Cognitive-Behavioral Treatments/Pathological Gambling

Summary

Principal Investigator: Nancy Petry
Affiliation: University of Connecticut Health Center
Country: USA
Abstract: [unreadable] DESCRIPTION (provided by applicant): Pathological gambling is serious problem, with significant psychological, financial, and public health consequences. Nevertheless, controlled trials examining the efficacy of therapeutic interventions for pathological gamblers are sparse. Gambler's Anonymous (GA) is the most popular form of treatment, and GA participation may improve outcomes among patients who become actively involved in the fellowship. Results from our first cycle of funding indicate that cognitive-behavioral (CB) treatment in conjunction with GA is more efficacious in reducing gambling than referral to GA alone. However, only about 60% of patients assigned to the CB condition became actively involved in treatment, and only about a third attended GA even once during the 8-weeks of treatment. The purposes of the present study are two-fold. First, we will compare the efficacy of CB treatment to an active control condition to ascertain whether the beneficial effects are related specifically to CB therapy or to more general therapeutic processes. Second, we will evaluate the efficacy of CB therapy to an enhanced CB approach that utilizes contingency management (CM). CM treatments provide tangible rewards for objective behavior changes, and these procedures are highly efficacious in improving retention and reducing substance use in drug abusing patients. We have pilot data from pathological gamblers suggesting that we can enhance engagement in therapy to over 85% utilizing CM techniques, and patients receiving the CB-CM treatment are more likely to complete CB homework exercises and become engaged with GA. This study will assess whether these effects are associated with long-term improved outcomes. In total, 210 pathological gamblers will be randomized to one of three conditions: psychoeducation plus case management (an active control condition), CB therapy, or CB therapy plus CM. Patients in each group will receive 8 individual therapy sessions, and all will be referred to GA. Gambling and psychosocial problems will be assessed from both the patient and a collateral using standardized instruments at pre- and post-treatment, and at 6, 9, 12, 18, and 24-month follow-up evaluations. We expect that CB will improve outcomes relative to psychoeducation, and that CB-CM will reduce gambling to a greater extent than CB alone. We will also assess whether the interventions result in better psychosocial functioning during treatment and follow-up. Patient characteristics that may be associated with outcomes will be evaluated, and a cost-effectiveness evaluation of the interventions also will be conducted. [unreadable] [unreadable]
Funding Period: 1999-08-15 - 2009-07-31
more information: NIH RePORT

Top Publications

  1. pmc Pathological gamblers respond equally well to cognitive-behavioral therapy regardless of other mental health treatment status
    Robey B Champine
    Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    Am J Addict 19:550-6. 2010
  2. pmc The Inventory of Gambling Situations in problem and pathological gamblers seeking alcohol and drug abuse treatment
    Nancy M Petry
    Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Exp Clin Psychopharmacol 18:530-8. 2010
  3. pmc Interpersonal guilt in college student pathological gamblers
    Geoffrey W Locke
    School for Social Work, Smith College, Northampton, MA, USA
    Am J Drug Alcohol Abuse 39:28-32. 2013
  4. pmc National gambling experiences in the United States: will history repeat itself?
    Nancy M Petry
    University of Connecticut Health Center, 63 Farmington Avenue, Farmington, CT 06030 3944, USA
    Addiction 108:1032-7. 2013
  5. pmc The effects of alcohol problems and smoking on delay discounting in individuals with gambling problems
    Leonardo F Andrade
    University of Connecticut School of Medicine, Farmington, CT 06030 3944, USA
    J Psychoactive Drugs 45:241-8. 2013
  6. pmc Older methadone patients achieve greater durations of cocaine abstinence with contingency management than younger patients
    Lindsay Weiss
    University of Connecticut School of Medicine, Farmington, CT 06030, USA
    Am J Addict 22:119-26. 2013
  7. pmc An overview of and rationale for changes proposed for pathological gambling in DSM-5
    Nancy M Petry
    MC 3944, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030 3944, USA
    J Gambl Stud 30:493-502. 2014
  8. pmc Prize-based contingency management is efficacious in cocaine-abusing patients with and without recent gambling participation
    Nancy M Petry
    Calhoun Cardiology Center, Department of Medicine, University of Connecticut Health Center MC 3944, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    J Subst Abuse Treat 39:282-8. 2010
  9. pmc Subtyping pathological gamblers based on impulsivity, depression, and anxiety
    David M Ledgerwood
    Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Farmington, CT 06030, USA
    Psychol Addict Behav 24:680-8. 2010
  10. pmc Interaction effects of age and contingency management treatments in cocaine-dependent outpatients
    Lindsay M Weiss
    Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Exp Clin Psychopharmacol 19:173-81. 2011

Scientific Experts

Detail Information

Publications74

  1. pmc Pathological gamblers respond equally well to cognitive-behavioral therapy regardless of other mental health treatment status
    Robey B Champine
    Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    Am J Addict 19:550-6. 2010
    ..Individual cognitive-behavioral therapy was efficacious in reducing gambling problems irrespective of mental health treatment utilization. ..
  2. pmc The Inventory of Gambling Situations in problem and pathological gamblers seeking alcohol and drug abuse treatment
    Nancy M Petry
    Calhoun Cardiology Center, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Exp Clin Psychopharmacol 18:530-8. 2010
    ..Results from this study indicate that the IGS has good psychometric properties and suggest areas in which intervention efforts may be tailored to prevent or treat gambling problems among individuals seeking substance abuse treatment...
  3. pmc Interpersonal guilt in college student pathological gamblers
    Geoffrey W Locke
    School for Social Work, Smith College, Northampton, MA, USA
    Am J Drug Alcohol Abuse 39:28-32. 2013
    ..Interpersonal guilt is associated with psychopathology, but its relationship to pathological gambling has not been studied...
  4. pmc National gambling experiences in the United States: will history repeat itself?
    Nancy M Petry
    University of Connecticut Health Center, 63 Farmington Avenue, Farmington, CT 06030 3944, USA
    Addiction 108:1032-7. 2013
    ..The aim of this paper is to offer an account of the history and current status of gambling research in the United States...
  5. pmc The effects of alcohol problems and smoking on delay discounting in individuals with gambling problems
    Leonardo F Andrade
    University of Connecticut School of Medicine, Farmington, CT 06030 3944, USA
    J Psychoactive Drugs 45:241-8. 2013
    ....
  6. pmc Older methadone patients achieve greater durations of cocaine abstinence with contingency management than younger patients
    Lindsay Weiss
    University of Connecticut School of Medicine, Farmington, CT 06030, USA
    Am J Addict 22:119-26. 2013
    ..This study evaluated the impact of age on treatment outcomes in cocaine abusing methadone patients...
  7. pmc An overview of and rationale for changes proposed for pathological gambling in DSM-5
    Nancy M Petry
    MC 3944, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, 06030 3944, USA
    J Gambl Stud 30:493-502. 2014
    ..This paper reviews the rationale for these changes and addresses how they may impact diagnosis and treatment of the disorder, as well as potential for future research in the field. ..
  8. pmc Prize-based contingency management is efficacious in cocaine-abusing patients with and without recent gambling participation
    Nancy M Petry
    Calhoun Cardiology Center, Department of Medicine, University of Connecticut Health Center MC 3944, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    J Subst Abuse Treat 39:282-8. 2010
    ..These data suggest that prize CM is equally efficacious for substance-abusing patients who do and do not gamble, and they extend prior studies indicating that prize CM does not increase gambling...
  9. pmc Subtyping pathological gamblers based on impulsivity, depression, and anxiety
    David M Ledgerwood
    Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Farmington, CT 06030, USA
    Psychol Addict Behav 24:680-8. 2010
    ..Thus, the three Pathways subtypes differ on some baseline characteristics, but subtyping did not predict treatment outcomes beyond a simple association with problem gambling severity...
  10. pmc Interaction effects of age and contingency management treatments in cocaine-dependent outpatients
    Lindsay M Weiss
    Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Exp Clin Psychopharmacol 19:173-81. 2011
    ..These findings demonstrate that age may play a role in moderating intervention outcomes, and tailoring CM to the needs of older and middle-aged substance abusers may be important for improving outcomes in this growing population...
  11. pmc A quick and simple screening method for pathological and problem gamblers in addiction programs and practices
    Rachel A Volberg
    Gemini Research, Northampton, MA 01061, USA
    Am J Addict 20:220-7. 2011
    ..The original and the alternative brief screens are likely to be useful in a range of clinical settings. ..
  12. pmc Discounting of probabilistic rewards is associated with gambling abstinence in treatment-seeking pathological gamblers
    Nancy M Petry
    Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    J Abnorm Psychol 121:151-9. 2012
    ..No associations were noted between delay discounting and gambling treatment outcomes. These data suggest that probability discounting may be an important construct in understanding pathological gambling and its treatment...
  13. pmc Drinking patterns of pathological gamblers before, during, and after gambling treatment
    Carla J Rash
    Calhoun Cardiology Center Behavioral Health, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Psychol Addict Behav 25:664-74. 2011
    ....
  14. pmc Delay and probability discounting in pathological gamblers with and without a history of substance use problems
    Leonardo F Andrade
    Calhoun Cardiology Center, MC 3944, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Psychopharmacology (Berl) 219:491-9. 2012
    ..Although much data exist regarding the association between delay discounting and these psychiatric disorders, relatively little research has examined probability discounting and its relationship with either substance use or gambling...
  15. pmc Cocaine abusers with and without alcohol dependence respond equally well to contingency management treatments
    Carla J Rash
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06033, USA
    Exp Clin Psychopharmacol 16:275-81. 2008
    ..Further, alcohol dependent participants are able to offset greater baseline severity in psychosocial functioning and maintain these improvements with CM...
  16. pmc Gender differences in associations between stressful life events and body mass index
    Danielle Barry
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue MC 3944, Farmington, CT 06030, USA
    Prev Med 47:498-503. 2008
    ..To identify relationships between body mass index (BMI) and stressful life events and to determine whether relationships differ by gender...
  17. pmc Associations between body mass index and substance use disorders differ by gender: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Danielle Barry
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, Connecticut 06030, USA
    Addict Behav 34:51-60. 2009
    ..Further research is needed to identify reasons for observed gender differences in relationships between BMI and substance use disorders...
  18. pmc Serious adverse events in randomized psychosocial treatment studies: safety or arbitrary edicts?
    Nancy M Petry
    Calhoun Cardiology Center, Department of Medicine, University of Connecticut Health Center, USA
    J Consult Clin Psychol 76:1076-82. 2008
    ..These data underscore the need to reconsider the rationale behind, and appropriate methods for, monitoring safety during psychosocial therapy trials...
  19. pmc Ethnic differences in HIV risk behaviors among methadone-maintained women receiving contingency management for cocaine use disorders
    Danielle Barry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, United States
    Drug Alcohol Depend 98:144-53. 2008
    ....
  20. ncbi Psychiatric disorders are associated with hospital care utilization in persons with hypertension: results from the National Epidemiologic Survey on alcohol and related conditions
    Julie A Wagner
    Division of Behavioral Sciences and Community Health, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
    Soc Psychiatry Psychiatr Epidemiol 43:878-88. 2008
    ..However, the contribution of specific psychiatric disorders to healthcare utilization in persons with hypertension is unknown...
  21. doi Psychometric properties of the inventory of gambling situations with a focus on gender and age differences
    Lindsay M Weiss
    Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    J Nerv Ment Dis 196:321-8. 2008
    ..The IGS may assist in better understanding situations in which pathological gamblers wager, and individual differences with respect to these situations...
  22. pmc Social support is associated with gambling treatment outcomes in pathological gamblers
    Nancy M Petry
    University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Am J Addict 18:402-8. 2009
    ..These findings demonstrate that social support plays an important role in moderating outcomes, and enhancing social support may be an important aspect of effective gambling treatments...
  23. doi Overweight and obesity are associated with psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Psychosom Med 70:288-97. 2008
    ..This study evaluated associations between body mass index (BMI) and psychiatric disorders...
  24. pmc Contingency management is efficacious for cocaine abusers with prior treatment attempts
    Carla J Rash
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Exp Clin Psychopharmacol 16:547-54. 2008
    ..The results provide support for CM as an advantageous option for individuals with multiple prior treatment attempts, as well as for substance abuse treatment patients in general...
  25. pmc Comparable efficacy of contingency management for cocaine dependence among African American, Hispanic, and White methadone maintenance clients
    Danielle Barry
    Department of Psychiatry, University of Connecticut School of Medicine, USA
    Psychol Addict Behav 23:168-74. 2009
    ..CM appears to be an efficacious treatment for cocaine dependence among methadone maintenance clients, regardless of ethnicity. (PsycINFO Database Record (c) 2009 APA, all rights reserved)...
  26. ncbi Prize-based contingency management does not increase gambling
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Drug Alcohol Depend 83:269-73. 2006
    ..No differences in gambling over time were noted between those assigned to the prize CM versus standard care conditions, indicating that this prize CM procedure does not adversely impact gambling behavior among stimulant abusers...
  27. pmc Cognitive-behavioral therapy for pathological gambling: cultural considerations
    Mayumi Okuda
    New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA
    Am J Psychiatry 166:1325-30. 2009
    ....
  28. pmc Obesity and its relationship to addictions: is overeating a form of addictive behavior?
    Danielle Barry
    University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    Am J Addict 18:439-51. 2009
    ..Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention and treatment of obesity...
  29. pmc Pathological gamblers discount probabilistic rewards less steeply than matched controls
    Gregory J Madden
    Department of Applied Behavioral Science, University of Kansas, Lawrence, KS 66045, USA
    Exp Clin Psychopharmacol 17:283-90. 2009
    ..The nature of the relation between probability discounting and severity of problem gambling is deserving of further study...
  30. pmc Brief motivational interventions for college student problem gamblers
    Nancy M Petry
    University of Connecticut School of Medicine, Calhoun Cardiology Center, MC 3944, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Addiction 104:1569-78. 2009
    ..College students experience high rates of problem and pathological gambling, yet little research has investigated methods for reducing gambling in this population. This study sought to examine the efficacy of brief intervention strategies...
  31. pmc Behavioral assessment of impulsivity in pathological gamblers with and without substance use disorder histories versus healthy controls
    David M Ledgerwood
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030 3944, USA
    Drug Alcohol Depend 105:89-96. 2009
    ..More research should focus on specific ways in which PGs exhibit impulsivity to better address impulsive behaviors in treatment...
  32. pmc Income does not affect response to contingency management treatments among community substance abuse treatment-seekers
    Carla J Rash
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 1410, USA
    Drug Alcohol Depend 104:249-53. 2009
    ....
  33. pmc The cost-effectiveness of prize-based and voucher-based contingency management in a population of cocaine- or opioid-dependent outpatients
    Todd A Olmstead
    University of Connecticut Health Center, Department of Medicine, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Drug Alcohol Depend 102:108-15. 2009
    ..To evaluate the cost-effectiveness of using prize-based and voucher-based contingency management (CM) as additions to standard treatment for cocaine- or heroin-dependent outpatients in community treatment centers...
  34. pmc A randomized trial of brief interventions for problem and pathological gamblers
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    J Consult Clin Psychol 76:318-28. 2008
    ..These results suggest the efficacy of a very brief intervention for reduction of gambling among problem and pathological gamblers who are not actively seeking gambling treatment...
  35. pmc Gender differences in associations between body mass index and DSM-IV mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Danielle Barry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Ann Epidemiol 18:458-66. 2008
    ..The purpose of this study is to examine gender differences in associations between body mass index (BMI) and affective disorders...
  36. ncbi [Ludomania: cross-cultural examinations of gambling and its treatment]
    Jeremiah Weinstock
    Health Center, University of Connecticut, Farmington, CT 06030 3944, USA
    Rev Bras Psiquiatr 30:S3-S10. 2008
    ..Therefore, direct screening for gambling problems is recommended. Increasing education about the disorder, from both the provider and societal perspective, is necessary to reduce the personal and societal consequences of this disorder...
  37. ncbi Posttraumatic stress disorder symptoms in treatment-seeking pathological gamblers
    David M Ledgerwood
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    J Trauma Stress 19:411-6. 2006
    ..These findings point to a need for more assessment and research about PTSD in PGs...
  38. ncbi Severity of gambling problems and psychosocial functioning in older adults
    Robert H Pietrzak
    Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    J Geriatr Psychiatry Neurol 19:106-13. 2006
    ....
  39. ncbi Gambling problems and health functioning in individuals receiving disability
    Benjamin J Morasco
    Portland VA Medical Center, Portland, OR, USA
    Disabil Rehabil 28:619-23. 2006
    ..This study evaluated the rates and correlates of disordered gambling, with a focus on gambling behavior among participants receiving disability...
  40. ncbi Sex differences in subclinical and DSM-IV pathological gambling: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Carlos Blanco
    Department of Psychiatry, Columbia University New York State Psychiatric Institute, New York, NY, USA
    Psychol Med 36:943-53. 2006
    ..To examine sex differences in DSM-IV subclinical and pathological gambling in nationally representative data of the US population...
  41. ncbi Internet gambling: an emerging concern in family practice medicine?
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Fam Pract 23:421-6. 2006
    ..Recent availability and easy accessibility of Internet gambling may be associated with pathological gambling status, and Internet gambling may confer health risks...
  42. ncbi Prevalence and health correlates of gambling problems in substance abuse counselors
    Jeremiah Weinstock
    University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    Am J Addict 15:144-9. 2006
    ..Poorer physical health was associated with pathological gambling, but mental health was not. These results suggest that substance abuse counselors may benefit from education, prevention, and intervention efforts for disordered gambling...
  43. ncbi Severity of gambling is associated with physical and emotional health in urban primary care patients
    Benjamin J Morasco
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA
    Gen Hosp Psychiatry 28:94-100. 2006
    ..The purpose of this study is to assess the prevalence of recreational and disordered gambling, and to identify its association with health functioning, in urban primary care patients...
  44. ncbi Health correlates of pathological gambling in a methadone maintenance clinic
    Jeremiah Weinstock
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA
    Exp Clin Psychopharmacol 14:87-93. 2006
    ..These results extend previous research in other populations that has found that pathological gamblers report poorer mental and physical health than nonpathological gamblers...
  45. ncbi What do we know about relapse in pathological gambling?
    David M Ledgerwood
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030 3944, USA
    Clin Psychol Rev 26:216-28. 2006
    ..The application of psychological, biological, environmental, and treatment factors are described as they may relate to relapse among pathological gamblers...
  46. ncbi Antisocial personality disorder is associated with increased severity of gambling, medical, drug and psychiatric problems among treatment-seeking pathological gamblers
    Robert H Pietrzak
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA
    Addiction 100:1183-93. 2005
    ....
  47. ncbi Problem and pathological gambling are associated with poorer mental and physical health in older adults
    Lauren Erickson
    University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Int J Geriatr Psychiatry 20:754-9. 2005
    ..To evaluate the prevalence and correlates of problem and pathological gambling in older adults...
  48. ncbi Childhood maltreatment in male and female treatment-seeking pathological gamblers
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, 06030, USA
    Psychol Addict Behav 19:226-9. 2005
    ..These results warrant further investigation of the role of childhood maltreatment in the etiology of pathological gambling and its treatment...
  49. ncbi Health and psychosocial correlates of disordered gambling in older adults
    Robert H Pietrzak
    Dept of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    Am J Geriatr Psychiatry 13:510-9. 2005
    ..However, little research has evaluated whether older adults with a gambling disorder experience increased health, psychiatric, substance use, and social problems as compared with older adults without a gambling disorder...
  50. ncbi Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
    J Clin Psychiatry 66:564-74. 2005
    ..To present nationally representative data on lifetime prevalence and comorbidity of pathological gambling with other psychiatric disorders and to evaluate sex differences in the strength of the comorbid associations...
  51. ncbi Prize reinforcement contingency management for cocaine dependence: integration with group therapy in a methadone clinic
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    J Consult Clin Psychol 73:354-9. 2005
    ..On average, patients in the CM condition earned $117 in prizes. Data from this study suggest that some aspects of reinforcement can be implemented in group therapy in community-based clinics...
  52. ncbi Stages of change in treatment-seeking pathological gamblers
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    J Consult Clin Psychol 73:312-22. 2005
    ..This study provides initial support for reliability and validity of the URICA in treatment-seeking gamblers, and it suggests that stage of change may have an impact on outcomes...
  53. ncbi Pre/early adolescent onset of gambling and psychosocial problems in treatment-seeking pathological gamblers
    Alesia N Burge
    Department of Psychiatry, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    J Gambl Stud 22:263-74. 2006
    ..Taken together, these data suggest that pre/early adolescent-onset of gambling may be a risk factor for later-life psychiatric, family/social, and substance abuse problems in treatment-seeking pathological gamblers...
  54. ncbi Cognitive-behavioral therapy for pathological gamblers
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Storrs, CT 06030 3944, USA
    J Consult Clin Psychol 74:555-67. 2006
    ..Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence. These data suggest the efficacy of this CB therapy approach...
  55. ncbi Randomized trial of contingent prizes versus vouchers in cocaine-using methadone patients
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030, USA
    J Consult Clin Psychol 75:983-91. 2007
    ..Thus, reinforcement with prizes was similar to voucher CM in promoting LDA, which is associated with posttreatment benefits...
  56. ncbi Lifetime major depression is associated with coronary heart disease in older adults: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Sarah Herbst
    Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
    Psychosom Med 69:729-34. 2007
    ..To examine the association between mood and anxiety disorders and coronary heart disease (CHD) in a nationally representative sample of older adults...
  57. pmc Predictors of decision-making on the Iowa Gambling Task: independent effects of lifetime history of substance use disorders and performance on the Trail Making Test
    Danielle Barry
    Department of Psychiatry MC 3944, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
    Brain Cogn 66:243-52. 2008
    ..A lifetime SUD diagnosis was associated with performance on the IGT after controlling for covariates, and Trail Making Test performance was associated with IGT performance in both SUD and control participants...
  58. ncbi DSM-IV personality disorders and coronary heart disease in older adults: results from The National Epidemiologic Survey on Alcohol And Related Conditions
    Robert H Pietrzak
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    J Gerontol B Psychol Sci Soc Sci 62:P295-9. 2007
    ..63), and obsessive-compulsive (OR = 1.37) personality disorders increased the odds of having CHD. Personality disorders may increase the risk of CHD in older adults. Putative mechanisms and directions for future research are proposed...
  59. ncbi Clinical features and treatment prognosis of pathological gamblers with and without recent gambling-related illegal behavior
    David M Ledgerwood
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT, USA
    J Am Acad Psychiatry Law 35:294-301. 2007
    ....
  60. ncbi Concurrent and predictive validity of the Addiction Severity Index in pathological gamblers
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    Am J Addict 16:272-82. 2007
    ..Thus, the ASI may be a useful tool for assessing gambling and psychosocial problems in the growing population of treatment-seeking gamblers...
  61. ncbi Do coping skills mediate the relationship between cognitive-behavioral therapy and reductions in gambling in pathological gamblers?
    Nancy M Petry
    University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Addiction 102:1280-91. 2007
    ..This study examined whether coping skills acquisition mediated the effects of CBT on decreasing gambling in pathological gamblers...
  62. ncbi Gambling and substance use disorders: current status and future directions
    Nancy M Petry
    University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA
    Am J Addict 16:1-9. 2007
    ..Finally, areas for future research are suggested to advance our understanding of pathological gambling and its relationship to substance use disorders...
  63. ncbi What do we get for our money? Cost-effectiveness of adding contingency management
    Jody Sindelar
    Yale School of Public Health and Yale Medical School, CT 06520, USA
    Addiction 102:309-16. 2007
    ..To assess the relative cost-effectiveness of lower versus higher cost prize-based contingency management (CM) treatments for cocaine abuse...
  64. ncbi Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Benjamin J Morasco
    Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut, USA
    Psychosom Med 68:976-84. 2006
    ..We sought to examine medical disorders and health service utilization associated with problem and pathologic gambling...
  65. ncbi Gambling level and psychiatric and medical disorders in older adults: results from the National Epidemiologic Survey on Alcohol and Related Conditions
    Robert H Pietrzak
    Department of Psychiatry, University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Am J Geriatr Psychiatry 15:301-13. 2007
    ..This study examined the association between gambling level and psychiatric and medical disorders in a nationally representative sample of older adults...
  66. ncbi Gambling severity and health functioning in adolescents recruited from urban primary care settings
    Robert H Pietrzak
    Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut 06030 3944, USA
    J Adolesc Health 39:764-6. 2006
    ..A total of 11.8% were probable pathological gamblers, and 5.5% were problem gamblers. Probable pathological/problem gambling was associated with poor mental health and perceived social functioning...
  67. pmc Regardless of psychiatric severity the addition of contingency management to standard treatment improves retention and drug use outcomes
    Jeremiah Weinstock
    University of Connecticut Health Center, Farmington, CT 06030 3944, USA
    Drug Alcohol Depend 87:288-96. 2007
    ..Overall, these findings suggest contingency management is an efficacious and appropriate intervention for substance use disordered individuals across a range of psychiatric problems...
  68. ncbi Should the scope of addictive behaviors be broadened to include pathological gambling?
    Nancy M Petry
    University of Connecticut Health Center, Farmington, CT, USA
    Addiction 101:152-60. 2006
    ..This paper considers the prospect of reclassifying and broadening the substance use disorders to include non-pharmacological addictions such as pathological gambling...
  69. ncbi Psychological experience of gambling and subtypes of pathological gamblers
    David M Ledgerwood
    Department of Psychiatry, School of Medicine, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT 06030 3944, United States
    Psychiatry Res 144:17-27. 2006
    ..Male gender and impulsivity were associated with the Egotism factor. These data offer preliminary evidence of the validity and reliability of the GEM in distinguishing subgroups of gamblers...
  70. ncbi Contingency management treatments: Reinforcing abstinence versus adherence with goal-related activities
    Nancy M Petry
    Department of Psychiatry, University of Connecticut Health Center, Storrs, CT 06030 3944, USA
    J Consult Clin Psychol 74:592-601. 2006
    ..Abstinence at 6- and 9-month follow-ups did not differ by group, but longest duration of abstinence achieved during treatment was associated with abstinence posttreatment...
  71. ncbi Gamblers anonymous and cognitive-behavioral therapies for pathological gamblers
    Nancy M Petry
    Department of Psychiatry, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030 3944, USA
    J Gambl Stud 21:27-33. 2005
    ..This paper describes some outcome data associated with the two approaches. It also reviews evidence suggesting that a combined intervention may enhance therapy engagement and reduce relapse rates...