View clinical trials related to Gambling Disorder.
Filter by:Research has shown that cognitive-behavioral therapy (CBT) is an effective treatment for gambling disorder. Several studies had also been done to evaluate the effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) in addiction management, particularly in alleviating craving. A randomised controlled trial (RCT) of 60 subjects would be conducted to evaluate the effectiveness of transmodalistic therapy with a combination of rTMS and CBT for online gambling disorder.
The main objective of present project is assess the preliminary efficacy of a blended psychological intervention, by comparing the improvements in the CBT and waiting list control groups of an evidence-based treatment protocol for problems related to gambling applied in a blended format (sessions through an online protocol treatment combining with face-to-face group sessions), as well as to evaluate the opinion and acceptance of the intervention.
Background: Gambling disorder (GD), is a behavioral addiction based on keeping play despite medical, economic and social consequences. GD is characterized by progressive and persistent brain circuits alterations (reward, stress, memory, impulse control and cognitive functions), so a possible treatment could be based on neuromodulation of specific brain areas. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation, which provides magnetic stimuli on certain brain areas parts with short and long-term effects. rTMS has the FDA approval for some neurological (headache) and psychiatric (treatment-resistant depression, obsessive-compulsive disorder) disease. Nowadays several evidence in scientific literature lead to a promise use of rTMS also in addiction field with a possible indication also for GD. Objectives: the main outcome is to assess symptoms related to GD (craving, play frequencies, money lost) before and after rTMS stimulation on left dorsolateral prefrontal cortex (DLPFC). Eligibility: Healthy, right-handed adults ages 18-65 with a diagnosis of GD. Design: This is a randomized, sham-controlled study. The study includes two phases:1) a rTMS continued treatment phase and 2) a follow-up without rTMS stimulation (30 days). In order to be enrolled, participants will be screened with: - Questionnaires - Medical history - Physical exam - f-MRI After being enrolled, baseline behavioral and imaging data will be collected. In particular, participants will submit: - Questionnaires - Functional MRI - Cognitive tasks During the continued rTMS phase, participants with gambling disorder will be randomized to receive real or sham rTMS. RTMS will be delivered during 5 outpatient treatment days, (3 times/die). After the last stimulation and at the end of the 30-days of follow-up period, subjects will undergo the neurocognitive and psychometric evaluation. Twenty randomized patients of whole enrolled group will undergo fMRI at baseline and at the end of arTMS treatment phase. Treatment includes: - rTMS: A weak electrical current passes through a coil placed on the head. During each stimulation day, participants will receive three rTMS sessions (13 min), with a 50 min of interval. - fMRI: Participants lie on a table that slides into a cylinder that takes pictures of the brain. They respond to images while in the scanner. - Repeat of screening tests and questionnaires
The primary objective of this study is to determine whether favorable response to naltrexone orally taken in treatment of GD can be predicted by patterns of visual scanning, assessed by eye-tracking technology before, at the start and throughout gambling treatment with naltrexone.
Gambling disorder (GD) is recognized as an addictive disorder in the DSM-5. Craving is a core phenomenon in addiction that can lead to relapse in problem gambling for pathological gamblers. Exposure Therapy (ET) focuses on craving in addiction treatment. ET in Cognitive-Behavioral Therapy (CBT) is based on classical conditioning that addresses the association between contextual cues and the craving response. ET helps the patient to reduce craving when faced with cues triggering craving. ET includes in vivo exposure and imaginal exposure. The literature recommends being as close as possible to the context of addiction to facilitate the extinction of craving but in vivo ET is complicated to perform. For GD, in outpatient consultation, bringing a patient to a casino presents obstacles (e.g., time, human and financial cost, agreement with casino for therapy). The study will be to assess the effectiveness of Virtual Reality Exposure Therapy (VRET) in a virtual gambling environment. Various trials show that VRET is no more or less effective than classical ET in CBT but has other advantages for motivation to treatment. This research aims to compare efficacy between CBT with VRET and CBT with imaginal exposure for treatment of GD in a multicenter, randomized, controlled, non-inferiority clinical trial.
The goal of this project is to develop and to test the efficacy of a novel mHealth app for gambling disorder. The app capitalizes on smartphones' global positioning software (GPS) that recognizes a user's location to within 15 feet. Users will receive an alert of this go near a gambling venue. The project will conduct a 12-week pilot randomized clinical trial to test the short-term efficacy of the app with gambling disorder individuals.
Gambling craving is involved in the development, maintenance and relapse of gambling disorder. Yet, it lacks research regarding evidence-based interventions available to mitigate craving in patients displaying gambling disorder. The elaborated intrusion theory of desire (EIT) is a cognitive model of craving which offers important avenues for the development of psychological interventions, as it clearly describes the processes at play in craving experiences (e.g., mental imageries, working memory). Recent research evidenced that the elaborated intrusion theory is relevant to account for gambling craving experiences. According to this model, craving (and desire) is the result of an elaboration process where "desires thoughts" (mental images and thoughts), induced by internal (e.g., frustration) and/or external (e.g., advertisement) triggers, require attentional and cognitive resources. The principle of interference-based techniques is to move the resources allocated to the elaboration of intrusive desire thoughts to a competing task (e.g., clay modelling, competitive mental imagery, Tetris) in order to monopolize the resources underlying craving, thus preventing its elaboration and reducing its vividness and overwhelming nature. Several studies have shown the efficacy of such techniques to reduce substance-related craving. Yet, data obtained on clinical samples remain scarce. Preliminary data have been obtained prior to this application. In order to investigate the relevance of interference-based techniques, an experimental study was conducted in community gamblers. In two conditions (19 gamblers per condition), gambling craving was first induced via a short mental imagery session and a computer-generated gambling simulation task. Then, the experimental group was asked to perform an interference task consisting of creating a vivid mental image of a bunch of keys. The control group completed a task in which they had to pop and count bubble wrap. The analyses revealed that induced craving decreases significantly in both groups. However, participants that are considered problem gamblers showed a greater decrease of their craving in the experimental condition. This previous "proof of principle" study supports that interference-based techniques are potentially promising interventions to reduce craving in problem gambling. It also warrants further research as no data is available in clinical population. The current project consists in a pilot study aiming to test the efficacy of interference-based techniques in a sample of gambling disorder patients. The investigators decided to adopt a multiple single case design, as this methodology is ideal in the sense that it helps to understand the whole process of an interference-based intervention among a small number (10) of outpatients with a gambling disorder, without control group. Ecological Momentary Assessment will be used to allow intervention no naturally occuring craving. In addition to be easily implementable in a clinical design, this design will provide sufficient evidences before possibly, in a second time, further validation of these techniques using a randomized-control trial.
Primary objective: *To determine whether treatment with naloxone hydrochloride nasal spray reduces gambling urge symptoms in patients with gambling disorder The secondary objectives of the study are: - To determine the effects of naloxone hydrochloride nasal spray on gambling severity, frequency and time, internet use, self-efficacy, quality of life, alcohol consumption, depression - To evaluate the safety of naloxone hydrochloride nasal spray in the treatment of gambling disorder