Treatments for PTSD and Pathological Gambling: What Do Patients Want?
- 370 Downloads
This study explored the treatment preferences of 106 people with posttraumatic stress disorder (PTSD), pathological gambling (PG), or both. It is the first know study of its type for this comorbidity. Sixteen different treatment types were rated, with a broad array of modalities including manualized psychotherapies, medication, self-help, alternative therapies, coaching, and self-guided treatments (use of books and computerized therapy). A consistent finding was that PTSD treatments were rated more highly than PG treatments, even among those with both disorders. Further, of the sixteen treatment types, the sample expressed numerous preferences for some over others. For example, among PG treatments, self-help was the highest-rated. Among PTSD treatments, psychotherapies were the highest-rated; and individual therapy was rated higher than group therapy. For both PG and PTSD, medications were rated lower than other treatment types. Non-standard treatments (i.e., computerized treatment, books, coaching, family therapy, alternative therapies) were generally rated lower than other types. Discussion includes implications for the design of treatments, as well as methodological limitations.
KeywordsPTSD Posttraumatic stress disorder Pathological gambling Problem gambling Therapy
This study was funded by a grant to Treatment Innovations from the Ontario Problem Gambling Research Centre. Opinions expressed in this final report are those of the author, and do not necessarily represent the views of the Ontario Problem Gambling Research Centre. 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).
- Ferris, J., & Wynne, H. (2001). The Canadian Problem Gambling Index: User manual. Canadian Centre on Substance Abuse. Internet: www.ccsa.ca.
- Foa, E. B., Keane, T. M., Friedman, M. J., & Cohen, J. (Eds.). (2008). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies (2nd ed.). New York: Guilford.Google Scholar
- 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
- 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, 1–10.Google Scholar
- Najavits, L. M. (2007a). Interest in Treatment Scale. Boston, MA: Unpublished measure, Harvard Medical School.Google Scholar
- Najavits, L. M. (2007b). Treatment Summary Questionnaire for PG and PTSD. Boston, MA: Unpublished measure, Harvard Medical School/McLean Hospital.Google Scholar
- Najavits, L. M. (in press). Treatment utilization of pathological gamblers with and without PTSD. Journal of Gambling Studies.Google Scholar
- Najavits, L. M., Korn, D. A., Johnson, K. M., & Meyer, T. (under review). Pathological gambling and posttraumatic stress disorder: A study comparing each alone and in combination.Google Scholar
- Najavits, L. M., & Weiss, R. D. (1996). Treatment Summary Questionnaire. Boston, MA: Unpublished measure, Harvard Medical School/McLean Hospital.Google Scholar
- Ouimette, P., & Brown, P. J. (2002). Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders. Washington, DC: American Psychological Association Press.Google Scholar
- 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.PubMedCrossRefGoogle Scholar
- 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
- 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