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Assessing Randomised Clinical Trials of Cognitive and Exposure Therapies for Gambling Disorders: A Systematic Review

Published online by Cambridge University Press:  12 August 2013

David P. Smith ,
Kirsten I. Dunn ,
Peter W. Harvey ,
Malcolm W. Battersby  and
Rene G. Pols
David P. Smith*
Affiliation:
Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Adelaide, South Australia, Australia
Kirsten I. Dunn
Affiliation:
Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Adelaide, South Australia, Australia
Peter W. Harvey
Affiliation:
Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Adelaide, South Australia, Australia
Malcolm W. Battersby
Affiliation:
Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Adelaide, South Australia, Australia
Rene G. Pols
Affiliation:
Flinders Human Behaviour and Health Research Unit, Department of Psychiatry, Flinders University, Adelaide, South Australia, Australia
*
Address for correspondence: David P. Smith, Flinders University, Department Of Psychiatry, Flinders Human Behaviour And Health Research Unit, GPO Box 2100, Adelaide SA 2001, Australia. Email: david.smith@flinders.edu.au
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Abstract

Aims: Problem or pathological gambling is associated with significant disruption to the individual, family and community with a range of adverse outcomes, including legal, financial and mental health impairment. It occurs more frequently in younger populations, and comorbid conditions are common. Cognitive–behaviour therapy (CBT) is the most empirically established class of treatments for problematic gambling. This article reports on a systematic review and evaluation of randomised clinical trials (RCTs) concerning two core techniques of CBT: cognitive and behavioural (exposure-based) therapies. Methods: PsycINFO, MEDLINE and the Cochrane library were searched from database inception to December 2012. The CONsolidated Standards Of Reporting Trials (CONSORT) for non-pharmacological treatments was used to evaluate each study. Results: The initial search identified 104 references. After two screening phases, seven RCTs evaluating either cognitive (n = 3), exposure (n = 3) or both (n = 1) interventions remained. The studies were published between 1983 and 2003 and conducted across Australia, Canada, and Spain. On average, approximately 31% of CONSORT items were rated as ‘absent’ for each study and more than 52% rated as ‘present with some limitations’. For all studies, 70.83% of items rated as ‘absent’ were in the methods section. Conclusions: The findings from this review of randomised clinical trials involving cognitive and exposure-based treatments for gambling disorders show that the current evidence base is limited. Trials with low risk of bias are needed to be reported before recommendations are given on their effectiveness and clinicians can appraise their potential utility with confidence.

Keywords

gambling disorderscognitive therapyexposure therapyrandomised clinical trialCONSORT statement
Type
Review Article
Information
Behaviour Change , Volume 30 , Issue 3 , September 2013 , pp. 139 - 158
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
Battersby, M., Oakes, J., Tolchard, B., Forbes, A., & Pols, R. (2008). Cognitive behavioural treatment for problem gamblers. In Zangeneh, M., Blaszczynski, A., & Turner, N.E. (Eds.), In the pursuit of winning (pp. 179–197). New York: Springer.CrossRefGoogle Scholar
Beck, A.T., & Dozois, D.J.A. (2011). Cognitive therapy: Current status and future directions. Annual Review of Medicine, 62 (1), 397–409.Google Scholar
Becona, E. (1996). Prevalence surveys of problem and pathological gambling in Europe: The cases of Germany, Holland and Spain. Journal of Gambling Studies, 12 (2), 179–192.Google Scholar
Begg, C., Cho, M., Eastwood, S., Horton, R., Moher, D., Olkin, I., . . . Stroup, D.F. (1996). Improving the quality of reporting of randomized controlled trials: The CONSORT Statement. Journal of the American Medical Association, 276 (8), 637–639.CrossRefGoogle ScholarPubMed
Bondolfi, G., Osiek, C., & Ferrero, F. (2000). Prevalence estimates of pathological gambling in Switzerland. Acta Psychiatrica Scandinavica, 101 (6), 473–475.Google Scholar
Boutron, I., Moher, D., Altman, D., Schulz, K., & Ravaud, P. (2008). Extending the CONSORT Statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration. Annals of Internal Medicine, 148 (4), 295–309.CrossRefGoogle Scholar
Brown, R.I.F. (1987). Classical and operant paradigms in the management of gambling addictions. Behavioural Psychotherapy, 15 (2), 111–122.Google Scholar
Campbell, M.K., Elbourne, D.R., & Altman, D.G. (2004). CONSORT statement: Extension to cluster randomised trials. BMJ (Clinical Research Ed.), 328 (7441), 702–708.Google Scholar
Carlbring, P., Jonsson, J., Josephson, H., & Forsberg, L. (2010). Motivational interviewing versus cognitive behavioral group therapy in the treatment of problem and pathological gambling: A randomized controlled trial. Cognitive Behaviour Therapy, 39 (2), 92–103.CrossRefGoogle ScholarPubMed
Carlbring, P., & Smit, F. (2008). Randomized trial of internet-delivered self-help with telephone support for pathological gamblers. Journal of Consulting and Clinical Psychology, 76 (6), 1090–1094.Google Scholar
Clark, L. (2010). Decision-making during gambling: An integration of cognitive and psychobiological approaches. Philosophical Transactions of the Royal Society B: Biological Sciences, 365 (1538), 319–330.Google Scholar
Cowlishaw, S., Merkouris, S., Dowling, N., Anderson, C., Jackson, A., & Thomas, S. (2012). Psychological therapies for pathological and problem gambling. Cochrane Database of Systematic Reviews, (11). CD008937.Google ScholarPubMed
Daughters, B., Lejuez, C.W., Lesieur, H.R., Strong, D.R., & Zvolensky, M.J. (2003). Towards a better understanding of gambling treatment failure: Implications of translational research. Clinical Psychology Review, 23 (4), 573–586.Google Scholar
Delfabbro, P. (2009). Australasian Gambling Review. Adelaide, Australia: Independent Gambling Authority of South Australia.Google Scholar
Dowling, N. (2006). Treatment of female pathological gambling: The efficacy of a cognitive-behavioural approach. Journal of Gambling Studies, 22 (4), 355–372.Google Scholar
Echeburua, E., Baez, C., & Fernandez-Montalvo, J. (1996). Comparative effectiveness of three therapeutic modalities in the psychological treatment of pathological gamblers: Long-term outcome. Behavioural and Cognitive Psychotherapy, 24, 51–72.Google Scholar
Echeburua, E., Fernández-Montalvo, J., & Báez, C. (2000). Relapse prevention in the treatment of slot-machine pathological gambling: Long-term outcome. Behavior Therapy, 31 (2), 351–364.Google Scholar
Echeburua, E., Gomez, M., & Freixa, M. (2011). Cognitive-behavioural treatment of pathological gambling in individuals with chronic schizophrenia: A pilot study. Behaviour Research and Therapy, 49 (11), 808–814.Google Scholar
Fink, A., Parhami, I., Rosenthal, R.J., Campos, M.D., Siani, A., & Fong, T.W. (2012). How transparent is behavioral intervention research on pathological gambling and other gambling-related disorders? A systematic literature review. Addiction, 107 (11), 1915–1928.Google Scholar
Gadboury, A., & Ladouceur, R. (1989). Erroneous perceptions and gambling. Journal of Social Behavior & Personality, 4 (4), 411–420.Google Scholar
Gooding, P., & Tarrier, N. (2009). A systematic review and meta-analysis of cognitive-behavioural interventions to reduce problem gambling: Hedging our bets? Behaviour Research and Therapy, 47 (7), 592–607.Google Scholar
Higgins, J., & Green, S. (Eds.). (2011). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. Retrieved from www.cochrane-handbook.orgGoogle Scholar
Hodgins, D.C., Stea, J.N., & Grant, J.E. (2011). Gambling disorders. The Lancet, 378 (9806), 1874–1884.Google Scholar
Hopewell, S., Wolfenden, L., & Clarke, M. (2008). Reporting of adverse events in systematic reviews can be improved: Survey results. Journal of Clinical Epidemiology, 61 (6), 597–602.CrossRefGoogle ScholarPubMed
Jackson, A., Thomas, S., & Blaszczynski, A. (2003). Best practice in problem gambling services. Melbourne, Australia: Gambling Research Panel.Google Scholar
Jacobson, N.S., Dobson, K.S., Truax, P.A., Addis, M.E., Koerner, K., Gollan, J.K., . . . Prince, S.E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64 (2), 295–304.Google Scholar
Jakobsen, J.C., Hansen, J. L., Simonsen, S., Simonsen, E., & Gluud, C. (2012). Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: A systematic review of randomized clinical trials with meta-analyses and trial sequential analyses. Psychological Medicine, 1 (1), 1–15.Google Scholar
Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., & Leblond, J. (2003). Group therapy for pathological gamblers: A cognitive approach. Behaviour research and therapy, 41 (5), 587–596.CrossRefGoogle ScholarPubMed
Ladouceur, R., Sylvain, C., Boutin, C., Lachance, S., Doucet, C., Leblond, J., & Jacques, C. (2001). Cognitive treatment of pathological gambling. Journal of Nervous and Mental Disease, 189, 774–780.Google Scholar
Lorains, F.K., Cowlishaw, S., & Thomas, S.A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction 106 (3), 490–498.Google Scholar
Marks, I., Lovell, K., Noshirvani, H., Livanou, M., & Thrasher, S. (1998). Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: A controlled study. Archives of General Psychiatry, 55 (4), 317–325.Google Scholar
McConaghy, N., Armstrong, M. S., Blaszczynski, A., & Allcock, C. (1983). Controlled comparison of aversive therapy and imaginal desensitization in compulsive gambling. British Journal of Psychiatry, 142, 366–372.Google Scholar
McConaghy, N., Armstrong, M. S., Blaszczynski, A., & Allcock, C.C. (1988). Behavior completion versus stimulus control in compulsive gambling: Implications for behavioral assessment. Behavior Modification, 12 (3), 371–384.Google Scholar
McConaghy, N., Blaszczynski, A., & Frankova, A. (1991). Comparison of imaginal desensitisation with other behavioural treatments of pathological gambling: A two- to nine-year follow-up. British Journal of Psychiatry, 159, 390–393.Google Scholar
Melville, K.M., Casey, L.M., & Kavanagh, D.J. (2007). Psychological treatment dropout among pathological gamblers. Clinical Psychology Review, 27 (8), 944–958.CrossRefGoogle ScholarPubMed
Miller, L. E., & Stewart, M. E. (2011). The blind leading the blind: Use and misuse of blinding in randomized controlled trials. Contemporary Clinical Trials, 32 (2), 240–243.Google Scholar
Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioral treatment of problem gambling. Journal of Gambling Studies, 18 (2), 207–229.Google Scholar
Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P.C., Devereaux, P.J., . . . Altman, D.G. (2010). CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, c869.Google Scholar
Moher, D., Schulz, K.F., & Altman, D.G. (2001). The CONSORT statement: Revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Medical Research Methodology, 1 (2).Google Scholar
Myrseth, H., Litlere, I., Stoylen, I., & Pallesen, S. (2009). A controlled study of the effect of cognitive-behavioural group therapy for pathological gamblers. Nordic Journal of Psychiatry, 63 (1), 22–31.Google Scholar
Myrseth, H., Molde, H., Stoylen, I., Johnsen, B., Holsten, F., & Pallesen, S. (2011). A pilot study of CBT versus escitalopram combined with CBT in the treatment of pathological gamblers. International Gambling Studies, 11 (1), 121–141.Google Scholar
Oakes, J., Battersby, M., Pols, R., & Cromarty, P. (2008). Exposure therapy for problem gambling via videoconferencing: a case report. Journal of Gambling Studies, 24 (1), 107–119.Google Scholar
Öst, L.-G. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy, 46 (3), 296–321.Google Scholar
Ougrin, D. (2011). Efficacy of exposure versus cognitive therapy in anxiety disorders: Systematic review and meta-analysis. BMC Psychiatry, 11 (1), 200.Google Scholar
Petry, N.M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., . . . Steinberg, K. (2006). Cognitive-behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74 (3), 555–567.Google Scholar
Petry, N.M., & Hodgins, D.C. (2012). An introduction to Addiction's new series on gambling. Addiction, 107 (6), 1034–1035.Google Scholar
Piaggio, G., Elbourne, D., Altman, D.G., Pocock, S.J., & Evans, S.J.W. (2006). Reporting of noninferiority and equivalence randomized trials: An extension of the CONSORT Statement. Journal of the American Medical Association, 295 (10), 1152–1160.CrossRefGoogle ScholarPubMed
Plint, A., Moher, D., Morrison, A., Schulz, K., Altman, D., Hill, C., & Gaboury, I. (2006). Does the CONSORT checklist improve the quality of reports of randomised controlled trials? A systematic review. Medical Journal of Australia, 185 (5), 263–267.Google Scholar
Potenza, M.N. (2006). Should addictive disorders include non-substance-related conditions? Addiction, 101 (S1), 142–151.Google Scholar
Problem Gambling Research and Treatment Centre (PGRTC). (2011). Guideline for screening, assessment and treatment in problem gambling: Melbourne, Australia: Monash University.Google Scholar
Raylu, N., & Oei, T. (2004). The Gambling Related Cognitions Scale (GRCS): Development, confirmatory factor validation and psychometric properties. Addiction, 99 (6), 757–769.Google Scholar
Raylu, N., & Oei, T.P. (2012). A cognitive behavioural therapy programme for problem gambling: Therapist manual. Behavioural and Cognitive Psychotherapy, 40, 504–507.Google Scholar
Sackett, D., Rosenberg, W., Gray, J., Haynes, R., & Richardson, S. (1996). Evidence-based medicine: What it is and what it isn’t. BMJ (Clinical Research Ed.), 312 (7023), 71–72.Google Scholar
Saunders, J.B., & Cottler, L.B. (2007). The development of the Diagnostic and Statistical Manual of Mental Disorders version V substance use disorders section: Establishing the research framework. Current Opinion in Psychiatry, 20, 208–212.Google Scholar
Shaffer, H.J., & Hall, M.N. (2001). Updating and refining prevalence estimates of disordered gambling behaviour in the United States and Canada. Canadian Journal of Public Health, 92 (3), 168–172.Google Scholar
Sharpe, L., & Tarrier, N. (1992). A cognitive-behavioral treatment approach for problem gambling. Journal of Cognitive Psychotherapy, 6 (3), 193–203.Google Scholar
StataCorp. (2011). Stata Statistical Software: Release 12. College Station, TX: Author.Google Scholar
Sylvain, C., Ladouceur, R., & Boisvert, J.M. (1997). Cognitive and behavioral treatment of pathological gambling: A controlled study. Journal of Consulting & Clinical Psychology, 65 (5), 727–732.Google Scholar
Tolchard, B., Thomas, L., & Battersby, M.W. (2006). Single-session exposure therapy of problem gambling: A single case experimental design. Behaviour Change, 23 (2), 148–155.Google Scholar
Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M.D., Constantine, R., & Pigott, S. (2007). The British Gambling Prevalence Survey. London: The Stationery Office.Google Scholar
West, R. (2012). Trial protocols. Addiction, 107 (9), 1544.Google Scholar
White, P.D., Goldsmith, K.A., Johnson, A.L., Potts, L., Walwyn, R., DeCesare, J.C., . . . PACE trial management group. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. The Lancet, 377 (9768), 823–836.Google Scholar
Wong, I.L.K., & Ernest, M.T.S. (2003). Prevalence estimates of problem and pathological gambling in Hong Kong. The American Journal of Psychiatry, 160 (7), 1353–1354.Google Scholar