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      Gamblers seeking treatment: Who does and who doesn’t?

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          Abstract

          Background and aims: As only a minority of pathological gamblers (PGr) presents for treatment, further knowledge about help-seeking behavior is required in order to enhance treatment utilization. The present study investigated factors associated with treatment participation in gamblers in Germany. As subclinical pathological gamblers (SPGr, fulfilling one to four DSM-IV-criteria) are target of early intervention due to high risk of transition to pathological gambling, they were subject of special interest. Methods: The study analyzed data from a general population survey (n = 234, SPGr: n = 198, PGr: n = 36) and a treatment study (n = 329, SPGr: n = 22, PGr: n = 307). A two-step weighting procedure was applied to ensure comparability of samples. Investigated factors included socio-demographic variables, gambling behavior, symptoms of pathological gambling and substance use. Results: In PGr, regular employment and non-German nationality were positively associated with being in treatment while gambling on the Internet and gaming machines and fulfilling more DSM-IV-criteria lowered the odds. In SPGr, treatment attendance was negatively associated with married status and alcohol consumption and positively associated with older age, higher stakes, more fulfilled DSM-IV criteria and regular smoking. Conclusions: In accordance to expectations more severe gambling problems and higher problem awareness and/or external pressure might facilitate treatment entry. There are groups with lower chances of being in treatment: women, ethnic minorities, and SPGr. We propose target group specific offers, use of Internet-based methods as possible adaptions and/or extensions of treatment offers that could enhance treatment attendance.

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          Most cited references 77

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          Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

          To present nationally representative data on lifetime prevalence and comorbidity of pathological gambling with other psychiatric disorders and to evaluate sex differences in the strength of the comorbid associations. Data were derived from a large national sample of the United States. Some 43,093 household and group quarters residents age 18 years and older participated in the 2001-2002 survey. Prevalence and associations of lifetime pathological gambling and other lifetime psychiatric disorders are presented. The diagnostic interview was the National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV Version. Fifteen symptom items operationalized the 10 pathological gambling criteria. The lifetime prevalence rate of pathological gambling was 0.42%. Almost three quarters (73.2%) of pathological gamblers had an alcohol use disorder, 38.1% had a drug use disorder, 60.4% had nicotine dependence, 49.6% had a mood disorder, 41.3% had an anxiety disorder, and 60.8% had a personality disorder. A large majority of the associations between pathological gambling and substance use, mood, anxiety, and personality disorders were overwhelmingly positive and significant (p .05). Pathological gambling is highly comorbid with substance use, mood, anxiety, and personality disorders, suggesting that treatment for one condition should involve assessment and possible concomitant treatment for comorbid conditions.
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            The prevalence and demographics of pathological gamblers: implications for public health.

            A study of pathological gambling in five states provides information needed to address the public health threat that the expanding availability of legalized gambling poses to at-risk groups in the general population. Over the course of this project, epidemiological data were collected to determine the prevalence of probable pathological gambling in the general population in each study state and demographic data were collected from pathological gamblers entering treatment programs in each state. Among the states surveyed, the availability of and involvement in gambling differ significantly, as does the prevalence of pathological gambling. Despite these differences, the demographics of pathological gamblers in these states are similar. Like those in the general population, pathological gamblers entering treatment in each state are similar. However, pathological gamblers entering treatment do not represent the full spectrum of individuals in the general population who experience gambling-related problems. These findings raise a number of issues, including the potential impacts of continued gambling legalization on the overall rate of gambling problems in the general population and on specific at-risk groups, including women, minorities, and children. They thus have implications for policy and program decisions now being made throughout the United States.
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              Natural and treatment-assisted recovery from gambling problems: a comparison of resolved and active gamblers.

              An exploratory study was conducted to understand the process of recovery from gambling problems. Media recruitment was used to identify a resolved (n = 43) and a comparison group of active pathological gamblers (n = 63). Participants showed evidence of significant problems related to gambling as well as high rates of co-morbid mood and substance use disorders. The median length of resolution was 14 months with a range of 6 weeks to 20 years. Resolved gamblers reported a variety of reasons for quitting gambling, related mainly to emotional and financial factors. They did not experience a greater number of precipitating life events compared with active gamblers but did report an increase in positive and a decrease in negative life events in the year after resolution. Both resolved and active gamblers who had relatively more severe problems were more likely to have had treatment or self-help involvement, whereas those with less severe problems, if resolved, were "naturally recovered". The results support the need for a continuum of treatment options for problem gamblers and provide helpful information about recovery processes.
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                Author and article information

                Journal
                J Behav Addict
                jba
                Journal of Behavioral Addictions
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                September 2014
                27 September 2014
                : 3
                : 3
                : 189-198
                Affiliations
                1IFT Institut fűr Therapieforschung, Munich, Germany
                2Institut fűr Psychologie, Universität Hildesheim, Germany
                3Addiction Research Unit, Institut fűr Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Germany
                4Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Sweden
                Author notes
                *Corresponding author: Barbara Braun; IFT Institut für Therapieforschung, Parzivalstr.25, 80804 Munich, Germany; E-mail: braunbarbara@ 123456ift.de
                Article
                jba.3.2014.3.7
                10.1556/JBA.3.2014.3.7
                4189314
                © 2014 Akadémiai Kiadó

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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