Treatment of gambling disorder: review of evidence-based aspects for best practice
GD was reclassified recently into the “Substance-Related and Addictive Disorders” group of theDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)1, a first for a behavioral addiction. The recategorization of GD was essentially due to the similarities between this clinical condition and substance use disorders. Numerous studies find analogous characteristics between the two in reference to diagnostic criteria, symptomatology, genetic vulnerabilities, high rates of comorbidity, and their association with biological markers and cognitive deficits2,3.
MeSH terms
- Having covered 30 RCTs in our meta-analysis, and bearing in mind the aforementioned limitations, a number of conclusions can be drawn.
- Thus, studying interactions between (novel) psychological, pharmacological, or neuromodulation interventions in PG, and their effect on the neurocircuitry of cognitive control in PG, is a very relevant venue for future neuroimaging and clinical intervention studies in PG (detailed in the Discussion section).
- When gambling is interfering with an individual’s relationships, job, mental or physical health or any other area of life it is a problematic behavior.
- 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.
These steps included limiting amount of money spent gambling, reducing amount of time and days gambling, not viewing gambling as a way of making money, and spending time doing other activities. After completing the baseline evaluation, research assistants informed participants assigned to the assessment only control condition that they would be re-contacted in 6 weeks and 9 months for follow-up evaluations. Multi-part self-management interventions provide a variety of tools to help people who want to change their gambling behavior to monitor their gambling activities, set and monitor goals, use self-reflection to recognize underlying motivations and repercussion of their addiction.
Brief intervention vs. assessment only control
Analyzing risk-taking behavior, we observe that both groups often opt for «balanced» bets, offering approximately 50% probability of winning (or a multiplier of 2). However, the intensive group displays a much wider variation in risk-taking compared to the casual group. While the average bet sizes might not differ significantly, the maximum bets placed by players in the intensive group tend to be approximately an order of magnitude higher on average. The difference in expected losses (total payout) is a direct consequence of the aforementioned observations.
Psychological and, more specifically, cognitive behavioral approaches have provided satisfactory results, at least in the short to khelo24 medium term15,90. However, the combination of these programs with other therapeutic strategies, such as brief motivational interventions, mindfulness, or the use of new technologies, seems to be a promising approach in terms of cost-effectiveness. Treatment studies suggest that a percentage of patients fail with the most traditional treatments; therefore, it is compulsory as clinicians and researchers to continue advancing in this field, informing patients of the potential risks and improving the results of the usual psychological therapies. On the other hand, from a pharmacological perspective, opiate antagonists have shown the most promising evidence as being effective medications for GD. Finally, in terms of outcome predictors, numerous individual and social risk factors have been identified in the scientific literature, and prevention efforts should be targeted to those most at risk80.
] through their reclassification of gambling as a disease, and therefore that it should be addressed adequately by the NHS. Recognizing warning signs of problem gambling allows for proactive intervention before major life consequences occur. Whether you are concerned about your own gambling habits or those of someone close to you, understanding these indicators provides an opportunity to address issues before they escalate. These behavioral signs often indicate that gambling has moved beyond casual entertainment. However, for some individuals, what starts as casual fun can develop into problematic behavior with serious consequences.
