Gambling counselling in Australia: focus on cognitive counselling techniques

A number of specialised counselling services are now available to assist individuals who experience difficulties as a result of problem gambling behaviour. Clinicians within these services may utilise one or a number of counselling approaches depending on their own preferences and their assessment of the counselling style suitable for use with particular clients. The purpose of this paper is twofold. The first is to describe the range of specialised gambling counselling services now available in Australia. The second aim is to provide clinicians in the field with a range of practical cognitive counselling strategies that may be used to good effect to assist clients to reassess their attitudes towards and thoughts about gambling.     

Distorsions cognitives et pratique de jeu de hasard et d’argent : état de la question

Cognitive distorsions are inherent to any gambling situation whatever the level of commitment of the gambler. Irrational beliefs lead the subject to overestimate his share of control over the game's outcome to the detriment of chance. Knowing the objective probability to win and having good numeric capacities of reasoning does not prevent the gamblers from developing these false beliefs. According to the concept of double switching proposed by Ladouceur and Sévigny (2005), irrational beliefs would coexist with objective knowledges on the game and would bustle in situation of gambling. The progress and the outcome of the game influence the development and the maintenance of cognitive distorsions, which influences the subject's practice of gambling. Pathological gambling, repeated and persistent gambling behavior, is characterized in particular by the presence of cognitive distortions, leading the subject to maintain, even to increase his gambling practice. Indeed, if cognitive distorsions are present in any situation of gambling, it seems nevertheless that it is more frequent and more intense in problem and pathological gamblers. Cognitive distorsions, in particular illusion of control, thus lead to a more important practice of gambling and a financial risk-taking, favoring the installation and the preservation of problem gambling. Certain factors seem to influence cognitive distorsions. There is a gender effect: women would present fewer irrational beliefs than men. Depression, anxiety and stress would also favor the development of these beliefs in situation of gambling. Several methods exist to estimate cognitive distorsions in gamblers. The first researches are based on assessment made by others (observation and analysis of gambler's verbalizations). Afterward, several self-report scales were created. At the moment, none of these scales has been validated in French language. The identification of gambling related cognitive distortions permit to elaborate adapted modes of treatment. So, the cognitive therapy suggests identifying and restructuring the beliefs to bring the subject to change his gambling behavior. In spite of the current knowledge on cognitive distorsions, certain questions remain open, in particular about the implication of theses beliefs in games implying a part of strategy, in which the subject has effectively a certain control over the game.     

A comparison of individual and group cognitive-behavioural treatment for female pathological gambling

The current study aimed to determine the differential efficacy of a cognitive-behavioural treatment program for female pathological gamblers delivered in individual and group format. Fifty-six female pathological gamblers with electronic gaming machine gambling problems were randomly assigned to the control (waiting list) group or one of the treatment groups (individual or group treatment). Treatment comprised a 12-session program including financial limit setting, alternative activity planning, cognitive correction, problem solving, communication training, relapse prevention, and imaginal desensitisation. Treatment outcome was evaluated with conceptually related measures within the areas of gambling behaviour and psychological functioning. While individual and group treatment formats generally produced comparable outcomes in terms of gambling behaviour and psychological functioning, group treatment failed to produce superior outcomes to the control group in relation to several measures of psychological functioning. Moreover, by the completion of the six-month follow-up, 92% of the gamblers allocated to individual treatment compared with 60% allocated to group treatment no longer satisfied the diagnostic criteria for pathological gambling. These findings suggest that some caution should be employed when delivering cognitive-behavioural treatment in a group format until further research is conducted to establish its efficacy.     

Psychological Factors that Promote and Inhibit Pathological Gambling

This paper describes qualitative data regarding psychological factors that may affect gambling behavior among treatment-seeking pathological gamblers. Participants (n = 84) diagnosed with pathological gambling were treated in a clinical trial examining the efficacy of cognitive behavioral therapy (CBT). Qualitative data were collected from participants during each of 8 structured CBT sessions. Specific gambling-related psychological factors that were assessed include triggers, consequences, high-risk situations, craving experiences, assertiveness skills, cognitive distortions, and coping strategies. The most commonly reported triggers for gambling were lack of structured time and negative emotional state, which were similar to the high-risk times for gambling. The most frequently listed positive consequences of gambling were enjoyment associated with winning and use of gambling as an escape. Negative consequences of gambling included depressed mood, financial problems, and conflict with family. Coping strategies changed during treatment, as participants reported relying less upon avoidance and distraction, and became better able to utilize support networks and cognitive coping skills. These data are important to better understand the factors associated with the development, maintenance, and cessation of pathological gambling.     

Problem Gambling Features and Gendered Gambling Domains Amongst Regular Gamblers in a Swedish Population-Based Study

This study aimed to investigate, from a gender perspective, how different features of problem gambling present in men and women who gamble regularly in Sweden were distributed in four domains based on gambling type (chance or strategy) and setting (public or domestic). Problem gambling features were based on the nine items in the Problem Gambling Severity Index (PGSI). It was hypothesized that men and women gamble in different domains. Further, it was hypothesized that male gamblers overall experienced more problems with gambling than female gamblers, although in the same domains they would report the same level of problems. A further hypothesis predicted that regular female gamblers would experience more health and social problems and men would experience more financial difficulties. Interviews with a subsample of gamblers (n?=?3191) from a Swedish nationally representative sample (n?=?8179) was used to examine how features of problem gambling correspond with gender and the domains. Only the first hypothesis was fully supported. Men were more likely to participate in forms of gambling requiring strategy in a public setting, and women were more likely to participate in chance-based gambling in a domestic setting. Male and female gamblers had similar levels of problem gambling in the bi-variate analysis, but if controlling for age and gambling in multiple domains, women were more at risk than men. Additionally, men and women presented similar health and economic situations. The differences between male and female gamblers in Sweden have implications for research and prevention.     

A systematic review and meta-analysis of cognitive-behavioural interventions to reduce problem gambling: Hedging our bets?

Problem gambling is of serious public, social and clinical concern, especially so because ease of access to different types of gambling is increasing. A systematic review and meta-analysis was carried out to determine whether Cognitive-Behavioural Therapies (CBT) were effective in reducing gambling behaviour. Twenty-five studies which met the inclusion criteria were identified. Overall, there was a highly significant effect of CBT in reducing gambling behaviours within the first three months of therapy cessation regardless of the type of gambling behaviour practiced. Effect sizes were also significant at six, twelve and twenty-four month follow-up periods. Sub-group analysis suggested that both individual and group therapies were equally as effective in the 3 month time window, however this equivalence was not clear at follow-up. All variants of CBT (cognitive therapy, motivational interviewing and imaginal desensitization) were significant, although there was tentative evidence that when different types of therapy were compared cognitive therapy had an added advantage. Meta-regression analyses showed that the quality of the studies influenced the effect sizes, with those of poorer quality having greater effect sizes. These results give an optimistic message that CBT, in various forms, is effective in reducing gambling behaviours. However, caution is warranted because of the heterogeneity of the studies. Evaluation of treatment for problem gambling lags behind other fields and this needs to be redressed in the future.     

The reasoning skills and thinking dispositions of problem gamblers: a dual‐process taxonomy

We present a taxonomy that categorizes the types of cognitive failure that might result in persistent gambling. The taxonomy subsumes most previous theories of gambling behavior, and it defines three categories of cognitive difficulties that might lead to gambling problems: The autonomous set of systems (TASS) override failure, missing TASS output, and mindware problems. TASS refers to the autonomous set of systems in the brain (which are executed rapidly and without volition, are not under conscious control, and are not dependent on analytic system output). Mindware consists of rules, procedures, and strategies available for explicit retrieval. Seven of the eight tasks administered to pathological gamblers, gamblers with subclinical symptoms, and control participants were associated with problem gambling, and five of the eight were significant predictors in analyses that statistically controlled for age and cognitive competence. In a commonality analysis, an indicator from each of the three categories of cognitive difficulties explained significant unique variance in problem gambling, indicating that each of the categories had some degree of predictive specificity. Copyright © 2006 John Wiley & Sons, Ltd.     

Aggressive behaviour in adult slot machine gamblers: an interpretative phenomenological analysis

A growing number of studies have reported a link between gambling and aggressive behaviour. The aim of this study was to contextualize objective findings of a previous observational study regarding slot machine gambling and aggressive behaviour (Parke & Griffiths, Psychological Reports, 95, 109–114, 2004). Interpretative Phenomenological Analysis was applied using the Idiographic Case Study method. The data revealed three superordinate themes regarding slot machine gambling‐induced aggression (i.e. Competitive Advantage Reduction, Self‐esteem Reduction, and Cognitive Regret). Within these superordinate themes, subordinate themes emerged identifying how environmental factors and structural characteristics of slot machine gambling, along with the consequences of losing, produced aggressive behaviour. It is concluded that gambling‐induced aggression is a manifestation of the underlying conflict of engaging in dysfunctional behaviour while consciously acknowledging its detrimental effects. Copyright © 2005 John Wiley & Sons, Ltd.     

Impulsivity facets and cognitive distortions associated with problem gambling: Differences between ADHD and non-ADHD gamblers

ObjectiveTo compare the association between (1) impulsivity facets or cognitive distortions, and (2) problem gambling between male gamblers with versus without self-reported Attention-Deficit/Hyperactivity Disorder (ADHD).MethodIn 287 male gamblers recruited online, we assessed problem gambling (South Oaks Gambling Screen; cut-off ≥ 3), Adult ADHD Self-report Scale-V1.1 (ADHD), impulsivity facets (UPPS Impulsive Behavior Scale-short version) and gambling-related cognitions (Gambling-Related Cognitions Scale).ResultsThe prevalence of self-reported ADHD was 21.6%. In both ADHD and non-ADHD groups, problem gambling was associated with negative urgency, positive urgency and the same cognitive distortions. Sensation seeking and lack of premeditation were associated with problem gambling, but only in non-ADHD gamblers (significant interaction effect).ConclusionDifferent impulsivity facets, but not different cognitive distortions, are associated with problem gambling in male gamblers with or without ADHD. Emotion dysregulation (positive and negative urgency) and cognitive distortions are involved in both groups, but sensation seeking and lack of premeditation may be specific to non-ADHD problem gamblers.     

Risky decision making and cognitive flexibility among online sports bettors in Nigeria

Online sports betting is a popular recreational activity in Nigeria. Like other forms of gambling, risk of pathological progression exists for gamblers who continue betting despite severe financial and psychosocial consequences. In the present study, we examined whether this population of gamblers shows deficits in decision making and cognitive flexibility that have been documented in Western gambling populations. Thirty-six online sports bettors and 42 non-gambling participants completed a version of the Iowa gambling task (IGT) and an established set-shifting task for the assessment of cognitive flexibility. The two groups did not differ significantly in the selection of disadvantageous decks on the IGT. In contrast, sports bettors committed significantly more errors on the set-shifting task than non-gambling control participants. As this performance deficit was not specific to trials requiring a set shift, it most likely resulted from gambling-related changes in general cognitive or motivational abilities that are required to successfully complete challenging mental tasks. While our results illustrate that findings from Western populations cannot automatically be generalised to other contexts, it should be noted that we focused on only one particular type of gambling and included mostly participants with mild gambling-related problems.     

Predictive value of cognitive variables for the information utilization process

Sequential predictive behaviour is used to analyse human problem solving. The most predictive and discriminative variables regarding the observable information reducing phases of the problem solving process are variables of cognitive complexity. The same holds for variables of cognitive flexibility regarding the information generating phase. Empirical evidence with respect to the thereby occurring interaction between the heuristic and epistemic part of the cognitive structure is yielded.     

Risk Factors of Adolescent Pathological Gambling: Permissive Gambling Culture and Individual Factors

This study investigated the relationships between types of gambling activity, problem behaviors, and self-esteem with adolescent problem gambling in Hong Kong. From a sample of 2,258 students aged between 12 and 17, study results showed that playing Poker and gaming in Amusement Game Centers (entertainment venues with gaming machines) had the strongest predictive value, implying a gambling-permissive culture regarding gambling as an entertainment, with parental and societal support and availability of gambling opportunities, has more impact on adolescent problem gambling than other personal risk factors like problem behaviors and low self-esteem. Prevention strategies at individual and societal levels are discussed.     

Executive Functioning and Gambling: Performance on the Trail Making Test is Associated with Gambling Problems in Older Adult Gamblers

ABSTRACT

Rates of gambling problems in older adults have risen with increased accessibility of gambling venues. One possible contributor to problem gambling among older adults is decreased self-control brought about by diminished executive functioning. Consistent with this possibility, Study 1 revealed that older adults recruited from gambling venues reported greater gambling problems if they also experienced deficits in executive functioning, measured via the Trail Making Test. Study 2 replicated this finding and demonstrated that problem gambling is associated with increased depression among older adults, mediated by increased financial distress. These studies provide support for the hypothesis that older adult gamblers who have executive functioning problems are also likely to have gambling problems.     

认知信息的详尽度与锚定对决策策略的影响

以191名大学生为被试,采用2×3的完全组间设计,探讨不同认知信息详尽度和有无锚定材料条件下大学生决策策略类型的选择。结果发现:(1)认知信息详尽度对被试的决策策略选择的影响显著,被试在低认知信息详尽度水平下倾向于选择采用维度比较策略,而在高认知信息详尽度水平下倾向于选择采用综合比较策略,并且倾向程度差异显著。(2)锚定效应对决策策略选择的影响不显著,认知信息详尽度与锚定的交互作用也不显著。     

Personality,gambling motives and cognitive distortions in electronic gambling machine players

This study examined gambling motives, distorted beliefs about gambling, and personality traits in a paid community sample of frequent electronic gambling machine (EGM) players from Manitoba, Canada. Participants completed the Problem Gambling Severity Index, the Gambling Motives Questionnaire, the Informational Biases Scale, and the NEO PI-R in group testing sessions. The Five Factor Model facets of Neuroticism, Extraversion, Agreeableness and Conscientiousness were divided into ‘aspects’ that align with self-regulation and the Behavioral Approach and Inhibition systems of revised Reinforcement Sensitivity Theory. Regression analysis found that problem gambling severity scores were independently predicted by older age, being female, having distorted gambling beliefs, and by gambling to win money and to cope with negative emotional states. Problem gambling scores were also correlated positively with Withdrawal (N) and Volatility (N), and negatively with Enthusiasm (E), Compliance (A), and Industriousness (C). Mediation tests found that low scores on the Industriousness facet of Conscientiousness were associated with increased problem gambling severity through an effect on the gambling to cope motive. Distorted beliefs about gambling also mediated low Industriousness, as well as high Withdrawal and Volatility. Poor self-regulation and avoidance motivation contribute to problem gambling among frequent EGM players through increased cognitive distortion and escapism.     

Beyond opposites: Extending the cultural boundaries of CBT methodology

In cognitive behavioural therapy (CBT), a black or white perception of the world is generally considered to be a distortion of reality. This paper addresses the issue of bipolar or categorical thinking and its role in creating disturbance. It introduces a new quantitative methodology known as fuzzy logic (FL) and shows its potential in developing new effective CBT strategies to address bipolar thinking. The paper maintains that the roots of such thinking can be traced back to the Aristotelian logic which posits a 'black or white' view of the world. It is argued that a bipolar perspective is no longer defendable given recent developments in the field of literature, physics and logic. Moreover CBT can derive significant benefits by embracing the fuzzy logic paradigm. In particular it can, first, benefit by improving the degree of precision of its diagnostic tools and, second, by applying the FL principles to derive alternative strategies for inducing healthy changes in clients. Such improvements are believed to enhance CBT profile in terms of the degree of realism, flexibility and efficiency of its methods. The illustrations offered throughout this paper are based on the two main CBT perspectives; rational emotive behaviour therapy (REBT) and cognitive therapy (CT).     

Does the Treatment of Cognitive Distortions Improve Clinical Outcomes for Problem Gambling?

Although dysfunctional beliefs about gambling outcomes among problem gamblers have been well-established, there is less known about whether specifically treating such beliefs is necessarily more effective than other therapeutic approaches. In the present study, brief, homogenous treatments for problem gambling (i.e., cognitive, behavioral, motivational, minimal intervention) were compared to each other. Each intervention was based on approaches empirically demonstrated to be clinically effective. The treatment sample consisted primarily of middle-aged, non-partnered, underemployed men recruited from the community via newspaper advertisements. The results showed that a cognitive approach did not yield superior outcomes than did treatments that did not explicitly address cognitive distortions. It is likely that there are several pathways to therapeutic change that may not necessarily require the modification of gambling-related psychopathology.     

Internet‐based CBT intervention for gamblers in Finland: Experiences from the field

From September 2007 to May 2011 a total of 471 participants (325 males and 146 females) signed up for an 8‐week Internet‐based cognitive behavioral therapy offered for gamblers in Finland. Sixty‐four percent of the participants were pathological gamblers (PGs) (NODS 5> points), 14% were problem gamblers (NODS 3–4 points) and 10% were at risk of gambling problems (NODS 1–2 points). Two hundred and twenty four participants completed the treatment and after the treatment period significant changes were found in the following variables: gambling related problems (NODS), gambling urge, impaired control of gambling, alcohol consumption (AUDIT‐C), social consequences, gambling‐related cognitive erroneous thoughts and depression (MARD‐S). In this sample co‐morbid alcohol consumption was stronger among males. The main finding of this study was that the onset age of gambling was associated with a greater amount of gambling‐related cognitive erroneous thoughts.     

Improving access to psychological therapies: systemic therapy in the Newham pilot site

The improving access to psychological therapies (IAPT) programme, which started with two pilot sites, has dramatically changed the provision of mental health services for depression and anxiety disorders in the National Health Service. The IAPT initiative has focused on the provision of cognitive behaviour therapy but incorporated a small systemic therapy service in the Newham pilot site. The outcomes of this systemic service are presented in this article. Most clients seen by the service suffered from depression and anxiety disorders. The response rate for the evaluation questionnaires was high. For the depression and anxiety measures the recovery rate was above 50 per cent and the effect sizes were large. Most of the clients were satisfied with the service. A trend towards employment was identified. The outcomes are discussed in comparison with those of the cognitive behaviour therapy service and recommendations for the process of further studies are made.