Treating Addiction Is A Complex Issue – Observations From The NCRG Staff

The NCRG Webinar Series is a great way to obtain the essential training for clinicians and researchers to understand science-based information about gambling disorders and responsible gaming. We like to cover a wide variety of topics related to this issue and give a diverse group of people the tools they need to apply the research findings to their everyday lives.

This is the same approach that we take during the pre-conference workshops for the NCRG Conference on Gambling and Addiction. Last year, we had the pleasure of having Mark Dixon, Ph.D., from Southern Illinois University lead aworkshop on Acceptance and Commitment Therapy (ACT). We were excited when he agreed to do an NCRG webinar on this topic more than 200 attendees last week.

Dr. Dixon’s presentation covered the basis of ACT. For those of you who don’t know, ACT is a unique evidenced-based psychological intervention that uses acceptance and mindfulness strategies together with commitment and behavior change strategies to increase psychological flexibility. It is considered a second generation cognitive behavioral therapy (CBT) model and is based on behavioral principles on the nature of language and cognition. He also outlinedthe six tenets of ACT: contact with the present moment, acceptance, diffusion, self as context, values and committed actions.

By explaining the difference between ACT, CBT, Motivational Interviewing and other therapeutic options, Dr. Dixon’s presentation elicited one very clear observation:there is no treatment standard for gambling disorders yet. As with any other psychological disorder, individuals can respond differently to treatment. Research has also shown that, in some cases, those with a gambling disorder can even enter recovery on their own. One person may be very responsive to CBT, being able to recognize their thought process that makes them want to gamble and modifying their behavior accordingly. Another person may be more receptive to ACT, allowing them to accept what they’re thinking and find other committed actions, instead of gambling, that align with their core values.

Treatment for addiction, whether substance use or one that is substance-less such as a gambling disorder, can vary for the individual. For clinicians and researchers, it is most important to understand and use evidence-based therapy techniques. If not, we have no measure by which to evaluate a treatment strategy for addiction.

For those of who you attended theNCRG webinar on July 31, what did you take away from Dr. Dixon’s session? Please leave your comments in the section below.

NCRG staffICRG NewsACTDr. Mark DixonNCRG Conference on Gambling and AddictionWebinar Series

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Register Now For The NCRG’s Free Webinar On Act For Gambling Disorders And Other Addictive Behaviors

Dr. Mark Dixon will lead NCRG Webinar

Next Wednesday, July 31, 2013, the NCRG will hold afree webinarfrom 2-3 p.m. on Acceptance and Commitment Therapy (ACT), a unique evidence-based psychological intervention that uses acceptance and mindfulness strategies together with commitment and behavior change strategies to increase psychological flexibility. ACT is considered a second generation cognitive behavioral therapy (CBT) model and is based on behavioral principles on the nature of language and cognition.

Mark Dixon, Ph.D.,professor and coordinator for the Behavior Analysis and Therapy Program at Southern Illinois University, will lead this webinar and will discuss how he uses ACT with clients who have gambling and other addictive disorders.

The NCRG Webinar Series sessions are approved for one hour of continuing education by:

  • NAADAC, the Association for Addiction Professionals (provider #737)
  • The California Board of Behavioral Sciences (for MFT and LCSW licensure requirements in California) (Approval #PCE 4619)
  • The National Board for Certified Counselors (provider #6474)
  • The NCRG is also approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. The NCRG maintains responsibility for this program and its contents.

This is sure to be an informative session, soregister todayto secure you spot!

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The Discovery Project: Get The Facts At Your Fingertips!

The Discovery Project

“This is the type of site you will want to visit again and again to stay up to date with the latest information on gambling disorders and responsible gaming,” said NCRG Chairman Alan Feldman.

Last week, the NCRG unveiled its newest resource:The Discovery Project. Located on the NCRG website, The Discovery Project is an easy-to-use online library for finding the latest science-based information on gambling disorders and responsible gaming. It synthesizes the NCRG’s numerous resources—including videos, guidebooks, brochures and condensed information on research studies—and allows users to search for information by date, keyword, topic or content type.

To further enhance The Discovery Project, the NCRG also created topic-specific fact sheets that cover the most pressing topics in the field, including: the prevalence of gambling disorders; the impact of proximity and exposure to gambling on gambling disorders; brief screens and assessments; and more. Like all materials developed by the NCRG and included within The Discovery Project, the fact sheets were developed using findings from scientific, peer-reviewed research studies.

Feldman commented on why the NCRG created The Discovery Project:

‘For those who don’t regularly pore through dense research articles, the NCRG developed The Discovery Project. This useful tool breaks down the latest scientific information into easily understandable resources that can be used and shared.”

The Discovery Project will be continually updated to address and explain other relevant topics. The NCRG encourages you to visit The Discovery Project and hopes you will share it with your colleagues and friends.

Are there any specific topics you would like addressed within The Discovery Project? Leave your suggestions below.

NCRG staffICRG NewsNCRG ResourcesRaising AwarenessResearch-based factsThe Discovery Project

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Drs. David Hodgins, Gloria Miele And Wendy Slutske Named To NCRG Scientific Advisory Board

Earlier this week, the NCRG sharedtwo exciting announcementsabout itsScientific Advisory Board(SAB). First,Ken Winters, Ph.D., professor of psychiatry and director of the Center for Adolescent Substance Abuse at the University of Minnesota, was named the next chairman of the NCRG’s SAB. (Read the blog post here.)

The NCRG also added three new members with diverse research backgrounds.

  • David Hodgins, Ph.D., professor of psychology in the department of psychology and institute node coordinator for the University of Calgary, Alberta Gaming Research Institute;
  • Gloria M. Miele, Ph.D., instructor at the Columbia University College of Physicians and Surgeons, and principal at Optimal Development Coaching; and
  • Wendy Slutske, Ph.D., professor in the department of psychological sciences at the University of Missouri-Columbia.
Dr. David Hodgins
Dr. Gloria Miele
Dr. Wendy Slutske

Commenting on these new members, Dr. Winters said:

“We are also thrilled to welcome Drs. Hodgins, Miele and Slutske as new board members. With their diverse backgrounds and expertise, I am confident that they will make invaluable contributions to help further the organization and its goal of supporting high-quality research.”

Here’s more about the three additions to the SAB:

Dr. David Hodgins

At the University of Calgary, Dr. Hodgins focuses on three interrelated lines of cutting-edge research in the area of gambling disorders—natural history research, the design and evaluation of brief interventions, and the study of the precipitants of relapse to gambling disorders. His research on brief treatment interventions is recognized around the world and is listed as an evidence-based treatment by the Substance Abuse and Mental Health Services Administration (SAMHSA). Dr. Hodgins has published more than 100 articles in prestigious scientific journals, and has authored and co-authored a number of books on this topic. He was also the recipient of the 2010 NCRG Scientific Achievement Award in recognition of his significant contributions to this field of research.

Dr. Gloria Miele

In addition to her role as a professor at Columbia University, Dr. Miele is a business development and leadership coach, speaker, consultant and trainer who has been helping people reach their goals for more than 25 years. She previously served as a training director and research scientist at the New York State Psychiatric Institute/Columbia University where she developed training programs on good research practices, HIV risk behavior assessment, diagnostic interviewing and behavioral interventions. Prior to this, she was the program director for the Women’s Health Project Treatment and Research Center at St. Luke’s-Roosevelt Hospital Center, where she developed programs and treatment strategies for women with a history of trauma and substance abuse. She has also contributed to more than 30 publications and serves as a reviewer for several high-impact, peer-reviewed journals.

Dr. Wendy Slutske

Dr. Slutske has been with the University of Missouri-Columbia since 1997 and is regarded as one of the world’s leading experts on the behavioral genetics of gambling disorders. Her work on the landmark all-male Vietnam Era Twin Study demonstrated that there are shared susceptibility genes that contribute to the risk for gambling disorders, alcohol use disorders and antisocial behavior. Dr. Slutske’s analysis of large epidemiological studies has also led to the groundbreaking finding that gambling disorders are episodic rather than chronic. She has published more than 100 articles in highly-cited, peer-reviewed journals and was the recipient of the 2011 NCRG Scientific Achievement Award.

In addition to Drs. Cottler, Hodgins, Meile, Slutske and Winters, the NCRG SAB includes Tammy Chung, Ph.D., associate professor of psychiatry and epidemiology at the University of Pittsburgh; Mark S. Gold, M.D., Donald Dizney Eminent Scholar, Distinguished Professor and Chair of psychology in the College of Medicine at the University of Florida; and Miriam Jorgensen, Ph.D., M.P.P., research director at the Native Nations Institute of the University of Arizona and research director for the Harvard Project on American Indian Economic Development at Harvard University.

NCRG staffICRG NewsDr. HodginsDr. MieleDr. SlutskeScientific Advisory Board

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Dr. Ken Winters Takes The Helm Of The NCRG’s Scientific Advisory Board

Dr. Ken Winters Named NCRG Scientific Advisory Board Chairman

Today, the NCRG is excited toannouncethatKen Winters, Ph.D.,professor of psychiatry and director of the Center for Adolescent Substance Abuse at the University of Minnesota, was named the next chairman of the NCRG’s Scientific Advisory Board (SAB).

Dr. Winters is a leading expert in the study of risky behaviors among youth, including gambling. His research interests include assessment and treatment of adolescent drug abuse and gambling; adolescent brain development and vulnerability to drug abuse; and assessment and treatment of adult problem gambling. He has published numerous research articles in these areas, and has received numerous research grants from the National Institute of Health (NIH) and various foundations. Dr. Winters was honored by the NCRG with the Scientific Achievement Award in 2005 for his work on gambling disorders.

Dr. Winters serves on the editorial boards of theJournal of Child and Adolescent Substance Abuse,Psychology of Addictive Behaviorsand theJournal of Substance Abuse Treatment. He was also the lead editor for two Treatment Improvement Protocol Series editions published by the Center for Substance Abuse Treatment (SAMHSA) that focused on adolescent drug abuse assessment and treatment. Dr. Winters is a consultant to many organizations, including the Hazelden Foundation, National Institute on Drug Abuse, Center for Substance Abuse Treatment, the Partnership at Drugfree.org, the World Health Organization and the Mentor Foundation (an international drug abuse prevention organization).

Dr. Winters replacesLinda B. Cottler, Ph.D., M.P.H.,associate dean for research and planning in the College of Public Health and Health Professions and Dean’s Professor and Chair for the department of epidemiology in the Colleges of Medicine and Public Health and Health Professions at the University of Florida, who will remain as a member of the SAB.

Theeight-member panelof leading, independent scientists plays a vital role by ensuring that the organization follows rigorous standards inawarding grants, monitoring the work of theNCRG Centers of Excellence in Gambling Researchand advising the NCRG on funding initiatives and educational activities.

Commenting on his new position, Dr. Winters said:

“I am honored to accept this expanded role on the NCRG’s SAB. On behalf of the entire board, we thank Dr. Cottler for her leadership and guidance for the past four years and we look forward to her continued contribution to the board.”

The NCRG also announced today that three new members were added to the SAB:

  • David Hodgins, Ph.D., professor of psychology in the department of psychology and institute node coordinator for the University of Calgary, Alberta Gaming Research Institute;
  • Gloria M. Miele, Ph.D., instructor at the Columbia University College of Physicians and Surgeons, and principal at Optimal Development Coaching; and
  • Wendy Slutske, Ph.D., professor in the department of psychological sciences at the University of Missouri-Columbia.

Stay tuned for a blog post later this week about these new additions to the board.

NCRG staffICRG NewsDr. Ken WintersDr. Linda CottlerScientific Advisory Board

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Searching For Pioneers In The Field Of Gambling Disorders Research!

Nominations for the NCRG Scientific Achievement Award are Due Aug. 1

Do you know of a researcher, educator or a recent publication that has advanced the field of gambling disorder research? The National Center for Responsible Gaming (NCRG) annually recognizes outstanding contributions to the field of gambling studies with theNCRG Scientific Achievement Award. This year’s award will be presented during theNCRG Conference on Gambling and Addictionin Las Vegas, Sept. 22-24, 2013.

Dr. Randy Stinchfield receives the 2012 Scientific Achievement Award

Nominations for the NCRG Scientific Achievement Award may include:

  • Research investigatorsat any stage in their careerwhose research has made significant contributions to the knowledge base about gambling disorders.
  • Educators who have successfully mentored young investigators in the field or have excelled at promoting public awareness and education about gambling disorders and responsible gaming.
  • A recent publication in a scientific, peer-reviewed journal that represents seminal work in the field.

Guidelines for Submitting a Nomination

The nomination package must include the following:

  1. Letter of recommendation:A detailed letter of recommendation describing the worthiness of the nominee, specifying his or her contribution to the field of gambling studies, or the significance of the publication nominated.
  2. Curriculum vitae (CV):For individual nominees, include an up-to-date CV. For research investigators, include a comprehensive bibliography of the nominee’s publications.
  3. Publications:For research investigators, submit no more than five scientific publications representative of the nominee’s work. In the case of a nomination of a publication, include a copy of the published version of the article. The publication must have been published in the same year as or the year prior to the nomination.

Nominations must be submitted in in PDF format to Christine Reilly (creilly@ncrg.org), senior research director of the NCRG by August 1, 2013. The selection committee, composed of distinguished scientists in the addictions field, will select one recipient for the 2013 Scientific Achievement Award.

For more information and a list of past award recipients, please visit the NCRG’s Scientific Achievement Awardwebsite.

Do you have questions or comments about the NCRG Scientific Achievement Awards or the 13th annual NCRG Conference on Gambling and Addiction? Please let us know in the comments below!

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Submit Your Poster By August 1 For The 2013 NCRG Conference Poster Session

2012 NCRG Outstanding Poster Award Winner Dr. Gerhard Meyer

The deadline to submit a poster for this year’sNCRG Conference on Gambling and Addictionis fast approaching, and submissions have begun arriving from around the world! There are only 30 days left before the August 1 deadline. In addition to the outstanding poster award, we also will recognize high quality posters with honorable mention awards as directed by the scientists on the poster review committee.

If you have new empirical research on gambling disorders that you want to share with colleagues we encourage you to submit a poster abstract for the session on Sept. 22, 2013.

Subject Matter

Posters can focus on any aspect of gambling disorders and must report on empirical research. Abstracts will be reviewed for scientific merit. An award for the outstanding poster and honorable mentions will be presented at the conference.

Submission Guidelines

Abstracts are limited to 500 words and should be submitted electronically in Microsoft Word or other word processing software using a font size no smaller than 12 pt. font. Please include the following information:

  1. Title of presentation
  2. Name(s) and affiliation(s) of the author(s)
  3. Mailing address, telephone and email address of the first author
  4. Poster abstract (no more than 500 words). Please follow APA format for text and references. The abstract should address sample and methods, preliminary findings and implications for the field.
  5. By submitting a poster, at least one author must agree to attend the conference and to participate as the poster presenter. No individual can be first author on more than one abstract.

Abstracts will be accepted on a rolling basis until August 1, 2013. Send abstracts via email to Nathan Smith, program officer at the NCRG:nsmith@ncrg.org.

Questions? Email Nathan Smith or call 978-338-6610.

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NCRG On The Road: Meeting With Substance Abuse Researchers In Orlando, Fla.

NCRG Senior Research Director Christine Reilly

A part of the NCRG’s outreach strategy is to attend and exhibit at meetings that help increase the awareness of gambling disorders among other co-occurring disorders, such as substance use problems. NCRG Senior Research Director Christine Reilly is exhibiting at theResearch Society on Alcoholism’s annual meeting from June 22 to 26 and is visiting with many NCRG-funded researchers. Below is her take on the meeting so far.

The Research Society on Alcoholism is meeting in sunny Florida this week, and I’m here to connect with researchers and hear presentations by NCRG-funded investigators. The young field of gambling disorders often borrows interventions and treatment therapies from the more mature alcohol research area and, therefore, keeping up-to-date on brief interventions research is vital for the NCRG.

One example of this isClayton Neighbors, Ph.D.,a professor of psychology at the University of Houston who is currently working on anNCRG-funded online screening and brief intervention for college gambling, reported findings from a preliminary study that tested the use of expressive writing as an intervention for alcohol use among college students. Based on the research showing that keeping a diary has positive health effects, this project randomly assigned 201 students to three groups: one assigned to write a negative story about a drinking episode; a positive story about a drinking episode; and a story about the first day of college. (The two latter groups functioned as controls for the negative story group.) The objective was to see if writing about the negative alcohol experience resulted in intentions to drink less in the future.

Dr. Neighbors characterized the study as a promising start but with mixed results. The light drinkers who wrote about negative alcohol episodes indicated that they intended to imbibe less in the future. However, the heavier drinkers did not intend to adjust their future drinking. Future research on expressive writing as an intervention will be tweaked and expanded to cover behaviors as well as intention; measure shame and guilt; and perhaps provide multiple opportunities for writing.

We’ll be sure to ask Dr. Neighbors if such an intervention might be useful for college gambling. What do you think? Share your comments below.

NCRG's Christine Reilly connects with Dr. Matthew P. Martens at RSoA
NCRG's Christine Reilly connects with Dr. Mary Larimer at RSoA

NCRG staffIn the NewsChris ReillyDr. Clayton NeighborsDr. Mary LarimerDr. Matthew MartensResearch Society on Alcoholism

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NCRG On The Road: Amy’s Recap Of The NCRG’s May And June Travels

As you have read on Gambling Disorders 360˚, the NCRG’s staff and NCRG-funded researchers have been on the road in recent weeks learning from experts and forming new partnerships.

We traveled to San Francisco, Calif., for the American Psychological Association’s conference that largely focused on the changes to the fifth edition of theDiagnostic and Statistical Manual (DSM-5). A few days later, NCRG staff member Amy Kugler traveled to Las Vegas for the 15thInternational Conference on Gambling and Risk Taking, which was packed with interesting sessions from researchers from across the world. We rounded this all out with a trip to Boston, Mass., for the American College Health Association’s national conference, where we discussed upcoming plans forCollegeGambling.organd heard more aboutClayton Neighbors’s, Ph.D.,research about an online screen for college students that he has worked on at the University of Houston.

Take a minute to check out Amy’s video that recaps some of the things we learned and partnerships we were able to forge during our travels!

NCRG staffICRG NewsACHAAPADr. Clayton NeighborsICGRTNCRG on the RoadVideo

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Does Exposure To Gambling Lead To More Problems?

When a new opportunity to gamble – whether a casino, the lottery or other forms of gambling – comes into a community, assumptions swirl around about whether or not the rate of disordered gambling will increase. Does exposure to gambling opportunities pose a risk to our health and increase the rate of gambling problems in a community?

Conventional wisdom assumes that the expansion of lotteries, casinos, Internet gambling and other forms of gaming will result in an increased rate of gambling disorders. One advocate of the exposure model predicted in 1994 that “when gambling activities are legalized, economies will be plagued with 100% to 550% increases in the numbers of addicted gamblers (probably within one to five years, but almost certainly within fifteen years).”1

This prediction, however, has not been borne out by the research conducted over the past 35 years. National surveys of gambling problems in the U.S. conducted in 1977 and 2008 found the same rate of 1% –in spite of the massive expansion of legalized gambling in the U.S. during this period.2,3Prevalence rates have remained stable in other countries as well, including Switzerland which has experienced widespread openings of casinos over the past decade.4

Harvard Medical School researchers have proposed the theory of ‘adaptation’ to account for the stability of prevalence rates. They suggest that, ‘following initial increases in the number and types of adverse reactions to new and novel social opportunities (e.g., substance use, gambling), people will adapt gradually and become more resistant to those events, eventually leading to stable or lower prevalence rates.’5(p621)

In other words, when a new gambling opportunity comes to town, the prevalence rate of gambling disorders might initially increase slightly. Researchers surmise that it is the “novelty effect of a new form of gambling. But, over time, the “novelty” wears off and prevalence rates of gambling disorders fall back to the 1% level.

The Harvard researchers found evidence for the adaptation theory in a study of Nevada, the state in the U.S. most exposed to gambling in terms of both gambling opportunities and employment in gaming operations. The Volberg study6used two instruments to measure the prevalence of gambling disorders in Nevada: theSouth Oaks Gambling Screen (SOGS)7and theNORC DSM-IV Screen for Gambling Problems (NODS).8The SOGS, known for reporting false positives, found a rate of gambling problems higher than the national average found by Kallick in 1979.2However, the NODS instrument reported rates that were half of those reported for the nation one year earlier when the same instrument was used, providing support for the adaptation model. Moreover, the Nevada study found that newer residents had higher rates of gambling problems than residents who had lived in the state for 10 or more years.6

A more recent test of the adaptation theory comes from Iowa. A survey conducted by Black et al. found that gambling participation had decreased since 1995, and the prevalence rate of gambling disorders had remained stable despite the continuing proliferation of casinos and other gambling opportunities.9The authors concluded that the results confirm the adaptation hypothesis.

Do these findings square with your experience? Share your comments below.

References

1. Kindt J. The economic impacts of legalized gambling activities.Drake Law Rev. 43:51–95.

2. Kallick M, Suits D, Dielman T, Hybels J.A Survey of American Gambling Attitudes and Behavior. Ann Arbor: University of Michigan Press; 1979.

3. Kessler RC, Hwang I, LaBrie R, et al. DSM-IV pathological gambling in the National Comorbidity Survey Replication.Psychol Med. 2008;38(9):1351–60. doi:S0033291708002900 [pii] 10.1017/S0033291708002900.

4. Bondolfi G, Jermann F, Ferrero F, Zullino D, Osiek C. Prevalence of pathological gambling in Switzerland after the opening of casinos and the introduction of new preventive legislation.Acta Psychiatr Scand. 2008;117(3):236–239. doi:10.1111/j.1600-0447.2007.01149.x.

5. LaPlante DA, Shaffer HJ. Understanding the influence of gambling opportunities: Expanding exposure models to include adaptation.Am J Orthopsychiatry. 2007;77(4):616–623.

6. Volberg R.Gambling and Problem Gambling in Nevada. Northampton, MA: Gemini Research Ltd.; 2002.

7. Lesieur HR, Blume SB. The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers.Am J Psychiatry. 1987;144(9):1184–8. Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=3631315.

8. Gerstein D, Murphy S, Toce M, et al.Gambling Impact and Behavior Study: Report to the National Gambling Impact Study Commission. Chicago: National Opinion Research Center; 1999.

9. Black DW, McCormick B, Losch ME, Shaw M, Lutz G, Allen J. Prevalence of problem gambling in Iowa: Revisiting Shaffer’s adaptation hypothesis.Ann Clin Psychiatry Off J Am Acad Clin Psychiatr. 2012;24(4):279–284.

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