Randomized Trial of Brief Motivational Treatments for Pathological Gamblers: More Is Not Necessarily Better
ABSTRACT The efficacy of brief treatments for media-recruited pathological gamblers was tested in a randomized clinical trial design (N = 314). Two self-directed motivational interventions were compared with a 6-week waiting list control and a workbook only control. Brief motivational treatment involved a telephone motivational interview and a mailed self-help workbook. Brief motivational booster treatment involved a telephone motivational interview, a workbook, and 6 booster telephone calls over a 9-month period. Primary outcomes were gambling frequency and dollar losses. As hypothesized, brief and brief booster treatment participants reported less gambling at 6 weeks than those assigned to the control groups. Brief and brief booster treatment participants gambled significantly less often over the first 6 months of the follow-up than workbook only participants. However, the workbook only participants were as likely to have significantly reduced their losses over the year and to have not met criteria for pathological gambling. Contrary to the hypothesis, participants in the brief booster treatment group showed no greater improvement than brief treatment participants. These results provide further support for the value of brief motivational treatments for pathological gambling.
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ABSTRACT: BACKGROUND: When gambling opportunities are made available to the public in a given jurisdiction, some individuals participate occasionally and others more frequently. Among frequent gamblers, some individuals develop problematic involvement and some do not. This study addresses the association among demographic and social risk factors, frequency of gambling and gambling disorders.Method Data from an adult community sample (n=1372) were used to identify risk factors for higher-frequency gambling and disordered gambling involvement. RESULTS: Individuals with higher intelligence, older individuals and more religious individuals were less frequent gamblers. Males, single individuals and those exposed to gambling environments (friends and family who gamble) and those who started to gamble at a younger age were more frequent gamblers. Excitement-seeking personality traits were also higher among more frequent gamblers. A different set of risk factors was associated with the likelihood of gambling disorder among these higher-frequency gamblers. These variables included mental health indicators, childhood maltreatment and parental gambling involvement. Among higher-frequency gamblers, individuals who smoke cigarettes, those with a diagnosis of alcohol or drug dependence or obsessive-compulsive disorder, those with higher anxiety or depression and those with higher impulsivity and antisocial personality traits were more likely to report gambling-related problems. These individuals were also more likely to report gambling on electronic gambling machines (e.g. slot machines). CONCLUSIONS: These data suggest a model in which higher-frequency gambling, particularly with electronic gambling machines, when combined with any type of emotional vulnerability increased the likelihood of gambling disorder.Psychological Medicine 04/2012; DOI:10.1017/S0033291712000724 · 5.43 Impact Factor
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ABSTRACT: Introduction: The aim of the review is to present the complexity of issues related to treatment of gambling disorders, including definition of gambling and diagnostic criteria, the coexistence of gambling disorders and other disorders, epidemiology of the phenomenon, the prevalence of help seeking, the therapeutic offer for gamblers and its effectiveness, motivations and barriers to treatment. Material and method: The review of the literature was conducted using the MEDLINE database and Google Scholar. Two general search terms: ''gambling'' and ''treatment'' were used, and exploration was limited to 2000–2014. A total number of 96 publications were included in the review. Results: The legalisation of gambling contributed to a growth in the social acceptance for this type of behaviour. Gambling disorders are often associated with mental disorders (mood, neurotic and personality disorders), and psychoactive substance dependence. The vast majority of gamblers do not seek treatment and about one third of them recover without professional help. Among those who decided on treatment, participation in the Gamblers Anonymous meetings is the most preferred form. Cognitive behavioural therapy, brief interventions and controlled gambling are effective forms of treatment as confirmed by evaluation studies. Gamblers decide to take treatment mainly for economic reasons or because of concerns about their mental and physical health. Barriers to treatment are primarily gamblers' beliefs that they can solve their