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Subtyping individuals who binge eat by "diet-DT" and "depression" has yielded two valid and clinically useful subtypes that predict eating severity, comorbid psychopathology and outcome. The present study aimed to find four subtypes based on these dimensions and test their validity. Besides, it explored the distribution of eating disorder (ED) diagnoses across subtypes given their known heterogeneity, crossover and binge-eating fluctuation. Cluster analysis grouped 1005 consecutively admitted ED adult women into four subtypes, those previously described "DT" (22%), "DT-depressive" (29%), and "mild DT" (25%) and "depressive-moderate DT" (24%). Overall "mild DT" presented lower and "DT-depressive" greater eating and comorbid psychopathology than the rest, whereas "pure DT" and "depressive-moderate DT" presented no differences on bulimic symptoms but in psychopathology (p < .01). Finally, while BN-P patients were mostly and similarly distributed in the "DT" and "DT-depressive" subtypes than in the other, AN were in the new "mild DT" and "depressive-moderate DT" (p < .01). However, BN-NP, BED and EDNOS were similarly represented across subtypes. Results are discussed with regard to 1) the newly emerged subtypes that may explain cases in which DT prevents or does not predict binge eating; 2) the confluence of DT-depression that signaled greater eating and comorbid pathology, particularly self-control problems; 3) ED-DSM-diagnostic criteria.

We aimed to examine baseline predictors of treatment response in bulimic patients. 241 seeking-treatment females with bulimia nervosa completed an exhaustive assessment and were referred to a six-session psychoeducational group. Regression analyses of treatment response were performed. Childhood obesity, lower frequency of eating symptomatology, lower body mass index, older age, and lower family's and patient's concern about the disorder were predictors of poor abstinence. Suicidal ideation, alcohol abuse, higher maximum BMI, higher novelty seeking and lower baseline purging frequency predicted dropouts. Predictors of early symptom changes and dropouts were similar to those identified in longer CBT interventions.

The aim of this study was to measure the reliability, validity, and classification accuracy of a Spanish translation of a measure of DSM-IV diagnostic criteria for Pathological Gambling (PG). Participants were 263 male and 23 female patients seeking treatment for PG and a matched non-psychiatric control sample of 259 men and 24 women. A Spanish translation of a 19-item measure of DSM-IV diagnostic criteria for PG (Stinchfield 2003) was administered along with other validity measures. The DSM-IV diagnostic criteria were found to be internally consistent with a coefficient alpha of .95 in the combined sample. Evidence of satisfactory convergent validity included moderate to high correlations with other measures of problem gambling. Using the standard DSM-IV cut-score of five, the ten criteria were found to yield satisfactory classification accuracy results with a high hit rate (.95), high sensitivity (.92), high specificity (.99), low false positive (.01), and low false negative rate (.08). Lowering the cut score to four resulted in modest improvements in classification accuracy and reduced the false negative rate from .08 to .05. The Spanish translation of a measure of DSM-IV diagnostic criteria for PG demonstrated satisfactory psychometric properties and a cut score of four improved diagnostic precision.

Objectives The aim of this study was to understand the clinical impact of the motivational stage of change on the psychopathology and symptomatology of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS). Method The participants were 218 eating disorder (ED) patients (58 AN, 95 BN and 65 EDNOS), consecutively admitted to our hospital. All patients fulfilled DSM-IV criteria for these disorders. Assessment Assessment measures included the Eating Disorders Inventory (EDI), Bulimic Investigation Test Edinburgh (BITE), Beck Depression Inventory (BDI), four analogue scales of motivational stage, as well as a number of other clinical and psychopathological indices. Results Our results indicated higher motivation for change in BN than in AN and EDNOS patients (p

Data based on general population studies of exposure-to-risk factors is not adequate to describe the mental health of children living in the most extreme "high-risk" environments.Data were collected in a longitudinal prospective study of two cohorts of 9 and 13 year-old socially at-risk children. Cluster analysis was used to classify youths based on the reports about potential areas of risk. The psychopathological structure of empirical clusters was compared through cross-sectional and longitudinal epidemiological indexes and through multiple regression and multivariate analysis of variance.Cluster analysis provided eight binary high-low risk classifications. Exposure to risk was highly prevalent. In preadolescence, broken family, parenting style and contextual profiles were the highest risk factors for psychopathology. In adolescence, they were psychological variables, verbal comprehension, pre-peri-postnatal history, physical health and family characteristics. Cumulative risk followed a linear trend for psychopathology and functional impairment. The child's perception of low marital discord and good school achievement were protective factors.Extreme socially at-risk populations have specific profiles of risk that can be identified through a person-centered approach and may be amenable to selective preventive interventions.

There is a need to know whether callous-unemotional (CU) traits identify a more severe group of oppositional defiant children (ODD). The aim of this study is to ascertain cross-sectionally and longitudinally the specific contribution of CU levels and the presence of ODD in the psychological state of preschool children from the general population. A total of 622 children were assessed longitudinally at ages 3 and 5 with a semi-structured diagnostic interview and questionnaires filled out by parents and teachers. In multivariate models simultaneously including ODD diagnosis and CU levels, controlling by socioeconomic status, ethnicity, sex, severity of conduct disorder symptoms and other comorbidity, high CU scores were related to higher levels of aggression, withdrawn, externalizing and global symptomatology, functional impairment and higher probability of comorbid disorders and use of services. The contribution of CU traits on children's psychological state was not moderated by the presence/absence of ODD. Stability for CU traits and number of ODD-symptoms between ages 3 and 5 was statistically significant but moderate-low (intra-class correlation under .40). Assessment and identification of CU traits from preschool might help to identify a subset of children who could have socialization problems, not only among those with ODD but also among those without a diagnosis of conduct problems.

This paper reports rates of psychopathology in a population of 9- and 13-yr olds from a Spanish slum. Two cohorts of all the children born in 1989 and in 1993 and registered in the census of a municipality in 2001 were assessed over a 3-yr period with structured diagnostic interviews and functional measures. In the first year of the study 79 (53.7%) children of the adolescent 13-yr-old population and 72 (59.5%) of the pre-adolescent 9-yr-old population participated. Between 30% and 60% of preadolescents and between 30% and 50% of adolescents presented some mental disorder. Anxiety and disruptive behavior disorders were the most frequent disorders in both cohorts. For both genders, the highest risk for any psychopathology was at 10 yr. We found that, psychopathology and functional impairment decreased with age, and that the psychopathology of children in a peripheral slum of a big city is 3 times higher than the median of the general population. This information should be useful for administrators providing services for children from the most disadvantaged segment of the population.

The aim of this study is to obtain dimensions from a categorical diagnostic interview. 512 children aged 8 to 17 attending public centers for children's mental health and presenting some form of psychological disorder were interviewed with the «Diagnostic Interview for Children and Adolescents»(DICA-IV). Analysis of the principal components indicate that a two-dimensional model (externalizing-internalizing) satisfactorily explain the data collected from the children and their parents. The data from the adolescents are better represented by a three-dimensional model (attention problems-internalizing-antisocial behavior). The factor scales show good internal consistency and significantly relate to other criteria of psychopathology and incapacity (concurrent validity). These results show that it is possible to use DICA-IV to obtain categorical and dimensional indicators simultaneously. The latter are particularly sensitive for measuring changes over the course of disorders El objetivo de este estudio es obtener dimensiones a partir de una entrevista diagnóstica categorial. Se entrevistó con la Entrevista Diagnóstica para Niños y Adolescentes a 512 participantes de entre 8 y 17 años de centros de asistencia primaria pediátrica o psiquiátrica que presentaban algún tipo de psicopatología. El análisis de componentes principales indica que un modelo bidimensional (exteriorizado-interiorizado) explica los datos recogidos de los niños y sus padres. Los datos de los adolescentes quedan mejor representados por un modelo de tres dimensiones (problemas de atención-interiorizados-comportamiento antisocial). Las escalas factoriales muestran una buena consistencia interna y se relacionan de forma significativa con otros criterios de psicopatología e incapacidad (validez concurrente). Los resultados indican que es posible obtener simultáneamente indicadores categoriales y dimensionales de esta entrevista. Estos últimos pueden ser especialmente útiles para medir cambios en el curso de los trastornos

Objective: Few studies have explored impulse control disorders (ICDs) in women with bulimia nervosa (BN). We explored the prevalence of lifetime ICDs in women with BN, compared the severity of eating disorder symptoms in women with BN with and without ICD, and compared their personality profiles to females with one form of ICD, namely, pathologic gambling. Method: A total sample of 269 female patients consecutively admitted to our unit participated in the current study (173 BN without comorbid ICD [BN − ICD]; 54 BN with comorbid ICD [BN + ICD]; and 42 pathologic gamblers [PG]). All participants were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Evaluation: Assessment measures included the Symptom Checklist–90 revised and the Temperament and Character Inventory–revised, as well as a number of other clinical and psychopathologic indices. Results: In BN, the observed lifetime prevalence of ICD was 23.8%. Lifetime compulsive buying (17.6%) and intermittent explosive disorder (13.2%) were the most frequently reported ICD. Bulimia nervosa subtype was not significantly associated with lifetime ICD (P = .051) or with ICD subtype (P = .253). After using multinomial regression models, we observed that BN + ICD and PG showed the highest scores on novelty seeking (P < .0001). But BN + ICD women had the lowest scores on self-directedness (P < .03) and higher scores on general psychopathology (P < .01) and drug abuse (P < .01). Conclusions: Individuals with BN + lifetime ICD presented more extreme personality profiles, especially on novelty seeking and impulsivity, and general psychopathology than individuals with BN without ICD. On some personality traits, those BN + ICD more closely resembled individuals with PG than those with BN without ICD.

The aim of the present study was to classify pathological gamblers based on their psychopathology as related to the variable sensation-seeking, and to check possible differences between the groups on the sociodemographic variables. The sample was composed of 110 male pathological gamblers using slot machines who requested treatment at the Pathological Gambling Unit at the Ciutat Sanitària i Universitària de Bellvitge. It was observed that pathological gamblers comprise three clusters, differentiated with differing severity depression, psychoticism, somatization, impulsiveness, interpersonal sensitivity, and phobic anxiety. Cluster 1, representing 46.7% of the sample, showed mean scores higher than or equal to T = 63. On the subscales of Depression, Psychoticism, Interpersonal Sensidvity, Phobic Anxiety, and Obsessiveness–Compulsiveness the score was close to T = 63 (the clinical cut-off score). Cluster 2, representing 23.8% of the sample, scored higher than Cluster 1 on the following subscales: Depression, Phobic Anxiety, Interpersonal Sensitivity, Psychoticism, Obsessive–Compulsive, and Somatization. On Cluster 3 highest mean scores were observed on all SCL-90-R dimensions relative to the other two groups. What distinguished these subgroups is not symptomatology but the severity of the psychopathology. On the other hand, sensation seeking was similar for the three clusters, and the slight differences depended on the subjects' psychopathology.

Aims:The objective of this study was to analyze clinical and personality differences in three groups of patients with eating disorders: binge eating disorder (BED), bulimia nervosa- purging type (BN-P) and bulimia nervosa-non purging type (BN-NP).Methods:The participants were 102 female patients (34 BED, 34 BN-P and 34 BN-NP), mean age 28.7. Assessment measures included the following tests: EDI-2, BITE, EAT-40, SCL-90-R and TCI-R, and other clinical and psychopathological indices that were collected via semi-structured interview.Results:When compared all three groups, BED were the oldest group, showed more frequent familial history of obesity and current or lifetime obesity. Regarding psychopathology, BN-P patients showed the most pathological scores, followed by BN-NP patients and BED patients showing the least pathological scores. Specifically, BN-P patients showed statistically higher scores than BED patients on SCL-90-R Paranoid Ideation, EAT-40 total score, EDI-2 Impulsivity subscale, and BITE Severity subscale. No statistically significant differences were observed among groups, on personality traits. A two-step cluster analysis procedure was conducted, to determine the clinical proximity among the three diagnostic groups. The relationship between cluster classification and diagnosis was statistically different (p

This study examined the association between life events and the level of their perceived impact with depressive symptoms in adolescents. A total of 1061 adolescents of both sexes (13 - 16 years) were evaluated through self-report questionnaires (Life Events Checklist and Children's Depression Inventory). Results showed that positive life events decrease the level of depressive symptoms, while negative ones increase them. The perceived impact level of negative life events increases the degree of depressive symptoms, while a significant interaction with students’ origin was observed (native people perceived a greater impact). Considering the subtypes of life events, family, school and negative health increased the level of depressive symptoms while it decreased with social life events. Results on the perceived impact of these subtypes depend on the type of event and the age of the subjects.

Objective:To explore gender differences on personality and clinical features in patients with eating disorders (ED) and a healthy control sample.Methods:60 ED males and 60 ED females, consecutively admitted to our Hospital and diagnosed according to DSM-IV-R criteria, were matched for age and diagnosis. A comparison group of 120 non clinical people (60 males, 60 females) were also collected. Measures: TCI-R, SCL-90-R, EDI-2.Results:Female ED patients scored significantly higher than males on Drive for Thinness, Body Dissatisfaction, Interoceptive Awareness and total EDI (p < 0.002). However, these differences were not significant when compared with controls. ED women exhibited higher SCL-90-R Somatization, Interpersonal Sensitivity, Depression, Anxiety, Hostility, GSI, PSDI and PST scores (p

Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.

Un videojoc, anomenat Island, dissenyat i desenvolupat per un equip multidisciplinari de clínics, enginyers i programadors, del que forma part l'Hospital Universitari de Bellvitge i en el qual hi col·laboren les professores Roser Granero i Eva Penelo de la UAB, sembla permetre a pacients amb malalties mentals adquirir noves estratègies per afrontar-se a les pròpies emocions negatives en situacions estressants de la vida quotidiana. Aquests pacients també senten que utilitzant aquest videojoc participen més activament en el seu procés de recuperació. Així, els videojocs apareixen amb un futur prometedor com a complement a tractaments tradicionals d'aquestes malalties. Un videojuego, llamado Island, diseñado y desarrollado por un equipo multidisciplinar de clínicos, ingenieros y programadores, del que forma parte el Hospital Universitario de Bellvitge y en el que colaboran las profesoras Rosario Granero y Eva Penelo de la UAB, parece permitir a pacientes con enfermedades mentales adquirir nuevas estrategias para afrontar las propias emociones negativas en situaciones estresantes de la vida cotidiana. Estos pacientes también sienten que utilizando este videojuego participan más activamente en su proceso de recuperación. Así, los videojuegos aparecen con un futuro prometedor como complemento a tratamientos tradicionales de estas enfermedades.

The study identifies the variables that predict the perception of need for psychiatric help and the use of mental health services in children and adolescents from 7 to 17 years old attending psychiatric and pediatric outpatient consultation. The perception of problems and consultation depend on the degree of functional impairment, parents' perception of the existence of problems, the age of the child, temperamental traits, parental rearing style and severe stressful life-events. The variables that permit realization of the existence of problems but do not lead to consultation are primarily developmental difficulties. Families consult with professionals, despite not perceiving the existence of psychiatric problems, when children have difficulties in their behavioral style. The presence of psychopathology is not enough to explain the perception of the need for help by the subject or the fact of attending consultation. Resultant indicators may be useful for planning mental health services El estudio identifica las variables que pueden predecir la percepción de necesidad de ayuda psicológica y el uso de los servicios de salud mental en jóvenes de 7 a 17 años que acudían a consultas ambulatorias psiquiátricas y pediátricas. La percepción de la existencia de problemas y la consulta por ellos depende de que los padres los perciban, de la incapacidad funcional que producen, la edad del niño, su temperamento, los acontecimientos estresantes que ha sufrido, y del estilo educativo de los padres. Las dificultades evolutivas se perciben como problemas pero no conducen a consulta. Las familias consultan con los profesionales, a pesar de que no perciban la existencia de problemas, cuando los niños presentan dificultades menores en su comportamiento. La presencia de psicopatología no es suficiente para explicar la percepción de la necesidad de ayuda o de acudir a consulta. Los indicadores hallados pueden ser útiles para planificar los servicios de salud mental

Reported one-year prevalence of service use due to mental disorders in children and adolescents from the general population varies according to country, organization of services, and services considered. Among factors associated with use of services, the literature lists parental and school personnel's perception of problems, having a psychiatric diagnosis (especially externalizing), symptom severity, comorbid disorders, functional impairment, family burden, family environment or being a boy (Cabiya et al., 2006; Farmer et al., 2003; Sayal, 2004). A better understanding of these factors may help to optimize access to services of children needing help.

Difficulties in emotion regulation (ER) are common in females with eating disorders (ED). However, no study to date has analyzed ER in males with ED. In the study at hand, we assessed ER in males with ED and compared results to both females with ED and healthy controls (HC). We also examined associations between ER difficulties, personality, and psychopathology. A total of 62 males with ED were compared with 656 females with ED, as well as 78 male and 286 female HC. ER was assessed by means of the Difficulties in Emotion Regulation Scale (DERS). We found that males and females with ED showed greater ER difficulties compared to HC. Pronounced general psychopathology was a shared factor associated with higher ER difficulties in both males and females with ED. However, whereas higher novelty seeking, higher cooperativeness, lower reward dependence, and lower self-directedness were related to higher ER difficulties in females with ED, lower persistence was associated with ER difficulties in males with ED. In sum, males and females with ED show similar ER difficulties, yet they are distinct in how ER deficits relate to specific personality traits. Research on strategies promoting ER in the treatment of males with ED is warranted.

The aims of the study were threefold: 1) analyze differences in symptomatology and general psychopathology among eating disorder (ED) patients and their sisters discordant for eating disorders, 2) identify differential personality vulnerabilities between ED patients and their healthy sisters and 3) identify predictors of developing an ED. The sample consisted of 92 female participants (46 ED patients fulfilling DSM-IV-TR criteria vs. 46 healthy sisters). The results showed significant differences in eating symptomatology and general psychopathology among the groups. In terms of personality traits, ED patients had higher harm avoidance (p

Background: The food addiction (FA) model is receiving increasing interest from the scientific community. Available empirical evidence suggests that this condition may play an important role in the development and course of physical and mental health conditions such as obesity, eating disorders, and other addictive behaviors. However, no epidemiological data exist on the comorbidity of FA and gambling disorder (GD), or on the phenotype for the co-occurrence of GD+FA. Objectives: To determine the frequency of the comorbid condition GD+FA, to assess whether this comorbidity features a unique clinical profile compared to GD without FA, and to generate predictive models for the presence of FA in a GD sample. Method: Data correspond to N = 458 treatment-seeking patients who met criteria for GD in a hospital unit specialized in behavioral addictions. Results: Point prevalence for FA diagnosis was 9.2%. A higher ratio of FA was found in women (30.5%) compared to men (6.0%). Lower FA prevalence was associated with older age. Patients with high FA scores were characterized by worse psychological state, and the risk of a FA diagnosis was increased in patients with high scores in the personality traits harm avoidance and self-transcendence, and low scores in cooperativeness (R2 = 0.18). Conclusion: The co-occurrence of FA in treatment-seeking GD patients is related to poorer emotional and psychological states. GD treatment interventions and related behavioral addictions should consider potential associations with problematic eating behavior and aim to include techniques that aid patients in better managing this behavior. OA gold

Background: Co-morbidity between Type 1 Diabetes Mellitus (T1DM) and eating disorders (ED) has been previously described; however the effect of this illness on the outcomes for conventional ED treatments has not been previously investigated. This study aims to compare clinical, psychopathological and personality features between two samples of ED individuals: those with comorbid T1DM and those without (No-DM); and to identify differences in treatment outcomes between the groups. Methods: This study compares treatment outcome, dropouts, ED psychopathology and personality characteristics for 20 individuals with ED and T1DM and 20 ED patients without diabetes, matched for diagnostic and treatment type. Results: The study found higher dropout rates from therapy in individuals with T1DM and worse treatment outcome in spite of having no significant differences in eating disorder psychopathology, although individuals with T1DM report misusing insulin. Conclusions: The low levels of motivation to change, and insulin abuse in T1DM patients, may suggest that treatment for patients with ED and T1DM should consider the individual's personality and role of insulin abuse when determining the appropriate intervention.

Objective: To classify into subgroups a sample of pathological gambling (PG) patients according to personality variables and to describe the subgroups at a clinical level. Method: PG patients (n = 1171) were assessed with the South Oaks Gambling Screen; the Temperament and Character Inventory-Revised; the Symptom Checklist-90-Revised; Eysenck's Impulsivity Scales, a diagnostic questionnaire for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) PG criteria; and the Structured Clinical Interview for the DSM-IV, Axis I disorders, substance use module. Clinical measures were collected through a semi-structured interview. We performed a 2-step cluster analysis based on the above-mentioned personality variables. Clinical data were compared across clusters. Results: Four clusters were generated. Type I (disorganized and emotionally unstable) showed schizotypic traits, high impulsiveness, substance and alcohol abuse, and early age of onset, as well as psychopathological disturbances. Type II (schizoid) showed high harm avoidance, social aloofness, and alcohol abuse. Type III (reward sensitive) showed high sensation seeking and impulsiveness but no psychopathological impairments. Type IV (high-functioning) showed a globally adaptive personality profile, low level of substance and alcohol abuse or smoking, and no psychopathological disturbances. Conclusions: At least 4 types of PG patients may be identified. Two types showed a response modulation deficit, but only one of them had severe psychopathological disturbances. Two other types showed no impulsiveness or sensation seeking and one of them even exhibited good general functioning. The different personality and clinical configuration of these clusters might be linked to different therapeutic approaches. Can J Psychiatry. 2010;55(8):498-506. Clinical Implications * At least 4 subtypes of pathological gamblers, with differing severity level, comorbidity, and personality profiles, may be distinguished. * Only some groups show high impulsiveness and (or) high sensation seeking. * PG is a highly heterogeneous disorder that may require different therapeutic approaches according to its specific characteristics. Limitations * Our sample consisted of treatment-seeking PG patients, which may affect generalizability of findings. * Most patients were mainly slot machine pathological gamblers. * Comorbidity with Axis I disorders other than substance use disorders was not directly assessed. Key Words: pathological gambling, subtypes, personality, impulsiveness, sensation seeking, harm avoidance, substance abuse, alcohol abuse Abbreviations used in this article DSM Diagnostic and Statistical Manual of Mental Disorders GSI Global Severity Index PG pathological gambling SCID Structured Clinical Interview for DSM-IV SCL-90-R Symptom Checklist-90 Items-Revised SOGS South Oaks Gambling Screen SUD substance use disorder TCI-R Temperament and Character Inventory-Revised The DSM-III1 included PG for the first time as an impulse control disorder. SUDs are the most frequent comorbid features of PG, ranging from 30% to 70%.2'3 Increasing evidence points to PG and other disorders of impulse control (for example, bulimia nervosa or sexual addictions) as part of an addictive spectrum sharing the same underlying biopsychosocial process, together with other types of addictions.4 In this regard, PG has been considered as an addictive disorder4 or behavioural addiction.5 In studies of alcohol- or cocaine-dependent patients, the presence of comorbidity with other SUDs frequently characterizes specific subgroups,6 and drug of choice is frequently associated with specific personality profiles.7 Concerning personality, impulsiveness and sensation seeking have received much attention and, together with low reward-dependence (sociability and emotional dependence), cooperativeness and self-directedness (goal-directed behaviour) have been identified as risk factors for the development of PG and the modulation of gambling behaviour. …

Gambling Disorder (GD) has a complex etiology that involves biological and environmental aspects. From a genetic perspective, neurotrophic factors (NTFs) polymorphisms have been associated with the risk of developing GD. The aim of this study was to assess the underlying mechanisms implicated in GD severity by considering the direct and mediational relationship between different variables including genetic, psychological, socio-demographic, and clinical factors. To do so, we used genetic variants that were significantly associated with an increased risk for GD and evaluated its relationship with GD severity through pathway analysis. We found that the interaction between these genetic variants and other different biopsychological features predicted a higher severity of GD. On the one hand, the presence of haplotype block 2, interrelated with haplotype block 3, was linked to a more dysfunctional personality profile and a worse psychopathological state, which, in turn, had a direct link with GD severity. On the other hand, having rs3763614 predicted higher general psychopathology and therefore, higher GD severity. The current study described the presence of complex interactions between biopsychosocial variables previously associated with the etiopathogenesis and severity of GD, while also supporting the involvement of genetic variants from the NTF family.