赌博障碍患者自控力对其冲动性及赌博严重程度的影响

Influence of Self-control on Impulsivity and Gambling Severity of Patients with Gambling Disorder

目的:探讨赌博障碍患者自控力对其冲动性及赌博严重程度的影响。方法:以中文版Barratt冲动性量表、自控力量表和DSM-5赌博障碍诊断条目为测量工具,对上海市精神卫生中心门诊及上海戒赌机构收治的129名赌博障碍患者进行横断面研究。结果:相关性分析显示,赌博障碍患者的自控力与冲动性(r=-0.67,P<0.01)、赌博障碍严重程度(r=-0.39,P<0.01)呈负相关;冲动性与赌博障碍严重程度呈正相关(r=0.28,P<0.01);回归分析表明,冲动性与赌博障碍的严重程度相关(β=0.30,P<0.01),冲动性与自控力相关(β=-0.67,P<0.01),自控力与赌博障碍的严重程度(β=-0.30,P<0.01)相关;路径分析表明,冲动性对赌博障碍严重程度的总效应显著[β=0.04,95%CI(0.02,0.06)],但直接效应不显著[β=0.01,95%CI(-0.02,0.04)];自控力在冲动性与赌博障碍严重程度之间具有中介(间接)效应[β=0.03,95%CI(0.01,0.05)],中介效应占总效应的75%。结论:自控力在赌博障碍患者冲动与赌博障碍严重程度的关系中起完全中介作用,赌博障碍患者的冲动性主要通过低自控力水平,进而加重赌博严重程度。这提示在治疗冲动较高的赌博障碍患者时可以将自控力作为治疗靶点。

Objective: To explore the effect of self-control on impulsivity and gambling severity in patients with gambling disorder. Methods: Using the Chinese version of the Barratt Impulsivity Scale, the Self-Control Scale and the DSM-5 Gambling Disorder Diagnostic Entry as measurement tools, a cross-sectional study was conducted on 129 patients with gambling disorder admitted to the outpatient clinics of the Shanghai Mental Health Center and the Shanghai Gambling Cessation Facility. Results: Correlation analysis showed that self-control of gambling disorder patients was negatively correlated with impulsivity(r=-0.67, P<0.01) and gambling disorder severity(r=-0.39,P<0.01);impulsivity was positively correlated with gambling disorder severity(r=0.28, P<0.01);regression analysis showed that impulsivity was correlated with gambling disorder severity(β=0.30, P<0.01), impulsivity was associated with self-control(β=-0.67, P<0.01), and self-control was associated with the severity of gambling disorder(β=-0.30,P<0.01);path analysis showed that the total effect of impulsivity on the severity of gambling disorder was significant [β=0.04, 95%CI(0.02, 0.06)], but the direct effect was not significant [β=0.01, 95%CI(-0.02, 0.04)];self-control had a mediating(indirect) effect between impulsivity and gambling disorder severity [β=0.03, 95%CI(0.01, 0.05)], with the mediating effect accounting for 75% of the total effect. Conclusion: Self-control plays a fully mediating role in the relationship between impulsivity and gambling disorder severity in patients with gambling disorder, with impulsivity in patients with gambling disorder mainly through low levels of self-control, which in turn exacerbates gambling severity.This suggests that self-control can be used as a therapeutic target in the treatment of gambling disorder patients with higher impulsivity.