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Dowling N, Merkouris S, Lorains F. Interventions for comorbid problem gambling and psychiatric disorders: Advancing a developing field of research. Addict Behav 2016; 58:21-30. [PMID: 26900888 DOI: 10.1016/j.addbeh.2016.02.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 02/04/2016] [Accepted: 02/07/2016] [Indexed: 12/15/2022]
Abstract
Despite significant psychiatric comorbidity in problem gambling, there is little evidence on which to base treatment recommendations for subpopulations of problem gamblers with comorbid psychiatric disorders. This mini-review draws on two separate systematic searches to identify possible interventions for comorbid problem gambling and psychiatric disorders, highlight the gaps in the currently available evidence base, and stimulate further research in this area. In this mini-review, only 21 studies that have conducted post-hoc analyses to explore the influence of psychiatric disorders or problem gambling subtypes on gambling outcomes from different types of treatment were identified. The findings of these studies suggest that most gambling treatments are not contraindicated by psychiatric disorders. Moreover, only 6 randomized studies comparing the efficacy of interventions targeted towards specific comorbidity subgroups with a control/comparison group were identified. The results of these studies provide preliminary evidence for modified dialectical behavior therapy for comorbid substance use, the addition of naltrexone to cognitive-behavioral therapy (CBT) for comorbid alcohol use problems, and the addition of N-acetylcysteine to tobacco support programs and imaginal desensitisation/motivational interviewing for comorbid nicotine dependence. They also suggest that lithium for comorbid bipolar disorder, escitalopram for comorbid anxiety disorders, and the addition of CBT to standard drug treatment for comorbid schizophrenia may be effective. Future research evaluating interventions sequenced according to disorder severity or the functional relationship between the gambling behavior and comorbid symptomatology, identifying psychiatric disorders as moderators of the efficacy of problem gambling interventions, and evaluating interventions matched to client comorbidity could advance this immature field of study.
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202
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Merkouris SS, Thomas SA, Browning CJ, Dowling NA. Predictors of outcomes of psychological treatments for disordered gambling: A systematic review. Clin Psychol Rev 2016; 48:7-31. [PMID: 27372437 DOI: 10.1016/j.cpr.2016.06.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 04/22/2016] [Accepted: 06/21/2016] [Indexed: 12/20/2022]
Abstract
This systematic review aimed to synthesise the evidence relating to pre-treatment predictors of gambling outcomes following psychological treatment for disordered gambling across multiple time-points (i.e., post-treatment, short-term, medium-term, and long-term). A systematic search from 1990 to 2016 identified 50 articles, from which 11 socio-demographic, 16 gambling-related, 21 psychological/psychosocial, 12 treatment, and no therapist-related variables, were identified. Male gender and low depression levels were the most consistent predictors of successful treatment outcomes across multiple time-points. Likely predictors of successful treatment outcomes also included older age, lower gambling symptom severity, lower levels of gambling behaviours and alcohol use, and higher treatment session attendance. Significant associations, at a minimum of one time-point, were identified between successful treatment outcomes and being employed, ethnicity, no gambling debt, personality traits and being in the action stage of change. Mixed results were identified for treatment goal, while education, income, preferred gambling activity, problem gambling duration, anxiety, any psychiatric comorbidity, psychological distress, substance use, prior gambling treatment and medication use were not significantly associated with treatment outcomes at any time-point. Further research involving consistent treatment outcome frameworks, examination of treatment and therapist predictor variables, and evaluation of predictors across long-term follow-ups is warranted to advance this developing field of research.
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Affiliation(s)
- S S Merkouris
- School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully road, Notting Hill, Victoria 3165, Australia; School of Psychology, Faculty of Health, Deakin University, Geelong, Locked Bag 20000, Geelong, 3220, Australia.
| | - S A Thomas
- School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully road, Notting Hill, Victoria 3165, Australia; International Institute for Primary Health Care Research, Shenzhen City, Guangdong Province, People's Republic of China
| | - C J Browning
- School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Building 1, 270 Ferntree Gully road, Notting Hill, Victoria 3165, Australia; RDNS Institute, RDNS, 31 Alma road, St Kilda, Victoria 3182, Australia; International Institute for Primary Health Care Research, Shenzhen City, Guangdong Province, People's Republic of China
| | - N A Dowling
- School of Psychology, Faculty of Health, Deakin University, Geelong, Locked Bag 20000, Geelong, 3220, Australia; Melbourne Graduate School of Education, University of Melbourne, Australia; Centre for Gambling Research, School of Sociology, Australian National University, ACT, Australia
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203
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Association of attention-deficit/hyperactivity disorder with gambling disorder. J Neural Transm (Vienna) 2016; 123:1013-9. [DOI: 10.1007/s00702-016-1566-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 04/30/2016] [Indexed: 12/31/2022]
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204
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Granero R, Fernández-Aranda F, Steward T, Mestre-Bach G, Baño M, Del Pino-Gutiérrez A, Moragas L, Aymamí N, Gómez-Peña M, Mallorquí-Bagué N, Tárrega S, Menchón JM, Jiménez-Murcia S. Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder. Front Psychol 2016; 7:625. [PMID: 27199853 PMCID: PMC4850691 DOI: 10.3389/fpsyg.2016.00625] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/14/2016] [Indexed: 01/03/2023] Open
Abstract
Compulsive buying behavior (CBB) has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD) exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n = 3221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n = 127), only-GD (n = 3118) and comorbid CBB+GD (n = 24). Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%), while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%). CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet), older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5 vs. 10.0%) but a higher proportion of men compared to only-CBB (62.5 vs. 24.4%). Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.
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Affiliation(s)
- Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
| | - Trevor Steward
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
| | - Gemma Mestre-Bach
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Marta Baño
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona Barcelona, Spain
| | - Laura Moragas
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Neus Aymamí
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Mónica Gómez-Peña
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
| | - Salomé Tárrega
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona Barcelona, Spain
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain; Ciber de Salud Mental, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain
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205
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Medeiros GC, Leppink EW, Redden SA, Yaemi A, Mariani M, Tavares H, Grant JE. A cross-cultural study of gambling disorder: a comparison between women from Brazil and the United States. BRAZILIAN JOURNAL OF PSYCHIATRY 2016; 38:53-7. [PMID: 27111699 PMCID: PMC7115477 DOI: 10.1590/1516-4446-2015-1718] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/10/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To perform a cross-cultural comparison of gambling disorder (GD) in women from Brazil and the United States, two countries with pronounced social and cultural differences. We hoped to produce insight into the impact of cultural influences on the presentation of GD in women, which may be useful for the development of culturally-sensitive interventions. METHOD We assessed 681 women with GD: 406 from a Brazilian sample and 275 from a U.S. SAMPLE We assessed demographic and gambling behavior variables in addition to co-occurring psychiatric disorders. RESULTS Fewer Brazilian participants were Caucasian (73.3 vs. 91.3%; p = 0.022). Also, Brazilian women had lower levels of education (59.9% with high school or less vs. 44.4%; p < 0.001), and were more likely to have a current partner (54.9 vs. 43.4%; p = 0.003). Brazilian gamblers also reported lower urge scores (6.6±4.3 vs. 11.6±2.4; p < 0.001) and higher chasing rates (89.1 vs. 80.0%; p = 0.002). Brazilian gamblers reported higher rates of bingo gambling (19.2 vs. 5.7%; p < 0.001), but lower rates of card game gambling (5.8 vs. 23.1%; p < 0.001). Finally, Brazilian gamblers were more likely to endorse a history of major depressive disorder (36.9 vs. 24.4%; p = 0.001). CONCLUSIONS This study reinforces the need for further general cross-cultural research on GD and particularly for studies investigating how gender mediates these differences. Finally, the differences noted in this analysis suggest that the findings of predominantly Anglo-Saxon cultures may not be generalizable to other world populations.
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Affiliation(s)
- Gustavo C Medeiros
- Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Eric W Leppink
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - Sarah A Redden
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - Ana Yaemi
- Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Mirella Mariani
- Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Hermano Tavares
- Departamento de Psiquiatria, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Jon E Grant
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
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206
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Jiménez-Murcia S, Del Pino-Gutiérrez A, Fernández-Aranda F, Granero R, Hakänsson A, Tárrega S, Valdepérez A, Aymamí N, Gómez-Peña M, Moragas L, Baño M, Sauvaget A, Romeu M, Steward T, Menchón JM. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use. Front Psychol 2016; 7:465. [PMID: 27065113 PMCID: PMC4815556 DOI: 10.3389/fpsyg.2016.00465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 03/15/2016] [Indexed: 11/15/2022] Open
Abstract
Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10–14 patients attending 16 weekly outpatient sessions lasting 90 min each. Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment.
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Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Departament of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain; Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of BarcelonaBarcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Departament of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain; Departament de Psicobiologia i Metodologia, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Anders Hakänsson
- Division of Psychiatry, Department of Clinical Sciences, Lund University Lund, Sweden
| | - Salomé Tárrega
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona Barcelona, Spain
| | - Ana Valdepérez
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau Barcelona, Spain
| | - Neus Aymamí
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Marta Baño
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL Barcelona, Spain
| | - Anne Sauvaget
- Addictology and Psychiatry Department, Nantes University Hospital Nantes, France
| | - Maria Romeu
- Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELLBarcelona, Spain; Departament of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain; CIBER Salud Mental, Instituto Carlos IIIBarcelona, Spain
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207
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Scholes-Balog KE, Hemphill SA, Toumbourou JW, Dowling NA. Problem gambling patterns among Australian young adults: Associations with prospective risk and protective factors and adult adjustment. Addict Behav 2016; 55:38-45. [PMID: 26790138 DOI: 10.1016/j.addbeh.2015.12.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/21/2015] [Accepted: 12/31/2015] [Indexed: 01/10/2023]
Abstract
There is instability in the developmental course of problem gambling [PG] over time; however, studies that examine PG at an aggregate level obscure these variations. The current study employed data from a longitudinal study of Australian young adults to investigate: 1) PG patterns (i.e., resistance, persistence, desistence, and new incidence); 2) prospective risk and protective factors for these patterns; and 3) behavioural outcomes associated with these patterns. A sample of 2261 young adults (55.73% female) from Victoria, Australia, who were part of the International Youth Development Study completed a survey in 2010 (T1, age 21) and 2012 (T2, age 23) measuring PG (two items based on established measures), risk and protective factors, and behavioural outcomes. The majority of the sample (91.69%) were resistors (no PG at T1 and T2), 3.62% were new incidence PG cases, 2.63% were desistors (PG at T1 but not T2), and 2.07% reported persistent PG at T1 and T2. Individual civic activism was protective of new incidence PG, while affiliation with antisocial peers and frequent alcohol use increased the risk of persistence. Persistent problem gamblers also experienced the greatest number of poor behavioural outcomes at T2. New incidence was associated with internalising symptoms at T2, while desistance was not associated with any behavioural outcomes. In conclusion, each PG pattern was associated with different predictors and outcomes, highlighting the need to consider variation in the course of young adult PG in order to provide efficacious prevention and intervention approaches, and to protect against relapse.
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208
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Josephson H, Carlbring P, Forsberg L, Rosendahl I. People with gambling disorder and risky alcohol habits benefit more from motivational interviewing than from cognitive behavioral group therapy. PeerJ 2016; 4:e1899. [PMID: 27069823 PMCID: PMC4824888 DOI: 10.7717/peerj.1899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 03/15/2016] [Indexed: 11/20/2022] Open
Abstract
Background. Effective psychological treatment, including cognitive behavioral therapy and motivational interviewing (MI), is available for people with problematic gambling behaviors. To advance the development of treatment for gambling disorder, it is critical to further investigate how comorbidity impacts different types of treatments. The purpose of this study was to investigate whether screening for risky alcohol habits can provide guidance on whether people with gambling disorder should be recommended cognitive behavioral group therapy (CBGT) or MI. Methods. The present study is a secondary analysis of a previous randomized controlled trial that compared the effects of CBGT, MI and a waitlist control group in the treatment of disordered gambling. Assessment and treatment was conducted at an outpatient dependency clinic in Stockholm, Sweden, where 53 trial participants with gambling disorder began treatment. A modified version of the National Opinion Research Centre DSM-IV Screen for gambling problems was used to assess gambling disorder. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen for risky alcohol habits. Results. The interaction between treatment and alcohol habits was significant and suggests that patients with gambling disorder and risky alcohol habits were better helped by MI, while those without risky alcohol habits were better helped by CBGT. Conclusions. The results support a screening procedure including the AUDIT prior to starting treatment for gambling disorder because the result of the screening can provide guidance in the choice of treatment. Patients with gambling disorder and risky alcohol habits are likely to be best helped if they are referred to MI, while those without risky alcohol habits are likely to be best helped if they are referred to CBGT.
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Affiliation(s)
- Henrik Josephson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University , Stockholm , Sweden
| | - Lars Forsberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
| | - Ingvar Rosendahl
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute & Stockholm Health Care Services, Stockholm County Council , Stockholm , Sweden
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209
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An Empirical Study of Personality Disorders Among Treatment-Seeking Problem Gamblers. J Gambl Stud 2016; 32:1079-1100. [DOI: 10.1007/s10899-016-9600-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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210
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Rash CJ, Weinstock J, Van Patten R. A review of gambling disorder and substance use disorders. Subst Abuse Rehabil 2016; 7:3-13. [PMID: 27051333 PMCID: PMC4803266 DOI: 10.2147/sar.s83460] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling disorder was recategorized from the "Impulse Control Disorder" section to the newly expanded "Substance-related and Addictive Disorders" section. With this move, gambling disorder has become the first recognized nonsubstance behavioral addiction, implying many shared features between gambling disorder and substance use disorders. This review examines these similarities, as well as differences, between gambling and substance-related disorders. Diagnostic criteria, comorbidity, genetic and physiological underpinnings, and treatment approaches are discussed.
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Affiliation(s)
- Carla J Rash
- Calhoun Cardiology Center – Behavioral Health, UConn Health, Farmington, CT, USA
| | | | - Ryan Van Patten
- Department of Psychology, Saint Louis University, St Louis, MO, USA
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211
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Thomas SA, Merkouris SS, Browning CJ, Radermacher H, Feldman S, Enticott J, Jackson AC. The PROblem Gambling RESearch Study (PROGRESS) research protocol: a pragmatic randomised controlled trial of psychological interventions for problem gambling. BMJ Open 2015; 5:e009385. [PMID: 26603250 PMCID: PMC4663416 DOI: 10.1136/bmjopen-2015-009385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/03/2015] [Accepted: 10/21/2015] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION International prevalence rates for problem gambling are estimated at 2.3%. Problem gambling is a serious global public health concern due to adverse personal and social consequences. Previous research evaluating the effectiveness of psychological interventions for the treatment of problem gambling has been compromised by methodological limitations, including small sample sizes and the use of waitlist control groups. This article describes the study protocol for a pragmatic randomised controlled trial (RCT) evaluating the effectiveness of cognitive-behavioural therapy (CBT), behaviour therapy (BT), motivational interviewing (MI) against a non-directive supportive therapy (NDST) control, in treating problem gambling. METHODS AND ANALYSIS This study was a mixed-methods design, with a parallel group, pragmatic RCT as the primary component, and embedded qualitative studies conducted alongside. A total of 297 participants were recruited from the community in Victoria, Australia. Individuals aged 18 years and over, could communicate in English and wished to receive treatment for a gambling problem were eligible. Participants were randomly allocated in to 1 of the 4 psychological interventions: CBT, BT, MI and NDST. Repeated measures were conducted at pretreatment and post-treatment, and 6 and 12 months post-treatment. The statistical analysis will use an intention-to-treat approach. Multilevel mixed modelling will be used to examine changes in the primary outcome measures: gambling symptom severity, using the Gambling Symptom Assessment Scale, and gambling behaviours (frequency, time and expenditure). Secondary outcomes are depression, anxiety, stress and alcohol use. Individual semistructured qualitative interviews were conducted at pretreatment and post-treatment and 12 months post-treatment for a subset of participants (n=66). ETHICS AND DISSEMINATION This study was approved by the Victorian Department of Justice, Monash University and the University of Melbourne Human Research Ethics Committees. Findings will be reported in a government report, peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER Current Controlled Trials ISRCTN01629698.
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Affiliation(s)
- Shane A Thomas
- Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Stephanie S Merkouris
- Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Colette J Browning
- Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
- RDNS Institute, St Kilda, Victoria, Australia
| | - Harriet Radermacher
- Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Susan Feldman
- Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Joanne Enticott
- Primary Care Research Unit, School of Primary Health Care, Monash University, Notting Hill, Victoria, Australia
| | - Alun C Jackson
- Melbourne Graduate School of Education, University of Melbourne, Carlton, Victoria, Australia
- Heart Research Centre, North Melbourne, Victoria, Australia
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212
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Verdura-Vizcaíno EJ, Fernández-Navarro P, Vian-Lains A, Ibañez Á, Baca-García E. [Sociodemographic Traits and Comorbidities in Pathological Gamblers With a Suicide Attempt in Spain]. ACTA ACUST UNITED AC 2015; 44:159-65. [PMID: 26578416 DOI: 10.1016/j.rcp.2015.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/15/2015] [Accepted: 03/21/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Suicide is the first cause of non-natural death in Spain. Among addictive disorders, pathological gambling is one the most significant independent risk factors for suicidal behavior. The objective of this study is to describe and compare the sociodemographic traits, comorbidity and attempt characteristics, between suicide attempters who fulfill diagnostic criteria for pathological gambling and those who do not. METHODS A total of 345 patients admitted to the emergency department of a University Hospital in Madrid between 1999 and 2004 were interviewed for this study. To describe and compare the demographic characteristics, comorbidity and those related to attempted suicide, using logistic regression models adjusted for sex and age were used. RESULTS Suicide attempters who fulfilled diagnostic criteria for pathological gambling were predominantly male, with a low education level, and had more offspring. Furthermore, these patients had more comorbidities, such as: global substance dependence, nicotine, cocaine and opioid dependence. CONCLUSIONS The present study suggests that pathological gamblers represent a distinct subgroup among suicide attempters, with particular characteristics, similar to those found in pathological gamblers in the general population.
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Affiliation(s)
| | - Pablo Fernández-Navarro
- Área de Epidemiología Ambiental y Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Epidemiología y Salud Pública (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, España
| | | | - Ángela Ibañez
- Servicio de Psiquiatría, Hospital Ramón y Cajal, IRYCIS, Madrid, España; Universidad de Alcalá, Madrid, España; Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, España
| | - Enrique Baca-García
- Servicio de Psiquiatría, Fundación Jiménez Díaz, Madrid, España; Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, España; Universidad Autónoma de Madrid, Madrid, España; Departamento de Psiquiatría, New York State Psychiatric Institute, Nueva York, Estados Unidos
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The Relationship Between Stress and Motivation in Pathological Gambling: a Focused Review and Analysis. CURRENT ADDICTION REPORTS 2015. [DOI: 10.1007/s40429-015-0064-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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214
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The Relationship Between Problem Gambling and Attention Deficit Hyperactivity Disorder. J Gambl Stud 2015; 32:591-604. [DOI: 10.1007/s10899-015-9564-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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215
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Scholes-Balog KE, Hemphill SA, Toumbourou JW, Dowling NA. Problem gambling and internalising symptoms: a longitudinal analysis of common and specific social environmental protective factors. Addict Behav 2015; 46:86-93. [PMID: 25827336 DOI: 10.1016/j.addbeh.2015.03.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Comorbidity between problem gambling and internalising disorders (anxiety and depression) has long been recognised. However, it is not clear how these relationships develop, and what factors can foster resilience to both conditions. The current study draws on longitudinal cohort data to investigate: 1) the cross-sectional and longitudinal relationships between problem gambling and internalising symptoms; 2) whether there are common and/or specific social environmental factors protective against both internalising symptoms and problem gambling in young adulthood; and 3) interactive protective factors (i.e., those that moderate the relationship between problem gambling and internalising symptoms). METHODS A sample of 2248 young adults (55% female) completed a survey in 2010 (T1) and 2012 (T2) which assessed problem gambling (measured via two items based on established measures), internalising symptoms, and social environmental protective factors. RESULTS A positive cross-sectional relationship between problem gambling and internalising symptoms was found; however, there was no statistically significant longitudinal relationship between the two conditions. Protective factors for internalising symptoms were observed within the domains of the community, family and peer group; however, there were no statistically significant protective factors identified for problem gambling. CONCLUSIONS These findings demonstrate that the social environmental protective factors for adult internalising symptoms assessed in the present study are poor longitudinal predictors of young adult problem gambling. Given the lack of common protective factors, it may be necessary to focus on separate factors to protect against each condition, if we are to address the comorbidity between problem gambling and internalising symptoms.
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Affiliation(s)
- Kirsty E Scholes-Balog
- Learning Sciences Institute Australia, Australian Catholic University, 115 Victoria Pde, Fitzroy, Victoria, Australia; School of Psychology, Australian Catholic University, 115 Victoria Pde, Fitzroy, Victoria, Australia.
| | - Sheryl A Hemphill
- Learning Sciences Institute Australia, Australian Catholic University, 115 Victoria Pde, Fitzroy, Victoria, Australia; School of Psychology, Australian Catholic University, 115 Victoria Pde, Fitzroy, Victoria, Australia; School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria, Australia; Centre for Adolescent Health, Murdoch Childrens Research Institute, 2 Gatehouse St, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.
| | - John W Toumbourou
- Centre for Adolescent Health, Murdoch Childrens Research Institute, 2 Gatehouse St, Parkville, Victoria, Australia; Prevention Sciences, School of Psychology and Research Centre for Social and Early Emotional Development, Deakin University, 1 Gheringhap St, Geelong, Victoria, Australia.
| | - Nicki A Dowling
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Victoria, Australia; School of Psychological Sciences, Monash University, Wellington Rd, Clayton, Victoria, Australia; Melbourne Graduate School of Education, University of Melbourne, Parkville, Victoria, Australia.
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216
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Cowlishaw S, Hakes JK. Pathological and problem gambling in substance use treatment: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Am J Addict 2015; 24:467-74. [DOI: 10.1111/ajad.12242] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/01/2015] [Accepted: 04/26/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sean Cowlishaw
- School of Social and Community Medicine; University of Bristol; United Kingdom
- Centre for Gambling Research; College of Arts Social Sciences; School of Sociology; The Australian National University (ANU); Australia
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