Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems

By Silvia Ronzitti, Emiliano Soldini, Neil Smith, Marc N. Potenza, Massimo Clerici, and Henrietta Bowden-Jones.

Background: Studies show higher lifetime prevalence of suicidality in individuals with pathological gambling. However, less is known about the relationship between pathological gambling and current suicidal ideation.

Objectives: We investigated socio-demographic, clinical and gambling-related variables associated with suicidality in treatment-seeking individuals.

Methods: Bivariate analyses and logistic regression models were generated on data from 903 individuals to identify measures associated with aspects of suicidality.

Results: Forty-six percent of patients reported current suicidal ideation. People with current suicidal thoughts were more likely to report greater problem-gambling severity (p < 0.001), depression (p < 0.001) and anxiety (p < 0.001) compared to those without suicidality. Logistic regression models suggested that past suicidal ideation (p < 0.001) and higher anxiety (p < 0.05) may be predictive factors of current suicidality.

Conclusions: Our findings suggest that the severity of anxiety disorder, along with a lifetime history of suicidal ideation, may help to identify treatment-seeking individuals with pathological gambling with a higher risk of suicidality, highlighting the importance of assessing suicidal ideation in clinical settings.

Ronzitti, S., Soldini, E., Smith, N., Potenza, M. N., Clerici, M., & Bowden-Jones, H. (2017). Current suicidal ideation in treatment-seeking individuals in the United Kingdom with gambling problems. Addictive Behaviors, 74, 33–40. https://doi.org/10.1016/j.addbeh.2017.05.032

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Internet-Based Delivery of Cognitive Behaviour Therapy Compared to Monitoring, Feedback and Support for Problem Gambling: A Randomised Controlled Trial

Leanne M. Casey, Tian P. S. Oei, Namrata Raylu, Katherine Horrigan, Jamin Day, Michael Ireland, Bonnie A. Clough.

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.

Problem gambling worldwide: An update and systematic review of empirical research (2000–2015) (Full text)

Filipa Calado and Mark D. Griffiths

Background and aims: Problem gambling has been identified as an emergent public health issue, and there is a need to identify gambling trends and to regularly update worldwide gambling prevalence rates. This paper aims to review recent research on adult gambling and problem gambling (since 2000) and then, in the context of a growing liberalization of the gambling market in the European Union, intends to provide a more detailed analysis of adult gambling behavior across European countries.

Methods: A systematic literature search was carried out using academic databases, Internet, and governmental websites.

Results: Following this search and utilizing exclusion criteria, 69 studies on adult gambling prevalence were identified. These studies demonstrated that there are wide variations in past-year problem gambling rates across different countries in the world (0.12–5.8%) and in Europe (0.12–3.4%). However, it is difficult to directly compare studies due to different methodological procedures, instruments, cut-offs, and time frames. Despite the variability among instruments, some consistent results with regard to demographics were found.

Discussion and conclusion: The findings highlight the need for continuous monitoring of problem gambling prevalence rates in order to examine the influence of cultural context on gambling patterns, assess the effectiveness of policies on gambling-related harms, and establish priorities for future research.

Assessing Problem Gambling: a Review of Classic and Specialized Measures (full text)

By Kyle Caler, Jose Ricardo Vargas Garcia, Lia Nower

Purpose of Review – The rapid expansion of legalized gambling opportunities over the past 20 years has generated interest in problem gambling and gambling disorder. This review will provide an overview of classic and newer instruments in the field.Recent FindingsEarly instruments in the field of gambling studies were focused exclusively on population prevalence or diagnosis of disorder. However, a growing body of research, particularly in the clinical and neurobiological areas, have led to the development of a targeted measurement instruments and increased specialization designed for screening of a gambling disorder. Newer instruments and those that with renewed clinical and research interest are focused on specific areas such as cognitive distortions, and control of urges and cravings, which are key components of sustained recovery.SummaryMeasurement in the field of problem gambling is moving away from solely measuring population prevalence and psychiatric disorder toward targeting the specific mechanisms that underlie problem gambling and barriers to recovery. Future advances in measurement will necessitate using standardized measures to assess various facets of problem gambling and adopting a holistic approach to assessing facets synergistically to identify sub-groups and inform targeted treatment strategies.

Caler, K., Garcia, J. R. V., & Nower, L. (2016). Assessing Problem Gambling: a Review of Classic and Specialized Measures. Current Addiction Reports, 1–8. https://doi.org/10.1007/s40429-016-0118-7

Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies – Open Access

Yakovenko, I., & Hodgins, D. C.

Purpose of review: Over the last decade, treatments for disordered gambling have developed rapidly. The goal of this paper is to review and to critically evaluate the literature published on the treatment of disordered gambling in the past 3 years. Important findings are emphasized and accompanied by the authors’ personal observations on controversial results or hypotheses of interest. Recent findings: Cognitive-behavioral interventions have been evaluated in treatment of Hong Kong Chinese individuals as well as in combination with mindfulness-based approaches. Personalized-feedback interventions have received increased attention, with brief treatments demonstrating overall efficacy. Pharmacological treatments continue to receive only limited support. On the other hand, web-based treatments appear to show promise. Summary: Cognitive-behavioral and brief treatments remain the most empirically supported approaches, but new inventive combinations of treatments such as web-based therapies are emerging. Future research could benefit from diversification of types of treatments evaluated as well as an examination of what is considered “evidence-based.”

Yakovenko, I., & Hodgins, D. C. (2016). Latest Developments in Treatment for Disordered Gambling: Review and Critical Evaluation of Outcome Studies. Current Addiction Reports, 1–8. http://doi.org/10.1007/s40429-016-0110-2

Gambling Disorder in the DSM-5: Opportunities to Improve Diagnosis and Treatment Especially in Substance Use and Homeless Populations – Open Access

Rash, C. J., & Petry, N. M.

Purpose of review: This paper reviews recent research related to the revisions of the gambling disorder (GD) criteria, including the elimination of the illegal acts criterion and the lowered diagnostic threshold. Recent findings: Studies suggest that the removal of the illegal acts criterion has little impact in terms of prevalence or loss of diagnostic status among gamblers, especially when considered in combination with the lowered diagnostic threshold. Overall, prevalence rates will increase modestly with the lowered threshold in community samples of gamblers. However, increases in GD prevalence rates may be more notable in settings that serve individuals at higher risk for gambling problems (e.g., substance abuse treatment clinics and homeless persons). Summary: Changes to the GD diagnostic criteria may lead to increased recognition of gambling problems, particularly in settings that serve high-risk populations. These changes also may necessitate the training of more clinicians in the delivery of efficacious gambling treatments.

Rash, C. J., & Petry, N. M. (2016). Gambling Disorder in the DSM-5: Opportunities to Improve Diagnosis and Treatment Especially in Substance Use and Homeless Populations. Current Addiction Reports, 1–5. http://doi.org/10.1007/s40429-016-0112-0

Populations at Risk for a Gambling Disorder: Older Adults – full text

Thompson, K. M., & McNeilly, D. P. (2016). Populations at Risk for a Gambling Disorder: Older Adults. Current Addiction Reports, 1–5.
Purpose of review: Older adults who gamble are a population of concern, yet older adult problem gambling remains a topic of limited examination. This article seeks to critically evaluate the existing older adult problem gambling literature. Recent findings Recent literature uses generational comparisons to predict gambling behaviors of those newest to older adulthood, the Baby Boomers. These studies indicate that Baby Boomers participate in gambling activities at a higher rate than previous generations and that they may be further negatively impacted as access to gambling expands. Prevalence rates of problem gambling vary across countries suggesting that culture influences perceptions of gambling for older adults. While poorer health outcomes have also been associated with problem gambling, positive effects of gambling on cognition have also been suggested. Summary Finally, the authors offer personal observations and hypothetical discussion about these research implications and emphasize the need for better awareness, screening, and study of gambling disorders among older adults.