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      Motivação para mudança de comportamento em amostra de jogadores patológicos Translated title: Motivation for behavior change in a sample of pathological gamblers

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          Abstract

          OBJETIVO: O objetivo deste trabalho foi conhecer o perfil e avaliar as características de jogadores patológicos que frequentavam clínicas e grupos especializados no tratamento desse problema, quanto à motivação para mudança de comportamento. MÉTODO: Foram avaliados 69 sujeitos com diagnóstico de jogo patológico, segundo critérios diagnósticos do DSM-IV-TR. A amostra foi subdividida em dois grupos, conforme o tipo de tratamento: grupo em tratamento ambulatorial (TA) e grupo de jogadores anônimos (JA). Os instrumentos utilizados foram a University of Rhode Island Change Assessment (URICA), a Régua de Prontidão e a South Oaks Gambling Screen (SOGS). RESULTADOS: A análise dos resultados evidenciou que o grupo TA apresentou escore médio maior do que o do grupo JA tanto no estágio de pré-contemplação quanto no estágio de ação. Comparando os grupos TA e JA com relação ao tempo de abstinência, observou-se que o grupo de JA está associado a um tempo maior de abstinência do que o grupo de ambulatório. CONCLUSÃO: A importância de pesquisar estratégias que favoreçam a compreensão e a adesão aos tratamentos para jogadores patológicos é fundamental. A avaliação da motivação e dos estágios para mudança permite uma direção para o tratamento, auxiliando na elaboração de estratégias terapêuticas.

          Translated abstract

          OBJECTIVE: The goal of this study was to evaluate the profile and the characteristics of pathological gamblers who attended clinics and groups specialized in the treatment of this problem, focusing on patients' motivation to change this behavior. METHOD: 69 subjects with a diagnosis of pathological gambling, according to diagnostic criteria of DSM-IV-TR were evaluated. The sample was divided in two groups according to treatment regimen: ambulatory care group and gamblers anonymous group (GA). The instruments used were the University of Rhode Island Change Assessment (URICA), the Ruler of Readiness and SOGS (South Oaks Gambling Screen). RESULTS: The results showed that the ambulatory group had a higher mean score than the GA group, both in the precontemplation stage and in the action stage. Comparing the group of ambulatory care and GA with regard to length of abstinence, it was observed that the group of GA is associated with a longer period of abstinence than the ambulatory group. CONCLUSION: The importance of searching strategies that enhance the understanding and treatment adherence for pathological gamblers is crucial. The evaluation of the motivation to change and the stages of change allow professionals to find a better direction for treatment, assisting in the development of therapeutic strategies.

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          Most cited references28

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          Reconceptualizing emetophobia: a cognitive-behavioral formulation and research agenda.

          Fear of vomiting (emetophobia) is a poorly understood anxiety disorder, with little research published into its conceptualization or treatment. The current article uses established cognitive and behavioral models of other anxiety disorders as a basis from which to propose a detailed model of emetophobia. The model proposes that emetophobia results from a constellation of factors including a general anxiety-vulnerability factor, a tendency to somatize anxiety as gastrointestinal distress, a tendency to catastrophically misappraise nausea and other gastrointestinal symptoms, hypervigilance to gastrointestinal cues, beliefs about the unacceptability of vomiting, negatively reinforced avoidance behavior, and selective confirmation biases. A formulation-based treatment package for emetophobia is outlined, including arousal management skills, distraction/attention training, exposure and cognitive restructuring.
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            Profile of the pathological gambler.

            R P Custer (1984)
            Pathological (compulsive) gambling is a serious emotional and social problem that has existed for centuries but has only recently been recognized as a distinct diagnostic entity that can be effectively treated. The development and progression of pathological gambling are outlined. The progression of the disorder through three identifiable phases leads to predictable complications. The treatment of the gambler within the framework of Gamblers Anonymous and/or by mental health professionals is described.
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              Manual diagnóstico e estatístico de transtornos mentais - DSM-IVTR

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                jbpsiq
                Jornal Brasileiro de Psiquiatria
                J. bras. psiquiatr.
                Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (Rio de Janeiro )
                1982-0208
                2011
                : 60
                : 2
                : 73-79
                Affiliations
                [1 ] Pontifícia Universidade Católica do Rio Grande do Sul Brazil
                Article
                S0047-20852011000200001
                10.1590/S0047-20852011000200001
                9872c632-117c-4145-8b1e-d916908c674c

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0047-2085&lng=en
                Categories
                PSYCHIATRY

                Clinical Psychology & Psychiatry
                URICA,motivation to change,stages of change,pathological gambling,motivação para mudança,estágios de mudança,jogo patológico

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