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Moderator effect of sex in the clustering of treatment-seeking patients with gambling problems

Moderierender Effekt des Geschlechts bei der Clusterbildung von behandlungssuchenden Patienten mit Glücksspielproblemen

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Summary

Background

There are no studies based on a person-centered approach addressing sex-related differences in the characteristics of treatment-seeking patients with gambling disorder (GD). The main objective of the current study is to identify empirical clusters of GD based on several measures of the severity of gambling behavior, and considering the potential role of patient sex as a moderator.

Methods

An agglomerative hierarchical clustering method was applied to an adult sample of 512 treatment-seeking patients (473 men and 39 women) by using a combination of the Schwarz Bayesian Information Criterion and log-likelihood function.

Results

Three clusters were identified in the subsample of men: cluster M1 (low-mild gambling severity level, 9.1%), cluster M2 (moderate level, 60.9%), and cluster M3 (severe level, 30.0%). In the women subsample, two clusters emerged: cluster W1 (mild-moderate level, 64.1%), and cluster W2 (severe level, 35.9%). The most severe GD profiles were related to being single, multiple gambling preference for nonstrategic plus strategic games, early onset of the gambling activity, higher impulsivity levels, higher dysfunctional scores in the personality traits of harm avoidance, and self-directedness, and higher number of lifespan stressful life events (SLE). Differences between the empirical men and women clusters were found in different sociodemographic and clinical measurements.

Conclusions

Men and women have distinct profiles regarding gambling severity that can be identified by a clustering approach. The sociodemographic and clinical characterization of each cluster by sex may help to establish specific preventive and treatment interventions.

Zusammenfassung

Hintergrund

Es gibt keine Studien, die auf einem personenzentrierten Ansatz beruhen und sich mit geschlechtsspezifischen Unterschieden in den Merkmalen von behandlungssuchenden Patienten mit einer Glücksspielstörung (GD) befassen. Wesentliches Ziel der vorgestellten Studie ist es, empirische GD-Cluster zu identifizieren, die auf mehreren Messungen der Schwere des Spielverhaltens basieren und dabei die mögliche Rolle des Geschlechts als moderierenden Faktor berücksichtigen.

Methodik

An einer erwachsenen Stichprobe von 512 behandlungssuchenden Patienten (473 männliche, 39 weibliche) wurde eine agglomerierende hierarchische Clustering-Methode angewendet unter Einsatz einer Kombination aus dem Schwarz-Bayes-Kriterium und einer logarithmischen Wahrscheinlichkeitsfunktion.

Ergebnisse

In der Unterstichprobe der Männer wurden 3 Cluster identifiziert: Cluster M1 (niedrig-mildes Niveau der Spielauffälligkeit, 9,1%), Cluster M2 (moderates Niveau, 60,9%) und Cluster M3 (hohes Niveau, 30,0%). In der Unterstichprobe der Frauen ergaben sich 2 Cluster: Cluster W1 (mäßiges Niveau, 64,1%) und Cluster W2 (hohes Niveau, 35,9%). Die gravierendsten GD-Profile bezogen sich auf Einzel- und Mehrfachspielpräferenz für nichtstrategische und strategisch orientierte Spiele, frühes Einsetzen der Spielaktivität, höhere Impulsivitätsgrade, höhere dysfunktionale Werte bei den Persönlichkeitsmerkmalen Schadensvermeidung und Selbststeuerung sowie eine höhere Anzahl von belastenden Lebensereignissen (SLE). Unterschiede zwischen den empirischen Männer- und Frauen-Clustern wurden in verschiedenen soziodemographischen und klinischen Messungen gefunden.

Schlussfolgerungen

Männer und Frauen haben unterschiedliche Profile hinsichtlich der Spielauffälligkeit, die sich durch einen Clustering-Ansatz identifizieren lassen. Die soziodemographische und klinische Charakterisierung jedes Clusters nach Geschlecht kann dazu beitragen, spezifische Präventions- und Behandlungsmaßnahmen zu etablieren.

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Funding

This manuscript and research were supported by grant from the Dirección General de Ordenación del Juego (DGOJ), Ministerio de Hacienda y Administraciones Públicas (RISCJPESP-2016). We thank the efforts of the following centers by contributing data recruited among their patients: ABAJ (Asociación Burgalesa Anónimo de Jugadores); ABLA (Associació Barcelonesa de Ludopatia i Addiccions); ACENCAS (Associació Catalana d’Addiccions socials); ACOGER (Asociación Cordobesa de Jugadores en Rehabilitación); ADAT (Asociación Dombenitense de Ayuda al Toxicómano); ALUJER (Asociación de Ludópatas Jienense en Rehabilitación); ASAJER (Asociación de Jugadores en Rehabilitación); Asociación Proyecto Hombre; AZAJER (Asociación Aragonesa de Jugadores de Azar); EL AZAR (Asociación de Jugadores en Recuperación); FAJER (Federación Andaluza de Asociaciones de Jugadores de Azar en Rehabilitación); FEJAR (Federación Española de Jugadores de Azar Rehabilitados); Fundación Acorde; Fundación Adsis; Fundación Salud y Comunidad; Institut Pere Mata; Jugadores Anónimos—Área 21; Jugadores Anónimos—España; Jugadores Anónimos—Grupo Arganda; JUGUESCA (Associació Juguesca Ludopatia); Oficina Registro de la DGOJ; PATIM (Prevención y Tratamiento de Drogodependencias y Otras Adicciones); Proyecto Amigó; Proyecto Hombre—La Rioja; Proyecto Hombre—Murcia; SEPD (Sociedad Española de Patología Dual, Dr. Ignacio Basurte); Unitat de Conductes Addictives (Hospital de la Santa Creu i Sant Pau); Unitat de Joc Patològic i Altres Adiccions Conductuals (Hospital Universitari de Bellvitge).

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Authors and Affiliations

  1. Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain

    Susana Jiménez-Murcia, Roser Granero, Gemma Mestre-Bach, Teresa Mena-Moreno & Fernando Fernández-Aranda

  2. Department of Psychiatry, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Spain

    Susana Jiménez-Murcia, Mònica Giménez, Amparo del Pino-Gutiérrez, Gemma Mestre-Bach, Teresa Mena-Moreno, Laura Moragas, Marta Baño, Jéssica Sánchez-González, Marta de Gracia, Isabel Baenas-Soto, S. Fabrizio Contaldo, Eduardo Valenciano-Mendoza, Bernat Mora-Maltas, Hibai López-González, José M. Menchón & Fernando Fernández-Aranda

  3. Psychiatry and Mental Health Group, Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge—IDIBELL, L’Hospitalet de Llobregat, Spain

    Susana Jiménez-Murcia, José M. Menchón & Fernando Fernández-Aranda

  4. Department of Clinical Sciences, School of Medicine, Universitat de Barcelona—UB, L’Hospitalet de Llobregat, Spain

    Susana Jiménez-Murcia & Fernando Fernández-Aranda

  5. Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain

    Roser Granero

  6. CIBER Salud Mental (CIBERSam), Instituto de Salud Carlos III, Madrid, Spain

    Mònica Giménez, Eduardo Valenciano-Mendoza & José M. Menchón

  7. Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona—UB, Barcelona, Spain

    Amparo del Pino-Gutiérrez

Authors
  1. Susana Jiménez-Murcia
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  2. Roser Granero
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  3. Mònica Giménez
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  7. Laura Moragas
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  8. Marta Baño
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  9. Jéssica Sánchez-González
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  10. Marta de Gracia
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  11. Isabel Baenas-Soto
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  12. S. Fabrizio Contaldo
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  14. Bernat Mora-Maltas
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  17. Fernando Fernández-Aranda
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Corresponding author

Correspondence to Susana Jiménez-Murcia.

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S. Jiménez-Murcia, R. Granero, M. Giménez, A. del Pino-Gutiérrez, G. Mestre-Bach, T. Mena-Moreno, L. Moragas, M. Baño, J. Sánchez-González, M. de Gracia, I. Baenas-Soto, S. F. Contaldo, E. Valenciano-Mendoza, B. Mora-Maltas, H. López-González, J.M. Menchón, and F. Fernández-Aranda declare that they have no competing interests.

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Jiménez-Murcia, S., Granero, R., Giménez, M. et al. Moderator effect of sex in the clustering of treatment-seeking patients with gambling problems. Neuropsychiatr 34, 116–129 (2020). https://doi.org/10.1007/s40211-020-00341-1

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