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Comorbidity, family history and personality traits in pathological gamblers compared with healthy controls

Published online by Cambridge University Press:  23 March 2020

K. Mann ,
T. Lemenager ,
E. Zois ,
S. Hoffmann ,
H. Nakovics ,
M. Beutel ,
M. Vogelgesang ,
K. Wölfling ,
F. Kiefer  and
M. Fauth-Bühler
K. Mann
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
T. Lemenager
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
E. Zois
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
S. Hoffmann
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
H. Nakovics
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
M. Beutel
Affiliation:
Kraichtal-Kliniken Am Mühlberg, Kraichtal76703, Germany
M. Vogelgesang
Affiliation:
AHG Klinik Münchwies, Neunkirchen, Germany
K. Wölfling
Affiliation:
Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
F. Kiefer
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
M. Fauth-Bühler*
Affiliation:
Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
*
*Corresponding author at: Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Department of Addictive Behavior and Addiction Medicine, Research Group on Pathological Gambling, Square J5, 68159 Mannheim, Germany. Tel.: +49 (0)621 1703 3543; fax: +49 (0)621 1703 3505. E-mail address:[email protected] (M. Fauth-Bühler).
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Abstract

Background

While DSM-5 classified pathological gambling as an addictive disorder, there is debate as to whether ICD-11 should follow suit. The debate hinges on scientific evidence such as neurobiological findings, family history of psychiatric disorders, psychiatric comorbidity, and personality variables.

Methods

In the “Baden-Württemberg Study of Pathological Gambling”, we compared a group of 515 male pathological gamblers receiving treatment with 269 matched healthy controls. We studied differences in sociodemographic characteristics, gambling-related variables, psychiatric comorbidity (lifetime), family history of psychiatric conditions, as well as personality traits such as impulsivity (Barratt Impulsiveness Scale), sensation seeking (Zuckerman's Sensation Seeking Scale) and the NEO-FFI big five. Personality traits were validated in an age- and ethnicity-matched subsample of “pure” gamblers without any psychiatric comorbidity (including nicotine dependence). Data were analyzed using two-sample t-tests, Chi2 analyses, Fisher's exact test and Pearson correlation analysis, as appropriate. Bonferroni correction was applied to correct for multiple comparisons.

Results

Only 1% of the gamblers had been diagnosed with an impulse control disorder other than gambling (ICD-10). Notably, 88% of the gamblers in our sample had a comorbid diagnosis of substance dependence. The highest axis I comorbidity rate was for nicotine dependence (80%), followed by alcohol dependence (28%). Early age of first gambling experience was correlated with gambling severity. Compared to first-degree relatives of controls, first-degree relatives of pathological gamblers were more likely to suffer from alcohol dependence (27.0% vs. 7.4%), pathological gambling (8.3% vs. 0.7%) and suicide attempts (2.7% vs. 0.4%). Significant group differences were observed for the NEO-FFI factors neuroticism, agreeableness and conscientiousness. Gamblers were also more impulsive than controls, but did not differ from controls in terms of sensation seeking.

Conclusions

Our findings support classifying pathological gambling as a behavioural addiction in the ICD-11. This decision will have a significant impact on the approaches available for prevention (e.g. age limits) and treatment.

Keywords

Pathological gamblingComorbidityFamily historyPersonality traitsTreatment-seeking pathological gamblers
Type
Original article
Information
European Psychiatry , Volume 42 , May 2017 , pp. 120 - 128
Copyright
Copyright © European Psychiatric Association 2017

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Footnotes

1

Tel.: +49 (0)621 1703 3543; fax: +49 (0)621 1703 3505.

References

Griffiths, M.D.Problem gambling worldwide: An update and systematic review of empirical research (2000–2015). J Behav Addict 2016;5(4):592–613.Google Scholar
Kessler, R.C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N.A., Winters, K.C.et al.DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychol Med 2008;38(9):1351–1360.CrossRefGoogle ScholarPubMed
Gowing, L.R., Ali, R.L., Allsop, S., Marsden, J., Turf, E.E., West, R.et al.Global statistics on addictive behaviours: 2014 status report. Addiction 2015;110(6):904–919.CrossRefGoogle ScholarPubMed
Hodgins, D.C., Stea, J.N., Grant, J.E.Gambling disorders. Lancet 2011;26(9806):1874–1884 [378]CrossRefGoogle Scholar
Petry, N.M., Stinson, F.S., Grant, B.F.Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2005;66(5):564–574.CrossRefGoogle ScholarPubMed
Premper, V., Schulz, W.Komorbidität bei Pathologischem Glücksspiel. Sucht 2008;54(3):131–140.CrossRefGoogle Scholar
Meyer, C., Rumpf, H., Kreuzer, A., de Brito, S., Glorius, S., Jeske, C.et al.Pathologisches Glücksspielen und Epidemiologie (PAGE): Entstehung, Komorbidität, Remission und Behandlung. Greifswald/Lübeck: Endbericht an das Hessische Ministerium des Innern und für Sport; 2011.Google Scholar
Dannon, P.N., Lowengrub, K., Aizer, A., Kotler, M.Pathological gambling: comorbid psychiatric diagnoses in patients and their families. Isr J Psychiatry Relat Sci 2006;43(2):88–92.Google ScholarPubMed
Black, D.W., Coryell, W.H., Crowe, R.R., McCormick, B., Shaw, M.C., Allen, J.A direct, controlled, blind family study of DSM-IV pathological gambling. J Clin Psychiatry 2014;75(3):215–221.CrossRefGoogle ScholarPubMed
Black, D.W., Coryell, W., Crowe, R., Shaw, M., McCormick, B., Allen, J.The relationship of DSM-IV pathological gambling to compulsive buying and other possible spectrum disorders: results from the Iowa PG family study. Psychiatry Res 2015;226(1):273–276.CrossRefGoogle ScholarPubMed
Versini, A., LeGauffre, C., Romo, L., Adès, J., Gorwood, P.Frequency of gambling problems among parents of pathological, versus nonpathological, casino gamblers using slot machines. Am J Addict 2012;21(1):86–95.CrossRefGoogle ScholarPubMed
Schreiber, L., Odlaug, B.L., Kim, S.W., Grant, J.E.Characteristics of pathological gamblers with a problem gambling parent. Am J Addict 2009;18(6):462–469.CrossRefGoogle ScholarPubMed
Kuley, N.B., Jacobs, D.F.The relationship between dissociative-like experiences and sensation seeking among social and problem gamblers. J Gambl Behav 1988;4:197–207.CrossRefGoogle Scholar
Powell, J., Hardoon, K., Derevensky, J.L., Gupta, R.Gambling and risk-taking behavior among university students. Subst Use Misuse 1999;34:1167–1184.CrossRefGoogle ScholarPubMed
Blaszczynski, A.P., Wilson, A.C., McConaghy, N.Sensation seeking and pathological gambling. Br J Addict 1986;81:113–117.CrossRefGoogle ScholarPubMed
Blanco, C., Orensanz-Munoz, L., Blanco-Jerez, C., Saiz-Ruiz, J.Pathological gambling and platelet MAO activity: a psychobiological study. Am J Psychiatry 1996;153:119–121.Google ScholarPubMed
Carrasco, J.L., Saiz-Ruiz, J., Hollander, E., Cesar, J., Lopez-Ibor, J.J.Low platelet monoamine oxidase activity in pathological gambling. Acta Psychiatr Scand 1994;90:427–431.CrossRefGoogle ScholarPubMed
Müller, K.W., Dreier, M., Beutel, M.E., Wölfling, K.Is sensation seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with gambling disorder and Internet addiction. Psychiatry Res 2016;242:319–325.CrossRefGoogle ScholarPubMed
Parke, A., Griffiths, M., Irwing, P.Personality traits in pathological gambling: sensation seeking, deferment of gratification and competitiveness as risk factors. Addict Res Theory 2004;12:201–212.CrossRefGoogle Scholar
Anderson, G., Brown, R.I.F.Real and laboratory gambling, sensation seeking and arousal. Br J Psychol 1984;75:401–410.CrossRefGoogle ScholarPubMed
Blaszczynski, A., McConaghy, N., Frankova, A.Boredom proneness in pathological gambling. Psychol Rep 1990;67:35–42.CrossRefGoogle ScholarPubMed
Bonnaire, C., Lejoyeux, M., Dardennes, R.Sensation seeking in a French population of PGs: comparison with regular and nongamblers. Psychol Rep 2004;94:1361–1371.CrossRefGoogle Scholar
Maclaren, V.V., Fugelsang, J.A., Harrigan, K.A., Dixon, M.J.The personality of pathological gamblers: a meta-analysis. Clin Psychol Rev 2011;31(6):1057–1067.CrossRefGoogle ScholarPubMed
Black, D.W., Coryell, W.H., Crowe, R.R., Shaw, M., McCormick, B., Allen, J.Personality disorders, impulsiveness, and novelty seeking in persons with DSM-IV pathological gambling and their first-degree relatives. J Gambl Stud 2015;31(4):1201–1214.CrossRefGoogle ScholarPubMed
Kräplin, A., Dshemuchadse, M., Behrendt, S., Scherbaum, S., Goschke, T., Bühringer, G.Dysfunctional decision-making in pathological gambling: pattern specificity and the role of impulsivity. Psychiatry Res 2014;215(3):675–682.CrossRefGoogle ScholarPubMed
Lai, F.D., Ip, A.K., Lee, T.M.Impulsivity and pathological gambling: is it a state or a trait problem?. BMC Res Notes 2011;4:49210.1186/1756-0500-4-492CrossRefGoogle ScholarPubMed
Sáez-Abad, C., Bertolín-Guillén, J.M.Personality traits and disorders in pathological gamblers versus normal controls. J Addict Dis 2008;27(1):33–40.CrossRefGoogle ScholarPubMed
Hwang, J.Y., Shin, Y.C., Lim, S.W., Park, H.Y., Shin, N.Y., Jang, J.H.et al.Multidimensional comparison of personality characteristics of the Big Five model, impulsiveness, and affect in pathological gambling and obsessive-compulsive disorder. J Gambl Stud 2012;28(3):351–362.CrossRefGoogle ScholarPubMed
Myrseth, H., Tverå, R., Hagatun, S., Lindgren, C.A comparison of impulsivity and sensation seeking in pathological gamblers and skydivers. Scand J Psychol 2012;53(4):340–346.CrossRefGoogle ScholarPubMed
Allcock, C.C., Grace, D.M.Pathological gamblers are neither impulsive nor sensation-seekers. Aust N Z J Psychiatry 1988;22(3):307–311.CrossRefGoogle ScholarPubMed
Langewisch, M.W.J., Frisch, G.R.Gambling behavior and pathology in relation to impulsivity, sensation seeking, and risky behavior in male college students. J Gambl Stud 1998;14:245–262.CrossRefGoogle Scholar
Bagby, R.M., Vachon, D.D., Bulmash, E.L., Toneatto, T., Quilty, L.C., Costa, P.T.Pathological gambling and the five-factor model of personality. Pers Individual Differences 2007;43:873–880.CrossRefGoogle Scholar
Myrseth, H., Pallesen, S., Molde, H., Johnsen, B.H., Lorvik, I.M.Personality factors as predictors of pathological gambling. Pers Individual Differences 2009;47(8):933–937.CrossRefGoogle Scholar
MacLaren, V.V., Best, L.A., Dixon, M.J., Harrigan, K.A.Problem gambling and the five-factor model in university students. Pers Individual Differences 2011;50(3):335–338.CrossRefGoogle Scholar
Carlotta, D., Krueger, R.F., Markon, K.E., Borroni, S., Frera, F., Somma, A.et al.Adaptive and maladaptive personality traits in high-risk gamblers. J Pers Disord 2015;(3):378–392.CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed.. Washington, DC: American Psychiatric Association; 2013.Google Scholar
Grant, J.E., Atmaca, M., Fineberg, N.A., Fontenelle, L.F., Matsunaga, H., Janardhan Reddy, Y.C.et al.Impulse control disorders and “behavioural addictions” in the ICD-11. World Psychiatry 2014;13:125–127.CrossRefGoogle ScholarPubMed
Mann, K., Fauth-Bühler, M., Higuchi, S., Potenza, M.N., Saunders, J.B.Pathological gambling. A behavioural addiction. World Psychiatry 2016;15(3):297–298.CrossRefGoogle Scholar
Kräplin, A., Bühringer, G., Oosterlaan, J., van den Brink, W., Goschke, T., Goudriaan, A.E.Dimensions and disorder specificity of impulsivity in pathological gambling. Addict Behav 2014;39(11):1646–1651.CrossRefGoogle ScholarPubMed
Anghelescu, I., Klawe, C., Singer, P., Fehr, C., Hiemke, C., Quante, A.et al.Low novelty seeking and high self-directedness scores in alcohol-dependent patients without comorbid psychiatric disorders homozygous for the A10 allele of the dopamine transporter gene. World J Biol Psychiatry 2010;11:382–389.CrossRefGoogle ScholarPubMed
Hittner, J.B., Swickert, R.Sensation seeking and alcohol use: a meta-analytic review. Addict Behav 2006;31(8):1383–1401.CrossRefGoogle ScholarPubMed
Lister, J.J., Milosevic, A., Ledgerwood, D.M.Psychological characteristics of problem gamblers with and without mood disorder. Can J Psychiatry 2015;60(8):369–376.CrossRefGoogle ScholarPubMed
Lucas, R.E., Donnellan, M.B.Personality development across the life span: longitudinal analyses with a national sample from Germany. J Pers Soc Psychol 2011;101(4):847–861.CrossRefGoogle ScholarPubMed
Franz, M., Salize, H.J., Lujic, C., Koch, E., Gallhofer, B., Jacke, C.O.Illness perceptions and personality traits of patients with mental disorders: the impact of ethnicity. Acta Psychiatr Scand 2014;129(2):143–155.CrossRefGoogle ScholarPubMed
Fauth-Bühler, M., Zois, E., Vollstädt-Klein, S., Lemenager, T., Beutel, M., Mann, K.Insula and striatum activity in effort-related monetary reward processing in gambling disorder: the role of depressive symptomatology. Neuroimage Clin 2014;16(6):243–251.CrossRefGoogle Scholar
Zois, E., Kortlang, N., Vollstädt-Klein, S., Lemenager, T., Beutel, M., Mann, K.et al.Decision-making deficits in patients diagnosed with disordered gambling using the Cambridge Gambling task: the effects of substance use disorder comorbidity. Brain Behav 2014;4(4):484–494.CrossRefGoogle ScholarPubMed
Zois, E., Kiefer, F., Lemenager, T., Vollstädt-Klein, S., Mann, K., Fauth-Bühler, M.Frontal cortex gray matter volume alterations in pathological gambling occur independently from substance use disorder. Addict Biol 201610.1111/adb.12368 [Epub ahead of print]Google ScholarPubMed
Lang, M., Leménager, T., Streit, T., Fauth-Bühler, M., Frank, J., Mann, K.Genome-wide association study of pathological gambling. Eur Psychiatry 2016;36:38–46. http://dx.doi.org/10.1016/j.eurpsy.2016.04.001.CrossRefGoogle ScholarPubMed
Lesieur, H.R., Blume, S.B.The South Oaks Gambling Screen (SOGS): a new instrument for the identification of pathological gamblers. Am J Psychiatry 1987;144(9):1184–1188.Google ScholarPubMed
Wittchen, H.-U., Zaudig, M., Fydrich, T.Strukturiertes Klinisches Interview für DSM-IV. Göttingen: Hogrefe; 1997.Google Scholar
Müller, K.U., Gan, G., Banaschewski, T., Barker, G.J., Bokde, A.L., Büchel, C.et al.No differences in ventral striatum responsivity between adolescents with a positive family history of alcoholism and controls. Addict Biol 2015;20(3):534–545.CrossRefGoogle ScholarPubMed
Pallanti, S., DeCaria, C.M., Grant, J.E., Urpe, M., Hollander, E.Reliability and validity of the pathological gambling adaptation of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS). J Gambl Stud 2005;21(4):431–443.CrossRefGoogle Scholar
Heatherton, T.F., Kozlowski, L.T., Frecker, R.C., Fagerström, K.O.The Fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 1991;86(9):1119–1127.CrossRefGoogle ScholarPubMed
Patton, J.H., Stanford, M.S., Barratt, E.S.Factor structure of the Barratt Impulsiveness Scale. J Clin Psychol 1995;51(6):768–774.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Preuss, U.W., Rujescu, D., Giegling, I., Watzke, S., Koller, G., Zetzsche, T.et al.[Psychometric evaluation of the German version of the Barratt Impulsiveness Scale]. Nervenarzt 2008;79(3):305–319 [Article in German]CrossRefGoogle Scholar
Zuckerman, M., Eysenck, S.B.J., Eysenck, H.J.Sensation seeking in England and America: cross-cultural, age, and sex comparisons. J Consult Clin Psychol 1978;46(1):139–149.CrossRefGoogle ScholarPubMed
Beauducel, A., Brocke, B., Strobel, A., Strobel, A.Construct validity of sensation seeking: a psychometric investigation. Z Differentielle Diagn Psychol 1999;20(3):155–171.CrossRefGoogle Scholar
Kanning, U.P.NEO-Fünf-Faktoren-Inventar nach Costa und McCrae (NEO-FFI). Z Arbeits Organ Psychol A&O 2015;53:194–198. http://dx.doi.org/10.1026/0932-4089.53.4.194 [Hogrefe Verlag. 2009].Google Scholar
Borkenau, P., Ostendorf, F.NEO-Fünf-Faktoren-Inventar (NEO-FFI) nach Costa und McCrae. Handanweisung. Göttingen: Hogrefe; 1993.Google Scholar
Subramaniam, M., Wang, P., Soh, P., Vaingankar, J.A., Chong, S.A., Browning, C.J.et al.Prevalence and determinants of gambling disorder among older adults: a systematic review. Addict Behav 2015;41:199–209.CrossRefGoogle ScholarPubMed
Castrén, S., Basnet, S., Salonen, A.H., Pankakoski, M., Ronkainen, J.E., Alho, H.et al.Factors associated with disordered gambling in Finland. Subst Abuse Treat Prev Policy 2013;8:24.CrossRefGoogle ScholarPubMed
Hayer, T.Geldspielautomaten und Suchtgefahren – Wissenschaftliche Erkenntnisse und Suchtpolitischer Handlungsbedarf. Sucht Aktuell 2010;17(1):47–52.Google Scholar
Goudriaan, A.E., Slutske, W.S., Krull, J.L., Sher, K.J.Longitudinal patterns of gambling activities and associated risk factors in college students. Addiction 2009;104(7):1219–1232.CrossRefGoogle ScholarPubMed
Welte, J.W., Barnes, G.M., Wieczorek, W.F., Tidwell, M.C., Parker, J.C.Risk factors for pathological gambling. Addict Behav 2004;29(2):323–335.CrossRefGoogle ScholarPubMed
Moragas, L., Granero, R., Stinchfield, R., Fernández-Aranda, F., Fröberg, F., Aymamí, N.et al.Comparative analysis of distinct phenotypes in gambling disorder based on gambling preferences. BMC Psychiatry 2015;15:86.CrossRefGoogle ScholarPubMed
Jiménez-Murcia, S., Granero, R., Tárrega, S., Angulo, A., Fernández-Aranda, F., Arcelus, J.et al.Mediational role of age of onset in gambling disorder, a path modeling analysis. J Gambl Stud 2016;32(1):327–340.CrossRefGoogle ScholarPubMed
Shek, D.T., Chan, E.M., Wong, R.H.Associations between pathological gambling and psychiatric comorbidity among help-seeking populations in Hong Kong. Sci World J 2012;2012:571434.CrossRefGoogle ScholarPubMed
Sinclair, H., Pasche, S., Pretorius, A., Stein, D.J.Clinical profile and psychiatric comorbidity of treatment-seeking individuals with pathological gambling in South Africa. J Gambl Stud 2015;31(4):1227–1243.CrossRefGoogle ScholarPubMed
Maccallum, F., Blaszczynski, A.Pathological gambling and comorbid substance use. Aust N Z J Psychiatry 2002;36(3):411–415.CrossRefGoogle ScholarPubMed
Crockford, D.N., el-Guebaly, N.Psychiatric comorbidity in pathological gambling: a critical review. Can J Psychiatry 1998;43(1):43–50.CrossRefGoogle ScholarPubMed
Grant, J.E., Kushner, M.G., Kim, S.W. Pathological gambling and alcohol use disorder. 2002. http://pubs.niaaa.nih.gov/publications/arh26-2/143-150.htm.Google Scholar
Fauth-Bühler, M., Mann, K., Potenza, M.N.Pathological gambling: a review of the neurobiological evidence relevant for its classification as an addictive disorder. Addict Biol 201610.1111/adb.12378 [Epub ahead of print]Google ScholarPubMed
Eisen, S.A., Lin, N., Lyons, M.J.et al.Familial influences on gambling behavior: an analysis of 3359 twin pairs. Addiction 1998;93(9):1375–1384.Google ScholarPubMed
Slutske, W.S., Eisen, S., True, W.R.et al.Common genetic vulnerability for pathological gambling and alcohol dependence in men. Arch Gen Psychiatry 2000;57(7):666–673.CrossRefGoogle ScholarPubMed
Slutske, W.S., Eisen, S., Xian, H.et al.A twin study of the association between pathological gambling and antisocial personality disorder. J Abnorm Psychol 2001;110(2):297–308.CrossRefGoogle ScholarPubMed
Potenza, M.N.Review: the neurobiology of pathological gambling and drug addiction: an overview and new findings. Philos Trans R Soc Lond B Biol Sci 2008;363(1507):3181–3189.CrossRefGoogle ScholarPubMed
Ramos-Grille, I., Gomà-i-Freixanet, M., Aragay, N., Valero, S., Vallès, V.Predicting treatment failure in pathological gambling: the role of personality traits. Addict Behav 2015;43:54–59.CrossRefGoogle ScholarPubMed
de Wit, H.Impulsivity as a determinant and consequence of drug use: a review of underlying processes. Addict Biol 2009;14(1):22–31.CrossRefGoogle ScholarPubMed
Leeman, R.F., Potenza, M.N.Similarities and differences between pathological gambling and substance use disorders: a focus on impulsivity and compulsivity. Psychopharmacology (Berl) 2012;219(2):469–490.CrossRefGoogle ScholarPubMed
Miller, M.E., Badger, G.J., Heil, S.H., Higgins, S.T., Sigmon, S.C.Associations between sensation seeking and d-amphetamine reinforcement. Am J Addict 2015;24(5):435–442.CrossRefGoogle ScholarPubMed
Hojjat, S.K., Golmakani, E., Bayazi, M.H., Mortazavi, R., Norozi Khalili, M., Akaberi, A.Personality traits and identity styles in methamphetamine-dependent women: a comparative study. Glob J Health Sci 2015;8(1):14–20.CrossRefGoogle ScholarPubMed
Ronzitti, S., Lutri, V., Smith, N., Clerici, M., Bowden-Jones, H.Gender differences in treatment-seeking British pathological gamblers. J Behav Addict 2016;5(2):231–238.CrossRefGoogle ScholarPubMed
George, S., Bowden-Jones, H.Treatment provision for gambling disorder in Britain: call for an integrated addictions treatment and commissioning model. BJ Psych Bull 2016;40(3):113–115.Google ScholarPubMed
Körner, A., Geyer, M., Brähler, E.Das NEO-Fünf-Faktoren-Inventar (NEO-FFI). Validierung anhand einer deutschen Bevölkerungsstichprobe. Diagnostica 2002;48(1):19–27.CrossRefGoogle Scholar
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