P7 "Impulsivity in pathological gambling: Decomposing the construct to detect disorder-specific characteristics"
Dipl.-Psych. Anja Kräplin
Supervisor: Prof. Dr. Gerhard Bühringer
Submitted: 10.06.2014
Abstract
The clinical picture of pathological gambling (PG) is strongly related to the construct impul- sivity. While increasing evidence has suggested that impulsivity is a multidimensional con- struct, the specific role of different impulsivity dimensions in PG remains unclear. This disser- tation aimed to decompose impulsivity into sub-dimensions to shed new light on the specific patterns of impulsivity alterations 1) in PG compared with healthy controls (HCs), 2) in PG compared with other mental disorders and 3) regarding comorbid mental disorders within PG.
In three cross-sectional studies PG was compared to HCs, to nicotine dependence (ND), to alcohol dependence (AD) and to Gilles de la Tourette syndrome (GTS). The studies applied a broad assessment battery of different behavioral and self-report measures acquiring the four dimensions response, choice and attentional impulsivity, as well as sensation seeking.
The main results are as follows: 1) PG is associated with a specific impulsivity profile com- pared to HCs, which is characterized by increased response and choice impulsivity whereas attention impulsivity and sensation seeking are comparable. 2) Heightened scores in impul- sivity are not disorder-specific for PG compared to ND, AD or GTS. PG is only specifically re- lated to increased choice impulsivity compared to ND and GTS and 3) PG comorbid with ND is also related to additive increased choice impulsivity compared with ND alone.
The current research has demonstrated that dysfunctions in inhibition-related and valuation- related brain networks may be a core characteristic of PG resulting in lower inhibitory control in responses and a changed valuation of outcomes in choices. However, those alterations are not disorder-specific for PG supporting the importance to development mechanism-targeted rather than disorder-specific intervention strategies. In addition to well implemented control strategies in therapy, computer-aided neurocognitive trainings may be effective to enhance unconscious processes. The obtained intact attention and planning abilities in PG may be used in therapy for the formation and monitoring of implementation intentions.