The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis

The paper describes a treatment pilot for gambling and compulsive addiction within an NHS problem gambling clinic. The pilot study used a brief relational psychodynamic treatment protocol specifically designed to meet the needs of a group of patients who had not responded to CBT and who had other addictions or co‐morbidities. Seventy‐two (n = 72) patients were offered 12 sessions of therapy by four psychodynamic counsellors. Results were assessed using scores from a pre‐ and post‐treatment patient health questionnaire, the generalised anxiety disorder—7 (GAD‐7) and the Problem Gambling Severity Index (PGSI). Weekly feedback and supervision from counsellors and patients were used to assess the treatment model. The results highlighted that the psychodynamic addiction model was associated with reduced depression (Mean = 14.9; SD: 6.7), anxiety (Mean = 11.5; SD: 5.9), and gambling severity (p < .001), suggesting that a relational psychodynamic treatment is needed for complex patients with compulsive addiction, where CBT had not been successful. These results also highlight the importance of the therapeutic relationship as a critical factor in the treatment of patients with compulsive addiction problems.     

De‐escalation after repeated negative feedback: emergent expectations of failure

Research on willingness to make marginal investments (e.g., the escalation and sunk cost literatures) has often focused on project completion decisions, such as the “radar‐blank plane.” This paper discusses a fundamentally different type of marginal investment decision, that of couples deciding whether to continue infertility treatment in the face of repeated failures. Two experiments based on this context show that when people face multiple independent chances to achieve a valued goal but are unsure about chances of success, premature quitting or “de‐escalation” is the norm. Repeated negative feedback appears to induce individuals to see each successive failure as more and more diagnostic. As a result, even a short series of failed attempts evokes beliefs that future attempts will also fail. These emergent expectations of failure, generated by causal attribution processes, associative learning, and/or discounting of ambiguous information, appear very compelling and induce people to forgo profitable marginal investments. Copyright © 2004 John Wiley & Sons, Ltd.     

预防导尿管相关性感染的临床问题及决策

留置导尿是一项侵袭性操作,易引起尿道黏膜损伤,且留置导尿时间过长,容易引起泌尿系统的逆行感染。为了预防导尿管相关性感染,我们从临床角度讨论是否需要更换一次性尿袋以及更换尿袋的时间,留置导尿尿道外口的清洗,留置导尿膀胱冲洗的必要性及是否应用抗生素,更换导尿管的时间及导尿管的选择等临床问题,为临床人员做该项操作时提供参考,做出正确的临床决策。     

Contextual control of slot-machine gambling: replication and extension

Participants were trained and tested to select stimuli of differing physical quantities in the presence of 2 color contextual cues for more than and less than. Following more than and less than relational training, participants allocated the majority of their responses to the slot machine that shared formal properties of color with the contextual cue for more than, despite the identical payout probabilities of the slot machines.     

The path or the goal? Decision vs. information focus in biased information seeking after preliminary decisions

Research on the phenomenon of selective exposure to information demonstrates that after preliminary or final decisions, people show a preference for supporting rather than conflicting information (confirmation bias). In this article, we examine conditions that increase or decrease distortions in the search for information. We report on four experiments indicating that the confirmation bias is influenced by whether people focus on their decision or on the presented pieces of information during the information search. Focusing on the decision, for example, because a reward for a correct decision is promised or simply because participants repeatedly think of it, increases the confirmation bias. On the other hand, if participants focus on the available pieces of information because they have to invest money in order to search for information or because they have to evaluate the individual pieces of information, the confirmation bias decreases. Implications for theoretical understanding and interventions for decision-making situations are discussed.     

Reliability and Validity of the Gamblers Anonymous Twenty Questions

One of the earliest instruments to screen for problem gambling, the Twenty Questions (20Q), was developed within Gamblers Anonymous. This instrument has not received serious research attention, however, and its psychometric properties are generally unknown. This study reports reliability and validity data for this instrument in 3 independent samples totaling 456 participants: two samples of problem gamblers in treatment and a non-treatment sample of problem gamblers. The Twenty Questions was shown to possess high reliability as measured by Cronbach’s alpha. Concurrent, convergent and predictive validity of the 20Q supported the use of this instrument as an acceptable screening instrument. Classification analyses indicated that the 20Q is comparable to the DSM-IV diagnostic criteria for pathological gambling in specificity, sensitivity and rates of false negatives and false positives. The 20Q appears to be a reliable and valid measure of problem gambling and warrants continued research attention.     

BEHAVIOR ANALYSIS: THRIVING,BUT HOW ABOUT ITS FUTURE?

Behavior analysis has been thriving by continuing to make important theoretical and empirical contributions to a wide array of problems, as well as by contributing to interdisciplinary research. Applied research in behavior analysis is flourishing. Despite these positive signs there may be an erosion of support for basic research in animal learning and behavior, including behavior analysis. Increased attention by behavior analysts to fundamental problems in areas of cognition, including decision-making and language, may help behavior analysis to evolve more successfully. An experimental analysis of gambling may prove particularly fruitful.     

THE MEDIATING ROLE OF PROCEDURAL JUSTICE IN RESPONSES TO PROMOTION DECISIONS

This study used structural equations modeling to examine the mediating role of procedural justice in the relationships between promotion decisions and organizational commitment and between promotion decisions and intent to leave the organization. 156 managers and executives in Italian subsidiaries of two large multinational organizations in the chemical industry were surveyed about their career history within the organization and their reactions to promotion decisions over an 8-year period. The results showed that promotion decisions influenced feelings of organizational commitment through perceptions of procedural justice in promotion decision-making processes. The theoretical and practical implications of the study’s findings are discussed.This research was supported by the Italian Ministry of University and Scientific Research (MURST). A previous version of this paper was presented at the 2000 Academy of Management meetings in Toronto and published in the Best Paper Proceedings. We would like to thank Paula Caliguiri, Jason Shaw, M. Susan Taylor, and two anonymous Academy reviewers for their helpful suggestions on prior drafts of this article.     

Aging, Executive Functioning, and Social Control

ABSTRACT— Aging is associated with atrophy of the frontal lobes of the brain, which are the seat of executive functions. Because successful social functioning often requires executive control, aging can lead to unintended social changes via deficits in executive control. In this article I review evidence that, due to losses in executive control, aging leads to increased prejudice and social inappropriateness and, under certain circumstances, increased depression and problem gambling. I then discuss theory and research suggesting possible interventions that might ameliorate unwanted social changes brought about by executive decline.     

Is control a viable goal in the treatment of pathological gambling?

According to a report of National Gambling Impact Study Commission (National Gambling Impact Study Commission (1999). Final report. Washington, DC: Government Printing Office.), 97% of problem gamblers in the United States do not seek treatment. Within the small proportion of problem gamblers who enter into treatment, a high percentage drops out. Despite the fact that some researchers argue against abstinence as the only acceptable treatment goal and that regaining control over gambling behaviour appears to be possible for some pathological gamblers (PG), abstinence has been the only gambling intervention treatment goal. The primary goal of this study was to verify whether controlled gambling is a viable goal for pathological gamblers. The second goal was to identify the characteristics that predicted a successful outcome for treatment with a controlled gambling goal. Eighty-nine PGs were enrolled in cognitive-behavioural treatment aimed at controlled gambling. Six and twelve month follow-ups were conducted in order to evaluate the maintenance of therapeutic gains and to identify significant predictors of successful controlled gambling. Results showed that using the intent-to-treat procedure, 63% had a score of 4 or less on the DSM-IV at the end of treatment. That proportion was 56% and 51% at the 6- and 12-month follow-ups. If we retain only those who completed the treatment, these proportions increased to 92%, 80% and 71% at post-treatment, 6- and 12-month follow-ups, respectively. On the majority of the measures, significant improvements were found at post-treatment and the therapeutic gains were maintained at the 6- and 12-month follow-ups. However, few variables were identified to predict who would benefit from control rather than abstinence. The clinical and philosophical implications of these results are discussed in this paper.