Genetic Epidemiology of Pathological Gambling

描述（由申请人提供）：病态赌博（PG）已成为一个主要的公共卫生问题，由于在过去的二十年中，合法化的赌博场所，如赌场和国家彩票的增长速度前所未有；PG在美国的患病率预计会随着赌博机会的增加而增加。然而，目前美国PG疾病的终生患病率较低，约为1-2%，再加上患者寻求治疗的比例较低，这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，通过确定一个设置，澳大利亚，PG的患病率现在比它目前在美国更高。澳大利亚是开展以社区为基础的PG研究的理想环境，也非常适合进行遗传流行病学调查，因为它将允许在大多数个人大量接触赌博机会的文化中检查遗传对PG易感性的影响。该提案的主要目的是利用流行病学和生物计量学建模方法，研究女性和男性中PG和问题赌博的原因。对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将对来自澳大利亚国家双胞胎登记处的5259对双胞胎（2235对同卵双胞胎，1697对同性异卵双胞胎和1327对异性异卵双胞胎）的10518个人（5885名女性，4633名男性）进行目标样本。这些数据将与1992-1994年或1996-2000年收集的关于酒精依赖、重度抑郁症和行为障碍的终身历史的结构化精神病学访谈评估以及1988年或1989年收集的关于人格主要方面的问卷评估相结合进行分析，以便研究：(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患及其共患原因，以及(c)人格在PG和问题赌博的病因学和共患性中的作用。

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.