Tratamiento del juego patológico: un estudio controlado

This paper discusses the efficacy of a cognitive and behavioral treatment for pathological gambling. Pathological gamblers were randomly assigned to treamlent or wait-list control. The treatment included four components: 1) Cognitive correction of erroneous perceptions about gambling, 2) problem solving training, 3) Social-skills training and 4) relapse prevention. The dependent variables were the South Oaks Gambling Screen, perception of control, frequency of gambling, perceived self-efficacy, desire to gamble, and number of DSM-111-R criteria met by participants. Results indicated highly significant changes in the treatment group on all outcome measures and analysis of data from six and twelve month follow-ups revealed maintenance of the rapeutic gains. It is recommended that cognitive and behavioral therapy include cognitive correction of erroneous perceptions in gambling.Este trabajo discute la eficacia de un tratamiento cognitivo-conductual para el juego patológico. Los jugadores patológicos fueron asignados de forma aleatorizada a tratamiento o a lista de espera. El tratamiento incluyó cuatro componentes: 1) Corrección cognitiva de las percepciones erróneas sobre el juego, 2) entrenamiento en solución de problemas, 3) entrenamiento en habilidades sociales y 4) prevención de recaídas. Las variables dependientes fueron el South Oaks Gambling Screen, la percepción de control, frecuencia de juego, percepción de autoeficacia, deseo de jugar y número de criterios diagnósticos DSM-III-R cumplidos. Los resultados indicaron cambios significativos en el grupo de tratamiento en todas las medidas, y el análisis de los datos a los seis y docemeses de seguimiento informó del mantenimiento de los éxitos terapéuticos. Se recomienda que la terapia cognitiva y conductual incluya la corrección de las percepciones erróneas sobre el juego

Tratamiento del juego patológico: un estudio controlado

This paper discusses the efficacy of a cognitive and behavioral treatment for pathological gambling. Pathological gamblers were randomly assigned to treamlent or wait-list control. The treatment included four components: 1) Cognitive correction of erroneous perceptions about gambling, 2) problem solving training, 3) Social-skills training and 4) relapse prevention. The dependent variables were the South Oaks Gambling Screen, perception of control, frequency of gambling, perceived self-efficacy, desire to gamble, and number of DSM-111-R criteria met by participants. Results indicated highly significant changes in the treatment group on all outcome measures and analysis of data from six and twelve month follow-ups revealed maintenance of the rapeutic gains. It is recommended that cognitive and behavioral therapy include cognitive correction of erroneous perceptions in gambling.Este trabajo discute la eficacia de un tratamiento cognitivo-conductual para el juego patológico. Los jugadores patológicos fueron asignados de forma aleatorizada a tratamiento o a lista de espera. El tratamiento incluyó cuatro componentes: 1) Corrección cognitiva de las percepciones erróneas sobre el juego, 2) entrenamiento en solución de problemas, 3) entrenamiento en habilidades sociales y 4) prevención de recaídas. Las variables dependientes fueron el South Oaks Gambling Screen, la percepción de control, frecuencia de juego, percepción de autoeficacia, deseo de jugar y número de criterios diagnósticos DSM-III-R cumplidos. Los resultados indicaron cambios significativos en el grupo de tratamiento en todas las medidas, y el análisis de los datos a los seis y docemeses de seguimiento informó del mantenimiento de los éxitos terapéuticos. Se recomienda que la terapia cognitiva y conductual incluya la corrección de las percepciones erróneas sobre el juego

Cognitive versus exposure therapy for problem gambling: Randomised controlled trial

© 2015. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Background Problem gambling-specific cognitive therapy (CT) and behavioural (exposure-based) therapy (ET) are two core cognitive-behavioural techniques to treating the disorder, but no studies have directly compared them using a randomised trial. Aims To evaluate differential efficacy of CT and ET for adult problem gamblers at a South Australian gambling therapy service. Methods Two-group randomised, parallel design. Primary outcome was rated by participants using the Victorian Gambling Screen (VGS) at baseline, treatment-end, 1, 3, and 6 month follow-up. Findings Of eighty-seven participants who were randomised and started intervention (CT = 44; ET = 43), 51 (59%) completed intervention (CT = 30; ET = 21). Both groups experienced comparable reductions (improvement) in VGS scores at 12 weeks (mean difference −0.18, 95% CI: −4.48–4.11) and 6 month follow-up (mean difference 1.47, 95% CI: −4.46–7.39). Conclusions Cognitive and exposure therapies are both viable and effective treatments for problem gambling. Large-scale trials are needed to compare them individually and combined to enhance retention rates and reduce drop-out

Self-help Treatment for At-risk and Pathological Gamblers: Results From an Efficacy Study

Available evidence suggests that self-help treatments may reduce problem gambling severity and gambling behaviour. However, decrease of gambling among control groups and rare assessment of key variables associated with improvement across studies leave the benefits of self-help treatments for problem gambling unclear. The current study assesses the efficacy of a self-help treatment program including three motivational telephone interviews spread over an 11-week period and a cognitive-behavioral self-help workbook. At-risk and pathological gamblers were randomly assigned to the treatment group (n = 31) or the waiting list (n = 31). Relative to the waiting list, the treatment group presented a significant reduction in the number of DSM-5 pathological gambling criteria met, gambling habits (frequency, money and time spent gambling, and gambling consequences at 11 weeks. Perceived self-efficacy and life satisfaction also significantly improved after 11 weeks for the treatment group, whereas no significant changes were observed for the waiting list group. All significant changes reported for the treatment group were maintained throughout 15 and 35-week follow-ups. Results support the efficacy of the self-help program to reduce problem gambling severity, gambling behaviour and to improve overall functioning of gamblers over short and medium term. Findings from this study lend support to the growing body of evidence on the appropriateness of self-help treatments for problem gamblers and help clarify inconsistencies found in the literature. The low dropout rate is discussed with respect to the advantages of the self-help format and clinical and methodological implications of the results are put forth

Two-group randomised, parallel trial of cognitive and exposure therapies for problem gambling: a research protocol

BACKGROUND: Problem gambling is a serious public health concern at an international level where population prevalence rates average 2% or more and occurs more frequently in younger populations. The most empirically established treatments until now are combinations of cognitive and behavioural techniques labelled cognitive behaviour therapy (CBT). However, there is a paucity of high quality evidence for the comparative efficacy of core CBT interventions in treating problem gamblers. This study aims to isolate and compare cognitive and behavioural (exposure-based) techniques to determine their relative efficacy. METHODS: A sample of 130 treatment-seeking problem gamblers will be allocated to either cognitive or exposure therapy in a two-group randomised, parallel design. Repeated measures will be conducted at baseline, mid and end of treatment (12 sessions intervention period), and at 3, 6 and 12 months (maintenance effects). The primary outcome measure is improvement in problem gambling severity symptoms using the Victorian Gambling Screen (VGS) harm to self-subscale. VGS measures gambling severity on an extensive continuum, thereby enhancing sensitivity to change within and between individuals over time. DISCUSSION: This article describes the research methods, treatments and outcome measures used to evaluate gambling behaviours, problems caused by gambling and mechanisms of change. This study will be the first randomised, parallel trial to compare cognitive and exposure therapies in this population. ETHICS AND DISSEMINATION: The study was approved by the Southern Adelaide Health Service/Flinders University Human Research Ethics Committee. Study findings will be disseminated through peer-reviewed publications and conference presentations.<br /

Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study

Background: Several studies have highlighted the implications of impulsivity and novelty seeking for both the maintenance and the process of recovery from bulimia nervosa (BN). Cognitive behavioral therapy (CBT) is the treatment of choice for BN, but for some cases, this treatment alone might not be sufficient for reducing the high levels of impulsivity. The paper presents a case report of a patient with BN, examining the effectiveness of using a videogame (VG; Playmancer) as an additional intervention designed to address impulsivity. Design: Psychometric and neuropsychological measures were collected at baseline. After this assessment, Playmancer was applied prior to CBT, following an 'A-B-A-C-A' single case experimental design. Impulsivity levels were assessed with the Conner's Continuous Performance Test II (CPT-II). After the Playmancer treatment, the patient started CBT, and the levels of impulsivity were recorded again. Finally, psychometric and neuropsychological measures were collected after treatment. Weekly frequency of binges and vomiting were also recorded during the entire procedure. Results: After the VG intervention, psychometric measures such as anxiety levels, impulsivity and novelty seeking decreased. Regarding the neuropsychological measures, impulsivity levels (measured with the CPT-II) progressively decreased throughout the intervention, and an improvement in decision making capacities was observed. Furthermore, the frequency of binges also decreased during and after the VG intervention. Discussion: This case report suggests that using the Playmancer VG to reduce impulsivity prior to CBT may enhance the final results of the treatment for BN

Submission 238 to: Australia's Science and Research Priorities - Conversation Starter

Australia plans to obtain, build, and operate nuclear propelled submarines. The immense challenges brought about by this change in national defence strategy, along with the ambition to create a 20,000 strong nuclear science and engineering capable workforce, must be reflected in the National Science and Research Priorities, and the National Science Statement. We therefore recommend the inclusion of Nuclear Technology as a contemporary National Science and Research Priority, for consideration by the Science Strategy and Priorities Taskforce

A Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults With Generalized Anxiety Disorder

This randomized clinical trial compared cognitive-behavioral therapy (CBT), applied relaxation (AR) and wait-list control (WL) in a sample of 65 adults with a primary diagnosis of generalized anxiety disorder (GAD). The CBT condition was based on the intolerance of uncertainty model of GAD, whereas the AR condition was based on general theories of anxiety. Both manualized treatments were administered over 12 weekly one-hour sessions. Standardized clinician ratings and self-report questionnaires were used to assess GAD and related symptoms at pretest, posttest, and at 6-, 12- and 24-month follow-ups. At posttest, CBT was clearly superior to WL, AR was marginally superior to WL, and CBT was marginally superior to AR. Over follow-up, CBT and AR were equivalent, but only CBT led to continued improvement. Thus, direct comparisons of CBT and AR indicated that the treatments were comparable; however, comparisons of each treatment with another point of reference (either waiting list or no change over follow-up) provided greater support for the efficacy of CBT than AR