Neurocognitive dysfunction in problem gamblers with co-occurring antisocial personality disorder

作者：Blum Austin W^*; Leppink Eric W; Grant Jon E

来源：Comprehensive Psychiatry, 2017, 76: 153-159.

DOI：10.1016/j.comppsych.2017.05.004

Objectives: Problem gamblers with symptoms of antisocial personality disorder (ASPD) may represent a distinct problem gambling subtype, but the neurocognitive profile of individuals affected by both disorders is poorly characterized.
Method: Non-treatment-seeking young adults (18-29 years) who gambled >= 5 times in the preceding year were recruited from the general community. Problem gamblers (defined as those meeting >= 1 DSM-5 diagnostic criteria for gambling disorder) with a lifetime history of ASPD (N = 26) were identified using the Mini International Neuropsychiatric Interview (MINI) and compared with controls (N = 266) using questionnaire-based impulsivity scales and objective computerized neuropsychological tasks. Findings were uncorrected for multiple comparisons. Effect sizes were calculated using Cohen's d.
Results: Problem gambling with ASPD was associated with significantly elevated gambling disorder symptoms, lower quality of life, greater psychiatric comorbidity, higher impulsivity questionnaire scores on the Barratt Impulsiveness Scale (d = 0.4) and Eysenck Impulsivity Questionnaire (d = 0.5), and impaired cognitive flexibility (d = 0.4), executive planning (d = 0.4), and an aspect of decision-making (d = 0.6). Performance on measures of response inhibition, risk adjustment, and quality of decision making did not differ significantly between groups.
Conclusions: These preliminary fmdings, though in need of replication, support the characterization of problem gambling with ASPD as a subtype of problem gambling associated with higher rates of impulsivity and executive function deficits. Taken together, these results may have treatment implications.

• 出版日期2017-7