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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

Published online by Cambridge University Press:  14 May 2007

A. E. Goudriaan ,
J. Oosterlaan ,
E. De Beurs  and
W. Van Den Brink
A. E. Goudriaan*
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
J. Oosterlaan
Affiliation:
Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
E. De Beurs
Affiliation:
Netherlands Institute for Forensic Psychiatry and Psychology, Utrecht, The Netherlands
W. Van Den Brink
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, and Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
*
*Address for correspondence: A. E. Goudriaan, Ph.D., Academic Medical Center, Department of Psychiatry, University of Amsterdam, Room PB0-433, PO Box 75867, 1070 AWAmsterdam, The Netherlands. (Email: [email protected] or [email protected])
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Abstract

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.

Method

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.

Keywords

Addictionimpulse control disorderlongitudinal studyneurocognitionneuropsychologypathological gamblingrelapse
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 1 , January 2008 , pp. 41 - 50
Copyright
Copyright © Cambridge University Press 2007

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