Abstract
This case series introduces the desensitization of triggers and urge reprocessing (DeTUR), as a promising adjunctive therapy in addition to comprehensive treatment package for pathological gambling. This addiction protocol of eye movement desensitization and reprocessing was delivered to four male inpatients admitted to a 10-week inpatient program for pathological gambling. The therapist gave three 60-min weekly sessions of the DeTUR using bilateral stimulation (horizontal eye movements or alternative tactile stimuli) focusing on the hierarchy of triggering situations and the urge to initiate gambling behaviors. After treatment, self-reported gambling symptoms, depression, anxiety, and impulsiveness were all improved, and all the participants reported satisfaction with the therapy. They were followed up for 6 months and all maintained their abstinence from gambling and their symptomatic improvements. Given the efficiency (i.e., brevity and efficacy) of the treatment, a controlled study to confirm the effects of the DeTUR on pathological gambling would be justified.
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References
Achab, S., & Khazaal, Y. (2011). Psychopharmacological treatment in pathological gambling: A critical review. Current Pharmaceutical Design, 17(14), 1389–1395.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association Press.
Bae, H., & Kim, D. (2012). Desensitization of triggers and urge reprocessing for an adolescent with internet addiction disorder. Journal of EMDR Practice and Research, 6(2), 73–81. doi:10.1891/1933-3196.6.2.73.
Barbieri, J. L. (2008). The URGES approach: Urge reduction by growing ego strength (URGES) for trauma/addiction treatment using alternative bilateral stimulation, hypnotherapy, ego state therapy and energy psychology. Sexual Addiction & Compulsivity, 15(2), 116–138.
Bisson, J., & Andrew, M. (2007). Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Systemic Reviews, (3), CD003388, doi:10.1002/14651858.CD003388.pub3.
Blaszczynski, A., McConaghy, N., & Frankova, A. (1990). Boredom proneness in pathological gambling. Psychological Reports, 67(1), 35–42.
Cowlishaw, S., Merkouris, S., Dowling, N., Anderson, C., Jackson, A., Thomas, S. (2012). Psychological therapies for pathological and problem gambling. Cochrane Database Systemic Reviews 11, CD008937, doi:10.1002/14651858.CD008937.pub2.
Denis, C., Fatseas, M., & Auriacombe, M. (2012). Analyses related to the development of DSM-5 criteria for substance use related disorders: 3. An assessment of pathological gambling criteria. Drug and Alcohol Dependence, 122(1–2), 22–27. doi:10.1016/j.drugalcdep.2011.09.006.
Evans, L., & Delfabbro, P. H. (2005). Motivators for change and barriers to help-seeking in Australian problem gamblers. Journal of Gambling Studies, 21(2), 133–155. doi:10.1007/s10899-005-3029-4.
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. doi:10.1111/j.1360-0443.2012.03911.x.
Freidenberg, B. M., Blanchard, E. B., Wulfert, E., & Malta, L. S. (2002). Changes in physiological arousal to gambling cues among participants in motivationally enhanced cognitive-behavior therapy for pathological gambling: A preliminary study. Applied Psychophysiology and Biofeedback, 27(4), 251–260.
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. doi:10.1016/j.brat.2009.04.002.
Henry, S. (1996). Pathological gambling: Etiologic consideration and treatment efficacy of eye movement desensitizaion/reprocessing. Journal of Gambling Studies, 12(4), 395–405.
Holub, A., Hodgins, D. C., & Peden, N. E. (2005). Development of the temptations for gambling questionnaire: A measure of temptation in recently quit gamblers. Addiction Research & Theory, 13(2), 179–191. doi:10.1080/16066350412331314902.
Ironson, G., Freund, B., Strauss, J. L., & Williams, J. (2002). Comparison of two treatments for traumatic stress: A community-based study of EMDR and prolonged exposure. Journal of Clinical Psychology, 58(1), 113–128.
Kim, S. W., Grant, J. E., Potenza, M. N., Blanco, C., & Hollander, E. (2009). The Gambling Symptom Assessment Scale (G-SAS): A reliability and validity study. Psychiatry Research, 166(1), 76–84. doi:10.1016/j.psychres.2007.11.008.
Kim, H. J., Kim, J.-H., Shin, Y. C., Shin, H. C., Grant, J. E., & Lee, T. K. (2005). The reliablity and validity of the Korean version of the Gambling Symptom Assessment Scale (KG-SAS). Journal of Korean Neuropsychiatric Association, 44(6), 683–689.
Ladouceur, R., Boisvert, J.-M., Pepin, M., Loranger, M., & Sylvain, C. (1994). Social cost of pathological gambling. Journal of Gambling Studies, 10(4), 399–409.
Ladouceur, R., Lachance, S., & Fournier, P. M. (2009). Is control a viable goal in the treatment of pathological gambling? Behaviour Research and Therapy, 47(3), 189–197. doi:10.1016/j.brat.2008.11.004.
Ledgerwood, D. M., & Petry, N. M. (2006). Posttraumatic stress disorder symptoms in treatment-seeking pathological gamblers. Journal of Traumatic Stress, 19(3), 411–416. doi:10.1002/jts.20123.
Lee, H. S. (1992). Impulsiveness Scale. Seoul: Guidance Korea.
Lee, J. H. (1995). Development of the Korean form of Zung’s Self-Rating Depression Scale. Yeungnam Univesity Medical Journal, 12, 292–305.
Lee, J. H. (1996). Development of the Korean form of Zung’s Self-Rating Anxiety Scale. Yeungnam Univesity Medical Journal, 13, 279–294.
Leung, K. S., & Cottler, L. B. (2009). Treatment of pathological gambling. Current Opinions in Psychiatry, 22(1), 69–74. doi:10.1097/YCO.0b013e32831575d9.
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. doi:10.1111/j.1360-0443.2010.03300.x.
Moore, S. M., Thomas, A. C., Kyrios, M., & Bates, G. (2012). The self-regulation of gambling. Journal of Gambling Studies, 28(3), 405–420. doi:10.1007/s10899-011-9265-x.
Nijdam, M. J., Gersons, B. P., Reitsma, J. B., de Jongh, A., & Olff, M. (2012). Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: Randomised controlled trial. British Journal of Psychiatry, 200(3), 224–231. doi:10.1192/bjp.bp.111.099234.
Ogden, P., Pain, C., Fisher, J. (2006). A sensorimotor approach to the treatment of trauma and dissociation. Psychiatric Clinics in North America, 29(1), 263–279, xi–xii, doi:10.1016/j.psc.2005.10.012.
Pallesen, S., Mitsem, M., Kvale, G., Johnsen, B. H., & Molde, H. (2005). Outcome of psychological treatments of pathological gambling: A review and meta-analysis. Addiction, 100(10), 1412–1422. doi:10.1111/j.1360-0443.2005.01204.x.
Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology, 51(6), 768–774.
Popky, A. J. (2005). DeTUR, an urge reduction protocol for addictions and dysfunctional behavior. In R. Shapiro (Ed.), EMDR solutions: Pathway to healing (pp. 167–188). New York: W.W. Norton and Company.
Popky, A. J. (2009). The desenstization of triggers and urge reprocessing (DeTUR) protocol. In M. Luber (Ed.), Eye movement desensitization and reprocessing scripted protocols: Special population (pp. 489–511). New York: Springer.
Rizeanu, S. (2012). The specificity of pathological gambling. Procedia-Social and Behavioral Science, 33, 1082–1086. doi:10.1016/j.sbspro.2012.01.289.
Rogers, S., & Silver, S. M. (2002). Is EMDR an exposure therapy? A review of trauma protocols. Journal of Clinical Psychology, 58(1), 43–59.
Rubak, S., Sandbaek, A., Lauritzen, T., & Christensen, B. (2005). Motivational interviewing: A systematic review and meta-analysis. British Journal of General Practice, 55(513), 305–312.
Shaffer, H. J., Hall, M. N., & Vander Bilt, J. (1999). Estimating the prevalence of disordered gambling behavior in the United States and Canada: A research synthesis. American Journal of Public Health, 89(9), 1369–1376.
Shapiro, F. (2001). Eye movement desensitization and reprocessing (EMDR): Basic priciples, protocols, and procedures (2nd ed.). New York: Guilford.
Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163(2), 297–302. doi:10.1176/appi.ajp.163.2.297.
Stea, J. N., & Hodgins, D. C. (2011). A critical review of treatment approaches for gambling disorders. Current Drug Abuse Reviews, 4(2), 67–80.
Toneatto, T., & Ladoceur, R. (2003). Treatment of pathological gambling: A critical review of the literature. Psychology of Addictive Behaviors, 17(4), 284–292. doi:10.1037/0893-164X.17.4.284.
Walker, M. B. (1992). The psychology of gambling. Oxford: Pergamon.
Walker, M. B. (2005). Problems in measuring the effectiveness of cognitive therapy for pathological gambling. Journal of Gambling Studies, 21(1), 79–92. doi:10.1007/s10899-004-1927-5.
Zung, W. W. (1965). A self-rating depression Scale. Archives of General Psychiatry, 12, 63–70.
Zung, W. W. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12(6), 371–379. doi:10.1016/S0033-3182(71)71479-0.
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Bae, H., Han, C. & Kim, D. Desensitization of Triggers and Urge Reprocessing for Pathological Gambling: A Case Series. J Gambl Stud 31, 331–342 (2015). https://doi.org/10.1007/s10899-013-9422-5
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DOI: https://doi.org/10.1007/s10899-013-9422-5