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Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial.

ABSTRACT: The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population.Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitive-behavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduction tips, delivered in a motivational interviewing style. CBI was delivered in small groups over four to six sessions and included functional analysis and brief cognitive correction, as well as identification of and alternatives for responding to gambling triggers.College campus.At-risk or probable pathological gamblers (n = 147; 65.3% male; group assignment: PFI, n = 52; CBI, n = 44; AOC, n = 51).Self-reported gambling quantity, frequency, consequences, psychopathology, normative perceptions and beliefs.Relative to control, results at 6-month follow-up indicated reductions in both interventions for gambling consequences (PFI d = 0.48; CBI d = 0.39) and DSM-IV criteria (PFI d = 0.60; CBI d = 0.48), reductions in frequency for PFI (d = 0.48). CBI was associated with reduced illusions of control, whereas PFI was associated with reduced perceptions of gambling frequency norms. Reductions in perceived gambling frequency norms mediated effects of PFI on gambling frequency.A single-session personalized feedback intervention and a multi-session cognitive-behavioral intervention may be helpful in reducing disordered gambling in US college students.

SUBMITTER: Larimer ME

PROVIDER: S-EPMC3528181 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial.

Larimer Mary E ME Neighbors Clayton C Lostutter Ty W TW Whiteside Ursula U Cronce Jessica M JM Kaysen Debra D Walker Denise D DD

Addiction (Abingdon, England) 20120228 6

<h4>Aims</h4>The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population.<h4>Design</h4>Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitive-behavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduc ...[more]

PMID: 22188239

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Project description:BACKGROUND:Brief interventions have been increasingly investigated to promote early intervention in gambling problems; an accurate estimate of the impact of these interventions is required to justify their widespread implementation. The goal of the current investigation was to evaluate the efficacy of in-person brief interventions for reducing gambling behaviour and/or problems, by quantifying the aggregate effect size associated with these interventions in the published literature to date. METHODS:Randomized controlled trials including the following design features were identified via systematic review: an adult sample experiencing problems associated with gambling; an in-person individual psychosocial intervention of brief duration (≤3 sessions); a control/comparison group; and an outcome related to gambling behaviour and/or problems. RESULTS:Five records compared brief interventions to assessment only control; using a random effect model, brief interventions were associated with a small but statistically significant reduction in gambling behaviour across short-term follow-up periods versus assessment only control (g = -.19, 95% CI [-.37, -.01]). Aggregate effect sizes for gambling problems and long-term follow-up periods were not statistically significant. Five records compared brief interventions to longer active interventions; there was no significant difference between brief interventions and longer active interventions. CONCLUSIONS:Results supported the efficacy of brief interventions for problem gambling compared to inactive control in the reduction of gambling behaviour; no differences were found across brief versus longer interventions for both gambling behaviour and problems. While these findings must be interpreted in the context of the limited number of studies and small magnitude of the combined effect sizes, the current meta-analysis supports the further investigation of the public health impact of these cost-effective interventions.

Project description:Various therapeutic approaches are available for the treatment of gambling disorder (GD), especially cognitive behavioral therapy (CBT; the most widely used treatment). However, CBT has high dropout and relapse rates as well as non-compliance issues, which may be partly due to resistance to changing core characteristics, such as executive functioning, attention, and emotional regulation abnormalities. Finding new therapeutic approaches to treat GD is thus a key challenge. Cognitive remediation (CR) interventions represent a promising approach to GD management, which has recently been demonstrated to have efficacy for treating other addictive disorders. The objective of this review is to describe the possible benefits of CR interventions for GD management. Two systematic searches in MEDLINE and ScienceDirect databases were conducted up until January 2017. Potential neurocognitive targets of CR interventions for GD were reviewed, as is the use and efficacy of such interventions for GD. While there is evidence of several neurocognitive deficits in individuals with GD in terms of impulsive, reflective, and interoceptive processes, the literature on CR interventions is virtually absent. No clinical studies were found in the literature, apart from a trial of a very specific program using Playmancer, a serious videogame, which was tested in cases of bulimia nervosa and GD. However, neurocognitive impairments in individuals with addictive disorders are highly significant, not only affecting quality of life, but also making abstinence and recovery more difficult. Given that CR interventions represent a relatively novel therapeutic approach to addiction and that there is currently a scarcity of studies on clinical populations suffering from GD, further research is needed to examine the potential targets of such interventions and the effectiveness of different training approaches. So far, no consensus has been reached on the optimal parameters of CR interventions (duration, intensity, frequency, group vs. individual, pencil-and-paper vs. computerized delivery, etc.). Although no firm conclusions can be drawn, CR interventions represent a promising adjunct treatment for GD. Such a novel therapy could be associated with common interventions, such as CBT and educational and motivational interventions, in order to make therapies more effective and longer-lasting and to decrease the risk of relapse.

Dataset Information

Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial.

Publications

Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: a randomized clinical trial.

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