Problem and Pathological Gambling

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Januar 2007



Over the past 30 years there has been a dramatic increase in the availability of convenient and legal gambling opportunities. Accompanying this proliferation of gambling is a growing understanding that between 5% and 9% of adults experience significant to severe problems due to their gambling activities. These problems have become a real health concern, with substantial costs to individuals, families, and communities.

The objective of this book is to provide the clinician ¿ or graduate student ¿ with essential information about problem and pathological gambling. After placing this behavioral addiction and its co-occurring difficulties in perspective, by describing its proliferation, the associated costs, and diagnostic criteria and definitions, the authors present detailed information on a strategy to assess and treat gambling problems in an outpatient setting.


Preface... v Acknowledgments ... vi Dedication... vii 1 Description of Problem and Pathological Gambling... 1 1.1 Terminology... 1 1.1.1 Gambling as Recreation ... 1 1.1.2 Continuum of Gambling-Related Harm... 2 1.2 Definitions... 4 1.2.1 Pathological Gambling ... 4 1.2.2 Problem Gambling... 6 1.3 Epidemiology... 7 1.3.1 Vulnerable Populations... 7 1.3.2 Types of Gambling and Gambling Problems... 9 1.3.3 Impact of Gambling Availability... 9 1.3.4 Demographic Correlates... 10 1.4 Course and Prognosis ... 11 1.4.1 Negative Effects ... 12 1.4.2 Natural Recovery ... 12 1.5 Differential Diagnosis... 13 1.6 Comorbidity... 13 1.6.1 Substance Use Disorders... 13 1.6.2 Mood Disorders... 14 1.6.3 Anxiety Disorders... 15 1.6.4 Axis II Disorders... 15 1.7 Diagnostic Procedures and Documentation ... 15 1.7.1 Diagnostic Interview for Gambling Severity (DIGS)... 15 1.7.2 South Oaks Gambling Screen (SOGS)... 16 1.7.3 Lie/Bet Questionnaire... 16 1.7.4 Gambling Timeline Follow-Back (G-TLFB) ... 16 1.7.5 Addiction Severity Index - Gambling Subscale (ASI-G)... 17 1.7.6 Gamblers Belief Questionnaire (GBQ)... 18 1.7.7 Gamblers Self-Efficacy Questionnaire (GSEQ)... 18 2 Theories and Models... 20 2.1 Gambling as an Addictive Behavior... 20 2.2 Learning Theories ... 22 2.3 Cognitive Theories ... 24 2.4 Biological Theories... 27 2.4.1 Family and Genetic Studies... 27 2.4.2 Neurotransmitter and Neuroanatomical Theories... 28 2.5 Disease Model... 29 2.6 An Integrated Model of Problem Gambling... 30 2.7 Guided Self-Change ... 31 Advances in Psychotherapy: Problem and Pathological Gambling 2.7.1 Harm Reduction ... 32 2.7.2 Rapid Change Response... 32 2.7.3 Self-Change... 33 2.7.4 Motivational Approach... 34 3 Diagnosis and Treatment Indications... 35 3.1 Diagnostic Assessment ... 35 3.2 Treatment Indications ... 35 3.3 Clinical Assessment... 36 3.3.1 Gambling Behavior ... 37 3.3.2 Assessment of Possible Treatment Mediators... 37 3.3.3 Systemic Factors... 39 3.3.4 Comorbid Psychopathology ... 40 3.4 Treatments ... 41 4 Treatment... 43 4.1 Method of Treatment... 43 4.1.1 Basic Principles ... 43 4.1.2 Phase 1: Running Start Assessment ... 47 4.1.3 Phase 2: Motivational Feedback ... 49 4.1.4 Phase 3: Triggers and Consequences ... 52 4.1.5 Phase 4: Options and Action Plan ... 53 4.1.6 Phase 5: Relapse Prevention ... 55 4.1.7 Follow-Up ... 56 4.2 Mechanisms of Action... 57 4.3 Efficacy and Diagnosis... 58 4.4 Variations and Combination Methods... 59 4.5 Problems in Carrying Out Treatment ... 61 4.6 Multicultural Issues... 62 5 Case Vignette... 64 5.1 Phase 1: Running Start Assessment ... 64 5.2 Phase 2: Motivation and Feedback... 68 5.3 Phase 3: Functional Analysis of Gambling... 76 5.4 Phase 4: Implementation of Alternative Behaviors... 78 5.5 Phase 5: Relapse Prevention... 79 5.6 Six Month Follow-up ... 80 6 Further Reading... 82 7 References... 83 8 Appendices: Tools and Resources ... 91


James P. Whelan, PhD, is Associate Professor of Psychology and Director of Clinical Training at the University of Memphis, as well as codirector of the Institute for Gambling Education and Research and the Gambling Clinic. He has also served as Director of Clinical Training and has won awards for his engaged scholarship. Dr. Whelan's research spans several areas, including efficacy for psychological treatments, problem gambling, and sport and exercise psychology. Timothy A. Steenbergh, PhD, is Associate Professor of Psychology and Director of the Lilly Student Research Initiative at Indiana Wesleyan University. Dr. Steenbergh's research on addictive behaviors has focused primarily on problem gambling. In addition to his research, Dr. Steenbergh also enjoys teaching and providing psychotherapy at a small clinical practice in Marion, IN. Andrew W. Meyers, PhD, is Professor in the Department of Psychology and Vice Provost for Research at the University of Memphis, as well as codirector of the Institute for Gambling Education and Research. Dr. Meyers has served on the editorial boards of the Journal of Consulting and Clinical Psychology, Behavior Therapy, Health Psychology, and Cognitive Therapy and Research, and for the past 25 years has maintained a private practice focused on addictions and health behavior.


"Beginning with a concise background of the disorder, its prevalence, risk factor, and comorbidities, and finishing with an illustrative case vignette, this brief but fulfilling handbook delivers - It is a quick read with no wasted space and provides a highly valuable and concise introduction to both problem and pathological gambling - This volume successfully distils a complicated topic into an easily readable primer, making it a first-line reference for gambling treatment." Carrie H. Kennedy in PsycCRITIQUES, 2008, Vol. 53 "This excellent publication provides a thorough coverage of the nature of this problem - I highly recommend this manual for all readers who are interested in learning more about gambling problems and effective treatment methods: It's a good bet!" G. Alan Marlatt, PhD, Professor and Director, Addictive Behaviors Research Center, University of Washington "A succinct review of a youthful field that is sure to please clinicians. [The authors] get right to the point and cover a range of important topics. Clinicians who treat gambling problems will be sure to find that this useful primer deserves a place on their bookshelves." Howard J. Shaffer, PhD, Editor of Psychology of Addictive Behaviors; Associate Professor, Harvard Medical School and Director, Division on Addictions, The Cambridge Health Alliance


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EAN: 9781613343128
Untertitel: EPUB. Sprache: Englisch.
Verlag: Hogrefe Publishing GmbH
Erscheinungsdatum: Januar 2007
Seitenanzahl: 123 Seiten
Format: epub eBook
Kopierschutz: Wasserzeichen
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