A randomized controlled trial of a personalized feedback intervention for problem gamblers

John A Cunningham, David C Hodgins, Tony Toneatto, Michelle Murphy, John A Cunningham, David C Hodgins, Tony Toneatto, Michelle Murphy

Abstract

Background: Personalized feedback is a promising self-help for problem gamblers. Such interventions have shown consistently positive results with other addictive behaviours, and our own pilot test of personalized normative feedback materials for gamblers yielded positive findings. The current randomized controlled trial evaluated the effectiveness, and the sustained efficacy, of the personalized feedback intervention materials for problem gamblers.

Methodology/principal findings: Respondents recruited by a general population telephone screener of Ontario adults included gamblers with moderate and severe gambling problems. Those who agreed to participate were randomly assigned to receive: 1) the full personalized normative feedback intervention; 2) a partial feedback that contained all the feedback information provided to those in condition 1 but without the normative feedback content (i.e., no comparisons provided to general population gambling norms); or 3) a waiting list control condition. The primary hypothesis was that problem gamblers who received the personalized normative feedback intervention would reduce their gambling more than problem gamblers who did not receive any intervention (waiting list control condition) by the six-month follow-up.

Conclusions/significance: The study found no evidence for the impact of normative personalized feedback. However, participants who received, the partial feedback (without norms) reduced the number of days they gambled compared to participants who did not receive the intervention. We concluded that personalized feedback interventions were well received and the materials may be helpful at reducing gambling. Realistically, it can be expected that the personalized feedback intervention may have a limited, short term impact on the severity of participants' problem gambling because the intervention is just a brief screener. An Internet-based version of the personalized feedback intervention tool, however, may offer an easy to access and non-threatening portal that can be used to motivate participants to seek further help online or in person.

Trial registration: ClinicalTrials.govNCT00578357.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Cunningham JA. Little use of treatment among problem gamblers. Psychiatric Services. 2005;56:1024–1025.
    1. Hodgins DC, el-Guebaly N. Natural and treatment-assisted recovery from gambling problems: a comparison of resolved and active gamblers. Addiction. 2000;95:777–789.
    1. Rockloff MJ, Schofield G. Factor analysis of barriers to treatment for problem gambling. Journal of Gambling Studies. 2004;20:121–126.
    1. Hodgins DC, Currie S, el-Guebaly N, Peden N. Brief motivational treatment for problem gambling: a 24-month follow-up. Psychology of Addictive Behaviors. 2004;18:293–296.
    1. Hodgins DC, Currie SR, el-Guebaly N. Motivational enhancement and self-help treatments for problem gambling. Journal of Consulting and Clinical Psychology. 2001;69:50–57.
    1. Hodgins DC, Makarchuk K. Becoming a winner: Defeating problem gambling. Calgary: Alberta Alcohol and Drug Abuse Commission; 1997.
    1. Toneatto T, Kosky B, Leo GI. How to quit or reduce your gambling: A personal workbook. Toronto: Centre for Addiction and Mental Health; 2003.
    1. Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York, NY: Guilford Press; 1991. 348
    1. Agostinelli G, Brown JM, Miller WR. Effects of normative feedback on consumption among heavy drinking college students. Journal of Drug Education. 1995;25:31–41.
    1. Cunningham JA, Koski-Jännes A, Wild TC, Cordingley J. Treating alcohol problems with self-help materials: A population study. Journal of Studies on Alcohol. 2002;63:649–654.
    1. Miller WR, Sovereign RG, Krege B. Motivational interviewing with problem drinkers: II. The Drinker's Check-up as a preventive intervention. Behavioural Psychotherapy. 1988;16:251–268.
    1. Borsari B, Carey KB. Effects of a brief motivational intervention with college student drinkers. Journal of Consulting and Clinical Psychology. 2000;68:728–733.
    1. Murphy JG, Duchnick JJ, Vuchinich RE, Davison JW, Karg RS, et al. Relative efficacy of a brief motivational intervention for college student drinkers. Psychology of Addictive Behaviors. 2001;15:373–379.
    1. Baer JS, Kivlahan DR, Blume AW, McKnight P, Marlatt GA. Brief intervention for heavy-drinking college students: 4-year follow-up and natural history. American Journal of Public Health. 2001;91:1310–1316.
    1. Curry SJ, Wagner EH, Grothaus LC. Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program. Journal of Consulting and Clinical Psychology. 1991;59:318–324.
    1. Curry SJ, Louie D, Grothaus L, Wagner EH. Written personalized feedback and confidence in smoking cessation. Psychology of Addictive Behaviors. 1992;6:175–180.
    1. Agostinelli G, Miller WR. Drinking and thinking: How does personal drinking affect judgments of prevalence and risk. Journal of Studies on Alcohol. 1994;55:327–337.
    1. Sanchez-Craig M, Davila R, Cooper G. A self-help approach for high-risk drinking: Effect of an initial assessment. Journal of Consulting and Clinical Psychology. 1996;64:694–700.
    1. Spivak K, Sanchez-Craig M, Davila R. Assisting problem drinkers to change on their own: Effect of specific and non-specific advice. Addiction. 1994;89:1135–1142.
    1. Larimer ME, Neighbors C. Normative misperception and the impact of descriptive and injunctive norms on college student gambling. Psychology of Addictive Behaviors. 2003;17:235–243.
    1. Takushi RY, Neighbors C, Larimer ME, Lostutter TW, Cronce JM, et al. Indicated prevention of problem gambling among college students. Journal of Gambling Studies. 2004;20:83–93.
    1. Cunningham JA, Hodgins DC, Toneatto T, Rai A, Cordingley J. Pilot study of a personalized feedback intervention for problem gamblers. Behavior Therapy. 2009;40:219–224.
    1. Ferris J, Wynne H. The Canadian Problem Gambling Index: Final Report. 2001. Canadian Centre on Substance Abuse.
    1. Statistics Canada. Canadian Community Health Survey: Mental Health and Well-being, 2002. Ottawa: 2003.
    1. Cunningham JA. Regression to the mean: what does it mean? Alcohol and Alcoholism. 2006;41:580; author reply 581.
    1. McCambridge J, Day M. Randomized controlled trial of the effects of completing the Alcohol Use Disorders Identification Test questionnaire on self-reported hazardous drinking. Addiction. 2008;103:241–248.
    1. Kypri K, Langley JD, Saunders JB, Cashell-Smith ML. Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking. Addiction. 2007;102:62–70.
    1. Toneatto T, Turner NE, Zack M, Farvolden P, Millar G, et al. The heterogeneity of problem gambling: An analysis of gambling sub-types. Ontario Problem Gambling Research Centre 2007

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する