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Published in: International Journal of Mental Health and Addiction 1/2023

14-01-2022 | Mood Disorders | Original Article

Dropout or Early Treatment Response Among Gamblers with Depressive Symptoms

Authors: Michael D. Campos, Ryan C. Williams, Vandana Joshi, Elizabeth Hall, Rory Reid, Richard J. Rosenthal, Timothy W. Fong

Published in: International Journal of Mental Health and Addiction | Issue 1/2023

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Abstract

Many individuals who start psychotherapy for gambling disorder leave treatment within the first five sessions. Researchers have viewed early dropouts as treatment failures, but some may be early responders. This study examined dropout and early treatment response among those with probable depression in the first six therapy sessions of a gambling problem treatment program. The percentage of individuals who dropped out of treatment was 37%. Dropout was highest after the intake session and decreased at each subsequent session. We identified a group of early treatment responders who showed reduced depressive symptoms and improvement on gambling-related variables. This group made up about 12% of the total sample and about half of those traditionally viewed as in-treatment dropouts. Demographic and gambling history/behavior variables were not associated with early treatment response. Baseline depression severity, number of sessions attended, change scores for gambling’s interference with normal activities, and overall life satisfaction, as well as meeting one’s intake gambling-related treatment goal, were associated with early treatment response. Study findings suggest that some may be early treatment responders, even those who leave psychotherapy after the first few sessions.
Literature
go back to reference Abend, R., Dan, O., Maoz, K., Raz, S., & Bar-Haim, Y. (2014). Reliability, validity and sensitivity of a computerized visual analog scale measuring state anxiety. Journal of Behavior Therapy Adn Experimental Psychiatry, 45, 447–453.CrossRef Abend, R., Dan, O., Maoz, K., Raz, S., & Bar-Haim, Y. (2014). Reliability, validity and sensitivity of a computerized visual analog scale measuring state anxiety. Journal of Behavior Therapy Adn Experimental Psychiatry, 45, 447–453.CrossRef
go back to reference Alvarez-Moya, E. M., Ochoa, C., Jimenez-Murcia, S., Aymami, M. N., Gomez-Pena, M., Fernandez-Aranda, F., … Menchon, J. M. (2011). Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathological gambling. Journal of Psychiatry and Neuroscience, 36(3), 165–175. Alvarez-Moya, E. M., Ochoa, C., Jimenez-Murcia, S., Aymami, M. N., Gomez-Pena, M., Fernandez-Aranda, F., … Menchon, J. M. (2011). Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathological gambling. Journal of Psychiatry and Neuroscience, 36(3), 165–175.
go back to reference Aragay, N., Jimenez-Murcia, S., Granero, R., Fernandez-Aranda, F., Ramos-Grille, I., Cardona, S., … Valles, V. (2015). Pathological gambling: Understanding relapses and dropouts. Comprehensive Psychiatry, 57, 58–64. Aragay, N., Jimenez-Murcia, S., Granero, R., Fernandez-Aranda, F., Ramos-Grille, I., Cardona, S., … Valles, V. (2015). Pathological gambling: Understanding relapses and dropouts. Comprehensive Psychiatry, 57, 58–64.
go back to reference Beard, C., Hsu, K. J., Rifkin, L. S., Busch, A. B., & Bjorgvinsson, T. (2016). Validation of the PHQ-9 in a psychiatric sample. Journal of Affective Disorders, 193, 267–273.CrossRef Beard, C., Hsu, K. J., Rifkin, L. S., Busch, A. B., & Bjorgvinsson, T. (2016). Validation of the PHQ-9 in a psychiatric sample. Journal of Affective Disorders, 193, 267–273.CrossRef
go back to reference Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory - II. Psychological Corporation. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory - II. Psychological Corporation.
go back to reference Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2), 205–219.CrossRef Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2), 205–219.CrossRef
go back to reference Echeburua, E., Baez, C., & Fernandez-Montalvo, J. (1996). Comparative effectiveness of three therapeutic modalities in the psychological treatment of pathological gambling: Long-term outcome. Behavioural and Cognitive Psychotherapy, 24(1), 51–72.CrossRef Echeburua, E., Baez, C., & Fernandez-Montalvo, J. (1996). Comparative effectiveness of three therapeutic modalities in the psychological treatment of pathological gambling: Long-term outcome. Behavioural and Cognitive Psychotherapy, 24(1), 51–72.CrossRef
go back to reference Echeburua, E., Fernandez-Montalvo, J., & Baez, C. (2001). Predictors of therapeutic failure in slot-machine pathological gamblers following behavioural treatment. Behavioural and Cognitive Psychotherapy, 29(3), 379–383.CrossRef Echeburua, E., Fernandez-Montalvo, J., & Baez, C. (2001). Predictors of therapeutic failure in slot-machine pathological gamblers following behavioural treatment. Behavioural and Cognitive Psychotherapy, 29(3), 379–383.CrossRef
go back to reference Frosini, D., Pesaresi, I., Cosottini, M., Belmonte, G., Rossi, C., Dell’Osso, L., … Ceravolo, R. (2010). Parkinson’s disease adn pathological gambling: Results from a functional MRI study. Movement Disorders, 25(14), 2449–2453. Frosini, D., Pesaresi, I., Cosottini, M., Belmonte, G., Rossi, C., Dell’Osso, L., … Ceravolo, R. (2010). Parkinson’s disease adn pathological gambling: Results from a functional MRI study. Movement Disorders, 25(14), 2449–2453.
go back to reference Haas, E., Hill, R. D., Lambert, M. J., & Morrell, B. (2002). Do early responders to psychotherapy maintain treatment gains? Journal of Clinical Psychology, 58(9), 1157–1172.CrossRef Haas, E., Hill, R. D., Lambert, M. J., & Morrell, B. (2002). Do early responders to psychotherapy maintain treatment gains? Journal of Clinical Psychology, 58(9), 1157–1172.CrossRef
go back to reference Hodgins, D. C., & Makarchuk, K. (2003). Trusting problem gamblers: Reliability and validity of self-reported gambling behavior. Psychology of Addictive Behaviors, 17(3), 244–248.CrossRef Hodgins, D. C., & Makarchuk, K. (2003). Trusting problem gamblers: Reliability and validity of self-reported gambling behavior. Psychology of Addictive Behaviors, 17(3), 244–248.CrossRef
go back to reference Hodgins, D. C., Currie, S. R., & el-Guebaly, N. . (2001). Motivational enhancement and self-help treatments for problem gambling. Journal of Consulting and Clinical Psychology, 69(1), 50–57.CrossRef Hodgins, D. C., Currie, S. R., & el-Guebaly, N. . (2001). Motivational enhancement and self-help treatments for problem gambling. Journal of Consulting and Clinical Psychology, 69(1), 50–57.CrossRef
go back to reference Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19.CrossRef Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19.CrossRef
go back to reference Jimenez-Murcia, S., Alvarez-Moya, E. M., Granero, R., Aymami, M. N., Gomez-Pena, M., Jaurrieta, N., … Vallejo, J. (2007). Cognitive-behavioral group treatment for pathological gambling: Analysis of effectiveness and predictors of therapy outcome. Psychotherapy Research, 17(5), 544–552. Jimenez-Murcia, S., Alvarez-Moya, E. M., Granero, R., Aymami, M. N., Gomez-Pena, M., Jaurrieta, N., … Vallejo, J. (2007). Cognitive-behavioral group treatment for pathological gambling: Analysis of effectiveness and predictors of therapy outcome. Psychotherapy Research, 17(5), 544–552.
go back to reference Kim, S. W., Grant, J. E., Eckert, E. D., Faris, P. L., & Hartman, B. K. (2006). Pathological gambling and mood disorders: Clinical associations and treatment implications. Journal of Affective Disorders, 92, 109–116.CrossRef Kim, S. W., Grant, J. E., Eckert, E. D., Faris, P. L., & Hartman, B. K. (2006). Pathological gambling and mood disorders: Clinical associations and treatment implications. Journal of Affective Disorders, 92, 109–116.CrossRef
go back to reference Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509–515.CrossRef Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509–515.CrossRef
go back to reference Kroenke, K., Spitzer, R., & Williams, J. W. (2001). The PHQ-9: Validity of a brief depression measure. Journal of General Internal Medicine, 16, 606–613.CrossRef Kroenke, K., Spitzer, R., & Williams, J. W. (2001). The PHQ-9: Validity of a brief depression measure. Journal of General Internal Medicine, 16, 606–613.CrossRef
go back to reference Ladouceur, R., Sylvain, C., Boutin, C. L., Doucet, C., Leblond, J., & Christian, J. (2001). Cognitive treatment of pathological gambling. The Journal of Nervous and Mental Disease, 189(11), 774–780.CrossRef Ladouceur, R., Sylvain, C., Boutin, C. L., Doucet, C., Leblond, J., & Christian, J. (2001). Cognitive treatment of pathological gambling. The Journal of Nervous and Mental Disease, 189(11), 774–780.CrossRef
go back to reference Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., & Doucet, C. L. (2003). Group therapy for pathological gamblers: A cognitive approach. Behaviour Research and Therapy, 41(5), 587–596.CrossRef Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., & Doucet, C. L. (2003). Group therapy for pathological gamblers: A cognitive approach. Behaviour Research and Therapy, 41(5), 587–596.CrossRef
go back to reference Leblond, J., Ladouceur, R., & Blaszczynski, A. (2010). Which pathological gamblers will complete treatment? British Journal of Clinical Psychology, 42(2), 205–209.CrossRef Leblond, J., Ladouceur, R., & Blaszczynski, A. (2010). Which pathological gamblers will complete treatment? British Journal of Clinical Psychology, 42(2), 205–209.CrossRef
go back to reference 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.CrossRef 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.CrossRef
go back to reference Lowe, B., Unutzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004). Monitoring depression treatment outcomes with the patient health questionnaire-9. Medical Care, 42, 1194–1201.CrossRef Lowe, B., Unutzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004). Monitoring depression treatment outcomes with the patient health questionnaire-9. Medical Care, 42, 1194–1201.CrossRef
go back to reference Mallorqui-Bague, N., Mestre-Bach, G., Lozano-Madrid, M., Fernandez-Aranda, F., Granero, R., Alcaraz, C. V., … Jiménez-Murcia, S. (2018). Trait impulsivity and cognitive domains involving impulsivity and compulsivity as predictors of gambling disorder treatment response. Addictive Behaviors, 87, 169–176. Mallorqui-Bague, N., Mestre-Bach, G., Lozano-Madrid, M., Fernandez-Aranda, F., Granero, R., Alcaraz, C. V., … Jiménez-Murcia, S. (2018). Trait impulsivity and cognitive domains involving impulsivity and compulsivity as predictors of gambling disorder treatment response. Addictive Behaviors, 87, 169–176.
go back to reference McCallum, F., Blaszczynski, A., Ladouceur, R., & Nower, L. (2007). Functional and dsyfunctional impulsivity in pathological gambling. Personality and Individual Differences, 43, 1829–1838.CrossRef McCallum, F., Blaszczynski, A., Ladouceur, R., & Nower, L. (2007). Functional and dsyfunctional impulsivity in pathological gambling. Personality and Individual Differences, 43, 1829–1838.CrossRef
go back to reference McMillan, D., Gilbody, S., & Richards, D. (2010). Defining successful treatment outcome in depression using the PHQ-9: A comparison on methods. Journal of Affective Disorders, 127, 122–129.CrossRef McMillan, D., Gilbody, S., & Richards, D. (2010). Defining successful treatment outcome in depression using the PHQ-9: A comparison on methods. Journal of Affective Disorders, 127, 122–129.CrossRef
go back to reference Melville, K. M., Casey, L. M., & Kavanagh, D. J. (2007). Psychological treatment dropout among pathological gamblers. Clinical Psychology Review, 27, 944–958.CrossRef Melville, K. M., Casey, L. M., & Kavanagh, D. J. (2007). Psychological treatment dropout among pathological gamblers. Clinical Psychology Review, 27, 944–958.CrossRef
go back to reference Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18(2), 207–229.CrossRef Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18(2), 207–229.CrossRef
go back to reference Moghaddam, J. F., Campos, M. D., Reid, R. C., & Fong, T. W. (2015). A longitudinal examination of depression among gambling inpatients. Journal of Gambling Studies, 31, 1245–1255.CrossRef Moghaddam, J. F., Campos, M. D., Reid, R. C., & Fong, T. W. (2015). A longitudinal examination of depression among gambling inpatients. Journal of Gambling Studies, 31, 1245–1255.CrossRef
go back to reference Pelletier, O., Ladouceur, R., & Rheaume, J. (2008). Personality disorders and pathological gambling: Comorbidity and treatment dropout predictors. International Gambling Studies, 8(3), 299–313.CrossRef Pelletier, O., Ladouceur, R., & Rheaume, J. (2008). Personality disorders and pathological gambling: Comorbidity and treatment dropout predictors. International Gambling Studies, 8(3), 299–313.CrossRef
go back to reference Petry, N. M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., … Stienberg, K. (2006). Cognitive-behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74(3), 555–567. Petry, N. M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., … Stienberg, K. (2006). Cognitive-behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74(3), 555–567.
go back to reference Robson, E., Edwards, J., Smith, G., & Colman, I. (2002). Gambling decisions: An early intervention program for problem gamblers. Journal of Gambling Studies, 18(3), 235–255.CrossRef Robson, E., Edwards, J., Smith, G., & Colman, I. (2002). Gambling decisions: An early intervention program for problem gamblers. Journal of Gambling Studies, 18(3), 235–255.CrossRef
go back to reference 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 & New Zealand Journal of Psychiatry, 44(10), 911–920.CrossRef 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 & New Zealand Journal of Psychiatry, 44(10), 911–920.CrossRef
go back to reference Spitzer, R. L., Williams, J. B., Kroenke, K., & Colleagues, & . . (2014). Test reviews: Patient health questionnaire-9 (PHQ-9). Rehabilitation Counseling Bulletin, 57(4), 246–248.CrossRef Spitzer, R. L., Williams, J. B., Kroenke, K., & Colleagues, & . . (2014). Test reviews: Patient health questionnaire-9 (PHQ-9). Rehabilitation Counseling Bulletin, 57(4), 246–248.CrossRef
go back to reference Sylvan, 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.CrossRef Sylvan, 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.CrossRef
go back to reference Wulfert, E., Blanchard, E. B., Freidenberg, B. M., & Martell, R. S. (2006). Retaining pathological gamblers in cognitive behavior therapy through motivational enhancement: A pilot study. Behavior Modification, 30(3), 315–340.CrossRef Wulfert, E., Blanchard, E. B., Freidenberg, B. M., & Martell, R. S. (2006). Retaining pathological gamblers in cognitive behavior therapy through motivational enhancement: A pilot study. Behavior Modification, 30(3), 315–340.CrossRef
go back to reference Zack, M., & Poulus, C. (2007). A D2 antagonist enhances the rewarding and priming effects of a gambling episode in pathological gamblers. Neuropsychopharmacology, 32, 1678–1686.CrossRef Zack, M., & Poulus, C. (2007). A D2 antagonist enhances the rewarding and priming effects of a gambling episode in pathological gamblers. Neuropsychopharmacology, 32, 1678–1686.CrossRef
Metadata
Title
Dropout or Early Treatment Response Among Gamblers with Depressive Symptoms
Authors
Michael D. Campos
Ryan C. Williams
Vandana Joshi
Elizabeth Hall
Rory Reid
Richard J. Rosenthal
Timothy W. Fong
Publication date
14-01-2022
Publisher
Springer US
Published in
International Journal of Mental Health and Addiction / Issue 1/2023
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI
https://doi.org/10.1007/s11469-021-00586-z

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