Abstract
This article reviews the literature with respect to mindfulness and its potential for reducing the severity of problem gambling behaviour. Interest in the role of mindfulness as a treatment for problem gambling has gained the attention of researchers across Australia, the United States, and Canada. However, the literature is limited and current studies have severe methodological limitations. Despite this issue, investigations have revealed that dispositional mindfulness is related to less severe problem gambling outcomes and that psychological distress, overconfidence and risk willingness, myopic focus on reward and ego involvement may act as mediators in this relationship. Moreover, the literature indicates that the inverse relationship between dispositional mindfulness and psychological distress may be mediated by factors such as values clarification; emotional, cognitive, and behavioural flexibility; non-attachment; emotion dysregulation/distress intolerance; thought suppression; and rumination. This article discusses the theoretical and clinical implications of these relationships with respect to mindfulness-based interventions for problem gambling. It is recommended that the approach be considered with cautious optimism.
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References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, text revision, 4th ed. Arlington, VA: Author.
Arch, J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focussed breathing induction. Behaviour Research and Therapy, 44, 1849–1858.
Atlas, G. D., & Peterson, C. (1990). Explanatory style and gambling: How pessimists respond to losing wagers. Behaviour Research and Therapy, 28(6), 523–529.
Australian Institute of Gambling Research. (1995). A critical analysis of two national prevalence studies: The case for alternative strategies. Sydney: Macarthur University of Western Sydney.
Baer, R. A. (2003). Mindfulness training as a clinical intervention—a conceptual and empirical review. Clinical Psychology Science and Practice, 10, 125–143.
Baer, R. A., Fischer, S., & Huss, D. B. (2005). Mindfulness and acceptance in the treatment of disordered eating. Journal of Rational-Emotive & Cognitive Behavior Therapy, 23(4), 281–300.
Baer, R. A., & Krietemeyer, J. (2006). Overview of mindfulness and acceptance-based treatment approaches. In R. Baer (Ed.), Mindfulness-based treatment approaches: A clinicians guide to evidence base and applications (pp. 3–27). London: Academic Press.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report methods to explore facets of mindfulness. Assessment, 13(1), 27–45.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15, 329–342.
Bechara, A., Damasio, A. R., Damasio, H., & Anderson, S. W. (1994). Insensitivity to future consequences following damage human prefrontal cortex. Cognition, 50, 7–15.
Bishop, S. R. (2002). What do we really know about mindfulness-based stress reduction? Psychosomatic Medicine, 64, 71–84.
Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.
Blaszczynski, A., & Nower, L. (2002). A pathways model for problem and pathological gambling. Addiction, 97(5), 487–499.
Borders, A., Earleywine, M., & Jajodia, A. (2010). Could mindfulness decrease anger, hostility, and aggression by decreasing rumination? Aggressive Behavior, 36, 28–44.
Bowen, S., Witkiewitz, K., Dillworth, T. M., & Marlatt, G. A. (2007). The role of thought suppression in the relationship between mindfulness meditation and alcohol use. Addictive Behaviors, 32, 2324–2328.
Boyer, M., & Dickerson, M. (2003). Attentional bias and addictive behaviour: Automaticity in a gambling-specific modified Stroop task. Addiction, 98(1), 61–70.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.
Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for salutary effects. Psychological Inquiry, 18(4), 211–237.
Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23–33.
Carmody, J., Baer, R. A., Lykins, E. L. B., & Olendzki, N. (2009). An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program. Journal of Clinical Psychology, 65, 613–626.
Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clinical Psychology Review, 29, 560–572.
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716.
Chan-Ob, T., & Boonyanaruthee, V. (1999). Meditation in association with psychosis. Journal of the Medical Association of Thailand, 82, 925–930.
Ciarrocchi, J. W. (2002). Counseling problem gamblers: A self regulation manual for individual and family therapy. San Diego: Academic Press.
Cocco, N., Sharpe, L., & Blaszczynski, A. P. (1995). Differences in preferred level of arousal in two sub-groups of problem gamblers: A preliminary report. Journal of Gambling Studies, 11, 221–229.
Coelho, H. F., Canter, P. H., & Ernst, E. (2007). Mindfulness-based cognitive therapy: Evaluating current evidence and informing future research. Journal of Consulting Clinical Psychology, 75(6), 1000–1005.
Coffey, K. A., & Hartman, M. (2008). Mechanisms of action in the inverse relationship between mindfulness and psychological distress. Complementary Health Practice Review, 13(2), 79–91.
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkrantz, M., Muller, D., Santoreli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564–570.
de Lisle, S., Dowling, N., & Allen, J. (2011a). Mindfulness-based cognitive therapy for problem gambling. Clinical Case Studies. Prepublished March 7, 2011. doi:10.1177/1534650111401016.
de Lisle, S., Dowling, N., & Allen, J. (2011b). Mechanisms of action in the inverse relationship between dispositional mindfulness and problem gambling. Manuscript submitted for publication.
Dickerson, M., Baron, E., Hong, S.-M., & Cottrell, D. (1996). Estimating the extent and degree of gambling related problems in the Australian population: A national survey. Journal of Gambling Studies, 12(2), 161–178.
Dimidjian, S. D., & Linehan, M. M. (2003). Mindfulness practice. In W. O’Donohue, J. Fisher, & S. Hayes (Eds.), Cognitive behavior therapy: Applying empirically supported techniques in your practice (pp. 229–237). New York: Wiley.
Dowling, N., Smith, D., & Thomas, T. (2006). Treatment of female pathological gambling: Efficacy of a cognitive-behavioural approach. Journal of Gambling Studies, 22, 355–372.
Dowling, N., Smith, D., & Thomas, T. (2007). A comparison of individual and group cognitive behavioral treatment for female pathological gambling. Behaviour Research and Therapy, 45, 2192–2202.
Dowling, N., Smith, D., & Thomas, T. (2009). A preliminary investigation of abstinence and controlled gambling as self-selected goals of treatment for female pathological gambling. Journal of Gambling Studies, 25(2), 201–214.
Goodie, A. S. (2003). The effect of control on betting: Paradoxical betting on items of high confidence with low value. Journal of Experimental Psychology: Learning, Memory, Cognition, 29, 598–610.
Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57, 35–43.
Harris, R. (2006). Embracing your demons: An overview of acceptance and commitment therapy. Psychotherapy in Australia, 12(4), 2–8.
Hayes, S. C., & Feldman, G. (2004). Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clinical Psychology: Science and Practice, 11(3), 255–262.
Hayes, S. C., Follette, V. M., & Linehan, M. M. (Eds.). (2004). Mindfulness and acceptance: Expanding the cognitive tradition. New York: Guilford Press.
Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy. New York: Guilford Press.
Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33, 11–21.
Joukhador, J., Maccallum, F., & Blaszczynski, A. (2003). Differences in cognitive distortions between problem and social gamblers. Psychological Reports, 92, 1203–1214.
Kabat-Zinn, J. (2005). Full catastrophe living—using the wisdom of your body and mind to face stress, pain, and illness (3rd ed.). New York: Bantam Dell.
Kabat-Zinn, J., & Chapman-Waldrop, A. (1988). Compliance with an outpatient stress-reduction program: Rates and predictors of program completion. Journal of Behavioral Medicine, 11(4), 333–352.
Kavanagh, D. J., Andrade, J., & May, J. (2004). Beating the urge: Implications of research into substance-related desires. Addictive Behaviors, 29, 1359–1372.
Korman, L., Collins, J., McMain, S., & Skinner, W. (2005). Concurrent gambling, substance use and anger: Development of a brief integrated treatment. Ontario: Ontario Problem Gambling Research Centre.
Krasner, M. (2004). Mindfulness-based interventions: A coming of age? Families, Systems, and Health, 22, 207–212.
Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4, 357–363.
Kumar, S., Feldman, G., & Hayes, S. C. (2008). Changes in mindfulness and emotion regulation in an exposure-based cognitive therapy for depression. Cognitive Therapy and Research, 32, 734–744.
Ladouceur, R., Sylvain, C., Boutin, C., & Doucet, C. (1998). Understanding and treating the pathological gambler. Chichester: Wiley.
Lakey, C. E., Campbell, W. K., Brown, K. W., & Goodie, A. S. (2007). Dispositional mindfulness as a predictor of the severity of gambling outcomes. Personality and Individual Differences, 43, 1698–1710.
Lau, M. A., & McMain, S. F. (2005). Integrating mindfulness meditation with cognitive and behavioural therapies: The challenge of combining acceptance- and change-based strategies. Canadian Journal of Psychiatry, 50(13), 863–869.
Lau, M., Segal, Z. V., & Williams, J. M. G. (2004). Teasdale’s differential activation hypothesis: Implications for mechanisms of depressive relapse and suicidal behaviour. Behaviour Research and Therapy, 42, 1001–1017.
Lazar, S. W., Kerr, C. E., Wasserman, R. H., Gray, J. R., Greve, D. N., Treadway, M. T., et al. (2005). Meditation experience is associated with increased cortical thickness. Neuroreport, 16, 1893–1897.
Lee, T. K., LaBrie, R. A., Grant, J. E., Kim, S. W., & Shaffer, H. J. (2008). The structure of pathological gambling among Korean gamblers: A cluster and factor analysis of clinical and demographic characteristics. International Journal of Mental Health and Addiction, 6, 551–563.
Linehan, M. M. (1993a). Cognitive-behavioural treatment of borderline personality disorder. New York: Guilford Press.
Linehan, M. M. (1993b). Skill training manual for treating borderline personality disorder. New York: Guilford Press.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., et al. (2006). Two-year randomized controlled trial and follow-up of dialectal behavior therapy vs. therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.
López Viets, V. C., & Miller, W. R. (1997). Treatment approaches for pathological gamblers. Clinical Psychology Review, 17, 689–702.
Lorains, F. K., Cowlishaw, S., & Thomas, S. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Manuscript submitted for publication.
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40.
McCusker, C. G., & Gettings, B. (1997). Automaticity of cognitive biases in addictive behaviours: Further evidence with gamblers. British Journal of Clinical Psychology, 36(4), 543–554.
McIntosh, W. D., & Martin, L. L. (1992). The cybernetics of happiness: The relation between goal attainment, rumination, and affect. In M. S. Clark (Ed.), Review of personality and social psychology (Vol. 14, pp. 222–246). Newbury Park: Sage Publications.
Melbourne Academic Mindfulness Interest Group. (2006). Mindfulness-based psychotherapies: A review of conceptual foundations, empirical evidence and practical considerations. Australian and New Zealand Journal of Psychiatry, 40, 285–294.
Najmi, S., & Wegner, D. M. (2008). Thought suppression and psychopathology. In A. J. Elliot (Ed.), Handbook of approach and avoidance motivation (pp. 447–459). New York: Psychology Press.
Orford, J., Morison, V., & Somers, M. (1996). Drinking and gambling: A comparison with implications for theories of addiction. Drug and Alcohol Review, 15, 47–56.
Palfai, T. P., Monti, P. M., Colby, S. M., & Rohsenow, D. J. (1997). Effects of suppressing the urge to drink on the accessibility of alcohol outcome expectancies. Behavior Research and Therapy, 35(1), 59–65.
Petry, N. M. (2005). Pathological gambling: Etiology, comorbidity, and treatment. Washington, D.C: American Psychological Association.
Petry, N. M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., et al. (2006). Cognitive-behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74(3), 555–567.
Problem Gambling Research and Treatment Centre. (2011). Guideline for screening, assessment and treatment in problem and pathological gambling. Melbourne: Monash University.
Productivity Commission. (2010). Gambling. Productivity commission inquiry report. Vol. 1. Report no. 50. Canberra: Productivity Commission.
Ramel, W., Goldin, P. R., Carmona, P. E., & McQuaid, J. R. (2004). The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28(4), 433–455.
Rassin, E. (2005). Thought suppression. Oxford: Elsevier.
Ratelle, C. F., Vallerand, R. J., Mageau, G. A., Rousseau, F. L., & Provencher, P. (2004). When passion leads to problematic outcomes: A look at gambling. Journal of Gambling Studies, 20(2), 105–119.
Ree, M. J., & Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behaviour Change, 24(2), 70–86.
Rickwood, D., Blaszczynski, A., Delfabbro, P., Dowling, N., & Heading, K. (2010). The psychology of gambling. InPsych, 32(6), 11–21.
Safran, J. D., & Segal, Z. V. (1990). Interpersonal process in cognitive therapy. New York: Basic Books.
Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.
Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness-based cognitive therapy for children: Promoting mindful attention to enhance social-emotional resiliency in children. Journal of Child and Family Studies, 19(2), 218–229.
Shapiro, D. H. (1992). A preliminary study of long term meditators: Goals, effects, religious orientation, cognitions. Journal of Transpersonal Psychology, 24(1), 23–39.
Shapiro, S., Brown, K., & Biegel, G. (2007). Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1(2), 105–115.
Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.
Sharpe, L. (2002). A reformulated cognitive-behavioral model of problem gambling: A biopsychosocial perspective. Clinical Psychology Review, 22(1), 1–25.
Shead, N. W., Callan, M. J., & Hodgins, D. C. (2008). Probability discounting among gamblers: Differences across problem severity and affect-regulation expectancies. Personality and Individual Differences, 45, 536–541.
Simons, J., & Gaher, R. (2005). The distress tolerance scale: Development and validation of a self-report measure. Motivation and Emotion, 29, 83–102.
Smith, A. (2006). “Like waking up from a dream”: Mindfulness training for older people with anxiety and depression. In R. Baer (Ed.), Mindfulness-based treatment approaches: A clinicians guide to evidence base and applications (pp. 191–215). London: Academic Press.
Smith, A., Graham, L., & Senthinathan, S. (2007). Mindfulness-based cognitive therapy for recurring depression in older people: A qualitative study. Aging & Mental Health, 11(3), 346–357.
Stewart, S. H., & Zack, M. (2008). Development and psychometric evaluation of a three-dimensional gambling motives questionnaire. Addiction, 103, 1110–1117.
Tavares, H., Martins, S. S., Zilberman, M. L., & el-Guebaly, N. (2002). Gamblers seeking treatment: Why haven’t they come earlier? Addictive Disorders & Their Treatment, 1(2), 65–69.
Taylor, D. G., & Mireault, G. C. (2008). Mindfulness and self-regulation: A comparison of long-term and short-term meditators. The Journal of Transpersonal Psychology, 40(1), 88–99.
Teasdale, J. D., Segal, Z. V., & Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behavioral Research and Therapy, 33, 25–39.
Toll, B. A., Sobell, M. B., Wagner, E. F., & Sobell, L. C. (2001). The relationship between thought suppression and smoking cessation. Addictive Behaviors, 26, 509–515.
Toneatto, T., Vettese, L., & Nguyen, L. (2007). The role of mindfulness in the cognitive-behavioural treatment of problem gambling. Journal of Gambling Issues, 19, 91–100.
Vohs, K. D., & Baumeister, R. F. (2004). Understanding self-regulation. In R. F. Baumeister & K. D. Vohs (Eds.), Handbook of self-regulation (pp. 1–9). New York: Guilford Press.
Walker, M., Toneatto, T., Potenza, M. N., Petry, N., Ladouceur, R., Hodgins, D. C., et al. (2006). A framework for reporting outcomes in problem gambling treatment research: The Banff, Alberta Consensus. Addiction, 101(4), 504–511.
Walsh, R., & Roche, L. (1979). Precipitation of acute psychotic episodes in intensive meditation in individuals with a history of schizophrenia. American Journal of Psychiatry, 136, 1085–1086.
Wegner, D. M. (1989). White bears and other unwanted thoughts: Suppression, obsession, and the psychology of mental control. London: The Guilford Press.
Wegner, D. M., & Erber, R. (1992). The hyperaccessibility of suppressed thoughts. Journal of Personality and Social Psychology, 63, 903–912.
Wells, A. (2002). GAD, metacognition, and mindfulness: An information processing analysis. Clinical Psychology: Science and Practice, 9(1), 95–100.
Wells, A., & Matthews, G. (1994). Attention and emotion: A clinical perspective. Hove: Erlbaum.
Wells, A., & Matthews, G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 33, 579–583.
Westphal, J. R. (2008). How well are we helping problem gamblers? An update to the evidence base supporting problem gambling treatment. International Journal of Mental Health and Addiction, 6(2), 249–264.
Williams, J. M. G., & Swales, M. (2004). The use of mindfulness-based approaches for suicidal patients. Archives of Suicide Research, 8, 315–329.
Williams, M., Teasdale, J., Segal, Z., & Kabat-Zinn, J. (2007). The mindful way through depression. New York: The Guilford Press.
Winters, K. C., & Kushner, M. G. (2003). Treatment issues pertaining to pathological gamblers with a comorbid disorder. Journal of Gambling Studies, 19(3), 261–277.
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de Lisle, S.M., Dowling, N.A. & Allen, J.S. Mindfulness and Problem Gambling: A Review of the Literature. J Gambl Stud 28, 719–739 (2012). https://doi.org/10.1007/s10899-011-9284-7
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DOI: https://doi.org/10.1007/s10899-011-9284-7