Objective: The aims of this systematic review and meta-analysis were to examine the overall prevalence of dropout from psychological treatments for problem gambling and gambling disorder and to examine how study, client, and treatment variables influenced dropout rates. Method: A systematic search was conducted to identify studies of cognitive and/or behavioral therapies and motivational interventions for problem gambling and gambling disorder. Meta-analysis was used to calculate an overall weighted dropout rate. Random effect meta-regressions were used to examine covariates of dropout rates. Mixed-effect subgroup analyses were used to examine moderators of dropout rates. Results: The systematic search identified 24 studies (31 dropout rates) comprising 2,791 participants. Using a random-effects model, the overall weighted dropout rate was 39.1%, 95% CI [33.0%, 45.6%]. Increases in the percentage of married participants were significantly associated with lower dropout rates. Dropout rates were significantly higher when dropout was defined as attending all sessions of a treatment protocol compared to when defined as attending a prespecified number of sessions different from the total in the protocol and when defined as study therapists judging participants to be dropouts. Insufficient reporting of some gambling-related variables and other psychological symptom variables prevented a thorough examination of covariates and moderators. Conclusions: A large proportion of individuals drop out of treatment for problem gambling and gambling disorder. Future research should examine the reasons for dropout across marital statuses and should adopt dropout definitions that consider session-by-session symptom change.
Public Health Significance StatementThis review suggests that a significant proportion of individuals drop out of psychological treatments for problem gambling and gambling disorder. This review also recommends that the field adopt symptombased dropout definitions to determine the adequate dosage of psychological treatment for problem gambling and gambling disorder.
Prior research has indicated that relative to other specialty areas in psychology, counseling psychology researchers are less likely to engage in research activities sponsored by external funding agencies. The primary purposes of this article were to address external funding in the counseling psychology profession and to compare the rates of articles published in the premier counseling psychology research journal (Journal of Counseling Psychology [JCP]) that reported external funding to other specialty areas' premier research journals. Between 2007 and 2011, articles in JCP were less likely than those in other journals to report external funding and less likely to report research designs associated with external sponsorship. Post hoc analyses indicated that articles in a leading vocational research journal also had relatively low rates of external funding, and counseling psychology faculty members were less likely than peers in other programs to report external funding. The implications of these findings for the field are discussed.
Aims: To measure the effect of cognitive-behavioral techniques (CBTs) on gambling disorder severity and gambling behavior at post-treatment and follow-up.Method: Seven databases and two clinical trial registries were searched to identify peerreviewed studies and unpublished studies of randomized controlled trials. The Cochrane Risk of Bias tool assessed risk of bias in the included studies. A random effect metaanalysis with robust variance estimation was conducted to measure the effect of CBTs relative to minimally treated or no treatment control groups. Results: Twenty-nine studies representing 3991 participants were identified. CBTs significantly reduced gambling disorder severity (g = −1.14, 95% CI = −1.68, −0.60, 95% prediction interval [PI] = −2.97, 0.69), gambling frequency (g = −0.54, 95% CI = −0.80, −0.27, 95% PI = −1.48, 0.40) and gambling intensity (g = −0.32, 95% CI = −0.51, −0.13, 95% PI = −0.76, 0.12) at post-treatment relative to control. CBTs had no significant effect on follow-up outcomes. Analyses supported the presence of publication bias and high heterogeneity in effect size estimates. Conclusions: Cognitive-behavioral techniques are a promising treatment for reducing gambling disorder and gambling behavior; however, the effect of cognitive-behavioral techniques on gambling disorder severity and gambling frequency and intensity at posttreatment is overestimated, and cognitive-behavioral techniques may not be reliably efficacious for all individuals seeking treatment for problem gambling and gambling disorder.
Introduction
Military veterans of the wars in Afghanistan and Iraq (OEF/OIF/OND) are at-risk for increased alcohol consumption and alcohol-related consequences. The Protective Behavioral Strategies Scale (PBSS) has been shown to be a reliable and valid measure of assessing strategies to facilitate more responsible drinking and to reduce alcohol-related harm among college student populations. The purpose of this study was to examine the psychometric properties of the PBSS among the OEF/OIF veteran population.
Method
Participants were 251 veterans (94% male; 83% White; M age = 31.77 years) who were participating in a larger alcohol intervention trial and reported consuming alcohol within the past 30 days.
Results
Confirmatory Factor Analyses indicated the model fit of the PBSS was similar to college student samples. Although a confirmatory three-factor model best fit the data, model fit indices were slightly below commonly accepted guidelines. All PBSS subscales were negatively correlated with alcohol outcomes. Greater use of Manner of Drinking (MOD) and Stopping/Limiting Drinking (SLD) strategies were associated with less alcohol consumption and lower peak BAC. Greater use of MOD strategies were associated with less alcohol-related problems.
Conclusions
Findings provide initial support for use of the PBSS among OEF/OIF veterans. Strategies aimed at stopping/limiting drinking and the manner of drinking may be more effective with a veteran sample. Additional studies examining the external validity of this measure are encouraged.
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