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David C Hodgins

Publications and source records attributed to David C Hodgins.

15 recordsLinked to original sources
PubMed2006

A framework for reporting outcomes in problem gambling treatment research: the Banff, Alberta Consensus.

OBJECTIVE: The objective is provide a framework concerning the minimum features of reporting efficacy of treatment in the problem gambling field. Research to date has not used uniform outcome measures and it is, therefore, difficult to compare the relative efficacy of various approaches. Some studies emphasize self-reported behavioural measures such as frequency and intensity of gambling whereas others emphasise change with respect to the criteria used to diagnose problem gambling or use composite measures of symptom severity in multiple domains involving gambling-related thoughts, urges, and behaviours. METHODS: An expert panel consensus. RESULTS: The proposed minimum features of reporting the efficacy of treatment outcome studies are: measures of gambling behaviour - the net expenditure each month, the frequency (in days per month) with which gambling takes place, and the time spent thinking about or engaged in the pursuit of gambling each month; measures of the problems caused by gambling - especially problems in the areas of personal health, relationships, financial, and legal; these measures can be complemented by additional measures of quality of life. measures of the processes of change - whatever mechanisms of change are assumed to occur. CONCLUSIONS: We believe that these guidelines are broad enough to allow clinical research conducted from diverse perspectives to allow valid cross study evaluations of intervention studies. Such conditions will facilitate the development of empirically validated best practice guidelines for use by clinicians in the management of problem gambling.

Behavior, Addictive↗
PubMed2006

Risk of harm among gamblers in the general population as a function of level of participation in gambling activities.

AIMS: To examine the relationship between gambling behaviours and risk of gambling-related harm in a nationally representative population sample. DESIGN: Risk curves of gambling frequency and expenditure (total amount and percentage of income) were plotted against harm from gambling. SETTING: Data derived from 19, 012 individuals participating in the Canadian Community Health Survey-Mental Health and Well-being cycle, a comprehensive interview-based survey conducted by Statistics Canada in 2002. MEASUREMENT: Gambling behaviours and related harms were assessed with the Canadian Problem Gambling Index. FINDINGS: Risk curves indicated the chances of experiencing gambling-related harm increased steadily the more often one gambles and the more money one invests in gambling. Receiver operating characteristic analysis identified the optimal limits for low-risk participation as gambling no more than two to three times per month, spending no more than 501-1,000 CAN dollars per year on gambling and investing no more than 1% of gross family income on gambling activities. Logistic regression modelling confirmed a significant increase in the risk of gambling-related harm (odds ratios ranging from 2.0 to 7.7) when these limits were exceeded. CONCLUSIONS: Risk curves are a promising methodology for examining the relationship between gambling participation and risk of harm. The development of low-risk gambling limits based on risk curve analysis appears to be feasible.

Adolescent↗
PubMed2005

Implications of a brief intervention trial for problem gambling for future outcome research.

We describe the development of an empirically supported brief workbook intervention. The implications for the design of future outcome research include the use of media recruitment of participants, the value of a broad conceptual treatment model, the limitations of a waiting list control design, the need for consensus on the measurement of outcome indicators.

Attitude to Health↗
PubMed2005

The association between comorbidity and outcome in pathological gambling: a prospective follow-up of recent quitters.

A naturalistic sample of pathological gamblers (N = 101) who recently quit gambling was followed prospectively for a year (follow-up rate 80%). Lifetime mood disorders were identified in 61% of participants and 73% and 48% had lifetime alcohol use and drug use disorders, respectively. Current prevalence rates, however, were much lower. Current mood disorders were found for 20% and 7% had a current alcohol disorder and 7% a current drug use disorder. Age of onset for substance use disorders was earlier than gambling disorders but mood disorders were equally likely to predate or follow gambling disorders. Lifetime mood disorder was associated with a longer time to achieve 3 months of stable abstinence. Participants who were currently in treatment or attending Gamblers Anonymous and the small number of participants with current alcohol disorders were also more likely to achieve abstinence earlier. The results underscore the importance of increasing our understanding of the role of comorbid disorders in the recovery process from gambling problems.

Adult↗
PubMed2005

Comparison of craving between pathological gamblers and alcoholics.

BACKGROUND: Craving is a central phenomenon in addiction. Temperament factors are also important for pathologic gambling and other addictions. The aim of this study was to compare craving between pathologic gamblers (PG) and alcohol-dependent subjects (ADS), correlating craving with personality. METHODS: Forty-nine PG and 101 ADS willing to start treatment were recruited. A trained psychiatrist diagnosed them according to DSM-IV criteria. To be included in this study, subjects had to be abstinent for at least five days and no longer than 21 days. Alcoholics should have no significant physical withdrawal symptoms by the time of craving assessment. Subjects with current comorbidity with other addictions were excluded, except nicotine. ADS rated craving for alcohol and PG rated craving for gambling on the same questions, respectively. Both answered a semistructured interview, the Temperament and Character Inventory and the Beck Scales for anxiety and depression. RESULTS: Pathologic gamblers scored higher than ADS on craving measures (p<0.001) and novelty seeking (p=0.01). ADS scored higher in harm avoidance (p=0.01). Alcohol craving correlated positively with anxiety and novelty seeking and negatively with length of abstinence and persistence. Gambling craving correlated positively with depression and negatively with length of abstinence and reward dependence CONCLUSIONS: Pathologic gamblers experienced stronger cravings than did ADS. This may be a disturbing experience for PG and a potential cause for relapse. The higher scores on novelty seeking concur with previous studies that associate PG and impulsivity. ADS higher scores on harm avoidance suggest anxiety vulnerability. The positive relation between alcohol craving, anxiety, and harm avoidance suggests that ADS rely on alcohol to deal with a proclivity to negative emotions. The positive relation of gambling craving to depression and negative relation to reward dependence suggests that individuals who have a lesser susceptibility to experience positive emotions are the ones who most miss gambling when abstaining.

Adult↗
PubMed2004

Using the NORC DSM Screen for Gambling Problems as an outcome measure for pathological gambling: psychometric evaluation.

The National Opinion Research Center DSM Screen for Gambling Problems (NODS), a population-based telephone-screening tool to identify gambling problems according to DSM-IV criteria, was examined as a potential outcome measure for gambling treatment studies. The NODS was administered to problem gamblers as part of a 1-year follow-up after a brief treatment. Internal reliability was fair to good and the factor structure and item-total correlations supported the existence of a single construct with three subfactors, measuring negative behavioral consequences, preoccupation and impaired control over gambling and tolerance, and withdrawal and relief gambling. The NODS total score correlated moderately with gambling behavior and outcome as predicted. The total score also correlated highly with the total score of the South Oaks Gambling Screen (SOGS) although the NODS and SOGS categorization of nonproblem, problem, and pathological gamblers showed poor agreement. The NODS, as designed, provided a more strict definition of disordered gambling than the SOGS. In summary, the NODS shows promise as an outcome measure of gambling problems.

Adult↗
PubMed2004

Retrospective and prospective reports of precipitants to relapse in pathological gambling.

A prospective design was used to explore the precipitants of relapse in a naturalistic sample of pathological gamblers (N = 101) who had recently quit gambling. Relapse rates were high; only 8% were entirely free of gambling during the 12-month follow-up. Relapses were highly variable but occurred most frequently in the evening, when the person was alone and thinking about finances. Moods prior to the gambling were as likely to be positive as negative. The most frequently reported attributions, particularly for major relapses, were cognitions about winning and feeling the need to make money, unlike substance abuse relapses that tend to be attributed to negative affect. Some gender differences were found, but the precipitants of shorter and longer relapses did not differ.

Adult↗
PubMed2004

Brief motivational treatment for problem gambling: a 24-month follow-up.

A 24-month follow-up of a randomized clinical trial of 2 brief treatments for problem gambling (N = 67) revealed an advantage for participants who received a motivational telephone intervention plus a self-help workbook compared with participants who received only the workbook. Although the 2 groups did not differ in the number of participants reporting 6 months of abstinence, the motivational intervention group gambled fewer days, lost less money, and had lower South Oaks Gambling Screen scores. They were more likely to be categorized as improved compared with the self-help workbook only group. Overall, the results support the effectiveness of a brief telephone- and mail-based treatment for problem gamblers.

Canada↗
PubMed2004

Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics.

AIMS: To test the efficacy of a cognitive-behavioural approach to treating disturbed sleep in abstinent alcoholics. DESIGN: Sixty recovering alcoholics with insomnia were assigned randomly to individual therapy, self-help with telephone support or waiting-list control. SETTING: Participants were volunteers recruited from out-patient treatment programs and through the media. MEASUREMENTS: Outcomes were assessed at post-treatment, 3-month and 6-month follow-ups using sleep diaries, the Pittsburgh Sleep Quality Index, wrist actigraphs and time-line follow-back interviews. INTERVENTION: Five sessions of out-patient cognitive-behavioural therapy for insomnia or a self-help manual with five telephone support calls. Treatment duration was 7 weeks. FINDINGS: Treated participants were significantly more improved than control participants on diary measures of sleep quality, sleep efficiency, awakenings and time to fall asleep. No significant differences between the individual therapy and self-help treatment conditions on measures of insomnia severity were evident at post-treatment. Self-reported improvement in sleep was corroborated by clinician and spousal ratings of insomnia severity, but not by actigraph recordings of nocturnal activity. At 3- and 6-month follow-up assessments treatment gains were reasonably maintained in both treatment groups, although individual therapy was associated with a higher rate of clinically significant improvement. At the 6-month follow-up, 60% participants who were regular users of sedative medication at baseline discontinued the use of their medication. Treatment appeared to have little impact in preventing relapses to alcohol. CONCLUSIONS: Recovering alcoholics with insomnia can achieve better sleep by applying cognitive-behavioural strategies.

Adolescent↗
PubMed2003

Trusting problem gamblers: reliability and validity of self-reported gambling behavior.

The retest reliability and validity of self-reported gambling behavior were assessed in 2 samples of problem gamblers. Days gambled and money spent gambling over a 6-month timeframe were reliable over a 2- to 3-week retest period using the timeline follow-back interview procedure (N=35; intraclass correlation coefficients [ICCs] ranged from .61 to .98). Gamblers did, however, report significantly more gambling at the 2nd interview. Agreement with collaterals was fair to good overall (ICCs ranged from.46 to.65) with no clear pattern of either over- or underreporting by gamblers. Spouses did not show greater agreement with gamblers compared with nonspouses, and greater agreement was not found for collaterals who were more versus less confident in their reports. The results are generally supportive of the use of self-reported gambling in studies of problem gamblers, assessed face to face and by telephone, although suggestions for further research are provided.

Adult↗
PubMed2003

Outcome from integrated pain management treatment for recovering substance abusers.

There is little information on the efficacy of pain management for substance abusers with noncancerous chronic pain conditions. The present study describes an outcome evaluation of a pain management group adapted to the needs of patients diagnosed with concurrent chronic pain and substance abuse disorders. A heterogeneous group of 44 patients (66% opioid dependent; 61% musculoskeletal pain) attended a 10-week outpatient group based within a multidisciplinary substance abuse treatment program. Measures of addiction severity, pain, use of self-management techniques, emotional distress, medication use, and functional status were obtained at pretreatment, post-treatment, 3-month, and 12-month follow-ups. Outcome data were analyzed on the group and individual level, the latter using the reliable change index. Intention-to-treat analyses showed significant improvements in pain, emotional distress, medication reduction, and coping style. Half of the patients showed a statistically reliable improvement on at least 1 outcome measure, and half were opioid free at the 12-month follow-up assessment. These results suggest that persons with concurrent chronic pain and substance use disorders are responsive to an integrated treatment model of pain management and relapse prevention.

Adult↗
PubMed2003

Factors at play in faster progression for female pathological gamblers: an exploratory analysis.

BACKGROUND: Previous studies reported a faster progression for alcohol dependence and pathological gambling among females as compared with males. This phenomenon was called the "telescoping effect." By comparing female gamblers with male gamblers regarding gambling preferences and comorbidity, the authors explored potential risk factors for telescoping. METHOD: A consecutive sample of Brazilian treatment-seeking pathological gamblers (DSM-IV criteria) was recruited. Genders were contrasted regarding comorbidity and gambling behavior, controlling for demographics, gambling severity, and previous access to mental health services. RESULTS: Seventy female gamblers and 70 male gamblers were interviewed. A greater proportion of women than men reported electronic bingo and video lottery terminals as their main type of gambling. Gambling was divided in 3 progressive stages: "social gambling," "intense gambling," and "problem gambling." Faster progression for female gamblers was confirmed; female gender and preference for electronic bingo and/or video lottery terminals were risk factors for telescoping throughout all stages. Female gamblers presented a higher comorbidity with depression, whereas male gamblers had higher rates of alcohol dependence. Nevertheless, comorbidity profiles were not related to gambling progression. CONCLUSION: Two factors could be at play for treatment-seeking female gamblers in Brazil: (1) a potential gender vulnerability and (2) a cultural environment yielding them access to a narrower range of gambling games that includes mainly the most addictive ones.

Adult↗
PubMed2002

Future time perspective in pathological gamblers.

The hypothesis that pathological gambling is associated with shortened time horizons was investigated by administering the Zimbardo Time Perspective Inventory (ZTPI) and the Future Time Perspective Inventory (FPTI) to a group of pathological gamblers and two comparison groups, psychiatric day patients and social gamblers. The South Oaks Gambling Screen (SOGS) was used to assess the severity of the participants' gambling. Sixty-six participants were recruited, of which 35 were women. The mean age of participants was 39 years. Results showed significantly shorter time horizons in pathological versus social gamblers but few differences between pathological gamblers and psychiatric patients. These results suggest that shortened time horizons are not a unique feature of addicted populations. The role of psychological distress as a possible explanatory variable is discussed.

Adult↗
PubMedDate not supplied

Risk factors for suicide ideation and attempts among pathological gamblers.

The link between pathological gambling and suicide is poorly understood. The current study has two major goals: to provide descriptive information about suicide ideation and attempts among pathological gamblers trying to quit, and to identify predictors of suicidal ideation and attempts, with a particular emphasis on mood and substance use disorders. A community sample of 101 individuals with gambling problems who had made a recent quit attempt was assessed using structured instruments. Of these, 28.7% reported no history of suicide ideation or attempts, 38.6% reported having only thoughts of suicide, and 32.7% reported a suicide attempt. Ideation predated the onset of gambling problems by an average of greater than ten years. History of ideation was increasingly likely with a greater severity of gambling problem as determined by DSM criteria. Those experiencing ideation were also more likely to over gamble on gambling days and five times more likely to have a history of depression. Substance abuse history was the only factor that distinguished between individuals who had a history of suicide attempts versus ideation only. Having a drug history was related to a more than six times greater likelihood of having made a suicide attempt. Gambling-related suicide attempts were relatively rare-21.2% of attempters, or 7% of the total sample. These findings are consistent with the common factor model of etiology in which the suicidality of gambling is related to prior mental health disorders. More research on the relationship between alcohol and other drug disorders and their complex relationship to pathological gambling and suicide is crucial.

Adult↗