Personality and pathological gambling. ? ? Pathological gambling is recognized as an impulse-control disorder in the DSM-IV, and is characterized by maladaptive gambling behavior that disrupts personal, family, or vocational pursuits. Past research linking personality to pathological gambling has been inconsistent, with some studies reporting a link to impulsivity, sensation-seeking, and related traits while other studies have not found this association. The goal of this investigation with collaborators from the Centre for Mental Health and Addiction (CAMH) in Toronto, Canada, was to examine the personality differences between non-treatment seeking pathological gamblers (PGs) and non-pathological gamblers (NPGs) using the domain and facet traits of the FFM, as measured by the NEO PI-R (46). Compared to NPGs, PGs scored significantly higher on the neuroticism domain and significantly lower on the conscientiousness domain. Significant differences between PGs and NPGs also emerged for three of four FFM facet traits associated with impulsivity, with PGs scoring higher on impulsiveness and lower on self-discipline and deliberation facets. Both PGs and NPGs had equally high scores (relative to the norm) on excitement-seeking, the fourth facet associated with impulsivity, suggesting that excitement-seeking characterizes gambling behavior rather than pathological gambling. These findings suggest that the overall personality profile of the PG is one that combines high impulsivity with emotional vulnerability. Importantly, the results also suggest that excitement-seeking, a personality construct akin to sensation-seeking, may not be a specific marker of PG but rather a characteristic common to all those who gamble.? ? ? ? The limitations of the current categorical framework found on Axis II (Personality Disorders) of the DSM-IV has prompted a voluminous amount of research into alternative models of personality disorders. The recently announced plans to create the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders- the DSM_V will explore alternative approaches and is currently considering dimensional alternatives to the present categorical system. There is a growing hope that the DSM will adopt a dimensional model of personality disorders, and the Five-Factor Model (FFM) deserves serious consideration inasmuch as many studies have shown empirical links and correspondences between the PDs and the traits and dimensions of the FFM.? However, there is a bolder proposal which seeks to replace the current nosological system. Work continues (33) in the effort to replace Axis II in the DSM-V with a 4-step process of personality disorder diagnosis based on the FFM, detailed initially in Widiger et al (2002): (1) Provide description of the persons personality traits with respect to the 5 domains and 30 facets of the FFM; (2) Identify the problems, difficulties, and impairments that are secondary to each trait; (3) Determine whether the impairments are clinically significant and, if so, diagnose the FFM-related disorders; (4) Determine whether the constellation of FFM traits matches sufficiently the profile for a particular personality disorder pattern. ? ? Step 2 in the system of Widiger et al. (2002) requires that there be a list of problems associated with the poles of each factor and facet that can be used to guide systematic inquiry. These lists were generated rationally: the authors considered each pole of each trait in turn and proposed problems they believed would be commonly found in people with this characteristic. These rational decisions were, of course, based on a clear conceptualization of each trait and on a familiarity with the voluminous empirical literature on trait correlates that has appeared over the past 20 years. However, even if the Widiger et al. catalogue is entirely correct, there is no evidence so far that it is comprehensive. It is possible that there are clinically significant problems related to personality traits that Widiger et al. simply overlooked. A number of researchers have attempted to develop lists of problems and psychiatric symptoms, and a comparison of their lists with that of Widiger et al. may give some idea of how complete the latter system is, and how it might be improved by the addition of new items. ? ? We used five problem checklists: The Computerized Assessment System for Psychotherapy Evaluation and Research (CASPER; Farrell & McCullough, unpublished manual); The Couples Critical Incidents Checklist (CCIC; Piedmont & Piedmont, 1996); The Inventory of Interpersonal Problems (IIP-64; Horowitz, Alden, Wiggins, & Pincus, 2000); The Personal Problems Checklist for Adults (PPCA; Schinka, 1985); and The ShedlerWesten Assessment Procedure (SWAP-200; Shedler & Westen, 1998). A single rater (Corinna Lckenhoff), familiar with the descriptions of the factors and facets of the NEO-PIR provided in the manual (Costa & McCrae, 1992), examined all 663 items in the five instruments. She first judged whether the item was relevant to personality or not, and then whether it was specific enough to be associated with a factor or facet. Eighty-one items such as being attacked by an animal were discarded as not relevant to personality (12% of all items); 36 items such as acting in an immature way were discarded as being too ambiguous to allow meaningful classification (5% of all items). Most of the items in all five inventories were, however, classifiable (CASPER, 85%; CCIC, 98%; IIP-64, 100%; PPCA, 61%; SWAP-200, 93%). We compared the newly classified problems in living to those identified by Widiger et al. (2002). Overall, the number of additions to the list is relatively small; this suggests that Widiger et al. did a reasonably thorough job of identifying personality-related problems. The updated list of personality-related problems could help to streamline clinical assessments by allowing clinicians to focus their questions towards areas in which clients are most likely to experience problems (8).
| Terracciano, Antonio; Sutin, Angelina R; McCrae, Robert R et al. (2009) Facets of personality linked to underweight and overweight. Psychosom Med 71:682-9 |
| Bagby, R Michael; Quilty, Lena C; Segal, Zindel V et al. (2008) Personality and differential treatment response in major depression: a randomized controlled trial comparing cognitive-behavioural therapy and pharmacotherapy. Can J Psychiatry 53:361-70 |
| Brummett, Beverly H; Siegler, Ilene C; Day, R Sue et al. (2008) Personality as a predictor of dietary quality in spouses during midlife. Behav Med 34:5-10 |
| Ryder, Andrew G; Costa, Paul T; Bagby, R Michael (2007) Evaluation of the SCID-II personality disorder traits for DSM-IV: coherence, discrimination, relations with general personality traits, and functional impairment. J Personal Disord 21:626-37 |
