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Vassallo M, DeGiovanni K, Montgomery P. The Efficacy of Psychosocial Interventions in Minimising the Harm Caused to Affected Others of Problem Gambling: A Systematic Review and Meta-Analysis. J Gambl Stud 2023; 39:1927-1958. [PMID: 37294395 PMCID: PMC10627969 DOI: 10.1007/s10899-023-10220-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/10/2023]
Abstract
Problem gambling not only impacts gamblers but also protrudes onto several affected others who experience adverse impacts, including financial, health, relationships, and psychological problems. The aims of this systematic review were twofold; to identify the psychosocial interventions to minimise the harm caused to affected others of problem gambling and to assess their efficacy. This study was conducted as outlined in the research protocol PROSPERO (CRD42021239138). Database searches were conducted in CENTRAL, MEDLINE, Social Science Database, CINHAL Complete, Academic Search Ultimate and PsycINFO. Randomised controlled trials of psychosocial interventions that aimed to minimise the harm caused to affected others of problem gambling written in English were eligible for inclusion. Risk of bias for included studies was assessed using the Cochrane ROB 2.0 tool. The identified interventions focused on two approaches to supporting affected others: interventions involving both the problem gambler and affected others, and interventions involving affected others only. As the interventions and outcome measures used were sufficiently similar, a meta-analysis was conducted. The quantitative synthesis revealed that generally, treatment groups were unable to show greater benefits over control groups. The goal for future interventions aimed at affected others of problem gambling should focus primarily on the wellbeing of affected others. The standardisation of outcome measures and data collection time points for better comparison of future research is needed.
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Affiliation(s)
| | | | - Paul Montgomery
- School of Social Policy, University of Birmingham, Birmingham, UK.
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Estévez A, Jauregui P, Momeñe J, Macía L, Etxaburu N. Mediating Role of Rumination Between Anger and Anxious-Depressive Symptomatology in Family Members of People with Gambling Disorder. J Gambl Stud 2023; 39:1225-1238. [PMID: 36572842 PMCID: PMC10397117 DOI: 10.1007/s10899-022-10178-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2022] [Indexed: 12/27/2022]
Abstract
Gambling disorder is characterized by a behavioural pattern of dysfunctional gambling that persists despite its negative implications in different areas of people's daily life. One of the most negatively affected areas is the one related to family members. This study aimed, firstly, to study the differences between family members of people with gambling disorder and a general population sample in anger (state, trait, expression-out, expression-in. control-out and control-in), rumination (brooding, reflection and total), and anxiety and depression. The second aim was to analyse the correlation between these variables in the family members of people with gambling disorder, and thirdly, to analyse the mediating role of rumination between anger, anxiety and depression. This study consisted of 170 people, of whom 87 were family members of people with a gambling disorder, and 83 were from the general population. Instruments measuring anger, anxiety, depression, and ruminative responses were administered. Results showed that family members had significantly higher scores in anger (state), depression, anxiety, rumination (total and brooding). Also, results showed that anger correlated positively and significantly with rumination, depression and anxiety, which also correlated positively and significantly with each other. Third, rumination mediated the relationship between the following variables: anger (state) and depression; anger (trait) and anxiety and depression; anger (external expression) and anxiety and depression. A complete mediating effect was found in the latter case and a partial mediating effect in the first two cases. In conclusion, it is found that having a family member with a gambling disorder may increase levels of anger, anxiety, depression and rumination. Furthermore, it is shown that working on rumination may reduce depression and anxiety in family members of gamblers.
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Affiliation(s)
- A Estévez
- Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain.
| | - P Jauregui
- Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain
| | - J Momeñe
- Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain
| | - L Macía
- Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain
| | - N Etxaburu
- Psychology Department, University of Deusto, Apartado 1, 48080, Bilbao, Spain
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Lind K, Castrén S, Hagfors H, Salonen AH. Harm as reported by affected others: A population-based cross-sectional Finnish Gambling 2019 study. Addict Behav 2022; 129:107263. [PMID: 35134630 DOI: 10.1016/j.addbeh.2022.107263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 12/26/2022]
Abstract
This study investigates the prevalence of being an affected other (AO) of a person with problem gambling; and the associations between being an AO and socio-demographics, gambling behaviour, health-related correlates and the amount and type of gambling-related harm (GRH) for the AOs. Furthermore, perspectives of the affected family members (AFMs) and close friends (ACFs) were acknowledged. Cross-sectional, random sample Finnish Gambling population-based survey data (n = 3,994) were collected in 2019. AOs were identified using a question with seven options. Information on GRH was sought using structured questions. One-fifth (21.2 %) of all respondents were AOs, men being typically ACFs and women being more often AFMs. Being an AO was associated with younger age, gambling participation, having a gambling problem of their own and health barriers such as psychological distress. AFMs experienced GRH more often and the amount of different GRHs was greater among the AFMs. The most common harm category experienced by the AOs was emotional harm. Both health-related issues and the amount of GRHs was largest among the AFMs. A substantial amount of GRH was also experienced by ACFs. The study suggests that support could be tailored for AFMs and ACFs, based on their AO status and individual needs. A public health approach for effective harm prevention in primary, secondary and tertiary levels are discussed.
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Edgren R, Pörtfors P, Raisamo S, Castrén S. Treatment for the concerned significant others of gamblers: A systematic review. J Behav Addict 2022; 11:1-25. [PMID: 35044325 PMCID: PMC9109622 DOI: 10.1556/2006.2021.00088] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/19/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Research recognizes the extent of harm experienced by concerned significant others (CSOs) of gamblers. This systematic review's aims are to examine the interventions for CSOs, evaluate potential benefits, and thematically describe treatment processes. The Stress-Strain-Coping-Support model (SSCS) served as the theoretical framework. METHODS Database searches were conducted in: MEDLINE, CINAHL Complete, Web of Science Core Collection, Social Services Abstracts, Applied Social Science Index and Abstracts, Cochrane Central Register of Controlled Trials, and APA PsycInfo (between 01/Jan 2011-10/Jun 2021). Other search methods were also utilized. Inclusion criteria: interventions for CSOs with CSO specific outcomes. The Evidence Project Risk of Bias Tool was used for assessment. RESULTS 19/768 records were included. Nine interventions were utilized: 3 CSO directed, 4 for couples, and 2 low threshold online interventions. A quantitative synthesis (N = 7 studies) of effect size estimates for depression and anxiety measures didn't indicate any intervention to have better outcomes than others. Core themes in the treatment process identified in the qualitative synthesis (N = 7) included: information and understanding, social support, coping skills, communication, and strain. Limitations in the evidence related to sampling, control-conditions and outcome measurements. DISCUSSION AND CONCLUSION Several interventions were identified, yet no specific interventions appeared more beneficial than others. Using the SSCS model, commonalities and differences in intervention content were identified, along with themes that influence treatment processes. The need for tailored interventions is discussed. Future treatment efficacy research should carefully select study designs and outcome measurements. PROSPERO (CRD42021229408).
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Affiliation(s)
- Robert Edgren
- Finnish Institute for Health and Welfare, Department of Public Health Solutions, The Alcohol, Drugs and Addictions Unit, Helsinki, Finland,Corresponding author. E-mail:
| | - Pia Pörtfors
- Finnish Institute for Health and Welfare, Department of Information Services, Health and Social Services Data and Information Management, Helsinki, Finland
| | - Susanna Raisamo
- Finnish Institute for Health and Welfare, Department of Public Health Solutions, The Alcohol, Drugs and Addictions Unit, Helsinki, Finland
| | - Sari Castrén
- Finnish Institute for Health and Welfare, Department of Public Health Solutions, The Alcohol, Drugs and Addictions Unit, Helsinki, Finland,University of Turku, Social Sciences Department of Psychology and Speech-Language Pathology, Turku, Finland,University of Helsinki, Department of Medicine, Helsinki, Finland
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Baloh J, Curran GM, Timko C, Grant KM, Cucciare MA. Al-Anon Intensive Referral (AIR): A qualitative formative evaluation for implementation. J Subst Abuse Treat 2022; 132:108520. [PMID: 34111772 PMCID: PMC8636615 DOI: 10.1016/j.jsat.2021.108520] [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: 03/08/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The Al-Anon mutual-help program helps concerned others (COs; e.g., families, friends) of persons with excessive alcohol use. Despite widespread availability of Al-Anon meetings, participation is limited and little is known about how to best facilitate engagement. Al-Anon Intensive Referral (AIR) was developed to facilitate COs' engagement in Al-Anon and is being tested in a randomized controlled trial (RCT). Toward the end of the recruitment for the RCT, a qualitative formative evaluation was conducted to learn about facilitators, barriers, and recommendations for AIR implementation in substance use disorder (SUD) treatment clinics. METHODS Thirty-one directors and staff at ten VA and community SUD clinics were interviewed. Semi-structured interviews were based on the Consolidated Framework for Implementation Research and were thematically analyzed to identify facilitators, barriers, and recommendations for AIR implementation. RESULTS Perceived facilitators of AIR implementation included AIR's face validity, adaptability, and alignment with staff values and skills, requiring only minimal training. Several interviewees in community settings thought AIR would fit with their current practices (e.g., family groups), and some clinics reported having sufficient staff available for delivering AIR. Perceived barriers included limited staff time, and VA clinics having limited resources for providing services to COs. Furthermore, many clients have no COs, or COs who are unwilling or unable to engage with them. Recommendations included fitting AIR within existing workflows and focusing on COs with highest readiness to receive support. Interviewees also thought AIR could be adapted to a website format or smartphone app, which may expand its reach while decreasing staff burden and cost; however, it may not be as effective and appealing to some demographic groups (e.g., older COs). CONCLUSIONS AIR has strong potential for implementation in SUD treatment settings, but clinics vary on implementation capacity. Most clinics could implement AIR partially (e.g., case-by-case basis) while clinics with sufficient capacity (e.g., staff time) could implement it more fully. These findings can also inform implementation of other interventions for concerned others.
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Affiliation(s)
- Jure Baloh
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Corresponding author: Department of Health Policy and Management, College of Public Health, 4301 W. Markham St., Mail slot 820, Little Rock, AR 72205,
| | - Geoffrey M. Curran
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
| | - Christine Timko
- VA Palo Alto Health Care System, Palo Alto, CA, USA,Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kathleen M. Grant
- VA Nebraska-Western Iowa Healthcare System (Omaha), Omaha, NE, USA,University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael A. Cucciare
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
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Onyedire NG, Chukwuorji JC, Orjiakor TC, Onu DU, Aneke CI, Ifeagwazi CM. Associations of Dark Triad traits and problem gambling: Moderating role of age among university students. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-018-0093-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Predictors of Strategy Engagement for the Prevention and Reduction of Gambling Harm: a Prospective Application of the Theory of Planned Behaviour. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00265-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Treatment for Family Members of People Experiencing Gambling Problems: Family Members Want Both Gambler-Focused and Family-Focused Options. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00143-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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