Genetic Epidemiology of Pathological Gambling

描述（由申请人提供）：由于过去二十年来赌场和州彩票等合法赌博场所的前所未有的增长率，病理性赌博（PG）已成为一个主要的公共卫生问题;预计PG在美国的患病率将随着赌博机会的增加而增加。然而，目前在美国，PG疾病的终生患病率较低，约为1-2%，再加上受影响者寻求治疗的比率较低，这对目前的流行病学研究构成了相当大的挑战。本申请成功地解决了这一问题，通过确定一个设置，澳大利亚，其中PG的患病率现在高于目前在美国。澳大利亚是进行以社区为基础的PG研究的理想环境，也非常适合进行遗传流行病学调查，因为它将允许检查遗传对PG易感性的影响，在这种文化中，大多数人都严重暴露于赌博机会。该提案的主要目的是利用流行病学和生物统计学建模方法，研究男女之间PG和问题赌博的原因。将对10，518名目标样本进行PG和问题赌博的电话访谈评估以及人格和反社会行为障碍的问卷评估（5，885名女性，4，633名男性）来自5，259对双胞胎（2，235个同卵对，1，697个同性异卵对，和1，327个异性异卵对）来自国家澳大利亚双胞胎登记处。这些数据将结合1992-1994年或1996-2000年收集的酒精依赖、重度抑郁和品行障碍终身史的结构化精神病学访谈评估以及1988年或1989年收集的人格主要维度的问卷评估进行分析，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生共病率以及共病原因，以及（c）人格在PG和问题赌博的病因和共病中的作用。

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.