Treatment for the addictions in a psychiatric setting

Pathological gambling and switching addictions: Report of a case

The phenomenon of "switching addictions," defined as a substitution of one chemical or behavioral addiction pattern for another, has been observed in clinical practices for some time. This case study describes a patient who, in attaining abstinence from alcohol and other drug dependence, became a pathological gambler. The complexities of personal history, medical history and psychiatric history are described as well problems in treatment.

Validity Study of the South Oaks Gambling Screen (SOGS) among distinct groups of Brazilian gamblers

OBJECTIVE: The main objective of this study was to assess the internal consistency and to perform a factor analysis of the Brazilian version of the SOGS - South Oaks Gambling Screen - scale, as well as its ability to discriminate between different profiles of gamblers. METHOD: Two hundred and seventeen subjects were enrolled in the study: 46 gamblers under treatment at the Gamblers Treatment Unit of PROAD - Program for Orientation and Attention of Dependent Persons- of the Federal University of São Paulo; 96 social gamblers and 75 subjects screened as pathological gamblers recruited at the local Jockey Club, video poker and bingo clubs. RESULTS: Differences in the score means of all three groups were statistically significant and were able to discriminate between social gamblers, pathological gamblers interviewed in a gambling site and the clinical sample. The internal consistency of the 20-item scale measured by Cronbach's alpha was 0.9304. Factor analysis resulted in a three-dimensional solution accounting for 58,6% of the total variance: a first factor composed mainly by questions related to the consequences of gambling; a second factor encompassing questions related to the gambling behavior of pathological gamblers; and a third and less expressive factor involving only two questions, probably a hybrid one of difficult interpretation. CONCLUSIONS: The Brazilian version of the SOGS was a useful screen to discriminate Brazilian pathological gamblers from social gamblers as well as to differentiate clinical pathological from non-clinical pathological gamblers, and to identify different levels of severity.

Cognitive treatment of pathological gambling

This study evaluated the efficacy of a cognitive treatment package for pathological gambling. Sixty-six gamblers, meeting DSM-IV criteria for pathological gambling, were randomly assigned to treatment or wait-list control conditions. Cognitive correction techniques were used first to target gamblers' erroneous perceptions about randomness and then to address issues of relapse prevention. The dependent measures used were the South Oaks Gambling Screen, the number of DSM-IV criteria for pathological gambling met by participants, as well as gamblers' perception of control, frequency of gambling, perceived self-efficacy, and desire to gamble. Posttest results indicated highly significant changes in the treatment group on all outcome measures, and analysis of data from 6- and 12-month follow-ups revealed maintenance of therapeutic gains. Recommendations for clinical interventions are discussed, focusing on the cognitive correction of erroneous perceptions toward the notion of randomness.

Cognitive treatment of pathological gamblers

This study evaluates the efficacy of a cognitive treatment for pathological gambling. Five pathological gamblers were treated in a multiple baseline across subjects design. Cognitive correction targeted the erroneous perceptions towards the notion of randomness. Four subjects reported a clinically significant decrease in the urge to gamble, an increase in their perception of control, and no longer met the DSM-IV criteria for pathological gambling. Therapeutic gains were maintained at the 6 month follow-up. Results suggest that cognitive therapy targeting the misconception of the notion of randomness is a promising treatment for pathological gambling, a refractory disorder to most therapeutic interventions.

Prevalence of pathological gambling and related problems among college students in the Quebec metropolitan area

The prevalence of pathological gambling and problems associated with it were measured among 1,471 students of three colleges in the Quebec city metropolitan area. Almost 90% of the students had gambled and 21.7% of the students engage in this behaviour once a week or more. The prevalence of pathological gamblers was found to be 2.8% for the entire sample. The percentage of pathological gamblers was much higher among males (5.7%) than females (0.6%). The results indicate that pathological gambling is associated with economic, professional and interpersonal problems. The discussion addresses the implications of the present findings and suggests avenues for future research.

Evaluation of patients treated for pathological gambling in a combined alcohol, substance abuse and pathological gambling treatment unit using the Addiction Severity Index

Seventy-two pathological gambling patients were followed-up after treatment in a combined alcohol, substance abuse and compulsive gambling treatment program. The Addiction Severity Index (modified for use with pathological gamblers) was used to evaluate the effectiveness of treatment. Patients reduced their intake of alcohol, other drugs and their gambling as well as improved in legal, family/social, and psychological functioning. There was a trend for improvement in medical condition and no net change in employment functioning. The study supports the idea that combined treatment is an effective way of dealing with patients whose gambling problems are discovered when they enter treatment for another addiction, as well as for patients whose initial complaints include pathological gambling, with or without additional problems.

Gambling and pathological gambling among university students

Students from six colleges and universities in five states in the U.S. (New York, New Jersey, Oklahoma, Texas, and Nevada) were surveyed concerning their gambling behavior and the rate of pathological gambling. Type of gambling varied by state, with students in the northeast and Nevada gambling more than students in Oklahoma and Texas. Over 90% of males and 82% of females had gambled. One third of the males and 15% of females gambled once a week or more. Rates of pathological gambling ranged from 8% in New York to 4% in Nevada. The incidence of pathological gambling was high among males, Hispanics, Asians, and Italian-Americans (compared with among other whites), students with non-traffic arrests, those with parents who have gambling problems, and those who abuse alcohol and other drugs. Pathological gambling was only weakly correlated with age, religion, lower grade point average in school, overeating, living in neighborhoods that are "poorer than most," family income, and parental drug use. It was not correlated with academic year in college, marital status, parental occupation, parental alcohol, and bulimic behavior. The implications of the findings for further research and social policy are discussed.