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Ede MO, Nwosu KC, Okeke CI, Oneli JO. Predictors of pathological gambling behaviours in parents population in Nigeria. Sci Rep 2024; 14:9197. [PMID: 38649388 PMCID: PMC11035556 DOI: 10.1038/s41598-024-56369-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024] Open
Abstract
The increasing incidence of psychological pains, burnout, and anxiety among gamblers in Nigeria is high. This is because pathological gambling (PG) is on the rise and it is linked to many social vices such as stealing, drug abuse, and sexual abuse. It is important to investigate the trajectories of PG in Nigeria. A cross-sectional survey design was employed in our study with 197 participants sampled from 28 gambling venues in Nigeria made up the study's sample size. Of the 197, 131 (66.5%) were males and 66 (33.5%) were females. 50 (25.4%) were within the age range of 20-30 years, 42 (21.3%) were within 31-40 years, 40 (20.3%) were within 41-50 years, 35 (17.8%) were within 51-60 years, and 30 (15.2%) were within 61 and above. Using the hierarchical regression analysis, our finding revealed a significant association between psychological distress and our respondents' pathological gambling behaviour whereas none of the sociodemographic variables made a significant contribution to their pathological gambling behaviour. We concluded that gamblers' psychological well-being is crucial to understanding their problematic gambling behaviours in the context of a developing nation such as Nigeria, and that this could be similar among our respondents. Implications of our findings were highlighted.
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Affiliation(s)
- Moses Onyemaechi Ede
- Department of Childhood Education, Faculty of Education, University of the Free State, Bloemfontein, South Africa
| | | | - Chinedu Ifedi Okeke
- Department of Childhood Education, Faculty of Education, University of the Free State, Bloemfontein, South Africa
| | - Joy Obiageli Oneli
- Teleo Network International School of Theology, Pastoral Ministry Grace Training International Bible Institute, Duluth, Gambia.
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2
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Eriksen JW, Fiskaali A, Zachariae R, Wellnitz KB, Oernboel E, Stenbro AW, Marcussen T, Petersen MW. Psychological intervention for gambling disorder: A systematic review and meta-analysis. J Behav Addict 2023; 12:613-630. [PMID: 37450372 PMCID: PMC10562823 DOI: 10.1556/2006.2023.00034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Background and aims Increasingly, gambling features migrate into non-gambling platforms (e.g., online gaming) making gambling exposure and problems more likely. Therefore, exploring how to best treat gambling disorder (GD) remains important. Our aim was to review systematically and quantitatively synthesize the available evidence on psychological intervention for GD. Methods Records were identified through searches for randomized controlled trials (RCTs) evaluating psychological intervention for GD via six academic databases without date restrictions until February 3, 2023. Study quality was assessed with the revised Cochrane risk-of-bias tool for randomized trials (RoB2). Primary outcomes were GD symptom severity and remission of GD, summarized as Hedges' g and odds ratios, respectively. The study was preregistered in PROSPERO (#CRD42021284550). Results Of 5,541 records, 29 RCTs (3,083 participants analyzed) were included for meta-analysis of the primary outcomes. The efficacy of psychological intervention across modality, format and mode of delivery corresponded to a medium effect on gambling severity (g = -0.71) and a small effect on remission (OR = 0.47). Generally, risk of bias was high, particularly amongst early face-to-face interventions studies. Discussion and conclusions The results indicate that psychological intervention is efficacious in treating GD, with face-to-face delivered intervention producing the largest effects and with strongest evidence for cognitive behavioral therapy. Much remains to be known about the long-term effects, and investigating a broader range of treatment modalities and digital interventions is a priority if we are to improve clinical practice for this heterogeneous patient group.
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Affiliation(s)
- Jakob W. Eriksen
- The Research Clinic on Gambling Disorders, Aarhus University Hospital, Denmark
| | - Anne Fiskaali
- The Research Clinic on Gambling Disorders, Aarhus University Hospital, Denmark
| | - Robert Zachariae
- Department of Psychology and Behavioural Science, Aarhus University, Denmark
- Department of Oncology, Unit for Psychooncology and Health Psychology, Aarhus University Hospital, Denmark
| | - Kaare B. Wellnitz
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
| | - Eva Oernboel
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
| | - Anna W. Stenbro
- The Research Clinic on Gambling Disorders, Aarhus University Hospital, Denmark
| | - Thomas Marcussen
- The Research Clinic on Gambling Disorders, Aarhus University Hospital, Denmark
| | - Marie W. Petersen
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
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3
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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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4
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Monreal-Bartolomé A, Barceló-Soler A, García-Campayo J, Bartolomé-Moreno C, Cortés-Montávez P, Acon E, Huertes M, Lacasa V, Crespo S, Lloret-Irles D, Sordo L, Clotas Bote C, Puigcorbé S, López-Del-Hoyo Y. Preventive Gambling Programs for Adolescents and Young Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4691. [PMID: 36981602 PMCID: PMC10048743 DOI: 10.3390/ijerph20064691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Gambling disorder in youth is an emerging public health problem, with adolescents and young adults constituting a vulnerable age group for the development of gambling-related problems. Although research has been conducted on the risk factors for gambling disorder, very few rigorous studies can be found on the efficacy of preventive interventions in young people. The aim of this study was to provide best practice recommendations for the prevention of disordered gambling in adolescents and young adults. We reviewed and synthesized the results of existing RCTs and quasi-experimental studies covering nonpharmacological prevention programs for gambling disorder in young adults and adolescents. We applied the PRISMA 2020 statement and guidelines to identify 1483 studies, of which 32 were included in the systematic review. All studies targeted the educational setting, i.e., high school and university students. Most studies followed a universal prevention strategy, that particularly targeted adolescents, and an indicated prevention strategy for university students. The reviewed gambling prevention programs generally showed good results in terms of reducing the frequency and severity of gambling, and also regarding cognitive variables, such as misconceptions, fallacies, knowledge, and attitudes towards gambling. Finally, we highlight the need to develop more comprehensive prevention programs that incorporate rigorous methodological and assessment procedures before they are widely implemented and disseminated.
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Affiliation(s)
- Alicia Monreal-Bartolomé
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Alberto Barceló-Soler
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Healthcare Research Institute of Navarre (IdiSNA), 31008 Pamplona, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain
- Department of Psychiatry, Hospital Miguel Servet, University of Zaragoza, 50009 Zaragoza, Spain
| | - Cruz Bartolomé-Moreno
- Primary Care Teaching Unit for Zaragoza Healthcare District 1, 50018 Zaragoza, Spain
| | - Paula Cortés-Montávez
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Esther Acon
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Huertes
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Víctor Lacasa
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Sofía Crespo
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
| | - Daniel Lloret-Irles
- Department of Health Psychology, Miguel Hernández University, 03202 Elche, Spain
| | - Luis Sordo
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | | | | | - Yolanda López-Del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Chronicity, Primary Care, and Health Promotion Research Network (RICAPPS), 50015 Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain
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5
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Preventive Interventions and Harm Reduction in Online and Electronic Gambling: A Systematic Review. J Gambl Stud 2022; 39:883-911. [PMID: 35999322 DOI: 10.1007/s10899-022-10126-6] [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: 11/19/2021] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 10/15/2022]
Abstract
Gambling possess both entertaining and potentially harmful aspects. It remains a challenge for public health authorities and gambling operators to recommend and implement effective evidence-based interventions to reduce gambling-related harm and prevent problematic gambling behavior. This systematic review examined studies on randomized controlled trials in this field, aiming to describe and evaluate the effect of preventive and harm-reducing interventions for online gambling and electronic gaming machines. A systematic literature search was performed in PsycINFO, PubMed, Embase, and SCOPUS. Study selection, risk of bias assessment, and data extraction were conducted by two reviewers independently, and a synthesis was performed. A total of 18 studies were included, of which the majority were limited by quality issues. The applied interventions focused on restraining gambling, providing feedback, delivering therapeutic and informative content, and priming analytical thinking. The studies varied greatly in terms of specific intervention content, study setting, participants, and outcome measures, and no consistent patterns could be detected between study characteristics and related effects. Although research in the field is growing, there is still a need for further methodologically rigorous investigation and consensus on outcome measures sensitive to effects of preventive and harm-reducing interventions.
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St Quinton T, Morris B, Pickering D, Smith DM. Behavior Change Techniques and Delivery Modes in Interventions Targeting Adolescent Gambling: A Systematic Review. J Gambl Stud 2022; 38:1503-1528. [PMID: 35239076 PMCID: PMC8891739 DOI: 10.1007/s10899-022-10108-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/19/2022] [Accepted: 01/29/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Adolescent gambling can lead to significant harms, yet participation rates continue to rise. Interventions targeting gambling reduction have been implemented in this population. However, it is not clear which behavior change techniques (BCTs) and modes of delivery (MOD) are most effective at reducing gambling. OBJECTIVE The objective of the study was to identify 'promising' BCTs and MODs by systematically reviewing interventions targeting adolescent gambling behavior. 'Promising' was defined as those present in at least 25% of all interventions and in at least two effective interventions. METHODS Three databases were searched (PsycINFO, Medline, and Scopus) from database inception to May 2021. Interventions were eligible if they were randomized controlled trials; targeting adolescents (aged 10-25 years); and assessing gambling behavior post-intervention. BCTs were identified using the Behavior Change Technique Taxonomy v1. RESULTS From the initial 3,315 studies, the removal of duplicates and ineligible articles resulted in sixteen studies included in the review. Eleven of these reported successfully reducing gambling behavior. Eighteen BCTs and six MODs were used across the interventions. The BCTs identified as promising were '4.2. Information about antecedents', '4.4. Behavioral experiments', '5.3. Information about social and environmental consequences', and '5.6. Information about emotional consequences'. Promising MODs were 'face-to-face', 'computer', and 'playable electronic storage'. CONCLUSIONS The study reviewed the content of interventions targeting adolescent gambling behavior. Four BCTs were identified as promising and should therefore be adopted in future interventions. To facilitate the delivery of these techniques, the study also identified three promising MODs. Interventions developed using these BCTs and MODs may successfully reduce adolescent gambling behavior.
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Affiliation(s)
- Tom St Quinton
- School of Social and Health Sciences, Leeds Trinity University, Brownberrie Lane, LS18 5HD, Leeds, UK.
| | - Ben Morris
- School of Social and Health Sciences, Leeds Trinity University, Brownberrie Lane, LS18 5HD, Leeds, UK
| | - Dylan Pickering
- Gambling Treatment and Research Clinic, School of Psychology, University of Sydney, Sydney, Australia
| | - Debbie M Smith
- Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, Manchester, UK
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7
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Pfund RA, Peter SC, McAfee NW, Ginley MK, Whelan JP, Meyers AW. Dropout from face-to-face, multi-session psychological treatments for problem and disordered gambling: A systematic review and meta-analysis. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:901-913. [PMID: 34881915 DOI: 10.1037/adb0000710] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The aims of this systematic review and meta-analysis were to examine the overall prevalence of dropout from psychological treatments for problem gambling and gambling disorder and to examine how study, client, and treatment variables influenced dropout rates. METHOD A systematic search was conducted to identify studies of cognitive and/or behavioral therapies and motivational interventions for problem gambling and gambling disorder. Meta-analysis was used to calculate an overall weighted dropout rate. Random effect meta-regressions were used to examine covariates of dropout rates. Mixed-effect subgroup analyses were used to examine moderators of dropout rates. RESULTS The systematic search identified 24 studies (31 dropout rates) comprising 2,791 participants. Using a random-effects model, the overall weighted dropout rate was 39.1%, 95% CI [33.0%, 45.6%]. Increases in the percentage of married participants were significantly associated with lower dropout rates. Dropout rates were significantly higher when dropout was defined as attending all sessions of a treatment protocol compared to when defined as attending a prespecified number of sessions different from the total in the protocol and when defined as study therapists judging participants to be dropouts. Insufficient reporting of some gambling-related variables and other psychological symptom variables prevented a thorough examination of covariates and moderators. CONCLUSIONS A large proportion of individuals drop out of treatment for problem gambling and gambling disorder. Future research should examine the reasons for dropout across marital statuses and should adopt dropout definitions that consider session-by-session symptom change. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Rory A Pfund
- Center on Alcohol, Substance use, and Addictions
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8
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Rosen LA, Weinstock J, Peter SC. A Randomized Clinical Trial Exploring Gambling Attitudes, Barriers to Treatment, and Efficacy of a Brief Motivational Intervention Among Ex-Offenders with Disordered Gambling. J Forensic Sci 2020; 65:1646-1655. [PMID: 32539157 DOI: 10.1111/1556-4029.14476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023]
Abstract
Correctional populations are disproportionately burdened by disordered gambling; yet, problem awareness is minimal among both offenders and professionals within the criminal justice system. The aims of the current study were twofold: (i) to examine gambling attitudes and problem awareness among ex-offenders, and (ii) to determine the efficacy of a brief online gambling intervention for ex-offenders. Participants (N = 126) were ex-offenders on probation and parole. Gambling attitudes, attitudes toward treatment, and disorder gambling status were assessed. Disordered gamblers (n = 102) were randomly assigned to (i) a brief intervention plus referral to treatment or (ii) referral to treatment only, and these individuals were re-assessed at a 30-day follow-up. Lifetime disordered gambling was highly prevalent (86%) in the ex-offender sample, and providing information regarding disordered gambler status and referral to treatment was effective in decreasing gambling attitudes, as well as gambling severity and frequency. The current study has direct implications for treatment and intervention efforts among ex-offenders with disordered gambling and yields a greater understanding of attitudes toward gambling among ex-offenders.
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Affiliation(s)
- Laura April Rosen
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd., Morrissey Hall, St. Louis, MO
| | - Jeremiah Weinstock
- Department of Psychology, Saint Louis University, 3700 Lindell Blvd., Morrissey Hall, St. Louis, MO
| | - Samuel Cody Peter
- Department of Psychology, The University of Memphis, 400 Innovation Dr., Memphis, TN, 38111
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9
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Abstract
Gambling disorder is characterized by a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The prevalence of gambling disorder has been estimated at 0.5% of the adult population in the United States, with comparable or slightly higher estimates in other countries. The aetiology of gambling disorder is complex, with implicated genetic and environmental factors. Neurobiological studies have implicated cortico-striato-limbic structures and circuits in the pathophysiology of this disorder. Individuals with gambling disorder often go unrecognized and untreated, including within clinical settings. Gambling disorder frequently co-occurs with other conditions, particularly other psychiatric disorders. Behavioural interventions, particularly cognitive-behavioural therapy but also motivational interviewing and Gamblers Anonymous, are supported in the treatment of gambling disorder. No pharmacological therapy has a formal indication for the treatment of gambling disorder, although placebo-controlled trials suggest that some medications, such as opioid-receptor antagonists, may be helpful. Given the associations with poor quality of life and suicide, improved identification, prevention, policy and treatment efforts are needed to help people with gambling disorder.
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Peter SC, Brett EI, Suda MT, Leavens ELS, Miller MB, Leffingwell TR, Whelan JP, Meyers AW. A Meta-analysis of Brief Personalized Feedback Interventions for Problematic Gambling. J Gambl Stud 2019; 35:447-464. [PMID: 30610506 DOI: 10.1007/s10899-018-09818-9] [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: 10/27/2022]
Abstract
Personal Feedback Interventions (PFIs) have been widely used to reduce the amount of time and money individuals spend on gambling. A central component of these interventions is personalized information about an individual's gambling behavior, often in comparison to others' gambling. The purpose of the present review and meta-analysis was to evaluate these interventions in terms of content, mode of delivery, target sample, and efficacy. Sixteen interventions from 11 studies were reviewed. We found a small, statistically significant effect in favor of PFIs versus control (d = 0.20, 95% CI 0.12, 0.27). Six moderators of intervention efficacy were explored. These interventions appeared to be most efficacious when used in populations of greater gambling severity, when individuals were provided with gambling-related educational information, and when used in conjunction with motivational interviewing. Factors associated with reduced efficacy include in-person delivery of feedback without motivational-interviewing and informing participants of their score on a psychological measure of gambling severity. Efficacy did not vary as a function of college or community samples. PFIs are a low cost, easily disseminated intervention that can be used as a harm-reduction strategy. However, more substantial effects may be attained if used as part of a larger course of therapy.
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Affiliation(s)
- Samuel C Peter
- Institute of Gambling Education and Research, The University of Memphis, Room 202 Psychology Building, 400 Innovation Drive, Memphis, TN, 38152-6400, USA.
| | | | - Matthew T Suda
- University of Tennessee Health Science Center, Memphis, TN, USA
| | | | | | | | - James P Whelan
- Institute of Gambling Education and Research, The University of Memphis, Room 202 Psychology Building, 400 Innovation Drive, Memphis, TN, 38152-6400, USA
| | - Andrew W Meyers
- Institute of Gambling Education and Research, The University of Memphis, Room 202 Psychology Building, 400 Innovation Drive, Memphis, TN, 38152-6400, USA
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11
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Grande-Gosende A, López-Núñez C, García-Fernández G, Derevensky J, Fernández-Hermida JR. Systematic Review of Preventive Programs for Reducing Problem Gambling Behaviors Among Young Adults. J Gambl Stud 2019; 36:1-22. [PMID: 31168687 DOI: 10.1007/s10899-019-09866-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Young adulthood is a developmental period from late adolescence to one's late twenties or early thirties. Prevalence studies internationally have reported that individuals in this age group tend to have the highest rates of problem gambling. However, much of the prevention work designed to minimize the risk of problem and disordered gambling has been primarily focused on school settings and aimed at high school students. The objective of this study was to summarize the existing literature on the effectiveness of prevention programs aimed at reducing the prevalence of gambling problems in young adults. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six electronic academic databases were consulted in order to examine the studies conducted during the last 20 years. After removing duplicates and adhering to the inclusion and exclusion criteria, nine studies were included in this review. All studies targeted college or university students and followed a selective or indicated prevention strategy. A Personalized Normative Feedback approach was incorporated in most of the studies, which had generally good results in reducing and/or minimizing at-risk or problem gambling. The limited number of studies included in this review highlights the need to address scientific quality standards before proceeding with the design, implementation and widespread dissemination of these preventive programs as well as the need to ensure the program's efficacy prior to implementation.
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Affiliation(s)
- Aris Grande-Gosende
- Addictive Behaviors Research Group, Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Asturias, Spain.
| | - Carla López-Núñez
- Department of Psychology, Universidad Loyola Andalucía (España), Andalucía, Spain
| | - Gloria García-Fernández
- Addictive Behaviors Research Group, Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Asturias, Spain
| | - Jeffrey Derevensky
- International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, Montreal, QC, Canada
| | - José Ramón Fernández-Hermida
- Addictive Behaviors Research Group, Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Asturias, Spain
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12
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Quilty LC, Wardell JD, Thiruchselvam T, Keough MT, Hendershot CS. Brief interventions for problem gambling: A meta-analysis. PLoS One 2019; 14:e0214502. [PMID: 30995229 PMCID: PMC6469774 DOI: 10.1371/journal.pone.0214502] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 03/14/2019] [Indexed: 01/18/2023] Open
Abstract
Background Brief interventions have been increasingly investigated to promote early intervention in gambling problems; an accurate estimate of the impact of these interventions is required to justify their widespread implementation. The goal of the current investigation was to evaluate the efficacy of in-person brief interventions for reducing gambling behaviour and/or problems, by quantifying the aggregate effect size associated with these interventions in the published literature to date. Methods Randomized controlled trials including the following design features were identified via systematic review: an adult sample experiencing problems associated with gambling; an in-person individual psychosocial intervention of brief duration (≤3 sessions); a control/comparison group; and an outcome related to gambling behaviour and/or problems. Results Five records compared brief interventions to assessment only control; using a random effect model, brief interventions were associated with a small but statistically significant reduction in gambling behaviour across short-term follow-up periods versus assessment only control (g = -.19, 95% CI [-.37, -.01]). Aggregate effect sizes for gambling problems and long-term follow-up periods were not statistically significant. Five records compared brief interventions to longer active interventions; there was no significant difference between brief interventions and longer active interventions. Conclusions Results supported the efficacy of brief interventions for problem gambling compared to inactive control in the reduction of gambling behaviour; no differences were found across brief versus longer interventions for both gambling behaviour and problems. While these findings must be interpreted in the context of the limited number of studies and small magnitude of the combined effect sizes, the current meta-analysis supports the further investigation of the public health impact of these cost-effective interventions.
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Affiliation(s)
- Lena C. Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- * E-mail:
| | - Jeffrey D. Wardell
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Thulasi Thiruchselvam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Christian S. Hendershot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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13
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Oei TPS, Raylu N, Lai WW. Effectiveness of a Self Help Cognitive Behavioural Treatment Program for Problem Gamblers: A Randomised Controlled Trial. J Gambl Stud 2018; 34:581-595. [PMID: 29032449 DOI: 10.1007/s10899-017-9723-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η 2) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.
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Affiliation(s)
- T P S Oei
- School of Psychology, The University of Queensland, St Lucia, QLD, 4072, Australia. .,Department of Psychology, James Cook University Singapore, 149 Sims Drive, Singapore, 387380, Singapore. .,Nanjing University, 22 Hankou Rd, Gulou Qu, Nanjing Shi, 210008, Jiangsu Sheng, China.
| | - N Raylu
- School of Psychology, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - W W Lai
- Department of Psychology, National University of Singapore, 21 Lower Kent Ridge Road, Singapore, 119077, Singapore
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14
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Change Strategies and Associated Implementation Challenges: An Analysis of Online Counselling Sessions. J Gambl Stud 2018; 33:955-973. [PMID: 27988863 DOI: 10.1007/s10899-016-9661-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Self-change is the most frequent way people limit or reduce gambling involvement and often the first choice of people experiencing gambling-related problems. Less well known is the range of change strategies gamblers use and how these are selected, initiated or maintained. This study examined change strategies discussed in counselling transcripts from 149 clients who accessed a national online gambling help service in Australia. Using thematic analysis, we identified the presence of six change strategies; cash control and financial management, social support, avoiding or limiting gambling, alternative activities, changing thoughts and beliefs, and self-assessment and monitoring. Four implementation issues were also identified; a mismatch between need and strategy selection or maintenance; importance and readiness versus the cost of implementation; poor or unplanned transitions between strategies; and failure to review the helpfulness of strategies resulting in premature abandonment or unhelpful prolonged application. This study is the first to identify change strategies discussed in online counselling sessions. This study suggests change strategies are frequently discussed in online counselling sessions and we identified multiple new actions associated with change strategies that had not previously been identified. However, multiple implementation issues were identified and further work is required to determine the helpfulness of change strategies in terms of their selection, initiation and maintenance.
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15
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Rodda S, Merkouris SS, Abraham C, Hodgins DC, Cowlishaw S, Dowling NA. Therapist-delivered and self-help interventions for gambling problems: A review of contents. J Behav Addict 2018; 7:211-226. [PMID: 29895185 PMCID: PMC6174602 DOI: 10.1556/2006.7.2018.44] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 04/13/2018] [Accepted: 04/14/2018] [Indexed: 01/12/2023] Open
Abstract
Background and aims To date, no systematic approach to identifying the content and characteristics of psychological interventions used to reduce gambling or problem gambling has been developed. This study aimed to develop a reliable classification system capable of identifying intervention characteristics that could, potentially, account for greater or lesser effectiveness. Methods Intervention descriptions were content analyzed to identify common and differentiating characteristics. A coder manual was developed and applied by three independent coders to identify the presence or absence of defined characteristics in 46 psychological and self-help gambling interventions. Results The final classification taxonomy, entitled Gambling Intervention System of CharacTerization (GIST), included 35 categories of intervention characteristics. These were assigned to four groups: (a) types of change techniques (18 categories; e.g., cognitive restructuring and relapse prevention), (b) participant and study characteristics (6 categories; e.g., recruitment strategy and remuneration policy), and (c) characteristics of the delivery and conduct of interventions (11 categories; e.g., modality of delivery and therapist involvement), and (d) evaluation characteristics (e.g., type of control group). Interrater reliability of identification of defined characteristics was high (κ = 0.80-1.00). Discussion This research provides a tool that allows systematic identification of intervention characteristics, thereby enabling consideration, not only of whether interventions are effective or not, but also of which domain-relevant characteristics account for greater or lesser effectiveness. The taxonomy also facilitates standardized description of intervention content in a field in which many diverse interventions have been evaluated. Conclusion Application of this coding tool has the potential to accelerate the development of more efficient and effective therapist-delivered and self-directed interventions to reduce gambling problems.
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Affiliation(s)
- Simone Rodda
- School of Population Health, University of Auckland, Auckland, New Zealand
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | | | - Charles Abraham
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Sean Cowlishaw
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicki A. Dowling
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
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16
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Weinstock J, April LM, Kallmi S. Is subclinical gambling really subclinical? Addict Behav 2017; 73:185-191. [PMID: 28531824 DOI: 10.1016/j.addbeh.2017.05.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/08/2017] [Accepted: 05/13/2017] [Indexed: 01/01/2023]
Abstract
Gambling disorder and substance use disorders (SUD) overlap in terms of etiology and diagnostic constructs (e.g., preoccupation, loss of control), yet diagnostic thresholds for the disorders are different. Currently, endorsing 2-3 gambling disorder criteria does not warrant a diagnosis while endorsing 2-3 SUD criteria does. The aim of this study was to examine whether subclinical gamblers (i.e., endorsing 2-3 gambling disorder criteria) experience psychosocial dysfunction equivalent to individuals who are diagnosed with mild severity SUD (i.e., 2-3 SUD criteria) and whether this level of dysfunction is significantly different from individuals with no psychopathology. Data are from the first wave of Quinte Longitudinal Study, a large epidemiological sample (N=4121). Psychometrically supported measures assessed for psychosocial functioning and the presence of Axis-I psychiatric disorders. Cross-sectional analysis examined 7 domains of psychosocial functioning using ANCOVA, which allowed for the inclusion of covariates, to test for difference between subclinical gamblers and individuals with no psychopathology and individuals with mild severity SUD. Equivalency testing compared subclinical gamblers in relation to mild severity SUD. Subclinical gamblers reported significantly poorer psychosocial functioning in relation to individuals endorsing no current psychopathology. Subclinical gamblers were also equivalent to and not significantly different from individuals with mild severity SUD. Subclinical gamblers experience similar psychosocial impairment to those individuals who endorse mild severity SUD, and this significantly differed from healthy individuals. The threshold for diagnosis of gambling disorder therefore warrants re-examination.
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Goslar M, Leibetseder M, Muench HM, Hofmann SG, Laireiter AR. Efficacy of face-to-face versus self-guided treatments for disordered gambling: A meta-analysis. J Behav Addict 2017; 6:142-162. [PMID: 28662618 PMCID: PMC5520130 DOI: 10.1556/2006.6.2017.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 05/21/2017] [Accepted: 06/04/2017] [Indexed: 12/22/2022] Open
Abstract
Background and aims In the light of growing traditional and novel forms of gambling, the treatment of disordered gambling is gaining increasing importance and practical relevance. Most studies have examined face-to-face treatments. Although trials implementing self-guided treatments have recently been conducted, these options have not yet been systematically examined. The primary objective of this meta-analysis, therefore, was to analyze the efficacy of all types of psychological face-to-face and self-guided treatments. Methods A multilevel literature search yielded 27 randomized controlled studies totaling 3,879 participants to provide a comprehensive comparative evaluation of the short- and long-term efficacies of face-to-face and self-guided treatments for disordered gambling. Results As expected, the results revealed significantly higher effect sizes for face-to-face treatments (16 studies with Hedges's g ranging from 0.67 to 1.15) as compared with self-guided treatments (11 studies with Hedges's g ranging from 0.12 to 0.30) regarding the reduction of problematic gambling behavior. The intensity of treatment moderated the therapy effect, particularly for self-guided treatments. Discussion and Conclusions The results of this meta-analysis favor face-to-face treatments over self-guided treatments for the reduction of disordered gambling. Although the findings broaden the scope of knowledge about psychological treatment modalities for disordered gambling, further research is needed to identify the reasons for these differences with the goal to optimize the treatment for this disabling condition.
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Affiliation(s)
- Martina Goslar
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Max Leibetseder
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Hannah M. Muench
- Department of Clinical Psychology and Psychotherapy, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Anton-Rupert Laireiter
- Department of Psychology, University of Salzburg, Salzburg, Austria
- Faculty of Psychology, University of Vienna, Wien, Austria
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18
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Nastally BL, Dixon MR. The Effect of a Brief Acceptance and Commitment Therapy Intervention on the Near-Miss Effect in Problem Gamblers. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/bf03395828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Nautiyal KM, Okuda M, Hen R, Blanco C. Gambling disorder: an integrative review of animal and human studies. Ann N Y Acad Sci 2017; 1394:106-127. [PMID: 28486792 PMCID: PMC5466885 DOI: 10.1111/nyas.13356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/22/2017] [Indexed: 11/29/2022]
Abstract
Gambling disorder (GD), previously called pathological gambling and classified as an impulse control disorder in DSM-III and DSM-IV, has recently been reclassified as an addictive disorder in the DSM-5. It is widely recognized as an important public health problem associated with substantial personal and social costs, high rates of psychiatric comorbidity, poor physical health, and elevated suicide rates. A number of risk factors have been identified, including some genetic polymorphisms. Animal models have been developed in order to study the underlying neural basis of GD. Here, we discuss recent advances in our understanding of the risk factors, disease course, and pathophysiology. A focus on a phenotype-based dissection of the disorder is included in which known neural correlates from animal and human studies are reviewed. Finally, current treatment approaches are discussed, as well as future directions for GD research.
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Affiliation(s)
- Katherine M. Nautiyal
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Mayumi Okuda
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
| | - Rene Hen
- New York State Psychiatric Institute, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Departments of Neuroscience and Pharmacology, Columbia University, New York, New York
| | - Carlos Blanco
- National Institute on Drug Abuse, Rockville, Maryland
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20
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Petry NM, Rash CJ, Alessi SM. A randomized controlled trial of brief interventions for problem gambling in substance abuse treatment patients. J Consult Clin Psychol 2016; 84:874-86. [PMID: 27398781 PMCID: PMC5036993 DOI: 10.1037/ccp0000127] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study evaluated the efficacy of brief gambling treatments in patients attending substance abuse treatment clinics. METHOD Substance abuse treatment patients with gambling problems (N = 217) were randomly assigned to a 10- to 15-min brief psychoeducation gambling intervention; a 10- to 15-min brief advice intervention addressing gambling norms, risk factors, and methods to prevent additional problems; or 4 50-min sessions of motivational enhancement therapy plus cognitive behavior therapy for reducing gambling (MET + CBT). Gambling and related problems were assessed at baseline and throughout 24 months. RESULTS In the sample as a whole, days and dollars wagered and gambling problems decreased markedly from baseline through Month 5; thereafter, reductions in dollars wagered and gambling problems continued to decrease modestly but significantly, and days gambled remained constant. Brief advice significantly reduced days gambled between baseline and Month 5 relative to brief psychoeducation. The MET + CBT condition engendered no benefit beyond brief advice in terms of days gambled but did lead to more precipitous reductions in dollars gambled and problems experienced in the initial 5 months, and greater clinically significant improvements in gambling in both the short and long term. MET + CBT also resulted in initial decreases in self-reported alcohol use and problems but did not differentially impact self-reported illicit drug use or submission of positive samples. CONCLUSIONS Gambling problems tend to dissipate over time regardless of the intervention applied, but offering MET + CBT was more efficacious in decreasing gambling than providing a brief single session intervention. (PsycINFO Database Record
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Affiliation(s)
- Nancy M Petry
- Calhoun Cardiology Center, University of Connecticut School of Medicine
| | - Carla J Rash
- Calhoun Cardiology Center, University of Connecticut School of Medicine
| | - Sheila M Alessi
- Calhoun Cardiology Center, University of Connecticut School of Medicine
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21
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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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22
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St-Pierre R, Derevensky JL. Youth Gambling Behavior: Novel Approaches to Prevention and Intervention. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0104-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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23
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Dixon MR, Wilson AN, Habib R. Neurological evidence of acceptance and commitment therapy effectiveness in college-age gamblers. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2016. [DOI: 10.1016/j.jcbs.2016.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Gambling-Related Problems as a Mediator Between Treatment and Mental Health with At-Risk College Student Gamblers. J Gambl Stud 2016; 31:1005-13. [PMID: 24706331 DOI: 10.1007/s10899-014-9456-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Disordered gambling has been linked to increased negative affect, and some promising treatments have been shown to be effective at reducing gambling behaviors and related problems (Larimer et al. in Addiction 107:1148-1158, 2012). The current study seeks to expand upon the findings of Larimer et al. (Addiction 107:1148-1158, 2012) by examining the relationship between gambling-related problems and mental health symptoms in college students. Specifically, the three-group design tested the effects of two brief interventions for gambling—an individual, in-person personalized feedback intervention (PFI) delivered using motivational interviewing and group-based cognitive behavioral therapy, versus assessment only on mood outcomes. The mediating effect of gambling-related problems on mood was also explored. Participants (N = 141; 65% men; 60% Caucasian, 28% Asian) were at-risk college student gamblers [South Oaks Gambling Screen (Lesieur and Blume in Am J Psychiatry 144:1184-1188, 1987) ≥3], assessed at baseline and 6-month follow-up. Gambling problems were assessed using the Gambling Problems Index (Neighbors et al. in J Gamb Stud 18:339-360, 2002). Mental health symptoms were assessed using the depression, anxiety, and hostility subscales of the Brief Symptom Inventory (Derogatis in Brief Symptom Inventory (BSI): administration, scoring, and procedures manual, National Computer Systems, Inc., Minneapolis, 1993). Results revealed that the PFI condition differentially reduced negative mood, and that reductions in gambling-related problems partially mediated this effect. Implications for intervention for comorbid mood and gambling disorders are discussed.
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25
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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: 77] [Impact Index Per Article: 9.6] [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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26
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Abstract
Internet gambling is popular in college students and associated with problem gambling behaviors. This study evaluated Internet gambling in 117 students participating in study evaluating brief interventions to reduce gambling; the brief interventions consisted of minimal advice, motivational enhancement therapy, and cognitive-behavioral therapy (1-4 sessions). Compared to their counterparts who did not gamble via the Internet (n = 60), those who reported recent Internet gambling (n = 57) wagered in greater frequencies and amounts and reported missing school more often and more problems with family and anxiety due to gambling. Recent Internet gamblers demonstrated similar reductions in gambling over time and in response to the brief interventions as non-Internet gamblers. These data suggest that Internet gambling is common in problem gambling college students, and students who wager over the Internet can benefit from brief interventions.
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Affiliation(s)
- Nancy M Petry
- Calhoun Cardiology Center, University of Connecticut School of Medicine, MC-3944, 263 Farmington Avenue, Farmington, CT, 06030-3944, USA,
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The moderating effect of gender on the relation between expectancies and gambling frequency among college students. J Gambl Stud 2015; 31:173-82. [PMID: 24065315 DOI: 10.1007/s10899-013-9409-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Compared to college females, college males are more likely to report frequent gambling. Research on gambling outcome expectancies has shown that expectations about gambling influence gambling behavior and that endorsement of particular expectancies differs by gender. Knowledge regarding the differential predictive utility of specific gambling expectancies based on gender would help to determine how beliefs about gambling may be fundamentally different for men and women. The present study explored whether gender moderates the relation between gambling expectancy and gambling frequency in a college sample. 421 college students completed an online survey that included questions about their demographics, gambling frequency, and gambling expectancies. Hierarchical regression analyses indicated that gender moderated the relations between the expectancies of social consequences, material gain, and gambling frequency. For females, greater endorsement of social consequences predicted less frequent gambling. For both males and females, greater endorsement of material gain predicted more frequent gambling. The current findings can help inform prevention and intervention efforts by identifying gambling expectations that are differentially related to college student gambling behavior choices.
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Yakovenko I, Quigley L, Hemmelgarn BR, Hodgins DC, Ronksley P. The efficacy of motivational interviewing for disordered gambling: systematic review and meta-analysis. Addict Behav 2015; 43:72-82. [PMID: 25577724 DOI: 10.1016/j.addbeh.2014.12.011] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
Abstract
Motivational interviewing is a client-centered therapeutic intervention that aims to resolve ambivalence toward change. We conducted a systematic review and meta-analysis on the efficacy of motivational interviewing, compared to non-motivational interviewing controls, in the treatment of disordered gambling. Electronic databases were searched for randomized controlled trials that evaluated change in gambling behavior using motivational interviewing in adult disordered gamblers. The primary outcomes were the weighted mean difference (WMD) for change in average days gambled per month and average dollars lost per month. The search strategy yielded 447 articles, of which 20 met criteria for full text review. Overall, 8 studies (N=730) fulfilled the inclusion criteria for systematic review and 5 (N=477) were included in the meta-analysis. Motivational interviewing was associated with significant reduction in gambling frequency up to a year after treatment delivery. For gambling expenditure, motivational interviewing yielded significant reductions in dollars spent gambling compared to non-motivational controls at post-treatment only (1-3 months). Overall, the results of this review suggest that motivational interviewing is an efficacious style of therapy for disordered gambling in the short term. Whether treatment effects are maintained over time remains unclear.
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Problem gambling subtypes based on psychological distress, alcohol abuse and impulsivity. Addict Behav 2014; 39:1741-5. [PMID: 25119420 DOI: 10.1016/j.addbeh.2014.07.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/09/2014] [Accepted: 07/23/2014] [Indexed: 10/25/2022]
Abstract
The notion of comorbidities within problem gambling populations has important clinical implications, particularly for appropriate treatment matching. The comorbidities most commonly cited in problem gambling literature include depression, anxiety, alcohol abuse and impulsivity. Previous research shows evidence of patterns in multiple co-occurring comorbidities and that there may be different subtypes of gamblers based on these patterns. To further the current understanding of gambling subtypes, the aim of our study was to identify subtypes of gamblers currently in treatment. Hierarchical Cluster Analysis yielded four mutually exclusive groups of 202 gamblers: (1) gamblers with comorbid psychological problems (35%); (2) 'pure' gamblers without other comorbidities (27%); (3) gamblers with comorbid alcohol abuse (25%); and (4) 'multimorbid' gamblers (13%). The four groups differed on demographic information, drug use and gambling behaviours including gambling activity and problem gambling severity. Gamblers with comorbid psychological problems were more likely to be older women on low income, more likely to report a family history of psychological problems and were more often electronic gaming machine players. As expected, 'pure' gamblers had lower problem gambling severity and were more likely to report current abstinence. Gamblers with comorbid alcohol abuse were more likely to be young men who used stimulant drugs, endorsed a higher quality of life and worked full-time. 'Multimorbid' gamblers were elevated on all comorbidities, had general problems related to their health and wellbeing and reported high rates of hostility and aggression. These groups combine elements of existing conceptual models of gambling subtypes and may require different treatments.
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Abstract
This review discusses the research evidence for psychological treatment of gambling disorder. Several treatment options for gamblers have been explored, ranging from self-help and peer support, to brief and motivational interventions, to more intensive therapy approaches. Involvement in peer support programs seems to be optimal when combined with professional treatment; however, engagement and retention in peer support is limited. Self-directed interventions appear to benefit some gamblers; however, the involvement of therapist support, either in person or by telephone, may bolster these effects and such support need not be extensive. These self-directed options reduce the barriers associated with treatment-seeking, and may reach a wider range of gamblers than professionally delivered treatments alone. Brief and motivational approaches similarly may extend treatment options to more gamblers, namely at-risk and problem gamblers and those not seeking treatment. Of more extensive therapies, no consistent benefit of one approach emerges, although cognitive-behavioral interventions have been most often applied. Overall, several treatments have been developed for gambling disorder and results are promising, but variability in findings suggests a need for further systematic evaluation.
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Affiliation(s)
- Carla J Rash
- Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Nancy M Petry
- Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
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Ledgerwood DM, Arfken CL, Wiedemann A, Bates KE, Holmes D, Jones L. Who goes to treatment? Predictors of treatment initiation among gambling help-line callers. Am J Addict 2014; 22:33-8. [PMID: 23398224 DOI: 10.1111/j.1521-0391.2013.00323.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 12/31/2011] [Accepted: 01/11/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although the consequences of problem gambling can be severe, few ever seek treatment for this disorder. Problem gambling help-lines represent a crucial point of entry into the treatment system. Through brief telephone counseling, help-lines have the potential of enhancing callers' motivations to engage in longer-term treatment. We prospectively examined treatment initiation and its predictors among individuals calling a state help-line. METHODS Participants (n = 143) were assessed shortly after their initial call and re-contacted at least two months later. RESULTS Overall 67% of the re-contacted help-line callers had attended at least one treatment session at the time of the follow-up interview (92.7% formal treatment and 28.1% peer-support meetings). Multivariate analysis revealed that gambling-related financial difficulties and past treatment for problem gambling (but not for mental health or substance abuse) predicted treatment initiation. CONCLUSIONS AND SIGNIFICANCE Enhanced counseling focusing on motivational factors may result in better treatment engagement for some problem gamblers.
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Affiliation(s)
- David M Ledgerwood
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
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Petry NM, Blanco C, Auriacombe M, Borges G, Bucholz K, Crowley TJ, Grant BF, Hasin DS, O'Brien C. An overview of and rationale for changes proposed for pathological gambling in DSM-5. J Gambl Stud 2014; 30:493-502. [PMID: 23526033 DOI: 10.1007/s10899-013-9370-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in 2013. It will include several changes to the diagnosis of pathological gambling: the name of the disorder will be altered, the threshold for diagnosis will decrease, and one criterion will be removed. This paper reviews the rationale for these changes and addresses how they may impact diagnosis and treatment of the disorder, as well as potential for future research in the field.
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Affiliation(s)
- Nancy M Petry
- MC-3944, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030-3944, USA,
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Bischof A, Meyer C, Bischof G, Guertler D, Kastirke N, John U, Rumpf HJ. Association of sociodemographic, psychopathological and gambling-related factors with treatment utilization for pathological gambling. Eur Addict Res 2014; 20:167-73. [PMID: 24401333 DOI: 10.1159/000356904] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 10/25/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Only a small percentage of pathological gamblers utilizes professional treatment for gambling problems. Little is known about which social and gambling-related factors are associated with treatment utilization. The aim of this study was to look for factors associated with treatment utilization for pathological gambling. METHODS The study followed a sampling design with 3 different recruitment channels, namely (1) a general population-based telephone sample, (2) a gambling location sample and (3) a project telephone hotline. Pathological gambling was diagnosed in a telephone interview. Participants with pathological gambling (n=395) received an in-depth clinical interview concerning treatment utilization, comorbid psychiatric disorders and social characteristics. RESULTS Variables associated with treatment were higher age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.08], an increased number of DSM-IV criteria for pathological gambling (OR 1.34, 95% CI 1.06-1.70), more adverse consequences from gambling (OR 1.10, 95% CI 1.03-1.16) and more social pressure from significant others (OR 1.17, 95% CI 1.07-1.27). Affective disorders were associated with treatment utilization in the univariate analysis (OR 1.81, 95% CI 1.19-2.73), but multivariate analysis showed that comorbid psychiatric disorders were not independently associated. CONCLUSION These results indicate that individuals with more severe gambling problems utilize treatment at an older age when more adverse consequences have occurred. Further research should focus on proactive early interventions.
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Affiliation(s)
- Anja Bischof
- Research Group Substance Abuse and Related Disorders: Treatment, Epidemiology and Prevention, Center for Integrative Psychiatry, Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
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Weinstock J, Rash C, Burton S, Moran S, Biller W, O'Neil K, Kruedelbach N. Examination of proposed DSM-5 changes to pathological gambling in a helpline sample. J Clin Psychol 2013; 69:1305-14. [PMID: 23797951 DOI: 10.1002/jclp.22003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To examine the effect of proposed the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) changes to pathological gambling relative to DSM-IV criteria in a large gambling helpline sample (N = 2,750). Changes in prevalence rates, the diagnostic utility of the illegal acts criterion, and severity of alternative diagnostic formulation thresholds were examined. METHOD Callers to the helpline completed a semistructured interview and DSM-IV criteria were assessed. RESULTS Without lowering the diagnostic threshold, removal of the illegal acts criterion resulted in loss of diagnostic status in less than 2% of helpline callers. The DSM-IV prevalence rate in this sample was 81.2%, and DSM-5 formulations with lowered thresholds of 4, 3, and 2 symptoms increased prevalence rates by 9% to 17%. However, item-level symptom endorsement suggested that subclinical gamblers experience significant adverse consequences. CONCLUSIONS Lowered thresholds may lead to earlier provision of treatment to gamblers and prevent escalation of the disorder, while being more consistent with diagnostic thresholds of other addiction disorders.
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Abstract
AIMS The aim of this paper is to offer an account of the history and current status of gambling research in the United States. METHODS A review of the literature. RESULTS Gambling has been a part of society in the United States since its early history. However, it was not until 1980 that the medical profession in the United States first recognized pathological gambling as a psychiatric disorder. Today, it is still rarely diagnosed or treated, and relatively little federal funding is available to support research in this area. With the upcoming fifth revision of the Diagnostic and Statistical Manual of Mental Disorders, pathological gambling is likely to be included alongside substance use disorders as the first non-substance-related addictive disorder. This change may represent an opportunity to expand research on gambling and treatment of pathological gambling. CONCLUSIONS We provide 10 suggestions for reducing societal and personal harm associated with this disorder.
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Cowlishaw S, Merkouris S, Dowling N, Anderson C, Jackson A, Thomas S. Psychological therapies for pathological and problem gambling. Cochrane Database Syst Rev 2012; 11:CD008937. [PMID: 23152266 DOI: 10.1002/14651858.cd008937.pub2] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Various psychological therapies for pathological and problem gambling have been evaluated in randomised trials. A synthesis of best-quality evidence is required. OBJECTIVES The objective was to synthesise evidence from randomised trials of psychological therapies for pathological and problem gambling (cognitive-behaviour therapy (CBT), motivational interviewing therapy, integrative therapy, other psychological therapy), in order to indicate the efficacy of therapies and durability of therapy effects, relative to control conditions. SEARCH METHODS We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR), which includes relevant randomised controlled trials from the following bibliographic databases: CENTRAL (The Cochrane Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We also carried out complementary searches of MEDLINE, EMBASE, PsycINFO, LILACS and CENTRAL for studies published between January 1980 and October 2011. We examined the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov and also conducted manual searches of selected journals and reference lists of included studies. SELECTION CRITERIA Included studies were clinical trials using random allocation to groups, considering pathological or problem gamblers, and evaluating a psychological therapy for pathological or problem gambling. Control conditions included 'no treatment' controls, referral to Gamblers Anonymous and non-specific treatment component controls. DATA COLLECTION AND ANALYSIS We systematically extracted data on the characteristics and results of studies. Primary outcomes were measures of gambling symptom severity, financial loss from gambling and frequency of gambling. Secondary outcomes were occurrence of pathological gambling diagnoses and depression and anxiety symptoms. Treatment effects were defined by comparisons between therapy and control conditions at post-treatment assessments (conducted from 0 to 3 months following completion of treatment) and follow-up assessments (conducted from 9 to 12 months following completion of treatment), respectively, using the standardised mean difference (SMD) or risk ratio (RR). We synthesised results through random-effects meta-analysis. MAIN RESULTS Fourteen studies (n = 1245) met the inclusion criteria. Eleven studies compared CBT with control and comparisons at 0 to 3 months post-treatment showed beneficial effects of therapy that ranged from medium (when defined by financial loss from gambling: SMD -0.52; 95% confidence interval (CI) -0.71 to -0.33, n = 505) to very large (for gambling symptom severity: SMD -1.82; 95% CI -2.61 to -1.02, n = 402). Only one study (n = 147) compared groups at 9 to 12 months follow-up and produced smaller effects that were not significant. Four studies of motivational interviewing therapy were identified and mainly considered samples demonstrating less severe gambling (relative to studies of pathological gamblers). Data suggested reduced financial loss from gambling following motivational interviewing therapy at 0 to 3 months post-treatment (SMD -0.41; 95% CI -0.75 to -0.07, n = 244), although comparisons on other outcomes were not significant. The effect approached zero when defined by gambling symptom severity (SMD -0.03; 95% CI -0.55 to 0.50, n = 163). Studies compared groups at 9 to 12 months follow-up and found a significant effect of motivational interviewing therapy in terms of frequency of gambling (SMD -0.53; 95% CI -1.04 to -0.02, n = 62), with comparisons on other outcomes that were not significant. Two studies of integrative therapies also considered samples demonstrating overall low gambling severity, and found no significant effects of therapy at 0 to 3 months post-treatment. Comparisons at 9 to 12 months follow-up suggested a medium effect from therapy in terms of gambling symptom severity, with no significant differences for other outcomes. One study (n = 18) considered another psychological therapy (i.e.Twelve-Step Facilitated Group Therapy) and suggested beneficial effects in terms of most outcomes at 0 to 3 months post-treatment. The evidence supporting these various classes of therapy ranged from very low to low quality. AUTHORS' CONCLUSIONS This review supports the efficacy of CBT in reducing gambling behaviour and other symptoms of pathological and problem gambling immediately following therapy. However, the durability of therapeutic gain is unknown. There is preliminary evidence for some benefits from motivational interviewing therapy in terms of reduced gambling behaviour, although not necessarily other symptoms of pathological and problem gambling. However, the findings are based on few studies and additional research is needed to inform conclusions. There is also evidence suggestive of some possible benefit from integrative therapies, and other psychological therapies for pathological and problem gambling. However, there are too few studies and evidence is insufficient to evaluate these therapies. The majority of studies in this review varied in risk of bias, and much of the evidence comes from studies with multiple limitations. The current data may thus reflect overestimates of treatment efficacy.
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Affiliation(s)
- Sean Cowlishaw
- School of Psychology and Psychiatry,Monash University, Melbourne, Australia.
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Fink A, Parhami I, Rosenthal RJ, Campos MD, Siani A, Fong TW. How transparent is behavioral intervention research on pathological gambling and other gambling-related disorders? A systematic literature review. Addiction 2012; 107:1915-28. [PMID: 22487136 PMCID: PMC3401241 DOI: 10.1111/j.1360-0443.2012.03911.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To review the transparency of reports of behavioral interventions for pathological gambling and other gambling-related disorders. METHODS We used the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) Statement to develop the 59-question adapted TREND questionnaire (ATQ). Each ATQ question corresponds to a transparency guideline and asks how clearly a study reports its objectives, research design, analytical methods and conclusions. A subset of 23 ATQ questions is considered particularly important. We searched PubMed, PsychINFO and Web of Science to identify experimental evaluations published between 2000 and 2011 aiming to reduce problem gambling behaviors or decrease problems caused by gambling. Twenty-six English-language reports met the inclusion criteria and were reviewed by three abstractors using the ATQ. RESULTS The average report adhered to 38.4 (65.1%) of the 59 ATQ transparency guidelines. Each of the 59 ATQ questions received positive responses from an average of 16.9 (63.8%) of the reports. The subset of 23 particularly relevant questions received an average of 15.3 (66.5%) positive responses. Thirty-two of 59 (54%) ATQ questions were answered positively by 75% or more of the study reports, while 12 (20.3%) received positive responses by 25% or fewer. Publication year did not affect these findings. CONCLUSIONS Gambling intervention reports need to improve their transparency by adhering to currently neglected and particularly relevant guidelines. Among them are recommendations for comparing study participants who are lost to follow-up and those who are retained, comparing study participants with the target population, describing methods used to minimize potential bias due to group assignment, and reporting adverse events or unintended effects.
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Affiliation(s)
- Arlene Fink
- University of California, Los Angeles (UCLA) Gambling Studies Program, Los Angeles, CA 90095, USA.
| | - Iman Parhami
- UCLA Gambling Studies Program, Los Angeles, CA, USA
,Department of Psychiatry and Biobehavioral Sciences at University of California, Los Angeles, USA
| | - Richard J. Rosenthal
- UCLA Gambling Studies Program, Los Angeles, CA, USA
,David Geffen School of Medicine, University of California, Los Angeles, USA
,Department of Psychiatry and Biobehavioral Sciences at University of California, Los Angeles, USA
| | - Michael D. Campos
- UCLA Gambling Studies Program, Los Angeles, CA, USA
,Department of Psychiatry and Biobehavioral Sciences at University of California, Los Angeles, USA
| | - Aaron Siani
- UCLA Gambling Studies Program, Los Angeles, CA, USA
,David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Timothy W. Fong
- UCLA Gambling Studies Program, Los Angeles, CA, USA
,David Geffen School of Medicine, University of California, Los Angeles, USA
,Department of Psychiatry and Biobehavioral Sciences at University of California, Los Angeles, USA
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Guercio JM, Johnson T, Dixon MR. Behavioral treatment for pathological gambling in persons with acquired brain injury. J Appl Behav Anal 2012; 45:485-95. [PMID: 23060663 DOI: 10.1901/jaba.2012.45-485] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Accepted: 04/29/2012] [Indexed: 10/27/2022]
Abstract
The present investigation examined a behavior-analytic clinical treatment package designed to reduce the pathological gambling of 3 individuals with acquired brain injury. A prior history of pathological gambling of each patient was assessed via caregiver report, psychological testing, and direct observation of gambling behavior. Using an 8-week one-on-one client-patient format, a treatment program was developed in which the patient learned about the antecedents, consequences, and motivating operations that controlled the emission of gambling behavior. Data were collected on both self-report of gambling urges and behavior following therapy and during in situ gambling opportunities. The therapy program reduced urges to gamble and actual gambling for all patients. The potential of behavior-analytic therapy for reducing the pathological gambling of patients with and without brain injury is discussed.
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Affiliation(s)
- John M Guercio
- Southern Illinois University, Carbondale, Illinois 62901, USA
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Larimer ME, Neighbors C, Lostutter TW, Whiteside U, Cronce JM, Kaysen D, Walker DD. Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial. Addiction 2012; 107:1148-58. [PMID: 22188239 PMCID: PMC3528181 DOI: 10.1111/j.1360-0443.2011.03776.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population. DESIGN Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitive-behavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduction tips, delivered in a motivational interviewing style. CBI was delivered in small groups over four to six sessions and included functional analysis and brief cognitive correction, as well as identification of and alternatives for responding to gambling triggers. SETTING College campus. PARTICIPANTS At-risk or probable pathological gamblers (n = 147; 65.3% male; group assignment: PFI, n = 52; CBI, n = 44; AOC, n = 51). MEASUREMENTS Self-reported gambling quantity, frequency, consequences, psychopathology, normative perceptions and beliefs. FINDINGS Relative to control, results at 6-month follow-up indicated reductions in both interventions for gambling consequences (PFI d = 0.48; CBI d = 0.39) and DSM-IV criteria (PFI d = 0.60; CBI d = 0.48), reductions in frequency for PFI (d = 0.48). CBI was associated with reduced illusions of control, whereas PFI was associated with reduced perceptions of gambling frequency norms. Reductions in perceived gambling frequency norms mediated effects of PFI on gambling frequency. CONCLUSIONS A single-session personalized feedback intervention and a multi-session cognitive-behavioral intervention may be helpful in reducing disordered gambling in US college students.
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Affiliation(s)
- Mary E. Larimer
- Center for the Study of Health and Risk Behaviors Department of Psychiatry and Behavioral Sciences School of Medicine, University of Washington Box 354944, Seattle, WA 98195
,Corresponding Author: Phone: (206) 543-3513 Fax: (206) 616-1705
| | - Clayton Neighbors
- Social Influences and Health Behaviors Lab Department of Psychology The University of Houston 126 Heyne Building, Houston, TX 77204-5502
| | - Ty W. Lostutter
- Center for the Study of Health and Risk Behaviors Department of Psychiatry and Behavioral Sciences School of Medicine, University of Washington Box 354944, Seattle, WA 98195
| | - Ursula Whiteside
- Group Health Research Institute 1730 Minor Ave, Suite 1600 Seattle WA 98101-1448
| | - Jessica M. Cronce
- Center for the Study of Health and Risk Behaviors Department of Psychiatry and Behavioral Sciences School of Medicine, University of Washington Box 354944, Seattle, WA 98195
| | - Debra Kaysen
- Center for the Study of Health and Risk Behaviors Department of Psychiatry and Behavioral Sciences School of Medicine, University of Washington Box 354944, Seattle, WA 98195
| | - Denise D. Walker
- Innovative Programs Research Group School of Social Work University of Washington Box 354690, Seattle, WA 98105
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Labrie RA, Peller AJ, Laplante DA, Bernhard B, Harper A, Schrier T, Shaffer HJ. A brief self-help toolkit intervention for gambling problems: a randomized multisite trial. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2012; 82:278-89. [PMID: 22506530 DOI: 10.1111/j.1939-0025.2012.01157.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Two studies conducted in Massachusetts and Nevada evaluated the efficacy of a self-help toolkit for problem gambling. Individuals concerned about gambling-related problems, in response to public notices and newspaper advertisements, volunteered for a randomized trial of the self-help toolkit, Your First Step to Change: Gambling. Participants were randomly assigned to 1 of 3 conditions: (a) a printed toolkit, (b) the toolkit and a brief guide to the toolkit's content, or (c) assignment to a wait-list condition. Participants, 145 in Massachusetts and 170 in Nevada, reported their gambling behavior, beliefs and attitudes about chance, and recent and planned help seeking at baseline, 88% at 1 month later, and 79% at 3 months later. Findings for the complete and intent-to-treat analyses at both sites indicated that participants significantly improved. At the end of the study period, significantly more toolkit recipients than control group participants reported recently abstaining from gambling. Minimally invasive, self-directed resources like this self-help toolkit can assist remediating gambling-related problems among gamblers who do not engage in formal treatment.
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Affiliation(s)
- Richard A Labrie
- Division on Addiction, Suite 2100, 101 Station Landing, Medford, MA 02155, USA.
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[Pathological gambling in adolescence]. Arch Pediatr 2012; 19:173-9. [PMID: 22239967 DOI: 10.1016/j.arcped.2011.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Revised: 11/17/2011] [Accepted: 11/25/2011] [Indexed: 11/23/2022]
Abstract
Today's juveniles are the first generation to be raised in an environment where gambling is very accessible and socially acceptable. The recent legalization of Internet gambling has increased this accessibility. With 28,8 millions of gamblers in France in 2010, many believe that gambling is an innocent leisure activity. The first results of the national survey on the prevalence of gambling practices conducted in France show that in 2010, 1.3% of the population had a gambling problem. Also, despite the prohibition of gambling to minors, the mean age of onset of gambling behavior in the world is 11.5 years. Gambling (even non-problematic) in adolescence is associated with poor school performance, criminal behavior and family conflict. Recreational gambling shares with pathological gambling high rates of psychiatric comorbidities in adults, and risk behaviors among adolescents. Similarly, international studies show prevalence of problem gambling 2 to 4 times higher among adolescents than among adult, 3.5% to 8% of adolescents between 12 and 17 are pathological gamblers. The validity of the screening instruments and the frequency of spontaneous recovery in adulthood are discussed to explain the high prevalence in adolescence. This article proposes a focus on the practice of gambling in adolescence and its characteristics when the practice becomes pathological. We discuss the epidemiological, diagnostic, etiologic and therapeutic aspects of this problem. Three major types of risk factors implicated in gambling problems are identified: some of them are related to the subject (individual factors), others are related to the object of the addiction, here the gambling activity by itself (structural factors) like Internet with the recent legalization of gambling online, and the last are related to environment (contextual or situational factors). Thus, the development and maintenance of pathological gambling in youth seems to be conditioned by the interaction of a person and a gambling activity, in a particular context. This conceptual model is based on the well-known theory of Olivenstein on toxicomania, which was proposed in the seventies. In France, very few is known about problem gambling in this age and its implications in terms of treatment, prevention and research. There is little in the way of specific treatments for adolescent pathological gamblers so we briefly reviewed possibilities and limits. We discuss the importance to develop prevention, in particular to delay the initiation, and the necessity of research to develop screening instruments and news studies to have a better knowledge of this population.
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Moore MJ, Werch CE, Bian H. Pilot of a computer-based brief multiple-health behavior intervention for college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2012; 60:74-80. [PMID: 22171732 DOI: 10.1080/07448481.2011.574765] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE Given the documented multiple health risks college students engage in, and the dearth of effective programs addressing them, the authors developed a computer-based brief multiple-health behavior intervention. This study reports immediate outcomes and feasibility of a pilot of this program. PARTICIPANTS Two hundred students attending a midsized university participated. METHODS Participants were randomly assigned to the intervention or control program, both delivered via computer. Immediate feedback was collected with the computer program. RESULTS Results indicate that the intervention had an early positive impact on alcohol and cigarette use intentions, as well as related constructs underlying the Behavior-Image Model specific to each of the 3 substances measured. Based on the implementation process, the program proved to be feasible to use and acceptable to the population. CONCLUSION Results support the potential efficacy of the intervention to positively impact behavioral intentions and linkages between health promoting and damaging behaviors among college students.
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Affiliation(s)
- Michele J Moore
- Department of Public Health, University of North Florida, Jacksonville, Florida 32224-2645, USA.
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Shaffer HJ, Martin R. Disordered gambling: etiology, trajectory, and clinical considerations. Annu Rev Clin Psychol 2011; 7:483-510. [PMID: 21219194 DOI: 10.1146/annurev-clinpsy-040510-143928] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Gambling-related research has advanced rapidly during the past 20 years. As a result of expanding interest in pathological gambling (PG), stakeholders (e.g., clinicians, regulators, and policy makers) have a better understanding of excessive gambling, including its etiology (e.g., neurobiological/neurogenetic, psychological, and sociological factors) and trajectory (e.g., initiation, course, and adaptation to gambling exposure). In this article, we examine these advances in PG-related research and then consider some of the clinical implications of these advances. We consider criteria changes for PG recently proposed by the DSM-V Impulse Control Work Group for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). We also review how clinicians can more accurately and efficiently diagnose clients seeking help for gambling-related problems by utilizing brief screens. Finally, we consider the importance of future research that can identify behavioral markers for PG. We suggest that identifying these markers will allow clinicians to make earlier diagnoses, recommend targeted treatments, and advance secondary prevention efforts.
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Wareham JD, Potenza MN. Pathological gambling and substance use disorders. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2010; 36:242-7. [PMID: 20575651 PMCID: PMC3671380 DOI: 10.3109/00952991003721118] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Pathological gambling (CPG) has been considered as a behavioral addiction having similarities with substance use disorders (SUDs). OBJECTIVES AND METHODS Current conceptualizations of addiction, as well as experimental studies of PG and SUDs, are reviewed in order to provide a perspective on tbe areas of convergence between addictive behaviors in PG and SUDs. RESULTS Shared features exist in diagnostic, clinical, physiological, and behavioral domains. CONCLUSIONS AND SCIELLTIFIC SIGNIFICANCE: Similarities between PG and SUDs have important implicatiol1s for categorizing, assessing, preventing and treating both PO and SUDs.
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Affiliation(s)
- Justin D. Wareham
- Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, United States
| | - Marc N. Potenza
- Division of Substance Abuse, Department of Psychiatry, Yale University School of Medicine, Connecticut Mental Health Center, New Haven, CT, United States
- Child Study Center, Yale University, School of Medicine, New Haven, CT, United States
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