Genetic Epidemiology of Pathological Gambling

描述(申请人提供)：病态赌博(PG)已经成为一个主要的公共卫生问题，因为在过去的二十年里，赌场和州彩票等合法化赌博场所以前所未有的速度增长；随着赌博机会的增加，病态赌博在美国的流行预计将会增加。然而，目前美国PG障碍的终生患病率很低，约为1-2%，再加上受影响的人寻求治疗的比率很低，对当前的流行病学研究构成了相当大的挑战。这个应用程序成功地解决了这个问题，通过识别一个环境，澳大利亚，在那里PG的流行率现在高于它在美国的当前水平。澳大利亚是以社区为基础进行PG研究的理想环境，也非常适合进行遗传流行病学调查，因为它将允许在大多数人严重接触赌博机会的文化中检查基因对PG易感性的影响。这项建议的广泛目标是，使用流行病学和生物统计学建模方法，检查PG和问题赌博在女性和男性中的原因。对PG和问题赌博的电话访谈评估以及对人格和反社会行为障碍的问卷评估将以来自澳大利亚国家双胞胎登记中心的5,259对双胞胎(2,235对同卵双卵对，1,697对同性双卵对和1,327对异性双卵对)中的10,518人(5,885名女性，4,633名男性)为目标样本。这些数据将与1992-1994年或1996-2000年收集的酒精依赖、严重抑郁和品行障碍终身病史的结构化精神病学访谈评估和1988或1989年收集的主要人格维度的问卷评估一起进行分析，以检查：(A)遗传和环境因素对PG和问题赌博风险的相对贡献，(B)PG和问题赌博与酒精依赖和共病精神障碍的终身共存及其共同发生的原因，以及(C)个性在PG和问题赌博的病因和共病中所起的作用。

DESCRIPTION (provided by applicant): Pathological gambling (PG) has become a major public health concern due to an unprecedented rate of growth of legalized gambling venues such as casinos and state lotteries over the past two decades; the prevalence of PG in the United States is predicted to increase with the increased access to gambling opportunities. However, the currently low lifetime prevalence of PG disorder of about 1-2% in the United States, coupled with low rates of treatment seeking among those affected, poses a considerable challenge for current epidemiologic research. This application successfully deals with this problem, by identifying a setting, Australia, where the prevalence of PG is now higher than it currently is in the United States. Australia is the ideal setting in which to conduct a community-based study of PG, and is also well suited for a genetic epidemiologic investigation because it will allow for an examination of the genetic influence on PG susceptibility in a culture in which most individuals have been heavily exposed to gambling opportunities. The broad aim of this proposal is to examine, using epidemiologic and biometrical modeling approaches, the causes of PG and problem gambling among both women and men. Telephone interview assessments of PG and problem gambling and questionnaire assessments of personality and antisocial behavior disorders will be conducted with a target sample of 10,518 individuals (5,885 women, 4,633 men) from 5,259 twin pairs (2,235 monozygotic pairs, 1,697 same-sex dizygotic pairs, and 1,327 unlike-sex dizygotic pairs) from the national Australian Twin Registry. These data will be analyzed in conjunction with structured psychiatric interview assessments of lifetime history of alcohol dependence, major depression, and conduct disorder collected in 1992-1994 or 1996-2000 and questionnaire assessments of major dimensions of personality collected in 1988 or 1989 in order to examine: (a) the relative contributions of genetic and environmental factors to the risk for PG and problem gambling, (b) the lifetime co-occurrence of PG and problem gambling with alcohol dependence and comorbid psychiatric disorders and the causes of co-occurrence, and (c) the role of personality in the etiology and comorbidity of PG and problem gambling.