HERMANO TAVARES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
17 resultados
Resultados de Busca
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- Examining the Gambling-Related Harms, Gambling Disorder, and Player Characteristics of Jogo do Bicho (an Illegal National Lottery) in a Representative Sample of Brazilian Lottery Players(2024) KIM, Hyoun S.; SANCHES, Marcos; MARIANI, Mirella Martins de Castro; HODGINS, David C.; TAVARES, HermanoWe investigated the demographics, gambling-related harms, and risk for gambling disorder (GD) associated with an illegal national lottery-type game called Jogo do Bicho that is culturally unique to Brazil in a sample of 5407 representative Brazilian lottery players. Participants reported on demographics, gambling behaviors, gambling-related harms, and GD. A total of 27.0% of the participants reported playing Jogo do Bicho in the past year. Jogo do Bicho was associated with greater risk of GD with 5.7% of current Jogo do Bicho players meeting diagnostic criteria. Jogo do Bicho was also associated with greater gambling-related harms. Older participants, males, individuals who self-identified as Black, and who were widowed were more likely to be current Jogo do Bicho players. Jogo do Bicho is a popular activity among legal lottery players in Brazil despite its illegal status and is associated with greater harms and increased risk of GD.
- Compulsive features in behavioural addictions: the case of pathological gambling(2012) EL-GUEBALY, Nady; MUDRY, Tanya; ZOHAR, Joseph; TAVARES, Hermano; POTENZA, Marc N.Aims To describe, in the context of DSM-V, how a focus on addiction and compulsion is emerging in the consideration of pathological gambling (PG). Methods A systematic literature review of evidence for the proposed re-classification of PG as an addiction. Results Findings include: (i) phenomenological models of addiction highlighting a motivational shift from impulsivity to compulsivity associated with a protracted withdrawal syndrome and blurring of the ego-syntonic/ego-dystonic dichotomy; (ii) common neurotransmitter (dopamine, serotonin) contributions to PG and substance use disorders (SUDs); (iii) neuroimaging support for shared neurocircuitries between behavioural and substance addictions and differences between obsessivecompulsive disorder (OCD), impulse control disorders (ICDs) and SUDs; (iv) genetic findings more closely related to endophenotypic constructs such as compulsivity and impulsivity than to psychiatric disorders; (v) psychological measures such as harm avoidance identifying a closer association between SUDs and PG than with OCD; (vi) community and pharmacotherapeutic trials data supporting a closer association between SUDs and PG than with OCD. Adapted behavioural therapies, such as exposure therapy, appear applicable to OCD, PG or SUDs, suggesting some commonalities across disorders. Conclusions PG shares more similarities with SUDs than with OCD. Similar to the investigation of impulsivity, studies of compulsivity hold promising insights concerning the course, differential diagnosis and treatment of PG, SUDs, and OCD.
- Responsible Gambling: General Principles and Minimal Requirements(2011) BLASZCZYNSKI, Alex; COLLINS, Peter; FONG, Davis; LADOUCEUR, Robert; NOWER, Lia; SHAFFER, Howard J.; TAVARES, Hermano; VENISSE, Jean-LucMany international jurisdictions have introduced responsible gambling programs. These programs intend to minimize negative consequences of excessive gambling, but vary considerably in their aims, focus, and content. Many responsible gambling programs lack a conceptual framework and, in the absence of empirical data, their components are based only on general considerations and impressions. This paper outlines the consensus viewpoint of an international group of researchers suggesting fundamental responsible gambling principles, roles of key stakeholders, and minimal requirements that stakeholders can use to frame and inform responsible gambling programs across jurisdictions. Such a framework does not purport to offer value statements regarding the legal status of gambling or its expansion. Rather, it proposes gambling-related initiatives aimed at government, industry, and individuals to promote responsible gambling and consumer protection. This paper argues that there is a set of basic principles and minimal requirements that should form the basis for every responsible gambling program.
- Gambling Disorder Due to Brazilian Animal Game (""Jogo do bicho''): Gambling Behavior and Psychopathology(2016) MEDEIROS, Gustavo; GRANT, Jon; TAVARES, HermanoGambling is currently widespread across the globe and despite legally restricted, it is significantly common in Brazil. A traditional and common form of gambling in Brazil is the Brazilian animal game (BAG)-""Jogo do bicho'' in Portuguese. In 2013, BAG activities collected approximately 19 billion Brazilian reais-equivalent to more than 8 billon American dollars, a figure almost 60 % higher than legal lotteries. Although a common form of gambling, the gambling behavior and psychopathology of gambling disorder (GD) associated with BAG has never been systematically studied. The aim of this study is to conduct, the first research approaching GD due to BAG. We assessed 897 participants of whom 63 subjects (7.0 %) presented with GD due to BAG and 834 with GD associated with other forms of gambling. After comparing these two groups, major differences were found in demographics, gambling behavior elements and psychopathological variables. This research reinforces the need for further research on BAG and the need for specific approaches in GD. The particularities of BAG may affect treatment strategies as, for example, suggest some adaptations in social and psychotherapeutic approaches. We also highlight the need to acknowledge the ""hidden'' BAG as a potential addictive game.
- Theoretical and Pragmatical Challenges in Game Studies in Brazil(2023) ANDRADE, Vinicius Oliveira de; MORAES, Yago Luksevicius de; TAVARES, HermanoBackground:The video game industry is increasing worldwide and Brazil is the leading market in South America. Abuse of video games has been an international concern for a few decades and the World Health Organization included gaming disorder in the 11th version of the International Classification of Diseases.Method:In this article, we cite some academic works and our own experiences to reflect about obstacles commonly found by researchers, beginning with the lack of a consensual definition of what is gaming. Then, we show some characteristics of the Brazilian scenario regarding research about gaming in general and clinical practices about gaming disorder in particular and discuss how sociopolitical traits may impact them.Conclusions:Finally, we discuss some options to avoid pathologizing normal behaviour and the importance of connections between psychiatrists and other groups from within and outside academia, such as researchers from game design and politicians, respectively. Arriere-plan:L'industrie des jeux video se developpe dans le monde entier et le Bresil est le marche principal d'Amerique du Sud. L'abus de jeux video est une preoccupation internationale depuis quelques decennies et l'Organisation mondiale de la sante a inclus le trouble du jeu dans la 11e version de la classification internationale des maladies.Methode:Dans cet article, nous passons en revue certains obstacles frequemment rencontres par les chercheurs, a commencer par l'absence de definition consensuelle de ce qu'est le jeu. Ensuite, nous montrons certaines caracteristiques du scenario bresilien concernant la recherche sur le jeu en general et les pratiques cliniques sur le trouble du jeu en particulier, et nous discutons de la maniere dont les caracteristiques sociopolitiques peuvent les influencer.Conclusion:Enfin, nous discutons de certaines options pour eviter de pathologiser un comportement normal et de l'importance des liens entre les psychiatres et d'autres groupes a l'interieur et a l'exterieur du monde universitaire, tels que respectivement les chercheurs en conception de jeux et les politiciens.
- Pathological gambling subtypes: A comparison of treatment-seeking and non-treatment-seeking samples from Brazil and Canada(2014) LOBO, D. S. S.; QUILTY, L. C.; MARTINS, S. S.; TAVARES, H.; VALLADA, H.; KENNEDY, J. L.; BAGBY, R. M.Background: Pathological gambling (PG) is a heterogeneous disorder. The identification and characterization of PG subtypes could lead to tailored treatment approaches, which may, in turn, improve treatment outcomes. Objective: To investigate PG subtypes based on personality traits across two different cultural and clinical settings. Consistent with the Pathways Model, we hypothesized the presence of three subtypes (behaviorally conditioned - BC, emotionally vulnerable - EV, and antisocial impulsivist - AI). Methods: 140 PG adults from Sao Paulo, Brazil (SP sample) and 352 adults with PG (n = 214) or sub-clinical PG (n = 138) from Toronto, Canada (TO sample) completed the Temperament and Character Inventory (TCI). Latent-class analysis was used to investigate subtypes. Results: A 2-class solution was the best model for the pooled SP and TO samples. Class 1 presented a normative personality profile and was composed exclusively of participants from Toronto (BC subtype). Class 2 was characterized by high novelty seeking, high harm avoidance, and low self-directedness, and included participants from both SP and TO (EV subtype). When sub-clinical PGs were excluded from the analysis, a single-class solution better characterized the SP and TO samples. Conclusions: Our results suggest that PG severity, rather than community or clinical settings, may have an effect on PG subtypes. The generalizability of the results is limited by the demographic and clinical features of the selected samples. Future neurobiological studies may contribute to the categorization of subjects into PG subtypes based on different underlying biological pathways.
- Neuroimaging of Dopamine Transporter Density in the Striatum of Disordered Gamblers(2023) GUERRA, Renata Faro; BATISTA, Ilza Rosa; KIM, Hyoun S.; HOEXTER, Marcelo Queiroz; SHIH, Ming Chi; BRESSAN, Rodrigo Affonseca; TAVARES, HermanoThe aim of the present research was to add to the growing literature on dopamine and gambling disorder (GD) by assessing whether GD is associated with dopamine transporter (DAT) density in the ventral striatum compared to healthy controls and whether DAT density was associated with key characteristics of GD (e.g., abstinence, craving). In a cross-sectional investigation using single-photon emission computed tomography with a technetium-(99)m-labeled tropane derivative as a radiotracer with SPECT imaging, fifteen participants with GD and 15 controls (non-gambling individuals, matched for age, gender, handedness, and smoking status) were measured. The GD group completed self-reported questionnaires regarding gambling. Striatal DAT density did not differ between the two groups. Conversely, striatal DAT density correlated significantly with various measures of recent gambling, but not with measures of chronic gambling. Multivariate analysis, adjusted for age and smoking status, showed that DAT density in the left striatum correlated positively with time spent gambling and gambling craving in the last month, whereas DAT density in the right striatum correlated negatively with abstinence self-efficacy. The results suggests that DAT density in the striatum is associated with recent gambling activity and gambling expectation.
- Uncovering Underlying Processes Before Illusion of Control Begins in Gambling Disorder: A Pilot Study(2020) BERG, Raquel; KIM, Hyoun S.; HODGINS, David C.; TAVARES, HermanoGambling Disorder (GD) is characterized by persistent betting even in face of accruing debts and psychosocial hardship. Gambling Disorder behavior has been linked to conditioning, cognitive distortions and superstitious behavior. Previous studies have demonstrated that during response-outcome analytical tests (ROAT), non-gambling individuals are precluded from response extinction when failure feedback is suppressed, and develop superstitious behaviors and illusion of control instead. Gambling can be regarded as a ROAT paradigm in which disordered gamblers (DGs) fail to compute failure feedback; hence they do not perceive the independence between response and outcome. In order to investigate early phenomena on response and outcome processing in DGs, we developed two short ROAT versions, one with a controllable outcome and one with an uncontrollable outcome, both with explicit failure feedback. Twenty DGs and twenty healthy controls were assessed using this novel paradigm. Compared to controls, DGs reported higher distress during the controllable ROAT, less self-confidence in the uncontrollable ROAT, and more random responses and less use of analytical strategies in both tests, evidencing potential deficits in cognitive control. In contrast to previous findings, DGs did not demonstrate more superstitious beliefs, or illusion of control, and were generally more skeptical than controls regarding the controllability of both ROAT versions. Taken together, our findings provide some support for deficits in cognitive control in GD that precede illusion of control and superstitious behaviors.
- Gender Differences in Gambling Exposure and At-risk Gambling Behavior(2020) CARNEIRO, Elizabeth; TAVARES, Hermano; SANCHES, Marcos; PINSKY, Ilana; CAETANO, Raul; ZALESKI, Marcos; LARANJEIRA, RonaldoThis study aimed to evaluate the differences in gambling exposure and onset of gambling problems among male and female gamblers by comparing their demographic and behavioral profiles. This study utilized data from the gambling section of the First Brazilian National Alcohol Survey and Related Behaviors. Interviews were conducted with 3007 participants who were recruited after screening for at-risk gambling behaviors. Individuals who tested positive for at-risk gambling behaviors completed the Gambling Progression Questionnaire comprising items on games of chance, and were evaluated using the DSM-IV pathological gambling criteria. The participants' ""lifetime gambling exposure"" was 12.5%, with 4% having experienced gambling problems during their lifetime. Majority of the male at-risk gamblers (78%) reported that they began gambling in their 20 s and took approximately 3 years to start experiencing gambling-related problems. Contrastingly, female at-risk gamblers started gambling in their 30 s and they took about 12 years to start experiencing gambling-related problems. The present results show that men were 2.3 times more at risk of gambling exposure and 3.6 times more likely to experience gambling-related problems. Male at-risk male gamblers seemed to be lonelier and to have a low socioeconomic status, while women seemed to have lower income and social insertion. Considering these significant differences, more studies evaluating gender differences in gambling behavior are necessary.
- Gambling-related cognitive distortions mediate the relationship between depression and disordered gambling severity(2019) SCHLUTER, Magdalen G.; KIM, Hyoun S.; POOLE, Julia C.; HODGINS, David C.; MCGRATH, Daniel S.; DOBSON, Keith S.; TAVERES, HermanoBackground and objectives: Symptoms of depression are highly prevalent among individuals with gambling disorder, and severity of depression is associated with severity of gambling problem. Yet, little is known about the psychological mechanisms by which symptoms of depression lead to greater gambling severity. In this study, we tested whether cognitive distortions represent one such mechanism, as cognitive distortions are key characteristics in both depression and gambling disorder and have been shown to be associated with gambling severity. Methods: A mediation model was tested among 345 treatment-seeking individuals with gambling disorder in Sao Paulo, Brazil. The diagnosis of gambling disorder was made using semi-structured clinical interviews and participants completed psychometrically sound self-report measures of depression symptoms (Beck Depression Inventory-I), gambling-related cognitive distortions (Gamblers' Beliefs Questionnaire), and gambling severity (Gambling Symptom Assessment Scale). Results: As hypothesized, increased symptoms of depression were significantly associated with both increased disordered gambling severity and increased gambling-related cognitive distortions. Further, gambling-related cognitive distortions predicted greater disordered gambling severity when controlling for depression symptomology. Results from the bootstrapping method indicated that the relationship between symptoms of depression and increased disordered gambling severity is mediated by gambling-related cognitive distortions. Conclusions: Consistent with our predictions, gambling-related cognitive distortions mediated the relationship between depression symptoms and gambling severity among a sample of treatment-seeking disordered gamblers. These results suggest that cognitive distortions may be a key intervention target for the treatment of concurrent depression and gambling disorder.