Advertisement

Journal of Gambling Studies

, Volume 26, Issue 4, pp 583–592 | Cite as

Treatment Utilization of Pathological Gamblers with and without PTSD

  • Lisa M. Najavits
Original Paper

Abstract

This paper represents the first study of treatment utilization among pathological gamblers with and without PTSD. Comorbidity of PG and PTSD is increasingly recognized as an important association, both in its rate and clinical severity. The sample comprised 106 adults from the community (35 with current PG; 36 with current PTSD, and 35 with BOTH). Four areas were addressed: current treatment utilization, lifetime treatment utilization, specific treatments utilized, and satisfaction with treatments. Results indicated that the presence of PTSD was associated with higher treatment utilization (for current utilization, PTSD was higher than PG; and for lifetime, PTSD and PTSD/PG were both higher than PG). Indeed, only a minority of the PG group had ever attended current or lifetime treatment, whereas the majority of PTSD and PTSD/PG had. Yet notably, those with PG who utilized current treatment had no less satisfaction, number of treatment types, nor number of days in treatment than the other two groups. For all three groups, the most common current treatments were individual therapy and psychiatric medications. Study strengths include a rigorously diagnosed sample; an extensive interview-based assessment of treatment utilization, and identification of both current and lifetime utilization. Limitations include the inability to explore change over time or test–retest reliability of responses.

Keywords

PTSD Pathological gambling Problem gambling Treatment utilization Therapy 

Notes

Acknowledgements

This study was funded by the Ontario Problem Gambling Research Centre. Opinions expressed in this final report are those of the author only. Collaborators on data collection are sincerely thanked: David A. Korn, MD, CAS, DTPH (University of Toronto); Kay Johnson, LICSW (St. Luke’s-Roosevelt Hospital System); Tamar Meyer, MA (Centre for Addiction and Mental Health, formerly of the University of Toronto).

References

  1. Biddle, D., Hawthorne, G., Forbes, D., & Coman, G. (2005). Problem gambling in Australian PTSD treatment-seeking veterans. Journal of Traumatic Stress, 18(6), 759–767.CrossRefPubMedGoogle Scholar
  2. Davidson, J. R. T. (2001). Recognition and treatment of posttraumatic stress disorder. Journal of the American Medical Association, 286, 584–588.CrossRefPubMedGoogle Scholar
  3. Gotestam, K. G., Johansson, A., Wenzel, H. G., & Simonsen, I. E. (2004). Validation of the Lie/Bet screen for pathological gambling on two normal population data sets. Psychological Reports, 95(3 Pt 1), 1009–1013.PubMedGoogle Scholar
  4. Johnson, E. E., Hamer, R., Nora, R. M., Tan, B., Eistenstein, N., & Englehart, C. (1988). The Lie/Bet questionnaire for screening pathological gamblers. Psychological Reports, 80, 83–88.Google Scholar
  5. Kausch, O., Rugle, L., & Rowland, D. Y. (2006). Lifetime histories of trauma among pathological gamblers. The American Journal on Addictions, 15(1), 35–43.CrossRefPubMedGoogle Scholar
  6. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 593–602.CrossRefPubMedGoogle Scholar
  7. Kessler, R. C., Hwang, I., Labrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38, 1351–1360.PubMedGoogle Scholar
  8. Kimerling, R., Ouimette, P., Prins, A., Nisco, P., Lawler, C., Cronkite, R., et al. (2006). Brief report: Utility of a short screening scale for DSM-IV PTSD in primary care. Journal of General Internal Medicine, 21(1), 65–67.CrossRefPubMedGoogle Scholar
  9. Korn, D., & Shaffer, H. (1999). Gambling and the health of the public: Adopting a public health perspective. Journal of Gambling Studies, 15, 289–365.CrossRefPubMedGoogle Scholar
  10. Ledgerwood, D. M., & Petry, N. M. (2006). Posttraumatic stress disorder symptoms in treatment-seeking pathological gamblers. J Traumatic Stress, 19, 411–416.CrossRefGoogle Scholar
  11. Leung, K., & Cottler, L. (2008). Treatment of pathological gambling. Current Opinion in Psychiatry, 22, 69–74.CrossRefGoogle Scholar
  12. McLellan, A. T., Kushner, H., Metzger, D., Peters, R., Smith, I., Grissom, G., et al. (1992). The fifth edition of the Addiction Severity Index. Journal of Substance Abuse Treatment, 9, 199–213.CrossRefPubMedGoogle Scholar
  13. Najavits, L. M. (2007). Treatment summary questionnaire for PG and PTSD. Boston, MA: Unpublished measure, Harvard Medical School/McLean Hospital.Google Scholar
  14. Najavits, L. M., Ryngala, D., Back, S. E., Bolton, E., Mueser, K. T., & Brady, K. T. (2008). Treatment for PTSD and comorbid disorders: A review of the literature. In E. B. Foa, T. M. Keane, M. J. Friedman, & J. Cohen (Eds.), Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies (2nd ed.). New York: Guilford.Google Scholar
  15. Najavits, L. M., & Weiss, R. D. (1996). Treatment summary questionnaire. Boston, MA: Unpublished measure, Harvard Medical School/McLean Hospital.Google Scholar
  16. Najavits, L. M., Weiss, R. D., & Shaw, S. R. (1997). The link between substance abuse and posttraumatic stress disorder in women: A research review. American Journal on Addictions, 6, 273–283.PubMedGoogle Scholar
  17. Ouimette, P., & Brown, P. J. (2002). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders (pp. 209–226). Washington, DC: American Psychological Association Press.Google Scholar
  18. Pallesen, S., Mitsem, M., Kvale, G., Johnsen, B., & Molde, H. (2005). Outcome of psychological treatments of pathological gambling: a review and meta-analysis. Addiction, 100, 1412–1422.Google Scholar
  19. Petry, N. M. (2004). Pathological gambling: Etiology, comorbidity, and treatment. Washington DC: American Psychological Association Press.Google Scholar
  20. Petry, N. M., & Steinberg, K. L. (2005). Childhood maltreatment in male and female treatment-seeking pathological gamblers. Psychology of Addictive Behaviors, 19(2), 226–229.CrossRefPubMedGoogle Scholar
  21. Pulford, J., Bellringer, M., Abbott, M., Clarke, D., Hodgins, D., & Williams, J. (2008). Barriers to help-seeking for a gambling problem: The experiences of gamblers who have sought specialist assistance and the perceptions of those who have not. Journal of Gambling Studies, 25, 33–48.CrossRefPubMedGoogle Scholar
  22. Sheehan, D., Lecrubier, Y., Harnett Sheehan, K., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMedGoogle Scholar
  23. Suurvali, H., Hodgins, D., Toneatto, T., & Cunningham, J. (2008). Treatment seeking among ontario problem gamblers: Results of a population survey. Psychiatric Service, 59, 1343–1346.CrossRefGoogle Scholar
  24. Taber, J. I., McCormick, R. A., & Ramirez, L. F. (1987). The prevalence and impact of major life stressors among pathological gamblers. The International Journal of the Addictions, 22(1), 71–79.PubMedGoogle Scholar
  25. Westermeyer, J., Canive, J., Garrard, J., Thuras, P., & Thompson, J. (2005). Lifetime prevalence of pathological gambling among American Indian and Hispanic American Veterans. American Journal of Public Health, 95(5), 860–866.CrossRefPubMedGoogle Scholar
  26. Winters, K. C., Specker, S., & Stinchfield, R. D. (2002). Diagnostic Interview for Gambling Severity-Revised (DIGS-R). Minneapolis, MN: University of Minnesota Medical School.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Harvard Medical School, Treatment InnovationsNewton CentreUSA

Personalised recommendations