To effectively reach through to pathological gamblers, clinicians may need to customize treatment strategies for patients that meet their specific therapeutic needs. A new study by researchers at la Unidad de Juego Patológico del Hospital de Bellvitge-IDIBELL de Barcelona (Pathological Gambling Unit at the Bellvitge-IDIBELL Hospital in Barcelona) and la Universidad Autónoma de Barcelona (the Autonomous University of Barcelona, or UAB) have identified four subtypes of pathological gamblers based on common personality and associated psychopathological characteristics. Their findings were recently published in The Canadian Journal of Psychiatry. Lead researchers Dr. Eva Álvarez-Moya and Dr. Susana Jiménez-Murcia and colleagues conducted a clinical study on 1,171 pathological gamblers seeking treating for their gambling addictions. According to current clinical mental illness manuals, including the APA, pathological gambling is classified as a chronic impulse disorder. Yet the researchers’ latest findings support the proposal of introducing a new diagnostic category in the pending fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) called “behavioral and substance addictions” to better categorize such disorders as pathological gambling. Furthermore, this newer classification may help determine risk of pathological gambling since the disorder is believed to be genetically influenced as well. After assessing participants using five different clinical screening modules as well as an interview procedure, the researchers were able to generate four groupings of characteristics to classify varying levels of pathological gambling. The most severe form was classified as Type I, also called “disorganized and emotionally unstable,” and is characterized by high levels of impulsiveness, schizotypic personality traits, psychopathological disturbances, alcohol or substance abuse, and early age of onset. The second subtype, Type II, known as “schizoid,” is characterized by high harm avoidance, alcohol abuse problems, and social detachment. Of the four subtypes, Type I and Type II pathological gamblers show signs of response modulation deficits, yet only Type II gamblers exhibit severe, simultaneous psychopathology, sensation-seeking, and impulsive behavior. Type III, called “reward sensitive,” is characterized by intense sensation-seeking behavior and impulsiveness, but no indication of psychopathological disturbances. Type IV, known as “high-functioning,” exhibits what researchers call a ‘globally-adapted personality profile,’ with low occurrence of substance abuse and no signs of psychopathological disturbances. From their findings, the researchers suggest that it is possible to categorize pathological gambling patients into at least four subtypes, based on severity of their symptoms, personality characteristics, and comorbidity of substance abuse. The four classifications that researchers have identified from their study may be linked to different therapeutic approaches that can utilized to better help treat pathological gamblers. Some limitations of the study may require the need for further research on subtyping gambling disorders. For example, the researchers only included in their study pathological gamblers who were self-seeking treatment, and their classifications may leave out those types who are not likely to seek help. Also, the majority of participants expressed an addiction to gambling on slot machines, and the prevalence of comorbidity with other clinical conditions besides substance abuse disorders was not assessed. Source: Medical News Today, Four Kinds of Compulsive Gamblers Identified, October 15, 2010
