A BRIEF INTRODUCTION TO GAMBLING INTERVENTIONS D AVID C. H ODGINS

Treatment Models 1.) Self-help/Gamblers Anonymous 2.) Inpatient 3.) Pharmacotherapy 4.) Marital/family 5.) Psychoanalytic 6.) Cognitive * 7.) Cognitive-behavioral * 8.) Brief treatments *

T REATMENT O UTCOME L ITERATURE Jim Westphal will provide up-to-date review Newer trials are methodologically more rigorous in terms of sample size, clinical design, measurement, AND inclusion of both genders. Cognitive-behavioural and brief motivational treatments have most support No gender differences uncovered

O BSERVATIONS ABOUT G ENDER FROM THE G AMBLING L ITERATURE Telescoping is a reliable phenomenon Blanco et al., 2006; Grant & Kim, 2002; Tavares et al., 2001 Later onset, shorter time to first symptoms, shorter time to treatment Women have more narrow range of gambling activities EMGs, not sports, table games, etc. Different motivations? Escape?

O BSERVATIONS ABOUT G ENDER FROM THE G AMBLING L ITERATURE Women PG have less substance abuse comorbidity, more depression, more childhood trauma Women are more likely to recognize the gambling problem Women in treatment have equivalent severity of PG

O BSERVATIONS ABOUT G ENDER FROM THE G AMBLING L ITERATURE Women are more likely to seek treatment Indirect evidence from: Mental health literature Treatment research studies Epidemiological studies

S LUTSKE (2006) – US S URVEY National Epidemiologic Survey on Alcohol & related Conditions (N=43,093) Lifetime PG – 0.4%, n=185 No past year symptoms – 38%, n=70 Treatment-seekers – 11%, n=8 5 women and 3 men Natural recovery – 89%, n=62 American Journal of Psychiatry, 163,

S LUTSKE ET AL. (2009) – AU S URVEY Australian Twin Registry (N=4,764 Twins) Lifetime PG – 2.2%, n=140 Men 3.5% Women 1.3% Treatment-seekers – 19%, n=20 Men 13% Women 32% No past year symptoms – 42%, n=44 Men 36% Women 56% Natural recovery – 82%, n=36 Men 92% Women 56% Twin Research & Human Genetics, 12,

T HOUGHTS Lots to learn about gender specific treatment approaches Focusing on pathways to treatment (problem recognition, willingness to seek treatment, differences in “natural recovery”) might be as equally fruitful as treatment content and focus (gambling motivations, types of gambling, mental health comorbidity, trauma).