Iman Parhami

Exploring facets of personality in a patient sample of hypersexual women compared with hypersexual men.

This study explored group differences among a treatment-seeking sample of hypersexual women (n = 31) and hypersexual men (n = 47) across facets of personality using the NEO-Personality Inventory–Revised and the Hyper sexual Behav ior Inventory. A number of striking parallels emerged between the two groups, including similar levels of impulsivity, emotional dysregulation, and difficulties coping with stress. Hypersexual women, compared to men, exhibited higher levels of distrust toward others, lower levels of self-confidence and ambition, and a greater preference for excitement and stimulation. These findings suggest that several common facets of personality precipitate or perpetuate hypersexual behavior in men and women, with some variations across genders. The implications of these findings for treatment interventions are discussed. (Journal of Psychiatric Practice 2012;18:262–268).

Gambling and the onset of comorbid mental disorders: a longitudinal study evaluating severity and specific symptoms.

While the association between gambling disorders and comorbid mental disorders has been extensively studied, only a few studies have used longitudinal data or evaluated the association across different levels of gambling behavior and specific gambling-related symptoms. In this study, longitudinal data from waves 1 and 2 of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) were used to determine whether different levels of gambling behavior and gambling-related symptoms were associated with the onset of psychiatric disorders. Although NESARC used DSM-IV diagnoses, for this study, the recently published DSM-5 diagnostic criteria for gambling disorder were used to group the NESARC respondents (N=34,653) into three levels of gambling (gambling disorder, sub-threshold gambling disorder, and recreational gambling) and one non-gambling comparison group. Three years after the initial intake interview, compared to the non-gamblers, those reporting any gambling behavior at baseline were at increased risk to have any mood, anxiety, or substance use disorders (recreational gambling: adjusted odds ratio [AOR]=1.16, 95% confidence interval [CI]=1.10–1.23; sub-threshold gambling disorder: AOR 1.77, 95% CI 1.63–1.92; gambling disorder: AOR 2.51, 95% CI 1.83–3.46). Similar graded relationships were found for a number of specific disorders. In addition, multiple specific gambling-related symptoms were associated with comorbid disorders, possibly suggesting the interaction of different mechanisms linking gambling disorder and the onset of comorbid psychopathology. In conclusion, a graded or dose-response relationship exists between different levels of gambling and the onset of comorbid psychopathology. Among gambling groups, those with a gambling disorder were at the highest risk for the new onset of comorbid conditions and those with recreational gambling were at the lowest risk, while the risk among participants with sub-threshold gambling disorder fell between these two groups. (Journal of Psychiatric Practice 2014;20:207–219)

Sleep and Gambling Severity in a Community Sample of Gamblers

Although sleep has been extensively studied in substance related disorders, it has yet to be examined as thoroughly in gambling-related disorders. The purpose of this study is to examine the relationship between gambling severity and sleep disturbances in a sample of non-treatment seeking gamblers (N = 96) using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Mean ESS scores for recreational, problem, and pathological gamblers were 4.13, 5.81, and 8.69, respectively, with a significant difference between pathological gamblers and both problem (P = .007) and recreational gamblers (P < .001). Mean PSQI scores for recreational, problem, and pathological gamblers were 3.35, 5.30, and 5.44, respectively, with a significant difference in sleep quality between recreational and problem gamblers (P = .018), as well as recreational and pathological gamblers (P = .008). As the first study to use objective sleep measures, these findings will not only increase awareness of this relationship, but also provide a foundation on which others can investigate the benefits of screening and adjunct treatment for sleep disorders in the gambling population.

Behavioral addictions: where to draw the lines?

Behavioral addictions can present in a variety of subtle and deceptive patterns. Because of the intense shame, guilt, and embarrassment felt by patients, it may fall to providers to utilize screening tools and deeper interviewing techniques to uncover the extent of these behaviors. Identifying when the line is crossed from recreation/habit to psychopathology relies on understanding current diagnostic criteria and consideration of cultural, ethnic, and local community standards. Individuals are also likely to cross back and forth between this line of pathology and habit, further clouding provider’s opinions of diagnosis; therefore, tracking and monitoring these symptoms over time is critical to establishing patterns of use and documenting ongoing consequences. Treatment for these conditions is emerging slowly, and treatment outcomes for these conditions appear to be similar to those with other addictive disorders.

Exploring Facets of Personality and Escapism in Pathological Gamblers

This study explored facets of personality between pathological gamblers (n = 69) and nonpathological gamblers (n = 55) in a convenience sample in Los Angeles, California. Pathological gamblers were more prone to mood disturbance, impulsivity, feelings of frustration, interpersonal sensitivity, vulnerability to distress, and distrust of others as measured by the NEO Personality Inventory–Revised. Pathological gamblers also reported diminished competence and self-discipline as well as tendencies toward hasty decision making when compared to nonpathological gamblers. A categorical analysis of subtypes revealed that those who gambled to escape experienced significantly greater levels of neuroticism and facets of impulsivity.

Screening for Addictive Disorders Within a Workers’ Compensation Clinic: An Exploratory Study

We conducted a cross-sectional study investigating the extent of addictive disorders within a workers’ compensation (WC) clinic. We also examined the feasibility of substance abuse screening within the same clinic. In , 100 patients were asked to complete the World Health Organizations Alcohol, Smoking, Substance Involvement Screening Test (WHO-ASSIST) and the Current Opioid Misuse Measure (COMM). According to the WHO-ASSIST, we found that 46% of WC patients required intervention for at least one substance-related disorder (25% tobacco, 23% sedatives, 8% opioids), and according to the COMM, 46% screened positive for prescription opioid misuse. Importantly, the addition of this screening was brief, economical, and well accepted by patients. Further research should analyze the costs and benefits of detection and intervention of substance-related disorders in this setting.

How transparent is behavioral intervention research on pathological gambling and other gambling‐related disorders? A systematic literature review

AIMS To review the transparency of reports of behavioral interventions for pathological gambling and other gambling-related disorders. METHODS We used the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) Statement to develop the 59-question adapted TREND questionnaire (ATQ). Each ATQ question corresponds to a transparency guideline and asks how clearly a study reports its objectives, research design, analytical methods and conclusions. A subset of 23 ATQ questions is considered particularly important. We searched PubMed, PsychINFO and Web of Science to identify experimental evaluations published between 2000 and 2011 aiming to reduce problem gambling behaviors or decrease problems caused by gambling. Twenty-six English-language reports met the inclusion criteria and were reviewed by three abstractors using the ATQ. RESULTS The average report adhered to 38.4 (65.1%) of the 59 ATQ transparency guidelines. Each of the 59 ATQ questions received positive responses from an average of 16.9 (63.8%) of the reports. The subset of 23 particularly relevant questions received an average of 15.3 (66.5%) positive responses. Thirty-two of 59 (54%) ATQ questions were answered positively by 75% or more of the study reports, while 12 (20.3%) received positive responses by 25% or fewer. Publication year did not affect these findings. CONCLUSIONS Gambling intervention reports need to improve their transparency by adhering to currently neglected and particularly relevant guidelines. Among them are recommendations for comparing study participants who are lost to follow-up and those who are retained, comparing study participants with the target population, describing methods used to minimize potential bias due to group assignment, and reporting adverse events or unintended effects.

Gambling in the Iranian-American Community and an Assessment of Motives: A Case Study

Nearly half a million United States residents identify themselves as being of Iranian origin, and many in this population are of high socioeconomic status. Although games of chance have been a notable part of Iranian culture for thousands of years, there is almost no research exploring gambling in this population. The objective of this case study is to explore gambling pathology, gambling behavior, and gambling motives among Iranian-Americans using a convenience sample (N = 182) at a September 2010 Iranian festival in Southern California. Of this sample, 20% (n = 37) and 7% (n = 13) screened positive for problem and pathological gambling, respectively. According to the Gambling Motives Questionnaire, enhancement was the preferred motive for gambling (“because you like the feeling, because it’s exciting, to get a high feeling, because it’s fun, because it makes you feel good”). Pathological gamblers showed a considerable difference in subscale scores between enhancement and either coping or social motives, and problem gamblers showed a considerable difference between enhancement and coping motives. Possible explanations for the higher prevalence of gambling disorders in this sample are discussed. Our results support the notion that underlying cultural factors play a role in the development of gambling disorders.

The implementation of a telephone-delivered intervention for Asian American disordered gamblers: A pilot study.

This report will discuss the implementation and preliminary results of a community-based telephone-delivered gambling treatment program specifically designed for Asian Americans. The intervention was implemented by the NICOS Chinese Health Coalition, a nonprofit community organization based in Northern California, overseen by the UCLA (University of California, Los Angeles) Gambling Studies Program and the California Office of Problem Gambling, and launched in December 2010. It consisted of six 1-hr long telephone-delivered sessions conducted by a mental health provider using a translated version of the Freedom from Problem Gambling Self-Help Workbook. In the current study, 6 providers completed a 30-hr training program for gambling related disorders. One-hundred and 40 callers inquired about the intervention within the first 6 months of its launch, 19 clients expressed interest in participating, and 8 enrolled into the program. The results show that the majority of clients who enrolled into the program did not report any gambling behavior after baseline and improved on self-reported measures of overall life satisfaction, gambling urges, and self-control. This study suggests that the implementation of this type of intervention is feasible at a small community-based organization and may be effective in treating gambling-related disorders for Asian American populations. The low rate of clientele enrollment is addressed and potential remedies are discussed.

A Preliminary 6-Month Prospective Study Examining Self-reported Religious Preference, Religiosity/Spirituality, and Retention at a Jewish Residential Treatment Center for Substance-Related Disorders

Although there is a substantial amount of research suggesting that higher levels of religiosity/spirituality (R/S) are associated with better treatment outcomes of substance-related disorders, no studies have explored this relationship at a faith-based residential treatment center. The objective of this prospective study is to explore the relationship between R/S, self-reported religious preference, and retention at a Jewish residential treatment center for substance-related disorders. Using the Daily Spiritual Experience Scale, R/S levels were assessed for 33 subjects at baseline, 1 month, 3 months, and 6 months. Results demonstrated a significant relationship between baseline R/S level and retention at 6 months, while R/S levels were unchanged during the course of treatment. Notably, no relationship was found between self-reported religious affiliation and retention. This study demonstrates that patients’ R/S level, rather than religious affiliation, is a possible predictor for better outcome at faith-based residential centers for substance-related disorders.