areas of their condition: definition of addiction, onset and maintenance of the addiction, relapses, desire, loss of control, control strategies, and treatment. Word usage in the self-narratives was categorized using James Pennebaker's Linguistic Inquiry and Word Count (LIWC) text-analysis software. Specifically, variables analyzed were emotion-related words, the use of pronoun-related words, and tense-related words. The findings showed a higher percentage of negative emotion-related words in the thematic areas of the definition of addiction, maintenance, and loss of control compared with other areas, which may suggest an emotional dysregulation; a higher percentage of first person singular-related words than other person-related words which decreases in the thematic areas of the desire, relapse, and loss of control, which may suggest dissociative phenomena; lastly, a high percentage of present tense-related words, which suggested a static and rigid representation of one's dependency condition in GD patients and a difficulty to self-project into the future. Overall, the linguistic analysis revealed critical issues in affective and cog-nitive processes in specific phases of addiction in GD patients which could help guide treatment.

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... A tal proposito il nostro gruppo di ricerca sta conducendo da un paio d'anni una ricerca sui racconti dei soggetti in trattamento per dipendenze al fine di individuare eventuali marcatori narrativi e linguistici specifici per le diverse fasi della dipendenza e del recupero. I primi dati della ricerca sono stati pubblicati in due diversi lavori scientifici (Altavilla et al. 2020;Canali et al. 2021). Questo articolo esaminerà alcuni aspetti salienti dei risultati già ottenuti e pubblicati. ...
... In tale ricerca abbiamo indagato gli aspetti psicologico-narrativi coinvolti nelle dipendenze, specificamente nel DUS e nel DGA, attraverso un'analisi quali-quantitativa multidimensionale di un'intervista semi-strutturata, che ha invitato due gruppi di soggetti dipendenti in trattamento (DGA e DUS) a raccontare le varie fasi della dipendenza. Più avanti illustreremo anche i risultati di un altro studio da noi condotto sulle narrazioni autobiografiche prodotte da pazienti con DGA pubblicato nel 2020 su Addictive Disorders & Their Treatment (Altavilla et al., 2020). I risultati principali di questi due lavori si sono dimostrato molto coerenti tra loro. ...
... Ciò suggerisce che, sebbene in alcune fasi specifiche i soggetti dipendenti si raccontino come agenti, le azioni dei soggetti sembrano essere principalmente legate a un locus of control esterno; cioè, sebbene si sentissero responsabili delle loro azioni, tendevano ad attribuire la responsabilità del loro comportamento a forze esterne, come persone o altri eventi. Questa discrepanza e questa inclinazione ad attribuire agli altri le proprie colpe potrebbero essere interpretate come un sintomo di processi dissociativi legati alla scarsa integrazione del Sé, che secondo diversi studi caratterizzano i disturbi da dipendenza (Keane, 2002;Reith & Dobbie, 2012) e DGA (Altavilla et al., 2020;Imperatori et al., 2017;Penta, 2000;Rogier et al., 2020a;Schluter & Hodgins, 2019). A tal proposito, protocolli di intervento che, attraverso la narrazione, mirino ad aumentare la consapevolezza dei soggetti della propria autoefficacia nel controllo degli impulsi, potrebbero promuovere capacità di autocontrollo e regolazione emotiva per favorire processi di integrazione degli aspetti dissociati dell'esperienza, come motivazioni e azioni (Liotti & Farina, 2011). ...
Article
[Medicina delle Dipendenze. Italian Journal of the Addictions] Diversi studi hanno dimostrato che l’analisi della dimensione narrativa può rappresentare un valido strumento per far luce su alcuni aspetti psicologici critici; in questo senso, può essere utile per capire meglio il disturbo da dipendenza. Il presente articolo riporta tra l’altro alcuni tra i dati principali di una ricerca da noi condotta e pubblicata nella rivista Journal of Gambling Issues nel 2021. In tale ricerca abbiamo indagato gli aspetti psicologico-narrativi coinvolti nelle dipendenze, specificamente nel DUS e nel DGA, attraverso un’analisi quali-quantitativa multidimensionale di un’intervista semi-strutturata, che ha invitato due gruppi di soggetti dipendenti in trattamento (DGA e DUS) a raccontare le varie fasi della dipendenza. Le analisi narrative multidimensionali da noi condotte sembrano aver portato alla luce alcuni punti critici su cui focalizzare l’attenzione per la costruzione di un adeguato trattamento dei soggetti con dipendenza. Nello specifico, i risultati suggerirebbero la necessità di lavorare su aspetti dissociati del Sé al fine di: 1) favorire il processo di integrazione di motivazioni e azioni, aumentando la consapevolezza e il senso di autoefficacia, soprattutto con i giocatori d’azzardo; 2) migliorare la coerenza globale nella narrazione del desiderio al fine di diminuire la disregolazione emotiva tipica di questa fase; 3) migliorare la capacità di proiezione del Sé nel tempo. Quest’ultimo punto potrebbe essere particolarmente rilevante in una prospettiva di intervento riabilitativo, soprattutto per quanto riguarda gli strumenti di trattamento legati alla dimensione narrativa. Il rapporto circolare tra regolazione dell’impulsività, autocontrollo, integrità dell’Io, funzioni cognitive e dimensione narrativa trova nel fattore temporale uno dei principali perni comuni.
... This association has recently been evidenced in language analysis. For instance, more negative emotional words has been found in gambling disorder patients' narratives (35). Differently, positive emotions promote health, including broadening and building social, physical, and cognitive resources (36), increasing self-rated health and life satisfaction (37), facilitating flexibility in thinking (38), and reducing suicide risk (39). ...
... Whereas, in SUD research, such associations are often overlooked and not consistent. For example, using the same language analysis method based on word count frequency, Linguistic Inquiry and Word Count (LIWC (59)), one (18) failed to predict future alcohol relapse with firstperson singular pronouns extracted from online forums; another study (60) found that the use of first-person singular pronoun "I" was positively correlated with tobacco, alcohol, and other substance use via Facebook language analysis; while a different study (35) found gambling disorder patients use less first-person singular pronouns in narratives about the definition of addiction and relapse, compared with that in their narratives about the onset and maintenance of the addiction. It remains unclear how the use of personal pronouns could be associated with SUD treatment outcomes. ...
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Background: Early indicators of who will remain in – or leave – treatment for substance use disorder (SUD) can drive targeted interventions to support long-term recovery. Objectives: To conduct a comprehensive study of linguistic markers of SUD treatment outcomes, the current study integrated features produced by machine learning models known to have social-psychology relevance. Methods: We extracted and analyzed linguistic features from participants’ Facebook posts (N = 206, 39.32% female; 55,415 postings) over the two years before they entered a SUD treatment program. Exploratory features produced by both Linguistic Inquiry and Word Count (LIWC) and Latent Dirichlet Allocation (LDA) topic modeling and the features from theoretical domains of religiosity, affect, and temporal orientation via established AI-based linguistic models were utilized. Results: Patients who stayed in the SUD treatment for over 90 days used more words associated with religion, positive emotions, family, affiliations, and the present, and used more first-person singular pronouns (Cohen’s d values: [−0.39, −0.57]). Patients who discontinued their treatment before 90 days discussed more diverse topics, focused on the past, and used more articles (Cohen’s d values: [0.44, 0.57]). All ps < .05 with Benjamini-Hochberg False Discovery Rate correction. Conclusions: We confirmed the literature on protective and risk social-psychological factors linking to SUD treatment in language analysis, showing that Facebook language before treatment entry could be used to identify the markers of SUD treatment outcomes. This reflects the importance of taking these linguistic features and markers into consideration when designing and recommending SUD treatment plans.
... Another fruitful way to analyze both the construction and alteration of self in reference to language use in conditions like ASD, SCZ and synesthesia is to investigate the narrative dimension (e.g., Giddens, 1991;McAdams & McLean 2013;Allé et al. 2015;Adornetti and Ferretti 2021). This view is founded on the position that human beings construct their own identities by means of stories, e.g., by producing autobiographical narratives (Schechtman 1996;McAdams 2001;Habermas & de Silveira 2008;Altavilla et al. 2020;Canali et al. 2021). Paradigmatic of this perspective is Bruner's constructivist model of personal identity (e.g., Bruner 2003Bruner , 2004. ...
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Recent research has proposed that certain aspects of psychosis, as experienced in, e.g., schizophrenia (SCZ), but also aspects of other cognitive conditions, such as autism spectrum disorders (ASD) and synesthesia, can be related to a shattered sense of the notion of self. In this paper, our goal is to show that altered processing of self can be attributed to an abnormal functioning of cortico-striatal brain networks supporting, among other, one key human distinctive cognitive ability, namely cross-modality, which plays multiple roles in human cognition and language. Specifically, our hypothesis is that this cognitive mechanism sheds light both on some basic aspects of the minimal self and on some aspects related to higher forms of self, such as the narrative self. We further link the atypical functioning in these conditions to some recent evolutionary changes in our species, specifically, an atypical presentation of human self-domestication (HSD) features. In doing so, we also lean on previous work concerning the link between cognitive disorders and language evolution under the effects of HSD. We further show that this approach can unify both linguistic and non-linguistic symptoms of these conditions through deficits in the notion of self. Our considerations provide further support for the hypothesis that SCZ and ASD are diametrically opposed cognitive conditions, as well for the hypothesis that their etiology is associated with recent human evolution, leading to a deeper understanding of the causes and symptoms of these disorders, and providing new cues, which can be used for an earlier and more accurate diagnostics.
... This suggests that, although in certain specific phases addicted subjects narrate themselves as agents, the subjects' actions seem to be mainly related to an external locus of control; that is, although they felt to be agents of their actions, they tended to attribute responsibility for their behaviour to external forces, such as people or other events. This discrepancy and this inclination to blame others for their own faults could be interpreted as a symptom of dissociative processes tied to poor self-integration, which according to several studies characterizes addictive disorders (Keane, 2002;Reith & Dobbie, 2012) and GD (Altavilla et al., 2020;Imperatori et al., 2017;Rogier et al., 2019;Schluter & Hodgins, 2019). In this regard, intervention protocols that, through narration, aim to increase the subjects' awareness of their self-efficacy in being able to control impulses could promote self-control and emotional regulation skills to favour integration processes of dissociated aspects of experience, as motivations and actions (Liotti & Farina, 2011). ...
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Several studies have shown that the analysis of the narrative dimension may represent a useful instrument to shed light on certain critical psychological aspects; to this extent, it might also be fruitful to understand better the addiction disorder. The present study aimed to investigate the critical psychological-narrative aspects involved in Gambling Disorder (GD). A semi-structured interview, one which invited participants to narrate the various phases of addiction (addiction definition, onset, chronicization, relapse, desire, loss of control, control strategies, treatment, future behaviours with respect to the object of addiction), was administered to two groups of subjects in treatment: thirty with GD and eighteen with Substance Use Disorder (SUD). A quali-quantitative multidimensional analysis of this interview was performed. The dependent variables were psychological aspects (agency, passivity, locus of control, motivation) and narrative variables (global narrative coherence and self-projection into the future). The main findings showed that the GD presented a higher sense of agency, passivity, external locus of control and external motivation compared to SUD. Both groups showed a lower global narrative coherence score during the narration of desire (craving) compared to other phases. Moreover, both groups showed an absent self-projection into the future. The findings could be linked to possible impairment of the integration of the self, emotional dysregulation and low self-control typical in addiction. In conclusion, the present study highlighted the importance of the narrative dimension to detect certain critical points in the addiction condition on which to potentially address the treatment.
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This study aimed to first investigate the interplay among self-rated ability in both retrospective and prospective memory, time perspective, and negative affectivity to gambling severity. Two hundred and three habitual players took part in the study. Participants were administered the South Oaks Gambling Screen (SOGS), the Consideration of Future Consequences scale (CFC-14), the Prospective and Retrospective Memory Questionnaire (PRMQ), as well as the Depression, Anxiety and Stress Scales-21 (DASS-21). Overall, data indicated that the higher the involvement in gambling, the higher the depression levels and the shorter the time horizon. The results of linear regression analysis showed that, along with gender, years of education, depression, and inattention to the future consequences of actual behavior, the negative self-perception of prospective memory functioning represents a significant predictor of gambling severity. Finally, to clarify if depression was on the path from prospective memory to gambling severity or if prospective memory was the mediator of the impact of depression on gambling severity, data were submitted to path analysis. Results indicated that depression has a direct effect on gambling severity and mediates the association between prospective memory and gambling involvement. The relation between gambling severity and prospective memory scores suggests that impairment in prospective memory plays a key role in adult problematic gambling.
Article
Gambling may constitute a strategy for coping with depressive mood, but a direct influence of depressive mood on gambling behaviors has never been tested via realistic experimental designs in gamblers. The current study tested whether experimentally-induced sadness increases persistence on a simulated slot machine task using real monetary reinforcement in recreational gamblers. Sixty participants were randomly assigned to an experimental (sadness induction) or control (no emotional induction) condition, and then performed a slot machine task consisting of a mandatory phase followed by a persistence phase. Potential confounding variables (problem gambling symptoms, impulsivity traits, gambling cognitions) were measured to ensure that the experimental and control groups were comparable. The study showed that participants in the sadness condition displayed greater gambling persistence than control participants (p=.011). These data support the causal role of negative affect in decisions to gamble and persistence, which bears important theoretical and clinical implications.
Article
We analyzed the verbal behavior of patients with mood or/and anxiety disorders during psychotherapy. Investigating the words people used, we expected differences due to cognitive and emotional foci in patients with depression vs. anxiety. Transcripts of therapy sessions from 85 outpatients treated with cognitive behavioral therapy were analyzed using the software program Linguistic Inquiry and Word Count. Multivariate group comparisons were carried out investigating the LIWC-categories first-person-singular pronouns, sad, anxiety and fillers. Differences between the three diagnostic groups were found in verbal utterances related to sadness (p = .05). No differences were found for first-person-singular pronouns and content-free fillers. Comparing the distinct groups “depression” and “anxiety”, depressed patients used more words related to sadness (p = .01). Mood and anxiety disorders differ in the experience of emotions, but only slightly in self-focused attention. This points to differences in language use for different diagnostic groups and may help to improve diagnostic procedures or language-driven interventions which enhance therapists’ attention to patients’ verbal behavior.
Article
Background: The new version of Diagnostic and Statistical Manual of Mental Disorders (DSM-5th) proposed the Internet Gaming Disorder for the diagnosis of Internet addiction (IA) considering the neurobiological evidence of the craving. Aims: The aim was to test the neural correlate in response to the Internet cue in patients with IA. Methods: Sixteen males with IA diagnosis (clinical group) and 14 healthy male (control group) were recruited for an experimental visual task composed of Internet images and emotional images. During the visual presentation of Internet cue, electroencefalographic data were recorded using Net Station 4.5.1 with a 256-channels HydroCel Geodesic Sensor Net. Event- related potential (ERP) components and low-resolution electromagnetic tomography (sLoreta) were analysed. Results: sLoreta analyses showed that patients from the clinical group presented a higher primary somatosensorial cortex and lower paralimbic, temporal and orbito-frontal activation in response to both Internet and emotional images compared to those of the control group. Conclusions: These results suggest that clinically recognized pathological use of Internet could be linked to dissociative symptoms.
Article
This study investigated the ability of individuals with disordered gambling to imagine future events. Problem gamblers (n=35) and control participants (n=35) were asked to imagine positive and negative future events for three temporal distances (one week, one year, 5-10 years). Then, a variety of phenomenological aspects of their future thoughts (e.g., sensory and contextual details, autonoetic consciousness) were rated. Compared to control subjects, problem gamblers generated fewer positive and negative events across all temporal distances, an impairment that was correlated to verbal fluency scores. Furthermore, problem gamblers rated imagined events as containing fewer sensory and contextual details, and lacking autonoetic consciousness. These findings demonstrate that problem gambling is associated with a reduced future-oriented mental time travel ability and, in particular, with diminished autonoetic consciousness when imagining future events.
Article
Few studies have examined the relationships between emotion regulation, autobiographical memory and autobiographical narrative despite evidence that suggests that these constructs are linked. The lack of research is likely ascribed to the specificity of the construct of emotion regulation. The present review examines this area of investigation and indicates two directions for the research: first, emotion regulation is considered to be an effect of autobiographical narratives; thus, individuals engage in the construction of a life story to regulate emotions. Second, emotion regulation is an ability that improves the processes of encoding and retrieving memories. The results of this research are presented, and the potential developments are discussed in terms of the relations among these three constructs.
Article
Introduction Since many psychopathological traits seem to be related to Gambling Disorder (GD), impulsivity, alexithymia and dissociation could play a central role in gambling behaviors, particularly in pathological gambling. We test this hypothesis in four distinct samples of gamblers, three undergoing different types of treatments and a control group. Methods The study sample consists of 204 subjects (males 87.3%, mean age = 47.75 years, SD= 12.08) divided into four groups: 1) 59 subjects belonging to an Outpatients Treatment Program in the National Health System (NHS); 2) 60 subjects of an Outpatients Self-Help Group Program; 3) 35 subjects belonging to a Residential Treatment Program (Inpatients Program); and 4) 50 subjects without gambling problems (Control Group). Results Results show a positive relationship between gambling behaviors, impulsivity and alexithymia, and a negligible link between gambling behaviors and dissociation. Findings also display the presence of higher levels of all these features in pathological gamblers with higher scores on the SOGS, and particularly, in participants attending a Residential Treatment Program (Inpatients Program). Conclusions This study confirms the hypothesis of the presence of higher levels of impulsivity, alexithymia and dissociation in pathological gamblers with a greater severity and seems to indicate a significant importance of impulsivity and alexithymia in predicting gambling behaviors.
Article
During early development, every human being is exposed to the relative impact of relational trauma – disconfirmation of aspects of oneself as having legitimate existence in the world of others – in shaping both the capacity for spontaneous human relatedness and the relative vulnerability to “adult-onset trauma.” To one degree or another, a wave of dysregulated affect – a dissociated “tsunami” – hits the immature mind, and if left relationally unprocessed leaves a fearful shadow that weakens future ability to regulate affect in an interpersonal context and reduces the capacity to trust, sometimes even experience, authentic human discourse.
Article
Objective: the main purpose of this study is to investigate the emotional and temperamental characteristics associated with gambling in Italy and to compare different groups of people on the basis of their risk of gambling: low-risk gamblers, problem gamblers, and pathological gamblers. Particularly, we examined the possible discriminant functions of perception of control, locus of control (whether internal or chance-based; that is, devoted to fate), and emotion-regulation strategies (cognitive reappraisal and expressive suppression). Method: a total of 251 adult regular gamblers (142 males and 109 females) recruited from different betting and bingo halls completed self-report questionnaires on gambling behaviors, lack of control as temperamental dimension, locus of control and emotional regulation strategies. Results: pathological gamblers, in comparison to low-risk gamblers, had lower levels of internal locus of control and cognitive reappraisal and higher levels of chance locus of control. Results from a discriminant function analysis have underlined the presence of two distinct functions: the former, named “unmanageable and stressful fate,” describes an egosyntonic position to gambling; the latter, named “I’d like to resist,” describes the egodystonic position to gambling. Conclusions: findings suggest considering regular gamblers as a heterogeneous group with respect to their attitudes towards their addiction. This can have important implications for their treatment.
Chapter
This chapter introduces a comprehensive descriptive model of which aspects of autobiographical memory narratives may be distorted in diverse clinical disorders, by defense and coping efforts, and how they may change in the course of psychotherapy. The different features will be systematically related to each other by the concepts of narrative perspective and emotion. Narrative perspective helps organize the narrative features, and emotion is assumed to be the motivating force behind the distortions. To indicate the organizing power of the model, various constructs that capture distortions of autobiographical memories are located within the model, thus creating an integrative framework. Selected disorders and selected findings on the process of coping and psychotherapy are also interpreted in terms of the model. The general approach to clinical dysfunctions of autobiographical memory is a narrative one, which is inspired by basic tenets of psychoanalysis.
Article
Each individual has a life story, and it is this story that gives us an identity, allowing us to exist and function among one another. It is natural for us to communicate through narratives. The process of creating a sense of identity through storytelling allows us to participate in interpersonal relationships, while constructing and sustaining a satisfying self-concept. Through a unique interplay of managing emotional experiences and constructing a way of communicating those experiences to others, and ourselves, we begin to construct who we think we are. This research study uses both oral and written narratives, full of emotion, as a means to uncover identity development. By researching both dimensions of narrative, this study reveals not only the tensions that exist between expressing our emotions and maintaining an acceptable image within organizations, but also shows the reality between how we see ourselves and how we want others to see us.
Article
When people write about their deepest thoughts and feelings about an emotionally significant event, numerous benefits in many domains (e.g., health, achievement, and well-being) result. As one step in understanding how writing achieves these effects, we have developed a computer program that provides a “fingerprint” of the words people use in writing or in natural settings. Analyses of text samples indicate that particular patterns of word use predict health and also reflect personality styles. We have also discovered that language use in the laboratory writing paradigm is associated with changes in social interactions and language use in the real world. The implications for using computer-based text analysis programs in the development of psychological theory are discussed.
Article
Recent years have witnessed an upsurge of interest among theorists and researchers in autobiographical recollections, life stories, and narrative approaches to understanding human behavior and experience. An important development in this context is D. P. McAdams's life story model of identity (1985; see also records 1993-97296-000 and 1996-06098-001), which asserts that people living in modern societies provide their lives with unity and purpose by constructing internalized and evolving narratives of the self. The idea that identity is a life story resonates with a number of important themes in developmental, cognitive, personality, and cultural psychology. This article reviews and integrates recent theory and research on life stories as manifested in investigations of self-understanding, autobiographical memory, personality structure and change, and the complex relations between individual lives and cultural modernity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The principles of narrative therapy imply that autobiographical diaries written by patients in treatment will not only facilitate but also elucidate progress. The relationship between the linguistic content of diaries and progress in treatment was examined in this study. Complete sets of daily diaries of ‘significant events’ written by 16 patients receiving treatment for drug, alcohol and food addictions at a residential centre, using the 12-step approach of the Anonymous fellowships, were typed up for analysis. Three forms of socio-linguistic enquiry were employed: narrative characterization; evaluative statement coding and computer analysis of word strategies. Results indicated that success in treatment as rated by counselling and psychiatric staff was associated with the following characteristics of diary narratives. They are (a) focused on individual progress, whether adopting a ‘positive interpretative’ or ‘negative reactive’ style; (b) less critical of self over time and more positive about others external to the treatment centre; (c) both positive about the treatment programme and critical of self; (d) using words indicative of ‘insight’ and ‘negativity’ as assessed by Pennebaker's LIWC programme. It is concluded that autobiographical material can usefully be employed to assess progress in treatment, and that its intrinsic value in effecting change should be further explored. © 1997 John Wiley & Sons, Ltd.
Article
The concept of emotion regulation features in many models of psychopathology and it has been proposed that individuals with poorly regulated emotions often engage in maladaptive behaviours to escape from or down-regulate their emotions, creating risk for a range of disorders. One such disorder may be pathological gambling. To our knowledge, no study had assessed the use of emotion-regulation strategies in this population. The goal of the present study was therefore to examine emotion-regulation difficulties among a sample of pathological gamblers (n= 56), a mixed clinical comparison group (n= 50), and a sample of healthy community controls (n= 49). Multivariate analysis of variance controlling for age. Participants were recruited from the community and a gambling treatment unit in Australia and completed clinical diagnostic interviews (ADIS-IV; SCIP), self-report measures of psychopathology (DASS-21), substance use (AUDIT), and emotion-regulation difficulties (DERS; ERQ). Pathological gamblers and the clinical comparison group reported significantly less use of reappraisal as an adaptive emotion-regulation strategy, and reported a greater lack of emotional clarity and more impulsivity than individuals in the healthy community comparison group. Pathological gamblers reported a greater lack of emotional awareness compared to the healthy control group and reported differences in access to effective emotion-regulation strategies compared to both comparison groups. The results support specific deficits of emotion regulation in pathological gamblers and emphasize the need to address these underlying vulnerabilities in addition to directly targeting gambling behaviours in therapy.
Article
Delayed reward discounting (DRD) is a behavioral economic index of impulsivity and numerous studies have examined DRD in relation to addictive behavior. To synthesize the findings across the literature, the current review is a meta-analysis of studies comparing DRD between criterion groups exhibiting addictive behavior and control groups. The meta-analysis sought to characterize the overall patterns of findings, systematic variability by sample and study type, and possible small study (publication) bias. Literature reviews identified 310 candidate articles from which 46 studies reporting 64 comparisons were identified (total N=56,013). From the total comparisons identified, a small magnitude effect was evident (d= .15; p< .00001) with very high heterogeneity of effect size. Based on systematic observed differences, large studies assessing DRD with a small number of self-report items were removed and an analysis of 57 comparisons (n=3,329) using equivalent methods and exhibiting acceptable heterogeneity revealed a medium magnitude effect (d= .58; p< .00001). Further analyses revealed significantly larger effect sizes for studies using clinical samples (d= .61) compared with studies using nonclinical samples (d=.45). Indices of small study bias among the various comparisons suggested varying levels of influence by unpublished findings, ranging from minimal to moderate. These results provide strong evidence of greater DRD in individuals exhibiting addictive behavior in general and particularly in individuals who meet criteria for an addictive disorder. Implications for the assessment of DRD and research priorities are discussed.
Article
Cognitive models of social anxiety disorder (SAD) posit aberrant beliefs about the social self as a key psychological mechanism that maintains fear of negative evaluation in social and performance situations. Consequently, a distorted self-view should be evident when recalling painful autobiographical social memories, as reflected in linguistic expression, negative self-beliefs, and emotion and avoidance. To test this hypothesis, 42 adults diagnosed with SAD and 27 non-psychiatric healthy controls (HC) composed autobiographical narratives of distinct social anxiety related situations, generated negative self-beliefs (NSB), and provided emotion and avoidance ratings. Although narratives were matched for initial emotional intensity and present vividness, linguistic analyses demonstrated that, compared to HC, SAD employed more self-referential, anxiety, and sensory words, and made fewer references to other people. There were no differences in the number of self-referential NSB identified by SAD and HC. Social anxiety symptom severity, however, was associated with greater self-referential NSB in SAD only. SAD reported greater current self-conscious emotions when recalling autobiographical social situations, and greater active avoidance of similar situations than did HC. These findings support cognitive models of SAD, and suggest that autobiographical memory of social situations in SAD may influence current and future thinking, emotion, and behavioral avoidance.
Article
Using Goffman's theory and the methods of narrative analysis, the paper examines the divorce account of a white working-class man with advanced multiple sclerosis to show how he constructs a definition of his divorcing situation, and a positive masculine identity, despite massive disability. He accomplishes this positive self through narrative retelling of key events in his biography, healing discontinuities by the way he structures his account in interaction with the listener. The strategic choice of genre, or forms of narrative, guides the impression we form of him. From this case study, I show the usefulness of close textual analysis of biographical accounts of illness.
Article
Writing about important personal experiences in an emotional way for as little as 15 minutes over the course of three days brings about improvements in mental and physical health. This finding has been replicated across age, gender, culture, social class, and personality type. Using a text-analysis computer program, it was discovered that those who benefit maximally from writing tend to use a high number of positive-emotion words, a moderate amount of negative-emotion words, and increase their use of cognitive words over the days of writing. These findings suggest that the formation of a narrative is critical and is an indicator of good mental and physical health. Ongoing studies suggest that writing serves the function of organizing complex emotional experiences. Implications for these findings for psychotherapy are briefly discussed.
Article
On a decision-making instrument known as the "gambling task" (GT), a subgroup of substance dependent individuals (SDI) opted for choices that yield high immediate gains in spite of higher future losses. This resembles the behavior of patients with ventromedial (VM) prefrontal cortex lesions. In this study, we addressed the possibility that hypersensitivity to reward may account for the "myopia" for the future in this subgroup of SDI. We used a variant version of the GT, in which the good decks yielded high immediate punishment but higher delayed reward. The bad decks yielded low immediate punishment and lower delayed reward. We measured the skin conductance response (SCR) of subjects after receiving reward (reward SCR) and during their pondering from which deck to choose (anticipatory SCR). A subgroup of SDI who was not impaired on the original GT performed normally on the variant GT. The subgroup of SDI who was impaired on the original GT showed two levels of performance on the variant GT. One subgroup (36% of the sample) performed poorly on the variant GT, and showed similar behavioral and physiological impairments to VM patients. The other subgroup of SDI (64% of the sample) performed normally on the variant task, but had abnormally large physiological responses to reward, i.e. large SCR after receiving reward (reward SCR) and large SCR in anticipation of outcomes that yield large reward. Thus, the combined cognitive and physiological approach of assessing decision-making characterizes three sub-populations of SDI. One sub-population is without impairments that can be detected by any measure of the GT paradigm. Another sub-population is similar to VM patients in that they are insensitive to the future, both positive and negative. A third sub-population is hypersensitive to reward, so that the presence or the prospect of receiving, reward dominates their behavior.
Article
Some substance dependent individuals (SDI) suffer from a decision-making impairment akin to that seen in neurological patients with lesions of the ventromedial (VM) prefrontal cortex. The somatic-marker hypothesis posits that decision-making is a process that depends on emotion and that deficits in emotional signaling will lead to poor decision-making. In this study, we tested the hypothesis that SDI who perform disadvantageously on a decision-making instrument, the gambling task (GT), have a deficit in the somatic signals that help guide their decision in the advantageous direction. Since deficits in decision-making/somatic markers can also result from dysfunctional amygdala, we asked indirectly (i.e. via tests sensitive to VM or amygdala dysfunction) whether such a deficit in SDI is restricted to VM dysfunction or includes the amygdala. Using the GT, and skin conductance response (SCR) as an index of somatic state activation, we studied groups of SDI (n=46), normal controls (n=49), and VM patients (n=10). A subgroup of SDI showed defective performance on the GT coupled with impaired anticipatory SCR, but normal SCR to punishment, and normal acquisition of conditioned SCR to an aversive loud sound. This supports the hypothesis that the poor decision-making in some SDI is associated with defective somatic state activation that is linked to a dysfunctional VM cortex. Thus, the dysfunctional VM cortex underlying the "myopia" for the future in some SDI may be one of the principle mechanisms underlying the transition from casual substance taking to compulsive and uncontrollable behavior.
Article
To better understand pathological gambling, potential risk factors were assessed within three domains--gambling behaviors, substance abuse and other problem behaviors, and sociodemographic factors. A random-digit-dial telephone survey was conducted in 1999-2000 with a representative sample of the U.S. population aged 18 or older. The current analyses uses data from the 2168 respondents who gambled in the year before the interview. Gambling measures included the Diagnostic Interview Schedule (DIS)-IV for pathological gambling, frequency of 15 types of gambling, and size of win or loss on the last occasion. Other measures included the quantity and frequency of alcohol consumption, frequency of illicit drug use and criminal offending, and the DIS-IV for alcohol and drug abuse and dependence. Results showed that casino gambling is associated with a high risk of gambling pathology. Lottery, cards, and bingo are associated with a moderately high risk of gambling pathology. Participation in a greater number of types of gambling is strongly predictive of gambling pathology, even after frequency of gambling and size of win or loss are taken into account. Alcohol abuse is strongly predictive of gambling pathology, even with gambling behaviors held constant. Minority and low socioeconomic status (SES) group members have higher levels of gambling pathology than other groups after all other factors are considered.
Article
Pro-anorexia has emerged as a new and emotionally charged eating disorder phenomenon. This study explored the linguistic markers of differences in Internet self-presentation of self-identified pro-anorexics who defend anorexia as a lifestyle and self-identified anorexics in recovery. One hundred sixty-two Internet message board entries and 56 homepages originating from either pro-anorexics or recovering anorexics were analyzed for linguistic markers of emotional, cognitive, and social functioning, temporal focus, and anorexia-related psychological concerns. Across both text sources, pro-anorexics displayed more positive emotions, less anxiety, a lower degree of cognitive reflection, and lower levels of self-directed attention than did recovering anorexics. Pro-anorexics were also more focused on the present and less on the past. Finally, pro-anorexics were more preoccupied with eating and less with school-related issues and death. Linguistically, pro-anorexics and recovering anorexics engage in distinct psychological self-presentation styles. More research is needed to understand the clinical implications of these different linguistic styles.
La costruzione narrativa della realtà
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Linguistic inquiry and word count: LIWC 2001. Mahwah: Lawrence Erlbaum Associates
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Does gender moderate associations among impulsivity and health-risk behaviors?
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