Gambling transitions among adult gamblers: A multi-state model using a Markovian approach applied to the JEU cohort
Addictive Behaviors. 2016-06-01; 57: 13-20
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1. Addict Behav. 2016 Jun;57:13-20. doi: 10.1016/j.addbeh.2016.01.010. Epub 2016 Jan
Gambling transitions among adult gamblers: A multi-state model using a Markovian
approach applied to the JEU cohort.
Bruneau M(1), Grall-Bronnec M(1), Vénisse JL(1), Romo L(2), Valleur M(3), Magalon
D(4), Fatséas M(5), Chéreau-Boudet I(6), Luquiens A(7); JEU-Group, Challet-Bouju
G(1), Hardouin JB(8).
(1)BALANCED Clinical Investigation Unit (« BehaviorAL AddictioNs and ComplEx mood
Disorders »), Department of Addictology and Psychiatry, University Hospital of
Nantes, France; EA 4275 SPHERE « MethodS for Patients-centered outcomes and HEalth
REsearch », University of Nantes, France.
(2)EA 4430 CLIPSYD « CLInique PSYchanalyse Développement », University of Paris
Ouest Nanterre La Défense, France; Louis Mourier Hospital of Colombes, Assistance
Publique – Hôpitaux de Paris (APHP), France.
(3)Marmottan Medical Center, GPS Perray-Vaucluse, Paris, France.
(4)Department of Adult Psychiatry, Sainte-Marguerite University Hospital of
(5)Psychiatry Laboratory, Sanpsy CNRS USR 3413, University of Bordeaux and
Charles Perrens Hospital, Bordeaux, France.
(6)Psychiatry Department, University Hospital of Clermont-Ferrand, France.
(7)Psychiatry and Addictology Department, Paul Brousse University Hospital of
Villejuif, Assistance Publique – Hôpitaux de Paris (APHP), France.
(8)EA 4275 SPHERE « MethodS for Patients-centered outcomes and HEalth REsearch »,
University of Nantes, France; Unit of Methodology and Biostatistics, University
Hospital of Nantes, France.
INTRODUCTION: The aim of this paper is to study transitions between two states of
gambling in adulthood (problem gambling and non-problem gambling) and to identify
factors that might influence these transitions.
METHODS: Data for this 2-year long longitudinal study were collected in a French
Outpatient Addiction Treatment Center, in gambling establishments and through the
press. Both problem gamblers and non-problem gamblers were evaluated using a
structured interview and self-report questionnaires. The statistical analysis was
carried out using a Markovian approach.
RESULTS: The analyzed cohort consisted of 304 gamblers with 519 observed
transitions. Participants with no past-year gambling problems (based on the
DSM-IV) had a probability of about 90% of also having no past-year gambling
problems at the following assessment, whereas the observed percentage of problem
gamblers transitioning to non-problem gambling was of 48%. We reported (i)
vulnerability factors of transitioning to problem gambling (such as an anxiety
disorder or an Attention Deficit Hyperactivity Disorder (ADHD) during the
childhood), (ii) protective factors for non-problem gamblers, (iii) recovery
factors (such as ongoing treatment and younger age) and (iv) persistence factors
of a gambling problem (such as a persistent ADHD).
CONCLUSIONS: The status of problem gambler is unstable over time, whereas we
found stability among non-problem gamblers. Our findings suggest the existence of
vulnerability and protective factors in gambling. These results lead to think
about preventive actions and adaptive care, such as cognitive-behavioral therapy
or researching gambling problems in people with an anxiety disorder or ADHD.
Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
PMID: 26827154 [Indexed for MEDLINE]