Top

Published in:

01-09-2015 | Original Paper

Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia

Authors: David Smith, Peter Harvey, Rachel Humeniuk, Malcolm Battersby, Rene Pols

Published in: Journal of Gambling Studies | Issue 3/2015

Abstract

This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive–behavioural therapy. A cohort study at a state-wide gambling therapy service in South Australia. Primary outcome measure was rated by participants using victorian gambling screen (VGS) ‘harm to self’ sub-scale with validated cut score 21+ (score range 0–60) indicative of problem gambling behaviour. Secondary outcome measure was Work and Social Adjustment Scale (WSAS). Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale. We used propensity score adjusted random-effects models to estimate treatment outcomes for sub-populations of individuals from baseline to 12 month follow-up. Between July, 2010 and December, 2012, 380 participants were eligible for inclusion in the final analysis. Mean age was 44.1 (SD = 13.6) years and 211 (56 %) were males. At baseline, 353 (92.9 %) were diagnosed with a gambling disorder using VGS. For exposure, 175 (46 %) had a very high probability of a 12-month affective or anxiety disorder, 103 (27 %) in the high range and 102 (27 %) in the low to moderate range. For the main analysis, individuals experienced similar clinically significant reductions (improvement) in gambling related outcomes across time (p < 0.001). Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive–behavioural therapy in the mid-term.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental health disorders: DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.

Andrews, G., & Slade, T. (2001). Interpreting scores on the Kessler psychological distress scale (K10). Australian and New Zealand Journal of Public Health, 25, 494–497.CrossRefPubMed

Battersby, M., Oakes, J., Tolchard, B., Forbes, A., & Pols, R. (2008). Cognitive behavioural treatment for problem gamblers. In M. Zangeneh, A. Blaszczynski, & N. E. Turner (Eds.), In the pursuit of winning (pp. 179–197). New York: Springer.CrossRef

Battersby, M., Smith, D., Harvey, P., & Pols, R. (2013). Cognitive versus exposure therapy for problem gambling: A pilot randomised controlled trial. Victoria, Australia: Victorian Responsible Gambling Foundation.

Beck, A. T., & Dozois, D. J. A. (2011). Cognitive therapy: Current status and future directions. Annual Review of Medicine, 62(1), 397–409.CrossRefPubMed

Becona, E. (1996). Prevalence surveys of problem and pathological gambling in Europe: The cases of Germany, Holland and Spain. Journal of Gambling Studies, 12(2), 179–192.CrossRef

Ben-Tovim, D., Esterman, A., Tolchard, B., & Battersby, M. W. (2001). The victorian gambling screen: Project report. Melbourne: Victorian Research Panel.

Berkson, J. (1946). Limitations of the application of fourfold table analysis to hospital data. Biometrics Bulletin, 2(3), 47–53.CrossRefPubMed

Bondolfi, G., Osiek, C., & Ferrero, F. (2000). Prevalence estimates of pathological gambling in Switzerland. Acta Psychiatrica Scandinavica, 101(6), 473–475.CrossRefPubMed

Brown, R. I. F. (1987). Classical and operant paradigms in the management of gambling addictions. Behavioural Psychotherapy, 15(2), 111–122.CrossRef

Brown, R. A., Evans, D. M., Miller, I. W., Burgess, E. S., & Mueller, T. I. (1997). Cognitive–behavioral treatment for depression in alcoholism. Journal of Consulting and Clinical Psychology, 65(5), 715.PubMedCentralCrossRefPubMed

Carlbring, P., Jonsson, J., Josephson, H., & Forsberg, L. (2010). Motivational interviewing versus cognitive behavioral group therapy in the treatment of problem and pathological gambling: A randomized controlled trial. Cognitive Behaviour Therapy, 39(2), 92.PubMedCentralCrossRefPubMed

Cowlishaw, S., Merkouris, S., Dowling, N., Anderson, C., Jackson, A., & Thomas, S. (2012). Psychological therapies for pathological and problem gambling Cochrane Database of Systematic Reviews, Issue 11. Art. No.: CD008937. DOI:008910.001002/14651858.CD14008937.pub14651852.

Crisp, B. R., Thomas, S. A., Jackson, A. C., Thomason, N., Smith, S., Borrell, J., et al. (2000). Sex differences in the treatment needs and outcomes of problem gamblers. Research on Social Work Practice, 10(2), 229–242.

d’Agostino, R. B. (1998). Tutorial in biostatistics: Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Statistics in Medicine, 17(19), 2265–2281.CrossRefPubMed

Daughters, B., Lejuez, C. W., Lesieur, H. R., Strong, D. R., & Zvolensky, M. J. (2003). Towards a better understanding of gambling treatment failure: Implications of translational research. Clinical Psychology Review, 23(4), 573–586.CrossRefPubMed

Delfabbro, P. (2009). Australasian gambling review: Independent gambling authority of South Australia.

Dempster, A., Laird, N., & Rubin, D. (1977). Maximum likelihood from incomplete data via the EM algorithm. Journal of the Royal Statistical Society: Series B (Methodological), 39(1), 1–38.

Dowling, N. (2006). Treatment of female pathological gambling: The efficacy of a cognitive–behavioural approach. Journal of Gambling Studies, 22(4), 355.CrossRefPubMed

Government of South Australia: Consumer and Business Services. (2012). Gaming Machines Act 1992, Annual Report 2011–2012.

Gueorguieva, R., & Krystal, J. H. (2004). Move over ANOVA: Progress in analyzing repeated-measures data and its reflection in papers published in the archives of general psychiatry. Archives of General Psychiatry, 61(3), 310–317.CrossRefPubMed

Hides, L., Samet, S., & Lubman, D. I. (2010). Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use: Current evidence and directions for future research. Drug and Alcohol Review, 29(5), 508–517.CrossRefPubMed

Hodgins, D. C., Peden, N., & Cassidy, E. (2005). The association between comorbidity and outcome in pathological gambling: A prospective follow-up of recent quitters. Journal of Gambling Studies, 21(3), 255–271.CrossRefPubMed

Jackson, A., Thomas, S., & Blaszczynski, A. (2003). Best practice in problem gambling services. Melbourne: Gambling Research Panel.

Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., et al. (1996). A component analysis of cognitive–behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295–304.CrossRefPubMed

Jimenez-Murcia, S., Alvarez-Moya, E. M., Granero, R., Aymami, M., Gomez-Pena, M., Jaurrieta, N., et al. (2007). Cognitive–behavioral group treatment for pathological gambling: Analysis of effectiveness and predictors of therapy outcome. Psychotherapy Research, 17(5), 544–552.CrossRef

Kampman, M., Keijsers, G. P., Hoogduin, C. A., & Hendriks, G.-J. (2008). Outcome prediction of cognitive behaviour therapy for panic disorder: Initial symptom severity is predictive for treatment outcome, comorbid anxiety or depressive disorder, cluster C personality disorders and initial motivation are not. Behavioural and Cognitive Psychotherapy, 36(01), 99–112.CrossRef

Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., & Leblond, J. (2003). Group therapy for pathological gamblers: A cognitive approach. Behaviour Research and Therapy, 41(5), 587.CrossRefPubMed

Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., Leblond, J., et al. (2001). Cognitive treatment of pathological gambling. Journal of Nervous and Mental Disease, 189, 774–780.CrossRefPubMed

Laird, N., Lange, N., & Stram, D. (1987). Maximum likelihood computations with repeated measures: Application of the EM algorithm. Journal of the American Statistical Association, 82(397), 97–105.CrossRef

Längle, G., Steinert, T., Weiser, P., Schepp, W., Jaeger, S., Pfiffner, C., et al. (2012). Effects of polypharmacy on outcome in patients with schizophrenia in routine psychiatric treatment. Acta Psychiatrica Scandinavica, 125(5), 372–381.CrossRefPubMed

Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction, 106(3), 490–498.CrossRefPubMed

Marks, I., Lovell, K., Noshirvani, H., Livanou, M., & Thrasher, S. (1998). Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: A controlled study. Archives of General Psychiatry, 55(4), 317.CrossRefPubMed

McMillen, J., & Wenzel, M. (2006). Measuring problem gambling: Assessment of three prevalence screens. International Gambling Studies, 6(2), 147–174.CrossRef

Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The work and social adjustment scale: A simple measure of impairment in functioning. British Journal of Psychiatry, 180(5), 461–464.CrossRefPubMed

Nemeroff, C. B., Bremner, J. D., Foa, E. B., Mayberg, H. S., North, C. S., & Stein, M. B. (2006). Posttraumatic stress disorder: A state-of-the-science review. Journal of Psychiatric Research, 40(1), 1–21.

Oakes, J., Battersby, M., Pols, R., & Cromarty, P. (2008). Exposure therapy for problem gambling via videoconferencing: A case report. Journal of Gambling Studies, 24(1), 107–119.CrossRefPubMed

Ougrin, D. (2011). Efficacy of exposure versus cognitive therapy in anxiety disorders: Systematic review and meta-analysis. BMC Psychiatry, 11(1), 200.

Pasche, S. C., Sinclair, H., Collins, P., Pretorius, A., Grant, J. E., & Stein, D. J. (2013). The effectiveness of a cognitive–behavioral intervention for pathological gambling: A country-wide study. Annals of Clinical Psychiatry, 25(4), 250–256.PubMed

Petry, N. M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., et al. (2006). Cognitive–behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74(3), 555–567.CrossRefPubMed

Petry, N. M., & Hodgins, D. C. (2012). An introduction to Addiction’s new series on gambling. Addiction, 107(6), 1034–1035.CrossRefPubMed

Problem Gambling Research and Treatment Centre (PGRTC). (2011). Guideline for screening, assessment and treatment in problem gambling. Clayton: Monash University.

Rabe-Hesketh, S., & Skrondal, A. (2012). Multilevel and longitudinal modelling using Stata (3rd ed.). College Station, Texas: Stata Press.

Raylu, N., & Oei, T. (2004). The Gambling Related Cognitions Scale (GRCS): Development, confirmatory factor validation and psychometric properties. Addiction, 99(6), 757–769.CrossRefPubMed

Raylu, N., & Oei, T. P. (2010). A cognitive behavioural therapy programme for problem gambling: Therapist manual. Hove: Routledge.

Shaffer, H. J., & Hall, M. N. (2001). Updating and refining prevalence estimates of disordered gambling behaviour in the United States and Canada. Canadian Journal of Public Health, 92(3), 168–172.PubMed

Slade, T., Grove, R., & Burgess, P. (2011). Kessler Psychological Distress Scale: Normative data from the 2007 Australian National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Psychiatry, 45, 308–316.CrossRefPubMed

Smith, D. P., Battersby, M. W., Harvey, P. W., Pols, R. G., Baigent, M. F., & Oakes, J. O. (2011). The influence of depression and other co-occurring conditions on treatment outcomes for problem gamblers: A cohort study. The Medical Journal of Australia, 195(3), S56–S59.PubMed

Smith, D., Harvey, P., Battersby, M., Pols, R., Oakes, J., & Baigent, M. (2010). Treatment outcomes and predictors of drop out for problem gamblers in South Australia: A cohort study. Australian and New Zealand Journal of Psychiatry, 44, 911–920.CrossRefPubMed

Soberay, A., Faragher, J. M., Barbash, M., Brookover, A., & Grimsley, P. (2014). Pathological gambling, co-occurring disorders, clinical presentation, and treatment outcomes at a university-based counseling clinic. Journal of Gambling Studies, 30(1), 61–69.

StataCorp. (2013). Stata: Release 13. Statistical Software. College Station, TX: StataCorp LP.

Sylvain, C., Ladouceur, R., & Boisvert, J. M. (1997). Cognitive and behavioral treatment of pathological gambling: a controlled study. Journal of Consulting and Clinical Psychology, 65(5), 727–732.CrossRefPubMed

Tolchard, B., & Battersby, M. (2010). The Victorian Gambling Screen: Reliability and validity in a clinical population. Journal of Gambling Studies, 26, 623–638.CrossRefPubMed

Tolchard, B., Thomas, L., & Battersby, M. W. (2006). Single-session exposure therapy of problem gambling: A single case experimental design. Behaviour Change, 23(2), 148–155.

Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M. D., Constantine, R., et al. (2007). The British gambling prevalence survey. London: The Stationery Office.

West, B. T., Welch, K. B., & Galecki, A. T. (2007). Linear mixed models: A practical guide using statistical software. Boca Raton: Chapman & Hall/CRC.

Winters, K. C., & Kushner, M. G. (2003). Treatment issues pertaining to pathological gamblers with a comorbid disorder. Journal of Gambling Studies, 19(3), 261–277.CrossRefPubMed

Wong, D. F., Chung, C. L., Wu, J., Tang, J., & Lau, P. (2014). A preliminary study of an integrated and culturally attuned cognitive behavioral group treatment for Chinese problem gamblers in Hong Kong. Journal of Gambling Studies. doi:10.1007/s10899-014-9457-2.

Wong, I. L. K., & Ernest, M. T. S. (2003). Prevalence estimates of problem and pathological gambling in Hong Kong. The American Journal of Psychiatry, 160(7), 1353.CrossRefPubMed

Title: Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia
Authors: David Smith
Peter Harvey
Rachel Humeniuk
Malcolm Battersby
Rene Pols
Publication date: 01-09-2015
Publisher: Springer US
Published in: Journal of Gambling Studies / Issue 3/2015
Electronic ISSN: 1573-3602
DOI: https://doi.org/10.1007/s10899-014-9465-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of Affective and Anxiety Disorders on Outcome in Problem Gamblers Attending Routine Cognitive–Behavioural Treatment in South Australia

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2015

The Incidence of Problem Gambling in a Representative Cohort of Swedish Female and Male 16–24 Year-Olds by Socio-demographic Characteristics, in Comparison with 25–44 Year-Olds

First Evidence of Comorbidity of Problem Gambling and Other Psychiatric Problems in a Representative Urban Sample of South Africa

Validation of the Gambling Motives Questionnaire in Emerging Adults

Internet Gambling Among Community Adults and University Students in Macao

Smoking and Gambling Disorder: Does Tobacco Use Influence Treatment Outcome?

Upping the Reinforcement Rate by Playing the Maximum Lines in Multi-line Slot Machine Play