Exploring the Association between Gambling-Related Offenses, Substance Use, Psychiatric Comorbidities, and Treatment Outcome

Abstract

Several studies have explored the association between gambling disorder (GD) and gambling-related crimes. However, it is still unclear how the commission of these offenses influences treatment outcomes. In this longitudinal study we sought: (1) to explore sociodemographic and clinical differences (e.g., psychiatric comorbidities) between individuals with GD who had committed gambling-related illegal acts (differentiating into those who had had legal consequences (n = 31) and those who had not (n = 55)), and patients with GD who had not committed crimes (n = 85); and (2) to compare the treatment outcome of these three groups, considering dropouts and relapses. Several sociodemographic and clinical variables were assessed, including the presence of substance use, and comorbid mental disorders. Patients received 16 sessions of cognitive-behavioral therapy. Patients who reported an absence of gambling-related illegal behavior were older, and showed the lowest GD severity, the most functional psychopathological state, the lowest impulsivity levels, and a more adaptive personality profile. Patients who had committed offenses with legal consequences presented the highest risk of dropout and relapses, higher number of psychological symptoms, higher likelihood of any other mental disorders, and greater prevalence of tobacco and illegal drugs use. Our findings uphold that patients who have committed gambling-related offenses show a more complex clinical profile that may interfere with their adherence to treatment.

Definitions and assessments of recovery from gambling disorder: A scoping review

“…Although various studies did not define "recovery" directly in terms of a state of abstinence, they used abstinence as an outcome to measure the effectiveness of the intervention in question (Dannon, Rosenberg, Schoenfeld, & Kotler, 2011;Hodgins & el-Guebaly, 2010;Jiménez-Murcia et al, 2007;Monnat et al, 2014;Oei & Gordon, 2008;Ouellet & Queloz, 2018;Sander & Peters, 2009). Similarly, the term "relapse", when included as an outcome, was defined in most studies as the exact opposite of abstinence, that is, as any episode of gambling during treatment and/or follow-up (Baño et al, 2021;Dannon et al, 2007Dannon et al, , 2011De Wilde, Goudriaan, Sabbe, Hulstijn, & Dom, 2013;Gómez-Peña et al, 2012;Granero, Blaszczynski, et al, 2020;Granero et al, 2022;Granero, Valero-Solis, et al, 2020;Hodgins & el-Guebaly, 2010;Jiménez-Murcia, Aymamí, et al, 2012;Jiménez-Murcia, Bove, et al, 2012;Jiménez-Murcia et al, 2007Lara-Huallipe et al, 2022;Mallorquí-Bagué et al, 2018Mena-Moreno, Testa, et al, 2022;Mestre-Bach et al, 2019Oei & Gordon, 2008;Ouellet & Queloz, 2018;Sander & Peters, 2009;Tárrega et al, 2015;Vintró-Alcaraz, Mestre-Bach, et al, 2022).…”

“…Nevertheless, these studies did not all define this form of therapeutic failure in the same way. While drop-out could be defined merely as not completing the treatment programme (Dowling, 2009;Echeburúa, Fernández-Montalvo, & Báez, 2001;Ladouceur et al, 2001;Mena-Moreno, Munguía, et al, 2022), some studies conceptualized therapeutic failure as conditional on a specific number of missed sessions, such as at least three consecutive missed sessions (Baño et al, 2021;Jiménez-Murcia et al, 2007Mena-Moreno, Testa, et al, 2022;Mestre-Bach et al, 2016Vintró-Alcaraz, Mestre-Bach, et al, 2022;Vintró-Alcaraz, Munguía, et al, 2022), failure to complete 75% (Granero, Blaszczynski, et al, 2020) or 50% (Rossini-Dib et al, 2015) of the planned programme sessions, or, in the case of one RCT, failure to complete any treatment session (Oei et al, 2018). Other studies added the condition of not having previously notified the therapist of one's absence at an upcoming session (Aragay et al, 2015;Gómez-Peña et al, 2012;Jiménez-Murcia, Aymamí, et al, 2012;Mallorquí-Bagué et al, 2018Ramos-Grille, Gomà-i-Freixanet, Aragay, Valero, & Vallès, 2013Tárrega et al, 2015).…”