The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers
The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers
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DOI：
10.1017/s0033291707000694
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发表时间：
2008-01-01
影响因子：
6.9
通讯作者：
Van Den Brink, W.
中科院分区：
文献类型：
--
作者：
Goudriaan, A. E.;Oosterlaan, J.;Van Den Brink, W.
背景。解除抑制和决策能力在物质使用障碍和病理性赌博等成瘾行为的原因和结果的理论研究中起着重要作用。在最近的研究中，通过神经认知测试发现，去抑制和不利的决策策略都影响物质使用障碍的过程。对病理性赌博复发的影响因素研究较少。本研究调查了自我报告的冲动性和奖励敏感性，以及冲突偶然性下的神经认知评估的去抑制和决策对46名病态赌徒复发的影响。Logistic回归分析表明，较长的障碍持续时间和神经认知指标去抑制（停止信号反应时间）和决策（纸牌游戏任务）是复发的显著预测因子（解释了53%的复发方差），而自我报告的冲动性和奖励敏感性对复发没有显著预测。总体分类准确率为76%，其中正分类准确率为76%，负分类准确率为75%。疾病持续时间和去抑制和决策的神经认知测量是病理性赌博复发的有力预测因素。结果表明，内表型神经认知特征比表型人格特征更能预测病理性赌博的复发。神经认知预测可能有助于指导后续接触和加强会议的治疗计划。
Background. Disinhibition and decision-making skills play an important role in theories on the cause and outcome of addictive behaviors such as substance use disorders and pathological gambling. In recent studies, both disinhibition and disadvantageous decision-making strategies, as measured by neurocognitive tests, have been found to influence the course of substance use disorders. Research on factors affecting relapse in pathological gambling is scarce.Method. This study investigated the effect of both self-reported impulsivity and reward sensitivity, and neurocognitively assessed disinhibition and decision-making under conflicting contingencies, on relapse in a group of 46 pathological gamblers.Results. Logistic regression analysis indicated that longer duration of the disorder and neurocognitive indicators of disinhibition (Stop Signal Reaction Time) and decision-making (Card Playing Task) were significant predictors of relapse (explaining 53% of the variance in relapse), whereas self-reported impulsivity and reward sensitivity did not significantly predict relapse. Overall classification accuracy was 76%, with a positive classification accuracy of 76% and a negative classification accuracy of 75%.Conclusions. Duration of the disorder and neurocognitive measures of disinhibition and decision-making are powerful predictors of relapse in pathological gambling. The results suggest that endophenotypical neurocognitive characteristics are more promising in the prediction of relapse in pathological gambling than phenotypical personality characteristics. Neurocognitive predictors may be useful to guide treatment planning of follow-up contacts and booster sessions.