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On the Processes Underlying the Relationship Between Alexithymia and Gambling Severity

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Abstract

A great number of individuals with persistent problematic gambling behavior exhibit alexithymic tendencies, greater impulsivity, impaired working memory and poor mood. However, the relationship between these cognitive, affective and personality factors in problem gambling remains poorly understood. Our aim was to investigate multiple pathways of the alexithymia and problem gambling relationship. One hundred and six male subjects with different levels of gambling problem severity were recruited. Alexithymia, impulsivity and verbal working memory were evaluated, and their relationships to disordered gambling was examined by means of a path analysis. Results indicate that alexithymia is related to an increase in the severity of gambling indirectly, i.e., through distress severity. In addition, a rise of alexithymic tendencies was also associated with problem gambling severity through enhanced impulsivity that directly increased distress. Working memory capacity failed to significantly impact our path model. Overall, our findings contribute a new finding to the literature by highlighting the importance of alexithymia, in addition to impulsivity, in the understanding of gambling problem severity and its clinical course.

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References

  • Ainslie, G. (1975). Specious reward: A behavioral theory of impulsiveness and impulse control. Psychological Bulletin, 82(4), 463–496.

    Article  CAS  Google Scholar 

  • Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994a). The twenty-item Toronto Alexithymia scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32.

    Article  CAS  Google Scholar 

  • Bagby, R. M., Taylor, G. J., & Parker, J. D. (1994b). The twenty-item Toronto Alexithymia scale—II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38(1), 33–40.

    Article  CAS  Google Scholar 

  • Bateman, A., & Fonagy, P. (2004). Psychotherapy for borderline personality disorder (7th ed.). New York: Oxford University Press.

    Book  Google Scholar 

  • Beck, A. T., & Beck, R. W. (1972). Screening depressed patients in family practice. A rapid technic. Postgraduate Medicine, 52(6), 81–85.

    Article  CAS  Google Scholar 

  • Becona, E., Del Carmen Lorenzo, M., & Fuentes, M. J. (1996). Pathological gambling and depression. Psychological Reports, 78(2), 635–640.

    Article  CAS  Google Scholar 

  • Billieux, J., Rochat, L., Ceschi, G., Carré, A., Offerlin-Meyer, I., Defeldre, A.-C., et al. (2012). Validation of a short French version of the UPPS-P Impulsive Behavior Scale. Comprehensive Psychiatry, 53(5), 609–615.

    Article  Google Scholar 

  • Blanco, C., Hasin, D. S., Petry, N., Stinson, F. S., & Grant, B. F. (2006). Sex differences in subclinical and DSM-IV pathological gambling: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine, 36(7), 943–953.

    Article  Google Scholar 

  • Blaszczynski, A., & Nower, L. (2002). A pathways model of problem and pathological gambling. Addiction, 97(5), 487–499.

    Article  Google Scholar 

  • Blaszczynski, A., Steel, Z., & McConaghy, N. (1997). Impulsivity in pathological gambling: The antisocial impulsivist. Addiction, 92(1), 75–87.

    Article  CAS  Google Scholar 

  • Bogdanova, Y., Díaz-Santos, M., & Cronin-Golomb, A. (2010). Neurocognitive correlates of alexithymia in asymptomatic individuals with HIV. Neuropsychologia, 48(5), 1295–1304.

    Article  Google Scholar 

  • Bonnaire, C., Bungener, C., & Varescon, I. (2009). Subtypes of French pathological gamblers: Comparison of sensation seeking, alexithymia and depression scores. Journal of Gambling Studies, 25(4), 455–471.

    Article  Google Scholar 

  • Bonnaire, C., Bungener, C., & Varescon, I. (2013). Alexithymia and gambling: A risk factor for all gamblers? Journal of Gambling Studies, 29(1), 83–96.

    Article  Google Scholar 

  • Brevers, D., Cleeremans, A., Goudriaan, A. E., Bechara, A., Kornreich, C., Verbanck, P., et al. (2012). Decision making under ambiguity but not under risk is related to problem gambling severity. Psychiatry Research, 200(2–3), 568–574.

    Article  Google Scholar 

  • Bruchon-Schweitzer, M., & Paulhan, I. (1993). Le manuel du STAI-Y de CD Spielberger, adaptation française. Paris: ECPA.

    Google Scholar 

  • Conway, A. R. A., Kane, M. J., Bunting, M. F., Hambrick, D. Z., Wilhelm, O., & Engle, R. W. (2005). Working memory span tasks: A methodological review and user’s guide. Psychonomic Bulletin & Review, 12(5), 769–786.

    Article  Google Scholar 

  • Cross, C. P., Copping, L. T., & Campbell, A. (2011). Sex differences in impulsivity: A meta-analysis. Psychological Bulletin, 137(1), 97–130.

    Article  Google Scholar 

  • Currie, S. R., Hodgins, D. C., & Casey, D. M. (2013). Validity of the Problem Gambling Severity Index interpretive categories. Journal of Gambling Studies, 29(2), 311–327.

    Article  Google Scholar 

  • Damasio, A. (2006). Descartes’ error: Emotion, reason and the human brain. London: Vintage.

    Google Scholar 

  • Davydov, D. M., Stewart, R., Ritchie, K., & Chaudieu, I. (2010). Resilience and mental health. Clinical Psychology Review, 30(5), 479–495.

    Article  Google Scholar 

  • Evenden, J. L. (1999). Varieties of impulsivity. Psychopharmacology, 146(4), 348–361.

    Article  CAS  Google Scholar 

  • Ferguson, E., Bibby, P. A., Rosamond, S., O’Grady, C., Parcell, A., Amos, C., et al. (2009). Alexithymia, cumulative feedback, and differential response patterns on the Iowa Gambling Task. Journal of Personality, 77(3), 883–902.

    Article  Google Scholar 

  • Ferris, J., & Wynne, H. (2001). The Canadian problem gambling index: Final report. Canadian Centre on Substance Abuse.

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.

    Article  CAS  Google Scholar 

  • Fornell, C., & Bookstein, F. (1982). A comparative analysis of two structural equation models: LISREL and PLS applied to market data. In C. Fornell (Ed.), A second general of multivariate analysis (Vol. 1, pp. 289–323). New York: Praeger.

    Google Scholar 

  • Fornell, C., & Larcker, D. F. (1981). Structural equation models with unobservable variables and measurement error: Algebra and statistics. Journal of Marketing Research, 18, 382–388.

    Article  Google Scholar 

  • Greenberg, L. (2002). Emotion-focused therapy: Coaching clients to work through their feelings. Washington: APA Press.

    Book  Google Scholar 

  • Gunnarsson, M., Petter Gustavsson, J., Tengström, A., Franck, J., & Fahlke, C. (2008). Personality traits and their associations with substance use among adolescents. Personality and Individual Differences, 45(5), 356–360.

    Article  Google Scholar 

  • Gustavsson, J. P., Jönsson, E. G., Linder, J., & Weinryb, R. M. (2003). The HP5 inventory: Definition and assessment of five health-relevant personality traits from a five-factor model perspective. Personality and Individual Differences, 35(1), 69–89.

    Article  Google Scholar 

  • Hair, J. F., Jr., Hult, G. T. M., Ringle, C., & Sarstedt, M. (2016). A primer on partial least squares structural equation modeling (PLS-SEM). Thousand Oaks: Sage.

    Google Scholar 

  • Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135.

    Article  Google Scholar 

  • Hofmann, W., Schmeichel, B. J., & Baddeley, A. D. (2012). Executive functions and self-regulation. Trends in Cognitive Sciences, 16(3), 174–180.

    Article  Google Scholar 

  • Ibáñez, A., Blanco, C., Moreryra, P., & Sáiz-Ruiz, J. (2003). Gender differences in pathological gambling. The Journal of Clinical Psychiatry, 64(3), 295–301.

    Article  Google Scholar 

  • Keller, D. S., Carroll, K. M., Nich, C., & Rounsaville, B. J. (1995). Alexithymia in cocaine abusers response to psychotherapy and pharmacotherapy. American Journal on Addictions, 4(3), 234–244.

    Article  Google Scholar 

  • Kökönyei, G., Urbán, R., Reinhardt, M., Józan, A., & Demetrovics, Z. (2014). The difficulties in emotion regulation scale: Factor structure in chronic pain patients. Journal of Clinical Psychology, 70(6), 589–600.

    Article  Google Scholar 

  • Koven, N. S., & Thomas, W. (2010). Mapping facets of alexithymia to executive dysfunction in daily life. Personality and Individual Differences, 49(1), 24–28.

    Article  Google Scholar 

  • Ladd, G. T., & Petry, N. M. (2002). Gender differences among pathological gamblers seeking treatment. Experimental and Clinical Psychopharmacology, 10(3), 302–309.

    Article  Google Scholar 

  • Lane, R. D., Weihs, K. L., Herring, A., Hishaw, A., & Smith, R. (2015). Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud’s legacy. Neuroscience and Biobehavioral Reviews, 55, 594–611.

    Article  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.

    Article  CAS  Google Scholar 

  • Levant, R., Hall, R., Williams, C., & Hasan, N. (2009). Sex differences in alexithymia: A review. Psychology of Men & Masculinity, 10, 190–203.

    Article  Google Scholar 

  • Leweke, F., Leichsenring, F., Kruse, J., & Hermes, S. (2012). Is alexithymia associated with specific mental disorders? Psychopathology, 45(1), 22–28.

    Article  Google Scholar 

  • Linehan, M., Schmidt, H., Dimeff, L., Craft, J., Kanter, J., & Comtois, K. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal of Addiction, 8, 279–292.

    Article  CAS  Google Scholar 

  • Loas, G., Fremaux, D., Otmani, O., Lecercle, C., & Delahousse, J. (1997). Is alexithymia a negative factor for maintaining abstinence? A follow-up study. Comprehensive Psychiatry, 38(5), 296–299.

    Article  CAS  Google Scholar 

  • Lohmoeller, J. (1989). Latent variable path modeling with partial least squares. New York: Springer.

    Book  Google Scholar 

  • Lumley, M. A., & Bazydlo, R. A. (2000). The relationship of alexithymia characteristics to dreaming. Journal of Psychosomatic Research, 48(6), 561–567.

    Article  CAS  Google Scholar 

  • Lumley, M. A., & Roby, K. J. (1995). Alexithymia and pathological gambling. Psychotherapy and Psychosomatics, 63(3–4), 201–206.

    Article  CAS  Google Scholar 

  • Marchesi, C., Brusamonti, E., & Maggini, C. (2000). Are alexithymia, depression, and anxiety distinct constructs in affective disorders? Journal of Psychosomatic Research, 49(1), 43–49.

    Article  CAS  Google Scholar 

  • Marchesi, C., Ossola, P., Tonna, M., & De Panfilis, C. (2014). The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression, panic disorder, eating disorders and substance use disorders. Comprehensive Psychiatry, 55(4), 972–978.

    Article  Google Scholar 

  • Masters, M. S., & Sanders, B. (1993). Is the gender difference in mental rotation disappearing? Behavior Genetics, 23(4), 337–341.

    Article  CAS  Google Scholar 

  • Mitrovic, D. V., & Brown, J. (2009). Poker mania and problem gambling: A study of distorted cognitions, motivation and alexithymia. Journal of Gambling Studies, 25(4), 489–502.

    Article  Google Scholar 

  • Noël, X., Brevers, D., & Bechara, A. (2013). A neurocognitive approach to understanding the neurobiology of addiction. Current Opinion in Neurobiology, 23(4), 632–638.

    Article  Google Scholar 

  • Nower, L., & Blaszczynski, A. (2016). Development and validation of the Gambling Pathways Questionnaire (GPQ). Psychology of Addictive Behaviors, 31(1), 95–109.

    Article  Google Scholar 

  • Nunnally, J. C., & Bernstein, I. H. (1994). The assessment of reliability. Psychometric theory, 3(1), 248–292.

    Google Scholar 

  • Parker, J., Bagby, M., Taylor, G., Endler, N., & Schmitz, P. (1993). Factorial validity of the twenty-item Toronto Alexithymia Scale. European Journal of Personality, 7(4), 221–232.

    Article  Google Scholar 

  • Parker, J. D. A., Wood, L. M., Bond, B. J., & Shaughnessy, P. (2005). Alexithymia in young adulthood: A risk factor for pathological gambling. Psychotherapy and Psychosomatics, 74(1), 51–55.

    Article  Google Scholar 

  • Potenza, M. N., Steinberg, M. A., McLaughlin, S. D., Wu, R., Rounsaville, B. J., & O’Malley, S. S. (2001). Gender-related differences in the characteristics of problem gamblers using a gambling helpline. The American Journal of Psychiatry, 158(9), 1500–1505.

    Article  CAS  Google Scholar 

  • Ringle, C. M., Wende, S., & Becker, J. M. (2015). SmartPLS 3. Boenningstedt: SmartPLS GmbH. http://www.smartpls.com.

  • Schweizer, S., Grahn, J., Hampshire, A., Mobbs, D., & Dalgleish, T. (2013). Training the emotional brain: Improving affective control through emotional working memory training. The Journal of Neuroscience, 33(12), 5301–5311.

    Article  CAS  Google Scholar 

  • Shishido, H., Gaher, R. M., & Simons, J. S. (2013). I don’t know how I feel, therefore I act: Alexithymia, urgency, and alcohol problems. Addictive Behaviors, 38(4), 2014–2017.

    Article  Google Scholar 

  • Smith, D., Battersby, M., & Harvey, P. (2015). Does gender moderate the subjective measurement and structural paths in behavioural and cognitive aspects of gambling disorder in treatment-seeking adults? Addictive Behaviors, 48, 12–18.

    Article  Google Scholar 

  • Speranza, M., Corcos, M., Stéphan, P., Loas, G., Pérez-Diaz, F., Lang, F., et al. (2004). Alexithymia, depressive experiences, and dependency in addictive disorders. Substance Use and Misuse, 39(4), 551–579.

    Article  Google Scholar 

  • Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P., & Jacobs, G. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Steel, Z., & Blaszczynski, A. (1998). Impulsivity, personality disorders and pathological gambling severity. Addiction (Abingdon, England), 93(6), 895–905.

    Article  CAS  Google Scholar 

  • Taylor, G. J., Bagby, R. M., & Parker, J. D. (1991). The alexithymia construct. A potential paradigm for psychosomatic medicine. Psychosomatics, 32(2), 153–164.

    Article  CAS  Google Scholar 

  • Taylor, G., Bagby, R., & Parker, J. (1997). Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge University Press.

  • Taylor, G. J., Ryan, D., & Bagby, R. M. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy and Psychosomatics, 44(4), 191–199.

    Article  CAS  Google Scholar 

  • Tenenhaus, M., Vinzi, V. E., Chatelin, Y.-M., & Lauro, C. (2005). PLS path modeling. Computational Statistics & Data Analysis, 48(1), 159–205.

    Article  Google Scholar 

  • Tolmunen, T., Heliste, M., Lehto, S. M., Hintikka, J., Honkalampi, K., & Kauhanen, J. (2011). Stability of alexithymia in the general population: An 11-year follow-up. Comprehensive Psychiatry, 52(5), 536–541.

    Article  Google Scholar 

  • Turner, M. L., & Engle, R. W. (1989). Is working memory capacity task dependent? Journal of Memory and Language, 28(2), 127–154.

    Article  Google Scholar 

  • Velotti, P., Garofalo, C., Petrocchi, C., Cavallo, F., Popolo, R., & Dimaggio, G. (2016). Alexithymia, emotion dysregulation, impulsivity and aggression: A multiple mediation model. Psychiatry Research, 237, 296–303.

    Article  Google Scholar 

  • Vitaro, F., Arseneault, L., & Tremblay, R. E. (1999). Impulsivity predicts problem gambling in low SES adolescent males. Addiction, 94(4), 565–575.

    Article  CAS  Google Scholar 

  • Vitaro, F., Wanner, B., Ladouceur, R., Brendgen, M., & Tremblay, R. E. (2004). Trajectories of gambling during adolescence. Journal of Gambling Studies, 20(1), 47–69.

    Article  Google Scholar 

  • Wardle, H., Moody, A., Spence, S., Orford, J., Volberg, R., Jotangia, D., et al. (2011). British Gambling Prevalence Survey 2010. London: The Stationery Office.

    Google Scholar 

  • Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30(4), 669–689.

    Article  Google Scholar 

  • Wickens, C. M., Toplak, M. E., & Wiesenthal, D. L. (2008). Cognitive failures as predictors of driving errors, lapses, and violations. Accident; Analysis and Prevention, 40(3), 1223–1233.

    Article  Google Scholar 

  • Will Shead, N., & Hodgins, D. C. (2009). Affect-regulation expectancies among gamblers. Journal of Gambling Studies, 25(3), 357–375.

    Article  CAS  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.

    Article  Google Scholar 

  • Zech, E., Luminet, O., Rimé, B., & Wagner, H. (1999). Alexithymia and its measurement: Confirmatory factor analyses of the 20-item Toronto Alexithymia Scale and the Bermond–Vorst Alexithymia Questionnaire. European Journal of Personality, 13, 511–532.

    Article  Google Scholar 

  • Zimmermann, G., Rossier, J., Meyer de Stadelhofen, F., & Gaillard, F. (2005). Alexithymia assessment and relations with dimensions of personality. European Journal of Psychological Assessment, 21(1), 23–33.

    Article  Google Scholar 

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Acknowledgements

X. Noël is supported by the Fonds de la Recherche Scientifique (F.R.S.-FNRS), Belgium.

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Authors and Affiliations

  1. Laboratoire de Psychologie Médicale et d’Addictologie, Université Libre de Bruxelles (ULB) - Campus Brugmann, place Van Gehuchten, 4, Brussels, Belgium

    Xavier Noël & Charles Kornreich

  2. Psychiatric Institut, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium

    Mélanie Saeremans & Charles Kornreich

  3. Brain and Creativity Institute, University of Southern California (USC), Los Angeles, CA, USA

    Antoine Bechara

  4. Unité de Recherche Clinique Intersectorielle en Psychiatrie à vocation régionale Pierre Deniker, Centre Hospitalier Henri Laborit, Poitiers, France

    Nematollah Jaafari

  5. INSERM U 1084, Experimental and Clinical Neuroscience Laboratory, Groupement de Recherche CNRS 3557, Université de Poitiers, INSERM CIC-P 1402 du CHU de Poitiers, Poitiers, France

    Nematollah Jaafari

  6. Research Center of Clinical Psychology, Psychopathology and Psychosomatic, Université Libre de Bruxelles (ULB), Brussels, Belgium

    Carole Fantini-Hauwel

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  1. Xavier Noël
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Noël, X., Saeremans, M., Kornreich, C. et al. On the Processes Underlying the Relationship Between Alexithymia and Gambling Severity. J Gambl Stud 34, 1049–1066 (2018). https://doi.org/10.1007/s10899-017-9715-1

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