Integrative Couple Treatment for Pathological Gambling or Individual Treatment: A Comparison of Efficacy
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 80
- 试验地点
- 2
- 主要终点
- Canadian Dollars Spent on Gambling
研究概览
简要总结
The aim of the study is to compare marital treatment to individual treatment for pathological gambling.
详细描述
The study as two goals: evaluate the efficacy of couple treatment for pathological gambling and develop a better understanding of the individual (substance use, mental health) and couple dimensions (communication, marital satisfaction, violence) as intermediate variables explaining this efficacy. Couples will be randomized between the couple treatment and the treatment as usual (individual or group). The experimental couple treatment is offered over 8 to 12 sessions of 90 minutes. The couple treatment called (Integrative Couple Therapy for Pathological Gambling - ICT-PG) is inspired by the "Alcohol Behavior Couple Therapy" from Epstein and McCrady, to which the team added diverse components to adjust to gamblers. During the sessions, the focus is on a) reducing/stopping gambling behaviors, b) helping the partner to stop behaviors facilitating gambling habits and rise the frequency of behaviors incompatible with gambling habits and c) improve marital components (communication, sharing positive moments, negotiation, mutual support).
The control group receives individual or group treatment as already offered by the specialized centers in addiction. Their partner can receive individual intervention if desired. All participants are recruited in Specialized Addiction Treatment Centers in Quebec province, Canada. Evaluation of participants is done at admission, three, nine and 18 months post-admission.
Repeated measures ANOVA will be used to compared evolutions of groups over time. Multiple regression will allow the estimation of components roles into as intermediate variables to predict rehabilitation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Living together for at least 1 year
- •Diagnosis of pathological gambling (WMH-CIDI) during the last 12 months
- •The gambler has not received treatment for their gambling for at least 6 months (excluding GA)
- •Presence of gambling behavior in the past 3 months
- •Degree of commitment to the couple indicating a desire to continue the relationship (score of 7 - MSI)
排除标准
- •Alcohol/Drug Dependence gambler/partner (Severity of Alcohol Dependence Data questionnaire - SADD >17 included in DEBA-A; Severity of Dependence Scale - SDS > 5 Included in DEBA-D)
- •Gambling problem for the partner (DEBA-Jeu > 10)
- •Presence of serious acts of violence endangering the safety of both spouses (CTS-2)
- •Disorder and serious mental health unstabilized one of two members of the couple (ASI: psychological scale)
- •Antisocial personality disorder or severe limit ( GAIN: 9 + Scale BCS / CDS)
- •Scenario with strong suicidal ideation or attempt in the last 30 days or less in the partner (ASI: psychological scale)
- •Low degree of commitment in the relationship of a risk of separation (8 + MSI)
结局指标
主要结局
Canadian Dollars Spent on Gambling
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome measure for Gamblers Total Money spent in canadian dollars for all gambling activities during the last 3 months previous each research interview.
Frequency of the Most Problematic Game
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Gamblers Among 12 types of gambling activities, the highest frequency of gambling behaviors for the past 6 months (never = 0; every or almost every day=5). Maximum score is 5. The higher is the score, the higher is the frequency.
Detection of Gambling Problems and Services Need ("Détection et Besoin d'Aide en Regard du Jeu Excessif- DÉBA-Jeu")
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Gamblers The DEBA-Jeu is a very brief screening grid comprising eight Likert-type items in five points (never = 0, always = 4). The eight items form a scale where the total score varies between 0 and 32. The suggested breaking points are as follows: 0 to 1 = No problem gambling; 2 to 5 =Problem gambling ; 6 to 24 = High probability of problem gambling.
Canadian Problem Gambling Index (CPGI)
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome measure for Gamblers The Canadian Problem Gambling Index (CPGI) is a 9-item measure with a 4-point Likert-type scale (0 = Never, 3 = Almost always).It asks questions about an individual's gambling habits in the last three months from four categories: Gambling involvement; Problem gambling behaviour; Adverse Consequences; Correlates of problem gambling. Scores for the nine items are summed, and the results are interpreted as follows: 0 = non-problem ; 1-4 = low risk; 5-7 = moderate risk; 8 and + (maximum 27) = probable pathological player.
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Gambler
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Gamblers This questionnaire measures people's beliefs about gambling. The ICROLJ has 29 items and uses a 4-point Likert-type scale ranging from "Strongly disagree" = 0 to "Strongly agree"=4. To compute a total score, all item' score are summed. The total score ranges from 0 to 116.Higher the score is, more it indicates the presence of erroneous beliefs.
Gambling Symptom Assessment Scale (G-SAS)
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome measure for Gamblers The G-SAS is a 12-item self-rated scale designed to assess gambling symptom severity and change during treatment. Each 12-item scale has a score ranging from 0 - 4 (adjective anchors for 0 and 4 vary for each item but "0 means no symptoms" and "4 means extreme symptoms"). All items ask for an average symptom based on the past 7 days (average urge, frequency, duration and control,thoughts associated with gambling,time spent on gambling,anticipatory tension and/or excitement, emotional distress). The total score ranges from 0 to 48. A score between 8 and 20 is an indicator of low urges to gamble, between 21 and 30, moderate urges, between 31 and 40 severe urges and a score of over 40 reveals the presence of extreme urges in the player.
Negative Gambling Consequences-Gambler
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Gamblers Short questionnaire of 10 items, assessing to what extent the respondent considers his gambling habits in the last 6 months have harmed various aspects of his life (financial, living conditions, marital, physical health, professional life, social, legal and family). A 5-point Likert-type scale is used "Not at all = 0" to "Extremely = 4". To compute a total score, all item' score are summed. The total score ranges from 0 to 40.Higher the score is, more it's indicate that the respondent is experiencing negative impacts because of his gambling habits.
Negative Gambling Consequences-Partner
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Partners Short questionnaire of 10 items, assessing to what extent the respondent considers that his partner's gambling habits have harmed various aspects of his life in the last 6 months (financial, living conditions, marital, physical health, professional life, social, legal and family). A 5-point Likert-type scale is used "Not at all = 0" to "Extremely = 4". To compute a total score, all item' score are summed. The total score ranges from 0 to 40. Higher the score is, more it's indicate that the respondent is experiencing negative impacts because of his partner's gambling habits.
Impaired Control Over Gambling Scale (ICOG)
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Gamblers The ICOG is used to measure two aspects of control related to the JHA processes, namely the level of control over the desire to start playing (e.g., when I decide not to play, I watch stick to that decision) as well as the level of control once the game has started (e.g., when I knew I had little time to play, I would limit myself to the scheduled time). This questionnaire has a total of 10 items and uses a 5-point Likert-type scale ranging from "Never = 1" to "Always = 5", with 4 inverted items. The total score varies between 10 and 50. A high control represents a score between 10 and 16, a moderate control between 17 and 23 and a score of 24 and more presents a low control in the player.
Inventory of Erroneous Beliefs Related to Gambling ("Inventaire Des Croyances liées Aux Jeux" - ICROLJ)-Partner
时间窗: Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016)
Outcome Measure for Partners This questionnaire measures people's beliefs about gambling. The ICROLJ has 29 items and uses a 4-point Likert-type scale ranging from "Strongly disagree" = 0 to "Strongly agree"=4. To compute a total score, all item' score are summed. The total score ranges from 0 to 116. Higher the score is, more it indicates the presence of erroneous beliefs.
次要结局
- Center for Epidemiologic Studies Depression Scale (CES-D)-Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Psychological Distress Index (IDPESQ-14)-Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Marital Status Inventory (MSI)-Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Conflict Tactics Scale-2_Psychological Violence Issued by the Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Interpersonal Communication Skills Inventory-self _Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Marital Problem Solving Scale (MPSS)-Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Conflict Tactics Scale-2_ Physique Violence Issued by the Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Coping Skills _Positive Reevaluation/Problem Solving Sub-scale_Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Psychological Distress Index (IDPESQ-14)-Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Dyadic Adjustment Scale (DAS-4)-Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Coping Skills _Social Support Sub-scale_Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Conflict Tactics Scale-2 _ Psychological Violence Issued by the Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Marital Problem Solving Scale (MPSS)-Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Center for Epidemiologic Studies Depression Scale (CES-D)-Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Dyadic Adjustment Scale (DAS-4)-Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Standard Units of Alcoholic Drinks Per Week _Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Coping Skills _Distancing / Withdrawal Sub-scale_Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Conjugal Support Questionnaire (CSQ)-Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Conjugal Support Questionnaire(CSQ)-Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Marital Status Inventory (MSI)-Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Conflict Tactics Scale-2 _ Physical Violence Issued by the Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Coping Skills _Social Support Sub-scale_Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Frequency of Cannabis Use Per week_Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Coping Skills _Distancing / Withdrawal Sub-scale_Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Standard Units of Alcoholic Drinks Per Week _Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Interpersonal Communication Skills Inventory-self _Gambler(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Coping Skills_Positive Reevaluation/Problem Solving Sub-scale_Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
- Frequency of Cannabis Use Per week_Partner(Admission, 3, 9 and 18 month post-admission (The first admission was March 2011 and the last admission will be June 2016))
研究者
Joël Tremblay
Principal Investigator
Université du Québec à Trois-Rivières