Characteristics of Treatment Seeking Problem Gamblers with Adult ADHD
The present study investigates characteristics of treatment seeking problem gamblers with adult ADHD (n = 39) and those without ADHD (n = 87). Patients completed self-report questionnaires about gambling behaviors, impulsivity (UPPS-P), substance abuse (AUDIT/DAST), emotional dysregulation (PHQ-4), illegal activities, and gambling consequences. Each patient received a structured diagnostic interview (MINI) to assess for psychopathology, adult ADHD (ACDS), and gambling disorder (NODS). Results revealed that problem gamblers with adult ADHD encounter unique challenges above those common among problem gamblers including more problems with alcohol/drug abuse and higher levels of impulsivity. Earlier age for first gambling activities, onset of gambling problems, and higher severity of gambling problems was found among gamblers with ADHD. Gamblers with ADHD pawned more items to obtain money for gambling, were more likely to have debt, had significantly higher rates of bankruptcy and domestic violence arising from conflict with family members about their gambling. Interestingly, groups did not differ significantly on their time spent gambling prior to treatment, their win-to-loss ratio, and a number of other gambling-related consequences. These findings are discussed with their clinical ramifications for treatment.
KeywordsGambling disorder Gambling addiction ADHD Impulsivity Pathological gambling
Financial support for this study was provided in part from the Florida Council on Compulsive Gambling, the Seminole Tribe of Florida, and the Office of Problem Gambling, California Department of Public Health.
Compliance with Ethical Standards
Conflicts of Interest
The authors declare that they have no conflicts of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.
- Fatseas, M., Alexandre, J. M., Venisse, J. L., Romo, L., Valleur, M., Magalon, D., et al. (2016). Gambling behaviors and psychopathology related to attention-deficit/hyperactivity disorder (ADHD) in problem and non-problem adult gamblers. Psychiatry Research, 239, 232–238.CrossRefPubMedGoogle Scholar
- Gerstein, D., Murphy, S., Toce, M., Hoffmann, J., Palmer, A., Johnson, R., et al. (1999). Gambling Impact and Behavior Study. Report to the National Gambling Impact Study. Commission. Chicago: National Opinion Research Center.Google Scholar
- Grall-Bronnec, M., Wainstein, L., Augy, J., Bouju, G., Feuillet, F., Venisse, J.-L., & Sebille-Rivain, V. (2011). Attention deficit hyperactivity disorder among pathological and at-risk gamblers seeking treatment: A hidden disorder. European Addiction Research, 17, 231–240.CrossRefPubMedGoogle Scholar
- Grall-Bronnec, M., Wainstein, L., Feuillet, F., Bouju, G., Rocher, B., Venisse, J. L., & Sebille-Rivain, V. (2012). Clinical profiles as a function of level and type of impulsivity in a sample group of at-risk and pathological gamblers seeking treatment. Journal of Gambling Studies, 28, 239–252.CrossRefPubMedGoogle Scholar
- Kessler, R. C., Green, J. G., Adler, L. A., Barkley, R. A., Chatterji, S., Faraone, S. V., et al. (2010). Structure and diagnosis of adult attention-deficit/hyperactivity disorder: Analysis of expanded symptom criteria from the adult ADHD clinical diagnostic scale. Archives of General Psychiatry, 67(11), 1168–1178.CrossRefPubMedPubMedCentralGoogle Scholar
- Lowe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., et al. (2010). A 4-item measure of depression and anxiety: Validation and standardization of the patient health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122, 86–95.CrossRefPubMedGoogle Scholar
- Lynam, D., Smith, G.T., Cyders, M.A., Fischer, S., Whiteside, S.A. (2007). The UPPS-P: A multidimensional measure of risk for impulsive behavior. Unpublished technical report.Google Scholar
- Reid, R. C., Rosenthal, R., and Fong, T. W. (2015). Psychometric properties of the gambling consequences scale in patients with a gambling disorder. Poster session presented at the National Center for Responsible Gaming Conference on Gambling and Addiction, Las Vegas, NV.Google Scholar
- Savvidou, L. G., Fagundo, A. B., Fernández-Aranda, F., Granero, R., Claes, L., Mallorquí-Baqué, N., et al. (2017). Is gambling disorder associated with impulsivity traits measured by the UPPS-P and is this association moderated by sex and age? Comprehensive Psychiatry, 72, 106–113.CrossRefPubMedGoogle Scholar
- Scherrer, J. F., Xian, H., Shah, K. R., Volberg, R., Slutske, W., & Eisen, S. A. (2005). Effect of genes, environment, and lifetime co-occurring disorders on health-related quality of life in problem and pathological gamblers. Archives of General Psychiatry, 142(4), 405–424.Google Scholar
- Sheehan, D. V., Lecrubier, Y., Harnett-Sheehan, K., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini international neuropsychiatric interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33.PubMedGoogle Scholar
- Theule, J., Hurl, K. E., Cheung, K., Ward, M., & Henrikson, B. (2016). Exploring the relationships between problem gambling and ADHD: A meta-analysis. Journal of Attention Disorders. https://doi.org/10.1177/1087054715626512.
- Ustun, B., Adler, L. A., Rudin, C., Faraone, S. V., Spencer, T. J., Berglund, P., Gruber, M. J., & Kessler, R. C. (2017). The World Health Organization adult attention-deficit/hyperactivity disorder self-report screening scale for DSM-5. JAMA Psychiatry, 74(5), 520–526.CrossRefPubMedPubMedCentralGoogle Scholar