No abstract

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.

ClinicalTrials.gov identifier: NCT00967005.

Objective Treatment for alcohol use disorder (AUD) is far less effective for those with a co-occurring anxiety disorder. Surprisingly, adding an independent anxiety treatment to AUD treatment does not substantially improve the poor alcohol outcomes of these patients. This may reflect the lack of attention from independent treatments to the dynamic interaction of anxiety symptoms with alcohol use and drinking motivation. On the basis of this view, we assembled a cognitive behavioral therapy (CBT) program designed to both reduce anxiety symptoms and weaken the links between the experience of anxiety and the motivation to drink. Method 344 patients undergoing residential AUD treatment with current social phobia, generalized anxiety disorder, or panic disorder were randomly assigned to receive either the CBT or an active comparison treatment, Progressive Muscle Relaxation Training (PMRT). Assessments took place immediately following treatment and 4 months later (n = 247). Results As predicted, the CBT group demonstrated significantly better alcohol outcomes 4 months following treatment than did the PMRT group. Although both groups experienced a substantial degree of anxiety reduction following treatment, there were no significant group differences immediately after treatment and only a slight advantage for the CBT group 4 months after treatment. Conclusions These findings suggest that specific interventions aimed at weakening the association between the experience of anxiety and drinking motivation play an important role in improving the alcohol outcomes of these difficult-to-treat patients beyond that of anxiety reduction alone.

The feasibility of using virtual reality (VR) technology to induce a physiological response to stress was assessed in 12 volunteers during a laboratory session in which each participant completed a speech task within a VR environment and a math task outside the VR environment. Both tasks were effective in eliciting a physiological response with significant increases observed in response to each stress task in systolic and diastolic blood pressure and heart rate. Increases in plasma epinephrine and norepinephrine concentrations were observed during the speech task and in plasma epinephrine concentrations during the math task although these differences did not reach statistical significance. The use of VR technology may be a viable alternative to methods currently employed in presenting stressful tasks with the potential advantage of decreased variability in the audience response to the participants' performance.