Struggling with Happiness: A Pathway Leading Depression to Gambling Disorder
Abstract
A number of studies have suggested that depressive mood might lead to the development and/or maintenance of a gambling disorder (GD). The pathways by which such relationships are fostered may involve deficits in emotional regulation capacity and dysfunctional coping styles. This study aims to explore the role played by depressive symptomatology and the regulation of positive emotion in GD. We administered the South Oaks Gambling Inventory (SOGS, Lesieur and Blume in Am J Psychiatry 144(9):1184–1188, 1987), the 21-item Depression Anxiety Stress Scale (DASS-21, Lovibond and Lovibond in Manual for the depression anxiety stress scales. Psychology Foundation, Sydney, 1995) and the Kill-joy Thinking subscale of the Ways of Savouring Checklist (WOSC, Bryant and Veroff in Savoring: a new model of positive experience. Lawrence Erlbaum, Mahwah, 2007) to a sample of pathological gamblers (n = 91) and a sample of community participants (n = 105). The pathological gamblers scored higher on the DASS-21 subscales and obtained higher scores on the Kill-joy Thinking subscale of the WOSC compared to the controls. Moreover, the SOGS scores positively correlate with the DASS-21 subscales, and with the Kill-Joy Thinking measure. Finally, it is evident that Kill-joy Thinking fully mediates the relationship between depressive symptomatology and GD severity. Our results further confirm the roles of depression, anxiety and stress in GD. Moreover, this is the first study to explore the mediating role of dampening processes in the relationship between depression and GD. Future lines of research are also discussed.
Keywords
Gambling disorder Depression Anxiety Emotion regulation Savoring DampeningNotes
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
References
- Afifi, T. O., Nicholson, R., Martins, S. S., & Sareen, J. (2016). A longitudinal study of the temporal relation between problem gambling and mental and substance use disorders among young adults. The Canadian Journal of Psychiatry, 61(2), 102–111.Google Scholar
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
- Balodis, I. M., Kober, H., Worhunsky, P. D., Stevens, M. C., Pearlson, G. D., & Potenza, M. N. (2012). Diminished frontostriatal activity during processing of monetary rewards and losses in pathological gambling. Biological Psychiatry, 71, 749–757.Google Scholar
- Balzarotti, S., Rogier, G., Tagliabue S., Velotti, P. (2018). Regulating positive emotions: A validation study of the Ways of savoring. Manuscript in preparation. Google Scholar
- Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173.Google Scholar
- Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: International Universities Press.Google Scholar
- Berridge, K. C., & Robinson, T. E. (2008). Review The incentive sensitization theory of addiction: Some current issues. Philosophical Transactions of the Royal Society of London Series B: Biological sciences, 363(1507), 3137–3146. https://doi.org/10.1098/rstb.2008.0093.Google Scholar
- Blain, B., Gill, P. R., & Teese, R. (2015). Predicting problem gambling in Australian adults using a multifaceted model of impulsivity. International Gambling Studies, 15(2), 239–255.Google Scholar
- Blaszczynski, A., & Farrell, E. (1998). A case series of 44 completed gambling-related suicides. Journal of Gambling Studies, 14(2), 93–109.Google Scholar
- Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97(5), 487–499.Google Scholar
- Bottesi, G., Ghisi, M., Altoè, G., Conforti, E., Melli, G., & Sica, C. (2015). The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples. Comprehensive Psychiatry, 60, 170–181.Google Scholar
- Bryant, F. B., & Veroff, J. (2007). Savoring: A new model of positive experience. Mahwah: Lawrence Erlbaum.Google Scholar
- Bylsma, L. M., Morris, B. H., & Rottenberg, J. (2008). A meta-analysis of emotional reactivity in major depressive disorder. Clinical Psychology Review, 28(4), 676–691.Google Scholar
- Carl, J. R., Soskin, D. P., Kerns, C., & Barlow, D. H. (2013). Positive emotion regulation in emotional disorders: A theoretical review. Clinical Psychology Review, 33(3), 343–360.Google Scholar
- Carroll, D., & Huxley, J. A. (1994). Young people and fruit machine gambling. In C. R. Legg, D. A. Booth, C. R. Legg, D. A. Booth (Eds.), Appetite: Neural and behavioural bases (pp. 285–304). New York, NY: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780198547877.003.0012.
- Chase, H. W., & Clark, L. (2010). Gambling severity predicts midbrain response to near-miss outcomes. Journal of Neuroscience, 30, 6180–6187.Google Scholar
- Comings, D. E., & Blum, K. (2000). Reward deficiency syndrome: Genetic aspects of behavioral disorders. Progress in Brain Research, 126, 325–341.Google Scholar
- Chou, K. L., & Afifi, T. O. (2011). Disordered (pathologic or problem) gambling and axis I psychiatric disorders: Results from the national epidemiologic survey on alcohol and related conditions. American Journal of Epidemiology, 173(11), 1289–1297.Google Scholar
- Cyders, M. A., & Smith, G. T. (2008). Emotion-based dispositions to rash action: Positive and negative urgency. Psychological Bulletin, 134(6), 807–828.Google Scholar
- Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19(1), 107–118.Google Scholar
- de Ruiter, M. B., Veltman, D. J., Goudriaan, A. E., Oosterlaan, J., Sjoerds, Z., & van den Brink, W. (2009). Response perseveration and ventral prefrontal sensitivity to reward and punishment in male problem gamblers and smokers. Neuropsychopharmacology, 34, 1027–1038.Google Scholar
- Devos, G., Clark, L., Maurage, P., & Billieux, J. (2018). Induced sadness increases persistence in a simulated slot machine task among recreational gamblers. Psychology of Addictive Behaviors, 32(3), 383–388.Google Scholar
- Dimaggio, G., Popolo, R., Montano, A., Velotti, P., Perrini, F., Buonocore, L., et al. (2017). Emotion dysregulation, symptoms, and interpersonal problems as independent predictors of a broad range of personality disorders in an outpatient sample. Psychology and Psychotherapy: Theory, Research and Practice, 90(4), 586–599.Google Scholar
- Dussault, F., Brendgen, M., Vitaro, F., Wanner, B., & Tremblay, R. E. (2011). Longitudinal links between impulsivity, gambling problems and depressive symptoms: a transactional model from adolescence to early adulthood. Journal of Child Psychology and Psychiatry, 52(2), 130–138.Google Scholar
- Eisner, L. R., Johnson, S. L., & Carver, C. S. (2009). Positive affect regulation in anxiety disorders. Journal of Anxiety Disorders, 23(5), 645–649.Google Scholar
- el-Guebaly, N., Patten, S. B., Currie, S., Williams, J. V. A., Beck, C. A., Maxwell, C. J., et al. (2006). Epidemiological associations between gambling behavior, substance use and mood and anxiety disorders. Journal of Gambling Studies, 22(3), 275–287.Google Scholar
- Feldman, G. C., Joormann, J., & Johnson, S. L. (2008). Responses to positive affect: A self-report measure of rumination and dampening. Cognitive Therapy and Research, 32(4), 507–525.Google Scholar
- Garland, E. (2016). Restructuring reward processing with Mindfulness-Oriented Recovery Enhancement: novel therapeutic mechanisms to remediate hedonic dysregulation in addiction, stress, and pain. Blackwell Publishing Inc. https://doi.org/10.1111/nyas.13034
- Giddens, J. L., Stefanovics, E., Pilver, C. E., Desai, R., & Potenza, M. N. (2012). Pathological gambling severity and co-occuring psychiatric disorders in individuals with and without anxiety disorders in a nationally representative sample. Psychiatry Research, 199(1), 58–64.Google Scholar
- Griffiths, M. (1995). The role of subjective mood states in the maintenance of fruit machine gambling behavior. Journal of Gambling Studies, 11(2), 123–135.Google Scholar
- Gruber, J., Oveis, C., Keltner, D., & Johnson, S. L. (2011). A discrete emotions approach to positive emotion disturbance in depression. Cognition and Emotion, 25(1), 40–52.Google Scholar
- Guerreschi, C., & Gander, S. (2002). Versione italiana del South Oaks Gambling Screen SOGS di H. R. Lesieur e S. B. Blume. In Guerreschi C., Giocati dal gioco. Quando il divertimento diventa una malattia: il gioco d’azzardo patologico. Milano: San Paolo.Google Scholar
- Haw, J. (2017). Impulsivity predictors of problem gambling and impaired control. International Journal of Mental Health and Addiction, 15(1), 154–165.Google Scholar
- Jacobs, D. F. (1986). A general theory of addictions: A new theoretical model. Journal of Gambling Behavior, 2(1), 15–31.Google Scholar
- Jauregui, P., Estévez, A., & Urbiola, I. (2016). Pathological gambling and associated drug and alcohol abuse, emotion regulation, and anxious-depressive symptomatology. Journal of Behavioral Addictions, 5(2), 251–260.Google Scholar
- Joutsa, J., Johansson, J., Niemela, S., Ollikainen, A., Hirvonen, M. M., & Piepponen, P. (2012). Mesolimbic dopamine release is linked to symptom severity in pathological gambling. Neuroimage, 60, 1992–1999.Google Scholar
- Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). The prevalence and correlates of DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38(9), 1351–1360.Google Scholar
- Kim, S. W., Grant, J. E., Eckert, E. D., Faris, P. L., & Hartman, B. K. (2006). Pathological gambling and mood disorders: Clinical associations and treatment implications. Journal of Affective Disorders, 92(1), 109–116.Google Scholar
- Larson, C. L., Nitschke, J. B., & Davidson, R. J. (2007). Common and distinct patterns of affective response in dimensions of anxiety and depression. Emotion, 7(1), 182–191.Google Scholar
- Lesieur, H. R. (2001). Cluster analysis of types of inpatient pathological gamblers. Dissertation Abstracts International, 62, 2065.Google Scholar
- Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. The American Journal of Psychiatry, 144(9), 1184–1188.Google Scholar
- Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction, 106(3), 490–498.Google Scholar
- Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.Google Scholar
- McConaghy, N., Armstrong, M. S., Blaszczynski, A., & Allcock, C. (1988). Behavior completion versus stimulus control in compulsive gambling: Implications for behavioral assessment. Behavior Modification, 12(3), 371–384.Google Scholar
- McDougall, J. (2004). L’economie psychique de l’addiction [The psychic economy of addiction]. Revue Française De Psychanalyse, 68(2), 511–527.Google Scholar
- Miyamoto, Y., & Ma, X. (2011). Dampening or savoring positive emotions: A dialectical cultural script guides emotion regulation. Emotion, 11(6), 1346–1357.Google Scholar
- Navas, J. F., Billieux, J., Verdejo-García, A., & Perales, J. C. (2018). Neurocognitive components of gambling disorder: Implications for policy, prevention, and treatment. In H. Bowden-Jones, C. Dickson, C. Dunand, & O. Simon (Eds.), Harm reduction for problem gambling: A public health approach (p. 2018). Abingdon: Routledge.Google Scholar
- Parhami, I., Mojtabai, R., Rosenthal, R. J., Afifi, T. O., & Fong, T. W. (2014). Gambling and the onset of comorbid mental disorders: A longitudinal study evaluating severity and specific symptoms. Journal of Psychiatric Practice, 20(3), 207–219.Google Scholar
- Petry, N. M., & Kiluk, B. D. (2002). Suicidal ideation and suicide attempts in treatment-seeking pathological gamblers. The Journal of Nervous and Mental Disease, 190(7), 462–469.Google Scholar
- Raes, F., Smets, J., Nelis, S., & Schoofs, H. (2012). Dampening of positive affect prospectively predicts depressive symptoms in non-clinical samples. Cognition and Emotion, 26(1), 75–82.Google Scholar
- Reuter, J., Raedler, T., Rose, M., Hand, I., Glascher, J., & Buchel, C. (2005). Pathological gambling is linked to reduced activation of the mesolimbic reward system. Nature Neuroscience, 8, 147–148.Google Scholar
- Roberts, A., Sharman, S., Coid, J., Murphy, R., Bowden-Jones, H., Cowlishaw, S., et al. (2017). Gambling and negative life events in a nationally representative sample of UK men. Addictive Behaviors, 75, 95–102.Google Scholar
- Rogier, G., & Velotti, P. (2018a). Narcissistic implications in gambling disorder: The mediating role of emotion dysregulation. Journal of Gambling Studies. https://doi.org/10.1007/s10899-018-9759-x.
- Rogier, G., & Velotti, P. (2018b). Conceptualizing gambling disorder with the process model of emotion regulation. Journal of Behavioral Addictions, 2, 239. https://doi.org/10.1556/2006.7.2018.52.Google Scholar
- Rogier, G., Velotti, P., & Zavattini, G. C. (2017). Gioco d’azzardo ed antisocialità: riflessioni su un’emergenza sociale. Giornale Italiano di Psicologia, 44(2), 219–248.Google Scholar
- Salk, R. H., Hyde, J. S., & Abramson, L. Y. (2017). Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms. Psychological Bulletin, 143(8), 783–822.Google Scholar
- Sescousse, G., Barbalat, G., Domenech, P., & Dreher, J. (2013). Imbalance in the sensitivity to different types of rewards in pathological gambling. Brain, 136(8), 2527–2538. https://doi.org/10.1093/brain/awt126.Google Scholar
- Sharpe, L. (2002). A reformulated cognitive-behavioral model of problem gambling: A biopsychosocial perspective. Clinical Psychology Review, 22(1), 1–25.Google Scholar
- Smith, J. L., & Hollinger-Smith, L. (2015). Savoring, resilience, and psychological well-being in older adults. Aging & Mental Health, 19(3), 192–200.Google Scholar
- Steward, T., Mestre-Bach, G., Fernàndez-Aranda, F., Granero, R., Perales, J. C., Navas, J. F., et al. (2017). Delay discounting and impulsivity traits in young and older gambling disorder patients. Addictive Behaviors, 71, 96–103.Google Scholar
- Straszewski, T., & Siegel, J. T. (2018). Positive emotion infusions: Can savoring increase help-seeking intentions among people with depression? Applied Psychology: Health and Well Being, 10(1), 171–190.Google Scholar
- Volkow, N., Wang, G., & Fowler, J. (2002). Role of dopamine in drug reinforcement and addiction in humans: Results from imaging studies. Behavioural Pharmacology, 13(5–6), 355–366. https://doi.org/10.1097/00008877-200209000-00008.Google Scholar
- Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070.Google Scholar
- Weinberg, A., Liu, H., Hajcak, G., & Shankman, S. A. (2015). Blunted neural response to rewards as a vulnerability factor for depression: Results from a family study. Journal of Abnormal Psychology, 124(4), 878–889.Google Scholar
- Williams, A. D., Grisham, J. R., Erskine, A., & Cassedy, E. (2012). Deficits in emotion regulation associated with pathological gambling. The British Journal of Clinical Psychology, 51(2), 223–238.Google Scholar
- Wood, J. V., Heimpel, S. A., & Michela, J. L. (2003). Savoring versus dampening: Self-esteem differences in regulating positive affect. Journal of Personality and Social Psychology, 85(3), 566–580.Google Scholar