Hostname: page-component-848d4c4894-jbqgn Total loading time: 0 Render date: 2024-06-20T17:33:43.688Z Has data issue: false hasContentIssue false
  • English
  • Français

Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study

Published online by Cambridge University Press:  23 March 2020

K.W. Müller ,
K. Wölfling ,
U. Dickenhorst ,
M.E. Beutel ,
J. Medenwaldt  and
A. Koch
K.W. Müller*
Affiliation:
Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Untere Zahlbacher Straße 8, 55131Mainz, Germany
K. Wölfling
Affiliation:
Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Untere Zahlbacher Straße 8, 55131Mainz, Germany
U. Dickenhorst
Affiliation:
Therapeutic leadership of LWL Rehabilitation Center Ostwestfalen–Bernhard-Salzmann-KlinikBuxelstraße 50, 33334Gütersloh, Germany
M.E. Beutel
Affiliation:
Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Untere Zahlbacher Straße 8, 55131Mainz, Germany
J. Medenwaldt
Affiliation:
Redline DATA GmbHDieksbarg 13, 23623Ahrensbök, Germany
A. Koch
Affiliation:
Bundesverband für Stationäre Suchtkrankenhilfe e.V. (‘buss’) Wilhelmshöher Allee 273, 34131Kassel, Germany
*
*Corresponding author. Tel.: +49 6131 174039; fax: +49 6131 176439. E-mail address:muellka@uni-mainz.de (K.W. Müller).
Get access

Abstract

Purpose:

Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched.

Materials and methods:

Patients (n = 270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter.

Results:

At follow-up, three groups were identified: subjects maintaining full abstinence (41.6%), patients still meeting criteria for gambling disorder (29.2%), and subjects still participating in gambling without meeting the diagnostic criteria for gambling disorder (29.2%). Every group had improvements in functional impairment, abstinent subjects showed the lowest psychopathology. Significant decreases in neuroticism and increases in both extraversion and conscientiousness were found among abstinent subjects but not in patients still meeting criteria for gambling disorder.

Discussion:

One year after treatment, a considerable percentage of patients kept on gambling but not all of them were classified with gambling disorder leading to the question if abstinence is a necessary goal for every patient.

Conclusions:

The changes of personality in abstinent patients indicate that after surmounting gambling disorder a subsequent maturing of personality might be a protective factor against relapse.

Keywords

AbstinenceGambling disorderPersonalityRelapsePsychopathology
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 28 - 34
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 5th ed., Arlington, USA: American Psychiatric Publishing; 2013.CrossRefGoogle Scholar
Lejoyeux, MMc Loughlin, MAdes, JEpidemiology of behavioral dependence: literature review and results of original studies. Eur Psychiatry 2000;15: 129–134.CrossRefGoogle ScholarPubMed
Lang, MLeménager, TStreit, FFauth-Bühler, MFrank, JJuraeva, Det al.Genome-wide association study of pathological gambling. Eur Psychiatry 2016;36: 38–46.CrossRefGoogle ScholarPubMed
Stucki, SRihs-Middel, MPrevalence of adult problem and pathological gambling between 2000 and 2005: an update. J Gambl Stud 2007;23: 245–257.CrossRefGoogle ScholarPubMed
Haß, WLang, PGlücksspielverhalten und Glücksspielsucht in Deutschland. Ergebnisse des Surveys 2015 und Trends. Forschungsbericht der BZgA Köln: Bundeszentrale für gesundheitliche Aufklärung; 2016 [German language].Google Scholar
Pallesen, SMitsem, MKvale, GJohansen, B-HMolde, HOutcome of psychological treatments of pathological gambling: a review and meta-analysis. Addiction 2005;100: 1412–1422.CrossRefGoogle ScholarPubMed
Ledgerwood, DMPetry, NMWhat do we know about relapse in pathological gambling?. Clin Psychol Rev 2006;26: 216–228.CrossRefGoogle ScholarPubMed
Hodgins, DCEl-Guebaly, NRetrospective and prospective reports of precipitants to relapse in pathological gambling. J Consult Clin Psychol 2004;72: 72–80.CrossRefGoogle ScholarPubMed
Blaszczynski, AMcConaghy, NFrankova, AControl versus abstinence in the treatment of pathological gambling: a two to nine year follow-up. Brit J Addict 1991;86: 299–306.CrossRefGoogle ScholarPubMed
Ladouceur, RControlled gambling for pathological gamblers. J Gamb Stud 2005;21: 51–58.CrossRefGoogle ScholarPubMed
Ladouceur, RLachance, SFournier, PIs control a viable goal in the treatment of pathological gambling?. Behav Res Ther 2009;47: 189–197.CrossRefGoogle ScholarPubMed
Petry, NMPathological gambling: etiology, comorbidity, and treatment Washington, DC: American Psychological Association; 2005.CrossRefGoogle Scholar
Weinstock, JLedgerwood, DMPetry, NMAssociation between post-treatment gambling behavior and harm in pathological gamblers. Psychol Addict Behav 2007;21: 185–193.CrossRefGoogle Scholar
Slutske, WSPiasecki, TMBlaszczynski, AMartin, NGPathological gambling recovery in the absence of abstinence. Addiction 2010;105: 2169–2175.CrossRefGoogle ScholarPubMed
Blaszczynski, ANower, LAPathways model of problem and pathological gambling. Addiction 2002;97: 487–499.CrossRefGoogle ScholarPubMed
Bagby, MRVachon, DDBulmash, ELToneatto, TQuilty, LCCosta, PTPathological gambling and the five-factor model of personality. Pers Indiv Differ 2007;43: 873–880.CrossRefGoogle Scholar
MacLaren, VVFugelsang, JAHarrigan, KADixon, MJThe personality of pathological gamblers: a meta-analysis. Clin Psychol Rev 2011;31: 1057–1067.CrossRefGoogle ScholarPubMed
Ramos-Grille, IGomà-i-Freixanet, MAragay, NValero, SVallès, VThe role of personality in the prediction of treatment outcome in pathological gamblers: a follow-up study. Psychol assessment 2013;25: 599–605.CrossRefGoogle ScholarPubMed
Soto, CJJohn, OPGosling, SDPotter, JAge differences in personality traits from 10 to 65: Big Five domains and facets in a large cross-sectional sample. J Pers Soc Psychol 2011;100: 330–348.CrossRefGoogle Scholar
Chassin, LDmitrieva, JModecki, KSteinberg, LCauffman, EPiquero, ARet al.Does adolescent alcohol and marijuana use predict suppressed growth in psychosocial maturity among male juvenile offenders?. Psychol Addict Behav 2010;24: 48–60.CrossRefGoogle ScholarPubMed
Hicks, BMDurbin, CEBlonigen, DMIacono, WGMcGue, MRelationship between personality change and the onset and course of alcohol dependence in young adulthood. Addiction 2011;107: 540–548.CrossRefGoogle ScholarPubMed
Littlefield, AKSher, KJWood, PKIs ‘maturing out’ of problematic alcohol involvement related to personality change?. J Abnorm Psychol 2009;118: 360–374.CrossRefGoogle Scholar
Grant, JESteinberg, MAKim, SWRounsaville, BJPotenza, MNPreliminary validity and reliability testing of a structured clinical interview for pathological gambling. Psychiat Res 2004;128: 79–88.CrossRefGoogle ScholarPubMed
Lesieur, HRBlume, SBRevising the south oaks gambling screen in different settings. J Gambl Stud 1993;9: 213–223.CrossRefGoogle Scholar
Stinchfield, RReliability, validity, and classification accuracy of the South Oaks Gambling Screen (SOGS). Addict Behav 2002;27: 1–19.CrossRefGoogle Scholar
Costa PTJr, McCrae, RRRevised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor Inventory (NEO-FFI) professional manual. Psychological Assessment Ressources Odessa, FL: Psychological Assessment; 1992.Google Scholar
Murray, GRawlings, DAllen, NBTrinder, JNEO-Five-Factor Inventory Scores: psychometric properties in a community sample. Meas Eval Couns Dev 2003;36: 140–149.CrossRefGoogle Scholar
Sheehan, DVThe Anxiety Disease New York: Charles Scribner's Sons; 1983.Google Scholar
Leon, ACOlfson, MPortera, LFarber, LSheehan, DVAssessing psychiatric impairment in primary care with the Sheehan Disability Scale. Int J Psychiat Med 1997;27: 93–105.CrossRefGoogle ScholarPubMed
Derogatis, LRSCL-90. Administration, scoring and procedures manual-I for the R (revised) version and other instruments of the Psychopathology Rating Scales Series Chicago: Johns Hopkins University School of Medicine; 1977.Google Scholar
Prinz, UNutzinger, DOSchulz, HPetermann, FBraukhaus, CAndreas, SComparative psychometric analyses of the SCL-90-R and its short versions in patients with affective disorders. BMC Psychiatry 2013;13:104. http://dx.doi.org/10.1186/1471-244x-13-104.CrossRefGoogle ScholarPubMed
Werbart, AForsstrom, DJeanneau, MLong-term outcomes of psychodynamic residential treatment for severely disturbed young adults: a naturalistic study at a Swedish therapeutic community. Nord J Psychiat 2012;66: 367–375.CrossRefGoogle Scholar
Deutsche Hauptstelle für Suchtfragen. Deutscher Kerndatensatz zur Dokumentation im Bereich der Suchtkrankenhilfe (KDS). Definitionen und Erläuterungen zum Gebrauch. Hamm: DHS; 2008.Google Scholar
Borkenau, POstendorf, FNeo-Fünf-Faktoren Inventar Göttingen: Hogrefe; 1993.Google Scholar
Miller, WRPage, ACWarm turkey: other routes to abstinence. J Subst Abuse Treat 1991;8: 227–334.CrossRefGoogle Scholar
Robinson, TEBerridge, KCAddiction. Annu Rev Psychol 2003;54: 25–53.CrossRefGoogle ScholarPubMed
Wölfling, KMörsen, CPDuven, EAlbrecht, UGrüsser, SMFlor, HTo gamble or not to gamble: at risk for craving and relapse – learned motivated attention in pathological gambling. Biol Psychol 2011;87: 275–281.CrossRefGoogle ScholarPubMed
Malouff, JMThorsteinsson, EBSchutte, NSThe relationship between the five-factor model of personality and symptoms of clinical disorders: a meta-analysis. J Psychopathol Behav 2005;27: 101–104.CrossRefGoogle Scholar
Melville, KCasey, LKavanagh, DPsychological treatment dropout among pathological gamblers. Clin Psychol Rev 2007;27: 944–958.CrossRefGoogle ScholarPubMed
Supplementary material: Image

Müller et al. supplementary material

Figure S1

Download Müller et al. supplementary material(Image)
Image 608.9 KB
Submit a response

Comments

No Comments have been published for this article.