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Free BL, Halle Smith E, Ginley MK, Whelan JP, Pfund RA. Does cognitive-behavioral treatment affect putative mechanisms of change among individuals with problem gambling? A systematic review and exploratory meta-analysis. Addict Behav 2024; 158:108110. [PMID: 39089195 DOI: 10.1016/j.addbeh.2024.108110] [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: 03/16/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 08/03/2024]
Abstract
OBJECTIVE The current study was a systematic review and meta-analysis of cognitive behavioral treatment (CBT) for problem gambling and gambling disorder and whether it produced different outcomes than minimal or no treatment controls on three putative change mechanisms: 1) gambling cognitions, 2) coping, and 3) self-efficacy. METHOD Studies were identified from five bibliographic databases (i.e., Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and PubMed). Included studies were randomized controlled trials of CBT that included posttreatment data on putative mechanisms. Between-group Hedges's g effect sizes were calculated to examine outcomes of CBT relative to minimal or no treatment control on gambling cognitions, coping, and self-efficacy at posttreatment. Risk of bias was determined using the Cochrane Risk of Bias tool. RESULTS Fifteen studies, representing 1,536 participants, were eligible for analysis. Participants in CBT had more favorable gambling cognitions (g = -0.41), coping behaviors (g = 0.27), and self-efficacy (g = 1.12) at posttreatment than minimal or no treatment control. CONCLUSIONS Results of the current study provided preliminary support for the effectiveness of CBT on three putative mechanisms of change among individuals experiencing problem gambling and gambling disorder. Although the results were promising, there was significant heterogeneity in the magnitude of effect sizes for all three outcomes, and outcomes were not consistently assessed with psychometrically established assessment tools.
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Affiliation(s)
- Bre'Anna L Free
- Department of Psychology, The University of Memphis, United States; Tennessee Institute for Gambling Education & Research, United States.
| | - E Halle Smith
- Department of Psychology, The University of Memphis, United States; Tennessee Institute for Gambling Education & Research, United States
| | - Meredith K Ginley
- Tennessee Institute for Gambling Education & Research, United States; Department of Psychology, East Tennessee State University, United States
| | - James P Whelan
- Department of Psychology, The University of Memphis, United States; Tennessee Institute for Gambling Education & Research, United States
| | - Rory A Pfund
- Department of Psychology, The University of Memphis, United States; Tennessee Institute for Gambling Education & Research, United States
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Pfund RA, Forman DP, Whalen SK, Zech JM, Ginley MK, Peter SC, McAfee NW, Whelan JP. Effect of cognitive-behavioral techniques for problem gambling and gambling disorder: A systematic review and meta-analysis. Addiction 2023; 118:1661-1674. [PMID: 37381589 PMCID: PMC10524575 DOI: 10.1111/add.16221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/14/2023] [Indexed: 06/30/2023]
Abstract
AIMS To measure the effect of cognitive-behavioral techniques (CBTs) on gambling disorder severity and gambling behavior at post-treatment and follow-up. METHOD Seven databases and two clinical trial registries were searched to identify peer-reviewed studies and unpublished studies of randomized controlled trials. The Cochrane Risk of Bias tool assessed risk of bias in the included studies. A random effect meta-analysis with robust variance estimation was conducted to measure the effect of CBTs relative to minimally treated or no treatment control groups. RESULTS Twenty-nine studies representing 3991 participants were identified. CBTs significantly reduced gambling disorder severity (g = -1.14, 95% CI = -1.68, -0.60, 95% prediction interval [PI] = -2.97, 0.69), gambling frequency (g = -0.54, 95% CI = -0.80, -0.27, 95% PI = -1.48, 0.40) and gambling intensity (g = -0.32, 95% CI = -0.51, -0.13, 95% PI = -0.76, 0.12) at post-treatment relative to control. CBTs had no significant effect on follow-up outcomes. Analyses supported the presence of publication bias and high heterogeneity in effect size estimates. CONCLUSIONS Cognitive-behavioral techniques are a promising treatment for reducing gambling disorder and gambling behavior; however, the effect of cognitive-behavioral techniques on gambling disorder severity and gambling frequency and intensity at post-treatment is overestimated, and cognitive-behavioral techniques may not be reliably efficacious for all individuals seeking treatment for problem gambling and gambling disorder.
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Affiliation(s)
- Rory A Pfund
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
- Tennessee Institute for Gambling Education & Research, Tennessee, USA
| | - David P Forman
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Shelby K Whalen
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - James M Zech
- Department of Counseling and Clinical Psychology, Columbia University, New York, New York, USA
| | - Meredith K Ginley
- Tennessee Institute for Gambling Education & Research, Tennessee, USA
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - Nicholas W McAfee
- Department of Psychiatry, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - James P Whelan
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
- Tennessee Institute for Gambling Education & Research, Tennessee, USA
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3
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Wall H, Magnusson K, Hellner C, Andersson G, Jayaram-Lindström N, Rosendahl I. The evaluation of a brief ICBT program with therapist support for individuals with gambling problems in the context of a gambling helpline: a randomized pilot trial. Pilot Feasibility Stud 2023; 9:26. [PMID: 36805024 PMCID: PMC9936663 DOI: 10.1186/s40814-023-01257-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 02/03/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND AND AIMS Gambling helplines are a natural way of first contact for individuals with gambling problems. However, few studies have evaluated the feasibility and effectiveness of brief interventions in a gambling helpline. To reduce this knowledge gap, this study evaluated the feasibility of an online cognitive behavioral therapy (ICBT) program in the context of a gambling helpline as a first step towards a full-scale RCT. DESIGN This is a two-group parallel randomized controlled pilot trial where the participants were randomized to either a brief four-module ICBT program (n = 22) or a control group (n = 21). Participants were followed up weekly during the intervention, post intervention, and 6 weeks upon completion of intervention. PARTICIPANTS A total of 43 self-identified individuals with gambling problems (scoring 3 or more on the Problem Gambling Severity Index) were recruited via the Swedish national gambling helpline, 59% females, mean age 43.7 years. MEASUREMENTS Feasibility of the procedure and intervention (i.e., recruitment pace, attrition, program engagement, and satisfaction) were the primary outcomes; treatment effect (net gambling losses) was the secondary outcome. RESULTS Approximately 2 participants per week were randomized, and retention was low, with 47% lost to follow-up at the 6-week follow-up time-point. Most participants engaged in the online modules (86%) and rated their overall satisfaction with the program as high (7.5 out of 10). Both groups decreased their weekly gambling losses at both follow-up time-points, but the between-group comparisons were inconclusive. CONCLUSION It is not advisable to conduct a full-scale RCT based on the results from this pilot study. Future studies in a gambling helpline should consider interventions that are more suited to be incorporated in a gambling helpline and identify ways to increase participant engagement. TRIAL REGISTRATION The study was retrospectively registered on ClinicalTrials.gov (ID: NCT04609007 , 29/10/2020).
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Affiliation(s)
- Håkan Wall
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Solna, Sweden. .,Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, 11364, Stockholm, Sweden.
| | - Kristoffer Magnusson
- grid.465198.7Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Solna, Sweden ,grid.425979.40000 0001 2326 2191Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, 11364 Stockholm, Sweden
| | - Clara Hellner
- grid.465198.7Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Solna, Sweden ,grid.425979.40000 0001 2326 2191Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, 11364 Stockholm, Sweden
| | - Gerhard Andersson
- grid.465198.7Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Solna, Sweden ,grid.425979.40000 0001 2326 2191Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, 11364 Stockholm, Sweden ,grid.5640.70000 0001 2162 9922Department of Behavioral Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Nitya Jayaram-Lindström
- grid.465198.7Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Solna, Sweden ,grid.425979.40000 0001 2326 2191Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, 11364 Stockholm, Sweden
| | - Ingvar Rosendahl
- grid.465198.7Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Solna, Sweden ,grid.425979.40000 0001 2326 2191Stockholm Health Care Services, Stockholm County Council, Norra Stationsgatan 69, 11364 Stockholm, Sweden
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Higueruela-Ahijado M, López-Espuela F, Caro-Alonso PÁ, Novo A, Rodríguez-Martín B. Efficacy of cognitive-behavioral therapy in improving the quality of life of people with compulsive gambling, a systematic review. Arch Psychiatr Nurs 2022; 43:127-142. [PMID: 37032006 DOI: 10.1016/j.apnu.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022]
Abstract
FUNDAMENTALS Cognitive-behavioral therapy can reduce gambling behavior and other symptoms of pathological gambling. AIM To synthesize and analyze the evidence on the efficacy of cognitive-behavioral interventions to improve the quality of life of people with pathological gambling. METHODOLOGY Systematic review with a narrative synthesis of clinical trials published in English and Spanish in Medline, Scopus, Web of Science, CINAHL, The Cochrane Library Plus, PsycoInfo, and ProQuest of articles until January 2020 that will analyze this phenomenon. The PRISMA Declaration was followed and the quality of the articles was analyzed with the Jadad scale. RESULTS 1233 articles were found, including nine in the review. Two studies confirmed the efficacy of cognitive behavioral therapy-based interventions for improving the quality of life in people with pathological gambling. In addition, these interventions improved depression, anxiety, the amount of money played, and reduced alcohol consumption and the gambling diagnosis score, which had an impact on improving the quality of life. Cognitive behavioral interventions were more effective when it was supported by a manual or when were combined with Mindfulness or Player Anonymous sessions. Having better long-term results in these cases. CONCLUSIONS Cognitive behavioral-based interventions can improve the quality of life of people with pathological gambling and other psychological variables without being its immediate effect. Future research should analyze whether they are more efficacy online or in person, individually, or in groups, and the number of sessions required for their effects to last over time.
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Affiliation(s)
- Marina Higueruela-Ahijado
- University of Castilla-La Mancha, Faculty of Health Sciences, Avd/ Real Fábrica de Sedas s/n, 4500 Talavera de la Reina, Toledo, Spain
| | - Fidel López-Espuela
- Metabolic Bone Diseases Research Group, Department of Nursing, Faculty of Nursing and Occupational Therapy, University of Extremadura, Extremadura, Spain.
| | - Pedro Ángel Caro-Alonso
- University of Castilla-La Mancha, Faculty of Health Sciences, Avd/ Real Fábrica de Sedas s/n, 4500 Talavera de la Reina, Toledo, Spain.
| | - Andre Novo
- Instituto Politécnico de Bragança, CINTESIS: NursID, Portugal.
| | - Beatriz Rodríguez-Martín
- University of Castilla-La Mancha, Faculty of Health Sciences, Avd/ Real Fábrica de Sedas s/n, 4500 Talavera de la Reina, Toledo, Spain.
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Intranasal as needed naloxone in the treatment of gambling disorder: A randomised controlled trial. Addict Behav 2022; 125:107127. [PMID: 34634640 DOI: 10.1016/j.addbeh.2021.107127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Gambling disorder (GD) is a global phenomenon affecting millions of people. GD can result in severe social and financial difficulties and efficacious treatments are warranted. Psychosocial treatments form the basis of treatment. Opioid antagonists (OAs) have however shown promise in previous studies. In a recent imaging study intranasal naloxone was found to rapidly and fully occupy brain μ-opioid receptors. This trial investigates the effect and safety of as needed naloxone in the treatment of gambling disorder. METHODS This was a 12-week double blind, randomised control trial comparing intranasal naloxone to placebo. The primary endpoint was gambling urge measured by the Gambling symptom Assessment Scale (G-SAS). Secondary outcome measures were gambling severity measures (PGSI) as well as quality of life (WHO:EUROHIS-8), alcohol consumption (AUDIT), depression (MARDS) and internet use (IDS-9SF). In addition, safety of treatment was assessed. Both treatment groups received psychosocial support. RESULTS 126 participants were randomised to treatment groups in a 1:1 ratio. 106 patients completed the study. Gambling urge (GSAS) and other gambling related measured improved in both groups, but no statistically significant difference could be found. Intranasal naloxone was well tolerated, no subjects discontinued the study due to adverse events. No serious adverse drug reactions were observed. CONCLUSIONS This study found no difference between the as-needed administration of intranasal naloxone and placebo in reducing gambling urge in persons with GD. Intranasal naloxone was safe and well tolerated.
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Diaz-Sanahuja L, Campos D, Mira A, Castilla D, García-Palacios A, Bretón-López JM. Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial. Internet Interv 2021; 26:100466. [PMID: 34646753 PMCID: PMC8501496 DOI: 10.1016/j.invent.2021.100466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 01/06/2023] Open
Abstract
UNLABELLED Gambling Disorder is a prevalent non-substance use disorder, which contrasts with the low number of people requesting treatment. Information and Communication Technologies (ICT) could help to enhance the dissemination of evidence-based treatments and considerably reduce the costs. The current study seeks to assess the efficacy of an online psychological intervention for people suffering from gambling problems in Spain. The proposed study will be a two-arm, parallel-group, randomized controlled trial. A total of 134 participants (problem and pathological gamblers) will be randomly allocated to a waiting list control group (N = 67) or an intervention group (N = 67). The intervention program includes 8 modules, and it is based on motivational interviewing, cognitive-behavioral therapy (CBT), and extensions and innovations of CBT. It includes several complementary tools that are present throughout the entire intervention. Therapeutic support will be provided once a week through a phone call with a maximum length of 10 min. The primary outcome measure will be gambling severity and gambling-related cognitions, and secondary outcome measures will be readiness to change, and gambling self-efficacy. Other variables that will be considered are depression and anxiety symptoms, positive and negative affect, difficulties in emotion regulation strategies, impulsivity, and quality of life. Individuals will be assessed at baseline, post-treatment, and 3-, 6-, and 12-month follow-ups. During the treatment, participants will also respond to a daily Ecological Momentary Intervention (EMI) in order to evaluate urges to gamble, self-efficacy to cope with gambling urges, gambling urge frequency, and whether gambling behaviour occurs. The EMI includes immediate automatic feedback depending on the participant's responses. Treatment acceptance and satisfaction will also be assessed. The data will be analysed both per protocol and by Intention-to-treat. As far as we know, this is the first randomized controlled trial of an online psychological intervention for gambling disorder in Spain. It will expand our knowledge about treatments delivered via the Internet and contribute to improving treatment dissemination, reaching people suffering from this problem who otherwise would not receive help. TRIAL REGISTRATION Clinicaltrials.gov as NCT04074681. Registered 22 July 2019.
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Key Words
- A, Action
- C, Contemplation
- CBT
- CBT, Cognitive Behavioral Therapy
- CIDI, Composite International Diagnostic Interview
- CONSORT-EHEALTH, Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth
- DERS, Difficulties in Emotion Regulation Scale
- DGOJ, Directorate General for the Regulation of Gambling
- DSM-5, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
- DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition Revised
- DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
- EDBs, Emotion Driven Behaviours
- EMA, Ecological Momentary Assessment
- EMI, Ecological Momentary Intervention
- Efficacy
- Emotion regulation
- G-SAS, The Gambling Symptom Assessment Scale
- GD, Gambling Disorder
- GE, Gambling Expectancies
- GI, Gambling history interview and current gambling situation and related variables assessment
- GRCS-S, Gambling-Related Cognitions Scale
- GSEQ, Gambling Self-Efficacy Questionnaire
- Gambling
- HADS, Hospital Anxiety Depression Scale
- IB, Interpretative Bias
- IC, Illusion of Control
- ICD-10, International Statistical Classification of Diseases and Related Health Problems 10th Revision
- ISG, Perceived Inability to Stop Gambling
- Internet
- M, Maintenance
- MFS, Monitoring, Feedback and Support
- MI, Motivational Interviewing
- MINI, Mini International Neuropsychiatric Interview
- NA, Negative Affect
- NODS, NORC DSM-IV Screen for Gambling Problems
- OASIS, The Overall Anxiety Severity and Impairment Scale
- ODSIS, The Overall Depression Severity and Impairment Scale
- P, Precontemplation
- PA, Positive Affect
- PANAS, The Positive and Negative Affect Schedule
- PC, Predictive Control
- PFIs, Personal Feedback Interventions
- QLI, Quality Life Index
- RCT, Randomized Controlled Trial
- SCID-P, The Structured Clinical Interview
- SPIRIT, Standard Protocol Items Recommendations for Interventional Trials
- SUS, System Usability Scale
- UPPS-P, The Short UPPS-P Impulsivity Scale
- URICA, The University of Rhode Island Change Assessment Scale
- WL, Waiting List
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Affiliation(s)
- Laura Diaz-Sanahuja
- Universitat Jaume I, Castellón, Spain
- Corresponding author at: Department of Basic Psychology, Clinical and Psychobiology, Universitat Jaume I, Avenida de Vicent Sos Baynat, s/n, 12071 Castellón, (Spain).
| | - Daniel Campos
- Universidad de Zaragoza, Huesca, Spain
- Instituto de Investigación Sanitaria Aragón (IISAragon), Zaragoza, Spain
| | | | - Diana Castilla
- Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Azucena García-Palacios
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Juana María Bretón-López
- Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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A systematic review and meta-analysis of psychological interventions to improve mental wellbeing. Nat Hum Behav 2021; 5:631-652. [PMID: 33875837 DOI: 10.1038/s41562-021-01093-w] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022]
Abstract
Our current understanding of the efficacy of psychological interventions in improving mental states of wellbeing is incomplete. This study aimed to overcome limitations of previous reviews by examining the efficacy of distinct types of psychological interventions, irrespective of their theoretical underpinning, and the impact of various moderators, in a unified systematic review and meta-analysis. Four-hundred-and-nineteen randomized controlled trials from clinical and non-clinical populations (n = 53,288) were identified for inclusion. Mindfulness-based and multi-component positive psychological interventions demonstrated the greatest efficacy in both clinical and non-clinical populations. Meta-analyses also found that singular positive psychological interventions, cognitive and behavioural therapy-based, acceptance and commitment therapy-based, and reminiscence interventions were impactful. Effect sizes were moderate at best, but differed according to target population and moderator, most notably intervention intensity. The evidence quality was generally low to moderate. While the evidence requires further advancement, the review provides insight into how psychological interventions can be designed to improve mental wellbeing.
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Hodgins DC, Cunningham JA, Murray R, Hagopian S. Online Self-Directed Interventions for Gambling Disorder: Randomized Controlled Trial. J Gambl Stud 2019; 35:635-651. [PMID: 30701377 DOI: 10.1007/s10899-019-09830-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Self-directed treatments for gambling disorder have been developed to attract individuals who are reluctant to seek formal treatment. Self-directed treatments provide individuals with information and support to initiate a recovery program without attending formal treatment. In this study, an online version of a previously evaluated telephone-based intervention package is compared to a brief online normative feedback intervention called Check Your Gambling. In a randomized controlled trial design, participants with gambling problems who were not interested in formal treatment (N = 181) were recruited through media announcements. After a baseline telephone assessment, participants were assigned to have access to either the brief Check Your Gambling, or the extended self-management tools intervention. Follow-up assessments were conducted at 3, 6, and 12 months post baseline by blinded interviewers. Participant nominated collaterals were contacted to validate self-reported gambling involvement. The follow-up rate at 12 months was 78%. Participants in both conditions showed significant reductions in days of gambling and problem severity but no differences between conditions were found, contrary to the primary hypothesis. Lack of previous treatment for gambling and higher baseline self-efficacy predicted fewer days of gambling in both conditions. Self-efficacy increased over time but did not appear to mediate changes in gambling. Participants who were most engaged in the extended online program showed better outcomes. Those with low engagement showed a slower trajectory of change but equivalent improvements by 12 months. The extended online intervention was not associated with better outcomes than the brief Check Your Gambling intervention. Future research needs to explore the attractiveness, uptake, and effectiveness of online interventions with and without therapist support to understand their potential role in gambling disorder treatment systems.Trial Registration ISRCTN06220098.
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Affiliation(s)
| | | | - Robert Murray
- Centre for Addiction and Mental Health, Toronto, Canada
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Bonfils NA, Aubin HJ, Benyamina A, Limosin F, Luquiens A. Quality of life instruments used in problem gambling studies: A systematic review and a meta-analysis. Neurosci Biobehav Rev 2019; 104:58-72. [PMID: 31271803 DOI: 10.1016/j.neubiorev.2019.06.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/26/2019] [Accepted: 06/29/2019] [Indexed: 01/22/2023]
Abstract
The purpose of this systematic review was to identify the instruments used in original articles to measure quality of life (QOL) or health-related QOL (HRQOL) in gambling-disorder patients and to assess their suitability. The systematic literature search to identify QOL/HRQOL instruments used among gambling-disorder patients was performed in PubMed, Embase and PsycINFO databases up to November 2018. A meta-analysis was performed to study the effect size of the QOL/HRQOL instruments and gambling outcomes after an intervention. Thirty-five studies were included. Seven types of instruments aiming at measuring QOL/HRQOL were identified. These instruments explored twenty-six domains. The instruments used were not properly validated in the studies. Most of the clinical trials reported a significant difference in QOL/HRQOL between pre- and post-intervention. These results were concordant with gambling outcomes but had a smaller effect size than gambling outcomes. The currently used general instruments are efficient to measure a significant change after an intervention but might not evaluate specific areas of health related QOL impacted by gambling disorders.
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Affiliation(s)
- Nicolas A Bonfils
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry and Addictology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France.
| | - Henri-Jean Aubin
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France; Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
| | - Amine Benyamina
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France; Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
| | - Frédéric Limosin
- AP-HP, Hôpitaux Universitaires Paris Ouest, Department of Psychiatry and Addictology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; Inserm, U894, Centre Psychiatrie et Neurosciences, Paris, France
| | - Amandine Luquiens
- CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France; APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France; Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
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10
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Abstract
PURPOSE OF REVIEW To assess recent developments in self-directed interventions for gambling disorder and at-risk gambling. RECENT FINDINGS Relevant reviews and meta-analyses were published during 2017 and 2018. These reviews assess the nature and efficacy of self-directed and largely self-directed interventions including self-change, assisted self-change and mutual aid support groups. Additional reviews cover government and industry strategies to reduce harm including gambling venue and site self-exclusion and a variety of responsible gambling and consumer protection measures. Further studies were published that advanced understanding of self-directed and related interventions and identified priorities for development and research. SUMMARY There is variable support for the effectiveness of the foregoing interventions. Some appear to achieve outcomes comparable with professionally delivered therapies. Research is required using more robust designs, larger and more diverse samples and longer follow-up to demonstrate effectiveness and provide a basis for matching at-risk and problem gamblers to interventions of different types and intensity.
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11
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Jiménez-Murcia S, Granero R, Fernández-Aranda F, Sauvaget A, Fransson A, Hakansson A, Mestre-Bach G, Steward T, Stinchfield R, Moragas L, Aymamí N, Gómez-Peña M, del Pino-Gutiérrez A, Agüera Z, Baño M, Talón-Navarro MT, Cuquerella À, Codina E, Menchón JM. A Comparison of DSM-IV-TR and DSM-5 Diagnostic Criteria for Gambling Disorder in a Large Clinical Sample. Front Psychol 2019; 10:931. [PMID: 31133919 PMCID: PMC6524728 DOI: 10.3389/fpsyg.2019.00931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/08/2019] [Indexed: 12/26/2022] Open
Abstract
Background and Aims: Gambling-related crimes are known to be associated with gambling disorder (GD). Due to a lack of consensus in the scientific community regarding the relevance of this diagnostic criterion, it was removed from the DSM-5. The primary aim of this study was to investigate through structural equation modeling (SEM) whether higher GD severity in treatment-seeking GD patients with a criminal record is mediated through the illegal acts criterion itself, or whether it can be better explained by other related clinical factors. Methods: An initial sample of 2,081 patients seeking treatment for gambling problems was included in the sample. SEM was used to evaluate the mediational role of the illegal acts criterion between the sex, age and personality traits, gambling severity, and comorbid depression levels. Comparisons between patients with coinciding and divergent DSM criterion for GD diagnosis were carried out. Results: Illegal acts mediated the relationship between personality traits and GD severity: younger age, high levels of novelty seeking, and low levels of self-transcendence increased the risk of endorsing the illegal acts criterion. No differences between coincident-divergent groups in terms of DSM-IV and DSM-5 diagnosis were found with regards to sex (p = 0.878), education level (p = 0.387), or civil status (p = 0.792). Discussion and Conclusion: The results obtained in the present study offer new insights into the utility of using a history of illegal acts, their different personality characteristics, and psychopathology to categorize GD patients. Our findings suggest that patients who engage in criminal behavior may require a more comprehensive intervention.
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Affiliation(s)
- Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Anne Sauvaget
- Addictology and Liaison Psychiatry Department, Nantes University Hospital, Nantes, France
| | - Andreas Fransson
- Faculty of Medicine, Department of Clinical Sciences Psychiatry, Lund, Sweden
| | - Anders Hakansson
- Faculty of Medicine, Department of Clinical Sciences Psychiatry, Lund, Sweden
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Randy Stinchfield
- Department of Psychiatry, University of Minnesota Medical School, Saint Paul, MN, United States
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, 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
| | - Amparo del Pino-Gutiérrez
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Public Health, Mental Health and Mother-Infant Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Baño
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | | | - Àngel Cuquerella
- Institute of Legal Medicine and Forensic Sciences of Catalonia, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Public Health, Mental Health and Mother-Infant Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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