Attachment states of mind and interoceptive accuracy in patients with gambling disorder: a pilot study

Introduction: Gambling Disorder (GD) is often associated with poor regulation of negative emotions and impulsive behaviours, including gambling urges. According to recent studies, processes involved in emotion regulation are linked to a coherent perception of the self, which starts from the body and goes towards feelings and mind. Emotion regulation was found to be related to the ability to detect and evaluate physiological signals of distress, and then to use appropriate strategies that temper emotional response. A growing body of evidence demonstrated a link between decreased accuracy in perceiving bodily sensory information and difficulties in emotion regulation. Other studies focused on the relationships between difficulties in discriminating sensations related to bodily self-states and attachment system. The present study aims to investigate the relationship between interoceptive accuracy and attachment state of mind in a group of patients with GD. Methods: For this purpose, 15 GD patients and 15 controls were included in the study. Interoceptive Accuracy (IA) was assessed using a heartbeat perception task. Attachment state of mind was assessed using the Adult Attachment Interview (AAI). GD patients also filled the Gambling Symptom Assessment Scale (G-SAS). Results: We found that patients with GD showed significantly lower IA compared to controls. Consistently with previous researches, they were more likely to have insecure or disorganized states of mind with respect to attachment. In addition, insecure and disorganized attachment states of mind were negatively correlated with IA scores within GD group. Conclusions: Although preliminary, our results showed that state of mind with respect to attachment as well as impaired IA may be involved in the clinical phenomenology of Gambling Disorder.