Ramos-Grille, Irene; Gomà-i-Freixanet, Montserrat; Aragay, Nùria; Valero, Sergi; Vallès, Vicenç
The aim of the present study was to determine which domains in NEO Personality Inventory-Revised would predict relapse and dropout in treatment-seeking slot-machine pathological gamblers after 1-year follow-up. The NEO PI-R was completed by 73 consecutive treatment-seeking outpatients before they began an open program of individual cognitive-behavioral therapy. Twelve months after starting treatment, patients were categorized in groups as abstinent versus relapsed or completers versus dropouts. At 1-year follow-up, 29% of patients were abstinent, and 48% had completed treatment. Those who had relapsed showed higher significant scores on Neuroticism and lower scores on Conscientiousness. The dropout group scored significantly higher on Neuroticism and lower on Agreeableness and Conscientiousness than the completer group. Low scores on Conscientiousness emerged as a significant predictor of relapse; while low scores on Conscientiousness and Agreeableness were significant predictors of dropout. It seems as if low Conscientiousness could be considered as a predictor of treatment failure measured by either relapses or dropouts, whereas, low Agreeableness seems to be a prognostic domain specifically for dropouts. Pathological gamblers with lower Conscientiousness and lower Agreeableness seem to be at risk of prematurely dropping out of treatment. Our findings support the importance of individual differences in personality on therapy outcomes. The NEO PI-R may constitute an important tool to identify treatment-seeking pathological gamblers who may be at risk of relapsing or dropping out of treatment.
Echeburúa, Enrique; González-Ortega, Itxaso; de Corral, Paz; Polo-López, Rocío
The current study aimed to identify personality traits, emotional states and adjustment variables in a sample of pathological gamblers as compared to a non-gambling control group taking gender differences into account. The sample for this study consisted of 206 subjects (103 pathological gamblers and 103 non-psychiatric subjects from the general population matched for age and gender). Pathological gamblers had a lower educational level and a family history of alcohol abuse higher than non-gamblers. In turn, female gamblers were affected by unemployment and a lower socioeconomic status more often than female non-gamblers. Pathological gamblers were more anxious and impulsive and suffered from a poorer self-esteem than non-gamblers. Likewise, pathological gamblers had a greater history of other Axis I psychiatric disorders and were more often affected by anxiety and depression symptoms and showed a more problematic adjustment to everyday life than non-gamblers. Alcohol abuse was not higher in pathological gamblers than in non-gamblers, but, when gender was taken into account, male gamblers were more affected by alcohol abuse than male non-gamblers. Importantly 68.6% of female gamblers versus 9.8% of control group women reported being victims of intimate partner violence. These findings can be used to specifically inform prevention and intervention efforts.
Petry, Nancy M.; Ammerman, Yola; Bohl, Jaime; Doersch, Anne; Gay, Heather; Kadden, Ronald; Molina, Cheryl; Steinberg, Karen
Few studies have evaluated efficacy of psychotherapies for pathological gambling. Pathological gamblers (N = 231) were randomly assigned to (a) referral to Gamblers Anonymous (GA), (b) GA referral plus a cognitive-behavioral (CB) workbook, or (c) GA referral plus 8 sessions of individual CB therapy. Gambling and related problems were assessed…
Locke, Geoffrey W.; Shilkret, Robert; Everett, Joyce E.; Petry, Nancy M.
Background Interpersonal guilt is associated with psychopathology, but its relationship to pathological gambling has not been studied. Objectives This study examined the relationship between interpersonal guilt and pathological gambling. Methods In total, 1,979 college students completed a questionnaire containing the South Oaks Gambling Screen, Interpersonal Guilt Questionnaire, and questions about substance use. Students identified as pathological gamblers (n = 145) were matched to non-problem gamblers with respect to demographics and substance use. Results Pathological gamblers had significantly higher interpersonal guilt than their non-problem gambling peers. Conclusions and Scientific Significance Pathological gambling college students have excessive interpersonal guilt, and these findings may lead to novel treatment approaches. PMID:22746179
Petry, Nancy M
Numerous types of treatments for pathological gambling have been described, but two of the most common are Gamblers Anonymous (GA) and cognitive-behavioral therapy. This paper describes some outcome data associated with the two approaches. It also reviews evidence suggesting that a combined intervention may enhance therapy engagement and reduce relapse rates.
Dowling, Nicki; Smith, David; Thomas, Trang
The available evidence suggests that pathological gambling significantly disrupts family relationships and has a substantial impact on family members. However, these conclusions are based almost exclusively on male pathological gamblers and their female spouses or partners. The current study, which was a secondary study derived from a treatment…
Dixon, Mark R.; Jacobs, Eric A.; Sanders, Scott
The present study demonstrated the relative impact of gambling and nongambling contexts on the degree of delay discounting by pathological gamblers. We used a delay-discounting task with 20 pathological gamblers in and out of the natural context in which they regularly gambled. For 16 of the 20 participants, it appeared that the difference of…
Müller, K W; Beutel, M E; Egloff, B; Wölfling, K
Engaging in online games has become increasingly important as a part of leisure activity in adolescents and adults. While the majority of people use these games in a healthy way, epidemiological studies show that some develop excessive use and symptoms that are related to those of substance-related addictions. Despite increasing research concerning the epidemiology of internet gaming disorder (IGD), predisposing factors have been examined to a lesser extent. Knowing about specific risk factors would help clarify the nosological features of IGD and enhance prevention and intervention. This study aimed to evaluate the relationships between personality traits and IGD. A total of 115 patients meeting the criteria for IGD were compared to 167 control subjects displaying either regular or intense use of online games. Additionally, 115 patients meeting diagnostic criteria for pathological gambling were included. IGD was associated with higher neuroticism, decreased conscientiousness and low extraversion. The comparisons to pathological gamblers indicate that low conscientiousness and low extraversion in particular are characteristic of IGD. An integration of personality variables into an etiopathological model describing presumable mechanisms fostering and maintaining addictive online gaming is proposed. This model could be helpful for the theoretical understanding of addictive gaming, public health campaigns and psychoeducation within therapeutic settings.
Ronzitti, Silvia; Lutri, Vittorio; Smith, Neil; Clerici, Massimo; Bowden-Jones, Henrietta
Background and aim Gambling is a widespread recreational activity in the UK. A significant percentage of gamblers develop subclinical or clinically relevant problem gambling issues, but only a low percentage of them seek treatment. Although characteristics of pathological gamblers from treatment-seeking population have been examined in some research, only a few studies have explored the differences between females and males. This study aimed to examine the gender-related differences in demographics, gambling measures, and clinical variables in an outpatient sample of pathological gamblers seeking treatment. Methods A total of 1,178 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. Sociodemographic characteristics, clinical variables, and gambling behavior habits were obtained during the assessment evaluation. Of the total sample, 92.5% were males and 7.5% were females. Results Males were more likely to be younger, white, and employed than females. In addition, compared to women, men showed a lower PGSI score, an earlier age of onset of gambling behavior, a higher gambling involvement, and preferred specific forms gambling. Female gamblers were more anxious and depressed, while men were more likely to use alcohol and illicit drugs. Conclusions Our findings support the importance of gender differences in a treatment-seeking population of pathological gamblers both in sociodemographic characteristics, gambling behavior variables, and clinical variables. Males and females might benefit from group-specific treatment. PMID:27348561
Dixon, Mark R.; Holton, Bethany
The present study explored the delay discounting of future and past monetary rewards by pathological gamblers. Using a multiple baseline design, following repeated exposure to choices between smaller immediate and larger delayed consequences, participants completed a relational responding task that attempted to alter the psychological functions of…
Nordin, Conny; Sjodin, Ingemar
Neurocognitive disturbances suggesting a frontal lobe dysfunction have been observed in pathological gamblers and alcohol dependents. Given that a high homocysteine level has been suggested to be a mediating factor in alcohol-related cognitive decline, we have determined homocysteine and cobalamine in cerebrospinal fluid (CSF) obtained from 11…
Echeburúa, Enrique; González-Ortega, Itxaso; de Corral, Paz; Polo-López, Rocío
This study aimed to examine the gender-related differences in demographics, gambling measures, psychological functioning, and motivation for therapy in an outpatient sample of pathological gamblers seeking treatment. Participants in this multisite study included 103 adult outpatients (51 women and 52 men) meeting current DSM-IV-TR criteria for PG. Logistic regression was used to examine if gender was related together to categorical and continuous independent variables. Female gamblers were older than men and more likely to be divorced or widowed and to have a lower annual income. Women became more dependent on bingo and men on slot machines. Gambling motivation and the course of illness for both sexes were also different. Female gamblers were more anxious and with a poorer self-esteem than male gamblers and more affected by depressive symptoms; in turn, men were more impulsive and higher sensation seekers than women and more affected by drug/alcohol abuse. The 68.6% of female gamblers reported being victims of intimate partner violence. There were no gender differences about the motivation for treatment. Future research should examine gambling behaviors and psychological functioning and suggest treatment approaches to address specific goals according to these gender-related differences.
Orgaz, Cristina; Estévez, Ana; Matute, Helena
An illusion of control is said to occur when a person believes that he or she controls an outcome that is uncontrollable. Pathological gambling has often been related to an illusion of control, but the assessment of the illusion has generally used introspective methods in domain-specific (i.e., gambling) situations. The illusion of control of pathological gamblers, however, could be a more general problem, affecting other aspects of their daily life. Thus, we tested them using a standard associative learning task which is known to produce illusions of control in most people under certain conditions. The results showed that the illusion was significantly stronger in pathological gamblers than in a control undiagnosed sample. This suggests (1) that the experimental tasks used in basic associative learning research could be used to detect illusions of control in gamblers in a more indirect way, as compared to introspective and domain-specific questionnaires; and (2), that in addition to gambling-specific problems, pathological gamblers may have a higher-than-normal illusion of control in their daily life.
Orgaz, Cristina; Estévez, Ana; Matute, Helena
An illusion of control is said to occur when a person believes that he or she controls an outcome that is uncontrollable. Pathological gambling has often been related to an illusion of control, but the assessment of the illusion has generally used introspective methods in domain-specific (i.e., gambling) situations. The illusion of control of pathological gamblers, however, could be a more general problem, affecting other aspects of their daily life. Thus, we tested them using a standard associative learning task which is known to produce illusions of control in most people under certain conditions. The results showed that the illusion was significantly stronger in pathological gamblers than in a control undiagnosed sample. This suggests (1) that the experimental tasks used in basic associative learning research could be used to detect illusions of control in gamblers in a more indirect way, as compared to introspective and domain-specific questionnaires; and (2), that in addition to gambling-specific problems, pathological gamblers may have a higher-than-normal illusion of control in their daily life. PMID:23785340
Venuleo, Claudia; Salvatore, Sergio; Mossi, Piergiorgio
It is recognised that cultural factors play a role in the onset and continuation of several mental health problems. However, there is a significant lack of empirical studies investigating the relationships between cultural factors and gambling behavior. This study assessed whether the subjective cultures through which subjects interpret and enact their experience of the social environment play a major role in increasing (or decreasing) the probability of pathological gambling. Participants, recruited in three different contexts (public health services for the treatment of addiction, casino, undergraduate course) were subjected to the South Oaks Gambling Screen (SOGS) (Lesieur and Blume in Am J Psychiatry 144(9):1184-1188, 1987), in order to identify a group of pathological gamblers-and with the Questionnaire on the Interpretation of the Social Environment (QUISE) (Mossi and Salvatore in Eur J Educ Psychol 4(2):153-169, 2011)-in order to detect their subjective cultures. The study compares pathological group (scoring >5 on SOGS, n = 34) and a healthy control group (scoring <1 on SOGS, n = 35). One-way analysis of variance (ANOVA) was used to compare groups on QUISE scores of subjective culture. Moreover, a logistic regression was applied in order to esteem the capability of the QUISE scores to differentiate between pathological gamblers and control. The results are consistent with the hypothesis that pathological group expresses different subjective cultures compared with no gambler subjects. The theoretical and clinical implications of the results are discussed.
Carlotta, Davide; Krueger, Robert F; Markon, Kristian E; Borroni, Serena; Frera, Fernanda; Somma, Antonella; Maffei, Cesare; Fossati, Andrea
Gambling Disorder (GD) is an addictive disorder resulting in significant impairment in occupational and social functioning. The aim of the present study was to investigate the relationship of GD risk to adaptive and maladaptive personality dimensions in a sample of nonreferred Italian gamblers. The authors found the risk for GD to show significant associations with the Openness and Conscientiousness scales of the Big Five Inventory (BFI); however, these effects were not significant after controlling for alcohol and drug use. GD risk showed significant associations with the Detachment and Antagonism domains of the Personality Inventory for DSM-5 (PID-5), as well as with the PID-5 facet scales of Hostility, Callousness, Deceitfulness, Manipulativeness, Irresponsibility, and (low) Rigid Perfectionism, even when controlling for alcohol and drug use. Maladaptive personality dispositions may serve as risk factors for pathological gambling, even beyond their impact on frequently concomitant problems with alcohol and other drugs.
Brown, M; Oldenhof, E; Allen, J S; Dowling, N A
The primary aims of this study were to examine the prevalence of personality disorders in problem gamblers, to explore the relationship between personality disorders and problem gambling severity, and to explore the degree to which the psychological symptoms highlighted in the biosocial developmental model of borderline personality disorder (impulsivity, distress tolerance, substance use, PTSD symptoms, psychological distress and work/social adjustment) are associated with problem gambling. A secondary aim was to explore the strength of the relationships between these symptoms and problem gambling severity in problem gamblers with and without personality disorder pathology. Participants were 168 consecutively admitted problem gamblers seeking treatment from a specialist outpatient gambling service in Australia. The prevalence of personality disorders using the self-report version of the Iowa Personality Disorders Screen was 43.3 %. Cluster B personality disorders, but not Cluster A or C personality disorders, were associated with problem gambling severity. All psychological symptoms, except alcohol and drug use, were significantly higher among participants with personality disorder pathology compared to those without. Finally, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for problem gamblers with personality disorder pathology, while impulsivity, psychological distress, and work and social adjustment were significantly associated with problem gambling severity for those without personality disorder pathology. High rates of comorbid personality disorders, particularly Cluster B disorders, necessitate routine screening in gambling treatment services. More complex psychological profiles may complicate treatment for problem gamblers with comorbid personality disorders. Future research should examine the applicability of the biosocial developmental model to problem gambling in community studies.
Petry, Nancy M
Although Gamblers Anonymous (GA) is a popular intervention for gamblers, many attendees later present for professional treatment. This study evaluated gambling and psychosocial problems in individuals seeking professional treatment for gambling and compared those with and without a history of GA attendance. At intake to treatment, 342 pathological gamblers completed the Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS). Fifty-four percent attended GA previously. Compared to non-GA attendees, GA attendees were older, had higher incomes, and were less likely to be single. They had higher SOGS scores, more years of gambling problems, and larger debts. GA attendees also had more serious family conflicts and less serious drug problems. Individuals with a history of GA attendance were more likely to be abstinent from gambling 2 months after treatment initiation. Logistic regression revealed that the number of professional sessions and GA meetings attended during treatment was independently associated with short-term abstinence. These data suggest that individuals entering professional treatment for gambling with a history of GA attendance differ from those who do not, and these differences may impact treatment recommendations and outcomes.
Maniaci, G; Goudriaan, A E; Cannizzaro, C; van Holst, R J
Gambling has been associated with increased sympathetic nervous system output and stimulation of the hypothalamic-pituitary-adrenal axis. However it is unclear how these systems are affected in pathological gambling. This study aimed to investigate the effect of the Trier Social Stress Test (TSST) on cortisol and on cardiac interbeat intervals in relation to impulsivity, in a sample of male pathological gamblers compared to healthy controls. In addition, we investigated the correlation between the TSST, duration of the disorder and impulsivity. A total of 35 pathological gamblers and 30 healthy controls, ranging from 19 to 58 years old and all male, participated in this study. Stress response was measured during and after the TSST by salivary cortisol and cardiac interbeat intervals; impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). Exposure to the TSST produced a significant increase in salivary cortisol and interbeat intervals in both groups, without differences between groups. We found a negative correlation between baseline cortisol and duration of pathological gambling indicating that the longer the duration of the disorder the lower the baseline cortisol levels. Additionally, we found a main effect of impulsivity across groups on interbeat interval during the TSST, indicating an association between impulsivity and the intensity of the neurovegetative stress response during the TSST. Involvement of the hypothalamic-pituitary-adrenal axis in pathological gambling was confirmed together with evidence of a correlation between length of the disorder and diminished baseline cortisol levels. Impulsivity emerged as a personality trait expressed by pathological gamblers; however the neurovegetative response to the TSST, although associated with impulsivity, appeared to be independent of the presence of pathological gambling.
Myrseth, Helga; Tverå, Renate; Hagatun, Susanne; Lindgren, Camilla
The aim of this study was to compare pathological gamblers and skydivers in relation to measures of impulsivity and sensation seeking. The Eysenck Impulsivity Scale - Narrow Impulsiveness Subscale and the Arnett Inventory of Sensation Seeking were administered to pathological gamblers (n = 29), skydivers (n = 93), and a control group (n = 43). A two-way multivariate analysis of variance was conducted to explore differences in impulsivity and sensation seeking between the groups and possible group by gender and group by age interaction effects. The significant effects were further investigated using follow-up univariate analysis of variance. The results showed significant main effects of Group, Gender and Age, and a significant Group by Gender interaction effect. The results showed no statistically significant differences in impulsivity between pathological gamblers and skydivers; however, both groups scored higher than the controls. The skydivers scored higher compared to the pathological gamblers and controls on both sensation seeking subscales. Pathological gamblers scored higher than the controls on the subscale Need for Stimulus Intensity, although lower than the controls on the subscale Need for Novelty. We conclude that skydivers and pathological gamblers do not seem to differ in terms of impulsivity, but that the two groups differ in terms of sensation seeking. Skydivers are hence characterized by more sensation seeking compared to pathological gamblers. Skydiving, as opposed to pathological gambling, is not considered a psychiatric disorder, and skydiving may represent a more non-pathological way to fulfill the need for stimulus intensity.
Cunningham, John A; Hodgins, David C; Toneatto, Tony; Rai, Aanchal; Cordingley, Joanne
A pilot study was conducted of a personalized feedback intervention for problem gamblers. Respondents (N=61) were recruited from an ongoing gambling research study to take part in another study to help us "develop and evaluate self-help materials for gamblers." Respondents were randomly assigned to receive a personalized feedback summary or to a waiting list control. At 3-month follow-up (80.3% follow-up rate, N=49), after controlling for baseline demographic characteristics and gambling severity, respondents in the feedback condition displayed some evidence that they were spending less money on gambling than those in the control condition. Further, ratings of the usefulness of the feedback summary were positive and most recipients (96%) recommended that they be made available to other gamblers interested in evaluating or modifying their gambling. Given these promising pilot results, a full-scale evaluation of these personalized feedback materials would appear justified. An online version of the intervention is now also available at www.CheckYourGambling.net.
Lahti, Tuuli; Halme, Jukka; Pankakoski, Maiju; Sinclair, David; Alho, Hannu
This article describes the socio-demographic characteristics and gambling behavior of 39 pathological gamblers who participated in our treatment study in 2009. The inclusion criteria of the study were: score of five or more on both the South Oaks Gambling Screen (SOGS) and a pathological gambling screen based on the Diagnostic and Statistical…
Carlbring, Per; Smit, Filip
Although effective therapies for pathological gambling exist, their uptake is limited to 10% of the target population. To lower the barriers for help seeking, the authors tested an online alternative in a randomized trial (N = 66). The participants were pathological gamblers not presenting with severe comorbid depression. A wait-list control was…
Back, Ki-Joon; Lee, Choong-Ki; Stinchfield, Randy
The aim of this study was to examine the structural relationship among gambling motivation, gambling passion, and behavioral intentions to gamble between recreational and pathological gamblers. Specifically, this study aimed to shed light on the different ways in which gambling motivation and affective attitude are associated with recreational and pathological gamblers. Using a purposive sampling method, 400 subjects were selected for and participated in this study during their visits to a casino. Study results echoed the notion of distinctive and separate gambling motivations and passions between recreational and pathological gamblers. Also, results identified specific areas to which casino operators or policy makers should pay special attention in developing effective marketing strategies to promote responsible gambling.
Saiz Ruiz, J; Moreno Oliver, I; López-Ibor Aliño, J J
Gambling dependence or pathological gambling is a psychiatric disorder, recognised as such by the North American Psychiatric Association since 1980. Since 1981 we are carrying out a treatment program for patients who suffer from pathological gambling at the Psychiatric Service of "Ramón y Cajal" Hospital. There is an individualized treatment for each patient and their inclusion in group therapy discussions. We present a descriptive study of the most representative socio-demographic, clinical and therapeutic-evolutive data of 46 patients following treatment in our program. All fulfill the diagnostic criteria of DSM III-R for pathological gambling. They were 37 males and 9 females, with an average age of 39 years. More than half of the patients (58%) were consumers of alcoholic beverages; the drug consumption index found was 4% and practically they all were smokers (87%). The excessive drinking and pathological gambling incidence found among family were 35% and 20% respectively. Our therapeutic results support the idea that pathological gambling is a treatable disorder. After an average of two years following treatment 46% of our patients stopped or notably reduced its impulse to gamble. The high incidence of alcohol or drugs consumption among pathological gamblers and their families suggest a biological and psychological relationship between pathological gambling and the classical addictive disorders.
Habib, Reza; Dixon, Mark R.
The purpose of this translational study was twofold: (1) to contrast behavioral and brain activity between pathological and nonpathological gamblers, and (2) to examine differences as a function of the outcome of the spin of a slot machine, focusing predominately on the "Near-Miss"--when two reels stop on the same symbol, and that symbol…
Hodgins, David C.; Currie, Shawn R.; Currie, Gillian; Fick, Gordon H.
The efficacy of brief treatments for media-recruited pathological gamblers was tested in a randomized clinical trial design (N = 314). Two self-directed motivational interventions were compared with a 6-week waiting list control and a workbook only control. Brief motivational treatment involved a telephone motivational interview and a mailed…
Johnson, Taylor E.; Dixon, Mark R.
Two pathological gamblers could choose between emitting or having the dealer emit the response options when playing each of three casino games. A response-cost procedure was introduced in a multiple baseline design across games in which the participant had to pay to perform the responses himself, which was somewhat effective at reducing many of…
Habib, Reza; Dixon, Mark R
The purpose of this translational study was twofold: (1) to contrast behavioral and brain activity between pathological and nonpathological gamblers, and (2) to examine differences as a function of the outcome of the spin of a slot machine, focusing predominately on the “Near-Miss”—when two reels stop on the same symbol, and that symbol is just above or below the payoff line on the third reel. Twenty-two participants (11 nonpathological; 11 pathological) completed the study by rating the closeness of various outcomes of slot machine displays (wins, losses, and near-misses) to a win. No behavioral differences were observed between groups of participants, however, differences in brain activity were found in the left midbrain, near the substantia nigra and ventral tegmental area (SN / VTA). Near-miss outcomes uniquely activated brain regions associated with wins for the pathological gamblers and regions associated with losses for the nonpathological gamblers. Thus, near-miss outcomes on slot machines may contain both functional and neurological properties of wins for pathological gamblers. Such a translational approach to the study of gambling behavior may be considered an example that gives life to B. F. Skinner's conceptualization of the physiologist of the future. PMID:21119848
Fong, Timothy; Kalechstein, Ari; Bernhard, Bo; Rosenthal, Richard; Rugle, Lori
Emerging evidence suggests that dopaminergic and serotonergic functioning are altered in pathological gamblers; yet, there are no FDA-approved medications for pathological gambling and there have only been a limited number of clinical trials that have been conducted. Olanzapine was identified as a candidate medication for pathological gamblers because it modifies both dopaminergic and serotonergic function. Moreover, preliminary studies have shown that olanzapine effectively reduces impulsivity in other psychiatric disorders, a pharmacological target of interest for pathological gamblers. In this study, 21 pathological gamblers, whose primary gambling activity was video poker, were enrolled in a seven-week, double-blind, placebo-controlled trial. Outcome measures included self-reported urges for gambling, frequency of gambling behavior, and self-reported mood and anxiety levels. The results revealed that all study participants reported reduced levels of gambling urges, gambling behavior, and mood and anxiety symptoms. Olanzapine administration was not associated with an incremental effect versus placebo. While these findings suggest that olanzapine is not an efficacious treatment for video poker pathological gamblers, olanzapine may still be an effective treatment for a specific subset of pathological gamblers, including those with a co-occurring psychiatric disorder.
Lam, Desmond; Mizerski, Richard
The objective of this study is to explore the gambling participations and game purchase duplication of light regular, heavy regular and pathological gamblers by applying the Duplication of Purchase Law. Current study uses data collected by the Australian Productivity Commission for eight different types of games. Key behavioral statistics on light regular, heavy regular, and pathological gamblers were computed and compared. The key finding is that pathological gambling, just like regular gambling, follows the Duplication of Purchase Law, which states that the dominant factor of purchase duplication between two brands is their market shares. This means that gambling between any two games at pathological level, like any regular consumer purchases, exhibits "law-like" regularity based on the pathological gamblers' participation rate of each game. Additionally, pathological gamblers tend to gamble more frequently across all games except lotteries and instant as well as make greater cross-purchases compared to heavy regular gamblers. A better understanding of the behavioral traits between regular (particularly heavy regular) and pathological gamblers can be useful to public policy makers and social marketers in order to more accurately identify such gamblers and better manage the negative impacts of gambling.
Jauregui, Paula; Onaindia, Jaione; Estévez, Ana
Coping plays a central role in the appearance and persistence of pathological gambling. Anxious and depressive symptomatology also influence pathological gambling and are related to coping. This study aimed to analyze pathological gamblers' coping strategies and styles, as well as associated anxious and depressive symptomatology. The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Measures of gambling, coping, and anxious and depressive symptomatology were used. Results showed that pathological gamblers' scored higher in all the maladaptive coping strategies, problem- and emotion-focused disengagement, and disengagement subscales. These subscales also correlated with pathological gambling, and anxious and depressive symptomatology. Pathological gamblers also scored higher in emotional expression and emotion-focused engagement, with no differences in the rest of the adaptive coping strategies. Coping was also found to predict pathological gambling and anxious and depressive symptomatology. It was found that coping mediated the relationship between pathological gambling and anxious symptomatology when controlling for the effect of age. Specifically, social withdrawal and disengagement stood out as mediators. These results provide practical information for use in clinical settings with people diagnosed with pathological gambling.
Subramaniam, Mythily; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Wong, Kim Eng; Chong, Siow Ann
The aim of the current study was to examine the comorbidity of pathological gambling with other mental and physical disorders as well as to examine health related quality of life perceived by those with pathological gambling using data from a community survey in Singapore. All respondents were administered the South Oaks Gambling Screen to screen for pathological gambling. The diagnosis of mental disorders was established using the Composite International Diagnostic Interview; while chronic physical conditions were established using a checklist. The weighted lifetime prevalence of pathological gambling was 2.7%. After multiple logistic regression, age 18-34 years (OR=5.3, 95% CI=1.6-17.4), male gender (OR=7.8, CI=3.8-16.2), widowhood (OR=4.2, 95% CI=1.02-17.5), and those with pre-primary (OR=17.1, CI=4.9-59.1), primary (OR=5.3, CI=1.7-16.6), and secondary education (OR=6, CI=2.5-14.7) had significantly higher odds of having pathological gambling. Those of Malay (OR=0.1, 95% CI=0.07-0.2) and Indian ethnicity (OR=0.2, 95% CI=0.1-0.3) had significantly lower odds of having pathological gambling compared to those of Chinese ethnicity. Pathological gamblers had significantly higher odds of having comorbid mental and physical disorders than non-gamblers/non-problem gamblers. The significant association of comorbid mental and physical disorders among those with pathological gambling indicates a need to screen for these disorders and for their subsequent treatment.
Bischof, Anja; Meyer, Christian; Bischof, Gallus; John, Ulrich; Wurst, Friedrich Martin; Thon, Natasha; Lucht, Michael; Grabe, Hans-Joergen; Rumpf, Hans-Juergen
Individuals with pathological gambling have an increased risk for suicidal events. Additionally, the prevalence of comorbid psychiatric disorders is high among pathological gamblers. This study analyzes whether the type of gambling is associated with suicidal events in pathological gamblers independently from comorbidity. Participants were recruited in 4 different ways: via random telephone sample from the general population, via individual invitation for study participation in gambling locations, through various media and the distribution of a leaflet in various settings, and via inpatient treatment facilities for pathological gambling. The final sample included 442 participants with a lifetime diagnosis of pathological gambling. A standardized clinical interview was conducted. High financial losses were associated with suicidal events (odds ratio [OR] = 1.94, 95% 95% confidence interval [CI], [1.11, 3.37]), as were mood disorders (OR = 7.70, 95% CI, [4.44, 13.37]) and female gender (OR = 2.52, 95% CI, [1.20, 5.28]). Gambling on electronic gambling machines in gambling halls or bars was associated with increased odds of suicidal events (OR = 2.94, 95% CI, [1.38, 6.24]). Other types of gambling, such as casino games or betting on sports, or the number of DSM-IV criteria for pathological gambling were not associated independently with suicidal events. Our findings suggest that gambling on electronic gambling machines in gambling halls or bars is associated with suicidal events in pathological gamblers independently of comorbidity. This result shows that the type of gambling needs to be considered as a relevant factor in gambling research.
Petry, Nancy M.; Weinstock, Jeremiah; Ledgerwood, David; Morasco, Benjamin
Limited research exists regarding methods for reducing problem gambling. Problem gamblers (N=180) were randomly assigned to: assessment only control, 10 minutes of Brief Advice, 1 session of motivational enhancement therapy (MET), or 1 session of MET plus 3 sessions of cognitive-behavioral therapy (CBT). Gambling was assessed at baseline, 6 weeks later, and a 9-month follow-up. Relative to assessment only, Brief Advice was the only condition that significantly decreased gambling between baseline and week 6, and it was associated with clinically significant reductions in gambling at month 9. Between week 6 and month 9, MET+CBT evidenced significantly reduced gambling on one index compared to the control condition. These results suggest the efficacy of a very brief intervention for reducing gambling among problem and pathological gamblers not actively seeking gambling treatment. PMID:18377127
Carlbring, Per; Smit, Filip
Although effective therapies for pathological gambling exist, their uptake is limited to 10% of the target population. To lower the barriers for help seeking, the authors tested an online alternative in a randomized trial (N = 66). The participants were pathological gamblers not presenting with severe comorbid depression. A wait-list control was compared with an 8-week Internet-based cognitive behavior therapy program with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min. Average time spent on each participant, including phone conversations, e-mail, and administration, was 4 hr. The Internet-based intervention resulted in favorable changes in pathological gambling, anxiety, depression, and quality of life. Composite between-group effect size (Cohen's d) at posttreatment was 0.83. Follow-ups carried out in the treatment group at 6, 18, and 36 months indicated that treatment effects were sustained (ds = 2.58, 1.96, and 1.98). This evidence is in support of Internet-delivered treatment for pathological gamblers. However, it is not clear how effective the treatment is for more severely depressed individuals.
Tang, Catherine So-kum; Wu, Anise M. S.
This study examined the role of impulsivity and its interplay with gambling correlates in influencing the severity of pathological gambling in Chinese societies. It also investigated the extent to which impulsivity would moderate and/or mediate the relationship between life stress and pathological gambling in 94 Chinese treatment-seeking gamblers.…
Kaare, Pille-Riin; Mõttus, René; Konstabel, Kenn
Due to changes in gambling accessibility during the last decade gambling has become more widespread in Estonia and the prevalence of pathological gambling has sharply increased. The present study attempts to identify psychological characteristics of Estonian pathological gamblers. It has been shown that a wide range of social, economic, and individual factors (e.g. personality traits and emotional states) predict the likelihood of becoming a pathological gambler. In the present study, pathological gamblers' (N = 33) personality traits, self-esteem, self-reported emotional states and cognitive ability were compared to the respective characteristics in a non-gambling control group (N = 42) matched for age, gender and educational level. It was found that compared to controls, pathological gamblers had higher scores on Neuroticism (especially on its immoderation facet) and lower scores on Conscientiousness (especially on its dutifulness and cautiousness facets) and on self-esteem scale. They reported more negative emotional states during the previous month (especially depression and anxiety). Finally, pathological gamblers had lower general cognitive ability. In a logistic regression model, the likelihood of being a pathological gambler was best predicted by high immoderation score and low cognitive ability.
Fuentes, Daniel; Rzezak, Patricia; Pereira, Fabricio R; Malloy-Diniz, Leandro F; Santos, Luciana C; Duran, Fábio L S; Barreiros, Maria A; Castro, Cláudio C; Busatto, Geraldo F; Tavares, Hermano; Gorenstein, Clarice
Several magnetic resonance imaging (MRI) studies to date have investigated brain abnormalities in association with the diagnosis of pathological gambling (PG), but very few of these have specifically searched for brain volume differences between PG patients and healthy volunteers (HV). To investigate brain volume differences between PG patients and HV, 30 male never-treated PG patients (DSM-IV-TR criteria) and 30 closely matched HV without history of psychiatric disorders in the past 2 years underwent structural magnetic resonance imaging with a 1.5-T instrument. Using Freesurfer software, we performed an exploratory whole-brain voxelwise volume comparison between the PG group and the HV group, with false-discovery rate correction for multiple comparisons (p < 0.05). Using a more flexible statistical threshold (p < 0.01, uncorrected for multiple comparisons), we also measured absolute and regional volumes of several brain structures separately. The voxelwise analysis showed no clusters of significant regional differences between the PG and HV groups. The additional analyses of absolute and regional brain volumes showed increased absolute global gray matter volumes in PG patients relative to the HV group, as well as relatively decreased volumes specifically in the left putamen, right thalamus and right hippocampus (corrected for total gray matter). Our findings indicate that structural brain abnormalities may contribute to the functional changes associated with the symptoms of PG, and they highlight the relevance of the brain reward system to the pathophysiology of this disorder.
Smart, Kelly; Desmond, Renée C; Poulos, Constantine X; Zack, Martin
This study examined the effects of modafinil (200 mg) on slot machine betting profiles from a previous sample of low and high impulsivity (LI/HI) pathological gamblers (10/Group; Zack and Poulos, 2009). Hierarchical regression assessed the prospective relationship between Payoff and Bet Size on consecutive trials, along with moderating effects of Group, Cumulative Winnings (low/high) and Phase of game (early/late) under drug and placebo. Y intercepts for the simple regressions of Bet Size on Payoff indexed overall motivation to bet. Under placebo, both groups gauged their bets less closely to the preceding Payoff as trials continued when Winnings were low but not high. Under modafinil, both groups gauged their bets more closely to the preceding Payoff when Winnings were low but gauged their bets less closely to the previous Payoff when Winnings were high. The tendency to gauge bets closely to the previous Payoff coincided with a bias toward low overall Bet Size, and modafinil accentuated this relationship, in LI but not HI subjects. Results suggest that modafinil increases the salience of environmental rewards, leading to more tightly calibrated responses to individual rewards when resources are low, but progressively loosens reward-response calibration when resources are high. Increased relative impact of phasic vs. tonic dopamine signals may account for patterns seen at low vs. high Winnings, respectively, under the drug. Clinically, modafinil may deter pathological gamblers from chasing losses but also encourage them to continue betting rather than quit while they are ahead. Whether low-dose modafinil confers more uniform benefits deserves investigation.
Tackett, Jennifer L; Rodriguez, Lindsey M; Rinker, Dipali V; Neighbors, Clayton
Increases in access to gambling venues have been accompanied by increased gambling behavior among young adults. The present research examined associations among Five Factor Model personality traits, motives for gambling, and gambling behavior and problems using latent class analysis. College students (N = 220) completed online measures of personality and gambling behavior as part of a larger intervention trial. Agreeableness and conscientiousness were negatively associated with indicators of gambling behavior. Low agreeableness and high neuroticism were associated with gambling-specific motives, particularly for less frequently endorsed motives. Personality-based latent class analyses of emerging adult gamblers revealed support for three distinct groups reflecting a resilient personality group, a normative personality group, and a vulnerable personality group, which were further differentiated by gambling behaviors and gambling-specific motives. Associations between personality traits and gambling-specific motives highlight potential heterogeneity among college students who gamble. Together, findings suggest that the correlational and latent class-based analyses, as well as the personality and motivation analyses, present complementary information with respect to the attributes of college student gamblers. Implications and future research directions are discussed.
Auer, Michael M; Griffiths, Mark D
Over the last few years, online gambling has become a more common leisure time activity. However, for a small minority, the activity can become problematic. Consequently, the gambling industry has started to acknowledge their role in player protection and harm minimization and some gambling companies have introduced responsible gambling tools as a way of helping players stay in control. The present study evaluated the effectiveness of mentor (a responsible gambling tool that provides personalized feedback to players) among 1,015 online gamblers at a European online gambling site, and compared their behavior with matched controls (n = 15,216) on the basis of age, gender, playing duration, and theoretical loss (i.e., the amount of money wagered multiplied by the payout percentage of a specific game played). The results showed that online gamblers receiving personalized feedback spent significantly less time and money gambling compared to controls that did not receive personalized feedback. The results suggest that responsible gambling tools providing personalized feedback may help the clientele of gambling companies gamble more responsibly, and may be of help those who gamble excessively to stay within their personal time and money spending limits.
Auer, Michael M.; Griffiths, Mark D.
Over the last few years, online gambling has become a more common leisure time activity. However, for a small minority, the activity can become problematic. Consequently, the gambling industry has started to acknowledge their role in player protection and harm minimization and some gambling companies have introduced responsible gambling tools as a way of helping players stay in control. The present study evaluated the effectiveness of mentor (a responsible gambling tool that provides personalized feedback to players) among 1,015 online gamblers at a European online gambling site, and compared their behavior with matched controls (n = 15,216) on the basis of age, gender, playing duration, and theoretical loss (i.e., the amount of money wagered multiplied by the payout percentage of a specific game played). The results showed that online gamblers receiving personalized feedback spent significantly less time and money gambling compared to controls that did not receive personalized feedback. The results suggest that responsible gambling tools providing personalized feedback may help the clientele of gambling companies gamble more responsibly, and may be of help those who gamble excessively to stay within their personal time and money spending limits. PMID:26441779
Mick, Inge; Myers, Jim; Ramos, Anna C; Stokes, Paul R A; Erritzoe, David; Colasanti, Alessandro; Gunn, Roger N; Rabiner, Eugenii A; Searle, Graham E; Waldman, Adam D; Parkin, Mark C; Brailsford, Alan D; Galduróz, José C F; Bowden-Jones, Henrietta; Clark, Luke; Nutt, David J; Lingford-Hughes, Anne R
Pathological gambling is a psychiatric disorder and the first recognized behavioral addiction, with similarities to substance use disorders but without the confounding effects of drug-related brain changes. Pathophysiology within the opioid receptor system is increasingly recognized in substance dependence, with higher mu-opioid receptor (MOR) availability reported in alcohol, cocaine and opiate addiction. Impulsivity, a risk factor across the addictions, has also been found to be associated with higher MOR availability. The aim of this study was to characterize baseline MOR availability and endogenous opioid release in pathological gamblers (PG) using [11C]carfentanil PET with an oral amphetamine challenge. Fourteen PG and 15 healthy volunteers (HV) underwent two [11C]carfentanil PET scans, before and after an oral administration of 0.5 mg/kg of d-amphetamine. The change in [11C]carfentanil binding between baseline and post-amphetamine scans (ΔBPND) was assessed in 10 regions of interest (ROI). MOR availability did not differ between PG and HV groups. As seen previously, oral amphetamine challenge led to significant reductions in [11C]carfentanil BPND in 8/10 ROI in HV. PG demonstrated significant blunting of opioid release compared with HV. PG also showed blunted amphetamine-induced euphoria and alertness compared with HV. Exploratory analysis revealed that impulsivity positively correlated with caudate baseline BPND in PG only. This study provides the first evidence of blunted endogenous opioid release in PG. Our findings are consistent with growing evidence that dysregulation of endogenous opioids may have an important role in the pathophysiology of addictions. PMID:26552847
Stewart, Sherry H; Zack, Martin; Collins, Pamela; Klein, Raymond M
Pathological gamblers who drink when gambling (n=158; 77% men; mean age=36.0 years) completed the Inventory of Gambling Situations (IGS) and gambling and drinking criterion measures. Principal components analysis on the IGS subscales revealed negative (e.g., Unpleasant Emotions) and positive (e.g., Pleasant Emotions) gambling situation factors. Subjecting IGS factor scores to cluster analysis revealed three clusters: (a) enhancement gamblers, with low negative and high positive factor scores; (b) coping gamblers, with very high negative and high positive factor scores; and (c) low emotion regulation gamblers, with low negative and positive factor scores (59%, 23%, and 18% of the sample, respectively). Clusters were validated with a direct measure of gambling motives. Additional validity analyses showed that coping gamblers scored higher than the other groups on a variety of different gambling activities, gambling problems, drinking frequency, drinking problems, and coping drinking motives, whereas low emotion regulation gamblers scored lower than the other groups on gambling frequency, gambling problems, drinking quantity, and enhancement drinking motives. The findings validate this empirical approach to subtyping gamblers and suggest consistency of motives across addictive behaviors.
Gelskov, Sofie V; Madsen, Kristoffer H; Ramsøy, Thomas Z; Siebner, Hartwig R
Pathological gambling is an addictive disorder characterized by an irresistible urge to gamble despite severe consequences. One of the hallmarks of pathological gambling is maladaptive and highly risky decision-making, which has been linked to dysregulation of reward-related brain regions such as the ventral striatum. However, previous studies have produced contradictory results regarding the implication of this network, revealing either hypo- or hypersensitivity to monetary gains and losses. One possible explanation is that the gambling brain might be misrepresenting the benefits and costs when weighting the potential outcomes, and not the gains and losses per se. To address this issue, we investigated whether pathological gambling is associated with abnormal brain activity during decisions that weight the utility of possible gains against possible losses. Pathological gamblers and healthy human subjects underwent functional magnetic resonance imaging while they accepted or rejected mixed gain/loss gambles with fifty-fifty chances of winning or losing. Contrary to healthy individuals, gamblers showed a U-shaped response profile reflecting hypersensitivity to the most appetitive and most aversive bets in an executive cortico-striatal network including the dorsolateral prefrontal cortex and caudate nucleus. This network is concerned with the evaluation of action-outcome contingencies, monitoring recent actions and anticipating their consequences. The dysregulation of this specific network, especially for extreme bets with large potentials consequences, offers a novel understanding of the neural basis of pathological gambling in terms of deficient associations between gambling actions and their financial impact.
Petry, Nancy M.; Weinstock, Jeremiah; Ledgerwood, David M.; Morasco, Benjamin
Limited research exists regarding methods for reducing problem gambling. Problem gamblers (N = 180) were randomly assigned to assessment only control, 10 min of brief advice, 1 session of motivational enhancement therapy (MET), or 1 session of MET plus 3 sessions of cognitive-behavioral therapy. Gambling was assessed at baseline, at 6 weeks, and…
Meisel, Matthew K.; Clifton, Allan D.; MacKillop, James; Miller, Joshua D.; Campbell, W. Keith; Goodie, Adam S.
Aims To apply social network analysis (SNA) to investigate whether frequency and severity of gambling problems were associated with different network characteristics among friends, family, and co-workers. is an innovative way to look at relationships among individuals; the current study was the first to our knowledge to apply SNA to gambling behaviors. Design Egocentric social network analysis was used to formally characterize the relationships between social network characteristics and gambling pathology. Setting Laboratory-based questionnaire and interview administration. Participants Forty frequent gamblers (22 non-pathological gamblers, 18 pathological gamblers) were recruited from the community. Findings The SNA revealed significant social network compositional differences between the two groups: pathological gamblers (PGs) had more gamblers, smokers, and drinkers in their social networks than did nonpathological gamblers (NPGs). PGs had more individuals in their network with whom they personally gambled, smoked, and drank with than those with who were NPG. Network ties were closer to individuals in their networks who gambled, smoked, and drank more frequently. Associations between gambling severity and structural network characteristics were not significant. Conclusions Pathological gambling is associated with compositional but not structural differences in social networks. Pathological gamblers differ from non-pathological gamblers in the number of gamblers, smokers, and drinkers in their social networks. Homophily within the networks also indicates that gamblers tend to be closer with other gamblers. This homophily may serve to reinforce addictive behaviors, and may suggest avenues for future study or intervention. PMID:23072641
Slot machines are the most "addictive" games because (a) the disorder (pathological gambling) appears more rapidly in these games than with any other; (b) most patients who seek professional help are mainly addicted to electronic gambling, and (c) even though it is not the more frequent game, most of all the money spent on legal games of chance (at least in Spain) goes to slot machines. Structural characteristics of slot machines induce to gamble because electronic games show the main parameters of operant conditioning, mainly the immediacy of the reinforcement. Ten pathological gamblers played slot machine in two conditions: immediate and delayed reinforcement. The results corroborate the importance of the immediacy of the reinforcement in gambling, because when the result appears immediately (after 2 s), more games are played than when the result is delayed only 10 s. Critical issues in problem gambling prevention and public health are discussed.
Ledgerwood, David M; Alessi, Sheila M; Phoenix, Natalie; Petry, Nancy M
Pathological gamblers (PGs) may have high levels of impulsivity, and a correlation between substance use disorders (SUDs) and impulsivity is well established. However, only a handful of studies have attempted to assess impulsivity and other impulse-spectrum traits (e.g., sensation seeking) using a variety of behavioral and self-report measures in PGs and few examined the independent impact of SUDs. We compared 30 PGs without SUD histories, 31 PGs with SUD histories and 40 control participants on self-reported impulsivity, delayed discounting, attention/memory, response inhibition, risk taking, sensation seeking and distress tolerance measures. PGs, regardless of SUD history, discounted delayed rewards at greater rates than controls. PGs also reported acting on the spur of the moment, experienced trouble planning and thinking carefully, and noted greater attention difficulties than controls. PGs with SUD took greater risks on a risk-taking task than did PGs without SUD histories, but the two groups did not differ on any other measures of impulsivity. We conclude that PGs are more impulsive than non-problem gamblers in fairly specific ways, but PGs with and without SUD histories differ on few measures. More research should focus on specific ways in which PGs exhibit impulsivity to better address impulsive behaviors in treatment.
Fernández-Montalvo, Javier; Echeburúa, Enrique
This article describes the most frequent personality disorders related to pathological gambling. Participants included 50 pathological gamblers assessed with the IPDE, and 50 normative subjects from the general population with the same demographic features (age, sex, and socioeconomic level). Thirty-two percent of the clinical sample (vs. the 8% of the normative sample) showed at least one personality disorder. The most prevalent disorders were Borderline (16%), followed by Antisocial, Paranoid, Narcissistic, and Non-specified (8% each). Gamblers with personality disorders presented an average of 1.5 disorders and they reported higher gambling severity and more severe symptoms of anxiety, depression and alcohol abuse. The implications of this study for clinical practice and research are discussed.
Lister, Jamey J; Milosevic, Aleks; Ledgerwood, David M
Objective: Problem and pathological gamblers are significantly more likely to experience mood disorders, compared with the general population. Our study examined the relation of psychological characteristics (personality, trait impulsiveness, and gambling motives) to current co-occurring mood disorder (major depression and dysthymia) status among problem and pathological gamblers. Method: Problem and pathological gamblers (N = 150) underwent a clinical interview to assess current co-occurring mood disorders; participants completed measures of problem gambling severity, personality, impulsiveness, and gambling motives. Results: Problem and pathological gamblers with a current co-occurring mood disorder were more likely to be female, older, and to report higher lifetime and past-year gambling severity. A co-occurring mood disorder was associated with higher personality scores for alienation and stress reaction, lower scores for well-being, social closeness, and control, as well as higher impulsiveness scores for urgency and lack of premeditation, and lower sensation seeking scores. Participants with a co-occurring mood disorder also reported higher coping motives for gambling. Multivariate logistic regression analyses demonstrated that personality factors (lower social closeness and higher alienation) contributed to the greatest likelihood of being diagnosed with a co-occurring mood disorder. Conclusions: Mood disorders frequently co-occur with problem and pathological gambling, and they are associated with greater gambling severity. These findings highlight that interpersonal facets of personality contribute substantially to co-occurring mood disorder status. Implications for treatment will be discussed. PMID:26454559
Schoenleber, Michelle; Berenbaum, Howard
Drawing on extant work on shame and emotion regulation, this article proposes that three broad forms of maladaptive shame regulation strategies are fundamental in much of personality pathology: Prevention (e.g., dependence, fantasy), used preemptively, lessens potential for shame; Escape (e.g., social withdrawal, misdirection) reduces current or imminent shame; Aggression, used after shame begins, refocuses shame into anger directed at the self (e.g., physical self-harm) or others (e.g., verbal aggression). This article focuses on the contributions of shame regulation to the development and maintenance of personality pathology, highlighting how various maladaptive shame regulation strategies may lead to personality pathology symptoms, associated features, and dimensions. Consideration is also given to the possible shame-related constructs necessitating emotion regulation (e.g., shame aversion and proneness) and the points in the emotion process when regulation can occur.
Grall-Bronnec, Marie; Wainstein, Laura; Feuillet, Fanny; Bouju, Gaëlle; Rocher, Bruno; Vénisse, Jean-Luc; Sébille-Rivain, Véronique
Level and type of impulsivity are essential variables to be taken into consideration during the initial evaluation of a pathological gambler. The aim of this study was to measure the score for 4 impulsivity-related traits (Urgency, (lack of) Premeditation, (lack of) Perseverance and Sensation seeking) in a sample group of at-risk and pathological gamblers, and to highlight any links with certain elements of clinical data. The UPPS Impulsive Behaviour Scale was administered to 84 problem gamblers seeking treatment. The severity of gambling disorders was evaluated using the diagnostic criteria of the DSM-IV. Psychiatric and addictive comorbidities were also explored. The results indicated that the score for the Urgency facet had a positive correlation with the severity of gambling disorders. It appeared that participants displayed different clinical profiles according to the level and type of impulsivity. Several of the UPPS scales were identified as risk factors for mood disorders, risk of suicide, alcohol use disorders, and Attention Deficit/Hyperactivity Disorder (ADHD). The results confirm both the complexity of the multi-dimensional concept of impulsivity and the reason why the UPPS is of interest for a more in-depth study of the subject.
Wenzel, Hanne Gro; Dahl, Alv A.
Recent evidence indicates that more and more women gamble and develop gambling problems and pathological gambling (PG). Research has further indicated that female and male PGs differ in their clinical characteristics. The aim of this study is to do a critical review of the literature concerning clinical characteristics of female pathological…
Pascual-Leone, Antonio; Campeau, Jennifer L; Harrington, Shawn J
The current study examined the differences in arousal (physiologically and subjectively) between gamblers and non-gamblers. Thirty students from a mid-sized university took part in the study for a chance to win money in a gambling task. Nearly half of the participants identified themselves as non-gamblers and slightly more than half of the participants considered themselves gamblers. Findings indicated that gamblers experienced a significantly higher increase in physiological arousal (heart rate) compared to non-gamblers during the gambling experience. The results suggests the possibility that physiological arousal may play a role in the appeal of gambling to certain types of people. Furthermore, when gamblers suffered a loss at the end of the game, they reported feeling worse as compared to the non-gamblers and relative to their state before playing. Moreover, this affective change explained 28.6% of the variance in gambling behavior according to self-reports. Findings suggest that gamblers in our study may have been more personally invested in the gambling tasks, such that losing was more disappointing to the habitual gamblers than the non-gamblers.
Paris, Jason J.; Franco, Christine; Sodano, Ruthlyn; Freidenberg, Brian; Gordis, Elana; Anderson, Drew A.; Forsyth, John P.; Wulfert, Edelgard; Frye, Cheryl A.
Sex differences in incidence and severity of some stress-related, neuropsychiatric disorders are often reported to favor men, suggesting that women may be more vulnerable to aberrant hypothalamic-pituitary-adrenal (HPA) axis responses to stress. In this review, we discuss several investigations that we, and others, have conducted assessing salivary cortisol as a measure of HPA function. We have examined basal cortisol among healthy men and women and also following acute exposure to stressors. Among healthy participants, men had higher basal cortisol levels than did women. In response to acute stressors, such as carbon dioxide or noise, respectively, cortisol levels were comparable between men and women or higher among women. We have also examined cortisol levels among those with problem eating, gambling, or post traumatic stress disorder (PTSD). Women with restrained eating habits have higher basal cortisol levels than do women without restrained eating habits. Pathological gamblers have more aberrant stress response to gambling stimuli than do recreational gamblers, and these effects are more prominent among men than women. Men who have motor-vehicle accident related PTSD, demonstrate more aberrant cortisol function, than do their female counterparts. Although these sex differences in cortisol seem to vary with type of stress exposure and/or pathophysiological status of the individual, other hormones may influence cortisol response. To address this, cortisol levels among boys and girls with different stress-related experiences, will be the subject of future investigation. PMID:19538960
Cunningham-Williams, Renee M.; Grucza, Richard A.; Cottler, Linda B.; Womack, Sharon B.; Books, Samantha J.; Przybeck, Thomas R.; Spitznagel, Edward L.; Cloninger, C. Robert
Objectives We report the prevalence of and risk and protective factors for DSM-IV sub-threshold gambling (1–4 criteria) and pathological gambling disorder (PGD; 5–10 criteria) in a non-clinical household sample of St. Louis area gamblers. Methods Of the 7689 individuals contacted via Random Digit Dialing, 3292 were screened eligible. Of these, 1142 from households in 6 contiguous regions in Missouri and Illinois consented to participate and were mailed a St. Louis Area Personality, Health, and Lifestyle (SLPHL) Survey. Results Post-stratification weighted data (n = 913) indicate lifetime prevalence rates of 12.4% sub-threshold and 2.5% PGD (conditional prevalence = 21.5% and 4.3% respectively). Risk and protective factors for gambling severity varied in the sample. Conclusions Targeted prevention messages are warranted specifically for gamblers of varying risk for PGD. PMID:15804388
Pincus, Aaron L; Lukowitsky, Mark R
We review the literature on pathological narcissism and narcissistic personality disorder (NPD) and describe a significant criterion problem related to four inconsistencies in phenotypic descriptions and taxonomic models across clinical theory, research, and practice; psychiatric diagnosis; and social/personality psychology. This impedes scientific synthesis, weakens narcissism's nomological net, and contributes to a discrepancy between low prevalence rates of NPD and higher rates of practitioner-diagnosed pathological narcissism, along with an enormous clinical literature on narcissistic disturbances. Criterion issues must be resolved, including clarification of the nature of normal and pathological narcissism, incorporation of the two broad phenotypic themes of narcissistic grandiosity and narcissistic vulnerability into revised diagnostic criteria and assessment instruments, elimination of references to overt and covert narcissism that reify these modes of expression as distinct narcissistic types, and determination of the appropriate structure for pathological narcissism. Implications for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the science of personality disorders are presented.
Auer, Michael M.; Griffiths, Mark D.
Responsible gambling tools (e.g., limit-setting tools, pop-up messages, and personalized feedback) have become increasingly popular as a way of facilitating players to gamble in a more responsible manner. However, relatively few studies have evaluated whether such tools actually work. The present study examined whether the use of three types of information (i.e., personalized feedback, normative feedback, and/or a recommendation) could enable players to gamble more responsibly as assessed using three measures of gambling behavior, i.e., theoretical loss (TL), amount of money wagered, and gross gaming revenue (GGR) (i.e., net win/loss). By manipulating the three forms of information, data from six different groups of players were analyzed. The participant sample drawn from the population were those that had played at least one game for money on the Norsk Tipping online platform (Instaspill) during April 2015. A total of 17,452 players were randomly selected from 69,631 players that fulfilled the selection criteria. Of these, 5,528 players participated in the experiment. Gambling activity among the control group (who received no personalized feedback, normative feedback or no recommendation) was also compared with the other five groups that received information of some kind (personalized feedback, normative feedback and/or a recommendation). Compared to the control group, all groups that received some kind of messaging significantly reduced their gambling behavior as assessed by TL, amount of money wagered, and GGR. The results support the hypothesis that personalized behavioral feedback can enable behavioral change in gambling but that normative feedback does not appear change behavior significantly more than personalized feedback. PMID:27965611
Auer, Michael M; Griffiths, Mark D
Responsible gambling tools (e.g., limit-setting tools, pop-up messages, and personalized feedback) have become increasingly popular as a way of facilitating players to gamble in a more responsible manner. However, relatively few studies have evaluated whether such tools actually work. The present study examined whether the use of three types of information (i.e., personalized feedback, normative feedback, and/or a recommendation) could enable players to gamble more responsibly as assessed using three measures of gambling behavior, i.e., theoretical loss (TL), amount of money wagered, and gross gaming revenue (GGR) (i.e., net win/loss). By manipulating the three forms of information, data from six different groups of players were analyzed. The participant sample drawn from the population were those that had played at least one game for money on the Norsk Tipping online platform (Instaspill) during April 2015. A total of 17,452 players were randomly selected from 69,631 players that fulfilled the selection criteria. Of these, 5,528 players participated in the experiment. Gambling activity among the control group (who received no personalized feedback, normative feedback or no recommendation) was also compared with the other five groups that received information of some kind (personalized feedback, normative feedback and/or a recommendation). Compared to the control group, all groups that received some kind of messaging significantly reduced their gambling behavior as assessed by TL, amount of money wagered, and GGR. The results support the hypothesis that personalized behavioral feedback can enable behavioral change in gambling but that normative feedback does not appear change behavior significantly more than personalized feedback.
Lee, Choong-Ki; Bernhard, Bo Jason; Kim, Jungsun; Fong, Timothy; Lee, Tae Kyung
This study investigated three different types of gamblers (recreational, problem, and pathological gamblers) to determine differences in gambling motivations and recreational activity preferences among casino gamblers. We collected data from 600 gamblers recruited in an actual gambling environment inside a major casino in South Korea. Findings indicate that motivational factors of escape, sightseeing, and winning were significantly different among these three types of gamblers. When looking at motivations to visit the casino, pathological gamblers were more likely to be motivated by winning, whereas recreational gamblers were more likely to be motivated by scenery and culture in the surrounding casino area. Meanwhile, the problem gamblers fell between these two groups, indicating higher preferences for non-gambling activities than the pathological gamblers. As this study builds upon a foundational previous study by Lee et al. (Psychiatry Investig 6(3):141-149, 2009), the results of this new study were compared with those of the previous study to see if new developments within a resort-style casino contribute to changes in motivations and recreational activity preferences.
Fatseas, Melina; Alexandre, Jean-Marc; Vénisse, Jean-Luc; Romo, Lucia; Valleur, Marc; Magalon, David; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Guilleux, Alice; Groupe Jeu; Challet-Bouju, Gaëlle; Grall-Bronnec, Marie
Previous studies showed that Pathological Gambling and Attention Deficit/Hyperactivity Disorder (ADHD) often co-occur. The aim of this study was to examine whether ADHD is associated with specific severity patterns in terms of gambling behavior, psychopathology and personality traits. 599 problem and non-problem-gamblers were recruited in addiction clinics and gambling places in France. Subjects were assessed with the Wender-Utah Rating Scale-Child, the Adult ADHD Self-Report Scale, the Mini International Neuropsychiatric Interview, the Temperament and Character Inventory, the South Oaks Gambling Screen and questionnaires assessing gambling related cognitive distortions and gambling habits. 20.7% (n=124) of gamblers were screened positive for lifetime or current ADHD. Results from the multivariate analysis showed that ADHD was associated with a higher severity of gambling-related problems and with more psychiatric comorbidity. Among problem gamblers, subjects with history of ADHD were also at higher risk for unemployment, psychiatric comorbidity and specific dysfunctional personality traits. This study supports the link between gambling related problems and ADHD in a large sample of problem and non-problem gamblers, including problem-gamblers not seeking treatment. This points out the necessity to consider this disorder in the prevention and in the treatment of pathological gambling.
Mathias, Ana Carolina R.; Vargens, Renata W.; Kessler, Felix H.; Cruz, Marcelo S.
There is a strong association between pathological gambling and substance abuse. The objective of this study is to identify the differences between substance abusers with and without gambling problems. A cross sectional study was conducted interviewing with Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS), alcohol and drug…
Weinstein, A; Dinur Klein, L; Dannon, P N
Gambling behavior is not a unique behavior. There are certain differences in behavior, gambling habits, gambling beliefs, and their reflection in psychosocial life. We have compared three groups of adult male gamblers—sports gamblers (n = 41), machine gamblers (n = 36), and poker gamblers (n = 35)—in regard to measures of personal status and legal-social characteristics. We found no difference between groups in terms of the length of gambling behavior, personal status, or age. We found no legal difference between groups in terms of the number of court cases for debt, stealing, or family court cases. In terms of economic circumstances, sports gamblers suffered more losses than the other groups (p < 0.0001). There were higher rates of bankruptcy among sports gamblers compared with machine gamblers (p < 0.01). Sports gamblers were more likely to borrow money from the black market compared with the other groups (p < 0.01). In terms of mental health, sports and machine gamblers had more suicidal thoughts and gestures than poker gamblers (p < 0.05), whereas the rate of suicide attempts was higher in machine gamblers compared with poker players (p < 0.05). Our results indicated higher vulnerability in sports gamblers in terms of economic problems compared with the other groups, whereas machine gamblers had vulnerability to suicidal thoughts and suicidal attempts compared with poker gamblers.
Chan, Victor K Y
This article describes the use of neural networks (a type of artificial intelligence) and an empirical data sample of, inter alia, the amounts of bets laid and the winnings/losses made in successive games by a number of cyber-gamblers to longitudinally model gamblers' behavior and decisions as to such bet amounts and the temporal trajectory of winnings/losses. The data was collected by videoing Texas Holdem gamblers at a cyber-gambling website. Six "persistent" gamblers were identified, totaling 675 games. The neural networks on average were able to predict bet amounts and cumulative winnings/losses in successive games accurately to three decimal places of the dollar. A more important conclusion is that the influence of a gambler's skills, strategies, and personality on his/her successive bet amounts and cumulative winnings/losses is almost totally reflected by the pattern(s) of his/her winnings/losses in the few initial games and his/her gambling account balance. This partially invalidates gamblers' illusions and fallacies that they can outperform others or even bankers. For government policy-makers, gambling industry operators, economists, sociologists, psychiatrists, and psychologists, this article provides models for gamblers' behavior and decisions. It also explores and exemplifies the usefulness of neural networks and artificial intelligence at large in the research on gambling.
De Bolle, Marleen; De Clercq, Barbara; Pham-Scottez, Alexandra; Mels, Saskia; Rolland, Jean-Pierre; Guelfi, Julien Daniel; Braet, Caroline; De Fruyt, Filip
Personality pathology is examined in 100 female in-patients diagnosed with eating disorders. The Eating Disorder Inventory-II and the NEO-PI-R were self-administered and personality pathology was assessed using a structured interview. Clinicians additionally evaluated patients' global functioning. The results indicated sizeable personality disorder comorbidity, and two dimensions of personality pathology, for example, an internalizing and an externalizing factor, could be identified. Patients' global functioning was primarily associated with dimensions of personality pathology, but not with eating disorder symptoms. Assessment and therapeutic interventions should focus on this co-occurring pathology in order to improve patients' functioning.
Bonnaire, Céline; Bungener, Catherine; Varescon, Isabelle
The purpose of this research is to examine the relationship between sensation seeking and gambling disorder (GD) in a community sample of gamblers (when controlling for the effect of substance use, gender and age) and see whether sensation seeking scores depend on the gambling activity when comparing strategic and non-strategic gamblers. A total of 380 gamblers was recruited. First, pathological gamblers (PGs) (n =143) were compared to non-pathological gamblers (NPGs) (n =237). Second, strategic gamblers (n =93) were compared to non-strategic gamblers (n =110). Sociodemographic data, gambling behavior (SOGS, DSM-IV), tobacco and alcohol use (CAGE), and sensation seeking (SSS) were evaluated. PGs have higher boredom susceptibility scores than NPGs and this factor is associated with GD. Nevertheless, the relationship between sensation seeking and GD depends on the gambling activity. In fact, sensation seeking is associated with GD in strategic gamblers only. PGs playing strategic games display different profiles from non-strategic PGs. Thus, factors associated with GD differ when the gambling activity is taken into account. These findings are consistent with the idea of it being essential to identify clinically distinct subgroups of PGs in the treatment of GD.
South, Susan C; Jarnecke, Amber M
Structural equation modeling (SEM) is a family of related statistical techniques that lend themselves to understanding the complex relationships among variables that differ among individuals in the population. SEM techniques have become increasingly popular in the study of personality disorders (PDs) and maladaptive personality traits. The current article takes a critical look at the ways in which SEM techniques have been used in the study of PDs, PD symptoms, and pathological personality traits. By far the most common use of SEM in the study of PDs has been to examine the latent structure of these constructs, with an overwhelming bulk of the evidence in favor of a dimensional, as opposed to categorical, conceptualization. Other common uses of SEM in this area are factor models that examine the joint multivariate space of PDs, maladaptive personality traits, and psychopathology. Relatively underused, however, are observed or latent variable path models. We review the strengths and weaknesses of the work done to date, focusing on ways that these SEM studies have been either theoretically and/or statistically sound. Finally, we offer suggestions for future research examining PDs with SEM techniques. (PsycINFO Database Record
James, Lisa M; Engdahl, Brian E; Leuthold, Arthur C; Krueger, Robert F; Georgopoulos, Apostolos P
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), includes an empirically supported dimensional model of personality pathology that is assessed via the Personality Inventory for the DSM-5 (PID-5). Here we used magnetoencephalography (MEG; 248 sensors) to evaluate resting-state neural network properties associated with the five primary DSM-5 maladaptive personality domains (negative affect, detachment, antagonism, disinhibition, and psychoticism) in 150 healthy veterans ("control" group) and 179 veterans with various psychiatric disorders ("psychopathology" group). Since a fundamental network property is the strength of functional connectivity among network elements, we used the absolute value of the pairwise correlation coefficient (aCC) between prewhitened MEG sensor time series as a measure of neural functional connectivity and assessed its relations to the quantitative PID-5 scores in a linear regression model, where the log-transformed aCC was the dependent variable and individual PID scores, age, and gender were the independent variables. The partial regression coefficient (pRC) for a specific PID-5 score in that model provided information concerning the direction (positive, negative) and size (absolute value) of the PID effect on the strength of neural correlations. We found that, overall, PID domains had a negative effect (i.e., negative pRC; decorrelation) on aCC in the control group, but a positive one (i.e., positive pRC; hyper-correlation) in the psychopathology group. This dissociation of PID effects on aCC was especially pronounced for disinhibition, psychoticism, and negative affect. These results document for the first time a fundamental difference in neural-PID relations between control and psychopathology groups.
Lee, Choong-Ki; Lee, BongKoo; Bernhard, Bo Jason
Objective The purpose of this paper is to investigate three different types of gamblers (which we label "non-problem", "some problem", and "probable pathological gamblers") to determine differences in involvement and motivation, as well as differences in demographic and behavioral variables. Methods The analysis takes advantage of a unique opportunity to sample on-site at a major casino in South Korea, and the resulting purposive sample yielded 180 completed questionnaires in each of the three groups, for a total number of 540. Factor analysis, analysis of variance (ANOVA) and Duncan tests, and Chi-square tests are employed to analyze the data collected from the survey. Results Findings from ANOVA tests indicate that involvement factors of importance/self-expression, pleasure/interest, and centrality derived from the factor analysis were significantly different among these three types of gamblers. The "probable pathological" and "some problem" gamblers were found to have similar degrees of involvement, and higher degrees of involvement than the non-problem gamblers. The tests also reveal that motivational factors of escape, socialization, winning, and exploring scenery were significantly different among these three types of gamblers. When looking at motivations to visit the casino, "probable pathological" gamblers were more likely to seek winning, the "some problem" group appeared to be more likely to seek escape, and the "non-problem" gamblers indicate that their motivations to visit centered around explorations of scenery and culture in the surrounding casino area. Conclusion The tools for exploring motivations and involvements of gambling provide valuable and discerning information about the entire spectrum of gamblers. PMID:20046388
Gaissmaier, Wolfgang; Wilke, Andreas; Scheibehenne, Benjamin; McCanney, Paige; Barrett, H Clark
Why do people gamble? A large body of research suggests that cognitive distortions play an important role in pathological gambling. Many of these distortions are specific cases of a more general misperception of randomness, specifically of an illusory perception of patterns in random sequences. In this article, we provide further evidence for the assumption that gamblers are particularly prone to perceiving illusory patterns. In particular, we compared habitual gamblers to a matched sample of community members with regard to how much they exhibit the choice anomaly 'probability matching'. Probability matching describes the tendency to match response proportions to outcome probabilities when predicting binary outcomes. It leads to a lower expected accuracy than the maximizing strategy of predicting the most likely event on each trial. Previous research has shown that an illusory perception of patterns in random sequences fuels probability matching. So does impulsivity, which is also reported to be higher in gamblers. We therefore hypothesized that gamblers will exhibit more probability matching than non-gamblers, which was confirmed in a controlled laboratory experiment. Additionally, gamblers scored much lower than community members on the cognitive reflection task, which indicates higher impulsivity. This difference could account for the difference in probability matching between the samples. These results suggest that gamblers are more willing to bet impulsively on perceived illusory patterns.
Hollander, E; Buchalter, A J; DeCaria, C M
With increasing access to gambling facilities through casinos, the Internet, and other venues, PG is a rapidly emerging mental health concern. This impulse-control disorder tends to be comorbid with a wide range of other disorders and is reportedly associated with a high rate of suicide. For most gamblers, gambling is a form of entertainment, but for many individuals, the activity leads to far-reaching disruption of family and work. The personal and societal financial ramifications are severe, and many individuals with PG end up in the criminal justice system. An understanding of the neurobiology of PG is beginning to surface. 5-HT is linked to behavioral initiation and disinhibition, which are important in the onset of the gambling cycle and the difficulty in ceasing the behavior. Norepinephrine is associated with the arousal and risk taking in patients with PG. Dopamine is linked to positive and negative reward, the addictive component of this disorder. Effective treatment strategies for pathological gamblers are emerging. Potentially useful pharmacologic agents include SRIs (clomipramine and fluvoxamine), mood stabilizers for pathological gamblers with comorbid bipolar disorders (lithium), and naltrexone. Cognitive-behavioral psychotherapies offer promising results in the treatment of patients with this disorder. To devise prevention and early-intervention programs, research is needed to identify specific features of the individuals at risk for gambling problems. Education targeting vulnerable youth that show early signs of gambling behavior may be worthwhile and should be investigated further. Funding is necessary to support these endeavors, so perhaps a portion of tax revenues generated from the gambling industry should go toward specialized treatment facilities, educational efforts, and research into the neurobiology and treatment of PG.
Skelton, Rachel L.; Kornhauser, Jon M.; Tate, Barbara A.
The recent approval of a therapeutic for a circadian disorder has increased interest in developing additional medicines for disorders characterized by circadian disruption. However, previous experience demonstrates that drug development for central nervous system (CNS) disorders has a high failure rate. Personalized medicine, or the approach to identifying the right treatment for the right patient, has recently become the standard for drug development in the oncology field. In addition to utilizing Companion Diagnostics (CDx) that identify specific genetic biomarkers to prescribe certain targeted therapies, patient profiling is regularly used to enrich for a responsive patient population during clinical trials, resulting in fewer patients required for statistical significance and a higher rate of success for demonstrating efficacy and hence receiving approval for the drug. This personalized medicine approach may be one mechanism that could reduce the high clinical trial failure rate in the development of CNS drugs. This review will discuss current circadian trials, the history of personalized medicine in oncology, lessons learned from a recently approved circadian therapeutic, and how personalized medicine can be tailored for use in future clinical trials for circadian disorders to ultimately lead to the approval of more therapeutics for patients suffering from circadian abnormalities. PMID:26150790
Skelton, Rachel L; Kornhauser, Jon M; Tate, Barbara A
The recent approval of a therapeutic for a circadian disorder has increased interest in developing additional medicines for disorders characterized by circadian disruption. However, previous experience demonstrates that drug development for central nervous system (CNS) disorders has a high failure rate. Personalized medicine, or the approach to identifying the right treatment for the right patient, has recently become the standard for drug development in the oncology field. In addition to utilizing Companion Diagnostics (CDx) that identify specific genetic biomarkers to prescribe certain targeted therapies, patient profiling is regularly used to enrich for a responsive patient population during clinical trials, resulting in fewer patients required for statistical significance and a higher rate of success for demonstrating efficacy and hence receiving approval for the drug. This personalized medicine approach may be one mechanism that could reduce the high clinical trial failure rate in the development of CNS drugs. This review will discuss current circadian trials, the history of personalized medicine in oncology, lessons learned from a recently approved circadian therapeutic, and how personalized medicine can be tailored for use in future clinical trials for circadian disorders to ultimately lead to the approval of more therapeutics for patients suffering from circadian abnormalities.
Tromp, Noor B; Koot, Hans M
The aim of the present study was to relate and compare two approaches to personality pathology in adolescents. Dimensions of personality pathology, assessed by the Dimensional Assessment of Personality Pathology-Basic Questionnaire for Adolescents (DAPP-BQ-A; Tromp & Koot, 2008), were related to DSM-IV personality disorder (PD) symptoms in 168 adolescents referred for mental health services. Correlational analyses revealed that the DAPP-BQ-A higher- and lower-order dimensions were related to PD symptoms in predictable ways. Regression analyses showed that for all but three PDs (Schizoid, Schizotypal, and Passive-Aggressive), lower-order dimensions accounted for unique variance, after controlling for gender, age, and co-occurring PD symptoms. It is concluded that dimensional assessment may provide valuable information on adolescent personality pathology, and facilitate the study of developmental antecedents of adult personality pathology.
Oliveira, M P; Silva, M T
In the present study Brazilian gamblers from different settings were compared on sociodemographic characteristics, gambling the behavior, and use of drugs. The SOGS was administered to 171 subjects at bingo (BG), video poker (VP), and horse-racing clubs (HR) of São Paulo. BG concentrated most women, VP the youngest and single gamblers, and HR the lowest income subjects. More VP than HR or BG gamblers reported taking time off work to gamble, as well as returning another day to win back lost money. They also had a higher number of scorable responses on the SOGS. The differences observed suggest that VP gamblers bear a greater risk of developing a pathological gambling pattern. The authors suggest that measures should be taken aimed at the prevention of pathological gambling, particularly among the young population of video poker gamblers.
Mulder, Roger T; Newton-Howes, Giles; Crawford, Michael J; Tyrer, Peter J
There is general agreement that the classification of personality disorders in DSM-IV is unsatisfactory. We systematically reviewed all studies that have analyzed patterns of personality disorder symptoms and signs in psychiatric patients; twenty-two papers were included in the final synthesis. There is reasonable consistency over the number and type of personality pathology traits reported despite differing samples, varying assessment methods, and different statistical manipulations. There are three or four high order traits; an externalizing factor incorporating borderline, narcissistic, histrionic, and antisocial traits (the latter is sometimes recorded as a separate trait); an internalizing factor incorporating avoidant and dependent traits; a schizoid factor; and often a compulsive factor. Using these domains of personality pathology would simplify classification, have higher clinical utility, and allow relatively easy translation of current research.
Thomas, Cannon; Turkheimer, Eric; Oltmanns, Thomas F.
This study explored how individuals apply features of personality disorders (PDs) to peers. Members of groups nominated peers who exhibited symptoms for each of the 10 PDs in the DSM–IV. Data were gathered in 2 samples: 1st-year college students (n = 1,440) and Air Force recruits (n = 2,075). The peer method reliably identified group members exhibiting specific PD features. Factor analyses identified a clearly interpretable structure relevant to the pathological personality constructs being assessed. The structure replicated well across samples and showed expected relationships to broader models of normal personality. However, cross-method correlations of factor scores were only moderate, suggesting that peer reports are reliably different from self-reports regarding the presence of pathological personality traits. PMID:12653416
Nastally, Becky L.; Dixon, Mark R.; Jackson, James W.
Pathological and nonpathological gamblers completed a task that assessed preference among 2 concurrently available slot machines. Subsequent assessments of choice were conducted after various attempts to transfer contextual functions associated with irrelevant characteristics of the slot machines. Results indicated that the nonproblem gambling…
Wright, Aidan G C; Pincus, Aaron L; Thomas, Katherine M; Hopwood, Christopher J; Markon, Kristian E; Krueger, Robert F
The Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) features two conceptions of Narcissistic Personality Disorder (NPD), one based on the retained DSM-IV's categorical diagnosis and the other based on a model that blends impairments in personality functioning with a specific trait profile intended to recapture DSM-IV NPD. Nevertheless, the broader literature contains a richer array of potential conceptualizations of narcissism, including distinguishable perspectives from psychiatric nosology, clinical observation and theory, and social/personality psychology. This raises questions about the most advantageous pattern of traits to use to reflect various conceptions of narcissistic pathology via the Personality Inventory for the DSM-5 (PID-5). In this study, we examine the associations of the Personality Disorder Questionnaire-Narcissistic Personality Disorder scale, Narcissistic Personality Inventory-16, and the Pathological Narcissism Inventory and the PID-5 dimensions and facets in a large sample (N = 1,653) of undergraduate student participants. Results point to strong associations with PID-5 Antagonism scales across narcissism measures, consistent with the DSM-5's proposed representation of NPD. However, additional notable associations emerged with PID-5 Negative Affectivity and Psychoticism scales when considering more clinically relevant narcissism measures.
Arvanitakis, Zoe; Leurgans, Sue E.; Wang, Zhenxin; Wilson, Robert S.; Bennett, David A.; Schneider, Julie A.
Objective To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia. Methods Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid-β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all rs > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5). Results CAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (rs = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings. Interpretation CAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. PMID:21387377
Simms, Leonard J
Proponents of the Big Seven model of personality have suggested that Positive Valence (PV) and Negative Valence (NV) are independent of the Big Five personality dimensions and may be particularly relevant to personality disorder. These hypotheses were tested with 403 undergraduates who completed a Big Seven measure and markers of the Big Five and personality pathology. Results revealed that PV and NV incrementally predicted personality pathology dimensions beyond those predicted by multiple markers of the Big Five. However, factor analyses suggested that PV and NV might be best understood as specific, maladaptive aspects of positive emotionality and low agreeableness, respectively, as opposed to independent factors of personality. Implications for the description of normal and abnormal personality are discussed.
Schreiber, Liana Renée Nelson; Odlaug, Brian Lawrence; Grant, Jon Edgar
Research has found that children who have parents with an addiction may be more vulnerable to developing psychopathology compared to children without parental addiction. We compared young adult, recreational gamblers with and without parental addiction on measures of gambling behavior and impulsivity. A total of 286 recreational gamblers (defined as having gambled at least five times in the past 12 months) between the ages of 18 and 29 participated in an initial intake of a longitudinal study assessing susceptibility to pathological gambling. Trained staff members interviewed subjects, and subjects completed cognitive testing and self-report measures. Fifty-three subjects (18.53%) reported at least one parent with an addiction (including alcohol and substance dependence and pathological gambling). Subjects with at least one addicted parent were significantly more likely to report problems resulting from gambling, have significantly greater rates of psychiatric comorbidity, and report significantly more current marijuana and tobacco use. Subjects with an addicted parent were not significantly different on measures of impulsivity. These findings suggest that even at a stage of low-risk gambling, before what has been considered a psychopathology arises, those with a possible environmental and/or genetic risk of addiction exhibit a range of problematic behaviors.
Guertler, Diana; Rumpf, Hans-Juergen; Bischof, Anja; Kastirke, Nadin; Petersen, Kay Uwe; John, Ulrich; Meyer, Christian
This study aims to analyze psychometric properties and validity of the Compulsive Internet Use Scale (CIUS) and the Internet Addiction Test (IAT) and, second, to determine a threshold for the CIUS which matches the IAT cut-off for detecting problematic Internet use. A total of 292 subjects with problematic or pathological gambling (237 men, 55 women) aged 14-63 years and with private Internet use for at least 1 h per working or weekend day were recruited via different recruitment channels. Results include that both scales were internally consistent (Cronbach's α=0.9) and had satisfactory convergent validity (r=0.75; 95% CI 0.70-0.80). The correlation with duration of private Internet use per week was significantly higher for the CIUS (r=0.54) compared to the IAT (r=0.40). Among all participants, 25.3% were classified as problematic Internet users based on the IAT with a cut-off≥40. The highest proportion of congruent classified cases results from a CIUS cut-off ≥18 (sensitivity 79.7%, specificity 79.4%). However, a higher cut-off (≥21) seems to be more appropriate for prevalence estimation of problematic Internet use.
Jansen, Willemijn J.; Ossenkoppele, Rik; Knol, Dirk L.; Tijms, Betty M.; Scheltens, Philip; Verhey, Frans R. J.; Visser, Pieter Jelle
IMPORTANCE Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies. OBJECTIVE To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators. STUDY SELECTION Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity. DATA EXTRACTION AND SYNTHESIS Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations. RESULTS The prevalence of amyloid pathology increased from age 50 to 90 years from 10% (95% CI, 8%-13%) to 44% (95% CI, 37%-51%) among participants with normal cognition; from 12% (95% CI, 8%-18%) to 43% (95% CI, 32%-55%) among patients with SCI; and from 27% (95% CI, 23%-32%) to 71% (95% CI, 66%-76%) among patients with MCI. APOE-ε4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15% of the participants with normal cognition were amyloid positive was approximately 40 years for APOEε4ε4 carriers, 50 years for ε2ε4 carriers, 55 years for ε3ε4 carriers, 65 years for ε3ε3 carriers, and
Wright, Aidan G C; Thomas, Katherine M; Hopwood, Christopher J; Markon, Kristian E; Pincus, Aaron L; Krueger, Robert F
A multidimensional trait system has been proposed for representing personality disorder (PD) features in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to address problematic classification issues such as comorbidity. In this model, which may also assist in providing scaffolding for the underlying structure of major forms of psychopathology more generally, 25 primary traits are organized by 5 higher order dimensions: Negative Affect, Detachment, Antagonism, Disinhibition, and Psychoticism. We examined (a) the generalizability of the structure proposed for DSM-5 PD traits, and (b) the potential for an integrative hierarchy based upon DSM-5 PD traits to represent the dimensions scaffolding psychopathology more generally. A large sample of student participants (N = 2,461) completed the Personality Inventory for DSM-5, which operationalizes the DSM-5 traits. Exploratory factor analysis replicated the initially reported 5-factor structure, as indicated by high factor congruencies. The 2-, 3-, and 4-factor solutions estimated in the hierarchy of the DSM-5 traits bear close resemblance to existing models of common mental disorders, temperament, and personality pathology. Thus, beyond the description of individual differences in personality disorder, the trait dimensions might provide a framework for the metastructure of psychopathology in the DSM-5 and the integration of a number of ostensibly competing models of personality trait covariation.
Studer, Joseph; Baggio, Stéphanie; Mohler-Kuo, Meichun; Simon, Olivier; Daeppen, Jean-Bernard; Gmel, Gerhard
The study aimed to identify different patterns of gambling activities (PGAs) and to investigate how PGAs differed in gambling problems, substance use outcomes, personality traits and coping strategies. A representative sample of 4989 young Swiss males completed a questionnaire assessing seven distinct gambling activities, gambling problems, substance use outcomes, personality traits and coping strategies. PGAs were identified using latent class analysis (LCA). Differences between PGAs in gambling and substance use outcomes, personality traits and coping strategies were tested. LCA identified six different PGAs. With regard to gambling and substance use outcomes, the three most problematic PGAs were extensive gamblers, followed by private gamblers, and electronic lottery and casino gamblers, respectively. By contrast, the three least detrimental PGAs were rare or non-gamblers, lottery only gamblers and casino gamblers. With regard to personality traits, compared with rare or non-gamblers, private and casino gamblers reported higher levels of sensation seeking. Electronic lottery and casino gamblers, private gamblers and extensive gamblers had higher levels of aggression-hostility. Extensive and casino gamblers reported higher levels of sociability, whereas casino gamblers reported lower levels of anxiety-neuroticism. Extensive gamblers used more maladaptive and less adaptive coping strategies than other groups. Results suggest that gambling is not a homogeneous activity since different types of gamblers exist according to the PGA they are engaged in. Extensive gamblers, electronic and casino gamblers and private gamblers may have the most problematic PGAs. Personality traits and coping skills may predispose individuals to PGAs associated with more or less negative outcomes.
Levenson, Jessica C.; Wallace, Meredith L.; Fournier, Jay C.; Rucci, Paola; Frank, Ellen
Background: Depressed patients with comorbid personality pathology may fare worse in treatment for depression than those without this additional pathology, and comorbid personality pathology may be associated with superior response in one form of treatment relative to another, though recent findings have been mixed. We aimed to evaluate the effect…
Hessels, Christel; van den Hanenberg, Danique; de Castro, Bram Orobio; van Aken, Marcel A G
This study seeks to integrate two research traditions that lie at the base of the understanding of personality pathology in adolescents. The first research tradition refers to normal personality according to the Five Factor Model (FFM). The second tradition specifies the key feature of personality disorder as the capacity to mentalize, which can be reflected in Social Information Processing (SIP). In a clinical sample of 96 adolescents, the authors investigated response generation, coping strategy, and memories of past frustrating experiences as part of SIP, as mediator in the relationship between personality and personality pathology, and a possible moderating role of personality on the relationship between SIP and personality pathology. The hypothesized mediation, by which the effects of personality dimensions on personality pathology was expected to be mediated by SIP variables, was found only for the effect of Neuroticism, most specifically on BPD, which appeared to be mediated by memories the patients had about past frustrating conflict situations with peers. Some moderating effects of personality on the relationship between SIP variables and personality pathology were found, suggesting that high Agreeableness and sometimes low Neuroticism can buffer this relationship. These results suggest that personality dimensions and social cognitions both independently and together play a role in adolescents' personality pathology.
Farmer, Richard F; Nash, Heather M; Dance, Darci
This study examined mood and mood variation in relation to varying forms and degrees of personality disorder (PD) pathology. Mood experiences of 98 psychotropic medication-free individuals were repeatedly assessed over a 4-day period. Persons with PDs (n = 57) generally displayed neutral to moderately positive moods; however, overall mood valence was less positive when compared to those without PDs (n = 41). Mood ratings demonstrated moderate covariations with anxious-fearful (A-F) PD traits but little or no association with erratic-emotional-dramatic (E-D) and odd-eccentric (O-E) PD traits once common variance among PD dimensions was removed. For PD diagnostic categories, the presence of avoidant and/or depressive PDs was most strongly associated with negative mood. When dimensional scores based on specific PD trait features were considered, avoidant, depressive, borderline, passive-aggressive, obsessive-compulsive, dependent, paranoid, and schizoid PD traits demonstrated the most reliable associations with negative mood. Apart from borderline PD features, traits associated with other E-D cluster PDs displayed little or no associations with mood quality. Consistent with previous research, mood variability emerged as an internally consistent and stable individual difference variable. Mood variability, however, was not generally associated with PD diagnostic categories or traits. Implications of this study's findings are considered in relation to the conceptual modeling of PDs.
Carlson, Erika N.; Vazire, Simine; Oltmanns, Thomas F.
Objective Self-reports of personality provide valid information about personality disorders (PDs). However, informant-reports provide information about PDs that self-reports alone do not provide. The current paper examines if and when one perspective is more valid than the other in identifying PDs. Method Using a representative sample of adults 55 to 65 year of age (N = 991; 45% males), we compared the validity of self- and informant- (e.g., spouse, family, or friend) reports of the FFM traits in predicting PD scores (i.e., composite of interviewer, self-, and informant-reports of PDs). Results Self-reports (particularly of neuroticism) were more valid than informant-reports for most internalizing PDs (i.e., PDs defined by high neuroticism). Informant-reports (particularly of agreeableness and conscientiousness) were more valid than self-reports for externalizing and/or antagonistic PDs (i.e., PDs defined by low agreeableness, conscientiousness). Neither report was consistently more valid for thought disorder PDs (i.e., PDs defined by low extraversion). However, informant-reports (particularly of agreeableness) were more valid than self-reports for PDs that were both internalizing and externalizing (i.e., PDs defined by high neuroticism and low agreeableness). Conclusions The intrapersonal and interpersonal manifestations of PDs differ, and these differences influence who knows more about pathology. PMID:22583054
González-Ibáñez, Angels; Rosel, Pilar; Moreno, Isabel
The aim of this article was to describe a model for evaluating and implementing cognitive-behavioral treatment for pathological gambling. The model takes into account the fact that pathological gamblers form a heterogeneous group with varied biopsychosocial characteristics.
Porchet, Roseline I.; Boekhoudt, Linde; Studer, Bettina; Gandamaneni, Praveen K.; Rani, Nisha; Binnamangala, Somashekar; Müller, Ulrich; Clark, Luke
Gambling is characterized by cognitive distortions in the processing of chance and skill that are exacerbated in pathological gambling. Opioid and dopamine dysregulation is implicated in pathological gambling, but it is unclear whether these neurotransmitters modulate gambling distortions. The objective of the current study was to assess the effects of the opioid receptor antagonist naltrexone and the dopamine D2 receptor antagonist haloperidol on gambling behavior. Male recreational gamblers (n = 62) were assigned to receive single oral doses of naltrexone 50 mg, haloperidol 2 mg or placebo, in a parallel-groups design. At 2.5 h post-dosing, participants completed a slot machine task to elicit monetary wins, “near-misses,” and a manipulation of personal choice, and a roulette game to elicit two biases in sequential processing, the gambler's fallacy and the hot hand belief. Psychophysiological responses (electrodermal activity and heart rate) were taken during the slot machine task, and plasma prolactin increase was assessed. The tasks successfully induced the gambling effects of interest. Some of these effects differed across treatment groups, although the direction of effect was not in line with our predictions. Differences were driven by the naltrexone group, which displayed a greater physiological response to wins, and marginally higher confidence ratings on winning streaks. Prolactin levels increased in the naltrexone group, but did not differ between haloperidol and placebo, implying that naltrexone but not haloperidol may have been functionally active at these doses. Our results support opioid modulation of cognition during gambling-like tasks, but did not support the more specific hypothesis that naltrexone may act to ameliorate cognitive distortions. PMID:24109443
Gibbons, Peter; Collins, Marjorie; Reid, Corinne
There has been considerable debate about profiling personality pathology when assessing and treating male perpetrators of domestic violence (DV). This study used the Millon Clinical Multiaxial Inventory (MCMI-III) to explore the severity and diversity of male perpetrator personality pathology and response bias in a group of DV perpetrators being…
Strunz, Sandra; Westphal, Linda; Ritter, Kathrin; Heuser, Isabella; Dziobek, Isabel; Roepke, Stefan
Differentiating autism spectrum disorders (ASDs) without accompanying intellectual impairment from personality disorders is often challenging. Identifying personality traits and personality pathology specific to ASD might facilitate diagnostic procedure. We recruited a sample of 59 adults with ASD without accompanying intellectual impairment, 62…
Goldstein, Abby L.; Vilhena-Churchill, Natalie; Stewart, Sherry H.; Hoaken, Peter N. S.; Flett, Gordon L.
Background and aims To date, there is a lack of research on psychological factors associated with young adult online gambling. The current study examined differences between young adult online and non-online gamblers, using information gathered at baseline and over 30 days during which participants reported on their moods, gambling behaviors, and reasons for initiating and discontinuing gambling. Methods Participants were 108 young adult regular gamblers (i.e., gambling four or more times in the past month) who participated in a 30-day daily diary study. Results Male gender, baseline coping motives for gambling and negative affect averaged across the 30 days emerged as significant correlates of online gambling, over and above other background variables. Online gamblers also scored higher on a baseline measure of pathological gambling. Over the 30 days of self-monitoring, online gamblers spent more time gambling, and won more money gambling, whereas non-online gamblers consumed more alcohol while gambling. Online gambling was more often initiated to make money, because of boredom and to demonstrate skills, whereas non-online gambling was more often initiated for social reasons and for excitement. Online gambling was more often discontinued because of boredom, fatigue or distress, whereas non-online gambling was discontinued because friends stopped gambling or mood was improved. Discussion and conclusions This study provides preliminary evidence that coping strategies may be particularly important to reduce risks for online gamblers, whereas strategies for non-online gamblers should focus on the social aspects of gambling. PMID:28092184
Ciccarelli, Maria; Griffiths, Mark D; Nigro, Giovanna; Cosenza, Marina
In the psychological literature, many studies have investigated the neuropsychological and behavioral changes that occur developmentally during adolescence. These studies have consistently observed a deficit in the decision-making ability of children and adolescents. This deficit has been ascribed to incomplete brain development. The same deficit has also been observed in adult problem and pathological gamblers. However, to date, no study has examined decision-making in adolescents with and without gambling problems. Furthermore, no study has ever examined associations between problem gambling, decision-making, cognitive distortions and alcohol use in youth. To address these issues, 104 male adolescents participated in this study. They were equally divided in two groups, problem gamblers and non-problem gamblers, based on South Oaks Gambling Screen Revised for Adolescents scores. All participants performed the Iowa gambling task and completed the Gambling Related Cognitions Scale and the alcohol use disorders identification test. Adolescent problem gamblers displayed impaired decision-making, reported high cognitive distortions, and had more problematic alcohol use compared to non-problem gamblers. Strong correlations between problem gambling, alcohol use, and cognitive distortions were observed. Decision-making correlated with interpretative bias. This study demonstrated that adolescent problem gamblers appear to have the same psychological profile as adult problem gamblers and that gambling involvement can negatively impact on decision-making ability that, in adolescence, is still developing. The correlations between interpretative bias and decision-making suggested that the beliefs in the ability to influence gambling outcomes may facilitate decision-making impairment.
Creswell, Kasey G.; Bachrach, Rachel L.; Wright, Aidan G.C.; Pinto, Anthony; Ansell, Emily
There is high comorbidity between personality disorders and alcohol use disorders, which appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. Very little is known about how the DSM-5 Section III trait model of personality pathology relates to alcohol problems, however, or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Further, two of the five higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these two specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. PMID:26389625
Galione, Janine N.; Oltmanns, Thomas F.
Major limitations are associated with the use of a single source of information to assess personality pathology. The construct validity of standardized interviews and informant reports on personality pathology has been established relative to other measures of personality pathology, but it is also important to consider these measures in relation to other constructs that should be related to personality pathology. One example is major depression. In this study, we evaluated whether less common clinical methods of assessment for measuring the same personality pathology constructs, including semistructured interviews and informant reports, demonstrate unique validity, using major depressive episode (MDE) as the external criterion. This analysis focuses on a representative, community-based sample of 1,437 participants and informants. We conducted a hierarchical logistic regression analysis and determined the order of entering the predictor variables based on likelihood of being used in a clinical setting as well as empirical recommendations. Each step of our regression model significantly increased our ability to predict lifetime MDE, including self, interviewer, and informant reports of personality pathology. Overall, these findings indicate that multiple sources of personality assessment provide unique information about the relationship between maladaptive personality traits and a history of MDE. Thus, semistructured diagnostic interviews and informant reports can be used as a resource to improve the validity of personality assessments. PMID:24004355
van Es, R.
OBJECTIVE: To present a meta-analysis of current research on the prevalence, identification, and treatment of problem and compulsive gamblers. QUALITY OF EVIDENCE: Problem and compulsive gambling was not a socio-scientific concern until the last two decades. Hence research on this topic is limited. The summary and analysis for this paper relied on computer searches of journal and news abstracts in addition to direct contact with organizations addressing the identification and treatment of compulsive gamblers. MAIN MESSAGE: An estimated 5% of those who gamble run into problems. About 1% of those who gamble are predicted to experience serious problems. Successful treatment of problem and compulsive gambling continues to be a challenge. Although cognitive therapy has been the favoured approach, a combination of several therapeutic approaches is advocated. CONCLUSIONS: Problem and compulsive gambling can present a real health threat. As with other addictions, treatment strategies continue to be a baffling social problem. Aware and informed physicians can have a pivotal role in the difficult process of identifying, acknowledging, and remediating problem and compulsive gambling. PMID:10907572
Shen, Yi; Kairouz, Sylvia; Nadeau, Louise; Robillard, Chantal
Background and Aims In an effort to provide further empirical evidence of meaningful differences, this study explores, in a student population, the distinctions in gambling behavioral patterns and specific associated problems of two levels of gambling severity by comparing problem gamblers (PG) and moderate-risk gamblers (MR) as defined by the score on the Problem Gambling Severity Index (PGSI; MR: 3-7; PG: 8 and more). Methods The study sample included 2,139 undergraduate students (male = 800, mean age = 22.6) who completed the PGSI and questionnaires on associated problems. Results Results show that problem gamblers engage massively and more diversely in gambling activities, more often and in a greater variety of locations, than moderate-risk gamblers. In addition, important differences have been observed between moderate-risk and problem gamblers in terms of expenditures and accumulated debt. In regards to the associated problems, compared to moderate-risk gamblers, problem gamblers had an increased reported psychological distress, daily smoking, and possible alcohol dependence. Discussion and Conclusions The severity of gambling and associated problems found in problem gamblers is significantly different from moderate-risk gamblers, when examined in a student population, to reiterate caution against the amalgamation of these groups in future research. PMID:26014673
Wright, Aidan G. C.; Pincus, Aaron L.; Hopwood, Christopher J.; Thomas, Katherine M.; Markon, Kristian E.; Krueger, Robert F.
The proposed changes to the personality disorder section of the "Diagnostic and Statistical Manual of Mental Disorders" (5th ed.) places an increased focus on interpersonal impairment as one of the defining features of personality psychopathology. In addition, a proposed trait model has been offered to provide a means of capturing…
Price, Reese E.
This paper considers the condition of Multiple Personality Disorder (MPD), which is defined as a separation of alternating personalities by rigid boundaries and amnestic barriers. It is proposed that MPD represents the end of a continuum of a defensive dissociation of the self that can result when a child employs a dissociative splitting of self…
This history is largely about the players on the stage of the Yale Pathology Department acting out their roles as observed by the author in over a half century as a member of the department and as associate dean of the medical school. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:10527367
Cayn, Delphine; Pham-Scottez, Alexandra
Comorbidity with a borderline personality disorder is far from rare in patients suffering from eating disorders. Clinically, this presents as chronic instability in many areas: interpersonal relationships, self-image, emotions, mood and acting out. Treatment is mainly based on a containing and reassuring therapeutic framework. A care plan may be put in place that incorporates reducing impulsive harmful, eating and self-harming behaviours. Dialectical behaviour therapy is intended in particular to prevent suicide risk in borderline personality disorder patients.
Creswell, Kasey G; Bachrach, Rachel L; Wright, Aidan G C; Pinto, Anthony; Ansell, Emily
High comorbidity between personality disorders and alcohol use disorders appears related to individual differences in underlying personality dimensions of behavioral undercontrol and affective dysregulation. However, very little is known about how the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5) Section III trait model of personality pathology relates to alcohol problems or how the strength of the relationship between personality pathology and alcohol problems changes with age and across gender. The current study examined these questions in a sample of 877 participants using the General Assessment of Personality Disorder to assess general personality dysfunction, the Personality Inventory for DSM-5 to measure specific traits, and the Alcohol Use Disorder Identification Test (AUDIT) to assess problematic alcohol use. Results demonstrated that general personality pathology (Criterion A) was significantly related to problematic alcohol use after controlling for age and gender effects. Furthermore, 2 of the 5 higher-order personality trait domains (Criterion B), Antagonism and Disinhibition, remained significant predictors of problematic alcohol use after accounting for the influence of general personality pathology; however, general personality pathology no longer predicted hazardous alcohol use once Antagonism and Disinhibition were added into the model. Finally, these 2 specific traits interacted with age, such that Antagonism was a stronger predictor of AUDIT scores among older individuals and Disinhibition was a stronger predictor of alcohol problems among younger individuals. Findings support the general validity of this new personality disorder diagnostic system and suggest important age effects in the relationship between traits and problematic alcohol use. (PsycINFO Database Record
van den Akker, Alithe L; Prinzie, Peter; Overbeek, Geertjan
To investigate validity of the dimensions that underlie pathological personality in adolescence, we delineated the hierarchical structure of the Dimensional Assessment of Personality Pathology-Short Form-Adolescent version (DAPP-SF-A; Tromp & Koot, 2008) and examined longitudinal associations with Big Five personality dimensions assessed four times from middle childhood to late adolescence. A total of 426 adolescents provided self-reports on the DAPP-SF-A (age M = 18.6, SD = 1.17; 53% female). Mothers provided information on their child's personality eleven, eight, five, and three years earlier. Previous findings on the hierarchical structure of the DAPP-BQ replicated up to the four-component solution (emotional dysregulation, dissocial behavior, inhibition, and compulsivity). In the solution, a thought disturbance component emerged. Interestingly, the five-component solution already showed most differentiated associations with childhood personality in middle childhood. Childhood personality dimensions predicted four out of five adolescent pathological personality traits, indicating continuity of normal and abnormal personality across childhood and adolescence.
A Swedish mutual support group for young problem gamblers is described and discussed. During the study period, 116 weekly meetings occurred, usually involving six to ten participants; in total, 69 problem gamblers (66 male and three female), aged 17-25, and 23 partners and friends attended the meetings. Half the gamblers had problems with Internet…
Scott, Lori N; Kim, Yookyung; Nolf, Kimberly A; Hallquist, Michael N; Wright, Aidan G C; Stepp, Stephanie D; Morse, Jennifer Q; Pilkonis, Paul A
Emotional dysregulation and impaired attachment are seen by many clinical researchers as central aspects of borderline personality disorder (BPD). Alternatively, these constructs may represent general impairments in personality that are nonspecific to BPD. Using multitraitmultimethod models, the authors examined the strength of associations among preoccupied attachment, difficulties with emotion regulation, BPD features, and features of two other personality disorders (i.e., antisocial and avoidant) in a combined psychiatric outpatient and community sample of adults. Results suggested that preoccupied attachment and difficulties with emotion regulation shared strong positive associations with each other and with each of the selected personality disorders. However, preoccupied attachment and emotional dysregulation were more strongly related to BPD features than to features of other personality disorders. Findings suggest that although impairments in relational and emotional domains may underlie personality pathology in general, preoccupied attachment and emotional dysregulation also have specificity for understanding core difficulties in those with BPD.
Ariyabuddhiphongs, Vanchai; Phengphol, Varich
Near miss, gambler's fallacy and entrapment are hypothesized to influence gambling behavior but their individual impact on gambling behavior and their relationships have not been investigated. This study examines the direct and mediated effects of near miss, gambler's fallacy and entrapment on lottery gambling among Thai lottery gamblers. Two groups of 200 lottery gamblers participated in the study. One group used superstitious methods to search for lottery numbers to bet, whereas the other group simply bought their tickets from lottery stalls. The superstitious group shows higher levels of near miss, gambler's fallacy, entrapment and lottery gambling. Three models of relationships among near miss, gambler's fallacy, entrapment and lottery gambling were constructed using LISREL program. The model that shows a direct effect of near miss, and one that shows a mediated effect of near miss fit the data equally. The results confirm a gambler's fallacy and entrapment as starting points in the theory of cognitive psychology of lottery gambling and the generalization of near miss in gambling motivation.
Zeigler-Hill, Virgil; McCabe, Gillian A.; Vrabel, Jennifer K.
Basic personality traits (e.g., extraversion) have been found to be associated with the humor styles that individuals employ. In the present study, we were interested in determining whether pathological personality traits were also associated with humor styles. We examined the associations between the pathological personality traits captured by the Personality Inventory for the DSM-5 (PID-5) and humor styles in a sample of college students (N = 594). Negative affectivity and detachment were negatively associated with the affiliative and self-enhancing humor styles. Antagonism was positively associated with the aggressive humor style but negatively associated with the affiliative humor style. Disinhibition was positively associated with the aggressive humor style, whereas disinhibition and psychoticism were both positively associated with the self-defeating humor style. Discussion focuses on the implications of these findings and how they can expand our understanding of the connections between the darker aspects of personality and humor. PMID:27547254
Lis, Eric; Myhr, Gail
Cognitive behavioral therapy (CBT) is an evidence-based psychotherapeutic approach which has been shown to be an effective intervention for most psychiatric disorders. There are conflicting data in the literature regarding whether a comorbid personality disorder worsens the prognosis of CBT for depression, anxiety, and other complaints. This study examined data collected before and after courses of CBT for patients with significant borderline (n=39, 11.5%) or obsessive-compulsive (n=66, 19.4%) personality pathology or no personality disorder (n=235, 69.1%). A diagnosis of personality pathology was not a significant predictor of outcome in CBT as measured by the reliable change index. However, patients with borderline personality pathology did demonstrate a greater response to CBT than other patients in terms of improvement on several measures of symptoms. Patients with borderline personality pathology appear to enter therapy with greater subjective depression and interpersonal difficulty than other patients but achieve larger gains during therapy. Implications and directions for future research are discussed.
Clark, Lee Anna; Ro, Eunyoe
The alternative dimensional model of personality disorder (PD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5; American Psychiatric Association, 2013), Section III, has two main criteria: impairment in personality functioning and one or more pathological personality traits. The former is defined as disturbances in self-functioning (viz., identity, self-direction), and/or interpersonal functioning (viz., empathy, intimacy). Distinguishing personality functioning and traits is important conceptually, because simply having extreme traits is not necessarily pathological. However, adding personality functioning to PD diagnosis represents an empirical challenge, because the constructs overlap conceptually. Further, there is debate regarding whether diagnosis of mental disorder requires either distress or disability, concepts that also overlap with maladaptive-range personality traits and personality dysfunction. We investigated interrelations among these constructs using multiple self-report measures of each domain in a mixed community-patient sample (N = 402). We examined the structures of functioning (psychosocial disability and personality) and personality traits, first independently, then jointly. The disability/functioning measures yielded the 3 dimensions we have found previously (Ro & Clark, 2013). Trait measures had a hierarchical structure which, at the 5-factor level, reflected neuroticism/negative affectivity (N/NA), (low) sociability, disinhibition, (dis)agreeableness, and rigid goal engagement. When all measures were cofactored, a hierarchical structure again emerged which, at the 5-factor level, included (a) internalizing (N/NA and self-pathology vs. quality-of-life/satisfaction); (b) externalizing (social/interpersonal dysfunction, low sociability, and disagreeableness); (c) disinhibition; (d) poor basic functioning; and (e) rigid goal engagement. Results are discussed in terms of developing an integrated PD diagnostic
Clark, Lee Anna; Ro, Eunyoe
The alternative dimensional model of personality disorder (PD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013), Section III, has two main criteria: Impairment in personality functioning and one or more pathological personality traits. The former is defined as disturbances in self functioning (viz., identity, self-direction), and/or interpersonal functioning (viz., empathy, intimacy). Distinguishing personality functioning and traits is important conceptually, because simply having extreme traits is not necessarily pathological. However, adding personality functioning to PD diagnosis represents an empirical challenge, because the constructs overlap conceptually. Further, there is debate regarding whether diagnosis of mental disorder requires either distress or disability, concepts that also overlap with maladaptive-range personality traits and personality dysfunction. We investigated interrelations among these constructs using multiple self-report measures of each domain in a mixed community-patient sample (N = 402). We examined the structures of functioning (psychosocial disability and personality), and personality traits, first independently, then jointly. The disability/functioning measures yielded the three dimensions we have found previously (Ro & Clark, 2013). Trait measures had a hierarchical structure which, at the five-factor level, reflected neuroticism/negative affectivity (N/NA), (low) sociability, disinhibition, (dis)agreeableness, and rigid goal engagement. When all measures were co-factored, a hierarchical structure again emerged which, at the five-factor level, included (1) internalizing (N/NA and self-pathology vs. quality-of-life/satisfaction), (2) externalizing (social/interpersonal dysfunction, low sociability, and disagreeableness), (3) disinhibition, (4) poor basic functioning, and (5) rigid goal engagement. Results are discussed in terms of developing an integrated PD
Iacovino, Juliette M.; Powers, Abigail D.; Oltmanns, Thomas F.
Borderline personality disorder (BPD) is associated with obesity, a major risk factor for a number of chronic illnesses (e.g., cardiovascular disease). We examined whether impulsivity and affective instability mediate the association between BPD pathology and body mass index (BMI). Participants were a community sample of adults ages 55–64 and their informants. The Structured Interview for DSM-IV Personality measured BPD symptoms and the Revised NEO Personality Inventory measured self- and informant-report impulsivity and affective instability. Mediation analyses demonstrated that only higher self-report impulsivity significantly mediated the association between greater BPD pathology and higher BMI. A subsequent model revealed that higher scores on the impulsiveness (lack of inhibitory control) and deliberation (planning) facets of impulsivity mediated the BPD–BMI association, with impulsiveness exerting a stronger mediation effect than deliberation. Obesity interventions that improve inhibitory control may be most effective for individuals with BPD pathology. PMID:24505165
Iacovino, Juliette M; Powers, Abigail D; Oltmanns, Thomas F
Borderline personality disorder (BPD) is associated with obesity, a major risk factor for a number of chronic illnesses (e.g., cardiovascular disease). We examined whether impulsivity and affective instability mediate the association between BPD pathology and body mass index (BMI). Participants were a community sample of adults ages 55-64 and their informants. The Structured Interview for DSM-IV Personality measured BPD symptoms and the Revised NEO Personality Inventory measured self- and informant-report impulsivity and affective instability. Mediation analyses demonstrated that only higher self-report impulsivity significantly mediated the association between greater BPD pathology and higher BMI. A subsequent model revealed that higher scores on the impulsiveness (lack of inhibitory control) and deliberation (planning) facets of impulsivity mediated the BPD-BMI association, with impulsiveness exerting a stronger mediation effect than deliberation. Obesity interventions that improve inhibitory control may be most effective for individuals with BPD pathology.
Turner, Hannah; Marshall, Emily; Wood, Francesca; Stopa, Lusia; Waller, Glenn
Whilst studies have consistently identified early symptom reduction as an important predictor of treatment outcome, the impact of early change on common comorbid features has not been investigated. This study of CBT for eating disorders explored patterns of early change in eating pathology and longer-term change in personality pathology, anxiety and depression. It also explored the impact of early change in eating pathology on overall change in personality pathology, anxiety and depression. Participants were 179 adults diagnosed with eating disorders who were offered a course of CBT in an out-patient community eating disorders service in the UK. Patients completed a measure of eating disorder psychopathology at the start of treatment and following the 6th session. They also completed measures of personality disorder cognitions, anxiety and depression at the start and end of treatment. There were significant changes in eating pathology over the first six sessions of treatment. Significant improvements were also seen in personality disorder pathology, anxiety and depression by the end of therapy. Effect sizes were medium to large for both completer and intention to treat analyses. Early changes in eating pathology were associated with later changes in common comorbid features, with early reduction in restraint being a key predictor. These findings demonstrate that early symptom change can be achieved in CBT for eating disorders when delivered in routine clinical practice. Such change has long-term benefits that go beyond the domain of eating pathology, enhancing change in personality pathology, anxiety and depression.
Yambe, Tomoyuki; Yoshizawa, Makoto; Fukudo, Shin; Fukuda, Hiroshi; Kawashima, Ryuta; Shizuka, Kazuhiko; Nanka, Shunsuke; Tanaka, Akira; Abe, Ken-ichi; Shouji, Tomonori; Hongo, Michio; Tabayashi, Kouichi; Nitta, Shin-ichi
The "Pockemon shock" is the most famous accident in the history of the broadcasting industry in Japan. Based on the experiences of this unfortunate accident from famous animation program "Pocket Monster", this study focused on the psychology and psychosomatics of the patients. A head-mounted display was used as the three-dimensional image presentation device and "Descent", a free software shooting game, was used as the software. Ten healthy adult male volunteers were used in this experiment after obtaining their informed consent. The oxygen metabolic change in the anterior lobe of the brain was measured by near infrared spectroscopy and recorded on an electrocardiogram. The mental scaling tendency of the object was analyzed using the type A behavior pattern and the hostility scaling. The Cook and Medley hostility (HO) scale from the Minnesota multiphasic personality inventory (MMPI) was also used in this experiment. From this scaling methodology, the paranoid scale, cynicism scale, lie scale, social support quality and social support quantity were calculated. All measured time series data were kept in the normal range, and no fatal arrhythmia or epilepsy were observed during experiments. In some cases, the brain oxygen metabolism may completely differ for the objects of Type A and Type B behavior patterns. On the whole, correlation did not become significant in type A scaling and hostility scaling. In a comparison of the percent changes of the HF in HRV with lie scaling, significant negative correlation was observed. The social support quantity was calculated from Cook and Medley, and significant negative correlations were observed with percent changes of LF/HF in HRV. The lie scale and social support quantity are opposite scaling. The sympathetic nervous system and parasympathetic nervous system have an opposite function also. Therefore, our results showed an interesting phenomenon, when considering the relationship between the autonomic function and the
Gu, Jiang; Taylor, Clive R.; Phil, D
The traditional task of the pathologist is to assist physicians in making the correct diagnosis of diseases at the earliest possible stage to effectuate the optimal treatment strategy for each individual patient. In this respect surgical pathology (the traditional tissue diagnosis) is but a tool. It is not, of itself, the purpose of pathology practice; and change is in the air. This January 2014 issue of Applied Immunohistochemistry and Molecular Morphology (AIMM) embraces that change by the incorporation of the agenda and content of the journal Diagnostic Molecular Morphology (DMP). Over a decade ago AIMM introduced and promoted the concept of “molecular morphology,” and has sought to publish molecular studies that correlate with the morphologic features that continue to define cancer and many diseases. That intent is now reinforced and extended by the merger with DMP, as a logical and timely response to the growing impact of a wide range of genetic and molecular technologies that are beginning to reshape the way in which pathology is practiced. The use of molecular and genomic techniques already demonstrates clear value in the diagnosis of disease, with treatment tailored specifically to individual patients. Personalized medicine is the future, and personalized medicine demands personalized pathology. The need for integration of the flood of new molecular data, with surgical pathology, digital pathology, and the full range of pathology data in the electronic medical record has never been greater. This review describes the possible impact of these pressures upon the discipline of pathology, and examines possible outcomes. There is a sense of excitement and adventure. Active adaption and innovation are required. The new AIMM, incorporating DMP, seeks to position itself for a central role in this process. PMID:24326463
Gu, Jiang; Taylor, Clive R
The traditional task of the pathologist is to assist physicians in making the correct diagnosis of diseases at the earliest possible stage to effectuate the optimal treatment strategy for each individual patient. In this respect surgical pathology (the traditional tissue diagnosis) is but a tool. It is not, of itself, the purpose of pathology practice; and change is in the air. This January 2014 issue of Applied Immunohistochemistry and Molecular Morphology (AIMM) embraces that change by the incorporation of the agenda and content of the journal Diagnostic Molecular Morphology (DMP). Over a decade ago AIMM introduced and promoted the concept of "molecular morphology," and has sought to publish molecular studies that correlate with the morphologic features that continue to define cancer and many diseases. That intent is now reinforced and extended by the merger with DMP, as a logical and timely response to the growing impact of a wide range of genetic and molecular technologies that are beginning to reshape the way in which pathology is practiced. The use of molecular and genomic techniques already demonstrates clear value in the diagnosis of disease, with treatment tailored specifically to individual patients. Personalized medicine is the future, and personalized medicine demands personalized pathology. The need for integration of the flood of new molecular data, with surgical pathology, digital pathology, and the full range of pathology data in the electronic medical record has never been greater. This review describes the possible impact of these pressures upon the discipline of pathology, and examines possible outcomes. There is a sense of excitement and adventure. Active adaption and innovation are required. The new AIMM, incorporating DMP, seeks to position itself for a central role in this process.
Kiel, Elizabeth J; Gratz, Kim L; Moore, Sarah Anne; Latzman, Robert D; Tull, Matthew T
This study sought to extend extant research on the association between borderline personality (BP) pathology and at-risk parenting by examining the dynamic nature of parenting in response to infant distress in mothers with and without clinically relevant levels of BP pathology. Findings revealed that mothers with clinically relevant levels of BP pathology were less likely than those without BP pathology to display positive affect in response to infant distress. There were no differences in the overall likelihood of insensitive parenting behaviors as a function of BP pathology, either in general or in response to infant distress. However, consistent with literature emphasizing the transactional nature of parent-child relationships, findings revealed that the likelihood of insensitive parenting behaviors among mothers with clinically relevant levels of BP pathology changed over time, increasing significantly as infant distress persisted for longer durations (a pattern not present for mothers without BP pathology). Moreover, maternal responses to infant distress were found to influence infant distress, with the likelihood of infant distress decreasing after maternal positive affect and increasing after maternal insensitive behaviors. The implications of findings for understanding the mechanisms of risk for children of mothers with BP pathology, as well as the transactional nature of mother-infant relationships in general, are discussed.
Glenn, Margaret K.; Diaz, Sebastian R.; Hawley, Carolyn
Professionals in the field of addictions view problems associated with recovery management across multiple domains. This exploratory study utilized concept mapping and pattern matching methodology to conceptualize the resulting 7 domains of concern for treatment and aftercare of problem and pathological gamblers. The information can be used by…
Greenspan, Stanley I.; Lourie, Reginald S.
This paper applies a developmental structuralist approach to the classification of adaptive and pathologic personality organizations and behavior in infancy and early childhood, and it discusses implications of this approach for preventive intervention. In general, as development proceeds, the structural capacity of the developing infant and child…
Black, Donald W; Coryell, William H; Crowe, Raymond R; Shaw, Martha; McCormick, Brett; Allen, Jeff
This study investigates the presence of personality disorders, impulsiveness, and novelty seeking in probands with DSM-IV pathological gambling (PG), controls, and their respective first-degree relatives using a blind family study methodology. Ninety-three probands with DSM-IV PG, 91 controls, and their 395 first-degree relatives were evaluated for the presence of personality disorder with the Structured Interview for DSM-IV Personality. Impulsiveness was assessed with the Barratt Impulsiveness Scale (BIS). Novelty seeking was evaluated using questions from Cloninger's Temperament and Character Inventory. Results were analyzed using logistic regression by the method of generalized estimating equations to account for within family correlations. PG probands had a significantly higher prevalence of personality disorders than controls (41 vs. 7 %, OR = 9.0, P < 0.001), along with higher levels of impulsiveness and novelty seeking. PG probands with a personality disorder had more severe gambling symptoms; earlier age at PG onset; more suicide attempts; greater psychiatric comorbidity; and a greater family history of psychiatric illness than PG probands without a personality disorder. PG relatives had a significantly higher prevalence of personality disorder than relatives of controls (24 vs. 9%, OR = 3.2, P < 0.001) and higher levels of impulsiveness. Risk for PG in relatives is associated with the presence of personality disorder and increases along with rising BIS Non-Planning and Total scale scores. Personality disorders, impulsiveness, and novelty seeking are common in people with PG and their first-degree relatives. The presence of a personality disorder appears to be a marker of PG severity and earlier age of onset. Risk for PG in relatives is associated with the presence of personality disorder and trait impulsiveness. These findings suggest that personality disorder and impulsiveness may contribute to a familial diathesis for PG.
Dowgwillo, Emily A; Ménard, Kim S; Krueger, Robert F; Pincus, Aaron L
The purpose of this study was to examine associations between pathological personality traits identified in the Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5) Section III alternative model of personality disorder (using the Personality Inventory for DSM-5; PID-5) and intimate partner violence (IPV; using the Conflict Tactics Scale [CTS]) in a sample of male (N = 1,106) and female (N = 1,338) college students. In this sample, self and partner perpetration of CTS Relationship Violence and CTS Negotiation tactics loaded onto 2 separate factors. The PID-5 facets and domains were differentially associated with these factors for both men and women. Facets and domains explained 10.1%-16.1% and 5.8%-10.6% of the variance in CTS Relationship Violence tactics, respectively. For both genders, detachment was positively associated with relationship violence. Antagonism was uniquely associated with relationship violence for women, whereas disinhibition was uniquely associated with relationship violence for men. Associations with lower level pathological personality facets were also examined. Overall, results indicate that DSM-5 pathological personality traits are associated with IPV reported by both men and women.
Wright, Aidan G.C.; Hopwood, Christopher J.; Skodol, Andrew E.; Morey, Leslie C.
Theorists have long argued that personality disorder (PD) is best understood in terms of general impairments shared across the disorders as well as more specific instantiations of pathology. A model based on this theoretical structure was proposed as part of the DSM-5 revision process. However, only recently has this structure been subjected to formal quantitative evaluation, with little in the way of validation efforts via external correlates or prospective longitudinal prediction. We used the Collaborative Longitudinal Study of Personality Disorders dataset to: (1) estimate structural models that parse general from specific variance in personality disorder features, (2) examine patterns of growth in general and specific features over the course of 10 years, and (3) establish concurrent and dynamic longitudinal associations in PD features and a host of external validators including basic personality traits and psychosocial functioning scales. We found that general PD exhibited much lower absolute stability and was most strongly related to broad markers of psychosocial functioning, concurrently and longitudinally, whereas specific features had much higher mean stability and exhibited more circumscribed associations with functioning. However, both general and specific factors showed recognizable associations with normative and pathological traits. These results can inform efforts to refine the conceptualization and diagnosis of personality pathology. PMID:27819472
Huprich, Steven K; Nelson, Sharon M
The Cognitive-Affective Processing System (CAPS) is a dynamic and expansive model of personality proposed by Mischel and Shoda (1995) that incorporates dispositional and processing frameworks by considering the interaction of the individual and the situation, and the patterns of variation that result. These patterns of cognition, affect, and behavior are generally defined through the use of if … then statements, and provide a rich understanding of the individual across varying levels of assessment. In this article, we describe the CAPS model and articulate ways in which it can be applied to conceptualizing and assessing personality pathology. We suggest that the CAPS model is an ideal framework that integrates a number of current theories of personality pathology, and simultaneously overcomes a number of limits that have been empirically identified in the past.
Wright, Aidan G. C.; Pincus, Aaron L.; Lenzenweger, Mark F.
The current study uses the Longitudinal Study of Personality Disorders dataset (Lenzenweger, 1999) to examine the development of personality traits in the context of the remission and onset of personality disorder (PD) symptoms. Despite high levels of stability, past research that has examined the development of basic personality traits has also found a mean trend towards increased maturity, and that individuals vary in their trajectories of trait development. Research on PD change has shown a similar pattern. We employ individual growth curve modeling to examine the relationship between personality trait development and PD symptom course. We found that the two are indeed related, and that remission in PD symptoms is associated with patterns of trait development associated with more rapid maturity. In contrast, deviating from the mean of trait development either through no change (i.e., stagnation) or change in the opposite direction (i.e., regression) was associated with developing PD symptoms over the course of the study. PMID:21967009
Conway, Christopher C; Hammen, Constance; Brennan, Patricia A
Longitudinal studies of the exact environmental conditions and personal attributes contributing to the development of borderline personality disorder (BPD) are rare. Furthermore, existing research typically examines risk factors in isolation, limiting our knowledge of the relative effect sizes of different risk factors and how they act in concert to bring about borderline personality pathology. The present study investigated the prospective effects of diverse acute and chronic stressors, proband psychopathology, and maternal psychopathology on BPD features in a high-risk community sample (N = 700) of youth followed from mid-adolescence to young adulthood. Multivariate analyses revealed significant effects of maternal externalizing disorder history, offspring internalizing disorder history, family stressors, and school-related stressors on BPD risk. Contrary to expectations, no interactions between chronically stressful environmental conditions and personal characteristics in predicting borderline personality features were detected. Implications of these findings for etiological theories of BPD and early screening efforts are discussed.
Vater, Aline; Schröder-Abé, Michela; Ritter, Kathrin; Renneberg, Babette; Schulze, Lars; Bosson, Jennifer K; Roepke, Stefan
The Narcissistic Personality Inventory (NPI) has dominated research on narcissism in the field of social and personality psychology. Surprisingly, it is unclear whether the NPI is useful for identifying pathological narcissism in patients with Narcissistic Personality Disorder (NPD). The goal of this study was to close this research gap. We used an extreme-group approach by including NPD patients and healthy controls and comparing their narcissism scores. We further investigated whether explicit self-esteem (assessed with the Rosenberg Self-Esteem Scale) suppressed the relationship between group membership and NPI narcissism. According to our results, NPD patients do not score higher on the NPI in comparison to healthy controls. Analysis of indirect effects revealed that differences in NPI scores are suppressed by NPD patients' low self-esteem. Our results indicate that the NPI is not a valid indicator of NPD, unless one controls for self-esteem. Implications for future research are discussed.
Bornstein, Robert F
The DSM-5 Personality and Personality Disorders Workgroup proposed that five DSM-IV personality disorders be eliminated as formal diagnostic categories (paranoid, schizoid, histrionic, narcissistic, and dependent), because these syndromes purportedly have low clinical utility and minimal evidence for validity. Scrutiny of studies cited in support of this proposal reveals difficulties in three areas: (1) Inadequate information regarding parameters of the literature search; (2) Mixed empirical support for proposed changes; and (3) Selective attention to certain disorders and not others. Review of validity and clinical utility data related to dependent personality disorder indicates that evidence regarding this syndrome does not differ from that of syndromes proposed for retention in DSM-5. Limitations in the research base cited by the workgroup illuminates gaps in the personality disorder literature, and may serve as a starting point for systematic research on personality pathology so that adequate empirical data are available to decide which syndromes to retain, revise, or remove in future versions of the diagnostic manual.
Conway, Christopher C.; Craske, Michelle G.; Zinbarg, Richard E.; Mineka, Susan
Background A diagnosis of personality disorder (PD) signals a negative prognosis for depressive and anxiety disorders, but the precise abnormal personality traits that regulate the temporal course of internalizing psychopathology are unknown. In the present study, we examined prospective associations between abnormal personality traits and the onset and recurrence of internalizing disorders. Methods A sample of 371 young adults at high risk for internalizing problems completed the Schedule for Nonadaptive and Adaptive Personality-Second Edition—a measure of 12 abnormal personality traits and three temperament dimensions (i.e., Negative Temperament, Positive Temperament, Disinhibition versus Control)—and underwent annual diagnostic interviews over four years of follow-up. Results In multivariate survival analyses, Negative Temperament was a robust predictor of both new onsets and recurrences of internalizing disorder. Further, the Dependency and Self-Harm abnormal personality dimensions emerged as independent predictors of new onsets and recurrences, respectively, of internalizing disorders after statistically adjusting for variation in temperament. Conclusions Our findings suggest that abnormal personality traits and temperament dimensions have complementary effects on the trajectory of internalizing pathology during young adulthood. In assessment and treatment settings, targeting the abnormal personality and temperament dimensions with the greatest prognostic value stands to improve the early detection of enduring internalizing psychopathology. PMID:26344411
Gauthier, Kris J; Furr, R Michael; Mathias, Charles W; Marsh-Richard, Dawn M; Dougherty, Donald M
Previous research has articulated the conceptual differentiation of impulsive and premeditated aggression. Little, if any, of this research has examined personological differences among adolescents with aggression-oriented pathology, and little, if any, has examined both self and informant perspectives. The current study examined such differentiation within a Conduct Disorder population in which normal and pathological personality characteristics were examined via self- and informant-report. Results indicated the two forms of aggression were independent: high impulsive aggression was associated with high Neuroticism, but high premeditated aggression was associated with low Agreeableness and high Extraversion. Overall, adolescents high in impulsive aggression had a pattern of personality characteristics that are seen as socially-detached and emotionally volatile. In contrast, adolescents high in premeditated aggression had a pattern of characteristics seen as egocentric and socially-engaged but without concern for others. The results have implications for the social and motivational mechanisms producing the two forms of aggression.
Li, En; Browne, Matthew; Rawat, Vijay; Langham, Erika; Rockloff, Matthew
This article examines gambling harms from both gamblers and affected others' perspectives. Participants (3076 gamblers and 2129 affected others) completed a retrospective survey that elicited information on harms they experienced from gambling across their lifetime. Their responses were analyzed through testing measurement invariance, estimating item-response theoretic parameters, calculating percentages, confidence intervals, and correlations, as well as regressions. The results indicated large commonalities in the experience of harms reported by gamblers and affected others. Further, gamblers appeared to 'export' about half of the harms they experienced to those around them. The findings also provided detailed profiles of evolving harms as problem gambling severity varies.
Oltmanns, Thomas F.
Sampling issues are extremely important in studies of psychopathology, especially with regard to the investigation of personality disorders (PDs). Many studies rely on clinical samples while others have focused on representative samples of community residents. Do people who qualify for a PD diagnosis seek and receive mental health services with greater (or possibly reduced) frequency compared to others in the community? Do community-based studies of PDs include people who have been treated? Analyses presented here examine connections between personality pathology and various aspects of treatment seeking in a representative sample of 1,630 middle-aged adults who completed a semi-structured diagnostic interview (SIDP-IV). Results demonstrate a disorder specific effect. Antisocial, borderline, avoidant, and dependent PDs are associated with increased levels of seeking treatment. Four PDs are associated with greater length of treatment. After accounting for lifetime presence of major depression and alcohol dependence, borderline, avoidant, and dependent pathology remained associated with increased treatment seeking. These findings point to several conclusions, including: 1) community samples do include a substantial proportion of people who have received various kinds of mental health services, 2) the association between personality pathology and mental health treatment seeking is not fully explained by comorbid depression and alcohol dependence. PMID:24343963
Andrade, Leonardo F; Riven, Levi; Petry, Nancy M
Numerous studies show that individuals with substance use and gambling problems discount delayed and probabilistic outcomes at different rates than controls. Few studies, however, investigated the association of discounting with antisocial personality disorders (ASPD), and none evaluated whether sex impacts these relationships. Because females with ASPD exhibit different patterns of antisocial behavior than their male counterparts, they may also differ in their decision-making tendencies. This study examined the effects of ASPD and sex on discounting in pathological gamblers. Results revealed effects of ASPD, and an interaction between ASPD and sex, on probability discounting rates. None of these variables, however, were related to delay discounting. Females with ASPD highly preferred probabilistic outcomes, suggesting that female gamblers with ASPD are particularly impulsive when it comes to probabilistic rewards. Greater understanding of sex differences in ASPD might help guide the selection of more effective sex-specific prevention and treatment programs.
Wenze, Susan J.; Gaudiano, Brandon A.; Weinstock, Lauren M.; Miller, Ivan W.
We conducted a secondary analysis of data from a clinical trial to explore the relationship between degree of personality disorder (PD) pathology (i.e., number of subthreshold and threshold PD symptoms) and mood and functioning outcomes in Bipolar I Disorder (BD-I). Ninety-two participants completed baseline mood and functioning assessments and then underwent 4 months of treatment for an index manic, mixed, or depressed phase acute episode. Additional assessments occurred over a 28-month follow-up period. PD pathology did not predict psychosocial functioning or manic symptoms at 4 or 28 months. However, it did predict depressive symptoms at both timepoints, as well as percent time symptomatic. Clusters A and C pathology were most strongly associated with depression. Our findings fit with the literature highlighting the negative repercussions of PD pathology on a range of outcomes in mood disorders. This study builds upon previous research, which has largely focused on major depression and which has primarily taken a categorical approach to examining PD pathology in BD. PMID:24516762
Will Shead, N; Hodgins, David C
Factor scores on a gambling expectancy questionnaire (GEQ) were used to subtype 132 university students who gamble regularly (37.9% male; M age = 22.6 years, SD = 6.04) as: Reward Expectancy Gamblers (Reward EGs)-have strong expectations that gambling augments positive mood, Relief Expectancy Gamblers (Relief EGs)-have strong expectations that gambling relieves negative affect, and Non-Expectancy Gamblers (Non-EGs)-have neither strong expectation. Gambling on a high-low card game was compared across subtypes following priming for either "relief" or "reward" affect-regulation expectancies with the Scrambled Sentence Test (SST). The hypothesized Prime type x GEQ subtype interaction was not significant. When a more stringent set of criteria for GEQ subtyping was imposed, the "purified" sub-sample (n = 54) resulted in the hypothesized statistically significant Prime type x GEQ subtype interaction. Relief EGs gambled more after being primed with the construct "relief of negative emotions" compared to after being primed with the construct "augmentation of positive emotion." Planned orthogonal contrasts showed a significant linear increase in number of bets made across GEQ subtypes when prime type corresponded to GEQ subtype. The results suggest a need for components in gambling treatment programs that address clients' expectancies that gambling can provide a specific desirable emotional outcome.
Oakes, J; Pols, R; Battersby, M; Lawn, S; Pulvirenti, M; Smith, D
This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine (EGM) problem gambling (PG) by describing the processes and factors that 'pull' the problem gambler away from relapse contrasted with the 'push' towards relapse. These conceptualisations describe two opposing, interacting emotional processes occurring within the problem gambler during any relapse episode. Each relapse episode comprises a complex set of psychological and social behaviours where many factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behaviour events that end (1) with relapse where 'push' overcomes 'pull' or (2) continued abstinence where 'pull' overcomes 'push'. Four focus groups comprising thirty participants who were EGM problem gamblers, gamblers' significant others, therapists and counsellors described their experiences and understanding of relapse. The groups were recorded, recordings were then transcribed and analysed using thematic textual analysis. It was established that vigilance, motivation to commit to change, positive social support, cognitive strategies such as remembering past gambling harms or distraction techniques to avoid thinking about gambling to enable gamblers to manage the urge to gamble and urge extinction were key factors that protected against relapse. Three complementary theories emerged from the analysis. Firstly, a process of reappraisal of personal gambling behaviour pulls the gambler away from relapse. This results in a commitment to change that develops over time and affects but is independent of each episode of relapse. Secondly, relapse may be halted by interacting factors that 'pull' the problem gambler away from the sequence of mental and behavioural events, which follow the triggering of the urge and cognitions to gamble. Thirdly, urge extinction and apparent 'cure' is possible for EGM gambling. This study provides a qualitative, empirical model for
Miller, Joshua D; Gentile, Brittany; Wilson, Lauren; Campbell, W Keith
The Diagnostic and Statistical Manual of Personality Disorders (4th ed., American Psychiatric Association, 2000) personality disorders (PDs) that will be included in the DSM-5 will be diagnosed in an entirely different manner; the explicit criterion sets will be replaced with impairments in self and interpersonal functioning and personality traits from a 25-trait dimensional model of personality pathology. From a trait perspective, narcissistic personality disorder (NPD), the focus of this study, is assessed using 2 specific traits: grandiosity and attention seeking. Using a sample collected online from Amazon's Mechanical Turk (MTurk; N=306), we examined the relations among traits from a new measure of DSM-5's trait model--the Personality Inventory for DSM-5 (PID5; Krueger, Derringer, Markon, Watson, & Skodol, in press)--and grandiose and vulnerable narcissism. The 25 traits from PID5 captured a significant portion of the variance in grandiose and vulnerable factors, although the 2 specific facets designated for the assessment of NPD fared substantially better in the assessment of grandiose rather than vulnerable narcissism. These results are discussed in the context of improving the DSM-5's ability to capture both narcissism dimensions.
Mansueto, Giovanni; Pennelli, Michele; De Palo, Valeria; Monacis, Lucia; Sinatra, Maria; De Caro, Maria Fara
Pathological gambling involves multitudinous costs related to financial, legal, and public health care aspects, as well as to specific psychological disorders. Despite the overall evidence suggesting that comorbid disorders represent a risk factor for pathological gambling, there is scant evidence on the appropriate treatments for gamblers with such disorders. In this context, metacognitive therapy is an interesting approach because it considers psychological disorders as a result of the activation of perseverative cognitive processes and attentional strategies in response to inner events. Several studies report that metacognition is associated with different psychological problems. This study investigated the relationship among comorbid disorders, metacognition, and pathological gambling. 69 pathological gamblers at the first hospital admission and 58 controls drawn from general population (matched for age, gender, education) completed a battery of self report instruments: Symptom Checklist-90-R, Metacognition Questionnaire 30, South Oaks Gambling Scale. Compared to controls, pathological gamblers showed higher level of comorbid symptomatology and metacognition. Correlation analyses showed that: comorbid symptomatology and metacognition were positively and significantly correlated with pathological gambling; metacognition was positively and significantly associated with comorbid symptomatology. Mediation analysis indicated that dysfunctional metacognitive strategies could have an indirect effect on pathological gambling mediated by concurrent psychological disorders. These findings provide some implications for gambling treatment programs: pathological gamblers should be screened for psychiatric disorders, and metacognitive therapy could be considered a correct treatment of pathological gamblers. Metacognitive therapy might lead to the reduction of the pathological gambling by the diminishing of the concurrent psychological disorders.
González-Ibáñez, A; Mora, M; Gutiérrez-Maldonado, J; Ariza, A; Lourido-Ferreira, M R
The aim of this study was to ascertain the possible differences in personality, psychopathology, and response to treatment in pathological gambling according to age. The sample, comprising 67 participants, was divided into three groups: 32.6% with ages ranging between 17 and 26 years, 31.3% between 27 and 43 years, and 35.8% over 44 years of age. The participants were administered the following tests, Minnesota Multiphasic Personality Inventory [MMPI; Hathaway, S.R. & McKinley, J.C. (1943, 1961). Cuestionario de personalidad MMPI. Madrid Seccion de Estudios de TEA ed. 1970, 1975], sensation-seeking questionnaire [SSS; Zuckerman, M. (1979). Sensation seeking; beyond the optimal level of arousal. Hillsdale, NJ: Lawrence Erlbaum Associates], and the Symptom Check List Revised [SCL-90-R; Derogatis, L.R. (1977). Symptom check list-90 revised. Administration scoring and procedures manual. Baltimore]. All underwent a group treatment programme that was carried out in the Pathological Gambling Unit at Ciutat Sanitaria i Universitaria de Bellvitge (CSUB), Teaching hospital, Barcelona, Spain. The findings show differences depending on age in the participants' personality and in psychopathology and in their response to treatment.
de Ruiter, Michiel B; Veltman, Dick J; Goudriaan, Anna E; Oosterlaan, Jaap; Sjoerds, Zsuzsika; van den Brink, Wim
Pathological gambling (PG) is associated with maladaptive perseverative behavior, but the underlying mechanism and neural circuitry is not completely clear. Here, the hypothesis was tested that PG is characterized by response perseveration and abnormalities in reward and/or punishment sensitivity in the ventral frontostriatal circuit. Executive functioning was assessed to verify if these effects are independent of the dorsal frontostriatal circuit. A group of smokers was also included to examine whether impairments in PG generalize to substance use disorders. Response perseveration and reward/punishment sensitivity were measured with a probabilistic reversal-learning task, in which subjects could win and lose money. Executive functioning was measured with a planning task, the Tower of London. Performance and fMRI data were acquired in 19 problem gamblers, 19 smokers, and 19 healthy controls. Problem gamblers showed severe response perseveration, associated with reduced activation of right ventrolateral prefrontal cortex in response to both monetary gain and loss. Results did not fully generalize to smokers. Planning performance and related activation of the dorsal frontostriatal circuit were intact in both problem gamblers and smokers. PG is related to response perseveration and diminished reward and punishment sensitivity as indicated by hypoactivation of the ventrolateral prefrontal cortex when money is gained and lost. Moreover, intact planning abilities and normal dorsal frontostriatal responsiveness indicate that this deficit is not due to impaired executive functioning. Response perseveration and ventral prefrontal hyporesponsiveness to monetary loss may be markers for maladaptive behavior seen in chemical and nonchemical addictions.
Hodgins, David C; Currie, Shawn R; el-Guebaly, Nady; Diskin, Katherine M
Relapse rates among pathological gamblers are high with as many as 75% of gamblers returning to gambling shortly after a serious attempt to quit. The present study focused on providing a low cost, easy to access relapse prevention program to such individuals. Based on information collected in our ongoing study of the process of relapse, a series of relapse prevention booklets were developed and evaluated. Individuals who had recently quit gambling (N = 169) were recruited (through media announcements) and randomly assigned to a single mailing condition in which they received one booklet summarizing all of the relapse prevention information or a repeated mailing condition in which they received the summary booklet plus 7 additional booklets mailed to them at regular intervals over the course of a year period. Gambling involvement over the course of the 12-month follow-up period, confirmed by family or friends, was compared between the two groups. Results indicated that participants receiving the repeated mailings were more likely to meet their goal, but they did not differ from participants receiving the single mailing in frequency of gambling or extent of gambling losses. The results of this project suggest that providing extended relapse prevention bibliotherapy to problem gamblers does not improve outcome. However, providing the overview booklet may be a low cost, easy to access alternative for individuals who have quit gambling.
Nigro, Giovanna; Cosenza, Marina
Several studies examining the relationship of affective decision-making and delay discounting in disordered gambling demonstrated that adult pathological gamblers differ from healthy controls on both reward-related decision tasks. To date no study analyzed the relative contribution of these variables in adolescent gambling. This study was designed to compare affective decision-making and delay discounting in gamblers and nongamblers Italian adolescents, controlling for alcohol consumption. A total of 138 adolescents took part in the research. Two equal-number groups, defined according to the scoring rules for the South Oaks Gambling Screen-Revised for Adolescents, were administered the Iowa Gambling Task (IGT), the Monetary Choice Questionnaire (MCQ), and the Alcohol Use Disorders Identification Test (AUDIT). Zero-order correlations among all variables revealed a moderate negative association between IGT and MCQ scores only in nongamblers group. Results of mixed-model ANOVAs indicated that, compared with nongamblers, adolescent gamblers performed worse on the IGT, showed steeper delay discounting, and scored significantly higher on the AUDIT. Results of logistic regression analysis indicated that IGT, MCQ, and AUDIT scores are all significant predictors of gambling status. This novel finding provides the first evidence of an association among problematic gambling, maladaptive decision-making, and steep delay discounting among adolescents, as already observed in adults.
Ubiquitous personalized health services including ePathology require comprehensive, but trusted interoperability. Contrary to regulated traditional health services with pre-defined policies, the solutions enabled by mobile, pervasive and autonomous technology have to follow dynamic policies reflecting the customers changing health services needs, expectations and wishes as well as contextual and environmental conditions. The paper introduces an advanced approach to trustworthy architecture-centric, policy-driven pHealth solutions. To some details, it also addresses security and privacy ontologies to represent the required policies.
Ménard, Kim S; Pincus, Aaron L
Self-report college student surveys on childhood maltreatment, and borderline and narcissistic personality features are examined to determine their influence on stalking victimization vulnerability. Stalking victimization was measured using Spitzberg and Cupach's (2008) Obsessive Relational Intrusion scale. Ordinary least squares (OLS) regression models were run separately for men (N = 677) and women (N = 1,017). Results indicated childhood sexual maltreatment and borderline traits were associated with stalking victimization among both men and women. These were the only significant relationships for men (R2 = .10). For women, stalking victimization was also associated with narcissistic grandiosity and vulnerability and with a child sexual abuse by borderline features interaction (R2 = .13), demonstrating women reporting prior sexual abuse and borderline personality pathology are especially vulnerable. Methodological and policy implications are discussed.
Cain, Nicole M; Pincus, Aaron L; Ansell, Emily B
This review documents two themes of emphasis found in phenotypic descriptions of pathological narcissism across clinical theory, social/personality psychology, and psychiatric diagnosis. Clinical theories of narcissism spanning 35 years consistently describe variations in the expression of pathological narcissism that emphasize either grandiosity or vulnerable affects and self-states. Recent research in social/personality psychology examining the structure of narcissistic personality traits consistently finds two broad factors representing Grandiosity-Exhibitionism and Vulnerability-Sensitivity-Depletion respectively. However, the majority of psychiatric criteria for narcissistic personality disorder (NPD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) emphasize expressions of grandiosity. By placing most of the diagnostic emphasis on overt grandiosity, DSM NPD has been limited by poor discriminant validity, modest levels of temporal stability, and the lowest prevalence rate on Axis II. Despite converging support for two phenotypic themes associated with pathological narcissism, psychiatric diagnosis and social/personality psychology research often focus only on grandiosity in the assessment of narcissism. In contrast, clinical theory struggles with a proliferation of labels describing these broad phenotypic variations. We conclude that the construct of pathological narcissism is at a crossroads and provide recommendations for diagnostic assessment, clinical conceptualization, and future research that could lead to a more integrated understanding of narcissistic personality and narcissistic personality pathology.
Jovev, Martina; Whittle, Sarah; Yücel, Murat; Simmons, Julian Guy; Allen, Nicholas B; Chanen, Andrew M
Investigating etiological processes early in the life span represents an important step toward a better understanding of the development of personality pathology. The current study evaluated the interaction between an individual difference risk factor (i.e., temperament) and a biological risk factor for aggressive behavior (i.e., atypical [larger] rightward hippocampal asymmetry) in predicting the emergence of borderline personality disorder (BPD) and antisocial personality disorder symptoms during early adolescence. The sample consisted of 153 healthy adolescents (M = 12.6 years, SD = 0.4, range = 11.4-13.7) who were selected from a larger sample to maximize variation in temperament. Interactions between four temperament factors (effortful control, negative affectivity, surgency, and affiliativeness), based on the Early Adolescent Temperament Questionnaire-Revised, and volumetric measures of hippocampal asymmetry were examined as cross-sectional predictors of BPD and antisocial personality disorder symptoms. Boys were more likely to have elevated BPD symptoms if they were high on affiliation and had larger rightward hippocampal asymmetry. In boys, low affiliation was a significant predictor of BPD symptoms in the presence of low rightward hippocampal asymmetry. For girls, low effortful control was associated with elevated BPD symptoms in the presence of atypical rightward hippocampal asymmetry. This study builds on previous work reporting significant associations between atypical hippocampal asymmetry and poor behavioral regulation.
Filteau, M J; Baruch, P; Vincent, P
This paper summarizes the current literature on pathological gambling. Interest in gambling has been present in every society but treated as an object of sociopolitical or literary interest. It is only from the beginning of this century that psychiatry began to look at pathological gambling, first with Freud and his writing on Dostoïevsky then with other theories like the learning theory, studies on substance dependence, the links with affective syndromes and the psychobiological studies. These studies are presented and discussed. Finally, the authors offer some guidelines for an approach to a pathological gambler.
Ohtsuka, Keis; Chan, Chi Chuen
This article examines portrayals of female gamblers in recent Hong Kong movies. The authors report that the depiction of female gamblers is very different from that of male gamblers in the movies made in the same period. Whereas the male gamblers are pitching a lonely and desperate battle against an evil opponent, the female gamblers portrayed in…
Spurrier, Michael; Blaszczynski, Alexander; Rhodes, Paul
Few studies have investigated how gamblers perceive risk or the role of risk perception in disordered gambling. The purpose of the current study therefore was to obtain data on lay gamblers' beliefs on these variables and their effects on decision-making, behaviour, and disordered gambling aetiology. Fifteen regular lay gamblers (non-problem/low risk, moderate risk and problem gamblers) completed a semi-structured interview following mental models and grounded theory methodologies. Gambler interview data was compared to an expert 'map' of risk-perception, to identify comparative gaps or differences associated with harmful or safe gambling. Systematic overlapping processes of data gathering and analysis were used to iteratively extend, saturate, test for exception, and verify concepts and themes emerging from the data. The preliminary findings suggested that gambler accounts supported the presence of expert conceptual constructs, and to some degree the role of risk perception in protecting against or increasing vulnerability to harm and disordered gambling. Gambler accounts of causality, meaning, motivation, and strategy were highly idiosyncratic, and often contained content inconsistent with measures of disordered gambling. Disordered gambling appears heavily influenced by relative underestimation of risk and overvaluation of gambling, based on explicit and implicit analysis, and deliberate, innate, contextual, and learned processing evaluations and biases.
Shaw, Martha C; Forbush, Kelsie T; Schlinder, Jessica; Rosenman, Eugene; Black, Donald W
Pathological gambling (PG) is widely reported to have negative consequences on marriages, families, and children. Empirical evidence is only now accumulating but when put together with anecdotal information, the extent of these problems is clear. PG contributes to chaos and dysfunction within the family unit, disrupts marriages, leading to high rates of separation and divorce, and is associated with child abuse and neglect. Divorce rates are high, not surprising in light of reports that these marriages are often abusive. Research shows that the families of pathological gamblers are filled with members who gamble excessively, suffer from depressive or anxiety disorders, and misuse alcohol, drugs, or both. Families of persons with PG are also large, a variable independently related to family dysfunction. The authors review the evidence on the impact of PG on families, marriages, and offspring, and make recommendations for future research targeting these problems.
Hanss, Daniel; Mentzoni, Rune A; Griffiths, Mark D; Pallesen, Ståle
Although there is a general lack of empirical evidence that advertising influences gambling participation, the regulation of gambling advertising is hotly debated among academic researchers, treatment specialists, lobby groups, regulators, and policymakers. This study contributes to the ongoing debate by investigating perceived impacts of gambling advertising in a sample of gamblers drawn from the general population in Norway (n = 6,034). Three dimensions of advertising impacts were identified, representing perceived impacts on (a) gambling-related attitudes, interest, and behavior ("involvement"); (b) knowledge about gambling options and providers ("knowledge"); and (c) the degree to which people are aware of gambling advertising ("awareness"). Overall, impacts were strongest for the knowledge dimension, and, for all 3 dimensions, the impact increased with level of advertising exposure. Those identified as problem gamblers in the sample (n = 57) reported advertising impacts concerning involvement more than recreational gamblers, and this finding was not attributable to differences in advertising exposure. Additionally, younger gamblers reported stronger impacts on involvement and knowledge but were less likely to agree that they were aware of gambling advertising than older gamblers. Male gamblers were more likely than female gamblers to report stronger impacts on both involvement and knowledge. These findings are discussed with regard to existing research on gambling advertising as well as their implications for future research and policy-making. (PsycINFO Database Record
Loganovsky, K M; Gresko, M V
Objective of the study was to determine pathological changes of the personality of the clean up workers (liquida tors) of the Chornobyl accident and the participants in the anti terrorist operation (ATO) in Eastern Ukraine and radiation threat perception assessment.Design, object and methods. The cross sectional and retrospective assessments of the clean up workers of the Chornobyl accident (n = 185), evacuees from the Chornobyl Exclusion Zone (n = 112) from the randomized sample of individuals who are registered in the Clinical and epidemiological registry (CER) of the State Institution «National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine» [NRCRM] and partici pants of the ATO in Eastern Ukraine (n = 62) who underwent treatment and rehabilitation in the Department of Radiation Psychoneurology of the NRCRM Clinic have been done. The neuropsychiatric clinical and psychometric methods as General Health Questionnaire, GHQ 28; Eysenck Personality Inventory, EPI; method of personality diag nostic by H. Schmischek - K. Leongard, and modified social psychological questionnaire (Joint Study Project 1993) - «dangers questionnaire» were used.
Dawood, Sindes; Thomas, Katherine M.; Wright, Aidan G.C.; Hopwood, Christopher J.
This study extended previous theory and research on interpersonal heterogeneity in depression by identifying groups of depressed young adults who differ in their type and degree of interpersonal problems, and by examining patterns of pathological personality traits and alcohol abuse among these groups. We examined the interpersonal problems, personality traits, and alcohol-related problems of 172 college students with at least moderate levels of self-reported depression on the Patient Health Questionnaire (Spitzer, Kroenke, & Williams, 1999). Scores from the Inventory of Interpersonal Problems – Short Circumplex (Soldz, Budman, Demby, & Merry, 1995) were subjected to latent profile analysis, which classified individuals into five distinct groups defined by the types of interpersonal problems they experience (dominant, warm, submissive, cold, and undifferentiated). As hypothesized, groups did not differ in depression severity, but did show predicted patterns of differences on normative and maladaptive personality traits, as well as alcohol-related problems. The presence of clinically meaningful interpersonal heterogeneity in depression may have important implications for designing more individualized treatments and prevention efforts for depression that target diverse associated interpersonal problems. PMID:23560433
Jauregui, Paula; Urbiola, Irache; Estevez, Ana
Gambling disorder is associated with elevated comorbidity with depressive and anxious disorders, and one variable that might help in the understanding of this association is metacognition. In the present study, the relationship between gambling and metacognition and the mediating role of metacognition in the relationship between gambling and depressive and anxious symptomatology were assessed. The sample comprised 124 pathological gamblers from centers that assist pathological gamblers and 204 participants from the general population. The results showed that pathological gamblers had higher levels of depressive and anxious symptomatology. Additionally, pathological gamblers had higher scores for positive beliefs about worry, negative beliefs of uncontrollability and danger, and beliefs about the need to control thoughts; these factors were also positively correlated with depressive and anxious symptomatology. Metacognition also fully mediated the association between gambling and depressive and anxious symptomatology. These results suggest that metacognition could contribute to explaining gambling disorder and the symptomatology associated with it.
Cantinotti, Michael; Ladouceur, Robert; Jacques, Christian
Although skills are not considered relevant in chance-governed activities, only a few studies have assessed the extent to which sport expert skills in wagering are a manifestation of the illusion of control. This study examined (a) whether expert hockey bettors could make better predictions than chance, (b) whether expert hockey bettors could achieve greater monetary gains than chance, and (c) what kind of strategies hockey gamblers rely on when betting. Accordingly, 30 participants were asked to report their state lottery hockey bets on 6 occasions. We suggest that the information used by bettors, along with near-misses, reinforces their perception of expertise. The results of this experiment suggest that the so-called "skills" of the sports bettors are cognitive distortions.
Agrawal, Arpana; Narayanan, Gitanjali; Oltmanns, Thomas F
The present study examined the association between personality pathology (PP) and alcohol dependence (AD; both lifetime and in the past 12 months) among middle-aged to older adults incorporating three sources of assessment, specifically, diagnostic interviews as well as self- and informant reports. We collected data from a representative sample of community participants (N = 1,630; ages 54-65 years) and their informants (N = 1,462). Measures employed were the substance use disorder sections of the Mini-International Neuropsychiatric Interview Schedule for Mental Disorders, the Structured Interview for DSM-IV Personality (American Psychiatric Association, 2000, Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev.; DSM-IV-TR SIDP) and the NEO-Personality Inventory-Revised (Costa, P. T., & McCrae, R. R., Revised NEO-Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) manual, 1992, Odessa, FL, Psychological Assessment Resources; self-report and informant versions). To complement the diagnostic interview for personality disorders (PDs), we utilized a PD-count technique derived from the five-factor model (FFM), which provided an index of PP liability. Factors representing lifetime and past-12 month AD were regressed on each of the 10 PP factors constructed from the SIDP interview, as well as self-report and informant FFM-count scores. Lifetime diagnosis of AD was positively associated with higher scores on several PP measures, including paranoid, schizotypal, antisocial, borderline, histrionic, and narcissistic PP. There was an inverse relation between lifetime AD and the factor score for obsessive-compulsive PP. With regard to AD in the past 12 months, antisocial, borderline, histrionic, and narcissistic PP factors were significantly associated with increased risk for AD, whereas the obsessive-compulsive and schizoid PP factors were associated with decreased risk for AD. The present data indicate that features of antisocial and
Aragay, Núria; Jiménez-Murcia, Susana; Granero, Roser; Fernández-Aranda, Fernando; Ramos-Grille, Irene; Cardona, Sara; Garrido, Gemma; Anisul Islam, Mohammed; Menchón, José M; Vallès, Vicenç
There is little available information on the factors that influence relapses and dropouts during therapy for pathological gambling (PG). The aim of this study was to determine socio-demographic, clinical, personality, and psychopathological predictors of relapse and dropout in a sample of pathological gamblers seeking treatment. A total of 566 consecutive outpatients diagnosed with PG according to DSM-IV-TR criteria were included. All patients underwent an individualized cognitive-behavioral treatment program. We analyzed predictors of relapse during 6months of treatment and during the subsequent 6months of follow-up, and predictors of dropout over the entire therapeutic program. Eighty patients (14.1%) experienced at least one relapse during the entire follow-up of the study: 50 (8.8%) within the treatment period and 12 (2.1%) during the subsequent 6-month follow-up period. The main predictors of relapse were single marital status, spending less than 100euros/week on gambling, active gambling behavior at treatment inclusion, and high scores on the TCI-R Harm Avoidance personality dimension. One hundred fifty-seven patients (27.8%) missed 3 or more therapeutic sessions over the entire therapeutic program. The main predictors of dropout were single marital status, younger age, and high scores on the TCI-R Novelty Seeking personality dimension. The presence of these factors at inclusion should be taken into account by physicians dealing with PG patients.
Pryor, Lauren R; Miller, Joshua D; Gaughan, Eric T
The current study examined the interrelations between two measures of pathological personality, the Schedule for Nonadaptive and Adaptive Personality (SNAP; Clark, 1993) and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ; Livesley, 1990), and their respective relations with psychopathy. Two hundred and twenty-nine undergraduate students completed the SNAP, DAPP-BQ, and two self-report psychopathy inventories, the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995) and the Psychopathic Personality Inventory-Revised (PPI-R; Lilienfeld & Widows, 2005). Results revealed good convergence between conceptually related SNAP and DAPP-BQ subscales. Both the SNAP and DAPP-BQ accounted for a substantial amount of variance in psychopathy scores although the DAPP-BQ accounted for a larger percentage of the variance and demonstrated greater incremental validity. Results suggest that both measures can be successfully used to assess traits associated with psychopathy.
Dannon, Pinhas N; Lowengrub, Katherine; Sasson, Marina; Shalgi, Bosmat; Tuson, Lali; Saphir, Yafa; Kotler, Moshe
Kleptomania and pathological gambling (PG) are currently classified in the DSM IV as impulse control disorders. Impulse control disorders are characterized by an overwhelming temptation to perform an act that is harmful to the person or others. The patient usually feels a sense of tension before committing the act and then experiences pleasure or relief while in the process of performing the act. Kleptomania and PG are often associated with other comorbid psychiatric diagnoses. Forty-four pathological gamblers and 19 kleptomanics were included in this study. All enrolled patients underwent a complete diagnostic psychiatric evaluation and were examined for symptoms of depression and anxiety using the Hamilton depression rating scale and the Hamilton anxiety rating scale, respectively. In addition, the patients completed self-report questionnaires about their demographic status and addictive behavior. The comorbid lifetime diagnoses found at a high prevalence among our kleptomanic patients included 47% with affective disorders (9/19) and 37% with anxiety disorders (7/19). The comorbid lifetime diagnoses found at a high prevalence in our sample of pathological gamblers included 27% with affective disorders (12/44), 21% with alcohol abuse (9/44), and 7% with a history of substance abuse (3/44). A larger study is needed to confirm these preliminary results.
Khazaal, Yasser; Chatton, Anne; Achab, Sophia; Monney, Gregoire; Thorens, Gabriel; Dufour, Magali; Zullino, Daniele; Rothen, Stephane
Online gambling has gained popularity in the last decade, leading to an important shift in how consumers engage in gambling and in the factors related to problem gambling and prevention. Indebtedness and loneliness have previously been associated with problem gambling. The current study aimed to characterize online gamblers in relation to indebtedness, loneliness, and several in-game social behaviors. The data set was obtained from 584 Internet gamblers recruited online through gambling websites and forums. Of these gamblers, 372 participants completed all study assessments and were included in the analyses. Questionnaires included those on sociodemographics and social variables (indebtedness, loneliness, in-game social behaviors), as well as the Gambling Motives Questionnaire, Gambling Related Cognitions Scale, Internet Addiction Test, Problem Gambling Severity Index, Short Depression-Happiness Scale, and UPPS-P Impulsive Behavior Scale. Social variables were explored with a latent class model. The clusters obtained were compared for psychological measures and three clusters were found: lonely indebted gamblers (cluster 1: 6.5%), not lonely not indebted gamblers (cluster 2: 75.4%), and not lonely indebted gamblers (cluster 3: 18%). Participants in clusters 1 and 3 (particularly in cluster 1) were at higher risk of problem gambling than were those in cluster 2. The three groups differed on most assessed variables, including the Problem Gambling Severity Index, the Short Depression-Happiness Scale, and the UPPS-P subscales (except the sensation seeking subscore). Results highlight significant between-group differences, suggesting that Internet gamblers are not a homogeneous group. Specific intervention strategies could be implemented for groups at risk.
Ruiz, Mark A; Pincus, Aaron L; Schinka, John A
In this meta-analysis we examined Five-Factor Model of personality (FFM) characteristics of externalizing disorders. Two pathologies, Antisocial Personality Disorder (APD) and Substance Use Disorder (SUD), have significant levels of co-occurrence that may be due to shared personality traits. Results from 63 samples (N = 15,331) were analyzed in order to summarize and compare five-factor results for APD, SUD, and co-occurring APD/SUD. Shared and unique personality features were identified at both the domain and the facet level of the FFM. Moderation analyses indicated that sample source (clinical versus community) and diagnosis (psychopathy versus DSM-based APD) accounted for some of the variability at the domain level. Results are discussed with respect to personality and externalizing disorders.
Barbot, Baptiste; Hunter, Scott R.; Grigorenko, Elena L.; Luthar, Suniya S.
This study explores longitudinally a four-factor structure of pathological personality trait dimensions (PPTDs) to examine both its structural stability and intra-individual changes among PPTDs over time. Personality Disorder (PD) scales of the Millon Clinical Multiaxial Inventory-III were administered to 361 low-income women with various psychiatric conditions (drug dependence, depression), who were followed in a two-wave study over 5-years. Cross-sectional and longitudinal factor analyses outlined a robust factorial structure of PPTDs, extrinsically invariant over time, representing Negative Emotionality, Introversion, Antagonism and Impulsivity. Despite moderate rank-order stability in the PPTDs, results also indicated substantial intra-individual variability in the degree and direction of change, consistent with trajectories of change in participants’ clinical diagnoses. Results are discussed in light of current debates on the structure and dynamic of pathological personality. PMID:23710108
Tanguy, Marie-Laure; Lagadec, Marthylle; Benyamina, Amine; Aubin, Henri-Jean; Reynaud, Michel
Background Internet-based interventions targeted at the most at-risk gamblers could reduce the treatment gap for addictive disorders. Currently, no clinical trial has included non–treatment-seeking patients who have been recruited directly in their gambling environment. This study was the first exclusively Internet-based randomized controlled trial among non–help-seeking problem gamblers with naturalistic recruitment in their gambling environment. Objective The aim of this study was to assess the efficacy of three modalities of Internet-based psychotherapies with or without guidance, compared to a control condition, among problem gamblers who play online poker. Methods All active poker gamblers on the Winamax website were systematically offered screening. All problem poker gamblers identified with a Problem Gambling Severity Index (PGSI) score of ≥5 were eligible to be included in the trial. Problem gamblers were randomized into four groups: (1) waiting list (control group), (2) personalized normalized feedback on their gambling status by email, (3) an email containing a self-help book to be downloaded with a Cognitive Behavioral Therapy (CBT) program without guidance, and (4) the same CBT program emailed weekly by a trained psychologist with personalized guidance. Efficacy was assessed based on the change in PGSI between baseline and 6 weeks (end of treatment) or 12 weeks (maintenance) and supported by player account-based gambling data automatically collected at the three time points. Results All groups met high attrition rates (83%), but the group with guidance had a significantly higher dropout rate than the other three groups, including the control group. Although all groups showed some improvement, with a mean decrease of 1.35 on the PGSI, no significant difference in efficacy between the groups was observed. One-third of the problem gamblers fell below the problem gambling threshold at 6 weeks. Conclusions Guidance could have aversively affected
Di Nicola, Marco; Pini, Stefano; Janiri, Luigi
Background. Nowadays, adult separation anxiety disorder (ASAD) is an established diagnostic category but is little investigated in subjects with addictive behaviours. Objective. To assess the presence of ASAD among patients with addictive disorders in comparison with anxiety patients and measure the personality correlates in all these groups. Methods. 103 outpatients, meeting DSM-IV-TR criteria for anxiety disorders (38 patients), alcohol dependence (30 patients), or pathological gambling (35 patients), were assessed by the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Adult Separation Anxiety Checklist (ASA-27) for separation anxiety and by the Temperament and Character Inventory-Revised (TCI-R) for personality characteristics. Results. ASAD is detected in 34.2% of anxiety patients, 13.3% of alcoholics, and 11.4% of gamblers. Separation anxiety scores correlate positively with harm avoidance and negatively with self-directedness in all groups; further correlations are seen among addictive patients only, that is, self-transcendence for gamblers and cooperativeness for both alcoholics and gamblers. Conclusions. The prevalence of ASAD is lower among addictive patients than in those with anxiety disorders; correlations are found between separation anxiety and specific TCI-R dimensions, with some matching across the three diagnostic groups. PMID:25105134
Gainsbury, Sally M; Russell, Alex; Blaszczynski, Alex
Students recruited from psychology undergraduate university populations are commonly used in psychology research, including gambling studies. However, the extent to which the use of this subpopulation produces findings that can be extrapolated to other groups is questionable. The present study was designed to compare results from university-recruited psychology student gamblers to those obtained from a sample of gamblers recruited from the general population that also included students. An online survey measuring gambling behavior and Internet gambling, attitudes and knowledge about gambling and problem gambling severity was posted on websites accessed by gamblers. Participants were recruited from two sources, a psychology undergraduate university population (n = 461) and online websites (n = 4,801). Results showed university-recruited students differed significantly from both adults and students recruited from the general population in respect to demographic variables and gambling behavior. Psychology undergraduate students were younger, more likely to be female, and had lower incomes. When relevant demographic variables were controlled, psychology undergraduate students were found to gamble less frequently, at different times, and to be at lower-risk for gambling-related problems, but had more irrational beliefs and more negative attitudes towards gambling than gamblers recruited from the general population. Results suggest that caution should be used in extrapolating findings from research using university-recruited psychology student gamblers to wide community populations due to differences related to gambling thoughts, attitudes and behaviors.
Electronic gambling offers the opportunity to analyze huge and unbiased data sets of automatically recorded actual gambling behavior. This study refers to data on 2,127,887 poker playing identities from the Online Poker Database of the University of Hamburg (OPD-UHH) to analyze three subgroups of gamblers: regulars, newcomers, and dropouts. Their gambling habits over 6 months are analyzed in total, as well as over time. Regulars show a much higher involvement than non-regulars and increase their playing volume slightly over the observation period. Newcomers have a lower involvement than non-newcomers and most of them decrease their playing volume over time. Still, there is a small group of newcomers which increases their playing volume sharply and is, hence, very interesting for the industry as well as for the early prevention of pathological gambling. Dropouts have a higher gambling involvement than newcomers but play less than players who have not stopped stop gambling. Most dropouts also show a decreasing playing volume before dropping out. An analysis of the correlations between different variables of gambling habits shows that most of them reinforce each other, for example: gamblers with a higher total playing time tend to play at more tables simultaneously. Only playing frequency is a moderating variable of gambling involvement.
Giacopassi, David; Stitt, B Grant; Nichols, Mark
Numerous studies have documented that under-age gambling is quite common. The present study employs interviews of 48 university students who gambled under-age to determine the motives and methods associated with casino gambling by minors. The information gathered in these interviews indicates that access to casinos is easily attained, that the risk of exposure once gambling is minimal, and the motivations of under-age gamblers differ in important ways from that of adults, as access to alcohol, accompanying parents, and the desire to experience the "forbidden fruit" of casino gambling are commonly mentioned motivations by under-age gamblers.
Guercio, John M.; Johnson, Taylor; Dixon, Mark R.
The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week…
Tang, Catherine So-kum; Wu, Anise M S; Tang, Joe Y C
A total of 952 (841 men and 111 women) Chinese treatment-seeking problem gamblers completed self-report assessment forms. Female in contrast to male gamblers were more likely to be older, married, less educated, and without employment. Female gamblers also started gambling at an older age, had a shorter gambling history, preferred casino and mahjong gambling, and reported more somatic complaints and suicidal thoughts. Male and female gamblers accumulated similar amount of gambling debt and reported an average of 12 gambling-related problems on the Chinese version of the South Oaks Gambling Screen [Lesieur and Blume (Am J Psychiatry 144:1184-1188, 1987)]. Both groups were similarly troubled by their indebtedness, inability to control gambling, and gambling-related interpersonal problems. However, female gamblers had fewer means to pay their gambling debt. Given that significant gender-related differences were observed in Chinese problem gamblers, prevention and treatment services should attend to specific needs of male and female gamblers.
Morey, Leslie C; Stagner, Brian H
Narcissistic personality disorder and related concepts have a complex history and have been subject to extensive theoretical discourse but relatively little empirical research. An initial proposal for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) that suggested eliminating this disorder as a discrete personality disorder type met with considerable controversy that ultimately led to its reinstatement in subsequent proposals. Nonetheless, the DSM-5 proposal for personality disorders as a whole would involve a significantly different formulation of narcissistic personality from that described in DSM-IV-one that places a greater emphasis on shared deficits among all personality disorders that tap elements thought to fall on the narcissistic spectrum, such as deficits in empathic capacity. This article describes this revised formulation, and presents a case study that illustrates the similarities and differences in the DSM-IV and proposed DSM-5 portrayal of narcissistic issues and related clinical problems over the course of a particular treatment.
Watson, David; Stasik, Sara M; Ro, Eunyoe; Clark, Lee Anna
The Personality Inventory for DSM-5 (PID-5) assesses traits relevant for diagnosing personality disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). We examined the PID-5 in relation to the Big-Three and Big-Five personality traits in outpatient and community adult samples. Domain-level analyses revealed that PID-5 Negative Affectivity correlated strongly with Neuroticism, and PID-5 Antagonism and Disinhibition correlated strongly negatively with Agreeableness and Conscientiousness, respectively; Antagonism and Disinhibition also were both linked strongly to Big-Three trait Disinhibition. PID-5 Detachment related strongly to personality, including Extraversion/Positive Temperament, but did not show its expected specificity to this factor. Finally, PID-5 Psychoticism correlated only modestly with Openness. Facet-level analyses indicated that some PID-5 scales demonstrated replicable deviations from their DSM-5 model placements. We discuss implications of these data for the DSM-5 model of personality disorder, and for integrating it with well-established structures of normal personality.
McBride, Jessica; Derevensky, Jeffrey
The present study examined Internet gambling behavior in a sample of online gamblers. Participants (N = 563; 382 male; ages 18-over 65) were recruited from a banner placed in an online newsletter. Questionnaires were completed online and assessed demographic information, game-play patterns (e.g., frequency, duration, wagering), preferred type of…
Markham, Francis; Young, Martin; Doran, Bruce
The multivariate socio-demographic risk factors for problem gambling have been well documented. While this body of research is valuable in determining risk factors aggregated across various populations, the majority of studies tend not to specifically identify particular subgroups of problem gamblers based on the interaction between variables. The…
Mutual support societies for problem gamblers have existed in Sweden for 20 years. They have helped more people with gambling problems than any other institution inside or outside the Swedish health care system. This paper outlines the background of these societies and describes the meetings of one of them. Data come from interviews with members…
Dixon, Mark R.; Nastally, Becky L.; Jackson, James E.; Habib, Reza
This study investigated the potential for recreational gamblers to respond as if certain types of losing slot machine outcomes were actually closer to a win than others (termed the "near-miss effect"). Exposure to conditional discrimination training and testing disrupted this effect for 10 of the 16 participants. These 10 participants demonstrated…
Jauregui, Paula; Estévez, Ana; Urbiola, Irache
Background and aims Pathological gambling is associated with comorbid disorders, such as anxiety, depression, and drug and alcohol abuse. Difficulties of emotion regulation may be one of the factors related to the presence of addictive disorders, along with comorbid symptomatology in pathological gamblers. Therefore, the aim of this study was to evaluate the difficulties of emotion regulation, drug and alcohol abuse, and anxious and depressive symptomatology in pathological gamblers, and the mediating role of difficulties of emotion regulation between anxiety and pathological gambling. Methods The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Pathological gambling (SOGS), difficulties of emotion regulation (DERS), drug and alcohol abuse (MUTICAGE CAD-4), and anxious and depressive symptomatology (SA-45) were measured. Student's t, Pearson's r, stepwise multiple linear regression and multiple mediation analyses were conducted. The study was approved by an Investigational Review Board. Results Relative to non-gamblers, pathological gamblers exhibited greater difficulties of emotion regulation, as well as more anxiety, depression, and drug abuse. Moreover, pathological gambling correlated with emotion regulation difficulties, anxiety, depression, and drug abuse. Besides, emotion regulation difficulties correlated with and predicted pathological gambling, drug and alcohol abuse, and anxious and depressive symptomatology. Finally, emotion regulation difficulties mediated the relationship between anxiety and pathological gambling controlling the effect of age, both when controlling and not controlling for the effect of other abuses. Discussion and conclusions These results suggest that difficulties of emotion regulation may provide new keys to understanding and treating pathological gambling and comorbid disorders.
Jauregui, Paula; Estévez, Ana; Urbiola, Irache
Background and aims Pathological gambling is associated with comorbid disorders, such as anxiety, depression, and drug and alcohol abuse. Difficulties of emotion regulation may be one of the factors related to the presence of addictive disorders, along with comorbid symptomatology in pathological gamblers. Therefore, the aim of this study was to evaluate the difficulties of emotion regulation, drug and alcohol abuse, and anxious and depressive symptomatology in pathological gamblers, and the mediating role of difficulties of emotion regulation between anxiety and pathological gambling. Methods The study sample included 167 male pathological gamblers (mean age = 39.29 years) and 107 non-gamblers (mean age = 33.43 years). Pathological gambling (SOGS), difficulties of emotion regulation (DERS), drug and alcohol abuse (MUTICAGE CAD-4), and anxious and depressive symptomatology (SA-45) were measured. Student’s t, Pearson’s r, stepwise multiple linear regression and multiple mediation analyses were conducted. The study was approved by an Investigational Review Board. Results Relative to non-gamblers, pathological gamblers exhibited greater difficulties of emotion regulation, as well as more anxiety, depression, and drug abuse. Moreover, pathological gambling correlated with emotion regulation difficulties, anxiety, depression, and drug abuse. Besides, emotion regulation difficulties correlated with and predicted pathological gambling, drug and alcohol abuse, and anxious and depressive symptomatology. Finally, emotion regulation difficulties mediated the relationship between anxiety and pathological gambling controlling the effect of age, both when controlling and not controlling for the effect of other abuses. Discussion and conclusions These results suggest that difficulties of emotion regulation may provide new keys to understanding and treating pathological gambling and comorbid disorders. PMID:27348555
Linde, Jennifer A.; Stringer, Deborah; Simms, Leonard J.; Clark, Lee Anna
The Schedule for Nonadaptive and Adaptive Personality-Youth Version (SNAP-Y) is a new, reliable self-report questionnaire that assesses 15 personality traits relevant to both normal-range personality and the alternative "DSM"-5 model for personality disorder. Community adolescents, 12 to 18 years old (N = 364), completed the SNAP-Y; 347…
Joutsa, Juho; Saunavaara, Jani; Parkkola, Riitta; Niemelä, Solja; Kaasinen, Valtteri
Several magnetic resonance imaging (MRI) studies in substance use disorders have shown brain white matter integrity abnormalities, but there are no studies in pathological gambling, a form of behavioral addiction. Our objective was to investigate possible changes in regional brain gray and white matter volumes, and axonal white matter integrity in pathological gamblers compared to healthy controls. Twenty-four subjects (12 clinically diagnosed male pathological gamblers and 12 age-matched healthy male volunteers) underwent structural and diffusion weighted brain MRI scans, which were analyzed with voxel-based morphometry and tract based spatial statistics. In pathological gamblers, widespread lower white matter integrity (lower fractional anisotropy, higher mean diffusivity) was seen in multiple brain regions including the corpus callosum, the cingulum, the superior longitudinal fascicle, the inferior fronto-occipital fascicle, the anterior limb of internal capsule, the anterior thalamic radiation, the inferior longitudinal fascicle and the uncinate/inferior fronto-occipital fascicle. There were no volumetric differences in gray or white matter between pathological gamblers and controls. The results suggest that pathological gambling is associated with extensive lower integrity of several brain white matter tracts. The diffusion abnormality closely resembles previous findings in individuals with substance addictions.
Horsley, Rachel R; Osborne, Matthew; Norman, Christine; Wells, Timothy
Behaviours that have been rewarded intermittently persist for longer during periods of non-reward than behaviours that have been rewarded continuously. This classic phenomenon is known as the partial reinforcement extinction effect. For decades it has been generally understood that this phenomenon is fundamental to the persistence of gambling in the absence of winning. One obvious, yet untested hypothesis arising from this is that persistent (here, high-frequency) gamblers might be more sensitive to partial reinforcement contingencies. Therefore, our aim was to test the hypothesis that compared to low-frequency gamblers, high-frequency gamblers would show greater resistance to extinction following partial reinforcement in a computer based experiment. Participants were 19 high-frequency gamblers and 21 low-frequency gamblers, all healthy non-smokers aged between 18 and 52. Following partial or continuous reinforcement, persistence of responding in extinction was measured as the number of times a target response was made. After partial reinforcement, high-frequency gamblers made the target response a greater number of times in extinction (compared to low-frequency gamblers). Moreover, the partial reinforcement extinction effect was larger in high-frequency gamblers than in low-frequency gamblers. It remains to be seen whether increased sensitivity to partial reinforcement is a cause or effect of persistent gambling. Nevertheless, the present study represents an important first step in investigating the role of simple partial reinforcement contingencies in determining resistance to extinction in gamblers, the importance of which, whilst hitherto recognised, has never been demonstrated experimentally.
Guercio, John M; Johnson, Taylor; Dixon, Mark R
The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week one-on-one client–patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self-report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior-analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed. PMID:23060663
Bothe, Anne K.; Richardson, Jessica D.
Purpose: To discuss constructs and methods related to assessing the magnitude and the meaning of clinical outcomes, with a focus on applications in speech-language pathology. Method: Professionals in medicine, allied health, psychology, education, and many other fields have long been concerned with issues referred to variously as practical…
Shek, Daniel T. L.; Chan, Elda M. L.; Wong, Ryan H. Y.
Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a) determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b) compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c) explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N = 201) who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders. PMID:22778700
Fong, Lawrence Hoc Nang; Law, Rob; Lam, Desmond
Gambling is a leisure activity, which is enjoyed by many people around the world. Among these people, Chinese are known for their high propensity to gamble and are highly sought after by many casinos. In this exploratory study, the effect of two types of fallacy bias-positive recency and negative recency-on the betting behavior of Chinese gamblers is investigated. Although the influence of fallacy bias on a betting decision is well documented, little is known about the interaction of the factors that dictate fallacy bias. Drawing from an analysis of 2,645 betting decisions, the results show that Chinese gamblers primarily endorse positive recency, especially when the latest outcome is more frequent. This is contrary to most findings on Western subjects in which negative recency is more common. Current findings have meaningful implications to casino gaming entertainment businesses and public policymakers.
Shedler, Jonathan; Westen, Drew
Results from a study involving 153 clinicians who used the new Shedler-Westen Assessment Procedure (a Q-sort approach) and eight patient interviews suggest the usefulness of the SWAP to measure personality disorders and refine categories and criteria according to Axis II of the "Diagnostic and Statistical Manual of Mental Disorders"…
Hing, Nerilee; Russell, Alex M T; Gainsbury, Sally M; Blaszczynski, Alex
Professional gamblers are more likely than amateur gamblers to meet criteria for problem gambling but minimal research has examined their gambling behavior and its consequences. This study compared gambling behavior, problem gambling symptoms, related harms, recognition, and help-seeking among problem semi/professional gamblers (PPGs/PSPGs) and problem amateur gamblers (PAGs). Surveys completed by 57 self-identified professional gamblers, 311 semi-professional gamblers and 4226 amateur gamblers were analysed. PPGs/PSPGs were significantly more likely than PAGs to be male, younger, never married, speak a language other than English at home, and have higher psychological distress, compared to PAGs. PPGs/PSPGs were more likely to gamble more frequently on many skills-based forms, but most also participated in several chance-based forms. PPGs'/PSPGs' most common problematic gambling form was electronic gaming machines and they were more likely to have problems with sports betting than PAGs. Most PPGs/PSPGs reported coming out behind on all gambling forms over the previous year. PPGs/PSPGs were more likely than PAGs to report chasing losses and numerous detrimental financial gambling consequences. This group's self-identification as PPGs/PSPGs is clearly inaccurate and perhaps a means to avoid stigma, elevate status and support problem denial. PPGs/PSPGs may represent an extreme example of gamblers with erroneous cognitions and beliefs who lack the required discipline and skill to be successful professional gamblers. The findings identify a group of problem gamblers who may benefit from interventions to dispel their mistaken self-identity, and emphasize the need for more rigorous confirmation of professional gambler status in future research.
A Head-to-Head Comparison of the Personality Inventory for DSM-5 (PID-5) With the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology Among Community Dwelling Subjects.
Fossati, Andrea; Somma, Antonella; Borroni, Serena; Maffei, Cesare; Markon, Kristian E; Krueger, Robert F
In order to evaluate if measures of DSM-5 Alternative PD Model domains predicted interview-based scores of general personality pathology when compared to self-report measures of DSM-IV Axis II/DSM-5 Section II PD criteria, 300 Italian community adults were administered the Iowa Personality Disorder Screen (IPDS) interview, the Personality Inventory for DSM-5 (PID-5), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Multiple regression analyses showed that the five PID-5 domain scales collectively explained an adequate rate of the variance of the IPDS interview total score. This result was slightly lower than the amount of variance in the IPDS total score explained by the 10 PDQ-4+ scales. The PID-5 traits scales performed better than the PDQ-4+, although the difference was marginal. Hierarchical regression analyses revealed that the PID-5 domain and trait scales provided a moderate, but significant increase in the prediction of the general level of personality pathology above and beyond the PDQ-4+ scales.
A Head-to-Head Comparison of the Personality Inventory for DSM-5 (PID-5) With the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology Among Community Dwelling Subjects.
Fossati, Andrea; Somma, Antonella; Borroni, Serena; Maffei, Cesare; Markon, Kristian E; Krueger, Robert F
In order to evaluate if measures of DSM-5 Alternative PD Model domains predicted interview-based scores of general personality pathology when compared to self-report measures of DSM-IV Axis II/DSM-5 Section II PD criteria, 300 Italian community adults were administered the Iowa Personality Disorder Screen (IPDS) interview, the Personality Inventory for DSM-5 (PID-5), and the Personality Diagnostic Questionnaire-4+ (PDQ-4+). Multiple regression analyses showed that the five PID-5 domain scales collectively explained an adequate rate of the variance of the IPDS interview total score. This result was slightly lower than the amount of variance in the IPDS total score explained by the 10 PDQ-4+ scales. The PID-5 traits scales performed better than the PDQ-4+, although the difference was marginal. Hierarchical regression analyses revealed that the PID-5 domain and trait scales provided a moderate, but significant increase in the prediction of the general level of personality pathology above and beyond the PDQ-4+ scales.
Hing, Nerilee; Tiyce, Margaret; Holdsworth, Louise; Nuske, Elaine
Problem gambling can significantly affect the lives of concerned significant others (CSOs) of problem gamblers, especially family members, but little is known about their help-seeking activities and experiences. This paper explores help-seeking by CSOs of problem gamblers and their related motivators and barriers. A telephone interview was…
Griffiths, Mark D.
Slot machine gambling is a popular leisure activity worldwide yet there has been very little research into different types of slot machine gamblers. Earlier typologies of slot machine gamblers have only concentrated on adolescents in arcade environments. This study presents a new typology of slot machine players based on over 1000 h of participant…
Hayer, Tobias; Meyer, Gerhard
Preliminary scientific evidence indicates that online gamblers are more likely to be problem gamblers and thus point to the need for effective protection measures. This study focuses on an online self-exclusion program and seeks to comprehensively examine the benefits of this measure. It was intended to collect detailed information on the…
Williams, Jeremy D.; Pulford, Justin; Bellringer, Maria; Abbott, Max
Multiple means exist by which gamblers including problem gamblers may be recruited from the general population for research survey purposes. However, there appears to be limited discussion in the published literature about the relative merits of one or other approach. This paper addresses this gap, in part, by reporting the experiences of…
Law, Mary Kate; Fleeson, William; Arnold, Elizabeth Mayfield; Furr, R Michael
While emotional difficulties are highly implicated in borderline personality disorder (BPD), the dynamic relationships between emotions and BPD symptoms that occur in everyday life are unknown. The current paper examined the function of negative emotions as they relate to BPD symptoms in real time. Experience sampling methodology with 281 participants measured negative emotions and borderline symptoms, expressed as a spectrum of experiences, five times daily for two weeks. Overall, having a BDP diagnosis was associated with experiencing more negative emotions. Multilevel modeling supported positive concurrent relationships between negative emotions and BPD symptoms. Lagged models showed that even after 3 hours negative emotions and several symptoms continued to influence each other. Therefore, results indicated that negative emotions and BPD symptoms are intricately related; some evidenced long-lasting relationships. This research supports emotion-symptom contingencies within BPD and provides insight regarding the reactivity and functionality of negative emotions in borderline pathology.
Pozza, Andrea; Giaquinta, Nicoletta; Dèttore, Davide
Pathological skin picking (SP) is a strongly impairing condition characterized by repetitive picking behaviors resulting in significant tissue damage and distress. Recent research suggested the presence of different subtypes of SP. No study has investigated which personality traits could be specifically associated with different subtypes. In a community sample (N=285, 71.20% females, mean age =34.98 years, standard deviation =15.91), this cross-sectional study investigated which personality traits and emotion regulation deficits could predict specific SP subtypes. Participants completed the Milwaukee Inventory for the Dimensions of Adult Skin Picking (MIDAS), Millon Clinical Multiaxial Inventory-III personality scales (MCMI-III), and Difficulties in Emotion Regulation Scale (DERS) questionnaires. Higher scores on the MCMI-III borderline (β=0.28, t=4.88, P<0.001), MCMI-III avoidant scale (β=0.18, t=2.59, P<0.01), and DERS difficulties engaging in goal-directed behavior (β=0.19, t=3.27, P<0.01) predicted higher scores on the MIDAS automatic scale. Higher scores on the MCMI-III borderline (β=0.30, t=5.23, P<0.001) and DERS difficulties engaging in goal-directed behavior (β=0.15, t=2.52, P<0.05) and DERS limited access to emotion regulation strategies (β=0.21, t=3.26, P<0.01) predicted higher scores on the MIDAS focused scale. Higher scores on the MCMI-III sadistic (β=0.19, t=3.30, P<0.001) and DERS difficulties engaging in goal-directed behavior (β=0.15, t=2.68, P<0.01) predicted higher scores on the MIDAS mixed scale. Implications for future research and treatment are discussed. PMID:27536108
Ariyabuddhiphongs, Vanchai; Chanchalermporn, Nathanat
This study tested social cognitive theory (Bandura, 1986) hypotheses of reciprocal and sequential effects among person, environment variables and behavior. The study examined the impact of hope, superstitious belief and environmental factors on the frequency, amounts of lottery gambling and chasing of particular numbers among Thai lottery gamblers. One hundred and fifty gamblers who visited two temples in Bangkok to search for number clues before buying tickets and 150 gamblers who simply bought lottery tickets from the stalls were recruited for the study. Models were constructed to test the effect of hope, superstitious belief and environmental factors on gambling behavior, and the reciprocal effect of gambling behavior on hope, superstitious belief and environmental factors. Results confirmed the theoretical reciprocal effects. A sequential effect model showing the effects of environmental factors on superstitious belief, hope and gambling behavior was also constructed and hope was found to be the result of superstitious belief. To reduce lottery gambling, the players need to be warned of their distorted hope and the small chance of winning lottery.
Yi, Sunghwan; Stewart, Melissa; Collins, Pamela; Stewart, Sherry H
Gambling outcome expectancies refer to the anticipated outcomes that gamblers expect will occur from gambling (i.e., learned memory associations between gambling cues, behavior, and outcomes). Unlike previous approaches to gambling outcome expectancies that have predominantly focused on the valence of outcome expectancies (positive vs. negative), the present study investigated two specific types of positive gambling outcome expectancies: reward and relief gambling outcome expectancies. Specifically, the primary purpose of the current research was to examine whether gambling prime exposure activates different types of positive gambling outcome expectancies in enhancement- versus coping-motivated gamblers. Fifty adult, community-recruited regular gamblers performed a reaction time (RT) task and completed a self-report expectancy scale, both designed to assess reward and relief gambling outcome expectancies. They also completed the Gambling Motives Questionnaire (Stewart and Zack in Addiction 103:1110-1117 2008) to assess their levels of coping and enhancement motives for gambling. As hypothesized, reward gambling outcome expectancies were more strongly activated by gambling prime exposure than relief outcome expectancies on the RT task for gamblers with high enhancement motives. On the self-report expectancy measure, high enhancement-motivated gamblers endorsed stronger reward gambling outcome expectancies than low enhancement-motivated gamblers, and high coping-motivated gamblers endorsed stronger relief gambling outcome expectancies than low coping-motivated gamblers. Results suggest that automatic activation of reward gambling outcome expectancies is particularly strong for high enhancement-motivated gamblers. Possible reasons for the failure to observe an association between coping gambling motives and automatic relief gambling outcome expectancies are discussed.
Subramaniam, Mythily; Tang, Benjamin; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Picco, Louisa; Chong, Siow Ann
The aim of the current study was to examine the socio-demographic correlates, the association of mental and physical illness, and the prevalence of pathological gambling among three groups (1) those with lottery gambling only (2) those with lottery and other types of gambling and (3) those with other types of gambling only-such as playing cards, sports betting, horse racing, casino gambling etc. Data was used from a nationwide cross-sectional epidemiological nationally representative survey of the resident (Singapore Citizens and Permanent Residents) population in Singapore of 6616 Singaporean adults aged 18 years and older. All respondents were administered the South Oaks Gambling Screen to screen for pathological gambling. The diagnoses of mental disorders were established using the Composite International Diagnostic Interview and relevant socio-demographic data was collected using a structured questionnaire. Lottery gambling was by far the most popular form of gambling in Singapore, with 83.5 % of those who had ever gambled indicating that they had participated in lottery gambling. Those who participated in lottery gambling alone were more likely to belong to the older age group (as compared to the 18-35 years age group), be of Indian ethnicity, have a secondary or vocational education, and earn a lower income as compared to the other two groups. Our findings that those with pure lottery gambling were significantly less likely to be pathological gamblers and had significantly lower odds of psychiatric and physical morbidity as compared to the other two groups are unique and need further research.
Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L
Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment.
Buckholdt, Kelly E.; Weiss, Nicole H.; Young, John; Gratz, Kim L.
Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment. PMID:25500759
Montes, Kevin S; Weatherly, Jeffrey N
Although research suggests that approximately 1 in 4 college students report having gambled online, few laboratory-based studies have been conducted enlisting online student gamblers. Moreover, it is unclear the extent to which differences in gambling behavior exist between online and non-online student gamblers. The current study examined if online gamblers would play more hands, commit more errors, and wager more credits than non-online student gamblers in a controlled, laboratory environment. Online (n = 19) and non-online (n = 26) student gamblers played video poker in three separate sessions and the number of hands played, errors committed, and credits wagered were recorded. Results showed that online student gamblers played more hands and committed more errors playing video poker than non-online student gamblers. The results from the current study extend previous research by suggesting that online gamblers engage in potentially more deleterious gambling behavior (e.g., playing more hands and committing more errors) than non-online gamblers. Additional research is needed to examine differences in the gambling behavior of online and non-online gamblers in a controlled, laboratory environment.
Joukhador, Jackie; Blaszczynski, Alex; Maccallum, Fiona
Superstitious beliefs, defined as a strong conviction based on the erroneous perception of a cause-effect association between two independent events, are considered to play an instrumental role in the maintenance of gambling behaviour. In this preliminary study, responses to eight items assessing superstitious beliefs were compared among 56 electronic gaming machine (EGM) problem gamblers, 22 non-problem EGM and 23 non-EGM non-problem gamblers. Results suggested that problem gamblers endorsed more superstitious beliefs than non-problem gamblers and that such beliefs were correlated with gambling intensity. Further research is required to determine if superstitious beliefs represent a vulnerability factor for the development of problem gambling or emerge as a consequence of involvement in gambling.
Delfabbro, P H; Winefield, A H
Previous research has suggested that irrational thinking may play a central role in the maintenance of behavior in slot machine gambling (M. B. Walker, 1992b). The present study is an evaluation of the validity and predictors of irrational thinking in a sample of regular gamblers (N = 20) drawn from the general community. The results were generally consistent with earlier findings; 75% of gambling-related cognitions were found to be irrational. Irrationality was unrelated to the amount of money lost or won during sessions but was positively related to risk taking. The most common irrational cognitions included false beliefs concerning the extent to which outcomes could be controlled or predicted and the attribution of human qualities (personification) to gambling devices. Gender comparisons showed that women were more likely than men to personify the machines. The validity of the speaking-aloud approach and suggestions for future research are discussed.
Summary Background Severe problem gambling is most often related to income producing offences such as larceny and embezzlement. In addition, the high rate of relapse to gambling problems and the link between gambling debts and crime have clinical, forensic and penitentiary implications. Considering the data from the literature presented here I decided to form and empirically verify a hypothesis that incarcerated men with a diagnosis of pathological gambling are characterized by psychopathic personality disorders, alcohol problems and criminality. Material/Methods The groups of participants encompassed 90 men 26–52 years of age, serving a criminal sentence. All participants had to fulfil the following clinical criteria: a) be interviewed by a psychiatrist and diagnosed with pathological gambling and/or antisocial personality disorders b) obtain a result in the PCL-R test; c) estimate the relationship between gambling problems and crime. Taking into consideration the abovementioned criteria three patient test groups were formed: Group 1, which included those for whom gambling had led to crime; Group 2, where gambling was a part of a criminal lifestyle, and Group 3, in which the mutual relationship between gambling and crime was unclear. Results The participants were diagnosed as pathological gamblers (DSM-IV-TR, ICD-10) and psychopaths (PCL-R). Those tested differed with regard to the intensification of the personality disturbance tested, the co-occurrence of other disturbances, particularly psychoactive addictions, the motivations for taking up gambling, and the type of criminal activity. Conclusions The hypothesis was confirmed that incarcerated men with a diagnosis of pathological gambling are characterized by psychopathic personality disorders, alcohol problems and criminality. PMID:22037748
Gratz, Kim L; Kiel, Elizabeth J; Latzman, Robert D; Elkin, T David; Moore, Sarah Anne; Tull, Matthew T
Evidence suggests that maternal borderline personality (BP) pathology increases offspring risk. This study examined the relations between maternal BP pathology and related emotional dysfunction (including emotion regulation [ER] difficulties and emotional intensity/reactivity) and infant ER difficulties. Specifically, we examined both self-focused and caregiver-focused ER behaviors and the modulation of emotional expressions (one indicator of ER in young children) in response to fear- and anger-eliciting stimuli among 101 infants (12 to 23 months old) of mothers with and without clinically relevant BP pathology. The authors also examined the moderating role of mother-infant attachment. Findings of a series of multiple regression mediation analyses revealed an indirect effect of maternal BP pathology on infant ER difficulties through maternal emotional dysfunction, with maternal ER difficulties facilitating an indirect effect of maternal BP pathology on expressivity-related indicators of infant ER difficulties and maternal emotional intensity/reactivity linking maternal BP pathology to lower self-focused ER for infants in insecure-resistant attachment relationships.
Yan, Wan-Sen; Zhang, Ran-Ran; Lan, Yan; Li, Yong-Hui; Sui, Nan
As a non-substance addiction, gambling disorder represents the model for studying the neurobiology of addiction without toxic consequences of chronic drug use. From a neuropsychological perspective, impulsivity is deemed as a potential construct responsible in the onset and development of drug addiction. The objective of this study was to investigate the associations between impulsivity and gambling status in young adults with varying severity of gambling. A sample of 1120 college students, equally divided into non-problem, at-risk and problem gamblers, were administered multiple measures of impulsivity including the UPPSP Impulsive Behaviors Scale (UPPSP), the Barratt Impulsiveness Scale-11 (BIS-11), and the Delay-discounting Test (DDT). Compared with non-problem gamblers, both at-risk gamblers and problem gamblers displayed elevated scores on Negative Urgency, Positive Urgency, Motor Impulsiveness, and Attentional Impulsiveness. Problem gamblers showed higher scores than at-risk gamblers on Positive Urgency. Logistic regression models revealed that only Negative Urgency positively predicted both at-risk gambling and problem gambling compared to non-problem gambling. These results suggest that dimensions of impulsivity may be differentially linked to gambling behavior in young adults, with Negative Urgency putatively identified as an important impulsivity-related marker for the development of gambling disorder, which may provide a better understanding of the pathogenesis. PMID:27976705
Griffiths, Mark D; Wood, Richard T A; Parke, Jonathan
To date, little empirical research has focused on social responsibility in gambling. This study examined players' attitudes and behavior toward using the social responsibility tool PlayScan designed by the Swedish gaming company Svenska Spel. Via PlayScan, players have the option to utilize various social responsibility control tools (e.g., personal gaming budgets, self-diagnostic tests of gambling habits, self-exclusion options). A total of 2,348 participants took part in an online questionnaire study. Participants were clientele of the Svenska Spel online gambling Web site. Results showed that just over a quarter of players (26%) had used PlayScan. The vast majority of those who had activated PlayScan (almost 9 in 10 users) said that PlayScan was easy to use. Over half of PlayScan users (52%) said it was useful; 19% said it was not. Many features were seen as useful by online gamblers, including limit setting (70%), viewing their gambling profile (49%), self-exclusion facilities (42%), self-diagnostic problem gambling tests (46%), information and support for gambling issues (40%), and gambling profile predictions (36%). In terms of actual (as opposed to theoretical) use, over half of PlayScan users (56%) had set spending limits, 40% had taken a self-diagnostic problem gambling test, and 17% had used a self-exclusion feature.
Hodgins, David C.; el-Guebaly, Nady
A prospective design was used to explore the precipitants of relapse in a naturalistic sample of pathological gamblers (N = 101) who had recently quit gambling. Relapse rates were high; only 8% were entirely free of gambling during the 12-month follow-up. Relapses were highly variable but occurred most frequently in the evening, when the person…
TACKETT, JENNIFER L.; BALSIS, STEVE; OLTMANNS, THOMAS F.; KRUEGER, ROBERT F.
Proposed changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) include replacing current personality disorder (PD) categories on Axis II with a taxonomy of dimensional maladaptive personality traits. Most of the work on dimensional models of personality pathology, and on personality disorders per se, has been conducted on young and middle-aged adult populations. Numerous questions remain regarding the applicability and limitations of applying various PD models to early and later life. In the present paper, we provide an overview of such dimensional models and review current proposals for conceptualizing PDs in DSM-V. Next, we extensively review existing evidence on the development, measurement, and manifestation of personality pathology in early and later life focusing on those issues deemed most relevant for informing DSM-V. Finally, we present overall conclusions regarding the need to incorporate developmental issues in conceptualizing PDs in DSM-V and highlight the advantages of a dimensional model in unifying PD perspectives across the life span. PMID:19583880
Tackett, Jennifer L; Balsis, Steve; Oltmanns, Thomas F; Krueger, Robert F
Proposed changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) include replacing current personality disorder (PD) categories on Axis II with a taxonomy of dimensional maladaptive personality traits. Most of the work on dimensional models of personality pathology, and on personality disorders per se, has been conducted on young and middle-aged adult populations. Numerous questions remain regarding the applicability and limitations of applying various PD models to early and later life. In the present paper, we provide an overview of such dimensional models and review current proposals for conceptualizing PDs in DSM-V. Next, we extensively review existing evidence on the development, measurement, and manifestation of personality pathology in early and later life focusing on those issues deemed most relevant for informing DSM-V. Finally, we present overall conclusions regarding the need to incorporate developmental issues in conceptualizing PDs in DSM-V and highlight the advantages of a dimensional model in unifying PD perspectives across the life span.
Barrault, Servane; Varescon, Isabelle
The aims were to assess cognitive distortions and psychological distress (anxiety and depression) among online poker players of different levels of gambling intensity (non-pathological gamblers [NPG], problem gamblers [PbG], and pathological gamblers [PG]), and to examine the relationship between these variables and gambling pathology. Overall, 245 regular online poker players recruited on an Internet forum completed online self-report scales assessing pathological gambling (South Oaks Gambling Screen [SOGS]), psychological distress (Hospital Anxiety and Depression Scale [HADS]) and cognitive distortions (Gambling-Related Cognition Scale). Based on their SOGS scores, poker players were ranked into three groups: NPG (n=146), PbG (n=55), and PG (n=44). All poker players appeared to be more anxious than depressive. PG exhibited higher levels of depression and anxiety than did PbG and NPG. Cognitive distortions also significantly discriminated PG from PbG and NPG. A regression model showed that the perceived inability to stop gambling, the illusion of control, depression (HADS D), and anxiety were good predictors for pathological gambling among poker players. Our results suggest that cognitive distortions play an important role in the development and maintenance of gambling pathology. This study also underlines the role of anxiety and depression in pathological gambling among poker players. It seems relevant to take these elements into account in the research, prevention, and treatment of pathological gambling poker players.
Neighbors, Clayton; Rodriguez, Lindsey M.; Rinker, Dipali V.; Agana, Maigen; Gonzales, Rubi G.; Tackett, Jennifer L.; Foster, Dawn W.
Objective Social influences on gambling among adolescents and adults have been well documented and may be particularly evident among college students, who have higher rates of problem and pathological gambling relative to the general population. Personalized normative feedback (PNF) is a brief intervention designed to correct misperceptions regarding the prevalence of problematic behavior by showing individuals engaging in such behaviors that their own behavior is atypical with respect to actual norms. The current randomized controlled trial evaluated a computer-delivered PNF intervention for problem gambling college students. Method Following a baseline assessment, 252 college student gamblers scoring 2+ on the South Oaks Gambling Screen (SOGS) were randomly assigned to receive PNF or attention-control feedback. Follow-up assessments were completed 3 and 6 months postintervention. Results Results indicated significant intervention effects in reducing perceived norms for quantities lost and won, and in reducing actual quantity lost and gambling problems at the 3-month follow-up. All intervention effects except reduced gambling problems remained at the 6-month follow-up. Mediation results indicated that changes in perceived norms at 3 months mediated the intervention effects. Further, the intervention effects were moderated by self-identification with other student gamblers, suggesting that PNF worked better at reducing gambling for those who more strongly identified with other student gamblers. Conclusions Results support the use of PNF as a stand-alone brief intervention for at-risk gambling students. Extending this approach more broadly may provide an accessible, empirically supported gambling prevention option for universities and related institutions. PMID:26009785
Lloyd, Joanne; Doll, Helen; Hawton, Keith; Dutton, William H; Geddes, John R; Goodwin, Guy M; Rogers, Robert D
In order to learn about the behaviours and health experiences of people who gamble on the Internet, we conducted an international online survey with respondents recruited via gambling and gambling-related websites. The mean (SD) age of the 4,125 respondents completing the survey was 35.5 (11.8) years, with 79.1% being male and 68.8% UK residents. Respondents provided demographic details and completed validated psychometric screening instruments for problem gambling, mood disturbances, as well as alcohol and substance misuse, and history of deliberate self harm. We applied latent class analysis to respondents' patterns of regular online gambling activities, and identified subgroups of individuals who used the Internet to gamble in different ways (L (2) = 44.27, bootstrap P = 0.07). We termed the characteristic profiles as 'non-to-minimal gamblers'; 'sports bettors'; 'casino & sports gamblers'; 'lottery players'; and 'multi-activity gamblers'. Furthermore, these subgroups of respondents differed on other demographic and psychological dimensions, with significant inter-cluster differences in proportion of individuals scoring above threshold for problem gambling, mood disorders and substance misuse, and history of deliberate self harm (all Chi (2)s > 23.4, all P-values <0.001). The 'casino & sports' and 'multi-activity-gamblers' clusters had the highest prevalence of mental disorder. Internet gamblers appear to be heterogeneous but composed of several subgroups, differing markedly on both demographic and clinical characteristics.
Luquiens, Amandine; Tanguy, Marie-Laure; Benyamina, Amine; Lagadec, Marthylle; Aubin, Henri-Jean; Reynaud, Michel
The aim was to develop and validate an instrument to track online problem poker gamblers with player account-based gambling data (PABGD). We emailed an invitation to all active poker gamblers on the online gambling service provider Winamax. The 14,261 participants completed the Problem Gambling Severity Index (PGSI). PGSI served as a gold standard to track problem gamblers (i.e., PGSI ≥ 5). We used a stepwise logistic regression to build a predictive model of problem gambling with PABGD, and validated it. Of the sample 18% was composed of online poker problem gamblers. The risk factors of problem gambling included in the predictive model were being male, compulsive, younger than 28 years, making a total deposit > 0 euros, having a mean loss per gambling session > 1.7 euros, losing a total of > 45 euros in the last 30 days, having a total stake > 298 euros, having > 60 gambling sessions in the last 30 days, and multi-tabling. The tracking instrument had a sensitivity of 80%, and a specificity of 50%. The quality of the instrument was good. This study illustrates the feasibility of a method to develop and validate instruments to track online problem gamblers with PABGD only. Copyright © 2016 John Wiley & Sons, Ltd.
In this research, we explore a unique Chinese peer to peer (P2P) online lottery gambling data (n = 388,123) and examine the rationality of Chinese online lottery gamblers. We show that Chinese online lottery gamblers are irrational in the sense that they are significantly affected by the lottery winning history of others even though this winning history is shown to be merely an exogenous random shock. Specifically, in this Chinese P2P online lottery gambling game, some of the lottery gamblers (named the proposers) propose lottery packages first, and then, other lottery gamblers (named the followers) will follow by choosing among the different packages and deciding on how much to purchase. The past lottery winning return rate of each proposer is provided as public information and calculated as the ratio between her past winning money and wager. It is shown that this past return rate is merely a random shock because winning in the past cannot predict anything about the performance in the future. However, we find that Chinese online P2P lottery gamblers are significantly more likely to join a lottery package if it is proposed by proposers with higher return rates.
Dixon, Mark R.; Bihler, Holly L.; Nastally, Becky L.
The current study attempted to alter preferences for concurrently available slot machines of equal payout through the development of equivalence classes and subsequent transfers of functions. Participants rated stimuli consisting of words thought to be associated with having a gambling problem (e.g., "desperation" and "debt"), words associated…
Braverman, Julia; LaPlante, Debi A; Nelson, Sarah E; Shaffer, Howard J
Using actual gambling behavior provides the opportunity to develop behavioral markers that operators can use to predict the development of gambling-related problems among their subscribers. Participants were 4,056 Internet gamblers who subscribed to the Internet betting service provider bwin.party. Half of this sample included multiple platform gamblers who were identified by bwin.party's Responsible Gambling (RG) program; the other half were controls randomly selected from those who had the same first deposit date. Using the daily aggregated Internet betting transactions for gamblers' first 31 calendar days of online betting activities at bwin.party, we employed a 2-step analytic strategy: (a) applying an exploratory chi-squared automatic interaction detection (CHAID) decision tree method to identify characteristics that distinguished a subgroup of high-risk Internet gamblers from the rest of the sample, and (b) conducting a confirmatory analysis of those characteristics among an independent validation sample. This analysis identified two high-risk groups (i.e., groups in which 90% of the members were identified by bwin.party's RG program): Group 1 engaged in three or more gambling activities and evidenced high wager variability on casino-type games; Group 2 engaged in two different gambling activities and evidenced high variability for live action wagers. This analysis advances an ongoing research program to identify potentially problematic Internet gamblers during the earliest stages of their Internet gambling. Gambling providers and public policymakers can use these results to inform early intervention programs that target high-risk Internet gamblers.
Bucknall, Vittoria; Burwaiss, Suendoss; MacDonald, Deborah; Charles, Kathy; Clement, Rhys
Background: Stereotypes in medicine have become exaggerated for the purpose of workplace amusement. Our objective was to assess the levels of “dark triad” personality traits expressed by individuals working in different health care specialties in comparison with the general population. Methods: We conducted a prospective, cross-sectional study within multiple departments of a UK secondary care teaching hospital. A total of 248 health care professionals participated, and 159 members of the general population were recruited as a comparison group. We measured 3 personality traits — narcissism, Machiavellianism and psychopathy — through the validated self-reported personality questionnaires Narcissistic Personality Inventory (NPI), MACH-IV and the Levenson Self-Report Psychopathy Scale (LSRP), respectively. Results: Health care professionals scored significantly lower on narcissism, Machiavellianism and psychopathy (mean scores 12.0, 53.0 and 44.7, respectively) than the general population (p < 0.001). Nursing professionals exhibited a significantly higher level of secondary psychopathy than medical professionals (p = 0.04, mean LSRP score 20.3). Within the cohort of medical professionals, surgeons expressed significantly higher levels of narcissism (p = 0.03, mean NPI score 15.0). Interpretation: Health care professionals expressed low levels of dark triad personality traits. The suggestion that health care professionals are avaricious and untrustworthy may be refuted, even for surgeons. PMID:26644545
Hwang, Jae Yeon; Shin, Young-Chul; Lim, Se-Won; Park, Hye Youn; Shin, Na Young; Jang, Joon Hwan; Park, Hye-Yoon; Kwon, Jun Soo
The phenomenological resemblance between pathological gambling (PG) and obsessive-compulsive disorder (OCD) has led to suggestions that PG be categorized as an obsessive-compulsive-spectrum disorder (OCSD). This study aimed to explore whether PG resembles OCD in terms of personality and temperament. Fifteen patients with PG, 18 patients with OCD, and 33 healthy control subjects were included in the study. The study subjects were all male and drug naïve. We analyzed data obtained from three self-report questionnaires assessing personality, impulsiveness, and affect: the short version of the NEO Personality Inventory-Revised (NEO-PI-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Positive Affect and Negative Affect Schedule (PANAS). Participants with PG and OCD demonstrated less conscientiousness (F = 7.089, P = .002) and less openness to experience (F = 6.268, P = .003) and less positive affect (F = 15.816, P < .001) than did healthy controls. The two diagnostic groups did not differ from each other with respect total BIS-11 scores, but those with OCD showed more neuroticism than did those with PG and healthy controls ( F = 9.556, P < .001), and those with PG obtained higher scores on the non-planning impulsiveness factor of BIS-11 than did those with OCD or healthy controls ( F = 9,835, P < .001). PG and OCD share similar profiles in terms of personality and temperament. This study provides phenomenological evidence supporting the conceptualization of PG as an OCSD.
Blackman, Sheldon; And Others
The Gamblers Treatment Clinic (GTC) opened in 1982 as a New York State Office of Mental Health Demonstration Program. The basic premise of the GTC is that excessive gambling is a disorder of impulse control. Treatment, conducted in the community in a time-limited fashion, attempts to uncover the underlying dynamics that precipitate disorders of…
Delfabbro, Paul; Thomas, Anna
Background and aims In many jurisdictions, where gambling services are provided, regulatory codes require gambling operators to apply a duty of care toward patrons. A common feature of these provisions is some expectation that venue staff identify and assist patrons who might be experiencing problems with their gambling. The effectiveness of such measures is, however, predicated on the assumption that there are reliable and observable indicators that might be used to allow problem gamblers to be distinguished from other gamblers. Methods In this study, we consolidate the findings from two large Australian studies (n = 505 and n = 680) of regular gamblers that were designed to identify reliable and useful indicators for identifying problem gambling in venues. Results It was found that problem gamblers are much more likely to report potentially visible emotional reactions, unusual social behaviors, and very intense or frenetic gambling behavior. Discussion and conclusions This study shows that there are a range of indicators that could potentially be used to identify people experiencing problems in venues, but that decisions are most likely to be accurate if based on an accumulation of a diverse range of indicators. PMID:27670713
Raylu, Namrata; Oei, Tian P S; Loo, Jasmine
The self-help treatment (SHT) studies for other psychological problems significantly outweigh those for problem gambling. Currently, very little is published about the application and efficacy of various forms of SHTs for problem gambling. Thus, this paper reviews the self-help literature (using the PsycINFO database--all years up to April 2008) to stimulate further research in this area for problem gambling. The findings show that SHTs in problem gambling are still in their infancy. Although the problem gambling literature has mainly reported on two forms of SHTs with problem gamblers (i.e. use of self-help manuals and audiotapes), the review discuss utilizing a wide range of SHTs with problem gamblers. These include written materials (e.g. self-help books and treatment manuals), audiotapes, videotapes, computer-based SHTs implemented on palmtop computers, desktop computers, via telephone (Interactive Voice Response systems--IVR) or via the Internet and virtual reality applications. These SHTs would suit those problem gamblers who are not accessing professional treatment due to shame, guilt, fear of stigma, privacy concerns or financial difficulties, as well as those living in rural areas or with less severe gambling problems. The review also suggest future protocols for conducting further research in this area with problem gamblers, highlighting a need for a cohesive theory to guide research.
Gray, Joshua C; MacKillop, James
Introduction Delay discounting is a behavioral economic index of impulsivity that reflects preferences for small immediate rewards relative to larger delayed rewards. It has been consistently linked to pathological gambling and other forms of addictive behavior, and has been proposed to be a behavioral characteristic that may link genetic variation and risk of developing addictive disorders (i.e., an endophenotype). Studies to date have revealed significant associations with polymorphisms associated with dopamine neurotransmission. The current study examined associations between delay discounting and both previously linked variants and a novel panel of dopamine-related variants in a sample of frequent gamblers. Methods Participants were 175 weekly gamblers of European ancestry who completed the Monetary Choice Questionnaire to assess delay discounting preferences and provided a DNA via saliva. Results In a priori tests, two loci previously associated with delayed reward discounting (rs1800497 and rs4680) were not replicated, however, the long form of DRD4 VNTR was significantly associated with lower discounting of delayed rewards. Exploratory analysis of the dopamine-related panel revealed 11 additional significant associations in genes associated with dopamine synthesis, breakdown, reuptake, and receptor function (DRD3, SLC6A3, DDC, DBH, and SLC18A2). An aggregate genetic risk score from the nominally significant loci accounted for 17% of the variance in discounting. Mediational analyses largely supported the presence of indirect effects between the associated loci, delay discounting, and pathological gambling severity. Conclusions These findings do not replicate previously reported associations but identify several novel candidates and provide preliminary support for a systems biology approach to understand the genetic basis of delay discounting. PMID:25365808
Carlbring, Per; Degerman, Nicklas; Jonsson, Jakob; Andersson, Gerhard
Effective therapies for pathological gambling exist, but their use is limited to about 10% of the target population. In an attempt to lower the barriers for help, Internet-based cognitive behavioural therapy (ICBT) has been shown to be effective when delivered to a non-depressed sample with pathological gambling. This study sought to extend this finding to a larger, more representative population, and also test a model to predict responder status. Following advertisement, a total of 284 participants started an 8-week ICBT programme with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min. The average time spent on each participant, including telephone conversations, e-mail, and administration, was 4 h. In addition to a mixed effects model to evaluate the effectiveness of the treatment, two logistic regression analyses were performed with the following eight pre-defined response predictor variables: work-life satisfaction, primary gambling activity, debts due to gambling, social support, personal yearly salary, alcohol consumption, stage of change, and dissociative gambling. ICBT resulted in statistically significant reductions in the scores of pathological gambling, anxiety, and depression as well as an increase in quality of life compared to pre-treatment levels. Follow-ups carried out in the treatment group at 6, 18, and 36 months indicated that treatment effects were sustained. Using the eight predictor variable model rendered an acceptable predictive ability to identify responders both at post-test (AUC = .72, p < .01) and at 36-month follow-up (AUC = .70, p < .01). We conclude that ICBT for pathological gamblers, even if depressed, can be effective and that outcome can partly be predicted by pre-treatment characteristics.
Wright, Aidan G C; Calabrese, William R; Rudick, Monica M; Yam, Wern How; Zelazny, Kerry; Williams, Trevor F; Rotterman, Jane H; Simms, Leonard J
This study was conducted to establish (a) the stability of the DSM-5 Section III personality disorder (PD) traits, (b) whether these traits predict future psychosocial functioning, and (c) whether changes in traits track with changes in psychosocial functioning across time. Ninety-three outpatients (61% female) diagnosed with at least 1 PD completed patient-report measures at 2 time-points (M time between assessments = 1.44 years), including the Personality Inventory for the DSM-5 and several measures of psychosocial functioning. Effect sizes of rank-order and mean-level change were calculated. In addition, Time 1 traits were used to predict functioning measures at Time 2. Finally, latent change score models were estimated for DSM-5 Section III traits and functioning measures, and correlations among latent change scores were calculated to establish the relationship between change in traits and functional outcomes. Findings demonstrated that the DSM-5 Section III traits were highly stable in terms of normative (i.e., mean-level) change and rank-order stability over the course of the study. Furthermore, traits prospectively predicted psychosocial functioning. However, at the individual level traits and functioning were not entirely static over the study, and change in individuals' functioning tracked with changes in trait levels. These findings demonstrate that the DSM-5 Section III traits are highly stable consistent with the definition of PD, prospectively predictive of psychosocial functioning, and are dynamically associated with functioning over time. This study provides important evidence in support of the DSM-5 Section III PD model.
Wright, Aidan G.C.; Calabrese, William R.; Rudick, Monica M.; Yam, Wern How; Zelazny, Kerry; Williams, Trevor F.; Rotterman, Jane H.; Simms, Leonard J.
This study was conducted to establish (a) the stability of the DSM-5 Section III personality disorder (PD) traits, (b) whether these traits predict future psychosocial functioning, and (c) whether changes in traits track with changes in psychosocial functioning across time. Ninety-three outpatients (61% Female) diagnosed with at least one PD completed patient-report measures at two time-points (M time between assessments = 1.44 years), including the Personality Inventory for the DSM-5 and several measures of psychosocial functioning. Effect sizes of rank-order and mean-level change were calculated. In addition, Time 1 traits were used to predict functioning measures at Time 2. Finally, latent change score models were estimated for DSM-5 Section III traits and functioning measures, and correlations among latent change scores were calculated to establish the relationship between change in traits and functional outcomes. Findings demonstrated that the DSM-5 Section III traits were highly stable in terms of normative (i.e., mean-level) change and rank-order stability over the course of the study. Furthermore, traits prospectively predicted psychosocial functioning. However, at the individual level traits and functioning were not entirely static over the study, and change in individuals’ functioning tracked with changes in trait levels. These findings demonstrate that the DSM-5 Section III traits are highly stable consistent with the definition of PD, prospectively predictive of psychosocial functioning, and dynamically associated with functioning over time. This study provides important evidence in support of the DSM-5 Section III PD model. PMID:25384070
Shore, Rebecca Martin
Describes how a typical high school in Huntington Beach, California, curbed disruptive student behavior by personalizing the school experience for "problem" students. Through mostly volunteer efforts, an adopt-a-kid program was initiated that matched kids' learning styles to adults' personality styles and resulted in fewer suspensions…
Corr, Philip J; Thompson, Stephen J
In a sample of normal volunteers, response perseveration (RP) on a computerised gambling task, the card perseveration task, was examined under two conditions: No pause (Standard task) and a 5-s pause (Pause task) following feedback from previous bet. Behavioural outcomes comprised number of cards played (and cash won/lost) and latency of response. Individual differences in these outcomes were conceptualised in terms of the reinforcement sensitivity theory of personality. Results showed that, on the Standard task only, sub-scales of the Carver and White (J Pers Social Psychol 67:319-333, 1994) Behavioural Approach System scale positively correlated with number of cards played and amount of money lost (indicative of impaired RP), but these associations were abolished with the imposition of a 5-s pause between feedback and the opportunity to make the next bet-this pause also had an overall main effect of improving RP and reducing losses. As related research shows that such a pause normalises the RP deficit seen in pathological gamblers, these findings hold potentially valuable implications for informing practice in the prevention and treatment of pathological gambling, and point to the role played by individual differences in approach motivation.
Paglieri, Fabio; Addessi, Elsa; De Petrillo, Francesca; Laviola, Giovanni; Mirolli, Marco; Parisi, Domenico; Petrosino, Giancarlo; Ventricelli, Marialba; Zoratto, Francesca; Adriani, Walter
The search for neuronal and psychological underpinnings of pathological gambling in humans would benefit from investigating related phenomena also outside of our species. In this paper, we present a survey of studies in three widely different populations of agents, namely rodents, non-human primates, and robots. Each of these populations offers valuable and complementary insights on the topic, as the literature demonstrates. In addition, we highlight the deep and complex connections between relevant results across these different areas of research (i.e., cognitive and computational neuroscience, neuroethology, cognitive primatology, neuropsychiatry, evolutionary robotics), to make the case for a greater degree of methodological integration in future studies on pathological gambling. PMID:24574984
Sleczka, Pawel; Braun, Barbara; Piontek, Daniela; Bühringer, Gerhard; Kraus, Ludwig
Background and Aims DSM-5 provides nine diagnostic criteria for gambling disorder. All criteria have a pre-assumed equal diagnostic impact and are applied to all individuals and groups in an equal manner. The aims of the study are to analyse the structure underlying the diagnosis and to assess whether DSM-5 is equally applicable to different groups of gamblers. Methods Data from the 2009 German Epidemiological Survey of Substance Abuse and from a study on slot machine gamblers were used. Item Response Theory analysis was applied to estimate discrimination and severity parameters of the criteria. With the use of Differential Item Functioning analysis, potential criterion biases were analysed. We analysed data from 107 participants from the general population sample and 376 participants from the slot machine gamblers’ sample who answered a 19-item diagnostic questionnaire based on the DSM criteria for gambling disorder. Results A single underlying factor, the severity of gambling disorder, was identified in both samples. In the general population sample the criteria of preoccupation and chasing were least severe and showed low discriminatory power. Bailout, withdrawal and jeopardized matters criteria had highest severity and discriminatory power. The comparison of the two samples revealed two criterion biases in the preoccupation and tolerance criteria. Conclusions The structure underlying the criteria is unidimensional but the disorder is manifested differently depending on disorder severity. The assumed equal impact of each criterion lacks support in the findings. The DSM-5 criteria measure a partially different construct in slot machine gamblers than in gamblers in the general population. PMID:26690617
Dixon, Mark R; Buono, Frank D; Belisle, Jordan
The present study required 9 disordered gamblers to make hypothetical selections between smaller and larger amounts of money at varying delays. Participants were also required to respond to the task given the contrived hypothetical conditions of earning twice or half as much as they did at their current jobs. The results demonstrated how participants' delay discounting was altered via contrived motivating operations, strengthening the argument that discounting may be a state variable.
McGrath, Daniel S; Konkolÿ Thege, Barna
Over the past decade, several motivational models have been proposed to explain the role of motives in gambling disorder. In the model captured by the four-factor Gambling Motives Questionnaire Financial (GMQ-F), gamblers are described as being primarily motivated to gamble for 'coping', 'enhancement', 'social', and 'financial' reasons. Although this model has received significant empirical support; to date, research assessing the role of motives in gambling disorder has been primarily cross-sectional in nature. Thus, the extent to which gambling motives remain stable over time has yet to be explored. In the current study, the stability versus fluidity of self-assessed gambling motives was investigated using the Quinte Longitudinal Study, a longitudinal dataset of gambling behaviour collected over 5 years. Gambling motives of 2795 gamblers were examined over all five annual assessments. The total proportion of gamblers who stayed in the same primary motive category across each of the 5 consecutive assessments was 22%, indicating substantial fluidity in category membership. Substantial movement between categories was seen for each GMQ-F group, as well as an additional group of non-classified motives. Logistic regression analyses suggest that greater resistance to gambling fallacies significantly predicted stability between the baseline assessment and a follow-up 1 year later, but gambling severity did not. Potential limitations in the study design and opportunities for future research are discussed.
Nower, Lia; Blaszczynski, Alex
Studies attempting to identify the specific 'addictive' features of electronic gaming machines (EGMs) have yielded largely inconclusive results, suggesting that it is the interaction between a gambler's cognitions and the machine, rather than the machine itself, which fuels excessive play. Research has reported that machine players with gambling problems adopt a number of erroneous cognitive perceptions regarding the probability of winning and the nature of randomness. What is unknown, however, is whether motivations for gambling and attitudes toward pre-session monetary limit-setting vary across levels of gambling severity, and whether proposed precommitment strategies would be useful in minimizing excessive gambling expenditures. The current study explored these concepts in a sample of 127 adults, ages 18 to 81, attending one of four gambling venues in Queensland, Australia. The study found that problem gamblers were more likely than other gamblers to play machines to earn income or escape their problems rather than for fun and enjoyment. Similarly, they were less likely to endorse any type of monetary limit-setting prior to play. They were also reticent to adopt the use of a 'smart card' or other strategy to limit access to money during a session, though they indicated they lost track of money while gambling and were rarely aware of whether they were winning or losing during play. Implications for precommitment policies and further research are discussed.
Gainsbury, Sally M; King, Daniel L; Russell, Alex M T; Delfabbro, Paul; Derevensky, Jeffrey; Hing, Nerilee
Digital advertising for gambling and specifically marketing via social media have increased in recent years, and the impact on vulnerable consumers, including moderate-risk and problem gamblers, is unknown. Social media promotions often fall outside of advertising restrictions and codes of conduct and may have an inequitable effect on susceptible gamblers. This study aimed to investigate recall of exposure to, and reported impact on gamblers of, gambling promotions and marketing content on social media, with a focus on vulnerable users currently experiencing gambling problems. Gamblers who use social media (N = 964) completed an online survey assessing their exposure to and engagement with gambling operators on social media, their problem gambling severity, and the impact of social media promotions on their gambling. Gamblers at moderate risk and problem gamblers were significantly more likely to report having been exposed to social media gambling promotions and indicated actively engaging with gambling operators via these platforms. They were more likely to self-report that they had increased gambling as a result of these promotions, and over one third reported that the promotions had increased their problems. This research suggests that gamblers at moderate risk or those experiencing gambling problems are more likely to be impacted by social media promotions, and these may play a role in exacerbating disordered gambling. Future research should verify these self-reported results with behavioral data. However, the potential influence of advertisements via these new platforms should be considered by clinicians and policymakers, given their potential role in the formation of this behavioral addiction.
Gainsbury, Sally M; Suhonen, Niko; Saastamoinen, Jani
Disordered Internet gambling is a psychological disorder that represents an important public health issue due to the increase in highly available and conveniently accessible Internet gambling sites. Chasing losses is one of the few observable markers of at-risk and problem gambling that may be used to detect early signs of disordered Internet gambling. This study examined loss chasing behaviour in a sample of Internet casino and poker players and the socio-demographic variables, irrational beliefs, and gambling behaviours associated with chasing losses. An online survey was completed by 10,838 Internet gamblers (58% male) from 96 countries. The results showed that Internet casino players had a greater tendency to report chasing losses than poker players and gamblers who reported chasing losses were more likely to hold irrational beliefs about gambling and spend more time and money gambling than those who reported that they were unaffected by previous losses. Gamblers who played for excitement and to win money were more likely to report chasing losses. This study is one of the largest ever studies of Internet gamblers and the results are highly significant as they provide insight into the characteristics and behaviours of gamblers using this mode of access.
Hounslow, Vanessa; Smith, David; Battersby, Malcolm; Morefield, Kate
Problem gambling has become a widespread problem following the rapid expansion of electronic gaming machines into hotels and clubs over the last 10 years. Recent literature indicates that certain factors can influence problem gambling severity, such as psychiatric co-morbidity and personality traits, gambling related cognitions, substance use and…
Wölfling, Klaus; Mörsen, Chantal P; Duven, Eva; Albrecht, Ulrike; Grüsser, Sabine M; Flor, Herta
In recent research similarities between pathological gambling and drug addiction have been identified, suggesting excessive gambling to constitute an addiction. So far, we have insufficient knowledge concerning the psychophysiological mechanisms underlying this kind of non-substance-related addiction. The objective of the study was to investigate emotional processing of gambling-relevant and -irrelevant stimuli in pathological gamblers and non-gambling controls using an EEG cue-reactivity paradigm. Whereas gambling-irrelevant stimuli were processed similarly in non-gambling controls (HC) and pathological gamblers (PG), PG showed significantly stronger gambling-relevant stimulus-induced psychophysiological cue-reactivity (larger gambling stimulus-induced late positive potential, LPP, higher arousal and more positively toned valence ratings as well as higher stimulus-induced craving for gambling cues compared to HC--but not the expectable increase of general craving over time and after stimulus presentation). Our findings suggest enhanced cue-reactivity in pathological gamblers indicative of learned motivated attention that may induce subjective craving and relapse.
Louis, David N.; Feldman, Michael; Carter, Alexis B.; Dighe, Anand S.; Pfeifer, John D.; Bry, Lynn; Almeida, Jonas S.; Saltz, Joel; Braun, Jonathan; Tomaszewski, John E.; Gilbertson, John R.; Sinard, John H.; Gerber, Georg K.; Galli, Stephen J.; Golden, Jeffrey A.; Becich, Michael J.
Context We define the scope and needs within the new discipline of computational pathology, a discipline critical to the future of both the practice of pathology and, more broadly, medical practice in general. Objective To define the scope and needs of computational pathology. Data Sources A meeting was convened in Boston, Massachusetts, in July 2014 prior to the annual Association of Pathology Chairs meeting, and it was attended by a variety of pathologists, including individuals highly invested in pathology informatics as well as chairs of pathology departments. Conclusions The meeting made recommendations to promote computational pathology, including clearly defining the field and articulating its value propositions; asserting that the value propositions for health care systems must include means to incorporate robust computational approaches to implement data-driven methods that aid in guiding individual and population health care; leveraging computational pathology as a center for data interpretation in modern health care systems; stating that realizing the value proposition will require working with institutional administrations, other departments, and pathology colleagues; declaring that a robust pipeline should be fostered that trains and develops future computational pathologists, for those with both pathology and non-pathology backgrounds; and deciding that computational pathology should serve as a hub for data-related research in health care systems. The dissemination of these recommendations to pathology and bioinformatics departments should help facilitate the development of computational pathology. PMID:26098131
Auer, Michael; Griffiths, Mark D
Social responsibility in gambling has become a major issue for the gaming industry. The possibility for online gamblers to set voluntary time and money limits are a social responsibility practice that is now widespread among online gaming operators. The main issue concerns whether the voluntary setting of such limits has any positive impact on subsequent gambling behaviour and whether such measures are of help to problem gamblers. In this paper, this issue is examined through data collected from a representative random sample of 100,000 players who gambled on the win2day gambling website. When opening an account at the win2day site, there is a mandatory requirement for all players to set time and cash-in limits (that cannot exceed 800
Cykowski, Matthew D; Takei, Hidehiro; Van Eldik, Linda J; Schmitt, Frederick A; Jicha, Gregory A; Powell, Suzanne Z; Nelson, Peter T
Transactivating responsive sequence (TAR) DNA-binding protein 43-kDa (TDP-43) pathology has been described in various brain diseases, but the full anatomical distribution and clinical and biological implications of that pathology are incompletely characterized. Here, we describe TDP-43 neuropathology in the basal forebrain, hypothalamus, and adjacent nuclei in 98 individuals (mean age, 86 years; median final mini-mental state examination score, 27). On examination blinded to clinical and pathologic diagnoses, we identified TDP-43 pathology that most frequently involved the ventromedial basal forebrain in 19 individuals (19.4%). As expected, many of these brains had comorbid pathologies including those of Alzheimer disease (AD), Lewy body disease (LBD), and/or hippocampal sclerosis of aging (HS-Aging). The basal forebrain TDP-43 pathology was strongly associated with comorbid HS-Aging (odds ratio = 6.8, p = 0.001), whereas there was no significant association between basal forebrain TDP-43 pathology and either AD or LBD neuropathology. In this sample, there were some cases with apparent preclinical TDP-43 pathology in the basal forebrain that may indicate that this is an early affected area in HS-Aging. We conclude that TDP-43 pathology in the basal forebrain is strongly associated with HS-Aging. These results raise questions about a specific pathogenetic relationship between basal forebrain TDP-43 and non-HS-Aging comorbid diseases (AD and LBD).
Jessup, Ryan K; O'Doherty, John P
Reinforcement learning theory has generated substantial interest in neurobiology, particularly because of the resemblance between phasic dopamine and reward prediction errors. Actor-critic theories have been adapted to account for the functions of the striatum, with parts of the dorsal striatum equated to the actor. Here, we specifically test whether the human dorsal striatum--as predicted by an actor-critic instantiation--is used on a trial-to-trial basis at the time of choice to choose in accordance with reinforcement learning theory, as opposed to a competing strategy: the gambler's fallacy. Using a partial-brain functional magnetic resonance imaging scanning protocol focused on the striatum and other ventral brain areas, we found that the dorsal striatum is more active when choosing consistent with reinforcement learning compared with the competing strategy. Moreover, an overlapping area of dorsal striatum along with the ventral striatum was found to be correlated with reward prediction errors at the time of outcome, as predicted by the actor-critic framework. These findings suggest that the same region of dorsal striatum involved in learning stimulus-response associations may contribute to the control of behavior during choice, thereby using those learned associations. Intriguingly, neither reinforcement learning nor the gambler's fallacy conformed to the optimal choice strategy on the specific decision-making task we used. Thus, the dorsal striatum may contribute to the control of behavior according to reinforcement learning even when the prescriptions of such an algorithm are suboptimal in terms of maximizing future rewards.
Papoff, Katharine M; Norris, Joan E
Instant ticket purchase gambling (ITPG) is pervasive in Ontario and has features that mimic slot machine play. Previous researchers have reported that ITPG is one preferred activity for at-risk/problem gamblers. In the general Canadian population, rate of participation in ITPG is second only to lottery ticket gambling. Both are particularly favored by youth and seniors. The next cohort of seniors will be Canada's baby boomers, one-third of whom live in Ontario. Secondary analysis of Statistics Canada data revealed that adults in this cohort who buy instant gambling tickets (N = 1781) are significantly different from the complete group of their age peers (N = 4266) in number of activities pursued and frequency of involvement. At-risk/problem gambling prevalence was 10.2% amongst Ontario baby boomers who participate in instant ticket gambling, significantly higher than the 6.7% found amongst the total group of baby boom gamblers. For those who reported experiencing one or more of the Canadian Problem Gambling Index indicators for problem gambling (N = 237), 73% were buying instant tickets. Future research should consider cohort effects and explore combinations of preferred gambling activities that may increase risk for problem gambling. Social policy recommendations include the use of all ITPG venues as key locations for promoting awareness of problem gambling treatment services.
McKeith, Charles F A; Rock, Adam J; Clark, Gavin I
In Australia, poker-machine gamblers represent a disproportionate number of problem gamblers. To cultivate a greater understanding of the psychological mechanisms involved in poker-machine gambling, a repeated measures cue-reactivity protocol was administered. A community sample of 38 poker-machine gamblers was assessed for problem-gambling severity and trait mindfulness. Participants were also assessed regarding altered state of awareness (ASA) and urge to gamble at baseline, following a neutral cue, and following a gambling cue. Results indicated that: (a) urge to gamble significantly increased from neutral cue to gambling cue, while controlling for baseline urge; (b) cue-reactive ASA did not significantly mediate the relationship between problem-gambling severity and cue-reactive urge (from neutral cue to gambling cue); (c) trait mindfulness was significantly negatively associated with both problem-gambling severity and cue-reactive urge (i.e., from neutral cue to gambling cue, while controlling for baseline urge); and (d) trait mindfulness did not significantly moderate the effect of problem-gambling severity on cue-reactive urge (from neutral cue to gambling cue). This is the first study to demonstrate a negative association between trait mindfulness and cue-reactive urge to gamble in a population of poker-machine gamblers. Thus, this association merits further evaluation both in relation to poker-machine gambling and other gambling modalities.
Shead, N. Will; Derevensky, Jeffrey L.; Fong, Timothy W.; Gupta, Rina
There is a current lack of descriptive information on college students who gamble on the Internet. With the increasing popularity of Internet gambling, this study aimed to better understand the profile of Internet gamblers among a sample of college students. Of 909 students at the University of California-Los Angeles who completed an online…
Chan, Chi Chuen; Ohtsuka, Keis
This study aims to investigate the characterization of male gamblers in popular Hong Kong movies in the past 50 years. A total of nine Hong Kong films with gambling themes were selected for analysis. The criteria for selection of the films were as follows: the movies in which the protagonists are portrayed by well known Hong Kong actors that…
Vachon, David D.; Bagby, R. Michael
Although pathological gambling (PG) is regarded in the 4th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (American Psychiatric Association, 1994) as a unitary diagnostic construct, it is likely composed of distinct subtypes. In the current report, the authors used cluster analyses of personality traits with a…
Torres, Ana; Catena, Andrés; Cándido, Antonio; Maldonado, Antonio; Megías, Alberto; Perales, José C.
Several recent studies have demonstrated that addicts behave less flexibly than healthy controls in the probabilistic reversal learning task (PRLT), in which participants must gradually learn to choose between a probably rewarded option and an improbably rewarded one, on the basis of corrective feedback, and in which preferences must adjust to abrupt reward contingency changes (reversals). In the present study, pathological gamblers (PG) and cocaine dependent individuals (CDI) showed different learning curves in the PRLT. PG also showed a reduced electroencephalographic response to feedback (Feedback-Related Negativity, FRN) when compared to controls. CDI’s FRN was not significantly different either from PG or from healthy controls. Additionally, according to Standardized Low-Resolution Electromagnetic Tomography analysis, cortical activity in regions of interest (previously selected by virtue of their involvement in FRN generation in controls) strongly differed between CDI and PG. However, the nature of such anomalies varied within-groups across individuals. Cocaine use severity had a strong deleterious impact on the learning asymptote, whereas gambling intensity significantly increased reversal cost. These two effects have remained confounded in most previous studies, which can be hiding important associative learning differences between different populations of addicts. PMID:23516173
Torres, Ana; Catena, Andrés; Cándido, Antonio; Maldonado, Antonio; Megías, Alberto; Perales, José C
Several recent studies have demonstrated that addicts behave less flexibly than healthy controls in the probabilistic reversal learning task (PRLT), in which participants must gradually learn to choose between a probably rewarded option and an improbably rewarded one, on the basis of corrective feedback, and in which preferences must adjust to abrupt reward contingency changes (reversals). In the present study, pathological gamblers (PG) and cocaine dependent individuals (CDI) showed different learning curves in the PRLT. PG also showed a reduced electroencephalographic response to feedback (Feedback-Related Negativity, FRN) when compared to controls. CDI's FRN was not significantly different either from PG or from healthy controls. Additionally, according to Standardized Low-Resolution Electromagnetic Tomography analysis, cortical activity in regions of interest (previously selected by virtue of their involvement in FRN generation in controls) strongly differed between CDI and PG. However, the nature of such anomalies varied within-groups across individuals. Cocaine use severity had a strong deleterious impact on the learning asymptote, whereas gambling intensity significantly increased reversal cost. These two effects have remained confounded in most previous studies, which can be hiding important associative learning differences between different populations of addicts.
The field of pathology has undergone considerable change in recent years. The editor and editorial board of this journal are to be commended for their decision to devote a special issue to the field of pathology. Pathology deals with the characterization, investigation, and diagnosis of disease and disease processes and as such, has Long been considered one of the foundations of medicine. It is a rich and multi-faceted field which has retained its breadth of scope in the face of ever-increasing specialization and sub-specialization in medicine. In addition to its classic roles in autopsy, case description, and the diagnosis of pathoLogic processes, new and innovative spheres of activity are becoming integral to the field, especially in the realm of molecular pathology. Pathology is a Leading player in the new age of "personalized cancer therapy", where pathologists are responsible not only for diagnosing disease in the tissue, but also for conducting additional tests which may predict its response to specific drug therapies. In this context, moLecular pathology has become essential to the field both in the provision of cLinical service and research. To fully implement this trend, we are witness to the rise of tissue collection and tissue banking initiatives for both diagnostic and research purposes. A national tissue banking project in Israel has recently received considerable attention.
Woodside, Arch G; Zhang, Mann
X-consumers are the extremely frequent (top 2-3%) users who typically consume 25% of a product category. This article shows how to use fuzzy-set qualitative comparative analysis (QCA) to provide "causal recipes" sufficient for profiling X-consumers accurately. The study extends Dik Twedt's "heavy-half" product users for building theory and strategies to nurture or control X-behavior. The study here applies QCA to offer configurations that are sufficient in identifying "whales" and "jumbo shrimps" among X-casino gamblers. The findings support the principle that not all X-consumers are alike. The theory and method are applicable for identifying the degree of consistency and coverage of alternative X-consumers among users of all product-service category and brands.
Grall-Bronnec, Marie; Sauvaget, Anne; Perrouin, Fanny; Leboucher, Juliette; Etcheverrigaray, François; Challet-Bouju, Gaëlle; Gaboriau, Louise; Derkinderen, Pascal; Jolliet, Pascale; Victorri-Vigneau, Caroline
Background In the last 10 years, dopamine replacement therapy (DRT) has become a well-known risk factor for developing an impulse control disorder, such as gambling disorder (GD). Another medication, aripiprazole (ARI), has been more recently identified as another risk factor. Dopamine replacement therapy and ARI share a dopamine agonist action. Our work aimed at comparing patients with PG according to their treatment with DRT or ARI. Methods Two methods were combined—a systematic review concentrated on case reports and the analysis of a French disordered gamblers cohort focused on patients using ARI or DRT at inclusion. Results We reported 48 cases of GD possibly due to DRT and 17 cases of GD possibly due to ARI. Because of their standardized assessment, only the EVALJEU patients could be compared. Two clinical patterns emerged. Patients in the ARI group were young, impulsive, and high novelty seekers and had a history of substance misuse. Their first gambling experience occurred during adolescence. Conversely, patients in the DRT group were old, and they began gambling late in life. They showed low levels of gambling-related cognition. Conclusions Patients in the ARI group seemed to be more severe pathological gamblers than patients in the DRT group. Aripiprazole is a partial D2 receptor agonist, whereas DRT includes full D2 receptor agonist. The trigger mechanism of PG development is complex and cannot only be attributed only to the pharmacodynamic effects of dopaminergic drugs. Indeed, individual vulnerability factors and environmental factors need to be considered. PMID:26658263
Niemiec, Brook A
Oral disease is exceedingly common in small animal patients. In addition, there is a very wide variety of pathologies that are encountered within the oral cavity. These conditions often cause significant pain and/or localized and systemic infection; however, the majority of these conditions have little to no obvious clinical signs. Therefore, diagnosis is not typically made until late in the disease course. Knowledge of these diseases will better equip the practitioner to effectively treat them. This article covers the more common forms of oral pathology in the dog and cat, excluding periodontal disease, which is covered in its own chapter. The various pathologies are presented in graphic form, and the etiology, clinical signs, recommended diagnostic tests, and treatment options are discussed. Pathologies that are covered include: persistent deciduous teeth, fractured teeth, intrinsically stained teeth, feline tooth resorption, caries, oral neoplasia, eosinophilic granuloma complex, lymphoplasmacytic gingivostomatitis, enamel hypoplasia, and "missing" teeth.
In this paper we study reputation mechanisms, and show how the notion of reputation can help us in building truthful online auction mechanisms. From the mechanism design prospective, we derive the conditions on and design a truthful online auction mechanism. Moreover, in the case when some agents may lay or cannot have the real knowledge about the other agents reputations, we derive the resolution of the auction, such that the mechanism is truthful. Consequently, we move forward to the optimal one-gambler/one-seller problem, and explain how that problem is refinement of the previously discussed online auction design in the presence of reputation mechanism. In the setting of the optimal one-gambler problem, we naturally rise and solve the specific question: What is an agent's optimal strategy, in order to maximize his revenue? We would like to stress that our analysis goes beyond the scope, which game theory usually discusses under the notion of reputation. We model one-player games, by introducing a new parameter (reputation), which helps us in predicting the agent's behavior, in real-world situations, such as, behavior of a gambler, real-estate dealer, etc.
Tomei, Alexander; Zumwald, Coralie
We assess how video lottery terminal (VLT) operators' self-perceive their ability to recognize a problem gambler, to what extent they are approached by problem gamblers seeking for assistance, how many detections and interventions they report, and the reasons they give for not intervening with clients who show signs of problem gambling. We also examine how these variables are related to the operators' gender and status in the establishment. 177 VLT operators anonymously completed a structured questionnaire at the beginning of a responsible gambling training class held in different French-speaking Swiss towns. The operators felt confident in their ability to detect problem gambling behaviors, were rarely approached by problem gamblers seeking assistance, and reported fewer interventions compared to the number of detections. This reluctance to intervene was mainly attributed to the fear of potential negative reactions from the client. Female staff were the most reluctant to intervene and the most fearful of potential negative reactions from the client. Responsible gambling training programs should include coping strategies for dealing with potential negative reactions from clients. Our findings suggest that staff gender and status are two individual characteristics that should be taken into account when planning responsible gambling trainings.
Christopher, Kelly; Lutz-Zois, Catherine J.; Reinhardt, Amanda R.
Objective: The goal was to examine, in an all female sample, possible mechanisms for the relationship between a history of childhood sexual abuse and the likelihood of perpetrating sexual abuse as an adult. It was hypothesized that Borderline and Antisocial Personality Disorder tendencies would mediate the relationship between these two forms of…
Guerra, Luis; Leonard, Michael
Infants, children, and adolescents with inguinoscrotal pathology comprise a significant proportion of emergency department and outpatient visits. Visits to the emergency department primarily comprise individuals presenting with scrotal pain due to testicular torsion or torsion of the testicular appendages. At such time, immediate urological consultation is sought. Outpatient visits comprise those individuals with undescended testes, hydroceles, and varicoceles. Rare, but important problems, such as pediatric testicular tumours, may also present in the office setting. Many of these outpatient visits are to primary care physicians, who should have an appreciation of the timing and need for referral. The purpose of this review is to familiarize the general urologist and primary care physician with these varied pathologies and give insight into their assessment and management. Some of these same conditions are seen in adult patients, but there are some significant differences in their management in the pediatric group. In addition, the utility of imaging studies, such as ultrasound, are discussed within each pathological entity. It is hoped that this overview will assist our general urology and primary care colleagues in patient management for diverse inguinoscrotal pathologies. PMID:28265317
Wakefield, James A., Jr.; Goad, Nancy A.
Creativity is discussed in terms of H. Eysenck's personality theory. Creative persons are characterized by introversion, neuroticism, psychoticism, and moderate to high intelligence. The literature is reviewed on similarities and differences between creativity and pathology. (Author/DB)
Jazaeri, Seyed Amir; Habil, Mohammad Hussain Bin
Gambling, including pathological gambling and problem gambling, has received increased attention from clinicians and researchers over the past three decades since gambling opportunities have expanded around the world. Gambling disorders affect 0.2-5.3% of adults worldwide, although measurement and prevalence varies according to the screening instruments and methods used, and availability and accessibility of gambling opportunities. Several distinct treatment approaches have been favorably evaluated, such as cognitive behavioral and brief treatment models and pharmacological interventions. Although promising, family therapy and support from Gamblers Anonymous are less well empirically supported. Gambling disorders are highly comorbid with other mental health and substance use disorders, and a further understanding is needed of both the causes and treatment implications of this disorder. This article reviews definition, causes and associated features with substance abuse, screening and diagnosis, and treatment approaches.
Plönes, Till; Engel-Riedel, Walburga; Stoelben, Erich; Limmroth, Christina; Schildgen, Oliver; Schildgen, Verena
Companion diagnostics (CDx) have become a major tool in molecular pathology and assist in therapy decisions in an increasing number of various cancers. Particularly, the developments in lung cancer have been most impressing in the last decade and consequently lung cancer mutation testing and molecular profiling has become a major business of diagnostic laboratories. However, it has become difficult to decide which biomarkers are currently relevant for therapy decisions, as many of the new biomarkers are not yet approved as therapy targets, remain in the status of clinical studies, or still have not left the experimental phase. The current review is focussed on those markers that do have current therapy implications, practical implications arising from the respective companion diagnostics, and thus is focused on daily practice.
Romo, Lucia; Legauffre, Cindy; Guilleux, Alice; Valleur, Marc; Magalon, David; Fatséas, Mélina; Chéreau-Boudet, Isabelle; Luquiens, Amandine; Vénisse, Jean-Luc; Grall-Bronnec, Marie; Challet-Bouju, Gaëlle
Introduction The primary outcome of our study was to assess the links between the level of cognitive distortions and the severity of gambling disorder. We also aimed at assessing the links between patient gambling trajectories and attention deficit and hyperactivity disorder (ADHD). Materials and methods The study population (n = 628) was comprised of problem and non-problem gamblers of both sexes between 18 and 65 years of age, who reported gambling on at least one occasion during the previous year. Data encompassed socio-demographic characteristics, gambling habits, the South Oaks Gambling Screen, the Gambling Attitudes and Beliefs Survey – 23, the Wender Utah Rating Scale – Child, and the Adult ADHD Self-report Scale. Results The cognitive distortions with the greatest correlation to the severity of gambling disorder were the “Chasing” and “Emotions.” These two dimensions were able to distinguish between problem gamblers seeking treatment or not. While age of onset of gambling and length of gambling practice were not associated with the level of distorted cognitions, a period of abstinence of at least 1 month was associated with a lower level of distorted cognitions. The presence of ADHD resulted in a higher level of distorted cognitions. Conclusion Cognitive work is essential to the prevention, and the treatment, of pathological gambling, especially with respect to emotional biases and chasing behavior. The instauration of an abstinence period of at least 1 month under medical supervision could be a promising therapeutic lead for reducing gambling-related erroneous thoughts and for improving care strategies of pathological gamblers. PMID:27774813
Nower, Lia; Blaszczynski, Alex
The present study explores gender-related differences in the demographic and gambling-related characteristics of 2670 problem gamblers participating in a state-administered (Missouri) casino self-exclusion program between 2001 and 2003. Female (n=1298, 48.4%) and male (n=1372, 51.1%) participants ranged in age from 21 to 84 years. Gender-related differences were noted among demographic variables, patterns of gambling behavior, reasons for self-exclusion, and involvement in self-help, counseling, and bankruptcy services. Female self-excluders were more likely than males to be older at time of application, African American, and either retired, unemployed or otherwise outside the traditional workforce. In addition, female self-excluders were more likely to report a later age of gambling onset, a shorter period between onset and self-exclusion, a preference for non-strategic forms of gambling and prior bankruptcy. The main predictors for female participation in self-exclusion included a desire to gain control and prevent suicide and referral by a counselor. The desire to save the marriage was a motivating factor for all participants. Findings suggest that the most efficacious treatment strategies with this group will include family systemic therapy and financial management in addition to pharmaco-treatment and culturally-sensitive individual therapy.
Cowlishaw, Sean; Jackson, Alun C; Merkouris, Stephanie S; Francis, Kate L; Christensen, Darren R
Objective: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. Methods: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. Results: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5–93.9) and lifetime (75.5%, 95% CI 46.5–91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9–34.0), alcohol use disorders (21.2%, 95% CI 15.6–28.1), anxiety disorders (17.6%, 95% CI 10.8–27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7–24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7–75.2) and major depressive disorder (29.9%, 95% CI 20.5–41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4–24.2), alcohol dependence (15.2%, 95% CI 10.2–22.0), social phobia (14.9%, 95% CI 2.0–59.8), generalised anxiety disorder (14.4%, 95% CI 3.9–40.8), panic disorder (13.7%, 95% CI 6.7–26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4–35.7), cannabis use disorder (11.5%, 95% CI 4.8–25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1–19.6), adjustment disorder (9.2%, 95% CI 4.8–17.2), bipolar disorder (8.8%, 95% CI 4.4–17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4–18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should
Caie, Peter D; Harrison, David J
The field of pathology is rapidly transforming from a semiquantitative and empirical science toward a big data discipline. Large data sets from across multiple omics fields may now be extracted from a patient's tissue sample. Tissue is, however, complex, heterogeneous, and prone to artifact. A reductionist view of tissue and disease progression, which does not take this complexity into account, may lead to single biomarkers failing in clinical trials. The integration of standardized multi-omics big data and the retention of valuable information on spatial heterogeneity are imperative to model complex disease mechanisms. Mathematical modeling through systems pathology approaches is the ideal medium to distill the significant information from these large, multi-parametric, and hierarchical data sets. Systems pathology may also predict the dynamical response of disease progression or response to therapy regimens from a static tissue sample. Next-generation pathology will incorporate big data with systems medicine in order to personalize clinical practice for both prognostic and predictive patient care.
Sundqvist, Kristina; Wennberg, Peter
The association between personality and gambling has been explored previously. However, few studies are based on representative populations. This study aimed at examining the association between risk gambling and personality in a representative Swedish population. A random Swedish sample (N = 19,530) was screened for risk gambling using the Lie/Bet questionnaire. The study sample (N = 257) consisted of those screening positive on Lie/Bet and completing a postal questionnaire about gambling and personality (measured with the NODS-PERC and the HP5i respectively). Risk gambling was positively correlated with Negative Affectivity (a facet of Neuroticism) and Impulsivity (an inversely related facet of Conscientiousness), but all associations were weak. When taking age and gender into account, there were no differences in personality across game preference groups, though preferred game correlated with level of risk gambling. Risk gamblers scored lower than the population norm data with respect to Negative Affectivity, but risk gambling men scored higher on Impulsivity. The association between risk gambling and personality found in previous studies was corroborated in this study using a representative sample. We conclude that risk and problem gamblers should not be treated as a homogeneous group, and prevention and treatment interventions should be adapted according to differences in personality, preferred type of game and the risk potential of the games.
Eyden, Julie; Winsper, Catherine; Wolke, Dieter; Broome, Matthew R; MacCallum, Fiona
There is growing interest in whether the parenting strategies and offspring outcomes of mothers with borderline personality disorder (BPD) differ from those of mothers without BPD. We searched PsychINFO, PubMed, EMBASE, Web of Science, Scopus and ASSIA databases for studies examining parenting skills and attitudes among mothers with BPD/BPD symptoms and/or offspring outcomes. PRISMA reporting guidelines were followed. Of 10,067 abstracts screened, 101 full-text articles were retrieved and 33 met pre-determined criteria for qualitative synthesis. Overall, studies suggest that mothers with BPD/BPD symptoms are more likely to engage in maladaptive interactions with their offspring characterised by insensitive, overprotective, and hostile parenting compared to mothers without BPD/BPD symptoms. Adverse offspring outcomes include BPD symptoms, internalising (including depression) and externalising problems, insecure attachment patterns, and emotional dysregulation. Findings suggest that vulnerability from mother to offspring may be partly transmitted via maladaptive parenting and maternal emotional dysfunction. Conclusions were limited by study heterogeneity in methodology and construct definitions, as well as a paucity of clinical comparison groups. Prospective studies of mothers with BPD and their offspring from pregnancy onwards may further elucidate mechanisms of transmission and identify resilience factors across development. Parenting behaviour awareness, improving attachment behaviours and emotional regulation strategies may be important intervention targets.
Stewart, Melissa J; Yi, Sunghwan; Stewart, Sherry H
The current research examined whether the presentation of gambling-related cues facilitates the activation of gambling outcome expectancies using both reaction time (RT) and self-report modes of assessment. Gambling outcome expectancies were assessed by having regular casino or online gamblers (N = 58) complete an outcome expectancy RT task, as well as a self-report measure of gambling outcome expectancies, both before and after exposure to one of two randomly assigned cue conditions (i.e., casino or control video). Consistent with hypotheses, participants exposed to gambling-related cues (i.e., casino cue video condition) responded faster to positive outcome expectancy words preceded by gambling prime relative to non-gambling prime pictures on the post-cue RT task. Similarly, participants in the casino cue video condition self-reported significantly stronger positive gambling outcome expectancies than those in the control cue video condition following cue exposure. Activation of negative gambling outcome expectancies was not observed on either the RT task or self-report measure. The results indicate that exposure to gambling cues activates both implicit and explicit positive gambling outcome expectancies among regular gamblers.
Khanbhai, Yasmin; Smith, David; Battersby, Malcolm
Problem gambling is a growing public health concern and treatment incompletion levels remain high. The study aims to support and extend previous studies in relation to the heterogeneity of the gambling population based on gender and gambling type, and the implications of subgroup differences on treatment outcomes. Additionally, the concept of drop-out is addressed in terms of categorical treatment measures. The empirical findings are examined in the context of the theoretical framework of the pathways model. Participants were recruited from the Statewide Gambling Therapy Service and stratified into subgroups based on gender and gambling mode preference [Electronic Gambling Machines (EGM) or track race betters]. Baseline predictors collected and analysed using multinomial logistical regression included demographic information as well as gambling variables, while treatment outcomes consisted of three therapist rated measures. Significant differences between the subgroups were found for age, marital and employment status, gambling duration, alcohol use and the Kessler 10 measure of psychological distress. Specifically, male track race gamblers were younger, married, employed, had a longer duration of gambling, higher alcohol use and lower psychological distress relative to EGM users. No difference was found in any of the treatment outcomes, however, consistent with previous studies, all subgroups had high treatment incompletion levels. The findings demonstrate the importance of screening, assessing and treating problem gamblers as a heterogeneous group with different underlying demographics and psychopathologies. It is also hoped future studies will continue to address treatment incompletion with a re-conceptualisation of the term drop-out.
Ponomarev, A B; Fedorov, D N
The paper gives experience with personal computers used at the Academician A.L. Strukov Department of Pathological Anatomy for more than 20 years. It shows the objective necessity of introducing computer technologies at all stages of acquiring skills in anatomical pathology, including lectures, students' free work, test check, etc.
Abouzari, Mehdi; Oberg, Scott; Tata, Matthew
Problemgambling is thought to be comorbid with attention-deficit hyperactivity disorder (ADHD). We tested whether gamblers and ADHD patients exhibit similar reward-related brain activity in response to feedback in a gambling task. A series of brain electrical responses can be observed in the electroencephalogram (EEG) and the stimulus-locked event-related potentials (ERP), when participants in a gambling task are given feedback regardless of winning or losing the previous bet. Here, we used a simplified computerized version of the Iowa Gambling Task (IGT) to assess differences in reinforcement-driven choice adaptation between unmedicated ADHD patients with or without problem gambling traits and contrasted with a sex- and age-matched control group. EEG was recorded from the participants while they were engaged in the task which contained two choice options with different net payouts and win/loss probabilities. Learning trend which shows the ability to acquire and use knowledge of the reward outcomes to obtain a positive financial outcome was not observed in ADHD gamblers versus nongamblers. Induced theta-band (4-8Hz) power over frontal cortex was significantly higher in gamblers versus nongamblers in all different high-risk/low-risk win/lose conditions. Whereas induced low alpha (9-11Hz) power at frontal electrodes could only differentiate high-risk lose between gamblers and nongamblers but not the other three conditions between the two groups. The results indicate that ADHD nongamblers do not share with problem gamblers underlying deficits in reward learning. These pilot data highlight the need for studies of ADHD in gambling to elucidate how motivational states are represented during feedback processing.
Savage, Jeanne E.; Slutske, Wendy S.; Martin, Nicholas G.
Individual differences in personality are likely to play an important role in explaining the propensity to gamble. One of the potential roadblocks to elucidating the relation between personality and gambling may be inadequately accounting for the diversity of gambling activities. The goal of the present study was to provide a comprehensive and nuanced portrait of the relation between personality and gambling by taking a multivariate approach to the co-use of multiple gambling activities and employing a broad inventory of potentially-relevant personality dimensions. Participants were 4,669 individuals from a national Australian twin registry. Structured interviews including an extensive assessment of gambling behaviors were conducted, and personality questionnaires that included the tidimensional Personality Questionnaire, the Sensation Seeking Scale, and the Magical Ideation Scale were completed. A latent class analysis of past-year involvement in 10 different gambling activities was performed to classify the participants into five groups. Unique personality configurations characterized the three more gambling-involved latent classes. Low behavioral control in the context of high negative emotionality and magical thinking typified extensive, versatile gamblers at high risk of gambling problems. Average behavioral control in the context of high negative emotionality and magical thinking typified those who primarily gambled on non-strategic games of chance. Low behavioral control in the context of high positive emotionality and low magical ideation typified those who primarily gambled on strategic games of skill. This study illustrates the value of using a multivariate person-centered approach for characterizing the personality correlates of the multi-faceted phenomenon that is gambling. PMID:25134059
Savage, Jeanne E; Slutske, Wendy S; Martin, Nicholas G
Individual differences in personality are likely to play an important role in explaining the propensity to gamble. One of the potential roadblocks to elucidating the relation between personality and gambling may be inadequately accounting for the diversity of gambling activities. The goal of the present study was to provide a comprehensive and nuanced portrait of the relation between personality and gambling by taking a multivariate approach to the co-use of multiple gambling activities and employing a broad inventory of potentially relevant personality dimensions. Participants were 4,669 individuals from a national Australian twin registry. Structured interviews including an extensive assessment of gambling behaviors were conducted, and personality questionnaires that included the Multidimensional Personality Questionnaire, the Sensation Seeking Scale, and the Magical Ideation Scale were completed. A latent class analysis of past-year involvement in 10 different gambling activities was performed to classify the participants into 5 groups. Unique personality configurations characterized the 3 more gambling-involved latent classes: (a) low behavioral control in the context of high negative emotionality and magical thinking typified extensive, versatile gamblers at high risk of gambling problems; (b) average behavioral control in the context of high negative emotionality and magical thinking typified those who primarily gambled on non-strategic games of chance; (c) low behavioral control in the context of high positive emotionality and low magical ideation typified those who primarily gambled on strategic games of skill. This study illustrates the value of using a multivariate person-centered approach for characterizing the personality correlates of the multifaceted phenomenon that is gambling.
Chen, Thomas J H; Blum, Kenneth; Mathews, Daniel; Fisher, Larry; Schnautz, Nancy; Braverman, Eric R; Schoolfield, John; Downs, Bernard W; Comings, David E
We hypothesize that pathological aggression, a complex behavioral disorder, in adolescents may in part involve polymorphisms of the dopaminergic system. While a number of neurotransmitter systems must be involved, due to polygenic inheritance, one major pathway should involve the dopaminergic system. Advances in our knowledge of the neurobiology of aggression and violence have given rise to rational pharmacological treatments for these behaviors. The main biological systems that are known to be involved are certain reward neurotransmitters including: serotonin, opioid peptides, gamma-aminobutyric acid, and the catecholamines (dopamine and norepinephrine). It is our notion that pathological aggressive behavior is in part similar mechanistically to other forms of impulsive behaviors such as pathological gambling. By analogy to drug dependence, it has been speculated that the underlying pathology in pathological gambling is a reduction in the sensitivity of the reward system. While studying pathological gamblers and controls during a guessing game using functional Magnetic Resonance Imaging, Reuter et al. observed a reduction of ventral striatal and ventromedial prefrontal activation in the pathological gamblers that were negatively correlated with gambling severity. Subsequently, linking hypo activation of these areas to disease severity. A positive correlation of both the dopamine D2 receptor gene (DRD2) and the dopamine transporter gene (DAT1) polymorphisms were observed with pathological violence in adolescents in a blinded clinical trial. Thus, this and other cited work preliminary suggest a role for both the DRD2 and DAT genes in pathological aggressive behavior. We further hypothesize that follow-up gene research in this area, albeit premature, resulting in confirmation of positive correlations with dopaminergic polymorphisms, and utilizing highly screened controls (eliminating any addictive, compulsive and impulsive behaviors in both proband and family) may
Fortune, Erica E.
Research investigating the relationship between gambling and sensation seeking has yet to establish conclusively whether pathological gamblers (PGs) are more or less sensation seeking than nonpathological gamblers (NPGs). Sensation seeking is usually measured with the Zuckerman et al. (J Consult Clin Psychol 46:139–149, 1978) SS Scale form V (SSS-V). Whereas previous studies relied on the SSS-V total score, the current study uses two samples to demonstrate the importance of the SSS-V subscales, which include Thrill and Adventure Seeking (TA), Experience Seeking (ES), Disinhibition (DS), and Boredom Susceptibility (BS). In two samples, strong intrascale correlations between DS and BS, and between TA and ES, suggest that certain subscales reflect similar underlying characteristics. In both samples PGs displayed higher scores than NPGs on the DS and BS subscales, with mean differences in Sample 2 reaching significant levels for both DS and BS. Results support the notion that the SSS-V can be divided into concepts reflecting actual behavior, based on the DS and BS subscales, and hypothetical behavior, based on the TA and ES subscales. Furthermore, PGs appear to have a preference for the more behavioral subscales while NPGs show a preference for the more hypothetical subscales. Reasons for the subscale divisions and preferences are discussed. PMID:19943092
Pincus, Aaron L.; Ansell, Emily B.; Pimentel, Claudia A.; Cain, Nicole M.; Wright, Aidan G. C.; Levy, Kenneth N.
The construct of narcissism is inconsistently defined across clinical theory, social-personality psychology, and psychiatric diagnosis. Two problems were identified that impede integration of research and clinical findings regarding narcissistic personality pathology: (a) ambiguity regarding the assessment of pathological narcissism vs. normal…
Lehr, Hans-Anton; Bosman, Fred T
Communication is an essential element of good medical practice also in pathology. In contrast to technical or diagnostic skills, communication skills are not easy to define, teach, or assess. Rules almost do not exist. In this paper, which has a rather personal character and cannot be taken as a set of guidelines, important aspects of communication in pathology are explored. This includes what should be communicated to the pathologist on the pathology request form, communication between pathologists during internal (interpathologist) consultation, communication around frozen section diagnoses, modalities of communication of a final diagnosis, with whom and how critical and unexpected findings should be communicated, (in-)adequate routes of communication for pathology diagnoses, who will (or might) receive pathology reports, and what should be communicated and how in case of an error or a technical problem. An earlier more formal description of what the responsibilities are of a pathologist as communicator and as collaborator in a medical team is added in separate tables. The intention of the paper is to stimulate reflection and discussion rather than to formulate strict rules.
Tabri, Nassim; Will Shead, N; Wohl, Michael J A
In the current research, we examined whether the known link between relative deprivation and disordered gambling (via delay discounting; i.e., preferences for immediate smaller rewards relative to delayed larger rewards) is moderated by the extent to which gamblers have a financially focused self-concept. Specifically, we hypothesized that delay discounting would be a strong predictor of disordered gambling among those who base their self-worth on their financial success. To test this moderated-mediation model, a community sample of gamblers (N = 239) completed measures that assessed relative deprivation, delay discounting, financially focused self-concept, and disordered gambling severity. As predicted, people who felt more relative deprivation reported more severe symptoms of disordered gambling and this association was mediated by delay discounting. Importantly, this mediated relationship was moderated by the extent to which participants' self-concept was focused on financial success. Among participants whose self-concept was high in financial focus, greater delay discounting (stemming from relative deprivation) was a strong predictor of disordered gambling. Among people whose self-concept was low in financial focus, delay discounting (stemming from relative deprivation) was a weak predictor of disordered gambling. Thus, the magnitude of the indirect effect of relative deprivation on disordered gambling severity was larger among people with a more financially focused self-concept-an effect mediated by delay discounting. These findings suggest that targeting gamblers' financial focus in prevention and treatment interventions may be instrumental in curtailing the development and maintenance of disordered gambling.
Temcheff, Caroline E; Paskus, Thomas S; Potenza, Marc N; Derevensky, Jeffrey L
The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item's diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation ("Have there been periods in the past year where you spent a lot of time thinking about gambling?") was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.
Lloret, Daniel; Montesinos, Rosa; Capafons, Antonio
Cognitive-behavioral therapy for pathological gambling has a long-term success rate of more than 50%. This study evaluated the effect of self-hypnosis in cognitive-behavioral treatment of pathological gamblers. Forty-nine participants were assigned to 2 groups. Both groups received a cognitive-behavioral protocol, and Group 1, the no-hypnosis group, received an 11-session intervention and Group 2, the hypnosis group, received 7 sessions that included self-hypnosis. Both groups were equal in gambling chronicity, frequency, intensity, change motivation, and problems derived from gambling. All participants reported significant improvement in gambling behavior and consequences at both treatment end and 6-month follow-up. Data show no differences between the interventions in abstinence, therapeutic compliance, fulfillment, and satisfaction. Results suggest that self-hypnosis reinforces treatment and can be a supportive technique for future brief interventions.
Despite 75 years of investigation, the concept of pathological grief remains tenuous and controversial. The author turns to the stories of two nineteenth century women, one real and the other fictitious to examine the syndrome of grief gone away. He concludes that pathological grief may be best viewed on a continuum of psychopathology, the expression of which depends upon the interaction between the personality of the patient, the nature of the lost relationship, and the circumstances of its loss.
Dickerson, M; Baron, E
The recent healthy increase in research into all aspects of gambling is noted. The dominant theme accounting for most of this research is the mental disorder model of pathological gambling and measures that have been derived from this conceptualization. It is suggested that an alternative approach focusing on the construct of choice or subjective control over gambling may be a research direction that will ensure that progress is maintained. In this paper a context for the discussion is provided by first identifying briefly fundamental conceptual and methodological issues associated with the mental disorder model. In particular it is argued that the heterogeneity of the diagnosis of pathological gambling makes the research task of assessing truly independent variables extremely difficult. Subsequently an illustrative schema is presented that demonstrates both the potential advantages and some of the complexities associated with the dependent variable of self-control over gambling behaviour. The main advantages are argued to be (a) the focus of research is narrowed to one potential cause of harmful impacts rather than the great diversity of impacts themselves, (b) prospective studies of regular gamblers in real gambling venues may be a key source of insight into the development of pathological gambling and (c) it promotes the development of theoretical links with the mainstream of the discipline of psychology. Despite the conceptual difficulties that may be associated with the variable of self-control, it is suggested that these may be overcome because contemporary research into the addictive behaviours has demonstrated considerable success in the definition and measurement of control and related themes such as craving, restraint and temptation.
Weinstock, Jeremiah; Burton, Steve; Rash, Carla J; Moran, Sheila; Biller, Warren; Krudelbach, Norman; Phoenix, Natalie; Morasco, Benjamin J
Gambling help-lines are an essential access point, or frontline resource, for treatment seeking. This study investigated treatment engagement after calling a gambling help-line. From 2000-2007 over 2,900 unique callers were offered an in-person assessment appointment. Logistic regression analyses assessed predictors of (a) accepting the referral to the in-person assessment appointment and (b) attending the in-person assessment appointment. Over 76% of callers accepted the referral and 55% of all callers attended the in-person assessment appointment. This treatment engagement rate is higher than typically found for other help-lines. Demographic factors and clinical factors such as gender, severity of gambling problems, amount of gambling debt, and coercion by legal and social networks predicted engagement in treatment. Programmatic factors such as offering an appointment within 72 hr also aided treatment engagement. Results suggest gambling help-lines can be a convenient and confidential way for many individuals with gambling problems to access gambling-specific treatment. Alternative services such as telephone counseling may be beneficial for those who do not engage in treatment.
Nowak, Donald E; Aloe, Ariel M
The problem of gambling addiction can be especially noteworthy among college and university students, many of whom have the resources, proximity, free time, and desire to become involved in the myriad options of gambling now available. Although limited attention has been paid specifically to college student gambling in the body of literature, there have been two published meta-analyses estimating the prevalence of probable pathological gambling among college students. This present study aims to be the third, presenting an up-to-date proportion of those students exhibiting gambling pathology, and is the first to include international studies from outside the United States and Canada. The purpose of this study was to use the most up-to-date meta-analytical procedures to synthesize the rates of probable pathological gambling for college and university students worldwide. A thorough literature review and coding procedure resulted in 19 independent data estimates retrieved from 18 studies conducted between 2005 and 2013. To synthesize the studies, a random effects model for meta-analysis was applied. The estimated proportion of probable pathological gamblers among the over 13,000 college students surveyed was computed at 10.23%, considerably higher than either of the two previously published meta-analyses, and more than double the rate reported in the first meta-analysis of this type published in 1999. Implications and recommendations for future practice in dealing with college students and gambling addiction are outlined and described for both administrators and mental health professionals.
Doiron, Jason P; Nicki, Richard M
Although the gambling industry is expanding rapidly throughout North America and around the world, there are only a few empirically evaluated programs aimed at the prevention of pathological gambling (PG). The purpose of this study was to measure the effectiveness of a new prevention program aimed at PG. The Stop & Think! program was designed to teach at-risk video lottery terminal (VLT) gamblers cognitive restructuring and problem-solving skills that may help to prevent the development of PG. These skills were taught through a variety of methods - including an automated educational presentation, video and text vignettes, audio training tapes, and skill rehearsal. The program was evaluated using a randomized, 2-group experimental design with a wait-list control group and pre-, post-, and follow-up measures. Results indicated that, compared with the control group, the experimental group was less at risk for developing a gambling problem after the program. The experimental group endorsed fewer gambling-related cognitive distortions, engaged in less VLT gambling, and had lower scores on a measure of PG. The results of this study provide the basis for the implementation of the Stop & Think! program in the province of Prince Edward Island, Canada, and perhaps other jurisdictions too.
Sinclair, Heidi; Pasche, Sonja; Pretorius, Adele; Stein, Dan J
Pathological gambling is a prevalent and disabling mental illness, which is frequently associated with mood, anxiety, and substance use disorders. However, there is relatively little data on comorbidity in individuals with pathological gambling from low and middle income countries such as South-Africa. The Mini-International Neuropsychiatric Interview was used to assess the frequency of DSM-IV-TR disorders among 100 male and 100 female treatment-seeking individuals with pathological gambling in South-Africa. The Sheehan Disability Scale was used to assess functional impairment. In a South-African sample of individuals with pathological gambling, the most frequent current comorbid psychiatric disorders were major depressive disorder (28%), anxiety disorders (25.5%) and substance use disorders (10.5 %). Almost half of the individuals had a lifetime diagnosis of major depressive disorder (46%). Female pathological gamblers were significantly more likely to be diagnosed with a comorbid major depressive disorder or generalised anxiety disorder than their male counterparts. Data from South-Africa are consistent with previously published data from high income countries. Psychiatric comorbidity is common among individuals with pathological gambling.
Theoretical pathology refers to the attempt to reintroduce methodical approaches from the humanities, philosophical logic and "gestalt philosophy" into medical research and pathology. Diseases, in particular disease entities and more complex polypathogenetic mechanisms of disease, have a "gestalt quality" due to the significance of their pathophysiologic coherence: they have a "gestalt". The Research group Theoretical Pathology at the Academy of Science in Heidelberg are credited with having revitalized the philosophical notion of "gestalt" for morphological and pathological diagnostics. Gestalt means interrelated schemes of pathophysiological significance in the mind of the diagnostician. In pathology, additive and associative diagnostic are simply not possible without considering the notion of synthetic entities in Kant's logic.
Alexander, C B
Comprehensive data show trends in graduate medical education in pathology with regard to the numbers of accredited programs, persons certified from those programs, and demographics of the population of first year-trainees in pathology. Experience with US seniors and foreign-trained physicians in the PGY match process for pathology from 1991 through 2000 is presented, along with data on the types of medical schools generating pathology trainees for the PGY-1 year and the top medical schools of origin of US medical graduates who completed the program and became certified in pathology between 1995 and 1999. The impact of reimbursement of the credentialing year is also addressed through data collected from the PRODS Survey 2000, and those results are reviewed. Finally, turnover rates among pathology program directors of combined AP/CP programs and subspecialty programs since 1994 are presented. An analysis of these trends is provided, along with suggestions to improve both the perception of careers in pathology and the actual choice of a career in pathology.
Clark, Gavin I; Rock, Adam J; McKeith, Charles F A; Coventry, William L
Poker-machine gamblers have been demonstrated to report increases in the urge to gamble following exposure to salient gambling cues. However, the processes which contribute to this urge to gamble remain to be understood. The present study aimed to investigate whether changes in the conscious experience of visual imagery, rationality and volitional control (over one's thoughts, images and attention) predicted changes in the urge to gamble following exposure to a gambling cue. Thirty-one regular poker-machine gamblers who reported at least low levels of problem gambling on the Problem Gambling Severity Index (PGSI), were recruited to complete an online cue-reactivity experiment. Participants completed the PGSI, the visual imagery, rationality and volitional control subscales of the Phenomenology of Consciousness Inventory (PCI), and a visual analogue scale (VAS) assessing urge to gamble. Participants completed the PCI subscales and VAS at baseline, following a neutral video cue and following a gambling video cue. Urge to gamble was found to significantly increase from neutral cue to gambling cue (while controlling for baseline urge) and this increase was predicted by PGSI score. After accounting for the effects of problem-gambling severity, cue-reactive visual imagery, rationality and volitional control significantly improved the prediction of cue-reactive urge to gamble. The small sample size and limited participant characteristic data restricts the generalizability of the findings. Nevertheless, this is the first study to demonstrate that changes in the subjective experience of visual imagery, volitional control and rationality predict changes in the urge to gamble from neutral to gambling cue. The results suggest that visual imagery, rationality and volitional control may play an important role in the experience of the urge to gamble in poker-machine gamblers.
Park, Seung; Pantanowitz, Liron; Parwani, Anil Vasdev
Advances in computing speed and power have made a pure digital work flow for pathology. New technologies such as whole slide imaging (WSI), multispectral image analysis, and algorithmic image searching seem poised to fundamentally change the way in which pathology is practiced. This article provides the practicing pathologist with a primer on digital imaging. Building on this primer, the current state of the art concerning digital imaging in pathology is described. Emphasis is placed on WSI and its ramifications, showing how it is useful in both anatomic (histology, cytopathology) and clinical (hematopathology) pathology. Future trends are also extrapolated.
Park, Seung; Parwani, Anil; Satyanarayanan, Mahadev; Pantanowitz, Liron
Handheld computing has had many applications in medicine, but relatively few in pathology. Most reported uses of handhelds in pathology have been limited to experimental endeavors in telemedicine or education. With recent advances in handheld hardware and software, along with concurrent advances in whole-slide imaging (WSI), new opportunities and challenges have presented themselves. This review addresses the current state of handheld hardware and software, provides a history of handheld devices in medicine focusing on pathology, and presents future use cases for such handhelds in pathology. PMID:22616027
Sakellariou, S; Patsouris, E
Pathology is the field of medicine that studies diseases. Ancient Greece hosted some of the earliest societies that laid the structural foundations of pathology. Initially, knowledge was based on observations but later on the key elements of pathology were established based on the dissection of animals and the autopsy of human cadavers. Christianized Greece under Ottoman rule (1453-1821) was not conducive to the development of pathology. After liberation, however, a series of events took place that paved the way for the establishment and further development of the specialty. The appointment in 1849 of two Professors of Pathology at the Medical School of Athens for didactical purposes proved to be the most important step in fostering the field of pathology in modern Greece. Presently in Greece there are seven university departments and 74 pathology laboratories in public hospitals, employing 415 specialized pathologists and 90 residents. The First Department of Pathology at the Medical School of Athens University is the oldest (1849) and largest in Greece, encompassing most pathology subspecialties.
Although the incidence of pathological grief does not appear to be high, the morbidity and mortality of sufferers is significant. Because of attitudes about grieving and the reluctance to experience grief, patients may avoid sharing grief with the family physician, who may then fail to recognize pathological grief. This article discusses clinical manifestations and situations which can lead to pathological grief. The types of pathological grief—chronic, inhibited, delayed, and atypical—are also discussed, along with personality variables which predispose some people to difficult grieving. Failure to grieve may also lead to a higher incidence of physical disease and various forms of mental illness. In order to manage grief, the physician must encourage the patient to express all his feelings of sadness, anger, and guilt; reassure him that his anger and guilt are a normal reaction to loss; and later, give him permission to stop grieving. PMID:21279045
Kalkhoven, Carla; Sennef, Cor; Peeters, Ard; van den Bos, Ruud
Huntington’s disease (HD) is a genetic, neurodegenerative disorder, which specifically affects striatal neurons of the indirect pathway, resulting in a progressive decline in muscle coordination and loss of emotional and cognitive control. Interestingly, predisposition to pathological gambling and other addictions involves disturbances in the same cortico-striatal circuits that are affected in HD, and display similar disinhibition-related symptoms, including changed sensitivity to punishments and rewards, impulsivity, and inability to consider long-term advantages over short-term rewards. Both HD patients and pathological gamblers also show similar performance deficits on risky decision-making tasks, such as the Iowa Gambling Task (IGT). These similarities suggest that HD patients are a likely risk group for gambling problems. However, such problems have only incidentally been observed in HD patients. In this review, we aim to characterize the risk of pathological gambling in HD, as well as the underlying neurobiological mechanisms. Especially with the current rise of easily accessible Internet gambling opportunities, it is important to understand these risks and provide appropriate patient support accordingly. Based on neuropathological and behavioral findings, we propose that HD patients may not have an increased tendency to seek risks and start gambling, but that they do have an increased chance of developing an addiction once they engage in gambling activities. Therefore, current and future developments of Internet gambling possibilities and related addictions should be regarded with care, especially for vulnerable groups like HD patients. PMID:24765067
Tricker, Christopher; Rock, Adam J; Clark, Gavin I
In order to enhance our understanding of the nature of poker-machine problem-gambling, a community sample of 37 poker-machine gamblers (M age = 32 years, M PGSI = 5; PGSI = Problem Gambling Severity Index) were assessed for urge to gamble (responses on a visual analogue scale) and altered state of consciousness (assessed by the Altered State of Awareness dimension of the Phenomenology of Consciousness Inventory) at baseline, after a neutral cue, and after a gambling cue. It was found that (a) problem-gambling severity (PGSI score) predicted increase in urge (from neutral cue to gambling cue, controlling for baseline; sr (2) = .19, p = .006) and increase in altered state of consciousness (from neutral cue to gambling cue, controlling for baseline; sr (2) = .57, p < .001), and (b) increase in altered state of consciousness (from neutral cue to gambling cue) mediated the relationship between problem-gambling severity and increase in urge (from neutral cue to gambling cue; κ(2) = .40, 99 % CI [.08, .71]). These findings suggest that cue-reactive altered state of consciousness is an important component of cue-reactive urge in poker-machine problem-gamblers.
Pulford, Justin; Bellringer, Maria; Abbott, Max; Clarke, Dave; Hodgins, David; Williams, Jeremy
This paper presents barriers to help-seeking data as reported by users of a national gambling helpline (help-seekers, HS, N = 125) as well as data pertaining to perceived barriers to seeking help as reported by gamblers recruited from the general population (non-help-seekers, NHS, N = 104). All data were collected via a structured, multi-modal survey. When asked to identify actual or perceived barriers to seeking help, responses indicative of pride (78% of HS participants, 84% of NHS participants), shame (73% of HS participants, 84% of NHS participants) or denial (87% of NHS participants) were most frequently reported. These three factors were also most often identified as the real or perceived primary barrier to help-seeking (collectively accounting for 55% of HS, and 60% of NHS, responses to this question) and were the only barriers to be identified by more than 10% of either HS and NHS participants without prompting. It was of note, however, that participants in both groups identified multiple barriers to help-seeking (mean of 6.7 and 12.2, respectively) and that, when presented with a list of 21 possible barrier items, NHS participants endorsed 19 of the listed items significantly more often than their HS counterparts. The implications of these findings, with respect to promoting greater or earlier help-seeking activity amongst problem gamblers, are discussed.
Goodwin, Belinda C.; Browne, Matthew; Rockloff, Matthew; Donaldson, Phillip
A diverse class of stimuli, including certain foods, substances, media, and economic behaviours, may be described as ‘reward-oriented’ in that they provide immediate reinforcement with little initial investment. Neurophysiological and personality concepts, including dopaminergic dysfunction, reward sensitivity and rash impulsivity, each predict the existence of a latent behavioural trait that leads to increased consumption of all stimuli in this class. Whilst bivariate relationships (co-morbidities) are often reported in the literature, to our knowledge, a multivariate investigation of this possible trait has not been done. We surveyed 1,194 participants (550 male) on their typical weekly consumption of 11 types of reward-oriented stimuli, including fast food, salt, caffeine, television, gambling products, and illicit drugs. Confirmatory factor analysis was used to compare models in a 3×3 structure, based on the definition of a single latent factor (none, fixed loadings, or estimated loadings), and assumed residual covariance structure (none, a-priori / literature based, or post-hoc / data-driven). The inclusion of a single latent behavioural ‘consumption’ factor significantly improved model fit in all cases. Also confirming theoretical predictions, estimated factor loadings on reward-oriented indicators were uniformly positive, regardless of assumptions regarding residual covariances. Additionally, the latent trait was found to be negatively correlated with the non-reward-oriented indicators of fruit and vegetable consumption. The findings support the notion of a single behavioural trait leading to increased consumption of reward-oriented stimuli across multiple modalities. We discuss implications regarding the concentration of negative lifestyle-related health behaviours. PMID:26551907
Akilesh, Shreeram; Juaire, Noemie; Duffield, Jeremy S; Smith, Kelly D
Ifosfamide is a nitrogen mustard alkylating agent used as both a first-line and a salvage chemotherapeutic agent in the treatment of testicular germ cell tumors, various sarcomas, carcinomas, and some lymphomas. A well-known complication of ifosfamide therapy is transient acute kidney injury. However, in a minority of patients, the reduction in kidney function is progressive and permanent, sometimes occurring long after exposure to ifosfamide. Scattered reports have described the pathologic findings in kidneys permanently affected by ifosfamide toxicity. We present the findings of an illustrative case and review the pathology and molecular mechanisms of long-term ifosfamide toxicity with implications for personalized medicine.
Lorin de la Grandmaison, Geoffroy
Gunshot wounds are among the most complex traumatic lesions encountered in forensic pathology. At the time of autopsy, careful scrutiny of the wounds is essential for correct interpretation of the lesions. Complementary pathological analysis has many interests: differentiation between entrance and exit wounds, estimation of firing distance, differentiation between vital and post mortem wounds and wounds dating. In case of multiple headshots, neuropathological examination can provide arguments for or against suicide. Sampling of gunshot wounds at autopsy must be systematic. Pathological data should be confronted respectively to autopsy and death scene investigation data and also ballistic studies. Forensic pathologist must be aware of the limits of optic microscopy.
Kong, Grace; Tsai, Jack; Krishnan-Sarin, Suchitra; Cavallo, Dana A.; Hoff, Rani A.; Steinberg, Marvin A.; Rugle, Loreen; Potenza, Marc N.
Objectives To identify subtypes of adolescent gamblers based on the 10 Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria for pathological gambling and the 9 Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria for gambling disorder and to examine associations between identified subtypes with gambling, other risk behaviors, and health/functioning characteristics. Methods Using cross-sectional survey data from 10 high schools in Connecticut (N = 3901), we conducted latent class analysis to classify adolescents who reported past-year gambling into gambling groups on the basis of items from the Massachusetts Gambling Screen. Adolescents also completed questions assessing demographic information, substance use (cigarette, marijuana, alcohol, and other drugs), gambling behaviors (relating to gambling formats, locations, motivations, and urges), and health/functioning characteristics (eg, extracurricular activities, mood, aggression, and body mass index). Results The optimal solution consisted of 4 classes that we termed low-risk gambling (86.4%), at-risk chasing gambling (7.6%), at-risk negative consequences gambling (3.7%), and problem gambling (PrG) (2.3%). At-risk and PrG classes were associated with greater negative functioning and more gambling behaviors. Different patterns of associations between at-risk and PrG classes were also identified. Conclusions Adolescent gambling classifies into 4 classes, which are differentially associated with demographic, gambling patterns, risk behaviors, and health/functioning characteristics. Early identification and interventions for adolescent gamblers should be sensitive to the heterogeneity of gambling subtypes. PMID:25275877
The class of Reptilia varies widely. Both the gross morphology and microscopic anatomy of the kidneys are specific for each species. In each species of reptile, the physiology of the renal system has adapted to the specific conditions of life, including, among other factors, the type of food, environmental temperature, and the availability of water. The pathology of the kidneys in reptiles has been poorly studied, but in recent years a number of investigators have specifically studied reptilian renal pathology.
Ong, Beng Beng; Milne, Nathan
One of the requirements for proper running of a pathology laboratory is implementation of a quality assurance programme. Forensic pathology is not exempted, especially so when cases are increasing in complexity. It is not difficult to introduce a quality assurance programme even in a small forensic centre. Among the steps that can be implemented including introduction of a set of minimal standards in performance of the autopsy, timeliness and report writing, a vigorous peer review process either internally or externally and participation in external quality programmes. Proper documentation of the post-mortem process (photography, slides and blocks and various imaging modalities) is to be encouraged. There should be limits set on workload of pathologists as overburden is known to lower standards. A pleasant work environment is also essential. Personal continuous medical education should be made mandatory. Introduction of a quality assurance programme will not only improve standards but minimise possible negligence. The post-mortem reports will be seen to carry more weight in court.
Nečas, Pavel; Hejna, Petr
The phenomenon of eponymous terms in forensic pathology is described in this paper. The authors analyzed representative textbooks (monographs) dealing with forensic pathology in both English and German and identified several eponymous terms. The paper aims to present to the reader the most important eponymous terms in forensic pathology. Included in the paper are the following terms: Beckwith's Sign, Casper's Rule, Krönlein's Shot, Lichtenberg's Figures, Nysten's Law, Paltauf's Spots, Puppe's Rule, Sehrt's Sign, Simon's Sign, Sveshnikov's Sign, Tardieu's Spots, Wischnewski Spots, Wydler's Sign. The spread of eponymous terms throughout various languages is mentioned. The linguistic basis of such terms as well as their advantages and disadvantages in specialist fields, and indeed in even wider circles, is discussed. The authors state that the main function of these terms is to facilitate the open flow of unambiguous information among scholars. Eponymous terms in forensic pathology are characteristic for the German speaking countries and for all countries influenced by the German school of forensic pathology. Their usage in the Anglo-Saxon world is much less widespread, meaning they do not occur very often in English monographs and textbooks.
Sansone, Lori A.
Obesity is a significant health problem in the United States. Therefore, it is extremely important to understand potential clinical associations with obesity, including personality pathology. From studies of personality disorders in other types of eating pathology, it appears that restrictive personality disorders (e.g., obsessive-compulsive disorder) are associated with restrictive eating pathology (e.g., anorexia nervosa, restricting type) whereas impulsive personality disorders (e.g., borderline personality disorder) are associated with impulsive eating pathology (e.g., anorexia nervosa, binge-eating/purging type; bulimia nervosa, binge eating disorder). Because binge eating disorder is oftentimes associated with an obese status, it seems likely that borderline personality disorder may also be associated with obesity. At the present time, there appear to be nine accessible studies in this area, comprising 639 obese individuals. While rates of borderline personality disorder in these studies vary from 2.2 to 94.1 percent, 10 of 19 measures detected this disorder at rates of 25 percent or higher, and the average of all percentages is 26.9 percent. Findings appear to support the association between impulsive personality pathology and impulsive eating pathology, and underscore that a significant minority of obese individuals may suffer from borderline personality disorder. PMID:23696958
Burns, R. J.; Jones, A. N.; Robertson, J. S.
After nothing the rarity of papers describing the pathology of delayed radiation necrosis of the spinal cord, the clinical and pathological findings from four cases are presented. The main pathological features are asymmetric demyelination of the lateral columns and to a lesser degree the posterior and anterior columns of white matter, with coagulative necrosis at the level of irradiation which affected the grey matter to a lesser degree. There is ascending and descending secondary tract degeneration, and poor glial response in the lesions themselves. Vascular changes, mainly hyalilne thickening of arteriolar walls, are present, but not in degree sufficient to explain the primary lesion. The discussion of the pathogenesis of the myelopathy weighs the merits of a primary vascular lesion against those of a primary effect of the radiation on neural tissue. The latter is favoured. Images PMID:4647860
Doyle, Leona A; Hornick, Jason L
Mastocytosis encompasses a group of clinically and pathologically heterogeneous disorders most commonly involving the skin, which typically takes the form of urticaria pigmentosa. Mastocytosis may also involve other organs, most often bone marrow, followed by gastrointestinal tract, liver, spleen, and lymph nodes. The presence of extracutaneous involvement by mastocytosis is a major diagnostic criterion for systemic disease. However, mast cell infiltrates are often subtle in skin and extracutaneous organs, and the histologic features of mastocytosis at different anatomic sites may be variable. This article reviews the pathologic features and clinical correlates of mastocytosis involving skin and other extramedullary sites.
Carr, Katelyn A; Daniel, Tinuke Oluyomi; Lin, Henry; Epstein, Leonard H
Obesity is, in part, a result of positive energy balance or energy intake exceeding physiological needs. Excess energy intake is determined by a series of food choices over time. These choices involve both motivational and executive function processes. Problems arise when there is excessive motivation to eat and low impulse control, a situation we have termed reinforcement pathology. Motivational and executive function processes have also been implicated in the development of drug dependence and addiction. In this review we discuss the application of reinforcement pathology to obesity, and implications of this approach for obesity treatment.
Weinberg, D S; Doolittle, M
Much of the diagnostic work in pathology, especially surgical pathology and cytology, involves the interpretation of images. Recent advances in digital imaging technologies and telecommunications will allow pathologists to use image-based information in ways that are not possible using conventional glass slides alone. We are entering an age in which image-based information can be more easily and widely shared, both locally and globally. In this article, some of the digital technologies that can allow pathologists to make more effective use of diagnostic images will be discussed.
Jones, Richard Martin
It has become increasingly apparent that nonlinearity and complexity are the norm in human physiological systems, the relevance of which is informing an enhanced understanding of basic pathological processes such as inflammation, the host response to severe trauma, and critical illness. This article will explore how an understanding of nonlinear systems and complexity might inform the study of the pathophysiology of deaths of medicolegal interest, and how 'complexity thinking' might usefully be incorporated into modern forensic medicine and forensic pathology research, education and practice.
Person changes can be of three kinds: developmental trends, swells, and tremors. Person unreliability in the tremor sense (momentary fluctuations) can be estimated from person characteristic curves. Average person reliability for groups can be compared from item characteristic curves. (Author)
Lukowitsky, Mark R; Pincus, Aaron L
Impairments in self and interpersonal functioning are core features of personality pathology. Clinical theory and research indicate that compromised self-awareness and distorted interpersonal perceptions are particularly prominent in individuals exhibiting pathological narcissism and Narcissistic Personality Disorder. Therefore we conducted a study to gain a better understanding of interpersonal perception of pathological narcissism. A large sample (N=437) of moderately acquainted individuals assigned to 1 of 93 small mixed-sex groups completed self- and informant ratings on the Pathological Narcissism Inventory (PNI) in a round-robin design. The social relations model (SRM) was used to partition the variance in dyadic ratings to investigate several hypotheses about interpersonal perception of pathological narcissism. SRM analyses demonstrated evidence of assimilation (the tendency to perceive and rate others similarly) and consensus (the extent to which multiple observers form similar impressions of another person) in interpersonal perception of pathological narcissism. Results also indicated modest self-other agreement and assumed similarity (the tendency for people to perceive others as similar to themselves) for PNI higher order factors and subscale ratings. Finally, results suggested that individuals high in pathological narcissism had some awareness of how peers would rate them (metaperception) but believed that others would rate them similarly to how they rated themselves.
Heckendorn, Emily; Auerbach, Aaron
An overview of the pathology of extranodal lymphoma is presented. The emphasis of this presentation is on the classification system of extranodal lymphomas, including both B-cell and T-cell lymphomas, based on their morphology, phenotype, and molecular alterations.
Joshi, V. V.
This report describes the renal pathology in three siblings with hereditary nephritis. All three cases showed combined features of chronic glomerulonephritis, pyelonephritis, and interstitial nephritis. Foam cells were seen in only one case. These findings support the contention of Krickstein, Gloor, and Balogh (1966) that the renal changes in hereditary nephritis are those of a mixed nephritis. Images PMID:5717545
The 24th European Congress of Pathology taking place in Prague is an opportunity to remind our society of the Czech names appearing as eponyms in pathological terminology: Karel Rokitanský - R. protuberance in dermoid cyst; R. thrombogenic theory of atherosclerosis; Mayer - R. - Küster - Hauser - Winckel syndrome (congenital malformation of the vagina and uterus); Václav Treitz - T. duodenal ligament; T. retroperitoneal hernia; T. uremic colitis; Vilém Dušan Lambl - L. excrescences of heart valves; Lamblia (Giardia) intestinalis, and also the foundation of urological cytology; Stanislav Provázek - Prowazek - Halberstädter bodies (trachoma), Rickettsia Prowazeki (typhus fever); Josef Vaněk - V. tumor (gastric inflammatory fibroid polyp), and also discovery of the etiology of pneumocystic pneumonia; Otto Jírovec - Pneumocystis Jiroveci; Blahoslav Bednář - B. tumor (pigmented dermatofibrosarcoma protuberans).
Stenzinger, A; Penzel, R; Endris, V; Weichert, W
Tissue-based molecular diagnostics is a fast growing diagnostic field, which already complements morphologic classifications in many cases. Pathology based molecular diagnosis is performed almost exclusively on paraffin embedded material and always in conjunction with histopathology. Besides the classic field of tissue based detection of pathogenic organisms such as bacteria, viruses and fungi, molecular diagnostics of tumor tissue is one of the current hot topics in oncology. In this context the detection of predictive molecular biomarkers, such as specific mutations, allows patient stratification for individually tailored treatment strategies and thereby is one of the key components of individualized patient care in oncology. The rapidly growing number of clinically relevant predictive biomarkers together with impressive technical advances, specifically the development of massive parallel sequencing, will modify the care of patients with malignant diseases. Pathology, therefore, has returned in the very center of interdisciplinary patient care.
Rampy, B Alan; Glassy, Eric F
The underutilized practice of photographing anatomic pathology specimens from surgical pathology and autopsies is an invaluable benefit to patients, clinicians, pathologists, and students. Photographic documentation of clinical specimens is essential for the effective practice of pathology. When considering what specimens to photograph, all grossly evident pathology, absent yet expected pathologic features, and gross-only specimens should be thoroughly documented. Specimen preparation prior to photography includes proper lighting and background, wiping surfaces of blood, removing material such as tubes or bandages, orienting the specimen in a logical fashion, framing the specimen to fill the screen, positioning of probes, and using the right-sized scale.
Singh, Jatinder P; Kumar, Shwetam; Kathiria, Atman V; Harjai, Rachit; Jawed, Akram; Gupta, Vikas
Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered. PMID:27857468
Miranda García, M; Gutiérrez Teira, B
The eosinophilic esofagitis is a pathology that consists of an inflammatory condition of the esophagus, which is characterized for having a high percentage of eosinophils. It is a problem of allergic origin and his diagnosis is increasing in the population, especially in children and adult young persons, throughout last decade. The fisiopathology is not completely established nowadays. The diagnosis is confirmed with endoscopia and capture of biopsies. The differential diagnosis is necessary to be done with the disease for reflux gastroesofágico, gastroenteritis eosinofílica, by Crohn's disease, pathology of connective fabric, syndrome hipereosinofílico, infections and response of hypersensitivity to medicaments. Nowadays there is no a treatment that is definitive. We present a clinical case, which was valued initially for the consultation of Primary care.
McGregor, Thomas B.; Pike, John G.; Leonard, Michael P.
OBJECTIVE To review the differences between physiologic and pathologic phimosis, review proper foreskin care, and discuss when it is appropriate to seek consultation regarding a phimotic foreskin. SOURCES OF INFORMATION This paper is based on selected findings from a MEDLINE search for literature on phimosis and circumcision referrals and on our experience at the Children’s Hospital of Eastern Ontario Urology Clinic. MeSH headings used in our MEDLINE search included “phimosis,” “referral and consultation,” and “circumcision.” Most of the available articles about phimosis and foreskin referrals were retrospective reviews and cohort studies (levels II and III evidence). MAIN MESSAGE Phimosis is defined as the inability to retract the foreskin. Differentiating between physiologic and pathologic phimosis is important, as the former is managed conservatively and the latter requires surgical intervention. Great anxiety exists among patients and parentsregarding non-retractile foreskins. Most phimosis referrals seen in pediatric urology clinics are normal physiologically phimotic foreskins. Referrals of patients with physiologic phimosis to urology clinics can create anxiety about the need for surgery among patients and parents, while unnecessarily expanding the waiting list for specialty assessment. Uncircumcised penises require no special care. With normal washing, using soap and water, and gentle retraction during urination and bathing, most foreskins will become retractile over time. CONCLUSION Physiologic phimosis is often seen by family physicians. These patients and their parents require reassurance of normalcy and reinforcement of proper preputial hygiene. Consultation should be sought when evidence of pathologic phimosis is present, as this requires surgical management. PMID:17872680
Berkowitz, E N
Effective marketing of the pathology practice is essential in the face of an increasingly competitive market. Successful marketing begins with a market-driven planning process. As opposed to the traditional planning process used in health care organizations, a market-driven approach is externally driven. Implementing a market-driven plan also requires recognition of the definition of the service. Each market to which pathologists direct their service defines the service differently. Recognition of these different service definitions and creation of a product to meet these needs could lead to competitive advantages in the marketplace.
Mansoor, Nyaish; Mansoor, Tihami; Ahmed, Mansoor
In the United Kingdom, newborn assessment incorporates a screening eye examination for any structural abnormalities, observation of neonate's visual behaviour and direct ophthalmoscopy examination looking for red reflex. Early identification and immediate management of eye related pathologies should commence soon after birth as early diagnosis and prompt intervention may have significant impact on the prognosis for many potentially blinding but treatable disorders such as congenital cataracts and retinoblastoma. If left undetected and untreated, such problems may potentially lead to irreversible damage to the vision which persists into adulthood resulting in lack of self-confidence together with difficulties in educational attainment and job opportunities. PMID:28003988
Clark, R P
Toxic effects of formaldehyde in humans are discussed in relation to occupational exposure and tolerance to this agent. Carcinogenic and mutagenic properties of formaldehyde have been reported in animals and this has led to concern about a possible role in human cancer. The current state of affairs is reviewed in the light of a lack of direct evidence linking formaldehyde with cancer in man and in relation to recommended exposure levels. It is important to employ effective means of containment and practical methods for reducing exposure to formaldehyde in pathology departments and post-mortem rooms are described. Images PMID:6223948
Achab, Sophia; Chatton, Anne; Khan, Riaz; Thorens, Gabriel; Penzenstadler, Louise; Zullino, Daniele; Khazaal, Yasser
Pathological gambling (PG) is an addictive disorder with harm related to the high psychiatric comorbidity and increased suicidal risk. Prevalence rates in general population range from 0.2% to 2.1%. Problem gamblers are hard to attract to treatment programs for several proper reasons and for obstacles (e.g., accessibility). To address these obstacles, primary care (where the problem gambling (PrG) prevalence seems to be 6.2%) has a crucial role to play (i.e., identifying and referring patients to specialized treatment programs and treating at first line when needed and possible) in the era of online gambling offer expansion. The present work aimed to collect data on resources in the field from GPs themselves, using a 24-item online questionnaire. Swiss French-speaking participants were asked about their screening practice and knowledge. The results state that the vast majority of them are aware of the existence and the potential impact of PrG on their patients. However, PrG screening is not systematic and their knowledge of adequate treatments or referral methods is scarce. GPs being central to health screening in general, targeted advice and training on short screening tools and better knowledge of referral pathways should be promoted and continued to empower the GP's management skills in a public health approach. PMID:25243136
Achab, Sophia; Chatton, Anne; Khan, Riaz; Thorens, Gabriel; Penzenstadler, Louise; Zullino, Daniele; Khazaal, Yasser
Pathological gambling (PG) is an addictive disorder with harm related to the high psychiatric comorbidity and increased suicidal risk. Prevalence rates in general population range from 0.2% to 2.1%. Problem gamblers are hard to attract to treatment programs for several proper reasons and for obstacles (e.g., accessibility). To address these obstacles, primary care (where the problem gambling (PrG) prevalence seems to be 6.2%) has a crucial role to play (i.e., identifying and referring patients to specialized treatment programs and treating at first line when needed and possible) in the era of online gambling offer expansion. The present work aimed to collect data on resources in the field from GPs themselves, using a 24-item online questionnaire. Swiss French-speaking participants were asked about their screening practice and knowledge. The results state that the vast majority of them are aware of the existence and the potential impact of PrG on their patients. However, PrG screening is not systematic and their knowledge of adequate treatments or referral methods is scarce. GPs being central to health screening in general, targeted advice and training on short screening tools and better knowledge of referral pathways should be promoted and continued to empower the GP's management skills in a public health approach.
Macher, A M
The acquired immunodeficiency syndrome (AIDS) is a devastating new disease caused by the human immunodeficiency virus (HIV). This retrovirus causes profound immunoincompetence in its infected hosts, who are thereafter susceptible to develop myriad severe and relapsing protozoal, fungal, bacterial, viral, and arthropodal opportunistic infections, as well as unusual malignancies. The more than 50,000 patients who have developed AIDS in the United States have produced a sudden unexpected deluge of diagnostic dilemmas that are stressing laboratories of pathology everywhere. This paper describes the gross and microscopic pathology of the numerous complications in patients infected by HIV: (a) the prodromal AIDS-related complex with persistent generalized lymphadenopathy, (b) lymphoid infiltration of salivary gland and lung, including the complex of lymphoid interstitial pneumonitis-pulmonary lymphoid hyperplasia, (c) extranodal non-Hodgkin's lymphomas, (d) multifocal mucocutaneous and visceral Kaposi's sarcoma, (e) small cell undifferentiated (oat cell) carcinomas, (f) protozoal infections caused by Pneumocystis carinii, Toxoplasma gondii, Acanthamoeba, Cryptosporidium species (sp.), and Isospora belli, (g) the causes of chronic enteritis, (h) mycotic infections caused by Candida sp., Cryptococcus neoformans, Histoplasma capsulatum, Coccidioides immitis, and Sporothrix schenckii, (i) bacterial infections caused by Mycobacterium avium-intracellulare, M. tuberculosis, M. kansasii, Nocardia sp., Listeria monocytogenes, Legionella sp., Treponema pallidum, and others, (j) viral infections caused by cytomegalovirus, herpes simplex and zoster, polyomavirus (progressive multifocal leukoencephalopathy), hepatitis B, molluscum contagiosum, and papillomavirus, (k) oral hairy leukoplakia, (l) subacute encephalopathy, and (m) Norwegian scabies. PMID:2836878
Hubbs, Ann F.; Sargent, Linda M.; Porter, Dale W.; Sager, Tina M.; Chen, Bean T.; Frazer, David G.; Castranova, Vincent; Sriram, Krishnan; Nurkiewicz, Timothy R.; Reynolds, Steven H.; Battelli, Lori A.; Schwegler-Berry, Diane; McKinney, Walter; Fluharty, Kara L.; Mercer, Robert R.
Nanotechnology involves technology, science, and engineering in dimensions less than 100 nm. A virtually infinite number of potential nanoscale products can be produced from many different molecules and their combinations. The exponentially increasing number of nanoscale products will solve critical needs in engineering, science, and medicine. However, the virtually infinite number of potential nanotechnology products is a challenge for toxicologic pathologists. Because of their size, nanoparticulates can have therapeutic and toxic effects distinct from micron-sized particulates of the same composition. In the nanoscale, distinct intercellular and intracellular translocation pathways may provide a different distribution than that obtained by micron-sized particulates. Nanoparticulates interact with subcellular structures including microtubules, actin filaments, centrosomes, and chromatin; interactions that may be facilitated in the nanoscale. Features that distinguish nanoparticulates from fine particulates include increased surface area per unit mass and quantum effects. In addition, some nanotechnology products, including the fullerenes, have a novel and reactive surface. Augmented microscopic procedures including enhanced dark-field imaging, immunofluorescence, field-emission scanning electron microscopy, transmission electron microscopy, and confocal microscopy are useful when evaluating nanoparticulate toxicologic pathology. Thus, the pathology assessment is facilitated by understanding the unique features at the nanoscale and the tools that can assist in evaluating nanotoxicology studies. PMID:23389777
Sutter, P M; Regazzoni, P
Pathological fractures will be encountered in increasing frequency due to more patients with cancer, surviving a longer period. The skeleton is the third most frequent localization for metastases. Breast cancer is still the most common primary tumor, but bone metastases from lung cancer seem to be diagnosed more and more. Despite of finding metastases most often in the spinal column, fractures are seen mostly at the femoral site. A pathological fracture and, in almost all cases, an impending fracture are absolute indication for operation. An exact definition of an "impending fracture" is still lacking; it is widely accepted, that 50 per cent of bone mass must be destroyed before visualization in X-ray is possible, thus defining an impending fracture. The score system by Mirels estimates the fracture risk by means of four parameters (localization, per cent of destructed bone mass, type of metastasis, pain). Improving quality of life, relieving pain, preferably with a single operation and a short length of stay are the goals of (operative) treatment. For fractures of the proximal femur, prosthetic replacement, for fractures of the subtrochanteric region or the shaft, intramedullary nails are recommended. Postoperative radiation therapy possibly avoids tumor progression. In patient with a good long term prognosis, tumor should be removed locally aggressive.
Vijgen, Sandrine; Terris, Benoit
Intrahepatic cholangiocarcinoma (iCC) is a primary carcinoma of the liver with increasing significance and major pathogenic, clinical and therapeutic challenges. Classically, it arises from malignant transformation of cholangiocytes bordering small portal bile duct (BD) to second-order segmental large BDs. It has three major macroscopic growth pattern [mass-forming (MF), periductal infiltrative (PI), and intraductal growth (IG)] and histologically is a desmoplastic stroma-rich adenocarcinoma with cholangiocyte differentiation. Recent data pointed out noteworthy degree of heterogeneity in regards of their epidemiology and risk factors, pathological and molecular features, pathogenesis, clinical behaviors and treatment. Notably, several histological variants are described and can coexist within the same tumor. Several different cells of origin have also been depicted in a fraction of iCCs, amongst which malignant transformation of ductules, of hepatic stem/progenitor cells, of periductal glands or through oncogenic reprogramming of adult hepatocytes. A degree of pathological overlap with hepatocellular carcinoma (HCC) may be observed in a portion of iCC. A series of precursor lesions are today characterized and emphasize the existence of a multistep carcinogenesis process. Overall, these new data have brought up in proposal of new histological or molecular classifications, which could soon replace current anatomic-based classification and could have major impact on establishment of prognosis and on development of novel target treatment approaches. PMID:28261592
Liu, Angen; Pollard, Kai
A biobank is an entity that collects, processes, stores, and distributes biospecimens and relevant data for use in basic, translational, and clinical research. Biobanking of high-quality human biospecimens such as tissue, blood and other bodily fluids along with associated patient clinical information provides a fundamental scientific infrastructure for personalized medicine. Identification of biomarkers that are specifically associated with particular medical conditions such as cancer, cardiovascular disease and neurological disorders are useful for early detection, prevention, and treatment of the diseases. The ability to determine individual tumor biomarkers and to use those biomarkers for disease diagnosis, prognosis and prediction of response to therapy is having a very significant impact on personalized medicine and is rapidly changing the way clinical care is conducted. As a critical requirement for personalized medicine is the availability of a large collection of patient samples with well annotated patient clinical and pathological data, biobanks thus play an important role in personalized medicine advancement. The goal of this chapter is to explore the role of biobanks in personalized medicine and discuss specific needs regarding biobank development for translational and clinical research, especially for personalized medicine advancement.
Gibson, J. B.; Carson, Nina A. J.; Neill, D. W.
Pathological findings are described in four cases of a new aminoaciduria in which homocystine is excreted in the urine. All the patients were mentally retarded children. Three of them presented diagnostic features of Marfan's syndrome. Necropsy on one case and biopsy findings in the others are described. Fatty change occurs in the liver. The most striking lesions are vascular. Metachromatic medial degeneration of the aorta and of the elastic arteries in the necropsied case are considered in relation to Marfan's syndrome. Other changes, particularly thrombosis which is prevalent in homocystinuria, suggest the possibility of a platelet defect. The findings are discussed in respect of an upset in the metabolism of sulphur-containing amino-acids and with particular reference to Marfan's syndrome. Images PMID:14195630
Cholangiocarcinoma (CC) arises from the biliary epithelium and in most cases represents adenocarcinoma. Pathomorphological evaluation is of decisive impact for the prognosis and management of CC. Morphological subtyping (histotype; hilar vs peripheral type), TNM classification, lymphatic spread, and resection margin status are of prognostic relevance. Distinction from hepatic metastases may be aided by immunohistology and clinico-pathological correlation. There is convincing evidence of the development of CC via premalignant lesions, especially biliary intraepithelial neoplasia, although further knowledge about the biology and diagnostic definition of these lesions has to be accumulated. Currently, there are no established molecular markers of prognosis or therapeutic target structures to be evaluated at the tissue level. Future progress is needed and expected in novel differential diagnostic and predictive markers, in uniform definition of resection margin status and further understanding of molecular and morphological changes in the development of CC. PMID:18773061
Lipscomb, T.P.; Harris, Richard K.; Rebar, A.H.; Ballachey, Brenda E.; Haebler, Romona J.; Loughlin, Thomas R.
In the months following the Exxon Valdez oil spill (EVOS), 994 sea otters (Enhydra lutris) from oil-spill-affected areas died (Doroff et al. 1993). Carcasses collected from these areas and otters that died in rehabilitation centers are included in this number. The actual number that died was probably much greater.Within days of the spill, the Exxon Company (USA) funded an effort to rehabilitate oil-contaminated sea otters (Davis 1990). Initially, clinical veterinarians working on the rehabilitation effort performed partial necropsies on some of the sea otters that died. Soon, veterinary pathologists from the University of Alaska and the U.S. Environmental Protection Agency provided assistance. Later, rehabilitation centers were constructed and other veterinarians with special training in pathology were hired by Exxon to provide diagnostic support.In late April 1989, veterinary pathologists from the U.S. Fish and Wildlife Service (USFWS) assumed responsibility for pathologic evaluation of oil-spill-affected sea otters. The USFWS requested assistance from veterinary pathologists of the Armed Forces Institute of Pathology (AFIP) in June 1989. Eventually, as part of the Natural Resources Damage Assessment program, AFIP veterinary pathologists were asked to carry out histopathological studies of the tissue specimens collected by all parties and to perform necropsies on carcasses that had been collected and frozen. A veterinary clinical pathologist was requested to assess hematology and clinical chemistry findings in otters that had been held in the rehabilitation centers.In spite of the best efforts of many dedicated people working under extremely difficult conditions, there are significant limitations in the pathological studies. The absence of a detailed necropsy protocol and of full documentation of necropsy findings during the first several weeks after the spill resulted in important data being lost. Often, samples of all major organs were not collected. In some
Lee, Jaeseok; Chen, Chih-Chien; Song, Hak-Jun; Lee, Choong-Ki
This study revised the theory of planned behavior (TPB) by incorporating the new concepts of gambling passion and responsible gambling strategy (RGS) to predict gamblers' intention to gamble in online sports betting. The data were collected at the end of March in 2012 through an online gambling website. The findings indicated that the inclusion of two types of gambling passion and two types of RGS explains online gambling intention well. Specifically, out of the original antecedent predictors of TPB, attitude toward online gambling was positively related to harmonious passion. Subjective norm had a positive relationship with both harmonious and obsessive passion. The results also showed that perceived behavioral control does not have a significant effect on the two gambling passions but has a direct and significant influence on behavioral intention. Additionally, the compulsory RGS had a negative effect on obsessive passion, whereas supplementary RGS had concurrent positive impacts on harmonious and obsessive passion. Lastly, the two gambling passions were notable predictors of behavioral intention toward online sports betting.
Galle, Omer R.; And Others
Evidence of high population density's serious inhibiting effects on the reproductive, aggressive, withdrawal and sexual behavior of various animals, motivated a study of human pathology in overcrowded areas. Ecological relationships in Chicago and their impact on human behavior were assessed. The number of persons per acre, Standardized Mortality…
Jordan, Holly L; Register, Thomas C; Tripathi, Niraj K; Bolliger, Anne Provencher; Everds, Nancy; Zelmanovic, David; Poitout, Florence; Bounous, Denise I; Wescott, Debra; Ramaiah, Shashi K
Most published reviews of preclinical toxicological clinical pathology focus on the fundamental aspects of hematology, clinical chemistry, coagulation, and urinalysis in routine toxicology animal species, for example, rats, mice, dogs, and nonhuman primates. The objective of this continuing education course was to present and discuss contemporary examples of nonroutine applications of clinical pathology endpoints used in the drug development setting. Area experts discussed bone turnover markers of laboratory animal species, clinical pathology of pregnant and growing laboratory animals, clinical pathology of nonroutine laboratory animal species, and unique applications of the Siemens Advia(®) hematology analyzer. This article is a summary based on a presentation given at the 31st Annual Symposium of the Society of Toxicologic Pathology, during the Continuing Education Course titled "Nontraditional Applications of Clinical Pathology in Drug Discovery and Preclinical Toxicology."
Morton, Daniel; Sellers, Rani S; Barale-Thomas, Erio; Bolon, Brad; George, Catherine; Hardisty, Jerry F; Irizarry, Armando; McKay, Jennifer S; Odin, Marielle; Teranishi, Munehiro
Pathology peer review verifies and improves the accuracy and quality of pathology diagnoses and interpretations. Pathology peer review is recommended when important risk assessment or business decisions are based on nonclinical studies. For pathology peer review conducted before study completion, the peer-review pathologist reviews sufficient slides and pathology data to assist the study pathologist in refining pathology diagnoses and interpretations. Materials to be reviewed are selected by the peer-review pathologist. Consultations with additional experts or a formal (documented) pathology working group may be used to resolve discrepancies. The study pathologist is solely responsible for the content of the final pathology data and report, makes changes resulting from peer-review discussions, initiates the audit trail for microscopic observations after all changes resulting from peer-review have been made, and signs the final pathologist's report. The peer-review pathologist creates a signed peer-review memo describing the peer-review process and confirming that the study pathologist's report accurately and appropriately reflects the pathology data. The study pathologist also may sign a statement of consensus. It is not necessary to archive working notes created during the peer-review process.
Advises child psychiatrists to use personality disorder diagnoses sparingly; to be aware of the constraints on adaptability of normal variations of temperament; and to positively diagnose those rare pathological impairments of personality brought about by minimal cerebral dysfunction, schizoid traits, and traits of excessive shyness. (RH)
Disney, Krystle L; Weinstein, Yana; Oltmanns, Thomas F
Divorce is associated with a multitude of outcomes related to health and well-being. Data from a representative community sample (N = 1,241) of St. Louis residents (ages 55-64) were used to examine associations between personality pathology and divorce in late midlife. Symptoms of the 10 DSM-IV personality disorders were assessed with the Structured Interview for DSM-IV Personality and the Multisource Assessment of Personality Pathology (both self and informant versions). Multiple regression analyses showed Paranoid and Histrionic personality disorder symptoms to be consistently and positively associated with number of divorces across all three sources of personality assessment. Conversely, Avoidant personality disorder symptoms were negatively associated with number of divorces. The present paper provides new information about the relationship between divorce and personality pathology at a developmental stage that is understudied in both domains.
Baliasnyĭ, M M
Five types of pathological synkinesis (++blepharo-ocular, ++blepharo-facial, ++bucco-manual, ++digito-digital on the hands, ++pedo-digital) are described. They are of definite importance for revealing pyramidal pathology including its early stages as well as for objective evaluation and observation of the time-course of changes in the illness.
Personality disorders are a group of mental illnesses. They involve long-term patterns of thoughts and behaviors ... serious problems with relationships and work. People with personality disorders have trouble dealing with everyday stresses and ...
Native Hawaiian forests are characterised by a high degree of endemism, including pathogens as well as their hosts. With the exceptions of koa (Acacia koa Gray), possibly maile (Alyxia oliviformis Gaud.), and, in the past, sandalwood (Santalum spp.), forest species are of little commercial value. On the other hand, these forests are immensely important from a cultural, ecological, and evolutionary standpoint. Forest disease research was lacking during the mid-twentieth century, but increased markedly with the recognition of ohia (Metrosideros polymorpha Gaud.) decline in the 1970s. Because many pathogens are themselves endemic, or are assumed to be, having evolved with their hosts, research emphasis in natural areas is on understanding host-parasite interactions and evolutionary influences, rather than disease control. Aside from management of native forests, attempts at establishing a commercial forest industry have included importation of several species of pine, Araucaria, and Eucalyptus as timber crops, and of numerous ornamentals. Diseases of these species have been introduced with their hosts. The attacking of native species by introduced pathogens is problematic - for example, Armillaria mellea (Vahl ex Fr.) Que??l. on koa and mamane (Sophora chrysophylla (Salisb.) Seem.). Much work remains to be done in both native and commercial aspects of Hawaiian forest pathology.
Haltia, M; Tarkkanen, A; Kivelä, T
Ocular pathology in the first European case of human bat-borne rabies is described. The patient was a 30-year-old bat scientist who seven weeks after bat bite developed neurological symptoms and died 23 days later. Rabies virus antigens were detected in brain smears. After extensive virological studies the virus turned out to be a rabies-related virus, closely resembling the Duvenhage virus isolated from bats in South Africa in 1980. By light microscopy focal chronic inflammatory infiltration of the ciliary body and of the choroid was found. PAS-positive exudate was seen in the subretinal and in the outer plexiform layers of the retina, and retinal veins showed endothelial damage and perivascular inflammation. Many of the retinal ganglion cells were destroyed. The presence of rabies-related viral antigen in the retinal ganglion cells was shown by positive cytoplasmic immunofluorescence, though electron microscopy failed to identify definite viral structures in the retina. By immunohistochemistry glial fibrillary acidic protein was observed in the Müller's cells, which are normally negative for this antigen but express it as a reactive change when the retina is damaged. Synaptophysin, a constituent of presynaptic vesicles of normal retinal neurons, was not detected in the retina. Images PMID:2920157
Sica, Antonio; Erreni, Marco; Allavena, Paola; Porta, Chiara
Macrophages are cells of the innate immunity constituting the mononuclear phagocyte system and endowed with remarkable different roles essential for defense mechanisms, development of tissues, and homeostasis. They derive from hematopoietic precursors and since the early steps of fetal life populate peripheral tissues, a process continuing throughout adult life. Although present essentially in every organ/tissue, macrophages are more abundant in the gastro-intestinal tract, liver, spleen, upper airways, and brain. They have phagocytic and bactericidal activity and produce inflammatory cytokines that are important to drive adaptive immune responses. Macrophage functions are settled in response to microenvironmental signals, which drive the acquisition of polarized programs, whose extremes are simplified in the M1 and M2 dichotomy. Functional skewing of monocyte/macrophage polarization occurs in physiological conditions (e.g., ontogenesis and pregnancy), as well as in pathology (allergic and chronic inflammation, tissue repair, infection, and cancer) and is now considered a key determinant of disease development and/or regression. Here, we will review evidence supporting a dynamic skewing of macrophage functions in disease, which may provide a basis for macrophage-centered therapeutic strategies.
Domingo, M; Vidal, E; Marco, A
Bovine tuberculosis (bTB) is a chronic granulomatous caseous-necrotising inflammatory process that mainly affects the lungs and their draining lymph nodes (Ln.). The pathological changes associated with bTB infection reflect the interplay between the host defence mechanisms and the mycobacterial virulence factors and the balance between the immunologic protective responses and the damaging inflammatory processes. Inhalation is the most common infection route and causes lesions of the nasopharynx and lower respiratory tract, including its associated lymph nodes. The initial infection (primary complex) may be followed by chronic (post-primary) tuberculosis or may be generalised. Goat tuberculosis often produces liquefactive necrosis and caverns, similarly to human TB. The assessment of the severity of TB lesions is crucial for vaccine trials. Semi-quantitative gross lesion scoring systems have been developed for cattle, but imaging technology has allowed the development of more standardised, objective, and quantitative methods, such as multi-detector computed tomography (MDCT), which provides quantitative measures of lesion volume.
Ferrando, Matteo; Bagnasco, Diego; Varricchi, Gilda; Bernardi, Stefano; Bragantini, Alice; Passalacqua, Giovanni
Allergic disease is among the most common pathologies worldwide and its prevalence has constantly increased up to the present days, even if according to the most recent data it seems to be slightly slowing down. Allergic disease has not only a high rate of misdiagnosis and therapeutic inefficacy, but represents an enormous, resource-absorbing black hole in respiratory and general medicine. The aim of this paper is to summarize principal therapeutic innovations in atopic disease management befallen in the recent years in terms of personalized/precision medicine. PMID:27826958
Dragicevic, Simo; Percy, Christian; Kudic, Aleksandar; Parke, Jonathan
As the popularity of internet gambling increases, the increased opportunities to participate serve to heighten concerns about the potential for gambling related harm. This paper focuses on self-exclusion as one of the main responsible gaming interventions, and is split into three sections. Firstly, we set out a three-tier model for assessing at-risk gambling behaviors which examines player exhibited, declared and inferred behavior. Secondly, we present a literature review relating to who self-excludes and whether self-exclusion is effective. Finally, we report the results of an analysis of the exhibited behavior of internet self-excluders as sampled from a research cohort of over 240,000 internet gaming accounts. Our analysis of self-excluders (N = 347) versus a control group (N = 871) of gamblers indicates self-excluders are younger than the control group, more likely to suffer losses and more likely to adopt riskier gambling positions. Unlike some previous studies, there was little difference in terms of mean gambling hours per month or minutes per session. Some self-excluders (N = 306) can be tracked from the date their account was created through their self-exclusion history, indicating a large number of very quick self-exclusions (e.g., 25 % within a day) and a small set of serial self-excluders. Younger and older males are likely to self-exclude faster than middle-aged males (N = 242), but there is no such age pattern across female self-excluders (N = 63).
Pincus, Aaron L; Ansell, Emily B; Pimentel, Claudia A; Cain, Nicole M; Wright, Aidan G C; Levy, Kenneth N
The construct of narcissism is inconsistently defined across clinical theory, social-personality psychology, and psychiatric diagnosis. Two problems were identified that impede integration of research and clinical findings regarding narcissistic personality pathology: (a) ambiguity regarding the assessment of pathological narcissism vs. normal narcissism and (b) insufficient scope of existing narcissism measures. Four studies are presented documenting the initial derivation and validation of the Pathological Narcissism Inventory (PNI). The PNI is a 52-item self-report measure assessing 7 dimensions of pathological narcissism spanning problems with narcissistic grandiosity (Entitlement Rage, Exploitativeness, Grandiose Fantasy, Self-sacrificing Self-enhancement) and narcissistic vulnerability (Contingent Self-esteem, Hiding the Self, Devaluing). The PNI structure was validated via confirmatory factor analysis. The PNI correlated negatively with self-esteem and empathy, and positively with shame, interpersonal distress, aggression, and borderline personality organization. Grandiose PNI scales were associated with vindictive, domineering, intrusive, and overly-nurturant interpersonal problems, and vulnerable PNI scales were associated with cold, socially avoidant, and exploitable interpersonal problems. In a small clinical sample, PNI scales exhibited significant associations with parasuicidal behavior, suicide attempts, homicidal ideation, and several aspects of psychotherapy utilization.
Tsokos, Michael; Erbersdobler, Andreas
Peliosis is a pathological entity characterized by the gross appearance of multiple cyst-like, blood-filled cavities within parenchymatous organs. Peliosis has been related to several underlying debilitating illnesses such as tuberculosis, hematological malignancies, the acquired immunodeficiency syndrome (AIDS), and post-transplant immunodeficiency, as well as intravenous drug abuse, chronic alcoholism, and in conjunction with the intake of oral contraceptives or steroids. The classical pathoanatomical concept is based upon the opinion that peliosis exclusively develops in organs belonging to the mononuclear phagocytic system (liver, spleen, bone marrow, and lymph nodes). However, a paucity of studies indicates that other organs such as lungs, parathyroid glands, and kidneys may be affected too. Concerning the underlying pathogenetic mechanisms of onset and maintenance of peliosis, the morphological data obtained by different investigators suggest that there is more than one path of formal pathogenesis (e.g., congenital malformation of vessels manifesting under altered local intravascular pressure conditions, acquired vascular disorder triggered by toxic noxae, active proliferation of vessels corresponding to the benign end on the spectrum of neoplastic vascular lesions). In the liver, at gross inspection, the peliotic lesions give the cut sections a "swiss cheese" appearance. Microscopically, two different types of peliosis can be distinguished in the liver: (1) "parenchymal peliosis" consisting of irregular cavities that are neither lined by sinusoidal cells nor by fibrous tissue, and (2) "phlebectatic peliosis" characterized by regular, spherical cavities lined by endothelium and/or fibrosis. One of the differential diagnoses that most closely resembles peliosis hepatis is secondary hepatic congestion due to veno-occlusive disease or the Budd-Chiari syndrome. In the spleen, the peliotic lesions may be arranged sporadically, disseminated, or in clusters in an
The tremendous advances in treatment brought about by corticotherapy applied to cutaneo-mucosal pathology should not be allowed to obscure the fact that its action is merely palliative, that it should only be proceeded with after careful diagnosis and that it may trigger undesirable side-effects. General corticotherapy is definitely indicated in certain serious dermatoses (e.g. pemphigus vulgaris) in large doses at the beginning of the course of treatment which often has to be kept up indefinitely; it is in these patients that the most serious accidents occur. It is also indicated in other dermatoses (e.g. lichen planus) in smaller doses and in separate courses, generally triggering incidents and accidents of a less serious nature which to a certain extent seem to be attenuated by taking the drug on alternate days. It is counter-indicated in one particular condition: psoriasis. Corticotherapy by intra- and sub-lesional local injection is most useful in the treatment of certain localised skin lesions (e.g. cheloids) and of the oral mucosa (e.g. erosive lichen planus). Either a few drops are injected or a larger quantity in a suspension of microcrystals. Complications have sometimes been observed in the skin (leukoderma, dermoepidermatrophia and, particularly, amaurosis), but never so far after sub-mucosal injections. Local corticotherapy by external application, very widely used in the form of ointments, creams and lotions for numerous cutaneous conditions may cause various more or less serious local side-effects, the systemic effects with depression of the hypophyso-adrenal axis, only seem to occur to any extent with occlusive dressings. It can also be used in the treatment of some conditions of the oral mucosa (e.g. some forms of lichen planus, benign mucous membrane pemphigoid) by means of either a corticosteroid incorporated into a special excipient which adheres to the mucous membrane or in tablets of 17-betamethasone valerate which gradually break up in the
Guénolé, Fabian; Marcaggi, Geoffrey; Baleyte, Jean-Marc; Garma, Lucile
Although most of scientific knowledge in dream research is based on young adult studies, this article provides a review of the effects of normal and pathological aging on dream psychology. It starts with preliminary comments about epistemological and methodological principles of dream research, its singularities in aged persons, and the modifications of sleep physiology with age. The whole literature agrees that dream recall progressively decreases from the beginning of adulthood - not in old age - and that dream reports become less intense, perceptually and emotionally. This evolution occurs faster in men than women, with gender differences in the content of dreams. The chronological modifications could be explained partly by changes in lifestyle and attitude towards dreams in early adulthood, but mainly by modifications of sleep physiology, particularly the decrease and qualitative changes of rapid eye movement (REM) sleep. Dreams have usually little subjective importance in the mental life of aged persons. However, working with dreams can be a valuable tool for psychotherapy in the aged. According to the few existing data, patients suffering degenerative dementia dream much less than healthy aged persons. In Alzheimer's disease, this could be linked to the decrease of REM sleep, and atrophy of associative sensory areas of the cerebral cortex. Most studied aspects of dreaming in degenerative cognitive disorders are REM sleep behavior disorders, and nightmares induced by cholinesterase inhibitors. More studies are needed to better characterize the evolution of dreams with age, particularly studies performed in sleep laboratory.
Guo, Huazhang; Birsa, Joe; Farahani, Navid; Hartman, Douglas J.; Piccoli, Anthony; O’Leary, Matthew; McHugh, Jeffrey; Nyman, Mark; Stratman, Curtis; Kvarnstrom, Vanja; Yousem, Samuel; Pantanowitz, Liron
Background: The adoption of digital pathology offers benefits over labor-intensive, time-consuming, and error-prone manual processes. However, because most workflow and laboratory transactions are centered around the anatomical pathology laboratory information system (APLIS), adoption of digital pathology ideally requires integration with the APLIS. A digital pathology system (DPS) integrated with the APLIS was recently implemented at our institution for diagnostic use. We demonstrate how such integration supports digital workflow to sign-out anatomical pathology cases. Methods: Workflow begins when pathology cases get accessioned into the APLIS (CoPathPlus). Glass slides from these cases are then digitized (Omnyx VL120 scanner) and automatically uploaded into the DPS (Omnyx® Integrated Digital Pathology (IDP) software v.1.3). The APLIS transmits case data to the DPS via a publishing web service. The DPS associates scanned images with the correct case using barcode labels on slides and information received from the APLIS. When pathologists remotely open a case in the DPS, additional information (e.g. gross pathology details, prior cases) gets retrieved from the APLIS through a query web service. Results: Following validation of this integration, pathologists at our institution have signed out more than 1000 surgical pathology cases in a production environment. Integration between the APLIS and DPS enabled pathologists to review digital slides while simultaneously having access to pertinent case metadata. The introduction of a digital workflow eliminated costly manual tasks involving matching of glass slides and avoided delays waiting for glass slides to be delivered. Conclusion: Integrating the DPS and APLIS were instrumental for successfully implementing a digital solution at our institution for pathology sign-out. The integration streamlined our digital sign-out workflow, diminished the potential for human error related to matching slides, and improved the sign
Lewandrowski, Kent; Black-Schaffer, Steven
There is relatively little published literature concerning utilization management in anatomic pathology. Nonetheless there are many utilization management opportunities that currently exist and are well recognized. Some of these impact only the cost structure within the pathology department itself whereas others reduce charges for third party payers. Utilization management may result in medical legal liabilities for breaching the standard of care. For this reason it will be important for pathology professional societies to develop national utilization guidelines to assist individual practices in implementing a medically sound approach to utilization management.
Wartberg, Lutz; Sack, Peter-Michael; Petersen, Kay-Uwe; Thomasius, Rainer
In Germany, the internet is used by 69.4% of the population or 49 million people, and 100% of adolescents (between 14 to 19 years of age) spend time in the internet at least occasionally. An excessive use of the internet may lead to negative psychosocial consequences and changes in behaviour. This phenomenon is named "pathological internet use". Until now, there are only few studies published that investigate mental well being in German adolescents with pathological internet use. 16 participants of an outpatient treatment program for pathological internet use and 16 healthy adolescents were compared on self-reported levels of psychopathology (SPS-J), achievement motivation (FLM 7-13) and personal experience of attention deficit (FEDA). There were no differences in age, gender, intelligence or education between the two groups. Pathological internet users exhibited significantly elevated scores on self-esteem problems and the summary score of the SPS-J and significantly lower scores on FLM 7-13-dimensions "achievement ambition" and "perseverance/diligence" compared to controls. The results revealed that adolescents with pathological internet use report a higher level of psychopathology and lower levels of achievement motivation and drive. These findings should be taken into account when conceptualizing treatments for pathological internet users.
Arias-Stella, Javier; Krüger, Hever; Recavarren, Sixto
Arias-Stella, J., Krüger, H., and Recavarren, S. (1973).Thorax, 28, 701-708. Pathology of chronic mountain sickness. Pathological data on chronic mountain sickness are scarce due to the fact that the disease is ameliorated or cured by descent to a low altitude. In this report we describe a case of chronic mountain sickness occurring in a woman of 48 years at Cerro de Pasco (4,300 m above sea level). The necropsy findings are compared with the limited pathological observations reported by others. It is apparent from our findings that in fatal cases the main changes are located within the pulmonary circulation. So far histological studies have been reported only in cases of the secondary form of chronic mountain sickness. The basic pathology of the primary form (Monge's disease) remains to be defined. Images PMID:4787982
Lushnikov, E F
The lecture gives the state-of-the-art of the methodology of human pathology that is an area of the scientific and practice activity of specialists to produce and systematize objective knowledge of pathology and to use the knowledge in clinical medicine. It considers the objects and subjects of an investigation, materials and methods of a pathologist, and the results of his/her work.
This article features a mathematical game called "Mystery Person." The author describes how the Mystery Person game was tried with first-graders [age 6]. The Mystery games involve the generation of key questions, the coordination of information--often very complex information--and the formulation of consequences based on this…
Wagner, June G.
This newsletter presents four articles designed to help business educators educate learners in grades K-12 about personal finance. "Now More Than Ever: The Need for Financial Literacy" examines the following topics: evidence that the United States is becoming a nation of debtors; the plummeting personal savings rate; the increasing…
Jubb, Adrian M; Koeppen, Hartmut; Reis-Filho, Jorge S
The rapid pace of drug discovery and drug development in oncology, immunology and ophthalmology brings new challenges; the efficient and effective development of new targeted drugs will require more detailed molecular classifications of histologically homogeneous diseases that show heterogeneous clinical outcomes. To this end, single companion diagnostics for specific drugs will be replaced by multiplex diagnostics for entire therapeutic areas, preserving tissue and enabling rapid molecular taxonomy. The field will move away from the development of new molecular entities as single agents, to which resistance is common. Instead, a detailed understanding of the pathological mechanisms of resistance, in patients and in preclinical models, will be key to the validation of scientifically rational and clinically effective drug combinations. To remain at the heart of disease diagnosis and appropriate management, pathologists must evolve into translational biologists and biomarker scientists. Herein, we provide examples of where this metamorphosis has already taken place, in lung cancer and melanoma, where the transformation has yet to begin, in the use of immunotherapies for ophthalmology and oncology, and where there is fertile soil for a revolution in treatment, in efforts to classify glioblastoma and personalize treatment. The challenges of disease heterogeneity, the regulatory environment and adequate tissue are ever present, but these too are being overcome in dedicated academic centres. In summary, the tools necessary to overcome the 'whens' and 'ifs' of the molecular revolution are in the hands of pathologists today; it is a matter of standardization, training and leadership to bring these into routine practice and translate science into patient benefit. This Annual Review Issue of the Journal of Pathology highlights the central role for pathology in modern drug discovery and development.
Ortigo, Kile M; Westen, Drew; Bradley, Bekh
Research into personality factors related to suicidality suggests substantial variability among suicide attempters. A potentially useful approach that accounts for this complexity is personality subtyping. As part of a large sample looking at personality pathology, this study used Q-factor analysis to identify subtypes of 311 adult suicide attempters using Shedler-Westen Assessment Procedure-II personality profiles. Identified subtypes included internalizing, emotionally dysregulated, dependent, hostile-isolated, psychopathic, and anxious somatizing. Subtypes differed in hypothesized ways on criterion variables that address their construct validity, including adaptive functioning, Axis I and II comorbidity, and etiology-related variables (e.g., history of abuse). Furthermore, dimensional ratings of the subtypes predicted adaptive functioning above DSM-based diagnoses and symptoms.
Personal competencies--cognitive, metacognitive, motivational, and social/emotional--are applied by students in learning (mastery of knowledge and skills). These competencies are both acquired through learning and applied in the learning process. Personalized learning--a promising approach to education made practical by advances in…
Chowdhury, Nahian S; Livesey, Evan J; Blaszczynski, Alex; Harris, Justin A
Motor impulsivity, which is an impairment in withholding and cancelling inappropriate responses, may account for the inability for pathological gamblers (PGs) to inhibit their urges to gamble. The aim of this systematic review was to perform a quantitative and qualitative synthesis of existing studies in order to assess whether PGs without comorbid substance use disorder have elevated motor impulsivity, relative to healthy controls. An exhaustive literature search led to the identification of 20 studies which met inclusion criteria. A meta-analysis was then conducted on the following measures: stop signal reaction time from the stop signal task; commission errors, omission errors, and Go reaction time from the Go/No-Go task; and the motor impulsiveness subscale of the Barratt Impulsiveness Scale (BIS-Motor). The results revealed a moderate to large mean effect size of stop signal reaction time, small to moderate mean effect sizes for commission errors, omission errors and Go reaction time, and a large mean effect size for the BIS-Motor. Significant heterogeneity in effect sizes was observed on most behavioural measures, but not for the BIS-Motor or omission errors on the Go/No-Go task. Overall, these results suggest that motor impulsivity may be one of the features of PG psychopathology, accounting for their poor inhibitory control over gambling behaviours. Moreover, other deficits in sustained attention, or more generally in executive/cognitive control, may be present in PGs. We discuss the implications, limitations of existing research, and suggested avenues for future studies, particularly the need to acknowledge heterogeneity amongst PGs and amongst different behavioural measures.
Berghuis, Han; Kamphuis, Jan H; Verheul, Roel
This study examined the associations of specific personality traits and general personality dysfunction in relation to the presence and severity of Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders in a Dutch clinical sample. Two widely used measures of specific personality traits were selected, the Revised NEO Personality Inventory as a measure of normal personality traits, and the Dimensional Assessment of Personality Pathology-Basic Questionnaire as a measure of pathological traits. In addition, 2 promising measures of personality dysfunction were selected, the General Assessment of Personality Disorder and the Severity Indices of Personality Problems. Theoretically predicted associations were found between the measures, and all measures predicted the presence and severity of DSM-IV personality disorders. The combination of general personality dysfunction models and personality traits models provided incremental information about the presence and severity of personality disorders, suggesting that an integrative approach of multiple perspectives might serve comprehensive assessment of personality disorders.
Toong, Hoo-min D.; Gupta, Amar
Describes the hardware, software, applications, and current proliferation of personal computers (microcomputers). Includes discussions of microprocessors, memory, output (including printers), application programs, the microcomputer industry, and major microcomputer manufacturers (Apple, Radio Shack, Commodore, and IBM). (JN)
Aymamí, N.; Jiménez-Murcia, S.; Granero, R.; Ramos-Quiroga, J. A.; Fernández-Aranda, F.; Claes, L.; Sauvaget, A.; Grall-Bronnec, M.; Gómez-Peña, M.; Savvidou, L. G.; Fagundo, A. B.; del Pino-Gutierrez, A.; Moragas, L.; Casas, M.; Penelo, E.; Menchón, J. M.
Objectives. (1) To assess the current presence of ADHD symptoms among patients seeking treatment for gambling disorder; (2) to explore clinical and sociodemographic differences between patients who score high and low on the measure of ADHD symptoms; (3) to analyze whether the presence of ADHD symptoms is associated with more severe psychopathology and with specific personality traits; (4) to analyze the mediating role of ADHD symptoms in the relationship between novelty seeking and gambling severity. Method. A total of 354 consecutive patients were administered an extensive battery assessing gambling behavior, psychopathology, and personality traits. Results. Male and female gamblers did not differ significantly in their mean scores on the ADHD measure. However, younger participants aged 18–35 scored higher. Higher ADHD scores were also associated with greater severity of gambling disorder and more general psychopathology. Regarding personality traits, high persistence and self-directedness were negatively related to ADHD scores, while in women alone a positive correlation was found between ADHD scores and scores on harm avoidance and self-transcendence. Conclusion. The presence of ADHD symptoms in both male and female gambling disorder patients may act as an indicator of the severity of gambling, general psychopathology, and dysfunctional personality traits. PMID:26229967
Bickel, Warren K.; Johnson, Matthew W.; Koffarnus, Mikhail N.; MacKillop, James; Murphy, James G.
The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics. PMID:24679180
Bickel, Warren K; Johnson, Matthew W; Koffarnus, Mikhail N; MacKillop, James; Murphy, James G
The field of behavioral economics has made important inroads into the understanding of substance use disorders through the concept of reinforcer pathology. Reinforcer pathology refers to the joint effects of (a) the persistently high valuation of a reinforcer, broadly defined to include tangible commodities and experiences, and/or (b) the excessive preference for the immediate acquisition or consumption of a commodity despite long-term negative outcomes. From this perspective, reinforcer pathology results from the recursive interactions of endogenous person-level variables and exogenous environment-level factors. The current review describes the basic principles of behavioral economics that are central to reinforcer pathology, the processes that engender reinforcer pathology, and the approaches and procedures that can repair reinforcement pathologies. The overall goal of this review is to present a new understanding of substance use disorders as viewed by recent advances in behavioral economics.
Karst, Stephanie M; Zhu, Shu; Goodfellow, Ian G
Norovirus infection in humans typically results in acute gastroenteritis but may also occur in many animal species. Noroviruses are recognized as one of the most common causes of acute gastroenteritis in the world, being responsible for almost 20% of all cases. Despite their prevalence and impact, our knowledge of the norovirus life cycle and the pathological processes associated with norovirus-induced disease is limited. Whilst infection of the intestine is the norm, extraintestinal spread and associated pathologies have also been described. In addition, long-term chronic infections are now recognized as a significant cause of morbidity and mortality in the immunocompromised. This review aims to summarize the current state of knowledge with respect to norovirus pathology and the underlying mechanisms that have been characterized to date.
Malik, R A
Pathologic study of a disease provides insights into the precise mechanisms and targets of damage and may provide insights into new therapies. The main targets in diabetic neuropathy are myelinated and unmyelinated fibers as dysfunction and damage to them explains the symptoms of painful neuropathy and the major end points of foot ulceration and amputation as well as mortality. Demyelination and axonal degeneration are established hallmarks of the pathology of human diabetic neuropathy and were derived from pioneering light and electronmicroscopic studies of sural nerve biopsies in the late 1960s and early 1970s. Additional abnormalities, which are relevant to the pathogenesis of human diabetic neuropathy, include pathology of the microvessels and extracellular space. Intraepidermal and sudomotor nerve quantification in skin biopsies provides a minimally invasive means for the detection of early nerve damage. Studies of muscle biopsies are limited and show significant alterations in the expression of neurotrophins, but limited changes in muscle fiber size and capillary density.
Pop, Monica; Gheorghe, Alina
Vitreous role in the pathophysiology of retinal diseases has increased importantly over the recent years. This was possible using Optical Coherence Tomography which reviewed the way the vitreoretinal interface should be looked at and defined and classified new pathologies such as Vitreoretinal Traction Syndrome. Vitreous is not an empty space but an important anatomical structure with role in ocular physiology. With age biochemical changes occur so that vitreous starts to liquefy. Once the vitreous is liquefied (sinchisis) it collapses and passes in the retrohialoid space (sineresis). In complete PVD besides sinchisis there is a weakness of the adherence between the posterior cortex and ILM with total detachment of posterior cortex. Abnormal adhesions are associated with incomplete PVD. The definition and understanting of vitreoretinal pathology is an active and continuous process, PVD being the trigger of a lot of retinal pathologies: epiretinal membrane, macular hole, tractional macular oedema, VMTS, myopic traction maculopathy, exacerbations of exudative ARMD.
Zander, Heike; Claes, Laurence; Voth, Eva M.; de Zwaan, Martina; Müller, Astrid
Aim To investigate impulsive behaviors in pathological buying (PB). Methods The study included three groups matched for age and gender: treatment seeking outpatients with PB (PB+), treatment seeking psychiatric inpatients without PB (PB−), and a healthy control group (HC). PB was assessed by means of the Compulsive Buying Scale and by the impulse control disorder (ICD) module of the research version of the Structured Clinical Interview for DSM-IV (SCID-ICD). All participants answered questionnaires concerning symptoms of borderline personality disorder, self-harming behaviors, binge eating and symptoms of attention deficit and hyperactivity disorder (ADHD). In addition, comorbid ICDs were assessed using the SCID-ICD. Results The PB+ and PB− groups did not differ with regard to borderline personality disorder or ADHD symptoms, but both groups reported significantly more symptoms than the HC group. Frequencies of self-harming behaviors did not differ between the three groups. Patients with PB were more often diagnosed with any current ICD (excluding PB) compared to those without PB and the HC group (38.7% vs. 12.9% vs. 12.9%, respectively, p=.017). Discussion Our findings confirm prior research suggesting more impulsive behaviors in patients with and without PB compared to healthy controls. The results of the questionnaire-based assessment indicate that outpatients with PB perceive themselves equally impulsive and self-harm as frequently as inpatients without PB; but they seem to suffer more often from an ICD as assessed by means of an interview. PMID:27415604
Porter, LF; Black, GCM
Porter L.F., Black G.C.M. Personalized ophthalmology. Clin Genet 2014: 86: 1–11. © 2014 The Authors. Clinical Genetics published by John Wiley & Sons A/S. Published by John Wiley & Sons Ltd., 2014 Ophthalmology has been an early adopter of personalized medicine. Drawing on genomic advances to improve molecular diagnosis, such as next-generation sequencing, and basic and translational research to develop novel therapies, application of genetic technologies in ophthalmology now heralds development of gene replacement therapies for some inherited monogenic eye diseases. It also promises to alter prediction, diagnosis and management of the complex disease age-related macular degeneration. Personalized ophthalmology is underpinned by an understanding of the molecular basis of eye disease. Two important areas of focus are required for adoption of personalized approaches: disease stratification and individualization. Disease stratification relies on phenotypic and genetic assessment leading to molecular diagnosis; individualization encompasses all aspects of patient management from optimized genetic counseling and conventional therapies to trials of novel DNA-based therapies. This review discusses the clinical implications of these twin strategies. Advantages and implications of genetic testing for patients with inherited eye diseases, choice of molecular diagnostic modality, drivers for adoption of personalized ophthalmology, service planning implications, ethical considerations and future challenges are considered. Indeed, whilst many difficulties remain, personalized ophthalmology truly has the potential to revolutionize the specialty. PMID:24665880
Chemerinski, Eran; Triebwasser, Joseph; Roussos, Panos; Siever, Larry J
Early phenomenological descriptions of schizophrenia have acknowledged the existence of milder schizophrenia spectrum disorders characterized by the presence of attenuated symptoms typically present in chronic schizophrenia. The investigation of the schizophrenia spectrum disorders offers an opportunity to elucidate the pathophysiological mechanisms giving rise to schizophrenia. Differences and similarities between subjects with schizotypal personality disorder (SPD), the prototypical schizophrenia personality disorder, and chronic schizophrenia have been investigated with genetic, neurochemical, imaging, and pharmacological techniques. Patients with SPD and the more severely ill patients with chronic schizophrenia share cognitive, social, and attentional deficits hypothesized to result from common neurodevelopmentally based cortical temporal and prefrontal pathology. However, these deficits are milder in SPD patients due to their capacity to recruit other related brain regions to compensate for dysfunctional areas. Individuals with SPD are also less vulnerable to psychosis due to the presence of protective factors mitigating subcortical DA hyperactivity. Given the documented close relationship to other schizophrenic disorders, SPD will be included in the psychosis section of DSM-5 as a schizophrenia spectrum disorder as well as in the personality disorder section.
Tot, T; Viale, G; Rutgers, E; Bergsten-Nordström, E; Costa, A
This manifesto was prepared by a European Breast Cancer (EBC) Council working group and launched at the European Breast Cancer Conference in Glasgow on 20 March 2014. It sets out optimal technical and organisational requirements for a breast cancer pathology service, in the light of concerns about variability and lack of patient-centred focus. It is not a guideline about how pathology services should be performed. It is a call for all in the cancer community--pathologists, oncologists, patient advocates, health administrators and policymakers--to check that services are available that serve the needs of patients in a high quality, timely way.
Cuellar, Vanessa; Strauss, Eric
The identification of biomarkers has become increasingly important in our fundamental understanding of the molecular basis for disease and subsequently in the advancement of modern medicine. Biomarkers have been identified in a plethora of normal and pathologic conditions and are most often found in blood, tissue, or synovial fluid. Orthopaedic research has more recently focused on biomarkers of cartilage and joint diseases, with an emphasis on understanding the molecular underpinnings of their pathophysiology. This article focuses on the biomarkers identified to date in several select knee pathologies and how further research can contribute to new diagnostic tools and targeted therapeutics.
Baron, D N
A survey has been made, mainly covering the second half of 1977, of career grade posts and senior training posts in pathology in the United Kingdom. The survey included all disciplines of pathology and all types of employment--National Health Service, medical school, and many others. The survey also examined the number of applicants for advertised posts and the number of posts left vacant. There were variations between disciplines and between regions; microbiology and Northern Ireland had most failures in filling posts. Overall about 3% of career grade posts, and 15% of training grade posts, were left unfilled. PMID:429573
Pryor, Lauren R; Miller, Joshua D; Gaughan, Eric T
Given the negative consequences of psychological entitlement, it is important to have a reliable and valid measure of the construct. We used an undergraduate sample (N = 271) to examine the Entitlement subscale (ENT) of the Narcissistic Personality Inventory (Raskin & Terry, 1988) and the Psychological Entitlement Scale (PES; Campbell, Bonacci, Shelton, Exline, & Bushman, 2004) in relation to general personality traits (i.e., Revised NEO Personality Inventory; Costa & McCrae, 1992) and personality disorders (PDs; Personality Diagnostic Questionnaire-4; Hyler, 1994). We found similar personality correlates (e.g., disagreeableness; Cluster B PDs) for both measures, although ENT was comprised of greater disagreeableness and less warmth and positive affect. ENT was also more positively associated with schizoid and borderline PDs compared to the PES. Overall, these measures are closely related with regard to their relations with general and pathological personality dimensions, although the ENT scale may capture a slightly more pathological variant.
Balachandra, A Thambirajah; Vadysinghe, Amal N; William, Anita L
The practice of forensic medicine and pathology in Sri Lanka is based on the British model. Medical students during their third and fourth years receive approximately 50 hours of lectures and tutorials in forensic medicine and pathology and then undergo an examination. After completing an internship, these doctors are sent to various hospitals throughout Sri Lanka where they may be asked to perform medicolegal examinations on victims and suspects in rape cases, persons suspected of being under the influence of drugs and/or alcohol, and, injured live patients. As well, they may be asked to perform medicolegal autopsies. Depending upon their experience, some medical officers may be designated as judicial medical officers and appointed full time to do medicolegal work. Up until 1980, judicial medical officers with at least 2 years of work experience were allowed to obtain their postgraduate qualifications in the United Kingdom. However, since 1981 and the establishment of its own Postgraduate Institute of Medicine in Colombo, Sri Lanka, medical officers are offered 2 postgraduate programs in forensic medicine and pathology, a diploma in legal medicine and a doctorate in medicine (forensic medicine). After completing the doctorate in forensic medicine, doctors are allowed to train abroad for a further year in an approved center. Upon return they can then be appointed as consultant judicial medical officers. The practice of forensic medicine and pathology in Sri Lanka is unique and vibrant. However, due to the country's prevailing civil war, the practice of forensic medicine and pathology is suboptimal.
Hamilton, Peter W; Bankhead, Peter; Wang, Yinhai; Hutchinson, Ryan; Kieran, Declan; McArt, Darragh G; James, Jacqueline; Salto-Tellez, Manuel
Digital pathology and the adoption of image analysis have grown rapidly in the last few years. This is largely due to the implementation of whole slide scanning, advances in software and computer processing capacity and the increasing importance of tissue-based research for biomarker discovery and stratified medicine. This review sets out the key application areas for digital pathology and image analysis, with a particular focus on research and biomarker discovery. A variety of image analysis applications are reviewed including nuclear morphometry and tissue architecture analysis, but with emphasis on immunohistochemistry and fluorescence analysis of tissue biomarkers. Digital pathology and image analysis have important roles across the drug/companion diagnostic development pipeline including biobanking, molecular pathology, tissue microarray analysis, molecular profiling of tissue and these important developments are reviewed. Underpinning all of these important developments is the need for high quality tissue samples and the impact of pre-analytical variables on tissue research is discussed. This requirement is combined with practical advice on setting up and running a digital pathology laboratory. Finally, we discuss the need to integrate digital image analysis data with epidemiological, clinical and genomic data in order to fully understand the relationship between genotype and phenotype and to drive discovery and the delivery of personalized medicine.
Marchica, Loredana; Derevensky, Jeffrey L.
Background and aims Personalized feedback interventions (PFI) have shown success as a low-cost, scalable intervention for reducing problematic and excessive consumption of alcohol. Recently, researchers have begun to apply PFI as an intervention method for problematic gambling behaviors. A systematic review of the literature on PFI as an intervention/prevention method for gambling behaviors was performed. Methods Studies were included if they met the following criteria: the design included both a PFI group and a comparison group, and the interventions focused on gambling prevention and/or reduction. Six relevant studies were found meeting all criteria. Results Results revealed that PFI treatment groups showed decreases in a variety of gambling behaviors as compared to control groups, and perceived norms on gambling behaviors significantly decreased after interventions as compared to control groups. Conclusions Overall, the research suggests that while PFI applied to gambling is still in its infancy, problematic gamblers appear to benefit from programs incorporating PFIs. Further, PFI may also be used as a promising source of preventative measures for individuals displaying at-risk gambling behaviors. While, evidence is still limited, and additional research needs to be conducted with PFI for gambling problems, the preliminary positive results along with the structure of PFI as a scalable and relatively inexpensive intervention method provides promising support for future studies. PMID:28092190
... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...
... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...
... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...
... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Pathological laboratories... Pathological laboratories. (a) Pathological laboratories, not operated by a hospital or sanitarium, may... sanitariums. If a pathological laboratory does not exclusively conduct analyses or tests for hospitals...
Sociopathic personality; Sociopathy; Personality disorder - antisocial ... are often seen in the development of antisocial personality. Some doctors believe that psychopathic personality (psychopathy) is ...
Javadpour, N.; Barsky, S.H.
This text details recent advances in methods for detecting, diagnosing, and managing genitourinary diseases. Included are chapters on imaging techniques (including magnetic resonance imaging, computed tomography, and ultrasound; tumor markers (such as alphafetoprotein, human chorionic gonadotropin, prostatic specific antigen, and T-antigens); immunocytochemistry; pediatric urologic pathology; and other key topics.
Carroll, Juliet E.
This monograph contains 10 plant pathology experiments that were written to correspond to portions of a biology curriculum. Each experiment is suitable to a biology topic and designed to encourage exploration of those biological concepts being taught. Experiments include: (1) The Symptoms and Signs of Disease; (2) Koch's Postulates; (3)…
CROME, L.; STERN, J.
DATA FROM RECENT COMPREHENSIVE STUDIES OF THE PATHOLOGY OF MENTAL RETARDATION ARE ASSEMBLED, INCLUDING MATERIAL ON ETIOLOGY, MORPHOLOGY, BIOCHEMISTRY, AND LABORATORY DIAGNOSIS. AREAS COVERED ARE (1) GENETIC CAUSES OF MENTAL RETARDATION, (2) DISORDERS OF GESTATION, (3) BIRTH INJURY, (4) GENERAL CONSIDERATIONS OF POSTNATAL CAUSES OF MENTAL…
Porter, L F; Black, G C M
Ophthalmology has been an early adopter of personalized medicine. Drawing on genomic advances to improve molecular diagnosis, such as next-generation sequencing, and basic and translational research to develop novel therapies, application of genetic technologies in ophthalmology now heralds development of gene replacement therapies for some inherited monogenic eye diseases. It also promises to alter prediction, diagnosis and management of the complex disease age-related macular degeneration. Personalized ophthalmology is underpinned by an understanding of the molecular basis of eye disease. Two important areas of focus are required for adoption of personalized approaches: disease stratification and individualization. Disease stratification relies on phenotypic and genetic assessment leading to molecular diagnosis; individualization encompasses all aspects of patient management from optimized genetic counseling and conventional therapies to trials of novel DNA-based therapies. This review discusses the clinical implications of these twin strategies. Advantages and implications of genetic testing for patients with inherited eye diseases, choice of molecular diagnostic modality, drivers for adoption of personalized ophthalmology, service planning implications, ethical considerations and future challenges are considered. Indeed, whilst many difficulties remain, personalized ophthalmology truly has the potential to revolutionize the specialty.
Skodol, Andrew E; Bender, Donna S; Morey, Leslie C
The criteria for personality disorders in Section II of DSM-5 have not changed from those in DSM-IV. Therefore, the diagnosis of Section II narcissistic personality disorder (NPD) will perpetuate all of the well-enumerated shortcomings associated with the diagnosis since DSM-III. In this article, we will briefly review problems associated with Section II NPD and then discuss the evolution of a new model of personality disorder and the place in the model of pathological narcissism and NPD. The new model was intended to be the official approach to the diagnosis of personality pathology in DSM-5, but was ultimately placed as an alternative in Section III for further study. The new model is a categorical-dimensional hybrid based on the assessment of core elements of personality functioning and of pathological personality traits. The specific criteria for NPD were intended to rectify some of the shortcomings of the DSM-IV representation by acknowledging both grandiose and vulnerable aspects, overt and covert presentations, and the dimensionality of narcissism. In addition, criteria were assigned and diagnostic thresholds set based on empirical data. The Section III representation of narcissistic phenomena using dimensions of self and interpersonal functioning and relevant traits offers a significant improvement over Section II NPD.
Marine Corps Inst., Washington, DC.
Developed as part of the Marine Corps Institute (MCI) correspondence training program, this course on personal finance is designed to provide all Marines with the ability to manage their financial affairs successfully. Introductory materials include specific information for MCI students, a course introduction, and a study guide (guidelines to…
Namrata, Raylu; Oei, Tian P. S.
Factors (demographics, gambling behaviors and comorbid problems) that may be related to the severity of gambling problems were investigated among 440 problem gamblers seeking treatment in an Australian outpatient treatment agency. The participants were divided into sub-threshold pathological gamblers (SPGs; N = 104) and pathological gamblers (PGs;…
Pun, Pamela Boon Li; Murphy, Michael P.
Glycation, the nonenzymatic glycosylation of biomolecules, is commonly observed in diabetes and ageing. Reactive dicarbonyl species such as methylglyoxal and glyoxal are thought to be major physiological precursors of glycation. Because these dicarbonyls tend to be formed intracellularly, the levels of advanced glycation end products on cellular proteins are higher than on extracellular ones. The formation of glycation adducts within cells can have severe functional consequences such as inhibition of protein activity and promotion of DNA mutations. Although several lines of evidence suggest that there are specific mitochondrial targets of glycation, and mitochondrial dysfunction itself has been implicated in disease and ageing, it is unclear if glycation of biomolecules specifically within mitochondria induces dysfunction and contributes to disease pathology. We discuss here the possibility that mitochondrial glycation contributes to disease, focussing on diabetes, ageing, cancer, and neurodegeneration, and highlight the current limitations in our understanding of the pathological significance of mitochondrial glycation. PMID:22778743
Matassini, L; Manfredi, C
A noise reduction scheme, particularly suited for the correction of vocal pathologies, is proposed. The filter makes use of concepts originated within the theory of dynamical systems and deterministic chaos. In particular, the idea of embedding scalar data in order to reconstruct a phase space is of fundamental importance here. Furthermore, the concept of an attractor as a result of dynamical constraints is exploited. In order to perform noise reduction one needs redundancy and the human voice provides it even within a phoneme, namely the smallest structural unit of speech. Due to several repetitions of a pattern called pitch inside a phoneme, separation between the pure voice signal and the noise is possible, provided the latter is uncorrelated with the former. With a proper parameter tuning, different kinds of noise can be removed. We describe the idea behind the noise reduction algorithm and present applications to vocal pathologies.
Quality refers not only to analytical quality control, a traditional area of laboratory excellence, but to the entire science of quality management. As measures of quality, structural indicators refer to staffing and physical facilities, process indicators to the institutions operations and, perhaps most importantly, outcome indicators address the ultimate patient care uses that pathology information is put to. Comparison of performance to peer laboratories, external quality control, is a practical, if limited, yardstick of performance. Customer satisfaction and turn-around-time of tests are receiving more recent attention as quality measures. Blood banking, because of its inherently complex cycle from donor phlebotomy to product infusion, requires special considerations with regard to quality management. Reporting of anatomical pathology, where the only gold standard is a consensus of experts, also does not lend itself to classical numerical quality assessment.
Dudakov, Jarrod A.; Hanash, Alan M.; van den Brink, Marcel R.M.
Interleukin-22 (IL-22) is a recently described IL-10 family cytokine that is produced by T-helper (Th)-17 cells, γδ T cells, NKT cells and newly described innate lymphoid cells (ILCs). Knowledge of IL-22 biology has rapidly evolved since its discovery in 2000, and a role for IL-22 has been identified in numerous tissues including the intestines, lung, liver, kidney, thymus, pancreas and skin. IL-22 primarily targets non-hematopoietic epithelial and stromal cells where it can promote proliferation and play a role in tissue regeneration. In addition, IL-22 regulates host defense at barrier surfaces. However, IL-22 has also been linked to several conditions involving inflammatory tissue pathology. In this review, we will assess the current understanding of this cytokine, including its physiologic and pathologic effects on epithelial cell function. PMID:25706098
Sun, Yanlong; Tweney, Ryan D.; Wang, Hongbin
In this postscript the authors applaud Hahn and Warren's effort in their reply to remove the ambiguity in distinguishing events such as occurrence, occurrence at least once, and nonoccurrence in Hahn and Warren (2009). Still, it appears that differences between us exist regarding the nature of waiting time and its connections to the probability of…
Baldwin, Clara P.; Baldwin, Alfred L.
Discussed are the personality and social development of children with physical handicaps, intellectual difficulties, or social and emotional disturbances, and recommended is the actual observation of the interactions of handicapped children with others in naturalistic situations. Stressed is the importance of pathological social interactions to…
Efimova, N V; Katul'skaia, O Iu; Abramatets, E A; Nesmeianova, N N; Tikhonova, I V
The proportion of individuals with respiratory organ pathology among the teenagers is shown to be 38.9% in a large industrial town with high ambient air pollution. Among the persons with chronic pathology, the proportion of children with high inoculation is 1.4 times higher than that in healthy individuals. The frequency of hypersensitivity to domestic dust allergen was noted in more than one half of the examinees.
In routine diagnosis on renal biopsy, one of the confusing fields for pathological diagnoses is the glomerulopathies with fibrillary structure. The primary glomerulopathies with a deposit of ultrastructural fibrillary structure, which are negative for Congo-red stain but positive for immunoglobulins, include fibrillary glomerulonephritis and immunotactoid glomerulopathy. Several paraproteinemias including cryoglobulinemia, monoclonal gammopathy, and light chain deposition disease as well as hematopoietic disorders including plasmacytoma, plasma cell dyscrasia, and B cell lymphoproliferative disorders involve glomerulopathy with an ultrastructural fibrillary structure. A rare glomerulopathy with fibrillary structure that stains negative for Congo-red as well as for immunoglobulins has been also reported. The pathological diagnoses of these glomerulopathies can include either glomerular diseases, or paraproteinemic diseases, or hematopoietic diseases. The terminology is still confusing when glomerular diseases can be combined with paraproteinemic diseases and/or hematopoietic diseases. Therefore, the generic term, 'glomerular deposition disease' (GDD), has been proposed by pathologists with a requirement for clinicians to detect autoantibodies, paraproteins as well as to carry out a bone marrow check. An attempt has been made to rearrange the diseases with related disorders of fibrillary deposits, based on detailed clinical and pathological finding and to elucidate the correlation between GDD, paraproteinemia, and hematopoietic disorder.
Tervaert, Thijs W Cohen; Mooyaart, Antien L; Amann, Kerstin; Cohen, Arthur H; Cook, H Terence; Drachenberg, Cinthia B; Ferrario, Franco; Fogo, Agnes B; Haas, Mark; de Heer, Emile; Joh, Kensuke; Noël, Laure H; Radhakrishnan, Jai; Seshan, Surya V; Bajema, Ingeborg M; Bruijn, Jan A
Although pathologic classifications exist for several renal diseases, including IgA nephropathy, focal segmental glomerulosclerosis, and lupus nephritis, a uniform classification for diabetic nephropathy is lacking. Our aim, commissioned by the Research Committee of the Renal Pathology Society, was to develop a consensus classification combining type1 and type 2 diabetic nephropathies. Such a classification should discriminate lesions by various degrees of severity that would be easy to use internationally in clinical practice. We divide diabetic nephropathy into four hierarchical glomerular lesions with a separate evaluation for degrees of interstitial and vascular involvement. Biopsies diagnosed as diabetic nephropathy are classified as follows: Class I, glomerular basement membrane thickening: isolated glomerular basement membrane thickening and only mild, nonspecific changes by light microscopy that do not meet the criteria of classes II through IV. Class II, mesangial expansion, mild (IIa) or severe (IIb): glomeruli classified as mild or severe mesangial expansion but without nodular sclerosis (Kimmelstiel-Wilson lesions) or global glomerulosclerosis in more than 50% of glomeruli. Class III, nodular sclerosis (Kimmelstiel-Wilson lesions): at least one glomerulus with nodular increase in mesangial matrix (Kimmelstiel-Wilson) without changes described in class IV. Class IV, advanced diabetic glomerulosclerosis: more than 50% global glomerulosclerosis with other clinical or pathologic evidence that sclerosis is attributable to diabetic nephropathy. A good interobserver reproducibility for the four classes of DN was shown (intraclass correlation coefficient = 0.84) in a test of this classification.
Weisberg, J N; Vaillancourt, P D
It has long been recognized that there is a relationship between certain personality types and personality disorders (PD) and chronic nonmalignant pain (CP). The relationship, however, is far from understood and the physiological and psychological mechanisms that underlie it are unclear. Those who treat chronic pain face many challenges when dealing with individuals who have personality disorders and they often become frustrated when interacting with these patients. Patients with certain traits and personality disorders may continue to worry and ruminate about their symptoms long after the tissue pathology has resolved. Other individuals may overly rely on the clinician and assume a passive role in their treatment, thereby decreasing the likelihood for a positive outcome. Moreover, patients with personality disorders may be demanding (eg, borderline), self-absorbed (eg, narcissistic), or substance seeking (eg, antisocial, borderline). In an attempt to improve management of such patients, pain specialists have attempted to better understand the complex relationship between personality and chronic pain. In this article, we will review the predominant historical and current theories of pain and personality, discuss aspects of the gate-control theory of pain that may relate to personality, and discuss the diathesis-stress model of personality disorders in pain. Last, we will review studies of personality and personality disorders in chronic pain and their treatment implications. We conclude that, based on the underlying neurochemistry, there may be a direct or indirect link between PD and CP, but further prospective research, both on the biological and psychological relationship, should be conducted.
Ramírez Pérez, A; Martínez López-Coterilla, M; Fajardo López, A; Lardelli Claret, A
The ordinary EEG, on only showing qualitative malfunction of abnormal graphoelements in the tracings, proves itself insufficient to go into the analysis of psychological and psycho-pathological problems. Since computerised studies of EEG permit quantitative comparisons, we tried to apply them in correlation with the characteristics of the personality classified also with quantitative criteria, such as those offered in the personality inventory 16 PF; from which have been chosen the so-called factors of the second order, and the subjectivity-objectivity factors. The test was carried out on 100 voluntary subjects from Almeria (Spain), all with High School grades, between 18 and 40 years of age, of both sexes, all right-handed, without neuro-psychiatric history, and with normal ordinary EEGs. From the statistical analysis of the results one could deduce that there are significant specific relationships from the computerised EEG, with those secondary polar values of 16 PF: high and low anxiety, extroversion-introversion. Subjects with low anxiety presented a significant increase of the alpha band opposed to the subjects with high anxiety. There is a significant differences in power of the frontal areas between extrovert and introvert subjects. The extroverted subjects have a greater power of the right side and the introverted subjects a greater power of the left.
The MicroPLB (personal locator beacon) is a search and rescue satellite-aided tracking (SARSAT) transmitter. When activated it emits a distress signal to a constellation of internationally operated satellites. The endangered person's identity and location anywhere on Earth is automatically forwarded to central monitoring stations around the world. It is accurate to within just a few meters. The user uses the device to download navigation data from a global positioning satellite receiver. After the download is complete, the MicroPLB functions as a self-locating beacon. Also, it is the only PLB to use a safe battery. In the past, other PLB devices have used batteries that have enough volatility to explode with extreme force. It was developed by Microwave Monolithic, Inc. through SBIR funding from Glenn Research Center and Goddard Space Flight Center.
Dagher, Alain; Robbins, Trevor W
In rare instances, patients with Parkinson's disease (PD) may become addicted to their own medication or develop behavioral addictions such as pathological gambling. This is surprising because PD patients typically have a very low incidence of drug abuse and display a personality type that is the polar opposite of the addictive personality. These rare addictive syndromes, which appear to result from excessive dopaminergic medication use, illustrate the link between dopamine, personality, and addiction. We describe the clinical phenomena and attempt to relate them to current models of learning and addiction. We conclude that persistently elevated dopaminergic stimulation promotes the development and maintenance of addictive behaviors.
Tsutsumi, Satoshi; Yasumoto, Yukimasa; Ito, Masanori
A 60-year-old, right-handed female presented with episodes of pathological laughter and left hemiparesis. She had no history of traumatic brain injury, or neurological or psychiatric disease, and showed no signs of drug or alcohol abuse. Neurological examination found moderate left hemiparesis. Her face was symmetrical with intact emotional expression. The episodes of pathological laughter had become more frequent during the 3 months since the onset of hemiparesis, were elicited by non-specific, trivial stimuli, and lasted for a few minutes until she gained some control. Her personal and social behavior was entirely appropriate except for the outbursts of laughter. Cerebral magnetic resonance (MR) imaging revealed a 2.5 x 2.5 x 3 cm ring-enhanced mass in the subcortical area of the right frontal lobe associated with extensive perifocal brain edema. The hypothalamus, thalamus, internal capsule, brainstem, and cerebellum were unaffected. Functional MR imaging showed the tumor located mainly in the prefrontal area with the posterior limit involving the premotor cortex. She underwent total tumor resection. The histological diagnosis was glioblastoma multiforme. The pathological laughter and hemiparesis resolved within 2 weeks after surgery. Invasive tumor in the frontal lobe involving the prefrontal cortex and subcortical structure may cause pathological laughter, and can be cured by surgery.
Exploring the interface of neurobehaviorally linked personality dimensions and personality organization in borderline personality disorder: the Multidimensional Personality Questionnaire and Inventory of Personality Organization.
Lenzenweger, Mark F; McClough, Joel F; Clarkin, John F; Kernberg, Otto F
Advances in our understanding of complex psychopathology will likely benefit from approaches to mind, brain, and behavior that seek to (a) specify those general neurobehavioral processes underpinning pathology and (b) bridge to other process-based models of psychopathology at different levels of analysis. Well-defined neurobehavioral processes (e.g., positive emotionality, negative emotionality, nonaffective constraint, fear, affiliation) and their phenotypic indicators are firmly rooted in neural substrates (Depue & Lenzenweger, 2005). Furthermore, long-studied psychodynamic psychological processes, such as identity diffusion, primitive psychological defensive functioning, and reality-testing dimensions, are important to understanding personality pathology (Kernberg & Caligor, 2005). Both theoretical perspectives view the cardinal processes involved in the determination of personality disorders (PDs) as relevant across existing PD diagnostic entities. The authors examined relationships between psychometric indicators of these two sets of processes, the neurobehavioral and the psychodynamic, in a well-characterized sample of individuals with borderline personality disorder (BPD; N = 92). In bridging these two levels of analysis, the authors found that the alienation, aggression, and absorption constructs represent important linkages to the psychodynamic processes, especially primitive psychological defenses and reality-testing impairments. These results are discussed in terms of their potential for joining these two domains of analysis--a neurobehaviorally informed view of personality and the psychodynamic--in efforts to (a) foster a process-oriented approach, (b) resolve heterogeneity, and (c) facilitate identification of endophenotypes in BPD. The heuristic value of this approach for understanding other forms of psychopathology is also discussed.
Taylor, Clive R
The extent to which data from immunohistochemical (IHC) staining are useful is critically dependent not only upon the proper performance and control of the method but also upon appropriate interpretation. A decade ago an individual pathologist may have nurtured a reasonable expectation of achieving a comprehensive understanding of the IHC literature across the whole field of pathology. Today such an expectation is clearly unreasonable with a simple Medline search of the IHC literature postdating the general adoption of antigen retrieval (arbitrarily 1996), yielding more than 100,000 "relevant" articles. The problem is compounded by enormous variability in sample preparation, by the literally thousands of antibodies that are available in catalogs, by the complexity of the tissue section environment, exactly which cells stain, or which do not, and by the subjective assessment of the presence and intensity of specific staining.This chapter describes attempts being made to address these issues. It also outlines the practical steps that may be taken to maximize effectiveness and reproducibility of IHC results within a lab. Adopting a "total test" mindset with attention to every phase of the process is the key initial step.The rapid growth of predictive markers, companion diagnostics, or advanced personalized diagnostics merely serves to underline the inadequacies of IHC and to reinforce the necessity for improved standardization, consistent interpretation, and precise quantification that almost certainly will involve the introduction of new internal and external reference standards, plus digital assistance in interpretation and quantification.
... 42 Public Health 5 2014-10-01 2014-10-01 false Condition: Pathology. 493.853 Section 493.853 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.853 Condition: Pathology. The specialty of pathology includes, for purposes...
... 42 Public Health 5 2013-10-01 2013-10-01 false Condition: Pathology. 493.853 Section 493.853 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.853 Condition: Pathology. The specialty of pathology includes, for purposes...
... 42 Public Health 5 2011-10-01 2011-10-01 false Condition: Pathology. 493.853 Section 493.853 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.853 Condition: Pathology. The specialty of pathology includes, for purposes...
... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Pathology. 493.853 Section 493.853 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.853 Condition: Pathology. The specialty of pathology includes, for purposes...
... 42 Public Health 5 2012-10-01 2012-10-01 false Condition: Pathology. 493.853 Section 493.853 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... These Tests § 493.853 Condition: Pathology. The specialty of pathology includes, for purposes...
Furnham, Adrian; von Stumm, Sophie; Fenton-O'Creevy, Mark
This study examined sex differences in money beliefs and behaviours. Over 100,000 British participants completed two measures online, one of which assessed "money pathology" (Forman in Mind over money, Doubleday, Toronto, 1987), and the other four "money types", based on the emotional associations of money (Furnham et al. in Personal Individ Differ, 52:707-711, 2012). Nearly all measures showed significant sex differences with medium to large effect sizes, and with females exhibiting more "money pathology" than males. The biggest difference on the money types was on money being associated with generosity (money representing love) where men scored much lower than females, and autonomy (money representing freedom) where men scored higher than women. For men, more than women, money represented Power and Security. Men were more likely to be Hoarders while women did more emotional regulatory purchasing. Implications and limitations of this study are discussed.
Gratz, Kim L.; Latzman, Robert D.; Tull, Matthew T.; Reynolds, Elizabeth K.; Lejuez, C. W.
Most of the extant literature on borderline personality disorder has focused on the course, consequences, and correlates of this disorder among adults. However, little is known about childhood borderline personality (BP) features, or the factors associated with the emergence of BP pathology in childhood. A greater understanding of childhood BP…
Müller, Astrid; de Zwaan, Martina; Mitchell, James E; Zimmermann, Tanja
This pilot study investigated the partnership status and the level of pathological buying (PB) in 157 female patients with PB and 1153 women from a German population-based sample. Slightly more than half of both samples were currently living with a partner. The results suggest a protective effect of being in a couple relationship in the representative sample. In contrast, having a partner was not related to the severity of PB among patients. Future studies should address the question of whether the characteristics and quality of partnership have an impact on the severity and course of PB, and vice versa.
Bastiaens, Tim; Smits, Dirk; De Hert, Marc; Vanwalleghem, Dominique; Claes, Laurence
The Personality Inventory for DSM-5 (PID-5; Krueger et al., 2012) is a dimensional self-report questionnaire designed to measure personality pathology according to the criterion B of the DSM-5 Section III personality model. In the current issue of DSM, this dimensional Section III personality model co-exists with the Section II categorical personality model derived from DSM-IV-TR. Therefore, investigation of the inter-relatedness of both models across populations and languages is warranted. In this study, we first examined the factor structure and reliability of the PID-5 in a Flemish community sample (N=509) by means of exploratory structural equation modeling and alpha coefficients. Next, we investigated the predictive ability of section III personality traits in relation to section II personality disorders through correlations and stepwise regression analyses. Results revealed a five factor solution for the PID-5, with adequate reliability of the facet scales. The variance in Section II personality disorders could be predicted by their theoretically comprising Section III personality traits, but additional Section III personality traits augmented this prediction. Based on current results, we discuss the Section II personality disorder conceptualization and the Section III personality disorder operationalization.
After a brief introduction into the psychiatric problems of pathological gambling, the author presents a statistical study on 72 delinquents, amongst them 14 excessive gamblers. The special design of this investigation consists in two comparative studies between the gambling and the non-gambling subgroups, first within the total of delinquents secondly within the group of the drugs- and property-offenders. There is a great number of traits compared concerning e.g. family history, personal biography, social status, drug-consumption-behavior and clinical traits. It is clearly shown that excessive gamblers are markedly overrepresented in the last-mentioned group and that gamblers are to be distinguished by a number of characteristics from their group-mates even in this comparatively homogenous subgroup. Thus, they seem to be negatively loaded by the high prevalence of psychiatric abnormalities in their families, by a higher frequency of birth complications, infantile behavioral disorders and an even more marked seeking behavior for addictive drugs.
Dee, Fred R
Technology for acquisition of virtual slides was developed in 1985; however, it was not until the late 1990s that desktop computers had enough processing speed to commercialize virtual microscopy and apply the technology to education. By 2000, the progressive decrease in use of traditional microscopy in medical student education had set the stage for the entry of virtual microscopy into medical schools. Since that time, it has been successfully implemented into many pathology courses in the United States and around the world, with surveys indicating that about 50% of pathology courses already have or expect to implement virtual microscopy. Over the last decade, in addition to an increasing ability to emulate traditional microscopy, virtual microscopy has allowed educators to take advantage of the accessibility, efficiency, and pedagogic versatility of the computer and the Internet. The cost of virtual microscopy in education is now quite reasonable after taking into account replacement cost for microscopes, maintenance of glass slides, and the fact that 1-dimensional microscope space can be converted to multiuse computer laboratories or research. Although the current technology for implementation of virtual microscopy in histopathology education is very good, it could be further improved upon by better low-power screen resolution and depth of field. Nevertheless, virtual microscopy is beginning to play an increasing role in continuing education, house staff education, and evaluation of competency in histopathology. As Z-axis viewing (focusing) becomes more efficient, virtual microscopy will also become integrated into education in cytology, hematology, microbiology, and urinalysis.
Nicholls, John M; Francis, Glenn D
The standard diagnostic instrument used for over 150 years by anatomical pathologists has been the optical microscope and glass slide. The advent of immunohistochemistry in the routine laboratory in the 1980s, followed by in situ hybridisation in the 1990s, has increased the armamentaria available to the diagnostic pathologist, and this technology has led to changed patient management in a limited number of neoplastic diseases. The first decade of the 21 century has seen an increasing number of publications using proteomic technologies that promise to change disease diagnosis and management, the traditional role of an anatomical pathologist. Despite the plethora of publications on proteomics and pathology, to date there are actually limited data where proteomic technologies do appear to be of greater diagnostic value than the standard histological slide. Though proteomic techniques will become more prevalent in the future, it will need the expertise of an anatomical pathologist to dissect out and validate this added information.
Abstract Vasoregression is a common phenomenon underlying physiological vessel development as well as pathological microvascular diseases leading to peripheral neuropathy, nephropathy, and vascular oculopathies. In this review, we describe the hallmarks and pathways of vasoregression. We argue here that there is a parallel between characteristic features of vasoregression in the ocular microvessels and atherosclerosis in the larger vessels. Shared molecular pathways and molecular effectors in the two conditions are outlined, thus highlighting the possible systemic causes of local vascular diseases. Our review gives us a system-wide insight into factors leading to multiple synchronous vascular diseases. Because shared molecular pathways might usefully address the diagnostic and therapeutic needs of multiple common complex diseases, the literature analysis presented here is of broad interest to readership in integrative biology, rational drug development and systems medicine. PMID:26669709
Tromp, Noor B; Koot, Hans M
The present study aimed to elucidate dimensions of normal and abnormal personality underlying DSM-IV personality disorder (PD) symptoms in 168 adolescents referred to mental health services. Dimensions derived from the Big Five of normal personality and from Livesley's (2006) conceptualization of personality pathology were regressed on interview-based DSM-IV PD symptom counts. When examined independently, both models demonstrated significant levels of predictive power at the higher order level. However, when added to the higher order Big Five dimensions, Livesley's higher and lower order dimensions afforded a supplementary contribution to the understanding of dysfunctional characteristics of adolescent PDs. In addition, they contributed to a better differentiation between adolescent PDs. The present findings suggest that adolescent PDs are more than extreme, maladaptive variants of higher order normal personality traits. Adolescent PDs seem to encompass characteristics that may be more completely covered by dimensions of abnormal personality. Developmental issues and implications of the findings are discussed.
Parodi, Stefano; Dosi, Corrado; Zambon, Antonella; Ferrari, Enrico; Muselli, Marco
Identifying potential risk factors for problem gambling (PG) is of primary importance for planning preventive and therapeutic interventions. We illustrate a new approach based on the combination of standard logistic regression and an innovative method of supervised data mining (Logic Learning Machine or LLM). Data were taken from a pilot cross-sectional study to identify subjects with PG behaviour, assessed by two internationally validated scales (SOGS and Lie/Bet). Information was obtained from 251 gamblers recruited in six betting establishments. Data on socio-demographic characteristics, lifestyle and cognitive-related factors, and type, place and frequency of preferred gambling were obtained by a self-administered questionnaire. The following variables associated with PG were identified: instant gratification games, alcohol abuse, cognitive distortion, illegal behaviours and having started gambling with a relative or a friend. Furthermore, the combination of LLM and LR indicated the presence of two different types of PG, namely: (a) daily gamblers, more prone to illegal behaviour, with poor money management skills and who started gambling at an early age, and (b) non-daily gamblers, characterised by superstitious beliefs and a higher preference for immediate reward games. Finally, instant gratification games were strongly associated with the number of games usually played. Studies on gamblers habitually frequently betting shops are rare. The finding of different types of PG by habitual gamblers deserves further analysis in larger studies. Advanced data mining algorithms, like LLM, are powerful tools and potentially useful in identifying risk factors for PG.
Schizotypal personality disorder Overview By Mayo Clinic Staff People with schizotypal personality disorder are often described as odd or eccentric ... in social situations, as the person with schizotypal personality disorder responds inappropriately to social cues and holds ...
Pagni, Fabio; L'Imperio, Vincenzo; Bono, Francesca; Garancini, Mattia; Roversi, Gaia; De Sio, Gabriele; Galli, Manuel; Smith, Andrew James; Chinello, Clizia; Magni, Fulvio
The incidence of thyroid cancer has continuously increased due to its detection in the preclinical stage. Clinical research in thyroid pathology is focusing on the development of new diagnostic tools to improve the stratification of nodules that have biological, practical and economic consequences on the management of patients. Several clinical questions related to thyroid carcinoma remain open and the use of proteomic research in the hunt for new targets with potential diagnostic applications has an important role in the solutions. Many different proteomic approaches are used to investigate thyroid lesions, including mass spectrometry profiling and imaging technologies. These approaches have been applied to different human tissues (cytological specimens, frozen sections, formalin-fixed paraffin embedded tissue or Tissue Micro Arrays). Moreover, other specimens are used for biomarker discovery, such as cell lines and the secretome. Alternative approaches, such as metabolomics and lipidomics, are also used and integrated within proteomics.
Waaijer, Laurien; van Diest, Paul J; van der Pol, Carmen C; Verolme, Berna; Hennink, Annelies; Witkamp, Arjen J
Pathologic nipple discharge is a symptom that frequently causes female patients to visit the outpatient breast clinic. In the vast majority of cases, the symptom is caused by a benign intraductal laesion. The options for diagnosis and treatment have long been limited; surgery was not infrequently the treatment of choice. With the advent of breast ductoscopy, a micro-endoscopic procedure, it is possible to visualise abnormalities in the ductal system. Tissue for histopathological investigation can be retrieved from the duct and the condition can be treated. The patient with nipple discharge is consequently prevented from having to undergo an invasive and fairly 'blindly' executed procedure under general anaesthesia. The miniscule dimensions of the duct in which the technique is carried out pose the greatest challenge to the further development of the ductoscope.
Clarke, Stephanie B.; Rizvi, Shireen L.; Resick, Patricia A.
Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment…
City Univ. of New York, Flushing. Queens Coll. Dept. of Communication Arts and Sciences.
Seven papers report on speech language pathology and audiology studies performed by graduate students. The first paper reports on intelligibility of two popular synthetic speech systems used in communication aids for the speech impaired, the Votrax Personal Speech System and the Echo II synthesizer. The second paper reports facilitation of tense…
Aisner, Dara L; Berry, Anna; Dawson, D Brian; Hayden, Randall T; Joseph, Loren; Hill, Charles E
Molecular pathology is an essential element of pathology training. As more molecular tests have become available, there is an increasing need for pathology trainees to receive a strong foundation in molecular pathology. Appointed by the Training and Education Committee of the Association for Molecular Pathology, the Molecular Curriculum Task Force has developed a suggested curriculum in molecular pathology for residents. The foundations of molecular pathology are presented as a series of goals and objectives that residency programs can use to develop their educational programs. As pathologists continue to expand their roles to include regular clinical consultations in the realm of molecular testing, a strong foundation in molecular pathology and genomic medicine has become essential to the practice of pathology.
Berman, David M; Bosenberg, Marcus W; Orwant, Robin L; Thurberg, Beth L; Draetta, Gulio F; Fletcher, Christopher D M; Loda, Massimo
The completion of the Human Genome Project and the development of genome-based technologies over the past decade have set the stage for a new era of personalized medicine. By all rights, molecularly trained investigative pathologists should be leading this revolution. Singularly well suited for this work, molecular pathologists have the rare ability to wed genomic tools with unique diagnostic skills and tissue-based pathology techniques for integrated diagnosis of human disease. However, the number of pathologists with expertise in genome-based research has remained relatively low due to outdated training methods and a reluctance among some traditional pathologists to embrace new technologies. Moreover, because budding pathologists may not appreciate the vast selection of jobs available to them, they often end up choosing jobs that focus almost entirely on routine diagnosis rather than new frontiers in molecular pathology. This review calls for changes aimed at rectifying these troubling trends to ensure that pathology continues to guide patient care in a post-genomic era.
Shrader, M Wade; Schwab, Joseph H; Shaughnessy, William J; Jacofsky, David J
Pathologic fractures in children occur in a variety of malignant and benign pathologic processes. Pediatric pathologic femoral neck fractures are particularly rare. Until now, all reported cases have been isolated cases, small series, or cases reported in series of adult pathologic hip fractures. The present article is the first report of a relatively large series of pathologic femoral neck fractures in a pediatric population. We identified pathologic femoral neck fractures, including 2 basicervical fractures, in 15 children (9 boys, 6 girls) ranging in age from 18 months to 15 years (mean age, 9 years) and treated between 1960 and 2000. The pathologic diagnoses were fibrous dysplasia (5 children), unicameral bone cyst (2), Ewing's sarcoma (2), osteomyelitis (2), leukemia (1), rhabdomyosarcoma (1), osteogenesis imperfecta (1), and osteopetrosis (1). Treatment methods, including time to reduction and fixation, were reviewed in detail. One patient was lost to follow-up. All others were followed until union; mean long-term follow-up was 7 years (range, 1-16 years). All patients ultimately went on to union. Mean time to union was 19 weeks (range, 5-46 weeks). However, 2 patients died before 2 years. There was a 40% complication rate, with limb-length discrepancy being the most common (4 children). No patient developed avascular necrosis. Pathologic femoral neck fractures are rare in children. Pediatric patients who present with a pathologic hip fracture are at significant risk for complications. Physicians and family should be alerted to the prolonged course involved in treating these fractures to union.
The term ‘Borderline Personality Disorder’ (BPD) refers to a psychiatric syndrome that is characterized by emotion dysregulation, impulsivity, risk-taking behavior, irritability, feelings of emptiness, self-injury and fear of abandonment, as well as unstable interpersonal relationships. BPD is not only common in psychiatric populations but also more prevalent in the general community than previously thought, and thus represents an important public health issue. In contrast to most psychiatric disorders, some symptoms associated with BPD may improve over time, even without therapy, though impaired social functioning and interpersonal disturbances in close relationships often persist. Another counterintuitive and insufficiently resolved question is why depressive symptoms and risk-taking behaviors can occur simultaneously in the same individual. Moreover, there is an ongoing debate about the nosological position of BPD, which impacts on research regarding sex differences in clinical presentation and patterns of comorbidity. In this review, it is argued that many features of BPD may be conceptualized within an evolutionary framework, namely behavioral ecology. According to Life History Theory, BPD reflects a pathological extreme or distortion of a behavioral ‘strategy’ which unconsciously aims at immediate exploitation of resources, both interpersonal and material, based on predictions shaped by early developmental experiences. Such a view is consistent with standard medical conceptualizations of BPD, but goes beyond classic ‘deficit’-oriented models, which may have profound implications for therapeutic approaches. PMID:26929090
Pettan-Brewer, Christina; Treuting, Piper M.
Old mice will have a subset of lesions as part of the progressive decline in organ function that defines aging. External and palpable lesions will be noted by the research, husbandry, or veterinary staff during testing, cage changing, or physical exams. While these readily observable lesions may cause alarm, not all cause undue distress or are life-threatening. In aging research, mice are maintained until near end of life that, depending on strain and genetic manipulation, can be upwards of 33 months. Aging research has unique welfare issues related to age-related decline, debilitation, fragility, and associated pain of chronic diseases. An effective aging research program includes the collaboration and education of the research, husbandry, and veterinary staff, and of the members of the institution animal care and use committee. This collaborative effort is critical to humanely maintaining older mice and preventing excessive censorship due to non-lethal diseases. Part of the educational process is becoming familiar with how old mice appear clinically, at necropsy and histopathologically. This baseline knowledge is important in making the determination of humane end points, defining health span, contributing causes of death and effects of interventions. The goal of this paper is to introduce investigators to age-associated diseases and lesion patterns in mice from clinical presentation to pathologic assessment. To do so, we present and illustrate the common clinical appearances, necropsy and histopathological lesions seen in subsets of the aging colonies maintained at the University of Washington. PMID:22953032
Alexander, Barbara T.; Dasinger, John Henry; Intapad, Suttira
Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension. In addition, impaired growth during fetal life also programs enhanced vulnerability to a secondary insult. Macrosomia, which occurs in response to maternal obesity, diabetes and excessive weight gain during gestation, is also associated with increased cardiovascular risk. Yet, the exact mechanisms that permanently change the structure, physiology and endocrine health of an individual across their lifespan following altered growth during fetal life are not entirely clear. Transmission of increased risk from one generation to the next in the absence of an additional prenatal insult indicates an important role for epigenetic processes. Experimental studies also indicate that the sympathetic nervous system, the renin angiotensin system, increased production of oxidative stress and increased endothelin play an important role in the developmental programming of blood pressure in later life. Thus, this review will highlight how adverse influences during fetal life and early development program an increased risk for cardiovascular disease including high blood pressure and provide an overview of the underlying mechanisms that contribute to the fetal origins of cardiovascular pathology. PMID:25880521
De Block, Andreas; Adriaens, Pieter R
This article provides a historical perspective on how both American and European psychiatrists have conceptualized and categorized sexual deviance throughout the past 150 years. During this time, quite a number of sexual preferences, desires, and behaviors have been pathologized and depathologized at will, thus revealing psychiatry's constant struggle to distinguish mental disorder--in other words, the "perversions," "sexual deviations," or "paraphilias"--from immoral, unethical, or illegal behavior. This struggle is apparent in the works of 19th- and early-20th-century psychiatrists and sexologists, but it is also present in the more recent psychiatric textbooks and diagnostic manuals, such as the consecutive editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). While much of the historical literature revolves around the controversy over homosexuality, this article also reviews the recent medicohistorical and sociohistorical work on other forms of sexual deviance, including the diagnostic categories listed in the latest edition, the DSM-IV-TR: exhibitionism, voyeurism, fetishism, frotteurism, pedophilia, sexual masochism, sexual sadism, and transvestic fetishism.
Sarcomas are a rare, complex group of childhood and adult neoplasms with differentiation towards mesenchymal tissue, which may arise almost anywhere in the body. Although pathologically diverse, they frequently exhibit similar clinical presentations and radiological features. Correct histopathological diagnosis is therefore crucial, but there is overlap between histological patterns of malignant tumours, between benign and malignant lesions, and with non-mesenchymal tumours. Immunohistochemistry and molecular genetic techniques, the latter to detect tumour-specific alterations, add significantly to histological interpretation, but several groups of tumours still lack reliable immunohistochemical markers or reproducible genetic changes. The classification of sarcomas is incomplete and continues to evolve, and although the biology of many remains relatively poorly understood, our increasing insight into molecular events occurring in these tumours is certain to aid future diagnosis and therapy. This paper aims to give a broad overview of several of the main soft tissue sarcomas from a clinicopathological perspective, discussing laboratory diagnosis and the use and limitations of ancillary investigations, including recent developments in molecular diagnosis.
Asa, Sylvia L; Mete, Ozgur
The history of pituitary pathology is a long one that dates back to biblical times, but the last 25 years have represented an era of "coming of age." The role of the pituitary in health and disease was the subject of many studies over the last century. With the development of electron microscopy, immunoassays, and immunohistochemistry, the functional alterations associated with pituitary disease have been clarified. The additional information provided by molecular genetic studies has allowed progress in understanding the pathogenesis of pituitary disorders. Nevertheless, many questions remain to be answered. For example, pathologists cannot morphologically distinguish locally aggressive adenomas from carcinomas when tumor is confined to the sella. Sadly, basal cell carcinoma, the most common carcinoma of skin, usually causes less morbidity than pituitary adenomas, which occur in almost 20 % of the general population, can cause significant illness and even death, and yet are still classified as benign. The opportunity to increase awareness of the impact of these common lesions on quality of life is the current challenge for physicians and patients. We anticipate that ongoing multidisciplinary approaches to pituitary disease research will offer new insights into diseases arising from this fascinating organ.
Mathas, Stephan; Hartmann, Sylvia; Küppers, Ralf
The Hodgkin and Reed-Sternberg (HRS) tumor cells of classical Hodgkin lymphoma (HL), as well as the lymphocyte predominant (LP) cells of nodular lymphocyte predominant HL (NLPHL), are derived from mature B cells. However, HRS cells have largely lost their B-cell phenotype and show a very unusual expression of many markers of other hematopoietic cell lineages, which aids in the differential diagnosis between classical HL (cHL) and NLPHL and distinguishes cHL from all other hematopoietic malignancies. The bi- or multinucleated Reed-Sternberg cells most likely derive from the mononuclear Hodgkin cells through a process of incomplete cytokinesis. HRS cells show a deregulated activation of numerous signaling pathways, which is partly mediated by cellular interactions in the lymphoma microenvironment and partly by genetic lesions. In a fraction of cases, Epstein-Barr virus contributes to the pathogenesis of cHL. Recurrent genetic lesions in HRS cells identified so far often involve members of the nuclear factor-κB (NF-κB) and JAK/STAT pathways and genes involved in major histocompatibility complex expression. However, further lead transforming events likely remain to be identified. We here discuss the current knowledge on HL pathology and biology.
The diagnosis of narcissistic personality disorder in the DSM-IV has been criticized foremost for its limitations in capturing the range and complexity of narcissistic pathology. The attention to the narcissistic individual's external, symptomatic, or social interpersonal patterns--at the expense of his or her internal complexity and individual suffering--has also added to the diagnosis' low clinical utility and limited guidance for treatment. Recent studies and reviews have pointed to the need for change in the diagnostic approach to and formulation of narcissism. This review focuses specifically on studies of features that add to the identification, understanding, and treatment of patients with pathological narcissistic functioning and narcissistic personality disorder. They have been integrated into a regulatory model that includes the functions and fluctuations of internal control, self-esteem, perfectionism with accompanying self-criticism, shame, and empathic ability and functioning.
Strickland, Casey M; Drislane, Laura E; Lucy, Megan; Krueger, Robert F; Patrick, Christopher J
Despite its importance historically and contemporarily, psychopathy is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR). Its closest counterpart, antisocial personality disorder, includes strong representation of behavioral deviance symptoms but weak representation of affective-interpersonal features considered central to psychopathy. The current study evaluated the extent to which psychopathy and its distinctive facets, indexed by the Triarchic Psychopathy Measure, can be assessed effectively using traits from the dimensional model of personality pathology developed for DSM-5, operationalized by the Personality Inventory for DSM-5 (PID-5). Results indicate that (a) facets of psychopathy entailing impulsive externalization and callous aggression are well-represented by traits from the PID-5 considered relevant to antisocial personality disorder, and (b) the boldness facet of psychopathy can be effectively captured using additional PID-5 traits. These findings provide evidence that the dimensional model of personality pathology embodied in the PID-5 provides effective trait-based coverage of psychopathy and its facets.
O'Nions, Elizabeth; Viding, Essi; Greven, Corina U; Ronald, Angelica; Happé, Francesca
"Pathological Demand Avoidance" is a term increasingly used by practitioners in the United Kingdom. It was coined to describe a profile of obsessive resistance to everyday demands and requests, with a tendency to resort to "socially manipulative" behaviour, including outrageous or embarrassing acts. Pathological demand…
Baloch, Zubair W; LiVolsi, Virginia A
This paper reviews the embryology, histology and pathology of the human parathyroid glands. It emphasizes those pathologic lesions which are found in the setting of clinical hyperparathyroidism. Also discussed are certain molecular features of hyperfunctioning parathyroid glands. The difficulties encountered in parathyroid FNA are reviewed and illustrated.
This book contains 22 papers under the headings of Diagnosis and Pathology of endocrine diseases. Topics covered include: Laboratory tests in the diagnosis and management of thyroid disorders, Pathology of thyroid diseases, Diagnosis of adrenourtical disease, Radiologic techniques in evaluating endocrine disorders; and the Pituitary and adrenal glands.
Ocular pathology laboratories have been one of the main reasons for the progress and evolution of ophthalmology in Latin America. This has been made possible through pathologic reports, meetings, and seminars and through the valuable help of basic teaching in residency programs in ophthalmology.
Spinella, Marcello; Lester, David; Yang, Bijou
In a community sample of 225 adults, scores on the Compulsive Buying Scale were associated with scores on the subscales of the Executive Personal Finance Scale (rs = -.35 to -.70) and the Money Attitudes Scale (positively with using money for impressing others, and negatively with saving and planning). The results suggested that common tendencies toward compulsive buying may not be pathological, but merely associated with attitudes toward money in general and financial management habits.
Konior, Anna; Schramm, Agata; Czesnikiewicz-Guzik, Marta
Abstract Significance: Reactive oxygen species (ROS) play a critical role in vascular disease. While there are many possible sources of ROS, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases play a central role. They are a source of “kindling radicals,” which affect other enzymes, such as nitric oxide synthase endothelial nitric oxide synthase or xanthine oxidase. This is important, as risk factors for atherosclerosis (hypertension, diabetes, hypercholesterolemia, and smoking) regulate the expression and activity of NADPH oxidases in the vessel wall. Recent Advances: There are seven isoforms in mammals: Nox1, Nox2, Nox3, Nox4, Nox5, Duox1 and Duox2. Nox1, Nox2, Nox4, and Nox5 are expressed in endothelium, vascular smooth muscle cells, fibroblasts, or perivascular adipocytes. Other homologues have not been found or are expressed at very low levels; their roles have not been established. Nox1/Nox2 promote the development of endothelial dysfunction, hypertension, and inflammation. Nox4 may have a role in protecting the vasculature during stress; however, when its activity is increased, it may be detrimental. Calcium-dependent Nox5 has been implicated in oxidative damage in human atherosclerosis. Critical Issues: NADPH oxidase-derived ROS play a role in vascular pathology as well as in the maintenance of normal physiological vascular function. We also discuss recently elucidated mechanisms such as the role of NADPH oxidases in vascular protection, vascular inflammation, pulmonary hypertension, tumor angiogenesis, and central nervous system regulation of vascular function and hypertension. Future Directions: Understanding the role of individual oxidases and interactions between homologues in vascular disease is critical for efficient pharmacological regulation of vascular NADPH oxidases in both the laboratory and clinical practice. Antioxid. Redox Signal. 20, 2794–2814. PMID:24180474
Grosenbaugh, D A; Morgan, S J; Hood, D M
This review indicates that the patient-to-patient uniqueness commonly seen in chronic laminitis represents the variable presence of the digital pathologies. Although some degree of mechanical failure is always present, the secondary metabolic and growth dysplasias, vascular pathologies, and sepsis may or may not be evident. The presence and severity of these pathologies appear to have a more significant impact on the prognosis of individual cases than does the displacement of the distal phalanx. It should be reiterated that it is often the combined presence of these individual pathologies that gives rise to the patient that is totally refractory to treatment. In the absence of these pathologies, many horses with significant displacement of the distal phalanx are not in pain and are not in need of treatment. It thus follows that a key to the improved rehabilitation of difficult patients is focusing research on the physiopathology and diagnosis of these nonmechanical problems.
Samuel, Douglas B; Carroll, Kathleen M; Rounsaville, Bruce J; Ball, Samuel A
Although the current diagnostic manual conceptualizes personality disorders (PDs) as categorical entities, an alternative perspective is that PDs represent maladaptive extreme versions of the same traits that describe normal personality. Existing evidence indicates that normal personality traits, such as those assessed by the five-factor model (FFM), share a common structure and obtain reasonably predictable correlations with the PDs. However, very little research has investigated whether PDs are more extreme than normal personality traits. Utilizing item-response theory analyses, the authors of the current study extend previous research to demonstrate that the diagnostic criterion for borderline personality disorder and FFM neuroticism could be fit along a single latent dimension. Furthermore, the authors' findings indicate that the borderline criteria assessed the shared latent trait at a level that was more extreme (d = 1.11) than FFM neuroticism. This finding provides further evidence for dimensional understanding of personality pathology and suggests that a trait model in DSM-5 should span normal and abnormal personality functioning, but focus on the extremes of these common traits.
Schnabel, Ph A; Petersen, I; Junker, K
The working group on pulmonary pathology of the German Society of Pathology (Deutsche Gesellschaft für Pathologie, DGP) developed very actively in the last year. Apart from the autumn meeting in Heidelberg in 2011 and the sessions at the annual DGP meeting in Berlin it was possible to realize a first publication with support and coauthorship of several members of the working group dealing with the classification of lung adenocarcinoma. In this report the key aspects of the activity related to the following issues are summarized including non-small cell lung carcinoma, neuroendocrine tumors of the lungs, interstitial pulmonary diseases, cell blocks in cytology and banking in thoracic pathology.
Personality disorder - histrionic; Attention seeking - histrionic personality disorder ... Causes of histrionic personality disorder are unknown. Genes and early childhood events may be responsible. It is diagnosed more often in women than ...
Schizoid personality disorder Overview By Mayo Clinic Staff Schizoid personality disorder is an uncommon condition in which people avoid ... range of emotional expression. If you have schizoid personality disorder, you may be seen as a loner ...
Background: There is a paucity of information about the oral pathology related articles published in a pathology journal. This study aimed to audit the oral pathology related articles published in Iranian Journal of Pathology (Iran J Pathol) from 2006 to 2015. Methods: Bibliometric analysis of issues of Iran J Pathol from 2006 to 2015 was performed using web-based search. The articles published were analyzed for type of article and individual topic of oral pathology. The articles published were also checked for authorship trends. Results: Out of the total 49 published articles related to oral pathology, case reports (21) and original articles (18) contributed the major share. The highest number of oral pathology related articles was published in 2011, 2014 and 2015 with 8 articles each and the least published year was 2012 with 1 article. Among the oral pathology related articles published, spindle cell neoplasms (7) followed by salivary gland tumors (5), jaw tumors (4), oral granulomatous conditions (4), lymphomas (4), oral cancer (3) and odontogenic cysts (3) form the major attraction of the contributors. The largest numbers of published articles related to oral pathology were received from Tehran University of Medical Sciences; Tehran (7) followed by Mashhad University of Medical Sciences, Mashhad (6) and Shahid Beheshti University of Medical Sciences, Tehran (5). Conclusion: This paper may be considered as a baseline study for the bibliometric information regarding oral pathology related articles published in a pathology journal. PMID:27799973
Ayearst, Lindsay E; Flett, Gordon L; Hewitt, Paul L
A radical reworking of Axis II has been proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders whereby personality disorder categories will be replaced by a trait dimensional model of personality pathology. Perfectionism is specified as a lower order facet of Compulsivity within this proposed model. This marginalization of the perfectionism construct is inconsistent with the empirical literature that suggests that perfectionism is an important dimension of maladaptive personality in its own right, complete with its own set of more specific lower order facets. Further, perfectionism in the current proposed system is relevant only to the characterization of the obsessive-compulsive personality disorder type, despite compelling empirical research that demonstrates that various dimensions of perfectionism are differentially associated with personality pathology of all kinds. The present article reviews existing research on the role of various dimensions of perfectionism in personality disorder, highlights these seemingly ignored areas of the perfectionism literature, and discusses the problems and consequences that will arise if perfectionism continues to be defined narrowly and is largely excluded from dimensional models of personality pathology.
Irvine, Michael A.; Worbe, Yulia; Bolton, Sorcha; Harrison, Neil A.; Bullmore, Edward T.; Voon, Valerie
Background Pathological gaming is an emerging and poorly understood problem. Impulsivity is commonly impaired in disorders of behavioural and substance addiction, hence we sought to systematically investigate the different subtypes of decisional and motor impulsivity in a well-defined pathological gaming cohort. Methods Fifty-two pathological gaming subjects and age-, gender- and IQ-matched healthy volunteers were tested on decisional impulsivity (Information Sampling Task testing reflection impulsivity and delay discounting questionnaire testing impulsive choice), and motor impulsivity (Stop Signal Task testing motor response inhibition, and the premature responding task). We used stringent diagnostic criteria highlighting functional impairment. Results In the Information Sampling Task, pathological gaming participants sampled less evidence prior to making a decision and scored fewer points compared with healthy volunteers. Gaming severity was also negatively correlated with evidence gathered and positively correlated with sampling error and points acquired. In the delay discounting task, pathological gamers made more impulsive choices, preferring smaller immediate over larger delayed rewards. Pathological gamers made more premature responses related to comorbid nicotine use. Greater number of hours played also correlated with a Motivational Index. Greater frequency of role playing games was associated with impaired motor response inhibition and strategy games with faster Go reaction time. Conclusions We show that pathological gaming is associated with impaired decisional impulsivity with negative consequences in task performance. Decisional impulsivity may be a potential target in therapeutic management. PMID:24146789
Röcken, C; Manke, H
In the last ten years, almost 60 departments of surgical pathology were accredited in Germany according to DIN EN ISO/IEC 17020. Accreditation in pathology was accompanied by the adoption of a highly dynamic process, which requires staff to be more aware of quality and to introduce a quality-oriented system. The accreditation body in turn needed to consider all the duties, responsibilities and processes in surgical pathology and was supported in this regard by the Sector Committee of Pathology and Neuropathology of the DGA German Association for Accreditation. In this review we illustrate the various problems associated with accreditation in surgical pathology by answering eight questions that have arisen over many years of activity. These include the registration and appropriate presentation of the scope of accreditation, the terminology, as well as the extent and depth of documentation. A department of pathology applying for accreditation is required to document the entire step-wise process leading to a surgical pathological diagnosis.
Samuel, Douglas B; Widiger, Thomas A
A dimensional perspective on personality disorder hypothesizes that the current diagnostic categories represent maladaptive variants of general personality traits. However, a fundamental foundation of this viewpoint is that dimensional models can adequately account for the pathology currently described by these categories. While most of the personality disorders have well established links to dimensional models that buttress this hypothesis, obsessive-compulsive personality disorder (OCPD) has obtained only inconsistent support. The current study administered multiple measures of 1) conscientiousness-related personality traits, 2) DSM-IV OCPD, and 3) specific components of OCPD (e.g., compulsivity and perfectionism) to a sample of 536 undergraduates who were oversampled for elevated OCPD scores. Six existing measures of conscientiousness-related personality traits converged strongly with each other supporting their assessment of a common trait. These measures of conscientiousness correlated highly with scales assessing specific components of OCPD, but obtained variable relationships with measures of DSM-IV OCPD. More specifically, there were differences within the conscientiousness instruments such that those designed to assess general personality functioning had small to medium relationships with OCPD, but those assessing more maladaptive variants obtained large effect sizes. These findings support the view that OCPD does represent a maladaptive variant of normal-range conscientiousness.
Chan, Alan Ka Ki; Zane, Nolan; Wong, Gloria M; Song, Anna V
Many college students are involved in gambling behavior as a recreational activity. Their involvement could potentially develop into problem gambling, an issue of increasing concern to student health. At the same time, evidence suggests that Asian Americans are overrepresented amongst problem gamblers in this age period. Research on factors related to initiation and development of problem gambling in college students is necessary to inform the development of effective and culturally-sensitive prevention efforts against gambling. The relationships between personal gambling expectancies at two levels of specificity (two general and six specific types of expectancies) and college student gambling at two levels of behavior (initiation and problems) were examined in a sample of 813 Asian American and White American college students. The study aimed to address (a) whether expectancies explained ethnic differences in gambling, (b) ethnic similarities and differences in the pattern of relationships between expectancies and gambling, and (c) whether expectancies that emerged in both ethnic groups have a greater risk or protective effect for one group than another. Results showed that Asian American students reported more problem gambling than White American students, but expectancies did not account for this group difference. Risk and protective factors for initiation were relatively similar between groups, but different patterns of risk emerged for each group for problem gambling. Implications for college primary prevention and harm reduction programs are discussed.
Savk, Oner; Savk, Ekin
A possible association of spinal pathology with notalgia paresthetica (NP) was investigated through clinical and radiographic evaluation. Forty-three NP patients underwent dermatologic and orthopedic examination accompanied by radiography of the spine. Sixty-one lesions in 43 patients were evaluated. In 34 patients, various vertebral pathologies were observed radiographically by a blinded investigator, and in 28 of these cases these changes were most prominent in the vertebrae which corresponded to a lesional dermatome. Thirty-seven lesions were accompanied by spinal changes decided to be relevant (60.7%). The striking correlation of NP localization with spinal pathology suggests that spinal nerve impingement may contribute to the pathogenesis of this entity.
Kealy, David; Ogrodniczuk, John S
Pathological narcissism is a form of maladaptive self-regulation that impedes the capacity to love. Although narcissism is often construed as excessive self-love, individuals with pathological narcissism are impaired in being able to love themselves as well as others. With the subject of impaired love in mind, we review selected conceptualizations from an enormous and diverse psychodynamic literature on narcissism. Major theoretical approaches illustrate a number of psychodynamics associated with narcissistic self-regulatory problems. This paper provides a concise overview of major conceptual themes regarding pathological narcissism and impaired capacity to love.
Schalinske, Kevin L; Smazal, Anne L
Perturbations in methyl group metabolism and homocysteine balance have emerged over the past few decades as having defining roles in a number of pathological conditions. Numerous nutritional, hormonal, and genetic factors that are characterized by elevations in circulating homocysteine concentrations are also associated with specific pathological conditions, including cancer development, autoimmune diseases, vascular dysfunction, and neurodegenerative disease. Although much remains to be explored, our understanding of the relationship between disease, methyl balance, and epigenetic control of gene expression has steadily progressed. However, homocysteine balance and its role in health and disease are not as clearly understood. This review presents our current understanding of homocysteine metabolism and its link to specific pathologies.
Ashish, Naveen; Dahm, Lisa; Boicey, Charles
We describe Pathology Extraction Pipeline (PEP)--a new Open Health Natural Language Processing pipeline that we have developed for information extraction from pathology reports, with the goal of populating the extracted data into a research data warehouse. Specifically, we have built upon Medical Knowledge Analysis Tool pipeline (MedKATp), which is an extraction framework focused on pathology reports. Our particular contributions include additional customization and development on MedKATp to extract data elements and relationships from cancer pathology reports in richer detail than at present, an abstraction layer that provides significantly easier configuration of MedKATp for extraction tasks, and a machine-learning-based approach that makes the extraction more resilient to deviations from the common reporting format in a pathology reports corpus. We present experimental results demonstrating the effectiveness of our pipeline for information extraction in a real-world task, demonstrating performance improvement due to our approach for increasing extractor resilience to format deviation, and finally demonstrating the scalability of the pipeline across pathology reports for different cancer types.
Miller, Joshua D; Lynam, Donald R; Campbell, W Keith
There exists substantial debate about how to best assess pathological narcissism with a variety of measures designed to assess grandiose and vulnerable narcissism, as well as the DSM-IV and DSM-5 based conceptualizations of narcissistic personality disorder (NPD). Wright and colleagues published correlations between several narcissism measures (Narcissistic Personality Inventory [NPI]; Pathological Narcissism Inventory [PNI]; Personality Diagnostic Questionnaire [PDQ] NPD) with the traits comprising the DSM-5 Section III personality trait model. In the current study, we examine the agreement manifested by Wright and colleagues' narcissism-DSM-5 trait profiles with expert ratings of the DSM-5 traits most relevant to descriptions of DSM-IV NPD. Despite concerns regarding the NPI's ability to measure pathological narcissism, its trait profile was strongly correlated with expert ratings, as was PDQ NPD's profile. Conversely, the trait profiles associated with the PNI were primarily uncorrelated with the expert rated NPD profile. The implications of these findings with regard to the assessment of narcissism are discussed.
Journal of Dental Education, 1987
Guidelines for structuring a pathology curriculum for dental hygienists include: definition of the field and its subfields; relationships with other fields; primary educational goals, prerequisites, core content, specific behavioral objectives; and suggestions for sequencing, faculty, facilities, and occupational safety. (MSE)
Rojo, Marcial García; Daniel, Christel; Schrader, Thomas
Background: EURO-TELEPATH is a European COST Action IC0604. It started in 2007 and will end in November 2011. Its main objectives are evaluating and validating the common technological framework and communication standards required to access, transmit, and manage digital medical records by pathologists and other medical specialties in a networked environment. Business Modelling: Working Group 1, “Business Modelling in Pathology,” has designed main pathology processes – Frozen Study, Formalin Fixed Specimen Study, Telepathology, Cytology, and Autopsy – using Business Process Modelling Notation (BPMN). Informatics Standards in Pathology: Working Group 2 has been dedicated to promoting the application of informatics standards in pathology, collaborating with Integrating Healthcare Enterprise (IHE), Digital Imaging and Communications in Medicine (DICOM), Health Level Seven (HL7), and other standardization bodies. Conclusion: Health terminology standardization research has become a topic of great interest. Future research work should focus on standardizing automatic image analysis and tissue microarrays imaging. PMID:21987588
Standaert, David G.
Dystonia is a clinical syndrome with sustained muscle contraction, twisting, and abnormal postures. A number of different genetic forms have been defined, but most cases are sporadic in nature and of uncertain cause. Relatively few cases of dystonia have been studied pathologically. In primary dystonias, where dystonia is the main symptom, most reports describe little or no detectable neuropathology, although changes in brainstem neurons have been described in some cases. Secondary dystonias are associated with degenerative or destructive diseases of the nervous system; the pathology may be located in the basal ganglia, but in some cases the primary pathological changes are found in the cerebellum or cerebellar outflow pathways, suggesting both regions may be involved in the pathogenesis of dystonic symptoms. Overall the number of well-documented pathological cases available for study are few, and there is an urgent need for additional postmortem studies. PMID:21220015
Miladinovic, Tanya; Nashed, Mina G.; Singh, Gurmit
As the major excitatory neurotransmitter in the mammalian central nervous system, glutamate plays a key role in many central pathologies, including gliomas, psychiatric, neurodevelopmental, and neurodegenerative disorders. Post-mortem and serological studies have implicated glutamatergic dysregulation in these pathologies, and pharmacological modulation of glutamate receptors and transporters has provided further validation for the involvement of glutamate. Furthermore, efforts from genetic, in vitro, and animal studies are actively elucidating the specific glutamatergic mechanisms that contribute to the aetiology of central pathologies. However, details regarding specific mechanisms remain sparse and progress in effectively modulating glutamate to alleviate symptoms or inhibit disease states has been relatively slow. In this report, we review what is currently known about glutamate signalling in central pathologies. We also discuss glutamate’s mediating role in comorbidities, specifically cancer-induced bone pain and depression. PMID:26569330
Copp, Jonathan A.; Fang, Ronnie H.; Luk, Brian T.; Hu, Che-Ming J.; Gao, Weiwei; Zhang, Kang; Zhang, Liangfang
Pathological antibodies have been demonstrated to play a key role in type II immune hypersensitivity reactions, resulting in the destruction of healthy tissues and leading to considerable morbidity for the patient. Unfortunately, current treatments present significant iatrogenic risk while still falling short for many patients in achieving clinical remission. In the present work, we explored the capability of target cell membrane-coated nanoparticles to abrogate the effect of pathological antibodies in an effort to minimize disease burden, without the need for drug-based immune suppression. Inspired by antibody-driven pathology, we used intact RBC membranes stabilized by biodegradable polymeric nanoparticle cores to serve as an alternative target for pathological antibodies in an antibody-induced anemia disease model. Through both in vitro and in vivo studies, we demonstrated efficacy of RBC membrane-cloaked nanoparticles to bind and neutralize anti-RBC polyclonal IgG effectively, and thus preserve circulating RBCs. PMID:25197051
Ottinger, T; Rasmusson, B; Segerstad, C H A; Merck, M; Goot, F V D; Olsén, L; Gavier-Widén, D
To investigate the current status of forensic veterinary pathology, a survey was composed directed at pathology laboratories and institutes, mostly in Europe. The questions included number of and type of cases, resources available, level of special training of the investigating pathologists and the general view on the current status and future of the discipline. The surveys were sent to 134 laboratories and were returned by 72 respondents of which 93 per cent work on forensic pathology cases. The results indicate scarcity of training opportunities and special education, and insufficient veterinary-specific reference data and information on forensic analyses. More cooperation with human forensic pathology was desired by many respondents, as was more interaction across country borders.
Kumar, Anand; Ceusters, Werner; Rosse, Cornelius
Tumours, abscesses, cysts, scars and fractures are familiar types of what we shall call pathological continuant entities. The instances of such types exist always in or on anatomical structures, which thereby become transformed into pathological anatomical structures of corresponding types: a fractured tibia, a blistered thumb, a carcinomatous colon. In previous work on biomedical ontologies we showed how the provision of formal definitions for relations such as is_a, part_of and transformation_of can facilitate the integration of such ontologies in ways which have the potential to support new kinds of automated reasoning. We here extend this approach to the treatment of pathologies, focusing especially on those pathological continuant entities which arise when organs become affected by carcinomas. PMID:18629199
Richter, G.W.; Epstein, M.A.
This book reviews the experimental pathology advancements made in recent years. Specifically discussed are - Epstein-Barr virus pathogenesis, immune deficient diseases, Hodgkin's disease, lymphomas and other lymphoproliferative disorders.
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www.ncbi.nlm.nih.gov/pubmed/21078227 5. Sundaram SK, Kumar A, Makki MI, Behen ME, Chugani HT, Chugani DC. Diffusion tensor imaging of frontal lobe in autism...other brain cells and analyzed for gene expression differences that might contribute to ASD pathology. The combination of LCM and transcriptional...analysis offer an innovative approach to determining the cellular basis of brain pathology in ASD. Due to the time intensive nature of LCM, the first
Siddiqui, Imran; Ali, Natasha
This article describes the evolution of the induction process of pathology residency at The Aga Khan University hospital. The Department of Postgraduate Medical Education was established in 1985. The induction process is an exhaustive exercise that includes an admission test held simultaneously in Karachi, Hyderabad, Lahore, and Rawalpindi, followed by an interview of the shortlisted candidates. The pathology residency program was started 25 years ago and since then the induction process has undergone major changes with the course of time. PMID:27313487
Narcissistic personality disorder (NPD) is a trait-based disorder that can be understood as a pathological amplification of narcissistic traits. While temperamental vulnerability and psychological adversity are risk factors for NPD, sociocultural factors are also important. This review hypothesizes that increases in narcissistic traits and cultural narcissism could be associated with changes in the prevalence of NPD. These shifts seem to be a relatively recent phenomenon, driven by social changes associated with modernity. While the main treatment for NPD remains psychotherapy, that form of treatment is itself a product of modernity and individualism. The hypothesis is presented that psychological treatment, unless modified to address the specific problems associated with NPD, could run the risk of supporting narcissism.
Everyone has a personal brand. To ensure success at work you need to manage your personal brand which is made up of your tangible and intangible attributes. This paper reviews the literature around personal branding, looks at some of the attributes and discusses ways you can reflect and begin to build your personal brand in a higher education…
Shishniashvili, T E; Tsagareli, Z G; Gogiashvili, L E; Khimshiashvili, N B
The study aimed at investigation of the rate of periodontal pathologies in juvenile adolescents, the analysis of the severity of the disease and detection of the correlation between the periodontal tissue pathology and hormonal status of pre-and pubertal periods. A stomatologic (dental) status of 618 pupils, 9-15 of ages in Tbilisi General Education Schools has been studied--to detect the rate and intensity of periodontal pathologies and analyze the influence of hormonal changes of juvenile periodontal tissues. According to the obtained results we can conclude that the high rate of periodontal diseases has been fixed in pre-pubertal and pubertal schoolchildren (pupils). It should be emphasized that the degree of periodontal tissue pathologies increases with age. In addition, the mentioned pathology was more frequently fixed and expressed in girls, 12-13 of ages and in boys, 14-15 of ages. Juvenile periodontal pathologies most frequently is generalized, which most frequently is aggravated with the existence of jaw-dental anomalies and the poor oral hygiene status.
Scarano, E; Fiorita, A; Picciotti, P M; Passali, G C; Calò, L; Cabras, T; Inzitari, R; Fanali, C; Messana, I; Castagnola, M; Paludetti, G
The salivary proteome is a complex protein mixture resulting from the activity of salivary glands with the contribution of other components that form the oral environment such as oral tissues and micro-organisms. For diagnosis purposes, saliva collection has the great advantage of being an easy and non-invasive technique. Human saliva proteomics have proven to be a novel approach in the search for protein biomarkers for detection of different local and systemic diseases. Currently, more than 1400 salivary proteins have been identified. In the last few years, our research group has extensively studied the salivary proteomics in order to analyse the salivary composition, investigating the major families of proteins present in human and mammalian saliva, the post-translational modifications, the different contributions of glands, the physiological and pathological modifications of saliva. The aim of this report is to present our personal experience in salivary proteomics. In conclusion, salivary proteome analysis represents an important field both for diagnosis and monitoring of various diseases and could be considered a novel approach to prevention of various pathological conditions.
Fossati, Andrea; Pincus, Aaron L; Borroni, Serena; Munteanu, Arina Ferrari; Maffei, Cesare
To understand the similarities and differences in personality traits and moral disengagement associated with pathological narcissism and psychopathy, 740 Italian active community members who voluntarily participated in the study were administered the Italian versions of the Pathological Narcissism Inventory, the Levenson Self-Report Psychopathy Scale, the HEXACO Personality Inventory, and the Moral Disengagement Scale. Hierarchical regression analyses showed that low Honesty-Humility and Antagonism (i.e., low Agreeableness) were personality traits common to both pathological narcissism and psychopathy, whereas low Conscientiousness was only related to psychopathy. Different associations with the HEXACO-PI scales and facets were observed for narcissistic grandiosity and narcissistic vulnerability, as well as for primary psychopathy and secondary psychopathy. Moral disengagement represented a common feature of pathological narcissism and psychopathy that was related to narcissistic vulnerability and to primary and secondary psychopathy, but not to narcissistic grandiosity.
Cornetta, Kenneth; Brown, Candy Gunther
The current description of personalized medicine by the National Institutes of Health is "the science of individualized prevention and therapy." Although physicians are beginning to see the promise of genetic medicine coming to fruition, the rapid pace of sequencing technology, informatics, and computer science predict a revolution in the ability to care for patients in the near future. The enthusiasm expressed by researchers is well founded, but the expectations voiced by the public do not center on advancing technology. Rather, patients are asking for personalized care: a holistic approach that considers physical, mental, and spiritual well-being. This perspective considers psychological, religious, and ethical challenges that may arise as the precision of preventive medicine improves. Psychological studies already highlight the barriers to single gene testing and suggest significant barriers to the predictive testing envisioned by personalized medicine. Certain religious groups will likely mount opposition if they believe personalized medicine encourages embryo selection. If the technology prompts cost-containment discussions, those concerned about the sanctity of life may raise ethical objections. Consequently, the availability of new scientific developments does not guarantee advances in treatment because patients may prove unwilling to receive and act on personalized genetic information. This perspective highlights current efforts to incorporate personalized medicine and personalized care into the medical curriculum, genetic counseling, and other aspects of clinical practice. Because these efforts are generally independent, the authors offer recommendations for physicians and educators so that personalized medicine can be implemented in a manner that meets patient expectations for personalized care.
Blagov, Pavel S; Westen, Drew
After the introduction of histrionic personality disorder (HPD), nosologists struggled to reduce its overlap with borderline personality disorder and other PDs. We studied the coherence of HPD in adults and adolescents as part of 2 larger studies. Clinicians described a random patient with personality pathology using rigorous psychometrics, including the SWAP-II (a Q-sort that captures personality and its pathology in adults) in study 1 and the SWAP-II-A (the adolescent version) in study 2. Using DSM-IV-based measures, we identified patients who met HPD criteria with varying degrees of diagnostic confidence. Central tendencies in the SWAP-II and SWAP-II-A profiles revealed that both the most descriptive and most distinctive features of the patients included some features of HPD but also many features of borderline personality disorder. Q-factor analyses of the SWAP data yielded 3 types of patients in each of the 2 samples. The HPD diagnosis may not be sufficiently coherent or valid.
D'Agati, Vivette D; Mengel, Michael
This review chronicles historical landmarks in the rise of renal pathology from the mid-20th century. Major technical advances followed the advent of percutaneous kidney biopsy in 1951, including applications of thin serial sections, special stains, immunofluorescence, and electron microscopy. Inspired by the 1961 Ciba Symposium, renal pathologists and nephrologists collaborated on detailed clinical-pathologic studies, and the publication of Robert Heptinstall's textbook in 1966 offered the first modern synthesis of these emerging entities. By 2000, refinements in morphology-based diagnosis had outstripped knowledge of pathogenesis. The last decade has witnessed an explosion of new insights into the cause of kidney disease fueled by advances in molecular diagnostics, such as genetic screening, transcriptomics, and proteomics. We are entering an era of personalized medicine in which more precise mechanism-based diagnosis is fostering the design of targeted therapies in the individual patient. Only the continued partnering of pathologists and nephrologists can meet the challenge of integrating molecular diagnostics into pathogenesis-based therapy.
Poon, Connie S K; Koehler, Derek J
This article tests whether individual differences in inferring one trait from another (intertrait inferences) can be linked to lay beliefs about the malleability of personality (person theories). It finds that holding the belief that personality is malleable (incremental theory) rather than fixed (entity theory) at the time of inferences is associated with less extreme inferences involving semantically related (but not unrelated) traits. Although person theories have been assumed to be stable over time, existing short-term test-retest coefficients do not capture their instability over a longer period. These results can illuminate interrater discrepancies in assessments of personality pathology and job performance, enrich understanding of such phenomena as stereotyping and impression formation, refine the interpretation of past research involving person theories, and inform research planning.
Gil, Tsvi E
Borderline personality is a well known concept in psychiatric literature, however, not fully understood as to its very nature. This article presents a short review of hypothesized etiologies of the borderline personality, starting with so called traditional theories, namely, borderline personality as a consolidated personality organization, in which the patient pathologically deals with his or her inner aggression, or with an enduring developmental failure. More modern hypotheses focus on possible childhood sexual abuse as the origin of the borderline, viewing the adult personality as a chronic, unresolved, post-traumatic disorder. Additionally, a neuro-epigenetic view hypothesized that a unique congenital neurological structure interacts with consequential events in early childhood to create the borderline personality.
Maeda, Hitoshi; Zhu, Bao-li; Ishikawa, Takaki; Michiue, Tomomi
In forensic pathology, while classical morphology remains a core procedure to investigate deaths, a spectrum of ancillary procedures has been developed and incorporated to detail the pathology. Among them, postmortem biochemistry is important to investigate the systemic pathophysiological changes involved in the dying process that cannot be detected by morphology. In addition, recent advances in molecular biology have provided a procedure to investigate genetic bases of diseases that might present with sudden death, which is called 'molecular autopsy'. Meanwhile, the practical application of RNA analyses to postmortem investigation has not been accepted due to rapid decay after death; however, recent experimental and practical studies using real-time reverse transcription-PCR have suggested that the relative quantification of mRNA transcripts can be applied in molecular pathology for postmortem investigation of deaths, which may be called 'advanced molecular autopsy'. In a broad sense, forensic molecular pathology implies applied medical sciences to investigate the genetic basis of diseases, and the pathophysiology of diseases and traumas leading to death at a biological molecular level in the context of forensic pathology. The possible applications include analyses of local pathology, including tissue injury, ischemia/hypoxia and inflammation at the site of insult or specific tissue damage from intoxication, systemic responses to violence or environmental hazards, disorders due to intoxication, and systemic pathophysiology of fatal process involving major life-support organs. A review of previous studies suggests that systematic postmortem quantitative analysis of mRNA transcripts can be established from multi-faceted aspects of molecular biology and incorporated into death investigations in forensic pathology, to support and reinforce morphological evidence.
Schwartz, D. A.; Bryan, R. T.; Hughes, J. M.
There have been dramatic changes in the occurrence of infectious diseases throughout the world in the previous two decades. The emergence of new microbial agents, and the reemergence of infections previously believed to be controlled, threatens the health of all populations. The emergence of these infectious diseases has occurred during a period of breakdown in the capabilities of the public health surveillance systems, prevention programs, and disease control efforts. Expertise in pathology is critical to provide a strong national control program for emerging and reemerging infectious diseases. Despite the many significant achievements made by pathologists in improving understanding of the pathogenesis and diagnosis of infectious diseases, the field of pathology remains largely oriented toward neoplastic diseases, and has not yet identified infectious disease diagnosis as an important component of anatomic pathology training and research, even in the face of the current threats posed by microbial agents. In addition, there is currently a dearth of infectious disease pathologists in the United States and elsewhere in the world, and the use of the autopsy, a prime pathological tool for diagnosis of emerging infections, is on the wane. The most serious problem is that no formal training program for infectious disease pathology currently exists in the United States or elsewhere in the world. As a consequence of this lack of training opportunities, there is a severe deficiency of young, well-educated pathologists with infectious disease expertise. This article explores the historical linkages between the disciplines of infectious diseases and pathology, and suggests that infectious disease pathology as a subspecialty be strengthened and training programs be initiated. Images Figure 1 Figure 2 PMID:7495275
Hartman, D J; Pantanowitz, L; McHugh, J S; Piccoli, A L; OLeary, M J; Lauro, G R
Digital pathology is becoming technically possible to implement for routine pathology work. At our institution, we have been using digital pathology for second opinion intraoperative consultations for over 10 years. Herein, we describe our experience in converting to a digital pathology platform for primary pathology diagnosis. We implemented an incremental rollout for digital pathology on subspecialty benches, beginning with cases that contained small amounts of tissue (biopsy specimens). We successfully scanned over 40,000 slides through our digital pathology system. Several lessons (both challenges and opportunities) were learned through this implementation. A successful conversion to digital pathology requires pre-imaging adjustments, integrated software and post-imaging evaluations.
Hopwood, Christopher J.; Grilo, Carlos M.
Ostensible psychiatric comorbidity can sometimes be explained by shared relations between diagnostic constructs and higher order internalizing and externalizing dimensions. However, this possibility has not been explored with regard to comorbidity between personality pathology and other clinical constructs in adolescents. In this study,…
Roberts, Christopher R D; Huprich, Steven K
Narcissistic pathology is assessed in the diagnostic manuals as a categorical construct characterized by cognitive, emotional, and behavioral indicators of grandiosity. This framework ignores the complexities of the construct that also include vulnerability. We suggest that assessing grandiosity and vulnerability as dimensional, interactive components provides the greatest utility when working with narcissistic patients. We describe a patient who presents as fragile, shy, and sensitive, but also has vivid fantasies about his superiority. While he does not meet the DSM-IV criteria for Narcissistic Personality Disorder, we highlight how anxiety, shame, and submissiveness co-occur with grandiosity, which maintain a narcissistic personality organization characterized by severe deficits in self-esteem regulation. We encourage the integration of dimensional assessment into the diagnosis of narcissistic pathology.
Hiemstra, Roger; Tucker, Hugh
The different uses to which two adult educators put their personal computers illustrate some of the many personal and professional applications of microcomputers and point to some implications for home computers in the field of adult education. Relying primarily upon prepared software packages, the first educator relies on his computer as a…
McDonough, S P; McEwen, B J
Veterinary forensic pathology is emerging as a distinct discipline, and this special issue is a major step forward in establishing the scientific basis of the discipline. A forensic necropsy uses the same skill set needed for investigations of natural disease, but the analytical framework and purpose of forensic pathology differ significantly. The requirement of legal credibility and all that it entails distinguishes the forensic from routine diagnostic cases. Despite the extraordinary depth and breadth of knowledge afforded by their training, almost 75% of veterinary pathologists report that their training has not adequately prepared them to handle forensic cases. Many veterinary pathologists, however, are interested and willing to develop expertise in the discipline. Lessons learned from tragic examples of wrongful convictions in medical forensic pathology indicate that a solid foundation for the evolving discipline of veterinary forensic pathology requires a commitment to education, training, and certification. The overarching theme of this issue is that the forensic necropsy is just one aspect in the investigation of a case of suspected animal abuse or neglect. As veterinary pathologists, we must be aware of the roles filled by other veterinary forensic experts involved in these cases and how our findings are an integral part of an investigation. We hope that the outcome of this special issue of the journal is that veterinary pathologists begin to familiarize themselves with not only forensic pathology but also all aspects of veterinary forensic science.
The present comment of mine will dwell mainly on my impressions about the format of teaching. It seems to be very difficult to judge how much classic practical training should be given since for example in histology, it may often go deep into details probably irrelevant for the students. It must be realized, however, that the rapid increase in general knowledge and in the special demands of various medical specialities also impose an ever-increasing stress on the pathologist himself. Therefore it is necessary to define certain limits, however difficult a problem this may be. I have proposed an integrated presentation. The integration should, however, not be made by the clinician as the first and the pathologist as the second violinist. In this case the clinician may misinterpret pathology and may interfere with the pathologist in presenting pathology with appropriate weight and adequate importance. The moderator is the director of the pathology department. No special clinical details are given but those sufficient to ensure a better understanding of the pathological changes presented. Under these conditions the pathologist has full control of the essential views and details given to the student, thus demonstrating the importance of pathology in medicine.
Development of molecular imaging agents for fibrillar β-amyloid positron-emission tomography during the past decade has brought molecular imaging of Alzheimer disease pathology into the spotlight. Large cohort studies with longitudinal follow-up in cognitively normal individuals and patients with mild cognitive impairment and Alzheimer disease indicate that β-amyloid deposition can be detected many years before the onset of symptoms with molecular imaging, and its progression can be followed longitudinally. The utility of β-amyloid PET in the differential diagnosis of Alzheimer disease is greatest when there is no pathologic overlap between 2 dementia syndromes, such as in frontotemporal lobar degeneration and Alzheimer disease. However β-amyloid PET alone may be insufficient in distinguishing dementia syndromes that commonly have overlapping β-amyloid pathology, such as dementia with Lewy bodies and vascular dementia, which represent the 2 most common dementia pathologies after Alzheimer disease. The role of molecular imaging in Alzheimer disease clinical trials is growing rapidly, especially in an era when preventive interventions are designed to eradicate the pathology targeted by molecular imaging agents.
Leong, F Joel W-M; Leong, Anthony S-Y
Digital imaging has progressed at a rapid rate and is likely to eventually replace chemical photography in most areas of professional and amateur digital image acquisition. In pathology, digital microscopy has implications beyond that of taking a photograph. The arguments for adopting this new medium are compelling, and given similar developments in other areas of pathology and radiologic imaging, acceptance of the digital medium should be viewed as a component of the technological evolution of the laboratory. A digital image may be stored, replicated, catalogued, employed for educational purposes, transmitted for further interpretation (telepathology), analyzed for salient features (medical vision/image analysis), or form part of a wider digital healthcare strategy. Despite advances in digital camera technology, good image acquisition still requires good microscope optics and the correct calibration of all system components, something which many neglect. The future of digital imaging in pathology is very promising and new applications in the fields of automated quantification and interpretation are likely to have profound long-term influence on the practice of anatomic pathology. This paper discusses the state of the art of digital imaging in anatomic pathology.
The author outlines his concept of reflective function or mentalization, which is defined as the capacity to think about mental states in oneself and in others. He presents evidence to suggest that the capacity for reflective awareness in a child's caregiver increases the likelihood of the child's secure attachment, which in turn facilitates the development of mentalization in the child. He proposes that a secure attachment relationship offers the child a chance to explore the mind of the caregiver, and in this way to learn about minds; he formulates this model of the birth of the psychological self as a variation on the Cartesian cogito: "My caregiver thinks of me as thinking and therefore I exist as a thinker." This model is then applied to provide insight into some personality-disordered individuals who were victims of childhood abuse. The author proposes (1) that individuals who experience early trauma may defensively inhibit their capacity to mentalize to avoid having to think about their caregiver's wish to harm them; and (2) that some characteristics of severe borderline personality disorder may be rooted in developmental pathology associated with this inhibition. He offers evidence for and some qualifications of this model, and argues that the therapeutic effect of psychoanalysis depends on its capacity to activate patients' ability to evolve an awareness of mental states and thus find meaning in their own and other people's behavior.
Guo, Jennifer; Kamel-Reid, Suzanne; Rutherford, Michael; Hart, Jennifer; Melamed, Saul; Pollett, Aaron
Personalized medicine is a rapidly expanding field, with the potential to improve patient care. Its benefits include increasing efficiency in cancer screening, diagnosis and treatment through early detection, targeted therapy and identifying individuals with an underlying genetic risk for cancer or adverse outcomes. Through the work of Cancer Care Ontario (CCO)'s Pathology and Laboratory Medicine Program, a number of initiatives have been undertaken to support developments in personalized medicine. In keeping with the momentum of recent accomplishments, CCO has led the formation of the Personalized Medicine Steering Committee to develop a comprehensive provincial genetics strategy for the future of cancer care.
Iannicelli, E; Sessa, B; Sapori, A; Cappucci, M; Briani, C; Federici, G F; Di Pietropaolo, M; Merola, S
Ultrasonography (US) is the imaging modality of choice for the evaluation of scrotal disease. It provides high anatomical detail and in most cases, it is essential to enable a correct diagnosis and to obtain the right management of the patient. Color Doppler ultrasonography is a non invasive technique that aids important information about testicular perfusion, necessary in reaching a specific diagnosis in many pathologic conditions; moreover contrast-enhanced ultrasonography (CEUS), recently introduced in the clinical practice, may be considered an additional tool in the classification and differentiation of testicular pathology. The purpose of this review, is to provide the state of the art on the role of ultrasonography in the evaluation of different scrotal pathologies including vaginal process' disorders, acute scrotum, varicocele, hydrocele, chronic inflammatory diseases and testicular tumours.
Finch, John M. . E-mail: email@example.com
In the late nineteenth century, microscopists developed a quaint method for examining the fine structure of biological specimens: paraffin embedding and staining with hematoxylin and eosin. This ancient technology is here to stay for the foreseeable future, because it can and does reveal the truth about biological processes. However, the role of pathology is developing with ever greater worldwide interaction between pathologists, and better communication and agreeing of international standards. Furthermore, recent techniques including immunohistochemistry, electron microscopy and image analysis complement the traditional tried and tested tools. There is also in toxicologic pathology a willingness to use pathology methods and skills in new contexts, drug discovery in particular. But even in these days of genetic modification, proteomics and high throughput screening, pathologists continue to rely on dyes extracted from a Central American logwood used in Mexico before the Spanish invasion in 1520.
Yang, L; Wu, D; Fan, Z-M
The cause of pathologic nipple discharge is mainly benign lesions, but there is still a possibility of malignancy. Pathologic nipple discharge may be the only or the first symptom of breast cancer. This study aimed to investigate the clinical factors associated with lesions in patients with pathologic nipple discharge using a retrospective analysis of clinical data in 207 cases. The univariate analysis showed that age >50 years, breast lumps, or breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Discharge characteristics, duration of disease, and identification of lesions had no clear clinical significance (P > 0.05). The multivariate analysis also showed that age >50 years, breast lumps, and breast calcifications were risk factors associated with breast cancer in nipple discharge patients (P < 0.05). Age, breast lumps, and breast calcifications had important clinical significance in identification of benign and malignant nipple discharge.