The predictive capacity of DSM-5 symptom severity and impulsivity on response to cognitive-behavioral therapy for gambling disorder: A 2-year longitudinal study

Gemma Mestre-Bach, Trevor Steward, Roser Granero, Fernando Fernández-Aranda, Amparo del Pino-Gutiérrez, Núria Mallorquí-Bagué, Teresa Mena-Moreno, Cristina Vintró-Alcaraz, Laura Moragas, Neus Aymamí, Mónica Gómez-Peña, Jéssica Sánchez-González, Zaida Agüera, María Lozano-Madrid, José M. Menchón, Susana Jiménez-Murcia

Research output: Contribution to journalArticleResearch

6 Citations (Scopus)

Abstract

© 2018 Elsevier Masson SAS Background: DSM-5 proposed a new operational system by using the number of fulfilled criteria as an indicator of gambling disorder severity. This method has proven to be controversial among researchers and clinicians alike, due to the lack of studies indicating whether severity, as measured by these criteria, is clinically relevant in terms of treatment outcome. Additionally, numerous studies have highlighted the associations between gambling disorder and impulsivity, though few have examined the impact of impulsivity on long-term treatment outcomes. Methods: In this study, we aimed to assess the predictive value of DSM-5 severity levels on response to cognitive-behavioral therapy (CBT) in a sample of male adults seeking treatment for gambling disorder (n = 398). Furthermore, we explored longitudinal predictors of CBT treatment response at a follow-up, considering UPPS-P impulsivity traits. Results: Our study failed to identify differences in treatment outcomes between patients categorized by DSM-5 severity levels. Higher baseline scores in negative urgency predicted relapse during CBT treatment, and higher levels of sensation seeking were predictive of drop-out from short-term treatment, as well as of drop-out at 24-months. Conclusions: These noteworthy findings raise questions regarding the clinical utility of DSM-5 severity categories and lend support to the implementation of dimensional approaches for gambling disorder.
Original languageEnglish
Pages (from-to)67-73
JournalEuropean Psychiatry
Volume55
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Cognitive-behavioral therapy
  • Dropout
  • DSM-5
  • Gambling disorder
  • Impulsivity
  • Relapse

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