Clases latentes de juego problemático en jóvenes: El papel de la comorbilidad, la alexitimia y los acontecimientos vitales estresantes en función del sexo
DOI:
https://doi.org/10.20882/adicciones.1838Palabras clave:
Trastorno de juego, jóvenes, sexo, comorbilidad, alexitimia, acontecimientos vitales estresantes.Resumen
La alexitimia se relaciona con la propensión a las respuestas conductuales impulsivas, en lugar de una regulación cognitiva de los acontecimientos estresantes. La juventud es una etapa de especial vulnerabilidad para la confluencia de estas variables, pudiendo repercutir en la severidad del trastorno de juego (TJ). No obstante, las diferencias entre sexos apenas han sido exploradas. Este estudio tuvo como objetivo, en primer lugar, explorar la frecuencia de TJ en los jóvenes, así como la presencia de TJ con otras adicciones comórbidas. En segundo lugar, se examinó el riesgo de juego y su relación con las otras conductas adictivas, la alexitimia y los acontecimientos vitales estresantes. En tercer lugar, se analizó si la pertenencia a una determinada clase latente era predicha por el sexo y la edad. La muestra estaba compuesta por 360 participantes, con edades comprendidas entre los 18 y 35 años, siendo la mayoría mujeres. Los resultados obtenidos revelaron que el abuso de alcohol era la conducta adictiva más prevalente, tanto para los jugadores problemáticos como para los no problemáticos de ambos sexos. Los análisis de pertenencia de grupo mostraron la presencia de dos clases latentes en base al riesgo de juego. El primero de ellos se caracterizaba por el riesgo de juego, la comorbilidad, la alexitimia y los acontecimientos vitales estresantes, y estaba principalmente predicho por la condición sexo-varón. El otro modelo se caracterizaba por la ausencia de riesgo de juego, niveles más bajos de acontecimientos vitales estresantes y alexitimia, y se predice principalmente por la condición sexo-mujer. En este segundo perfil se halló riesgo de abuso de alcohol y de compra compulsiva. Señalamos la necesidad de introducir una perspectiva de género tanto en la interpretación de los resultados de la investigación como en la aplicación clínica de los tratamientos.Citas
Abbott, M. W., Romild, U. y Volberg, R. A. (2014). Gambling and problem gambling in Sweden: Changes between 1998 and 2009. Journal of Gambling Studies, 30, 985–999. https://doi.org/10.1007/s10899-013-9396-3
American Psychiatric Association [APA]. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
Asparouhov, T. y Muthén, B. (2014). Auxiliary variables in mixture modeling: Three-step approaches using MPlus. Structural Equation Modeling: A Multidisciplinary Journal, 21(3), 329-341. https://doi.org/10.1080/10705511.2014.915181
Bergevin, T., Gupta, R., Derevensky, J. y Kaufman, F. (2006). Adolescent gambling: Understanding the role of stress and coping. Journal of Gambling Studies, 22, 195–208. http://dx.doi.org/10.1007/s10899-006-9010-z
Berntsen, D. y Rubin, D. C. (2006). The Centrality of Events Scale: A measure of integrating a trauma into one’s identity and its relation to post-traumatic stress disorder symptoms. Behavior Research and Therapy, 44(2), 219-231. https://doi.org/10.1016/j.brat.2005.01.009
Bibby, P. A. y Ross, K. E. (2017). Alexithymia predicts loss chasing for people at risk for problem gambling. Journal of Behavioral Addictions, 6, 630–638. https://doi.org/10.1556/2006.6.2017.076
Calado, F., Alexandre, J. y Griffiths, M. D. (2017). Prevalence of adolescent problem gambling: A systematic review of recent research. Journal of Gambling Studies, 33, 397–424. https://doi.org/10.1007/s10899-016-9627-5
Calado, F. y Griffiths, M. D. (2016). Problem gambling worldwide: An update and systematic review of empirical research (2000-2015). Journal of Behavioral Addictions, 5(4), 592–613. https://doi.org/10.1556/2006.5.2016.073
Castrén, S., Basnet, S., Pankakoski, M., Ronkainen, J. E., Helakorpi, S., Uutela, A., Alho, H. y Lahti, T. (2013). An analysis of problem gambling among the Finnish working-age population: A population survey. BMC Public Health, 13, 519. https://doi.org/10.1186/1471-2458-13-519
Celeux, G. y Soromenho, G. (1996). An entropy criterion for assessing the number of clusters in a mixture model. Journal of Classification, 13, 195-212. https://doi.org/10.1007/bf01246098
Chóliz, M., Marcos, M. y Lázaro-Mateo, J. (2021). The risk of online gambling: A study of gambling disorder prevalence rates in Spain. International Journal of Mental Health and Addiction, 19(2), 404-417. https://doi.org/10.1007/s11469-019-00067-4
Costes, J. M., Pousset, M., Eroukmanoff, V., Le Nezet, O., Richard, J. B., Guignard, R., Beck, F. y Arwidson, P. (2011). Les niveaux et pratiques des jeux de hasard et d’argent en 2010 [Levels and gambling practices in 2010]. Lettre Tendances, 77, 1–8.
De Luigi, N., Gibertoni, D., Randon, E. y Scorcu, A.E. (2018). Patterns of gambling activities and gambling problems among Italian high school students: Results from a latent class analysis. Journal of Gambling Studies, 34(2), 339–359. https://doi.org/10.1007/s10899-017-9694-2
Delegation of the Spanish Government for the National Plan on Drugs (2020). Informe sobre Adicciones Comportamentales 2020. [Behavioural Addictions Report 2020]. Spanish Health Ministry.
Echeburúa, E., Báez, C., Fernández-Montalvo, J. y Páez, D. (1994). El Cuestionario de Juego de South Oaks (SOGS): Validación española. [The South Oaks Gambling Questionnaire (SOGS): Spanish Validation]. Análisis y Modificación de Conducta, 20, 769-791.
Ellenbogen, S., Derevensky, J. y Gupta, R. (2007). Gender differences among adolescents with gambling-related problems. Journal of Gambling Studies, 23(2), 133-143. https://doi.org/10.1007/s10899-006-9048-y
Elman, I., Tschibelu, E. y Borsook, D. (2010). Psychosocial stress and its relationship to gambling urges in individuals with pathological gambling. American Journal on Addictions, 19, 332–339. http://dx.doi.org/10.1111/j.1521-0391.2010.00055.x
Estévez, A., Jauregui, P., López-Gonzalez, H., Macía, L., Granero, R., Mestre-Bach, G., Fernández-Aranda, F., Gómez-Peña, M., Moragas, L., Mena-Moreno, T., Lozano- Madrid, M., Del Pino-Gutierrez, A., Codina, E., Testa, G., Vintró-Alcaraz, C., Agüera, Z., Munguía, L, Baenas, I., Valenciano-Mendoza, E.,… Jiménez-Murcia, S. (2021). Comorbid behavioural and substance-related addictions in young population with and without gambling disorder. International Gambling Studies. 21, 133-152. https://doi.org/10.1080/14459795.2020.1836250
Estévez, A., Jauregui, P., Macía, L. y Martin, C. (2021). Alexithymia and emotion regulation strategies in adolescent gamblers with and without at-risk profiles. Journal of Gambling Studies, 1-15. https://doi.org/10.1007/s10899-021-10057-8
Etxandi, M., Baenas, I., Munguía, L., Mestre-Bach, G., Granero, R., Gómez-Peña, M., Moragas, L., del Pino-Gutiérrez, A., Codina, E., Mora-Maltas, B., Valenciano-Mendoza, E., Potenza, M. N., Gearhardt, A., Fernández-Aranda F. y Jiménez-Murcia, S. (2021). Clinical features of gambling disorder patients with and without food addiction: Gender-related considerations. Journal of Gambling Studies, 1-20. https://doi.org/10.1007/s10899-021-10071-w
Fernández-Alcántara, M., de los Santos-Roig, M., Pérez-Marfil, M. N., Catena-Martínez, A., Pérez-García, M., Martí-García, C. y Cruz-Quintana, F. (2015). Adaptación al castellano de la Centrality of Event Scale (CES). [Spanish adaptation of the Centrality of Event Scale]. Universitas Psychologica, 14(2), 499-510. http://dx.doi.org.10.11144/Javeriana.upsy14-2.acce
Frewen, P. A., Pain, C., Dozois, D. J. y Lanius, R. A. (2006). Alexithymia in PTSD: Psychometric and FMRI studies. Annals of the New York Academy of Sciences, 1071(1), 397-400. http://dx.doi.org/10.1196/annals.1364.029
González-Ortega, I., Echeburúa, E., Corral, P., Polo-López, R. y Alberich, S. (2013). Predictors of pathological gambling severity taking gender differences into account. European Addiction Research, 19(3), 146-154. https://doi.org/10.1159/000342311
Griffiths, M. (1994). An exploratory study of gambling cross addictions. Journal of Gambling Studies, 10(4), 371-84. https://doi.org/10.1007/BF02104903.
Griffiths, M. D., Parke, A., Wood, R. y Parke, J. (2006). Internet gambling: An overview of psychosocial impacts. UNLV Gaming Research & Review Journal, 10(1). https://digitalscholarship.unlv.edu/grrj/vol10/iss1/4
Hu, L. y Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118
Jauregui, P., Estévez, A. y Urbiola, I. (2016). Pathological gambling and associated drug and alcohol abuse, emotion regulation, and anxious-depressive symptomatology. Journal of Behavioral Addictions, 5(2), 251-260. https://doi.org/10.1556/2006.5.2016.038
Jiménez-Murcia, S., Granero, R., Fernández-Aranda, F., Stinchfield, R., Tremblay, J., Steward, T., Mestre-Bach, G., Lozano-Madrid, M., Mena-Moreno, T., Mallorquí- Bagué, N., Perales, J.C., Navas, J.F., Soriano-Mas, C., Aymamí, N., Gómez-Peña, M., Agüera, Z., del Pino-Gutiérrez, A., Martín-Romera, V. y Menchón, J.M. (2019). Phenotypes in gambling disorder using sociodemographic and clinical clustering analysis: An unidentified new subtype? Frontiers in Psychiatry, 10, 1-10. https://doi.org/10.3389/fpsyt.2019.00358
Jiménez-Murcia, S., Granero, R., Giménez, M., del Pino-Gutiérrez, A., Mestre-Bach, G., Mena-Moreno, T., Moragas, L., Baño, M., Sánchez-González, J., de Gracia, M., Baenas- Soto, I., Contaldo, S. F., Valenciano-Mendoza, E., Mora-Maltas, B., López-González, H., Menchón, J. M. y Fernández-Aranda, F. (2020). Moderator effect of sex in the clustering of treatment-seeking patients with gambling problems. Neuropsychiatrie, 34(3), 116-129. https://doi.org/10.1007/s40211-020-00341-1
Jun, H. J., Sacco, P., Bright, C. y Cunningham-Williams, R. M. (2019). Gender differences in the relationship between depression, antisocial behavior, alcohol use, and gambling during emerging adulthood. International Journal of Mental Health and Addiction, 17(6), 1328-1339. https://doi.org/10.1007/s11469-018-0048-9
Kovács, I., Pribék, I. K., Demeter, I., Rózsa, S., Janka, Z., Demetrovics, Z. y Andó, B. (2020). The personality profile of chronic alcohol-dependent patients with comorbid gambling disorder symptoms. Comprehensive Psychiatry, 101, 152183. https://doi.org/10.1016/j.comppsych.2020.152183
Lamas, J. L., Santolaria, R., Estévez, A. y Jáuregui, P. (2018). Guía clínica específica “Mujer y juego” [Specific clinical guideline “Women and Gambling”]. FEJAR: Government Delegation for the National Plan on Drugs (ES).
Lanza, S. T., Tan, X. y Bray, B. C. (2013). Latent class analysis with distal outcomes: A flexible model-based approach. Structural Equation Modeling: A Multidisciplinary Journal, 20(1), 1–26. https://doi.org/10.1080/10705511.2013.742377
Lesieur, H. R. y Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. American Journal of Psychiatry, 144(9), 1184-1188. https://doi.org/10.1176/ajp.144.9.1184
Macía, L., Momeñe, J., Macía, P., Herrero, M., Jauregui, P., Iruarrizaga, I. y Estévez, A. (2023). Latent Classes of Eating Disorders and Addictions by sex: Implication of Sex, Alexithymia and Stressful Life Events in youths. Frontiers- Psychology for Clinical Settings, 14. https://doi.org/10.3389/fpsyg.2023.1088595
Maniaci, G., Picone, F., van Holst, R. J., Bolloni, C., Scardina, S. y Cannizzaro, C. (2017). Alterations in the emotional regulation process in gambling addiction: The role of anger and alexithymia. Journal of Gambling Studies, 33(2), 633–647. https://doi.org/10.1007/s10899-016-9636-4
Marchetti, D., Verrocchio, M. C. y Porcelli, P. (2019). Gambling problems and alexithymia: A systematic review. Brain sciences, 9(8), 191. https://doi.org/10.3390/brainsci9080191
Martinez-Loredo, V., Garnde-Gosende, A., Fernández-Artamendi, S. y Fernández-Hermida, J.R. (2019). Substance use and gambling patterns among adolescents: Differences according to gender and impulsivity. Journal of Gambling Studies, 35, 63–78. https://doi.org/10.1007/s10899-018-09824-x
Martínez Sánchez, F. (1996). Adaptación española de la escala de Alexitimia de Toronto (TAS-20) [Spanish adaptation of the Toronto Alexithymia Scale (TAS-20).]. Clínica y Salud, 7(1), 19-32.
Muthén, L. K. y Muthén, B. O. (1998-2013). Mplus user’s guide. Seventh edition. Muthén & Muthén.
National Institute on Drug Abuse [NIDA]. (2021). Sex and gender differences in substance use. https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use
Nylund, K. L., Asparouhov, T. y Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535–569. https://doi.org/10.1080/10705510701575396
Pedrero Pérez, E. J., Rodríguez Monje, M. T., Gallardo Alonso, F., Fernández Girón, M., Pérez López, M. y Chicharro Romero, J. (2007). Validación de un instrumento para la detección de trastornos del control de impulsos y adicciones: el MULTICAGE CAD-4 [Validation of a tool for screening of impulse control disorders and addiction: The MULTICAGE CAD-4]. Trastornos Adictivos, 9(4), 269–278. https://doi.org/10.1016/S1575-0973(07)75656-8
Pérez de Albéniz-Garrote, G., Medina-Gómez, M. B. y Buedo-Guirado, C. (2021). Compulsive buying in adolescents. The impact of gender and alcohol and cannabis use. Sustainability, 13(7), 3982. https://doi.org/10.3390/su13073982
Roberts, J. A. y Roberts, C. (2012). Stress, gender and compulsive buying among early adolescents. Young Consumers, 13(2), 113-123. https://doi.org/10.1108/17473611211233440
Rodríguez, E., Megías, I., Martínez, P. y Sanmartín, A. (2019). Distintas miradas y actitudes, distintos riesgos. [Different views and attitudes, different risks. Women and men in the face of drug use]. Centro Reina Sofía sobre Adolescencia y Juventud. https://doi.org/10.5281/zenodo.3631644
Sanscartier, M. D., Shen, J. y Edgerton, J. D. (2019). Gambling among emerging adults: How gender and risk level influence associated problem behaviours. Journal of Gambling Issues, 41, 101–123. http://dx.doi.org/10.4309/jgi.2019.41.6
Satorra, A. y Bentler, P. M. (2010). Ensuring positiveness of the scaled difference chi-square test statistic. Psychometrika, 75(2), 243–248. https://doi.org/10.1007/s11336-009-9135-y
Sharman, S., Butler, K. y Roberts, A. (2019). Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations. Addictive Behaviors, 99, 106071. https://doi.org/10.1016/j.addbeh.2019.106071
Storr, C. L., Lee, G. P., Derevensky, J. L., Ialongo, N. S. y Martins, S. S. (2012). Gambling and adverse life events among urban adolescents. Journal of Gambling Studies, 28(2), 325-336. http://dx.doi.org/10.1007/s10899-011-9254-0
Sussman, S. y Arnett, J. J. (2014). Emerging adulthood: Developmental period facilitative of the addictions. Evaluation & the Health Professions, 37(2), 147-155. https://doi.org/10.1177/0163278714521812
Svensson, J. y Sundqvist, K. (2019). Gambling among Swedish youth: Predictors and prevalence among 15- and 17-year-old students. Nordic Studies on Alcohol and Drugs, 36(2), 177-189. https://doi.org/10.1177/1455072518807788
Taylor, G. J., Ryan, D. y Bagby, M. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy and Psychosomatics, 44(4), 191-199. https://doi.org/10.1159/000287912.
Wang, C., Cunningham-Erdogdu, P., Steers, M. L. N., Weinstein, A. P. y Neighbors, C. (2020). Stressful life events and gambling: The roles of coping and impulsivity among college students. Addictive Behaviors, 107, 106386. https://doi.org/10.1016/j.addbeh.2020.106386
Wang, J. y Wang, X. (2012). Structural Equation Modeling: Applications using Mplus. John Wiley & Sons. http://dx.doi.org/10.1002/9781118356258
Wong, G., Zane, N., Saw, A. y Chan, A. K. K. (2013). Examining gender differences for gambling engagement and gambling problems among emerging adults. Journal of Gambling Studies, 29(2), 171–189. https://doi.org/10.1007/s10899-012-9305-1
Zdankiewicz-Scigala, E. y Scigala, D. K. (2018). Trauma, temperament, alexithymia, and dissociation among persons addicted to alcohol: Mediation model of dependencies. Frontiers in Psychology, 9, 1570. https://doi.org/10.3389/fpsyg.2018.01570
