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Sixty-eight individuals were randomised to either six sessions of imaginal desensitisation plus motivational interviewing (IDMI) or Gamblers Anonymous. Individuals assigned to IDMI had significantly greater reductions in Yale-Brown Obsessive Compulsive Scale Modified for Pathological Gambling total scores, gambling urges and gambling behaviour. People who failed to respond to Gamblers Anonymous reported significantly greater reduction in pathological gambling symptoms following later assignment to IDMI. Abstinence was achieved by 63.6% during the acute IDMI treatment period. [ABSTRACT FROM AUTHOR]

Abstract: We examined the relationship between gambling severity, impulsivity and obsessionality/compulsivity in 38 pathological gamblers, representing the complete Minnesota sample of a randomized, placebo-controlled clinical trial of paroxetine for the treatment of pathological gambling (PG), using Pearson correlations and linear regression models at baseline and treatment endpoint. At baseline, Pathological Gambling Modification of the Yale–Brown Obsessive–Compulsive Scale (PG-YBOCS) scores correlated significantly with those of the Eysenck Impulsiveness Questionnaire (EIQ) Impulsiveness subscale and Padua Inventory (PI) factors I and IV (corresponding to impaired control over mental and motor activities, respectively). None of the associations between PI factors and the PG-YBOCS were significant after adjusting for Impulsiveness scores. There were no differences in changes in the PG-YBOCS between the paroxetine and placebo group. Changes in PG-YBOCS scores after treatment correlated with changes in Impulsiveness scores. These changes appeared independent of paroxetine treatment. The results suggest that, although PG exhibits features of both obsessionality/compulsivity and impulsivity and elements of both decrease with treatment, impulsivity predominates and changes in gambling severity are most associated with changes in impulsivity. [Copyright &y& Elsevier]

This study sought to examine the impact of tobacco use on gambling treatment. Pathological gambling (PG) is a psychiatric condition associated with significant financial, emotional, and psychosocial consequences. Elevated rates of nicotine dependence have been associated with increased gambling severity and more frequent psychiatric problems. A total of 385 treatment-seeking pathological gamblers enrolled in one of 11 gambling treatment providers in Minnesota were assessed. Linear regression modeling was used to examine demographic and clinical variables at treatment entry and the relationship between those variables and the number of days gambled at a 6-month posttreatment. Logistic regression was utilized to assess predictors of treatment completion. Daily tobacco use was reported in 244 (63.4%) subjects. Tobacco users presented with significantly more severe gambling and mental health symptoms at treatment intake. Daily tobacco use, however, was not significantly associated with the number of days gambled or with treatment completion. Although tobacco users present with greater gambling problem severity, they had similar rates of treatment completion and treatment outcomes as nonusers., (PsycINFO Database Record (c) 2013 APA, all rights reserved.)

Background: Although prior studies have examined various clinical characteristics of pathological gambling (PG), limited data exist regarding the clinical correlates of PG based on preferred forms of gambling., Methods: We grouped patients meeting DSM-IV criteria for pathological gambling into 3 categories of preferred forms of gambling: strategic (eg, cards, dice, sports betting, stock market), nonstrategic (eg, slots, video poker, pull tabs), or both. We then compared the groups' clinical characteristics, gambling severity (using the Yale-Brown Obsessive Compulsive Scale Modified for Pathological Gambling, the Clinical Global Impression-Severity scale, and time and money spent gambling) and psychiatric comorbidity., Results: The 440 patients included in this sample (54.1% females; mean age 47.69±11.36 years) comprised the following groups: strategic (n = 56; 12.7%), nonstrategic (n = 200; 45.5%), or both (n = 184; 41.8%). Nonstrategic gamblers were significantly more likely to be older and female. Money spent gambling, frequency of gambling, gambling severity, and comorbid disorders did not differ significantly among groups., Conclusions: These preliminary results suggest that preferred form of gambling may be associated with certain age groups and sexes but is not associated with any specific clinical differences.

Background: Parkinson's disease (PD) is a degenerative brain disorder accompanied by the loss of dopaminergic neurons and the presence of motor and non-motor symptoms., Objective: We performed a cross-sectional, questionnaire-based analysis of impulsive behavior in our PD clinic population to assess prevalence and associated characteristics., Results: We found a higher prevalence of impulsive behavior (29.7%) than previously reported, and found multiple, concurrent impulsive behaviors in 26% of subjects reporting impulsive behavior., Conclusions: Our findings contribute to the growing awareness of impulsive behavior in PD, and support the need for longitudinal studies to assess changes in impulsive behaviors in Parkinson's patients., (Published by Elsevier Inc.)

Background: Compulsive sexual behavior (CSB) is generally characterized by recurrent and intense sexually arousing fantasies, sexual urges, and behaviors, which cause individuals distress or impair daily functioning. Descriptive studies of individuals with paraphilic and nonparaphilic CSB indicate that they experience urges to engage in problematic sexual behavior. The opiate antagonist naltrexone has been successfully used to treat a number of disorders in which urges to engage in problematic behavior are a central feature, such as alcoholism. We hypothesized that naltrexone would reduce the urges and behaviors associated with CSB., Methods: Records of 19 male patients with CSB who were treated with naltrexone at an outpatient adult sexual health clinic were retrospectively reviewed., Results: Nearly all patients were already taking other psychotropic medications when naltrexone was initiated. Seventeen (89%) of the 19 patients reported a reduction in CSB symptoms when taking naltrexone for a period ranging from 2 months to 2.3 years, as judged by Clinical Global Impression scores of 1 or 2, indicating "very much improved" or "much improved." Five (26%) of the 19 patients chose to discontinue the medication., Conclusions: Naltrexone may be a useful adjunctive treatment for CSB.

This analysis compares the characteristics of adult pathological gamblers with and without a problem gambling parent. A sample of 517 individuals with current DSM-IV pathological gambling was categorized based on presence of a parental problem gambler. Groups were compared on clinical characteristics, gambling severity, gambling-related problems, and psychiatric comorbidity. Although the groups were similar on most measures, pathological gamblers with at least one problem gambling parent were more likely to have a father with an alcohol abuse/dependence problem; have financial and legal problems; and report daily nicotine use. Females with a problem gambling parent had significantly earlier onset of gambling behavior, were significantly more likely to have a father with an alcohol use disorder, and were significantly more likely to have financial problems secondary to gambling than females without a problem gambling parent. Males with a problem gambling parent were significantly more likely to have a father with an alcohol use disorder and have legal problems secondary to gambling compared to males without a problem gambling parent. Treatment approaches may need to be tailored for specific problems secondary to gambling and gender issues based on the history of having a problem gambling parent.

Gender differences in pathological gambling disorder (PGD) have received little investigation. This study was constructed to detail the demographic and phenomenological differences in men and women with PGD. We assessed gender differences in 131 subjects with PGD who were evaluated in terms of demographic characteristics, clinical features of PGD, and treatment history. Seventy-eight (60%) subjects were women, and 53 (40%) were men. Men had an earlier age of onset of gambling behavior, while women progressed to pathological gambling sooner after beginning to gamble. In terms of gambling behavior, men were more likely to engage in blackjack, cards, sporting events, and the track, whereas women played slot machines and bingo. Women reported that loneliness was the major trigger to gambling, while men were more likely to gamble secondary to sensory stimuli. Although men were as likely as women to have filed bankruptcy because of gambling, women were more likely to have written bad checks and men were more likely to have lost significant savings. Both groups were equally likely to seek treatment, but Gamblers Anonymous (GA) and outpatient therapy were reported equally ineffective in reducing gambling symptoms. There appear to be some gender differences in the clinical features of PGD, and these differences may have treatment implications., (Copyright 2002 by W.B. Saunders Company)