Cognitive distortions and ADHD in pathological gambling: A national longitudinal case-control cohort study

J Behav Addict. 2016 Dec;5(4):649-657. doi: 10.1556/2006.5.2016.070. Epub 2016 Oct 24.

Abstract

Introduction The primary outcome of our study was to assess the links between the level of cognitive distortions and the severity of gambling disorder. We also aimed at assessing the links between patient gambling trajectories and attention deficit and hyperactivity disorder (ADHD). Materials and methods The study population (n = 628) was comprised of problem and non-problem gamblers of both sexes between 18 and 65 years of age, who reported gambling on at least one occasion during the previous year. Data encompassed socio-demographic characteristics, gambling habits, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey - 23, the Wender Utah Rating Scale - Child, and the Adult ADHD Self-report Scale. Results The cognitive distortions with the greatest correlation to the severity of gambling disorder were the "Chasing" and "Emotions." These two dimensions were able to distinguish between problem gamblers seeking treatment or not. While age of onset of gambling and length of gambling practice were not associated with the level of distorted cognitions, a period of abstinence of at least 1 month was associated with a lower level of distorted cognitions. The presence of ADHD resulted in a higher level of distorted cognitions. Conclusion Cognitive work is essential to the prevention, and the treatment, of pathological gambling, especially with respect to emotional biases and chasing behavior. The instauration of an abstinence period of at least 1 month under medical supervision could be a promising therapeutic lead for reducing gambling-related erroneous thoughts and for improving care strategies of pathological gamblers.

Keywords: ADHD; adults; chasing; cognitive distortions; emotions; gambling.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Case-Control Studies
  • Cognition Disorders / complications
  • Cognition*
  • Emotions
  • Female
  • Gambling / complications
  • Gambling / psychology*
  • Gambling / therapy
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Psychiatric Status Rating Scales
  • Severity of Illness Index
  • Socioeconomic Factors
  • Thinking*
  • Young Adult

Grants and funding

Funding sources: This study received contributions from the French Inter-Departmental Mission for the fight against drugs and drug addiction (MILDT) and the French National Institute of Health and Medical Research (INSERM), as a part of a call for research projects launched by these two organizations in 2007 (MIL08010), and a grant from the French Ministry of Health (PHRC 2009 – RCB 2008-A01188-47). There were no publishing constraints. This research was conducted on the initiative of, and coordinated by, the Clinical Investigation Unit “BALANCED” (BehaviorAL AddictioNs and ComplEx mood Disorders) of the University Hospital of Nantes, who sponsored for this study.