Family history of substance use disorders: Significance for mental health in young adults who gamble.

Jon E Grant,Samuel R Chamberlain

doi:10.1556/2006.2020.00017

Abstract

BackgroundAlthough family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive family history means for people who gamble in the general community. We sought to understand the clinical and cognitive impact of having a first-degree relative with a substance use disorder (SUD) in a sample of non-treatment seeking young adults.Methods576 participants (aged 18–29 years) who gambled at least five times in the preceding year undertook clinical and neurocognitive evaluations. Those with a first-degree relative with a SUD were compared to those without on a number of demographic, clinical and cognitive measures. We used Partial Least Squares (PLS) regression to identify which variables (if any) were significantly associated with family history of SUDs, controlling for the influence of other variables on each other.Results180 (31.3%) participants had a first-degree family member with a SUD. In terms of clinical variables, family history of SUD was significantly associated with higher rates of substance use (alcohol, nicotine), higher rates of problem gambling, and higher occurrence of mental health disorders. Family history of SUD was also associated with more set-shifting problems (plus higher rates of obsessive-compulsive tendencies), lower quality of decision-making, and more spatial working memory errors.ConclusionsThese results indicate that gamblers with a first-degree family member with a SUD may have a unique clinical and cognition presentation. Understanding these differences may be relevant to developing more individualized treatment approaches for disordered gambling. Compulsivity may be important as a proxy of vulnerability towards addiction.

Highlights

Background: family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive family history means for people who gamble in the general community
Family history of substance use disorder (SUD) was significantly associated with older age, female gender, non-Caucasian racial-ethnic group, and lower quality of life
Family history of SUDs was significantly associated with more money lost to gambling in the past year, higher Structured Clinical Interview for Pathological Gambling (SCI-PG) scores, greater nicotine consumption, higher occurrence of one or more Mini International Neuropsychiatric Inventory (MINI) mental disorders, and higher Padua obsessive-compulsive scores

Summary

Introduction

History of substance use disorders (SUDs) has been examined for the past forty years, most often in the context of understanding phenomenological differences in those adults with alcoholism who have or do not have a family history of addictions (Latcham, 1985; Penick, Nickel, Powell, Bingham, & Liskow, 1990), identifying predictive factors that may or may not result in treatment differences in those with alcoholism (Drake et al, 1995), understanding cognitive and biological differences seen in neuroimaging of alcoholics (de Wit & McCracken, 1990; Krystal et al, 2003; Muller et al, 2015; Schaeffer, Parsons, & Yohman, 1984), and identifying those at risk for developing SUDs (Barnow, Schuckit, Lucht, John, & Freyberger, 2002; Beseler, Aharonovich, Keyes, & Hasin, 2008; Cloninger, Bohman & Sigvardsson, 1981; Dawson, Harford, & Grant, 1992; Goodwin, 1983; Harrington, Robinson, Bolton, Sareen, & Bolton, 2011; Schuckit and Duby, 1982).Unauthenticated | Downloaded 11/02/21 03:04 PM UTCJournal of Behavioral Addictions 9 (2020) 2, 289-297Other, albeit limited, research has suggested that a family history of SUDs may be an important information in terms of how it impacts other psychiatric symptoms. Despite gambling symptoms being nosologically related to substance addictions in the DSM-5, surprisingly little research has examined the impact of family history of SUDs on the clinical and cognitive presentation of people who gamble. Such examination could have implications for tailoring treatments for disordered gambling. Conclusions: These results indicate that gamblers with a first-degree family member with a SUD may have a unique clinical and cognition presentation Understanding these differences may be relevant to developing more individualized treatment approaches for disordered gambling. Compulsivity may be important as a proxy of vulnerability towards addiction

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