Seeking safety therapy for pathological gambling and PTSD: a pilot outcome study.
ABSTRACT This pilot study evaluated Seeking Safety (SS) therapy for seven outpatients with current comorbid pathological gambling (PG) and posttraumatic stress disorder (PTSD). This represents the first treatment outcome study of this population, and included both genders and 29% minorities. We found significant improvements in: PTSD/trauma (the PTSD Checklist criterion B symptoms; the Trauma Symptom Inventory overall mean and subscales anxiety, dissociation, sexual abuse trauma index, sex problems; and the World Assumptions Scale benevolence subscale); gambling (the Gamblers Beliefs Questionnaire overall mean and subscales illusion of control); functioning (the Basis-32 overall mean and depression/anxiety subscale); psychopathology (the Brief Symptom Inventory overall mean and subscales anxiety and depression; and the Addiction Severity Index, ASI, psychiatric composite score); self-compassion (the Self-Compassion Scale overall mean and subscales isolation, overidentified, and self-judgment); and helping alliance (the Helping Alliance Questionnaire overall mean). One variable indicated worsening (employment composite subscale on the ASI), possibly reflecting measurement issues. SS attendance was excellent. PTSD onset occurred prior to PG onset for most of the sample, and most believed the two disorders were related. Overall, we found that SS can be effectively conducted for comorbid PTSD and PG, with improvements in numerous domains and high acceptability. Limitations are discussed.
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ABSTRACT: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders contains significant changes related to the diagnosis of gambling problems. These changes include the renaming of the disorder from pathological gambling to gambling disorder, reclassification of gambling disorder from an impulse control disorder to an addictive disorder, removal of the illegal acts criterion, lowering diagnostic threshold to endorsement of four criteria, and recognizing that the course of the disorder is no longer chronic for all diagnosed. This paper reviews the rationale and research support for these changes. Implications of the new revisions for both research and clinical practice are reviewed, including a discussion about future directions for research efforts.09/2014; 1(3). DOI:10.1007/s40429-014-0026-7