Association between endocrine and neuropsychological endophenotypes and gambling disorder severity

Abstract

Altres ajuts: This work was supported by a grant from the Delegación del Gobierno para el Plan Nacional sobre Drogas (2021I031/), co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe. CIBEROBN is an initiative of ISCIII. IB is supported by Instituto de Salud Carlos III through the grant CM21/00172 2022-2023 (co-funded by European Social Fund-ESF investing in your future). IL is supported by the Ministerio de Ciencia e Innovación (MCIN), Agencia Estatal de Investigacion ' (AEI), and by the European Union "NextGenerationEU/Plan de Recuperación, Transformación y Resiliencia (PRTR)" (Juan de la Cierva-Formación program, FJC2021-046494-I). RG was supported by the Catalan Institution for Research and Advanced Studies (ICREAAcademia, 2021-Programme).

Background: Neurobiological characteristics have been identified regarding the severity of gambling disorder (GD). The aims of this study were: (1) to examine, through a path analysis, whether there was a relationship between neuroendocrine features, potentially mediational GD variables, and GD severity, and (2) to associate neuroendocrine variables, with GD severity-related variables according to gambling preferences. Methods: The sample included 297 outpatients with GD. We analyzed endocrine concentrations of different appetite-related hormones (ghrelin, liver antimicrobial peptide 2 [LEAP-2], leptin, adiponectin), and neuropsychological performance (working memory, cognitive flexibility, inhibition, decision making, premorbid intelligence). Path analysis assessed mechanisms between neuroendocrine features and GD severity, including mediational GD variables (impulsivity traits and gambling-related cognitive distortions). Partial correlations evaluated the associations between neuroendocrine variables, including impulsivity traits, and variables related to GD severity (DSM-5, South Oaks Gambling Screen, illness duration, and gambling-related cognitive distortions). Results: Lower adiponectin concentrations predicted greater GD severity, while higher LEAP-2 concentrations predicted more gambling-related cognitive distortions. Likewise, better neuropsychological performance directly predicted GD severity, but worse neuropsychological performance was associated with GD severity through the mediational variables of impulsivity traits and gambling-related cognitive distortions. Also, in non-strategic individuals with GD, poor working memory was associated with gambling expectancies and predictive control. In strategic individuals with GD, poor cognitive flexibility was associated with illusion of control, predictive control, and inability to stop gambling. Conclusions: These results provide updated information about the comprehension of the interaction between neuroendocrine features, clinical variables, and severity of GD. Thus, neurobiological functions seem to be strongly related to GD severity.