The role of self-reported impulsivity and reward sensitivity versus neurocognitive measures of disinhibition and decision-making in the prediction of relapse in pathological gamblers.
BACKGROUND
Disinhibition and decision-making skills play an important role in theories on the cause and outcome of addictive behaviors such as substance use disorders and pathological gambling. In recent studies, both disinhibition and disadvantageous decision-making strategies, as measured by neurocognitive tests, have been found to influence the course of substance use disorders. Research on factors affecting relapse in pathological gambling is scarce.


METHODS
This study investigated the effect of both self-reported impulsivity and reward sensitivity, and neurocognitively assessed disinhibition and decision-making under conflicting contingencies, on relapse in a group of 46 pathological gamblers.


RESULTS
Logistic regression analysis indicated that longer duration of the disorder and neurocognitive indicators of disinhibition (Stop Signal Reaction Time) and decision-making (Card Playing Task) were significant predictors of relapse (explaining 53% of the variance in relapse), whereas self-reported impulsivity and reward sensitivity did not significantly predict relapse. Overall classification accuracy was 76%, with a positive classification accuracy of 76% and a negative classification accuracy of 75%.


CONCLUSIONS
Duration of the disorder and neurocognitive measures of disinhibition and decision-making are powerful predictors of relapse in pathological gambling. The results suggest that endophenotypical neurocognitive characteristics are more promising in the prediction of relapse in pathological gambling than phenotypical personality characteristics. Neurocognitive predictors may be useful to guide treatment planning of follow-up contacts and booster sessions.
Goudriaan
A E
AE
Department of Psychiatry, Academic Medical Center, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands. agoudriaan@gmail.com
Oosterlaan
J
J
De Beurs
E
E
Van Den Brink
W
W
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D003657:Decision Making; D005260:Female; D005715:Gambling / Q000523:psychology*; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000523:psychology; D007266:Inhibition, Psychological; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010551:Personality / Q000145:classification*; D010555:Personality Inventory; D011336:Probability; D012008:Recurrence; D012201:Reward; D011795:Surveys and Questionnaires