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Lisa M. Najavits 《Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming》2011,27(2):229-241
This study explored the treatment preferences of 106 people with posttraumatic stress disorder (PTSD), pathological gambling
(PG), or both. It is the first know study of its type for this comorbidity. Sixteen different treatment types were rated,
with a broad array of modalities including manualized psychotherapies, medication, self-help, alternative therapies, coaching,
and self-guided treatments (use of books and computerized therapy). A consistent finding was that PTSD treatments were rated
more highly than PG treatments, even among those with both disorders. Further, of the sixteen treatment types, the sample
expressed numerous preferences for some over others. For example, among PG treatments, self-help was the highest-rated. Among
PTSD treatments, psychotherapies were the highest-rated; and individual therapy was rated higher than group therapy. For both
PG and PTSD, medications were rated lower than other treatment types. Non-standard treatments (i.e., computerized treatment,
books, coaching, family therapy, alternative therapies) were generally rated lower than other types. Discussion includes implications
for the design of treatments, as well as methodological limitations. 相似文献
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Lisa M. Najavits 《Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming》2010,26(4):583-592
This paper represents the first study of treatment utilization among pathological gamblers with and without PTSD. Comorbidity
of PG and PTSD is increasingly recognized as an important association, both in its rate and clinical severity. The sample
comprised 106 adults from the community (35 with current PG; 36 with current PTSD, and 35 with BOTH). Four areas were addressed:
current treatment utilization, lifetime treatment utilization, specific treatments utilized, and satisfaction with treatments.
Results indicated that the presence of PTSD was associated with higher treatment utilization (for current utilization, PTSD
was higher than PG; and for lifetime, PTSD and PTSD/PG were both higher than PG). Indeed, only a minority of the PG group
had ever attended current or lifetime treatment, whereas the majority of PTSD and PTSD/PG had. Yet notably, those with PG
who utilized current treatment had no less satisfaction, number of treatment types, nor number of days in treatment than the
other two groups. For all three groups, the most common current treatments were individual therapy and psychiatric medications.
Study strengths include a rigorously diagnosed sample; an extensive interview-based assessment of treatment utilization, and
identification of both current and lifetime utilization. Limitations include the inability to explore change over time or
test–retest reliability of responses. 相似文献
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Najavits LM Meyer T Johnson KM Korn D 《Journal of gambling studies / co-sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming》2011,27(4):663-683
This report is the first empirical study to compare pathological gambling (PG), posttraumatic stress disorder (PTSD), and their co-occurrence. The sample was 106 adults recruited from the community (35 with current PG; 36 with current PTSD, and 35 with BOTH). Using a cross-sectional design, the three groups were rigorously diagnosed and compared on various measures including sociodemographics, psychopathology (e.g., dissociation, suicidality, comorbid Axis I and II disorders), functioning, cognition, life history, and severity of gambling and PTSD. Overall, the PG group reported better psychological health and higher functioning than PTSD or BOTH; and there were virtually no differences between PTSD and BOTH. This suggests that it is the impact of PTSD, rather than comorbidity per se, that appears to drive a substantial increase in symptoms. We also found high rates of additional co-occurring disorders and suicidality in PTSD and BOTH, which warrants further clinical attention. Across the total sample, many reported a family history of substance use disorder (59%) and gambling problems (34%), highlighting the intergenerational impact of these. We also found notable subthreshold PTSD and gambling symptoms even among those not diagnosed with the disorders, suggesting a need for preventive care. Dissociation measures had mixed results. Discussion includes methodology considerations and future research areas. 相似文献
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