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. 2020 Mar 8:97:109799.
doi: 10.1016/j.pnpbp.2019.109799. Epub 2019 Oct 30.

Longitudinal subtypes of disordered gambling in young adults identified using mixed modeling

Samuel R Chamberlain  1 , Jan Stochl  2 , Jon E Grant  3
Affiliations

Longitudinal subtypes of disordered gambling in young adults identified using mixed modeling

Samuel R Chamberlain et al. Prog Neuropsychopharmacol Biol Psychiatry. .

Abstract

Objective: While many individuals gamble responsibly, some develop maladaptive symptoms of a gambling disorder. Gambling problems often first occur in young people, yet little is known about the longitudinal course of such symptoms and whether this course can be predicted. The aim of this study was to identify latent subtypes of disordered gambling based on symptom presentation and identify predictors of persisting gambling symptoms over time.

Methods: 575 non-treatment seeking young adults (mean age [SD] = 22.3 [3.6] years; 376 (65.4%) male) were assessed at baseline and annually, over three years, using measures of gambling severity. Latent subtypes of gambling symptoms were identified using latent mixture modeling. Baseline differences were characterized using analysis of variance and binary logistic regression respectively.

Results: Three longitudinal phenotypes of disordered gambling were identified: high harm group (N = 5.6%) who had moderate-severe gambling disorder at baseline and remained symptomatic at follow-up; intermediate harm group (19.5%) who had problem gambling reducing over time; and low harm group (75.0%) who were essentially asymptomatic. Compared to the low harm group, the other two groups had worse baseline quality of life, elevated occurrence of other mental disorders and substance use, higher body mass indices, and higher impulsivity, compulsivity, and cognitive deficits. Approximately 5% of the total sample showed worsening of gambling symptoms over time, and this rate did not differ significantly between the groups.

Conclusions: Three subtypes of disordered gambling were found, based on longitudinal symptom data. Even the intermediate gambling group had a profundity of psychopathological and untoward physical health associations. Our data indicate the need for large-scale international collaborations to identify predictors of clinical worsening in people who gamble, across the full range of baseline symptom severity from minimal to full endorsement of current diagnostic criteria for gambling disorder.

Keywords: Addiction; Cognition; Gambling; Impulsivity; Latent; Subtypes.

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Conflict of interest statement

Dr. Chamberlain consults for Cambridge Cognition, Shire, Promentis, and Ieso Digital Health. Dr. Chamberlain receives a stipend for role as Associate Editor at Neuroscience and Biobehavioral Reviews; and for his role as Associate Editor at Comprehensive Psychiatry. Dr. Stochl consults for Ieso Digital Health. Dr. Grant has received research grants from NIMH, National Center for Responsible Gaming, and Forest and Roche Pharmaceuticals. He receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill.

Figures

Fig. 1
Fig. 1
Computed SCI-GD total scores (number of diagnostic items endorsed) over time in each of the three identified latent groups. The Y-axis indicates SCI-GD total items endorsed, derived from latent modeling and fitting baseline data in regression. The X-axis indicates the time-point (baseline, +1 year, + 2 year, and + 3 year).
See this image and copyright information in PMC

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