Catherine Baxley1, Jeremiah Weinstock2, Carla J Rash3, Matthew M Yalch4, Brian Borsari5, Annie A Garner2, Jeffrey Benware6. 1. Saint Louis University, 3700 Lindell Blvd, St. Louis, MO 63108, United States; San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States; University of California San Francisco, 505 Parnassus Ave., San Francisco, CA 94143, United States. 2. Saint Louis University, 3700 Lindell Blvd, St. Louis, MO 63108, United States. 3. University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, United States. Electronic address: carlarash@gmail.com. 4. Palo Alto University, 1791 Arastradero Rd., Palo Alto, CA 94304, United States. 5. San Francisco VA Health Care System, 4150 Clement Street, San Francisco, CA 94121, United States; University of California San Francisco, 505 Parnassus Ave., San Francisco, CA 94143, United States. 6. Saint Louis University, 3700 Lindell Blvd, St. Louis, MO 63108, United States; VA St. Louis Health Care System, 915 N Grand Blvd., St. Louis, MO 63106, United States.
Abstract
BACKGROUND: Patients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories of non-gambling outcomes of three brief PG interventions (i.e., brief psychoeducation, brief advice, motivational enhancement therapy plus cognitive-behavioral therapy [MET + CBT]) among MMT patients. METHODS: Participants (N = 109) were engaged in substance use disorder treatment, met criteria for PG, and had a current or lifetime history of MMT. Latent growth curve models examined outcome trajectories of psychiatric, medical, legal, employment, and social problems, as well as psychological distress and quality of life. Follow-up analyses examined clinically significant change. RESULTS: MET + CBT patients reported lower medical problems at baseline and over time than the brief interventions. There was no evidence of differences between interventions on the other outcomes. Psychiatric problems and psychological distress decreased over time for the entire sample, regardless of the PG intervention. About 24% and 13% of the sample demonstrated clinically significant improvements in psychological distress from baseline to 5 months, and 5 months to 12 months, respectively. Nearly 21% of the sample showed clinically significant improvements in psychiatric problems from 5 months to 12 months. Among all patients, men and those with more severe opioid dependence symptoms demonstrated the greatest psychological improvements. CONCLUSIONS: Many patients in MMT with PG experience improvements in psychological problems, including long-term improvement, regardless of the PG intervention offered.
BACKGROUND: Patients in methadone maintenance treatment (MMT) with problem gambling (PG) experience worse psychosocial outcomes than their non-PG counterparts. Interventions targeting PG in MMT may enhance psychosocial functioning beyond gambling reduction and abstinence. The present study was a secondary data analysis that examined the trajectories of non-gambling outcomes of three brief PG interventions (i.e., brief psychoeducation, brief advice, motivational enhancement therapy plus cognitive-behavioral therapy [MET + CBT]) among MMT patients. METHODS: Participants (N = 109) were engaged in substance use disorder treatment, met criteria for PG, and had a current or lifetime history of MMT. Latent growth curve models examined outcome trajectories of psychiatric, medical, legal, employment, and social problems, as well as psychological distress and quality of life. Follow-up analyses examined clinically significant change. RESULTS: MET + CBT patients reported lower medical problems at baseline and over time than the brief interventions. There was no evidence of differences between interventions on the other outcomes. Psychiatric problems and psychological distress decreased over time for the entire sample, regardless of the PG intervention. About 24% and 13% of the sample demonstrated clinically significant improvements in psychological distress from baseline to 5 months, and 5 months to 12 months, respectively. Nearly 21% of the sample showed clinically significant improvements in psychiatric problems from 5 months to 12 months. Among all patients, men and those with more severe opioid dependence symptoms demonstrated the greatest psychological improvements. CONCLUSIONS: Many patients in MMT with PG experience improvements in psychological problems, including long-term improvement, regardless of the PG intervention offered.
Authors: Jichuan Wang; Brian C Kelly; Brenda M Booth; Russel S Falck; Carl Leukefeld; Robert G Carlson Journal: Addict Behav Date: 2009-08-14 Impact factor: 3.913