Skip to main content

Advertisement

SpringerLink
Log in

Testing the Validity of the Pathways Model: A Latent Class Analysis of Potential Pathological Gambling Subtypes in a Non-Treatment Sample

  • Original Paper
  • Published:
Journal of Gambling Studies Aims and scope Submit manuscript

Abstract

Latent class analysis (LCA) was used to test the validity of the Pathways Model in 285 subjects with DSM-IV pathological gambling (PG). In addition to identifying three subtypes that roughly correspond with those described in the model (Behaviorally Conditioned, or BC, Emotionally Vulnerable, or EV, Antisocial-Impulsivist, or AI), LCA identified a fourth class, termed the Antisocial Drinker, or AD, characterized by high rates of antisociality, conduct disorder, and alcohol use disorder. BC gamblers comprised 45% of the sample, followed by EV (24%), AD (22%), and AI (9%) gamblers. Women were more likely to be EV gamblers (OR = 1.89) and less likely to be AD gamblers (OR = 0.46). Those who had attempted suicide were more likely to be EV (OR = 3.06) or AI (OR = 3.05) gamblers and less likely to be BC (OR = 0.37) or AD gamblers (OR = 0.50). Greater childhood maltreatment was associated with AD (standardized OR = 1.81) and AI (standardized OR = 1.43) gamblers. Individuals with later PG onset were less likely to be AI gamblers (standardized OR = 0.48). Individuals who preferred slots were more likely to be EV gamblers (OR = 1.83) and less likely to be AD gamblers (OR = 0.33). The BC subtype was associated with better health outcomes, better social functioning, less childhood maltreatment, and less severe PG. The AI subtype was associated with worse health outcomes, worse social functioning, and higher PG severity. The findings provide a better understanding PG heterogeneity that could be relevant to clinical management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data are available to researchers.

References

  • Aasved, M. (2002). The Psychodynamics and Psychology of Gambling. Springfield, IL: C Thomas.

    Google Scholar 

  • Akaike, H. (1973). Information Theory and an Extension of the Maximum Likelihood Principle. In B. N. Petrov & F. Csake (Eds.), Second International Symposium on Information Theory (pp. 267–281). Akademiai Kiado.

    Google Scholar 

  • Allami, Y., Vitaro, F., Brendgen, M., Carbonneau, R., Lacourse, E., & Tremblay, R. E. (2017). A longitudinal empirical investigation of the pathways model of problem gambling. Journal of Gambling Studies, 33(4), 1153–1167.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). American Psychiatric Press.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). American Psychiatric Press.

    Book  Google Scholar 

  • Barratt, E. E. (1959). Anxiety and impulsiveness related to psychomotor efficiency. Perceptual and Motor Skills, 9, 191–198.

    Article  Google Scholar 

  • Black, D.W. (in press). Clinical Characteristics. In J Grant, MN Potenza (Eds.) Understanding and Treating Gambling Disorder, 2nd. Washington DC: American Psychiatric Publishing.

  • Black, D. W., Coryell, W. C., Crowe, R. R., McCormick, B., Shaw, M., & Allen, J. (2014). A direct, controlled, blind family study of pathological gambling. Journal of Clinical Psychiatry, 75, 215–221.

    Article  PubMed  Google Scholar 

  • Black, D. W., Coryell, W. H., Crowe, R. R., Shaw, M., McCormick, B., & Allen, J. (2015). Age at onset of DSM-IV pathological gambling in a non-treatment sample: Early-versus later-onset. Comprehensive Psychiatry, 60, 40–46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Black, D. W., Coryell, W., McCormick, B., Shaw, M., & Allen, J. (2017). A prospective follow-up study of younger and older subjects with pathological gambling. Psychiatry Research, 256, 162–168.

    Article  PubMed  PubMed Central  Google Scholar 

  • Black, D. W., Shaw, M. C., McCormick, B. A., & Allen, J. (2012). Marital status, childhood maltreatment, and family dysfunction: A controlled study of pathological gambling. Journal of Clinical Psychiatry, 73, 1293–1297.

    Article  PubMed  Google Scholar 

  • Blaszczynski, A., & McConaghy, N. (1989). Anxiety and/or depression in the pathogenesis of addictive gambling. International Journal of Addictions, 24, 337–350.

    Article  CAS  Google Scholar 

  • Blaszczynski, A., & Nower, L. (2002). Pathways model of problem and pathological gambling. Addiction, 97, 487–499.

    Article  PubMed  Google Scholar 

  • Christenson, G. A., Faber, R. J., De Zwaan, M., Raymond, N. C., Specker, S. M., Ekern, M. D., Mackenzie, T. B., Crosby, R. D., Crow, S. J., & Eckert, E. D. (1994). Compulsive buying: Descriptive characteristics and psychiatric comorbidity. Journal of Clinical Psychiatry, 55, 5–11.

    CAS  PubMed  Google Scholar 

  • Dowd, D. A., Keough, M. T., Jakobson, L. S., Bolton, J. M., & Edgerton, J. D. (2019). A longitudinal examination of gambling subtypes in young adulthood. International Gambling Studies, 20(2), 185–199. https://doi.org/10.1080/14459795.2019.1697343.

    Article  Google Scholar 

  • Grant, J. E., Potenza, M. N., Hollander, E., Cunningham-Williams, R., Nurminen, T., Smits, G., & Kallio, A. (2006). Multicenter investigation of the opioid antagonist nalmefene in the treatment of pathological gambling. American Journal of Psychiatry, 163, 303–312.

    Article  PubMed  Google Scholar 

  • Gupta, R., Nower, L., Deverensky, J. L., Blasczcynski, A., Faregh, N., & Temcheff, C. (2013). Problem gambling in adolescents: An examination of the pathways model. Journal of Gambling Studies, 29, 575–588.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., & Shaffer, H. J. (2008). The prevalence and correlates of DSM-IV pathological gambling in the National Comorbidity Study Replication. Psychological Medicine, 38, 1351–1360.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kim, S. W., Grant, J. E., Adson, D. E., & Shin, Y. C. (2001). Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling. Biological Psychiatry, 49, 914–921.

    Article  CAS  PubMed  Google Scholar 

  • Kim, S. W., Grant, J. E., Potenza, M. N., Blanco, C., & Hollander, E. (2009). The Gambling Symptom Assessment Scale (G-SAS): A reliability and validity study. Psychiatry Research, 166, 76–84.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lader, M. (2008). Antiparkinsonian medication and pathological gambling. CNS Drugs, 22, 407–416.

    Article  CAS  PubMed  Google Scholar 

  • Ledgerwood, D. M., & Petry, N. M. (2006). Psychological experience of gambling and subtypes of pathological gamblers. Psychiatry Research, 144, 17–27.

    Article  PubMed  Google Scholar 

  • Ledgerwood, D. M., & Petry, N. M. (2010). Subtyping pathological gamblers based on impulsivity, depression, and anxiety. Psychology of Addictive Behaviors, 24(4), 680–688.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for identification of pathological gamblers. American Journal of Psychiatry, 144, 1184–1188.

    Article  CAS  PubMed  Google Scholar 

  • Linzer, D. A., & Lewis, J. (2011). poLCA: Polytomous Variable Latent Class Analysis. Journal of Statistical Software, 42(10), 1–29.

    Article  Google Scholar 

  • Linzer, D. A., & Lewis, J. (2013). “poLCA: Polytomous Variable Latent Class Analysis." R package version 1.4. https://github.com/dlinzer/poLCA.

  • Mader, J., Christensen, D. R., & Williams, R. J. (2019). An evaluation of the pathways moel using the Quinte Longitudinal data set. International Gambling Studies, 19(3), 417–431.

    Article  Google Scholar 

  • Medieros, G. C., & Grant, J. E. (2019). Pharmacological interventions in gambling disorder. In Gambling Disorder (Ed.), A Heinz, NR Romanczuk-Seiferth, MN Potenza (pp. 171–180). Cham, Switzerland: Springer.

    Google Scholar 

  • Moon, M., Lister, J. J., Milosevic, A., & Ledgerwood, D. M. (2017). Subtyping non-treatment seeking problem gamblers using the Pathways Model. Journal of Gambling Studies, 33, 841–853.

    Article  PubMed  Google Scholar 

  • Moran, E. (1970). Varieties of pathological gambling. British Journal of Psychiatry, 116, 593–597.

    Article  CAS  Google Scholar 

  • National Opinion Research Center at the University of Chicago (NORC). (1999). Gambling Impact and Behavior Study, Report to the National Gambling Impact Study Commission, April 1.

  • Nower, L., & Blasczcynski, A. (2017). Development and validation of the Gambling Pathways Questionnaire (GPQ). Psychology of Addictive Behavior, 31(1), 95–109.

    Article  Google Scholar 

  • Nower, L., Martins, S. S., Lin, K. H., & Blanco, C. (2013). Subtypes of disordered gamblers: Results from the National Epidemiological Survey of Alcohol and Related Conditions. Addiction, 108(4), 789–798.

    Article  PubMed  PubMed Central  Google Scholar 

  • Petry, N. M. (2005). Cognitive biases and cognitive therapy. Pathological Gambling: Etiology, Comorbidity, and Treatment (pp. 209–226). Aperical Psychological Association.

    Chapter  Google Scholar 

  • Pfohl, B., Zimmerman, M., & Blum, N. (1997). A Structured Interview for DSM-IV Personality Disorders (SIDP-IV). American Psychiatric Press.

    Google Scholar 

  • Schwartz, G. (1978). Estimating the Dimension of a Model. Annals of Statistics, 6, 461–464.

    Google Scholar 

  • Sheehan, D., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini International Neuropsychiatric Interview (MINI). Journal of Clinical Psychiatry, 59(suppl 20), 22–33.

    PubMed  Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., & Gibbons, M. (1994). Structured Clinical Interview for DSM-IV. New York State Psychiatric Institute, Biometrics Research.

    Google Scholar 

  • Steel, Z., & Blaszczynski, A. (1996). The factorial structure of pathological gambling. Journal of Gambling Studies, 12, 3–20.

    Article  CAS  PubMed  Google Scholar 

  • Turner, N. E., Jain, U., Spence, D. W., & Zangeneh, M. (2008). Pathways to pathological gambling: Component analysis of variables related to pathological gambling. International Gambling Studies, 8(3), 281–298.

    Article  Google Scholar 

  • Valleur, M., Codina, I., Venisse, J. L., Romo, L., Magalon, D., Fatseas, M., et al. (2016). Towards a validation of the three pathways model of pathological gambling. Journal of Gambling Studies, 32, 757–771.

    Article  PubMed  Google Scholar 

  • van Buuren, S., & Groothuis-Oudshoorn, K. (2011). mice: Multivariate Imputation by Chained Equations in R. Journal of Statistical Software, 45(3), 1–67.

    Article  Google Scholar 

  • Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 Health Survey Manual and Interpretation Guide. New England Medical Center Health Institute.

    Google Scholar 

  • Winters, K. C., & Rich, T. (1998). A twin study of adult gambling behavior. Journal of Gambling Studies, 14, 213–225.

    Article  Google Scholar 

  • Winters, K. C., Stinchfield, R. C., Botzet, A., & Anderson, N. (1993). A prospective study of youth gambling behaviors. Psychology of Addictive Behaviors, 16(1), 3–9.

    Article  Google Scholar 

  • Zanarini, M. C. (1992). Revised Childhood Experiences Questionnaire (CEQ-R). McLean Hospital, Harvard Medical School.

    Google Scholar 

Download references

Funding

The research was supported through grants from the National Institute on Aging (RO1AG037132) and the National Institute on Drug Abuse (RO1DA021361) (both to Dr. Black).

Author information

Authors and Affiliations

  1. Department of Psychiatry, 2-126b MEB/Psychiatry Research, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA

    Donald W. Black & Jeff Allen

Authors
  1. Donald W. Black
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeff Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Dr. Black designed the study and contributed to preparing the manuscript. Dr. Allen analyzed the data and contributed to writing the manuscript. Both authors approved the final version.

Corresponding author

Correspondence to Donald W. Black.

Ethics declarations

Conflict of interest

Dr. Black is a consultant to Otsuka and receives royalties from American Psychiatric Publishing, Oxford University Press, Merck, and Kluwer Wolters. Drs. Allen reports no conflicts.

Consent to participate

All subjects gave written, informed consent.

Ethics approval

The research was approved by the University of Iowa Intuitional Review Board.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Black, D.W., Allen, J. Testing the Validity of the Pathways Model: A Latent Class Analysis of Potential Pathological Gambling Subtypes in a Non-Treatment Sample. J Gambl Stud 38, 663–679 (2022). https://doi.org/10.1007/s10899-021-10056-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10899-021-10056-9

Keywords

Search

Navigation