title: Pathological gambling subtypes: A comparison of treatment-seeking and non-treatment-seeking samples from Brazil and Canada.
abstract: BACKGROUND
  Pathological gambling (PG) is a heterogeneous disorder. The identification and characterization of PG subtypes could lead to tailored treatment approaches, which may, in turn, improve treatment outcomes.
  
  
  OBJECTIVE
  To investigate PG subtypes based on personality traits across two different cultural and clinical settings. Consistent with the Pathways Model, we hypothesized the presence of three subtypes (behaviorally conditioned - BC, emotionally vulnerable - EV, and antisocial impulsivist - AI).
  
  
  METHODS
  140 PG adults from São Paulo, Brazil (SP sample) and 352 adults with PG (n=214) or sub-clinical PG (n=138) from Toronto, Canada (TO sample) completed the Temperament and Character Inventory (TCI). Latent-class analysis was used to investigate subtypes.
  
  
  RESULTS
  A 2-class solution was the best model for the pooled SP and TO samples. Class 1 presented a normative personality profile and was composed exclusively of participants from Toronto (BC subtype). Class 2 was characterized by high novelty seeking, high harm avoidance, and low self-directedness, and included participants from both SP and TO (EV subtype). When sub-clinical PGs were excluded from the analysis, a single-class solution better characterized the SP and TO samples.
  
  
  CONCLUSIONS
  Our results suggest that PG severity, rather than community or clinical settings, may have an effect on PG subtypes. The generalizability of the results is limited by the demographic and clinical features of the selected samples. Future neurobiological studies may contribute to the categorization of subjects into PG subtypes based on different underlying biological pathways.
authors.affiliation: Addictions Program and Neurogenetics Laboratory, Centre for Addiction and Mental Health, 33 Russell St., R3020, Toronto, ON M5S 2S1, Canada; Department of Psychiatry, University of Toronto, 250 College St., R129, Toronto, ON M5T 1R8, Canada. Electronic address: Daniela.Lobo@camh.ca.
authors.forename: D S S
authors.initials: DS
authors.lastname: Lobo
authors.affiliation: Clinical Research Department, Centre for Addiction and Mental Health, 250 College St., R 648, Toronto, ON M5T 1R8, Canada. Electronic address: Lena.Quilty@camh.ca.
authors.forename: L C
authors.initials: LC
authors.lastname: Quilty
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, Rm. 509, New York, NY 10032, USA. Electronic address: ssm2183@columbia.edu.
authors.forename: S S
authors.initials: SS
authors.lastname: Martins
authors.affiliation: Gambling Outpatient Unit, Department of Psychiatry, University of São Paulo, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP 05403-903, Brazil. Electronic address: hermanot@uol.com.br.
authors.forename: H
authors.initials: H
authors.lastname: Tavares
authors.affiliation: Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP 05403-903, Brazil. Electronic address: homero.vallada@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Vallada
authors.affiliation: Department of Psychiatry, University of Toronto, 250 College St., R129, Toronto, ON M5T 1R8, Canada; Neurogenetics Laboratory, Centre for Addiction and Mental Health, Toronto, Canada. Electronic address: Jim.Kennedy@camh.ca.
authors.forename: J L
authors.initials: JL
authors.lastname: Kennedy
authors.affiliation: Departments of Psychology and Psychiatry, University of Toronto, Canada; Research Program, Centre for Addiction and Mental Health, 1265 Military Trail, Toronto, ON M1C 1A4, Canada. Electronic address: rmichael.bagby@utoronto.ca.
authors.forename: R M
authors.initials: RM
authors.lastname: Bagby
mesh_terms: D001938:Brazil; D002170:Canada; D005260:Female; D005715:Gambling / Q000145:classification* / Q000523:psychology; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010551:Personality; D010552:Personality Assessment; D011795:Surveys and Questionnaires
keywords: Gambling subtypes; Pathological gambling; Personality; Problem gambling