Towards a Validation of the Three Pathways Model of Pathological Gambling
With the aim of validating the three pathways hypothesis of pathological gambling (Blaszczynski and Nower in Addiction 97:487–499, 2002) 372 pathological gamblers meeting DSM IV (2000) criteria were assessed via a structured clinical interview as well as being subjected to personality tests and evaluation of their gambling practices. Our results show that it is possible to identify three subgroups corresponding to the three pathways: behaviourally conditioned problem gamblers, emotionally vulnerable problem gamblers and antisocial impulsivist problem gamblers. Our results particularly demonstrate that impulsivist gamblers preferentially choose semi-skilful gambling (horse racing and sports gambling) whereas emotionally vulnerable gamblers are significantly more attracted to games of chance (one-armed bandits, scratch cards, etc.) This led us to propose a functional presentation of the three pathways model which differs somewhat from the Blaszczynski and Nower presentation.
KeywordsProblem gambling Etiology Gambling subtypes Co morbidity Impulsivity Pathway model Addiction
We wish to sincerely thank all the staff who contributed to this study (JEU group), for their valuable assistance and significant investment. A special thanks to those who collected the data. Members of the JEU Group are: Marie Grall-Bronnec, Gaëlle Challet-Bouju, Jean-Luc Vénisse, Lucia Romo, Cindy Legauffre, Caroline Dubertret, Irène Codina, Marc Valleur, Marc Auriacombe, Mélina Fatséas, Jean-Marc Alexandre, Pierre-Michel Llorca, Isabelle Chéreau-Boudet, Christophe Lançon, David Magalon, Michel Reynaud and Mohamed-Ali Gorsane. We also wish to thank Aurélie Wellenstein from the Marmottan Hospital’s resource center for the bibliographic research. This study was supported by both the joint support of the French Inter-departmental Mission for the fight against drugs and drug addiction (MILDT) and the French National Institute of Health and Medical Research (INSERM), as part of the call for research projects launched by these two organizations in 2007, and a grant from the French Ministry of Health (PHRC 2009–RCB 2008-A01188-47). There were no constraints on publishing. This research was conducted at the initiative of and coordinated by the Clinical Investigation Unit BALANCED “BehaviorAL AddictioNs and ComplEx mood Disorders” of the University Hospital of Nantes, who is the sponsor of this study.
Conflict of interest
M.G.B., J.L.V. and G.C.B. declare that the University Hospital of Nantes has received funding from gambling industry (Française Des Jeux and Pari Mutuel Urbain) in the form of a sponsorship which supports the gambling section of the BALANCED Unit (the Reference Centre for Excessive Gambling). Scientific independence towards gambling industry operators is warranted. MV, IC, CL, DM, MF, ICB, MAG and AG declare that they have no conflicts of interest. There were no constraints on publishing.
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