Exploring Comorbid Addictive Symptoms in Gambling Disorder: The Role of Emotion Regulation, Alexithymia, and Social Support
Ismael Muela et al.
Abstract
Gambling disorder (GD) often co-occurs with other addictive behaviors, but the psychological mechanisms underlying this comorbidity remain poorly understood, particularly in clinical samples. This cross-sectional study examined whether alexithymia, dispositional emotion regulation strategies, and perceived social support help explain or moderate the association between problem gambling severity and additional addictive behaviors in 90 individuals diagnosed with GD and currently receiving treatment. Participants completed validated measures of addictive behaviors, emotion regulation (adaptive and maladaptive strategies), alexithymia, and perceived social support. A theory-informed, stepwise analytical approach was followed, including multiple linear regression, moderation, and mediation analyses. Problem gambling severity significantly predicted the presence of additional addictive behaviors. Maladaptive emotion regulation strategies (MERS), difficulty identifying feelings (DIF), and low social support were independently associated with comorbid addictive symptoms. Social support moderated the association between problem gambling severity and comorbidity, such that the link was weaker at higher support levels. The mediation model involving MERS showed a potential indirect effect, but this effect did not reach conventional statistical significance. No significant mediation was found for DIF. These findings highlight the relevance of emotional and interpersonal functioning in the broader addictive profile of individuals with GD. Clinically, they suggest that routine assessment of emotion regulation and perceived social support in GD services may help identify patients at greater risk for broader addictive comorbidity and inform more integrated interventions. Future studies should explore moderated mediation models to clarify these mechanisms and inform more targeted interventions.
Evidence weight
Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40
| F · citation impact | 0.50 × 0.4 = 0.20 |
| M · momentum | 0.50 × 0.15 = 0.07 |
| V · venue signal | 0.50 × 0.05 = 0.03 |
| R · text relevance † | 0.50 × 0.4 = 0.20 |
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