Biomedical subjects

Tony Toneatto

Publications and source records attributed to Tony Toneatto.

11 recordsLinked to original sources

PubMed2006

Overlap of clusters of psychiatric symptoms among clients of a comprehensive addiction treatment service.

This article describes the prevalence and overlap of psychiatric symptoms among 2,784 clients of the outpatient programs at a comprehensive addictions treatment facility. The psychiatric symptoms were assessed by a computer-based questionnaire, and the analysis focused on the overlap of symptom clusters (multimorbidity) and their relation to selected intake variables known to be predictors of treatment outcome. Of all clients, 27.4% scored positive for 1, 18.9% for 2, and 22.3% for 3 or more clusters, the most frequent being depression, anxiety, and history of conduct disorder. Multimorbidity was significantly correlated with female gender, unemployment, less social support, cannabis problems, fewer legal problems, and increased treatment engagement. Clients with more substance use disorders presented more psychiatric symptoms.

Adolescent↗

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↗

PubMed2005

A perspective on problem gambling treatment: issues and challenges.

Researchers face several challenges in conducting gambling treatment research. These include the impact of monetary incentives to participate, difficulty in subject recruitment, treatment ambivalence, heterogeneity of gambling behaviors among treatment samples, the role of natural recovery, the impact of intractable financial pressures, and the specification of adequate process and outcome measures. Each challenge is defined and potential resolutions suggested.

Behavior, Addictive↗

PubMed2005

Cognitive versus behavioral treatment of concurrent alcohol dependence and agoraphobia: a pilot study.

With the growing awareness of the prevalence of anxiety disorders among alcohol abusers there is a need for effective cognitive--behavioral treatments (CBTs). This study is a pilot investigation comparing two treatments for concurrent alcohol dependence and panic disorder with agoraphobia. A 10-session behavioral treatment (BT), consisting of five sessions treating alcohol dependence and five sessions treating panic disorder with agoraphobia, was compared to a 10-session cognitive treatment (CT) that addressed the dysfunctional cognitions mediating the alcohol problem and anxiety symptoms. There were no group differences in frequency or quantity of alcohol consumption or in anxiety symptoms posttreatment or at a 1-year follow-up in a sample of 14 subjects who completed the study. Both groups showed within-group improvements on measures of both alcohol and anxiety symptomatology. Approximately one-third of the subjects made clinically relevant gains on both alcohol and anxiety symptoms. A brief BT for concurrent alcohol dependence and agoraphobia appears encouraging.

Adult↗

PubMed2004

Lifetime rates of alcoholism in adults with anxiety, depression, or co-morbid depression/anxiety: a community survey of Ontario.

BACKGROUND: Separate lines of research have demonstrated strong associations linking alcohol misuse with major depression on the one hand, and anxiety disorders on the other. In the current study we examined the possible confounding and/or additive effects of co-morbid depression/anxiety in understanding these relationships. METHODS: A total of 7195 individuals in Ontario, aged 15-64, were interviewed using the CIDI. Based on lifetime diagnoses, we compared rates of alcohol abuse/dependence in four groups consisting of normal controls, individuals with unipolar major depression but no anxiety disorders, individuals with one or more anxiety disorders without depression, and individuals with co-morbid major depression and anxiety. Age of onset of alcoholism in the four study groups was also compared. RESULTS: In both genders, there were significantly higher rates of alcoholism in all three psychiatric groups relative to controls. In females only, there was also a significantly higher rate of alcoholism in the depressed/anxious group than in the pure anxious group. The age of onset of alcoholism was the same across all four study groups. LIMITATIONS: Due to limitations related to sample size, we combined subjects with various anxiety disorders into a single anxiety group and concurrent and sequential co-morbidity were not distinguished. CONCLUSIONS: Both gender effects and depression/anxiety co-morbidity may be important considerations in the design and interpretation of studies on alcohol misuse. This may be particularly relevant when considering the strength of the association between alcoholism and anxiety disorders in women. Depression and anxiety do not appear to influence the age of onset of alcoholism. Furthermore, no single temporal pattern of onset was identified in individuals with all three disorders, suggesting no obvious cause-effect relationship among them.

Adolescent↗

PubMed2004

Assessing and treating problem gambling: empirical status and promising trends.

OBJECTIVE: Ways to clinically assess and treat problem gambling evolve as our knowledge about this disorder increases. This paper summarizes current knowledge about treating problem gambling and describes developments in the assessment, psychology, and biology of problem gambling that may be important for treatment. METHODS: We reviewed recent published literature reporting advances in the assessment, psychology, and biology of problem gambling. We retained for review only controlled clinical trials in which subjects were randomized to either psychological or pharmacologic treatment. RESULTS: Although several gambling treatments were found to be efficacious, support for any specific treatment modality is still limited. Cognitive-behavioural treatments were most effective. Although diagnostic assessment has improved, there are still very few measures of gambling-related variables. The contribution to gambling of sex, concurrent psychiatric disorders, cognitive distortions, and impulsivity has been described. Evidence implicating decision-making areas of the cortex and disturbances in serotonin and dopamine functioning has been reviewed. Available evidence for a genetic contribution to problem gambling is weak. CONCLUSIONS: Improvements in the methodology of gambling-treatment research were discussed to advance the clinical approach to this disorder. Developments in the area of assessment, psychology, and biology of gambling should inform clinical approaches to a greater degree than they currently do. We identified the need to study different types of gambling separately, rather than combining them, as an important goal.

Disruptive, Impulse Control, and Conduct Disorders↗

PubMed2003

Treatment of pathological gambling: a critical review of the literature.

The legalization and availability of new forms of gambling are increasing in most Western countries. This trend has contributed to the fact that more individuals are developing gambling problems. As a result, there is a need for effective treatments. Although gambling treatment dates several decades, few empirically supported treatments for pathological gambling have been developed. This critical review includes only controlled treatment studies. The primary inclusion criterion was randomization of participants to an experimental group and to at least 1 control group. Eleven studies were identified and evaluated. Key findings showed that cognitive-behavioral studies received the best empirical support. Recommendations to improve gambling treatment research include better validated psychometric measures, inclusion of process measures, better definition of outcomes, and more precise definition of treatments.

Behavior, Addictive↗

PubMed2003

Effect of a new casino on problem gambling in treatment-seeking substance abusers.

Problem gambling rates are frequently found to be higher in those who abuse substances than in the general population, and this group represents a well-established high-risk population for developing the disorder. In this study of 853 residential substance abusers, approximately 10% scored in the problem gambling range on the South Oaks Gambling Screen (SOGS). On most descriptive variables, these subjects appeared to be similar to substance abusers who do not have gambling problems. However, they tended to participate in more gambling behaviours and had more relationships with individuals who also gambled. There is some evidence that the introduction of a new casino in the community increased the SOGS scores for subjects who gambled most frequently on such casino-related gaming as slot machines, cards, and casino games.

Adult↗

PubMed2002

Patterns of substance use in treatment-seeking problem gamblers: impact on treatment outcomes.

Accumulating evidence suggests that treatment-seeking problem gamblers have high rates of substance abuse. However, relatively little is known about the relation between gambling problems and specific psychoactive substances apart from alcohol and methadone-treated opiate addicts. In this study of 169 individuals seeking outpatient treatment for problem gambling, lifetime drug use and medication use were very high. Approximately half of the sample were using a psychiatric medication at the time they sought gambling treatment while very few individuals were using other drugs. Gambling treatment outcomes were unrelated to history of drug or medication use. No evidence was found for substitution of psychoactive substance use for gambling during the follow-up year. These findings indicate that gamblers are more likely to be involved with drug and medication use compared to the general population, but that such histories are not associated with gambling treatment outcomes.

Adult↗

PubMedDate not supplied

Pathological gambling in treatment-seeking substance abusers.

Accumulating evidence suggests that treatment-seeking substance abusers have high rates of gambling problems. However, relatively little is known about the relation between gambling problems and specific psychoactive substances apart from alcohol and methadone-treated opiate addicts. In this study of 580 individuals admitted to a residential addictions program, 10.5% were found to score in the pathological gambling range on the South Oaks Gambling Screen (SOGS) within the past year. The rate of pathological gambling was much higher for cannabis abusers (24%) than for alcohol (4%), cocaine (11.5%), and opiate abusers (4.8%). Men also reported higher rates of pathological gambling (11.9%) than women (7.5%). Individuals with a pathological gambling problem tended to report family histories of gambling problems as well.

Adult↗

PubMedDate not supplied

Anxiety and explicit alcohol-related memory in problem drinkers.

Anxiety is associated with increased craving following in vivo cue exposure in alcoholics. Theoretical accounts [Psychol. Rev. 97 (1990) 147.] have proposed that conscious, deliberate cognitive processes underlie increased craving in drinkers who are trying to abstain. The present study tested the hypothesis that anxiety is associated with biases in explicit (i.e., conscious, deliberate) memory that promote recall of alcohol-related concepts in response to negative affective cues. Fifty-two (seven females) outpatient problem drinkers performed a cued recall task that assessed memory for alcohol-related (ALC), negative affective (NEG), and neutral (NEU) target concepts that had been paired with NEG, ALC, and NEU cues during an incidental study phase. Higher anxiety was associated with increased recall of ALC targets paired with NEG cues. State and trait anxiety were intercorrelated, with higher levels coinciding with a higher frequency of drinking in negative mood states. These findings demonstrate a correspondence between anxiety and alcohol-related memory, and suggest that explicit memory biases may contribute to increased subjective responses (e.g., craving, expectancies) to alcohol stimuli in anxious problem drinkers.

Adult↗