More is Better: A Meta-Analysis of Dose and Efficacy in Face-to-Face Psychological Treatments for Gambling Disorder

More is Better: A Meta-Analysis of Dose and Efficacy in Face-to-Face Psychological Treatments for Gambling Disorde

Predicting Psychotherapy Session Attendance among Individuals Experiencing Gambling-Related Harms

Almost 2 in 5 individuals experiencing gambling-related harms will initiate treatment and then prematurely discontinue. However, studies have proven unsuccessful in identifying a consistent set of variables that predict discontinuation. The absence of consistent findings may be attributed to 1) disparate definitions of discontinuation and 2) the focus on demographic variables rather than personal history variables that might impact the receipt of treatment. The present study intends to improve upon existing research by focusing on treatment participation (i.e., number of sessions attended) rather than discontinuation and examining a broader set of variables that are specific to an individual’s gambling and financial status before deciding to enter treatment (i.e., pretreatment abstinence, bankruptcy, debt). Archival data from a sample of 128 patients receiving treatment for gambling-related harms at an outpatient treatment facility will be analyzed. On average, participants are 45 years old and predominantly men (55.8%) who represent diverse races (58% White and 37% Black). Participants completed a battery of self-report questions assessing for demographic information, pre-treatment financial status, and gambling history. Linear regressions and independent samples t-tests will be used. Implications: These results may elucidate a relation between previously unexplored variables and psychotherapy session attendance. We anticipate that this finding would enhance clinicians’ ability to identify patients at risk of low treatment engagement. It may also inform future research intending to mitigate the risk of low engagement through targeted interventions

Does Twitter User Activity Promote Gambling-Related Content?

Social media has provided gambling operators with access to millions of individuals and novel ways to promote gambling. Research has suggested that exposure to gambling advertisements on social media platforms is associated with increased gambling in individuals at-risk for problem gambling. These findings bring into question whether social media platforms are sensitive to differences in user account activity (e.g., tweets, likes, accounts visited) when displaying advertisements and gambling-related content. To assess for these differences, four Twitter accounts were created and assigned to send out tweets containing pro-wagering versus safe-wagering-related messages. Additionally, one of each account was assigned to interact with Twitter profiles associated with gambling operators or responsible gambling. Accounts were assessed daily for advertisement traffic and gambling-related content from January to March 2022. The study included three phases that implemented changes in privacy settings, websites visited, and gambling-related tweets observed. To assess for between-phase differences, Tau-U analyses were performed using R. No gambling advertisements were observed throughout the study. Nongambling advertisements remained constant across all accounts. Gambling-related content observed depended on assigned account activity. Accounts that interacted with gambling operators’ profiles were only displayed pro-wagering-related content. Conversely, accounts that interacted with responsible gambling profiles were only displayed safe-wagering-related content. Findings suggest that Twitter is sensitive to differences in account activity. Social media platforms’ ethical obligations have been a topic of concern. However, it seems that the type of gambling-related content displayed on Twitter largely depends on the user’s activity, thus, placing responsibility for what is displayed on the user

Measurement Models Matter: How Retrospective Calendar Versus Global Reports Yield Different Estimates of Treatment Outcome

Abstract: Retrospective reports are less accurate than objective measures of behavior and must be interpreted with consideration of the amount of distortion and error introduced by this methodology. The Gambling-Timeline Followback (G-TLFB) method is the gold standard retrospective assessment tool that is designed to minimize such error by asking for a specific recall of precise gambling behavior day-by-day using recall aids as compared to a global summation over time (e.g., how many gambling days in last month, how much money gambled in the last month). It remains an empirical question whether this difference in measurement format, G-TLFB versus global reports, alters the estimates of gambling treatment efficacy. Eighteen studies were identified for inclusion in a meta-analysis to explore this question. A mixed-effects subgroup analysis indicated that the effect of treatment relative to nonactive control on gambling frequency at posttreatment was significantly lower for studies using the G-TLFB (g = -0.20) than studies using other assessments (g = -0.71). There was no significant difference in the effect of treatment relative to nonactive control on gambling intensity at posttreatment between studies using the G-TLFB (g = -0.22) and studies using other assessments (g = -0.38). Implications: The G-TLFB yields more conservative and likely more precise estimates of the effect of gambling treatment on gambling frequency but not intensity than other retrospective assessments. The use of global retrospective assessments to assess gambling frequency and intensity may overestimate effects of gambling treatment on gambling frequency

Does Gambling-Focused Treatment Affect Mental Health and Quality of Life? A Systematic Review and Meta-Analysis

Abstract: Cognitive-behavioral (CB) techniques have received substantial empirical support for reducing gambling disorder symptoms and behavior. What has not been established is whether gambling-focused treatment reduces psychological problems and improves quality of life. Individuals experiencing gambling-related harms report that sustained recovery involves changing both gambling behaviors and psychological problems and building a meaningful life. The current systematic review and meta-analysis aimed to examine the effect of CB techniques targeting gambling harms on nontargeted outcomes such as psychological problems and quality of life. Following PRISMA guidelines, a systematic article search was conducted to locate published studies of randomized controlled trials of CB techniques targeting gambling harms and reporting nontargeted outcomes. Random effects meta-analysis was used to quantify the effect of CB techniques on nontargeted outcomes. Ten studies representing 797 participants were included. Eight studies reported the effect of CB techniques on anxiety, 8 on depression, 3 on substance use, and 7 on quality of life. CB techniques significantly reduced anxiety (g = -0.44), depression (g = -0.35), gambling frequency (g = -0.30), and gambling intensity (g = -0.36) at posttreatment, but not substance use. CB techniques also significantly improved quality of life (g = 0.39) at posttreatment. Implications: The targeted reduction of gambling harms may serve as a mechanism of change for reducing psychological problems and improving quality of life. Future studies should employ longitudinal designs to understand the associations between gambling reductions and changes in nontargeted recovery outcomes over time

Transdiagnostic prevention and intervention efforts are needed to address executive dysfunction

Abstract: Executive functioning (EF) is a multi-faceted construct important to activities of daily living, emotion regulation, and higher-order thinking and is often impaired in individuals with gambling disorder and/or alcohol use disorders. Deficits in EF are associated with poor treatment engagement, psychiatric comorbidities, and relapse. The present study examined EF in college students (N = 832) aged 18-24 (M= 19.23, SD=1.37, 76.5% Women) in relation to gambling and hazardous drinking. The Barkley’s Deficits in Executive Functioning was used to assess for global EF and 5 facets of EF: Time Management, Organization/Problem Solving, Self-Restraint, Self-Motivation, and Emotion-Regulation. Bivariate correlation and ANOVA analyses were conducted. Approximately 3% of college students reported problem gambling and 20% reported engagement in hazardous drinking. Compared to individuals with non-problem drinking and non-problem gambling: (1) individuals with problem gambling had worse global EF, self-restraint, emotion regulation, and self-motivation, (2) individuals with hazardous drinking had worse Global EF, self-restraint, and emotion regulation and (3) individuals with both problem gambling and hazardous drinking had worse EF on self-restraint. Implications: Impairments in several domains of EF (e.g., inhibition/self-restraint, emotion regulation, and self-motivation) were endorsed at a significantly higher rate among problematic gamblers and hazardous drinkers. Results partially support the pathways model of gambling (Blaszcynski & Nower, 2002) and support transdiagnostic prevention and intervention efforts around emotion regulation, motivation, and impulsivity

Indicators of Clinically Significant Gambling Treatment Gains

Treatments should be tailored to the individual in order to improve their effectiveness and efficiency. An assessment of treatment gains is essential to this goal, particularly the ability to identify when clinically significant change is achieved. This paper will examine the sensitivity and specificity of two constructs that moderate change for gambling-focused treatments: self-efficacy to control gambling and strength of gambling-related cognitive distortions. Participants completed measures of gambling symptoms: the Gambling Self-Efficacy Questionnaire (GSEQ) to assess self-efficacy to control gambling, and the Gamblers’ Beliefs Questionnaire to assess cognitive distortions (GBQ). Included was a clinical sample of 312 treatment-seeking outpatient disordered gamblers. We conducted sensitivity/specificity analyses with the clinical sample and a community sample. For the GSEQ analyses, the community sample included 309 adults. For the GBQ analyses, we recruited 204 past-year gamblers from Mechanical Turk. The clinical sample’s pre-treatment GSEQ scores (M = 42.3) were significantly lower than post-treatment scores (M = 77.9, t(210) = -10.8, p M = 71.2) were significantly higher than post-treatment scores (M = 46.7, t(126) = 6.5, p \u3c .05) indicating a decrease in cognitive distortions. ROC analyses indicated that a score of 70 on the GSEQ provided high sensitivity (89%) and specificity (81%) with gambling disorder diagnosis. We found a linear relationship between gambling disorder and GBQ score. These results can be used to guide clinical decisions about the inclusion of treatment elements and the conclusion of therapy