Subtyping study of a pathological gamblers sample.
OBJECTIVE
To classify into subgroups a sample of pathological gambling (PG) patients according to personality variables and to describe the subgroups at a clinical level.


METHODS
PG patients (n = 1171) were assessed with the South Oaks Gambling Screen; the Temperament and Character Inventory-Revised; the Symptom Checklist-90-Revised; Eysenck's Impulsivity Scales, a diagnostic questionnaire for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) PG criteria; and the Structured Clinical Interview for the DSM-IV, Axis I disorders, substance use module. Clinical measures were collected through a semi-structured interview. We performed a 2-step cluster analysis based on the above-mentioned personality variables. Clinical data were compared across clusters.


RESULTS
Four clusters were generated. Type I (disorganized and emotionally unstable) showed schizotypic traits, high impulsiveness, substance and alcohol abuse, and early age of onset, as well as psychopathological disturbances. Type II (schizoid) showed high harm avoidance, social aloofness, and alcohol abuse. Type III (reward sensitive) showed high sensation seeking and impulsiveness but no psychopathological impairments. Type IV (high-functioning) showed a globally adaptive personality profile, low level of substance and alcohol abuse or smoking, and no psychopathological disturbances.


CONCLUSIONS
At least 4 types of PG patients may be identified. Two types showed a response modulation deficit, but only one of them had severe psychopathological disturbances. Two other types showed no impulsiveness or sensation seeking and one of them even exhibited good general functioning. The different personality and clinical configuration of these clusters might be linked to different therapeutic approaches.
Alvarez-Moya
Eva Ma
EM
Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.
Jiménez-Murcia
Susana
S
Aymamí
Ma Neus
MN
Gómez-Peña
Mónica
M
Granero
Roser
R
Santamaría
Juanjo
J
Menchón
Jose M
JM
Fernández-Aranda
Fernando
F
D000328:Adult; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000145:classification / Q000175:diagnosis / Q000523:psychology; D005106:Exploratory Behavior; D005260:Female; D005715:Gambling / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007389:Internal-External Control; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics; D011599:Psychopathology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology