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Mansueto A, Challet-Bouju G, Hardouin JB, Grall-Bronnec M. Definitions and assessments of recovery from gambling disorder: A scoping review. J Behav Addict 2024; 13:354-412. [PMID: 38551669 PMCID: PMC11220822 DOI: 10.1556/2006.2024.00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/22/2023] [Accepted: 03/04/2024] [Indexed: 06/28/2024] Open
Abstract
Background and aims While the concept of recovery is receiving increasing attention in the context of gambling disorder (GD), no consensus has yet been reached regarding its definition. This scoping review aims to map the literature on GD recovery, identify gaps, and provide insights for a more holistic and patient-centred perspective. Methods A systematic search of three databases was conducted (PubMed, PsycINFO, and ScienceDirect). Based on the method by which the results of these studies were produced, the studies included were sorted into four categories (quantitative, instrument validation, qualitative, and mixed studies) and subsequently examined using conceptual analysis. Results One hundred thirteen articles were included in this research after the screening process. In the quantitative and instrument validation studies, recovery was defined or operationalized in terms of abstinence, the absence of a GD diagnosis, or mild GD severity, or by reference to treatment outcomes or controlled gambling. A meta-synthesis of the results of the qualitative studies revealed four core features of recovery (insight, empowerment and commitment, wellbeing enhancement, and reconsideration of the issue of relapse). Discussion Discrepancies in definitions, outcomes, and variables used were evident across studies. Additionally, the quantitative and standardized approaches employed in most studies exhibited severe limitations with regard to defining recovery from the subjective and multidimensional perspectives of people recovering from GD. Conclusions This lack of definitional clarity emphasizes the necessity for further qualitative research. This research should encompass multiple stakeholder perspectives to develop a working definition promoting recovery from a holistic, patient-centred, and tailored approach.
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Affiliation(s)
- Agathe Mansueto
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Gaëlle Challet-Bouju
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
| | - Jean-Benoit Hardouin
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
- Department of Clinical Research and Innovation, Biostatistics and Methodology Unit, Nantes Université, CHU Nantes, F-44000 Nantes, France
- Public Health Department, Nantes Université, CHU Nantes, F-44000 Nantes, France
| | - Marie Grall-Bronnec
- Nantes Université, CHU Nantes, UIC Psychiatrie et Santé Mentale, F-44000 Nantes, France
- Nantes Université, Univ Tours, CHU Nantes, INSERM, MethodS in Patient-Centered Outcomes and HEalth ResEarch, SPHERE, F-44000 Nantes, France
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Estévez A, Macía L, Macía P. Looking at Sex Differences in Gambling Disorder: The Predictive Role of the Early Abandonment Schema, Gambling Motives and Alexithymia in Depression. J Gambl Stud 2023; 39:1815-1832. [PMID: 37733147 PMCID: PMC10628046 DOI: 10.1007/s10899-023-10251-w] [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] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
A growing body of research indicates differences between men and women with gambling disorder. However, although alexithymia, gambling motives or abandonment have been associated with GD, women's clinical profile remains unexplored. This study aims, firstly, to explore mean differences in gambling motives (i.e. enhancement, coping and social [SOC]), the early maladaptive abandonment schema, alexithymia and depression in women and men with GD. Secondly, to analyse the correlation between the aforementioned variables as a function of sex. Thirdly, to examine the predictive role of gambling motives, early abandonment schema and alexithymia in depression as a function of sex. Lastly, to analyse the mediating role of COP between the early maladaptive abandonment schema and depression in women with GD, and the mediating role of ENH and the early maladaptive abandonment schema between alexithymia and depression in men with GD. The sample comprised 108 adults with GD diagnosis, of whom 60 were women and 48 were men. Regression and mediation analyses were carried out to explore possible sex differences in GD, through the SPSS programme. Results showed that depressive symptoms are predicted by alexithymia in men with GD and by the early maladaptive abandonment schema in women with GD. Regarding mediation analyses, the results suggest that COP mediated the relationship between early abandonment schema and depressive symptoms in females; and ENH and abandonment schema mediated the relationship between alexithymia and depressive symptoms in males. These results provide evidence of the relevance of considering sex differences when establishing therapeutic strategies in GD rehabilitation.
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Affiliation(s)
- Ana Estévez
- Psychology Department, Faculty of Health Sciences, University of Deusto, Apartado 1, 48080, Bilbao, Spain
| | - Laura Macía
- Psychology Department, Faculty of Health Sciences, University of Deusto, Apartado 1, 48080, Bilbao, Spain.
| | - Patricia Macía
- Department of Basic Psychological Processes and Their Development, University of the Basque Country/Euskal Herriko Unibertsitatea (UPV/EHU), 20018, Donostia-San Sebastián, Spain
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Mestre-Bach G, Potenza MN. Features Linked to Treatment Outcomes in Behavioral Addictions and Related Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2873. [PMID: 36833569 PMCID: PMC9957199 DOI: 10.3390/ijerph20042873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/28/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
Behavioral addictions are incompletely understood with respect to their underlying etiologies. This incomplete understanding may contribute to the frequent relapse and dropout rate often observed with behavioral addictions. The present state-of-the-art review aimed to review the literature that explored sociodemographic and clinical factors that link to poor treatment responses. Despite multiple studies, the definitions and evaluations of relapse and dropout are heterogeneous, complicating comparisons across studies. A scientific consensus on the conceptualization of both terms would help to better understand psychological features linked to treatment outcomes in behavioral addictions.
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Affiliation(s)
- Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, 26006 La Rioja, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA
- Connecticut Mental Health Center, New Haven, CT 06519, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA
- Wu Tsai Institute, Yale University, New Haven, CT 06510, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06510, USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT 06510, USA
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Gavriel-Fried B, Vana N, Lev-El N, Weinberg-Kurnik G. Recovery capital in action: How is gender understood and employed by men and women recovering from gambling disorder? Soc Sci Med 2022; 313:115401. [PMID: 36308888 DOI: 10.1016/j.socscimed.2022.115401] [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: 07/14/2022] [Revised: 09/01/2022] [Accepted: 09/24/2022] [Indexed: 01/26/2023]
Abstract
Gender is a multidimensional construct that differentiates males and females according to its meanings in different socio-cultural contexts. Recovery capital (RC) describes the internal and external resources individuals employ and/or have access to when overcoming addictions. Negative RC refers to elements that hinder recovery. The literature on gender and RC is baffling since unlike quantitative studies that have found no differences between men and women in the levels of RC, qualitative comparisons indeed underscore differences. This study employed qualitative and quantitative research methods to explore how men and women with gambling disorder (GD) understand and employ gender as a factor in their recovery. Participants with GD (N = 133, 39 women) answered an open-ended question on gender as a component in their recovery. Content analysis revealed that 41.35% of the interviewees did not consider gender as a significant factor in recovery. By contrast, 58.65% viewed gender as important to recovery, indicating four gender-related elements that either enhance and/or hinder recovery: gender stereotypes, gender roles, mixed-gender therapeutic space, and sex in exchange for money for gambling. Chi-square analyses showed no differences between men and women in the distribution of the relevance of gender to recovery. Both groups reported similar perceptions of gender in relation to recovery, and identified similar gender-related specific elements that enhanced or hindered recovery from GD except for exchanging sex for money for gambling. These findings are explained by a combination of macro and micro-level theories that result in a new conceptualization of RC. We coined the term "Recovery Capital in Action" to show how the "RC toolkit" that individuals employ can hinder or enhance their recovery depending on cultural context, and that gender can be both a negative and a positive RC. Mental health professionals should consider the interplay between gender and the socio-cultural contexts during recovery.
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Affiliation(s)
| | - Noa Vana
- The Bob Shapell School of Social Work, Tel Aviv, Israel
| | - Niva Lev-El
- The Bob Shapell School of Social Work, Tel Aviv, Israel
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Gavriel-Fried B, Lev-el N, Kraus SW. The Holistic Recovery Capital in Gambling Disorder index: A pilot study. J Behav Addict 2022; 11:600-606. [PMID: 35895478 PMCID: PMC9295245 DOI: 10.1556/2006.2022.00040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/25/2021] [Accepted: 05/15/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Recovery is a challenge for individuals coping with a gambling disorder (GD). Recovery capital (RC) is a conceptual framework describing positive external and internal (e.g., human, social, community and financial) resources that promote recovery. Negative RC relates to external and internal obstacles to recovery. To date, no scale has captured both positive and negative RC items in the gambling field. Based on the RC framework, this pilot study aimed to develop The Holistic Recovery Capital in Gambling Disorder (HRC-GD) instrument, and to explore its associations with recovery status, measures of psychopathology and happiness. We hypothesized that higher HRC-GD scores will be positively related to recovery and subjective happiness, but negatively linked to depression, anxiety, and gambling severity. METHOD Recovered and non-recovered individuals with a lifetime DSM-5 GD (n = 164) completed the HRC-GD instrument, the DSM-5 GD diagnostic criteria, and measures of depression, anxiety, and subjective happiness. RESULTS Through a process of item reduction, which included a principal components analysis, 19 items were retained. Since exploratory factor analysis (EFA) yielded uninterpretable findings, an index score reflecting human, financial, community, and social resources and obstacles was calculated. HRC-GD index scores were negatively correlated with anxiety, depression, and GD symptom severity, but positively related with subjective happiness. Index scores were significantly associated with recovery status. CONCLUSIONS The HRC-GD index holds promise as a new tool for measuring RC in GD. Additional research is needed to validate this index using larger and more ethnically and gender diverse clinical and community samples of individuals with GD.
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Affiliation(s)
- Belle Gavriel-Fried
- The Bob Shapell School of Social Work, Tel Aviv University, Israel,Corresponding author. Tel.: +971+36409151. E-mail:
| | - Niva Lev-el
- The Bob Shapell School of Social Work, Tel Aviv University, Israel
| | - Shane W. Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
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Baño M, Mestre-Bach G, Granero R, Fernández-Aranda F, Gómez-Peña M, Moragas L, Del Pino-Gutierrez A, Codina E, Guillén-Guzmán E, Valero-Solís S, Lizbeth Lara-Huallipe M, Baenas I, Mora-Maltas B, Valenciano-Mendoza E, Solé-Morata N, Gálvez-Solé L, González-Bueso V, José Santamaría J, Menchón JM, Jiménez-Murcia S. Women and gambling disorder: Assessing dropouts and relapses in cognitive behavioral group therapy. Addict Behav 2021; 123:107085. [PMID: 34425460 DOI: 10.1016/j.addbeh.2021.107085] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/02/2021] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gender-specific literature focused on gambling disorder (GD) is scarce, and women with GD have been understudied. Therefore, the aim of this study was to estimate the short-term effectiveness in women with GD (n = 214) of a group standardized cognitive-behavioral therapy (CBT) and to identify the most relevant predictors of the primary therapy outcomes (dropout and relapse). METHODS The manualized CBT consisted of 16 weekly outpatient group sessions. Women were provided with resources to obtain a better understanding of the GD, to improve self-control and to manage risk situations. RESULTS The dropout risk was higher for women with lower GD severity and higher psychopathological distress. Among other factors, lower education levels were a significant predictor of the relapse risk and and the frequency of relapses was higher for divorced women with a preference for non-strategic gambling and with substances consumption. CONCLUSIONS Our findings evidence women-specific predictors of the primary therapy outcomes. The results highlight the need to design psychological interventions that address dropout and relapse risk factors in women.
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Affiliation(s)
- Marta Baño
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network. Generalitat de Catalunya (XHUB), Barcelona, Spain
| | | | - Roser Granero
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Amparo Del Pino-Gutierrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Nursing Department of Mental Health, Public Health, Maternal and Child Health, Nursing School, University of Barcelona, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Elías Guillén-Guzmán
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Susana Valero-Solís
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | | | - Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | | | - Neus Solé-Morata
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Gálvez-Solé
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Vega González-Bueso
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network. Generalitat de Catalunya (XHUB), Barcelona, Spain
| | - Juan José Santamaría
- Atención e Investigación en Socioadicciones (AIS), Mental Health and Addictions Network. Generalitat de Catalunya (XHUB), Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Ciber Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain; Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Longitudinal Changes in Gambling, Buying and Materialism in Adolescents: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062811. [PMID: 33801993 PMCID: PMC8000979 DOI: 10.3390/ijerph18062811] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/12/2022]
Abstract
Gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values lead to impaired functioning in important areas of life. The aims of the present longitudinal study are (1) to evaluate the change produced after one year in those mentioned variables and (2) to examine the gender role in these changes and to analyze the mediational mechanisms among the variables of the study. The sample was composed of 182 adolescents (103 females and 79 males) from secondary education Spanish institutions who completed self-administered questionnaires. Structural equation modeling has been used to explore associations between the different variables. Our results show significant decreases in compulsive buying, materialism, and cognitive biases related to gambling after one year. Gambling disorder severity was directly related to cognitive distortions of gambling and being a man. Compulsive buying was associated with older age and the female gender. Materialism was associated with compulsive buying and the male gender. In conclusion, gambling disorder, gambling-related cognitive biases, compulsive buying, and materialistic values change over time in different ways, according to gender. The understanding of gambling disorder and compulsive buying in adolescents could potentially lead to early prevention and treatment programs for the specific needs of gender and age.
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Shi J, van der Maas M, Turner NE, Potenza MN. Expanding on the multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. •. J Behav Addict 2020; 9:886-897. [PMID: 33372914 PMCID: PMC8969719 DOI: 10.1556/2006.2020.00096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022] Open
Abstract
As new types of problematic behaviors and new forms of online risk-taking emerge, forming collaborative relationships while understanding complexities of motivations may help to promote harm reduction and intervention. While it may be too early to form a stakeholder framework without first conceptually understanding the problematic behaviors involved, we attempt to build upon a proposed multidisciplinary stakeholder framework to minimize harms for problematic risk-taking involving emerging technologies. We propose an expansion of roles for individual stakeholders and an expansion of proposed roles for family stakeholders to include partner/spouses, others living in the household, and/or those with close relationships with individuals who are experiencing problems. Empowering individuals who use emerging technologies through participatory action research and knowledge translation/dissemination may lead to improvements in the quality of research and a greater impact on policy and practice. Also, we discuss benefits of industry self-regulation and collaboration on data-sharing practices. We recommend approaches to promote global collaboration with a larger group of relevant stakeholders (including but not limited to individual consumers of technology, families, communities, treatment and welfare providers, researchers, industries, and governments) to address protection of vulnerable populations and reduce harms for users of rapidly advancing technologies.
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Affiliation(s)
- Jing Shi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Corresponding authors.
| | - Mark van der Maas
- Center for Gambling Studies, Rutgers University, New Brunswick, NJ, USA
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Nigel E. Turner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Marc N. Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Corresponding authors.
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