Dataset Information

Brief interventions for problem gambling: A meta-analysis.

ABSTRACT: 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.

SUBMITTER: Quilty LC

PROVIDER: S-EPMC6469774 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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Brief interventions for problem gambling: A meta-analysis.

Quilty Lena C LC Wardell Jeffrey D JD Thiruchselvam Thulasi T Keough Matthew T MT Hendershot Christian S CS

PloS one 20190417 4

<h4>Background</h4>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 da ...[more]

PMID: 30995229

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Project description:Gambling Disorder is a prevalent psychiatric condition often linked to dysfunction of cognitive domains regulating impulsive behavior. Despite the centrality of impulsivity to neurobiological models of Gambling Disorder, a comprehensive meta-analysis of all impulsive cognitive domains has yet to be conducted. It is also not clear whether cognitive deficits in Gambling Disorder extend to those with problem (at-risk) gambling. A systematic review was undertaken of case-control studies examining the following cognitive domains in Gambling Disorder or in at-risk (problem) gambling: attentional inhibition, motor inhibition, discounting, decision-making, and reflection impulsivity. Case-control differences in cognition were identified using meta-analysis (random-effects modeling). Moderation analysis explored potential influences of age, gender, presence/absence of comorbidities in cases, geographical region, and study quality on cognitive performance. Gambling Disorder was associated with significant impairments in motor (g = 0.39-0.48) and attentional (g = 0.55) inhibition, discounting (g = 0.66), and decision-making (g = 0.63) tasks. For problem gambling, only decision-making had sufficient data for meta-analysis, yielding significant impairment versus controls (g = 0.66); however, study quality was relatively low. Insufficient data were available for meta-analysis of reflection impulsivity. There was evidence for significant publication bias only for the discounting domain, after an outlier study was excluded. Study quality overall was reasonable (mean score 71.9% of maximum), but most studies (~85%) did not screen for comorbid impulse control and related disorders. This meta-analysis indicates heightened impulsivity across a range of cognitive domains in Gambling Disorder. Decision-making impulsivity may extend to problem (at-risk) gambling, but further studies are needed to confirm such candidate cognitive vulnerability markers.

Project description:BackgroundThis study seeks to give an overview of academic research on internet-based interventions that are used to address problem gambling. The rate of treatment seeking has been demonstrated to be low across several research environments. This is in part because of the systemic barriers that treatment seekers face to accessing traditional face-to-face treatment. Making treatment resources for problem gambling available through the internet is one way to reduce the impact of those systemic barriers. The use of internet-based resources to address problem gambling has been growing, and a field of research evaluating it has developed as well. However, little has been done to summarize this collection of research.ObjectiveThis study aimed to provide a scoping review of the use of internet-based interventions for problem gambling treatment and prevention to provide an understanding of the current state of the field.MethodsA scoping review was performed for 6 peer-reviewed research databases (Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Social Science Abstracts, and Scopus) and 3 gray literature databases (MedEdPortal, Proquest: Dissertations, and OpenGrey). Article inclusion criteria were as follows: published over the 10-year period of 2007 to 2017, including an intervention for problem gambling, and involving the use of internet to deliver that intervention.ResultsA total of 27 articles were found that met the review criteria. Studies were found from several different areas, with particularly strong representation for Australia, New Zealand, and Scandinavia. Cognitive behavioral therapy was the most common form of internet-based intervention. Internet-based interventions were generally shown to be effective in reducing problem gambling scores and gambling behaviors. A wide range of interventions that made use of internet resources included text-based interactions with counselors and peers, automated personalized and normative feedback on gambling behaviors, and interactive cognitive behavioral therapies. A lack of diversity in samples, little comparison with face-to-face interventions, and issues of changes in the treatment dynamic are identified as areas that require further investigation.ConclusionsInternet-based interventions are a promising direction for treatment and prevention of problem gambling, particularly in reducing barriers to accessing professional help. The state of the current literature is sparse, and more research is needed for directly comparing internet-based interventions and their traditional counterparts.

Dataset Information

Brief interventions for problem gambling: A meta-analysis.

Publications

Brief interventions for problem gambling: A meta-analysis.

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