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The Role of Metacognition in Pathological Gambling: A Mediation Model

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Abstract

Pathological gambling involves multitudinous costs related to financial, legal, and public health care aspects, as well as to specific psychological disorders. Despite the overall evidence suggesting that comorbid disorders represent a risk factor for pathological gambling, there is scant evidence on the appropriate treatments for gamblers with such disorders. In this context, metacognitive therapy is an interesting approach because it considers psychological disorders as a result of the activation of perseverative cognitive processes and attentional strategies in response to inner events. Several studies report that metacognition is associated with different psychological problems. This study investigated the relationship among comorbid disorders, metacognition, and pathological gambling. 69 pathological gamblers at the first hospital admission and 58 controls drawn from general population (matched for age, gender, education) completed a battery of self report instruments: Symptom Checklist-90-R, Metacognition Questionnaire 30, South Oaks Gambling Scale. Compared to controls, pathological gamblers showed higher level of comorbid symptomatology and metacognition. Correlation analyses showed that: comorbid symptomatology and metacognition were positively and significantly correlated with pathological gambling; metacognition was positively and significantly associated with comorbid symptomatology. Mediation analysis indicated that dysfunctional metacognitive strategies could have an indirect effect on pathological gambling mediated by concurrent psychological disorders. These findings provide some implications for gambling treatment programs: pathological gamblers should be screened for psychiatric disorders, and metacognitive therapy could be considered a correct treatment of pathological gamblers. Metacognitive therapy might lead to the reduction of the pathological gambling by the diminishing of the concurrent psychological disorders.

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Acknowledgments

We would like express our gratitude to Antonello Taranto, Rossella Melpignano and Isabella Macina of the Department of Pathological Addictions of Local Health Board (AUSL, Bari, Italy) for making available their ambulatory.

Conflict interest

All authors declare that they have no conflict of interest.

Integrity of research and reporting

The study protocol was approved by the local ethic committee and all participants provided written informed consent.

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Correspondence to Maria Sinatra.

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Mansueto, G., Pennelli, M., De Palo, V. et al. The Role of Metacognition in Pathological Gambling: A Mediation Model. J Gambl Stud 32, 93–106 (2016). https://doi.org/10.1007/s10899-014-9519-5

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