Biomedical subjects

Robert Ladouceur

Publications and source records attributed to Robert Ladouceur.

At least 19 recordsLinked to original sources

PubMed2005

Joint trajectories of gambling, alcohol and marijuana use during adolescence: a person- and variable-centered developmental approach.

The usefulness of Moffitt's (1993) [Moffitt, T. E. (1993). Adolescence-limited and life-course-persistent antisocial behavior: A developmental taxonomy. Psychological Review, 100, 674-701.] theory of antisocial behavior was examined regarding gambling, alcohol and marijuana use. We assessed 903 Caucasian boys' developmental trajectories of these behaviors annually from age 11 through age 16. Severity of problems with these behaviors were assessed at ages 17 and 23. As correlates of these behaviors, teacher-rated personality and self-reported parenting were assessed at age 10. Self-reported autonomy was measured at ages 11 and 14. A cluster analysis on the correlates yielded two clusters. Membership in the cluster without adult problems was associated with either late onset of gambling and/or alcohol use trajectories or consistently low involvement in each of the behaviors. This cluster may correspond to Moffitt's adolescence-limited group and uninvolved adolescents, respectively. Membership in the cluster with subsequent adult problems was associated with early initiation of at least one of the three behaviors and involvement in each of them during adolescence. This cluster may correspond to Moffitt's life-course-persistent group. Findings indicate that early assessment of correlates used in the cluster analysis may be useful for screening and preventive purposes.

Adolescent↗

PubMed2005

Treating problem gamblers: working towards empirically supported treatment.

There is an urgent need for mental health professionals to develop effective treatments for pathological gambling. A scientific meeting was held in Quebec City in June 2002 where 13 specialists in the treatment of gamblers pursued the objectives of making the "State of the art" statement concerning the procedures and the methodology to be used in future treatment outcome studies. This paper introduces this special issue of the Journal of Gambling Studies and identifies some of the key issues that confront clinicians and researchers interested in evidence based treatment for gambling related disorders.

Congresses as Topic↗

PubMed2005

Controlled gambling for pathological gamblers.

Despite its high prevalence, pathological gambling often remains untreated. It is estimated that only 10% of the pathological gamblers identified in prevalence studies will enter treatment. Within this small proportion, a high percentage will drop out. Despite the facts that some researchers argue against abstinence as the unique treatment goal and that regaining control appears to be possible for some pathological gamblers, abstinence has been the only treatment goal in most problem gambling interventions thus far. This paper examines the avenue of controlled gambling embedded in a harm reduction context as a viable solution for some pathological gamblers.

Adult↗

PubMed2005

Structural characteristics of video lotteries: effects of a stopping device on illusion of control and gambling persistence.

Two studies investigated the effects of a video lottery terminal stopping device on gamblers' thoughts and behavior. This structural characteristic allows players to voluntarily stop the spinning of the reels. The first study investigated the effect of this device on the development of illusions of control. It was predicted that players using the stopping device would believe that (1) symbols displayed could differ depending on when the game is stopped, (2) there is a possibility of controlling the outcome of the game, (3) skills may be a factor influencing the results, and finally (4) a stopping device would improve the probability of personal success (i.e., developing the illusion of control). The second study aimed to further evaluate the effects of the stopping device on gambling behavior. It was hypothesised that using the stopping device would encourage players to increase the number of games played in a session. Results confirmed all predictions and showed that offering a stopping device on video lottery terminals modifies gamblers' cognition and behavior. The theoretical and practical implications of these results are discussed in the context of responsible gambling policies.

Female↗

PubMed2005

Modifying youths' perception toward pathological gamblers.

This study evaluates the effectiveness of a video specifically designed to provide relevant information on gambling and to correct the perceptions that adolescents have about pathological gamblers. Results indicate that the video significantly improved participants' knowledge about gambling and corrected their misconceptions toward excessive gamblers. The implications of these results for the prevention of gambling problems are discussed.

Adolescent↗

PubMed2005

Further validation of a cognitive-behavioral model of generalized anxiety disorder: diagnostic and symptom specificity.

The goal of this study was to investigate the diagnostic and symptom specificity of a model of GAD that has four main features: intolerance of uncertainty, positive beliefs about worry, poor problem orientation, and cognitive avoidance. The authors compared 17 patients with non-comorbid generalized anxiety disorder (GAD) to 28 patients with non-comorbid panic disorder with agoraphobia (PDA) and found that only intolerance of uncertainty showed evidence of diagnostic specificity, i.e., intolerance of uncertainty scores were higher in the GAD group relative to the PDA group. In terms of symptom specificity, when both groups were combined, all model variables were significantly related to worry but unrelated to fear of bodily sensations, agoraphobic cognitions, and behavioral avoidance. Taken together, these findings provide further support for the link between intolerance of uncertainty and GAD and underscore the importance of pursuing the issue of specificity from both a diagnostic and symptom perspective.

Adult↗

PubMed2005

Self-efficacy and compliance with benzodiazepine taper in older adults with chronic insomnia.

Better understanding of compliance with BZD taper is warranted. Compliance with a taper program and perceived self-efficacy (SE) in being able to comply with hypnotic reduction goals was monitored weekly in 52 older adults (mean age: 63.0 years) with chronic insomnia (average duration: 21.9 years) who underwent a 10-week physician-supervised medication tapering. One group received cognitive- behavior therapy for insomnia during discontinuation, whereas the other did not. Compliant patients showed higher SE ratings at Weeks 6, 8, 9, and 10. Medication-free patients at the end of the treatment also reported higher mean SE ratings at those 4 weeks. Differences remained significant when withdrawal symptoms and sleep efficiency were controlled for. These results have important clinical implications because SE may indicate key time points when patients are experiencing more difficulty during discontinuation.

Aged↗

PubMed2005

Concordance between the SOGS-RA and the DSM-IV criteria for pathological gambling among youth.

This study assessed the possible differences in the classification of adolescent gamblers when using the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA; K. C. Winters, R. D. Stinchfield, & J. Fulkerson, 1993) versus a clinical interview that was based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) criteria for pathological gambling. A total of 631 adolescents ages 15-17 years participated in the two phases of the study. Results revealed that of the 93 adolescents who had been screened as problem gamblers according to the SOGS-RA, only 7 could be clinically confirmed as pathological gamblers according to the criteria used at present to define pathological gambling. The need to clarify the construct of pathological gambling among youth is discussed.

Adolescent↗

PubMed2005

A national survey of gambling problems in Canada.

OBJECTIVE: The 1990s saw widespread expansion of new forms of legalized gambling involving video lottery terminals (VLTs) in community settings (that is, in bars and restaurant lounges) and permanent casinos in several Canadian provinces. To date, there has never been a national survey of gambling problems with representative interprovincial data. Using a new survey, we sought to compare prevalence figures across the 10 Canadian provinces. METHOD: Using the Canadian Problem Gambling Index, we investigated the current 12-month prevalence of gambling problems in the Canadian Community Health Survey: Cycle 1.2--Mental Health and Well-Being, in which a random sample of 34,770 community-dwelling respondents aged 15 years and over were interviewed. The response rate was 77%. The data are representative at the provincial level and were compared with the availability of VLTs per 1000 population and with the presence of permanent casinos for each province. RESULTS: Manitoba (2.9%) and Saskatchewan (also 2.9%) had the highest prevalence of gambling problems (specifically, moderate and severe problem levels combined). These 2 provinces had significantly higher levels than the 2 provinces with the lowest prevalence of gambling problems: Quebec (1.7%) and New Brunswick (1.5%). CONCLUSIONS: The 12-month prevalence of gambling problems in Canada was 2.0%, with interprovincial variability. The highest prevalence emerged in areas with high concentrations of VLTs in the community combined with permanent casinos. These findings support earlier predictions that the rapid and prolific expansion of new forms of legalized gambling in many regions of the country would be associated with a considerable public health cost.

Adolescent↗

PubMed2005

Prevalence of pathological gambling in Quebec in 2002.

OBJECTIVE: To assess gambling behaviours and the problems associated with pathological gambling among the adult population of Quebec in 2002. METHOD: In Phase 1 of this 2-phase study, a total sample of 8842 adults was assessed. We used the South Oaks Gambling Screen (SOGS), adapted for telephone interview, to assess one-half of the sample; the other one-half was evaluated with the Canadian Problem Gambling Index (CPGI). In the study's second phase, we compared the classifications obtained from these screening instruments with classifications obtained by a psychologist using a semistructured clinical telephone interview. RESULTS: The results indicate that the prevalence of pathological gambling in 2002 (at which time 0.8% of the adult population were classified as probable pathological gamblers) did not differ from the proportion obtained in 1996 (1.0%), despite the significant decrease in gambling participation in 2002 (81% vs 90% in 1996). The most popular gambling activities were buying lottery tickets (68%), participating in fundraising draws (40%), gambling in casinos (18%), playing cards with family or with friends (10%), playing bingo (9%), and playing video lotteries (8%). The findings obtained from the SOGS and the CPGI revealed that the 2 instruments perform similarly when identifying pathological gambling prevalence. However, the results of the semistructured clinical telephone interviews differed from the results obtained with the screening instruments: 82% of the gamblers initially identified as probable pathological gamblers by the SOGS or the CPGI were not confirmed by a clinical interview. CONCLUSION: The discrepancy between the results of the screening questionnaires and the clinical evaluation is significant, and this difference needs to be addressed before further cross-sectional or longitudinal studies are conducted.

Adult↗

PubMed2004

Awareness of independence of events and erroneous perceptions while gambling.

The majority of individuals behaves and think irrationally when gambling. The fundamental mistake committed is to rely on previous events to predict the outcome of the game. This study examines if information, reminding the players about independence between events, while gambling influences their perception of the game and their motivation to continue gambling. Thirty-one occasional gamblers, 18 men and 13 women aged 20-64 years old (M=40), participated in the study. The hypotheses predicted that reminders about independence of events would decrease the number of erroneous perceptions and that the motivation to pursue the game would be weaker among participants who received reminders. Results confirmed both hypotheses. Interventions based on these results could significantly increase responsible gambling.

Adult↗

PubMed2004

Perceptions among pathological and nonpathological gamblers.

This study evaluated the perceptions of individuals while gambling on a Video Lottery Terminal. The primary goal was to compare the frequency of erroneous perceptions and of gambling-related perceptions among pathological and nonproblem gamblers. The degree of conviction in these perceptions was also evaluated. Each participant was assessed by a clinical psychologist using the DSM-IV criteria. Results showed that, contrary to the first hypothesis, no significant differences emerged between problem and nonproblem gamblers on the percentage of erroneous perceptions. But, pathological gamblers verbalized significantly more gambling related perceptions and were more convinced in the truth of their perceptions than the nonproblem gamblers. The theoretical and clinical implications of these results are discussed in order to improve the effectiveness of treatment interventions for pathological gamblers.

Adult↗

PubMed2004

Characteristics of illness intrusions in a non-clinical sample.

This study examines whether illness intrusions can be distinguished from obsessional intrusions and worries. It also assesses the relationship between strategies, thought characteristics, and appraisal of illness intrusions. Two hundred and forty-three non-clinical participants identified an obsessive intrusive thought, a worry, and an illness intrusion. They evaluated each thought using items from the Cognitive Intrusions Questionnaire. The comparisons of intrusions showed that illness intrusions share characteristics of worries and obsessional intrusions, but also have their own characteristics. Illness intrusions seem to be particularly egosyntonic. The relationships between the strategies used to counter illness intrusions and their appraisal were also tested. Results support the idea that there are specific links between the evaluation of cognitive intrusions and the way they are processed. It demonstrated that escape/avoidance strategies are associated with the egodystonic nature of the thought and that problem-focused strategies are associated with the thought's basis in reality. Illness intrusions may be conceptualised as either obsessions or worries. This study demonstrated that the category of an intrusive thought might not be as important as the way it is processed. It seems more important to consider appraisal of the disturbing thought and the way in which the person subsequently reacts and behaves.

Adaptation, Psychological↗

PubMed2004

Insomnia and generalized anxiety disorder: effects of cognitive behavior therapy for gad on insomnia symptoms.

Although clinical practice suggests that sleep complaints are frequent among patients with generalized anxiety disorder (GAD), frequency, severity, types of insomnia complaints, and relationship to GAD diagnosis severity in patients diagnosed using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria are not well documented. Clinical data about the impact on insomnia symptoms of treating GAD worries are also lacking. The present study examined these aspects in 44 GAD patients who participated in a treatment study specifically addressing excessive worries through CBT interventions. All patients were assessed using a structured clinical interview and the Anxiety Disorder Interview Schedule-IV (ADIS-IV). They also completed anxiety and insomnia inventories, including the Insomnia Severity Index (ISI), a self-report measure which assesses insomnia type, severity and interference with daily life. Among this sample, 47.7% reported difficulties initiating sleep, 63.6% reported difficulties maintaining sleep, and 56.8% complained of waking too early in the morning. The majority of these patients (86.5%) reported never having experienced insomnia without having excessive worries. However, insomnia severity and GAD severity were not correlated. In this sample, patients with severe GAD did not necessarily report more severe insomnia symptoms. Regarding treatment impact on insomnia complaints, ISI post-treatment scores were significantly lower after treatment. Mean post-treatment scores almost reached ISI's "absence of clinical insomnia" category. Results indicate that this CBT package for GAD does have a significant impact on sleep quality even if sleep disturbances were not specifically addressed during treatment.

Adult↗

PubMed2004

Cognitive-behavioral treatment of generalized anxiety disorder (GAD) for older adults.

BACKGROUND: Generalized Anxiety Disorder (GAD) is one of the most prevalent anxiety disorders among the elderly. Estimates of prevalence vary from around 3% to 12%, depending on the minimum age considered and the assessment instruments. The present study tests a GAD-specific treatment recently validated among adults (Ladouceur et al., 2000) and adapted for older adults. METHOD: Eight older adults (aged from 60 to 71) were included in a single-case experimental multiple-baseline design across subjects. Assessments were conducted at pre-test, post-test and at 6- and 12-months follow-ups. The treatment consisted of awareness training, worry interventions and relapse prevention. The worry interventions targeted intolerance of uncertainty, beliefs about worry, problem-solving and cognitive avoidance. RESULTS: According to daily self-monitoring of worry, ADIS-IV ratings and self-reported questionnaire scores, seven out of eight participants showed clinically significant improvement at post-test. These therapeutic gains were maintained at 6- and 12-month follow-ups. CONCLUSIONS: This study shows that a cognitive-behavioral treatment that targets intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation and cognitive avoidance is effective for treating GAD among elderly people.

Aged↗

PubMed2004

Trajectories of gambling during adolescence.

This study aimed at empirically identifying groups of adolescents with distinct longitudinal trajectories of gambling involvement and validating these groups by comparing them with respect to correlates. 903 low SES boys were followed annually from age 11 to 16 years. Three groups were found: an early-onset high-level chronic group, a late-onset high-level group, and a low gambler group. The Chronic group and the Low group consistently differed on teacher-rated inhibition (i.e., anxiety) during childhood and early adolescence. They also differed on concurrent teacher and self ratings of disinhibition (i.e., impulsivity), while the Late Onset group appeared to lie in between these groups. Compared to the Low group, both high groups subsequently had elevated scores on later gambling related problems.

Adolescent↗

PubMed2004

Awareness promotion about excessive gambling among video lottery retailers.

This paper describes and evaluates "As luck would have it," an awareness program completed by retailers in Quebec Province. This program, which is presented as a two-hour awareness promotion workshop, aimed to inform retailers about excessive gambling. More specifically, it provided answers to the following questions: (1) What is chance and randomness? (2) Is there a link between misunderstanding the concept of chance and excessive gambling? (3) How does one recognise the symptoms of this disorder? (4) How should retailers intervene if they decide to do so? Results showed that retailers developed a better understanding of problem gambling, could recognise its main symptoms, felt more capable of coping with excessive gamblers, and of choosing the most appropriate moment to do so. In the follow-up phase, retailers who had attended the workshop reported that they approached a problem gambler significantly more often than the retailers who had not attended the workshop, and had discussed how to help problem gamblers significantly more often. The practical implications of these results are briefly discussed.

Adult↗

PubMed2004

A science-based framework for responsible gambling: the Reno model.

As social observers increasingly identify gambling-related problems as a public health issue, key stakeholders need to join together to reduce both the incidence and prevalence of gambling-related harm in the community. This position paper describes a strategic framework that sets out principles to guide industry operators, health service and other welfare providers, interested community groups, consumers and governments and their related agencies in the adoption and implementation of responsible gambling and harm minimization initiatives.

Australia↗