Stea Jonathan N, Hodgins David C, Fung Tak
Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada,
J Gambl Stud. 2015 Sep;31(3):1029-45. doi: 10.1007/s10899-014-9461-6.
The present study examined the nature and impact of participant goal selection (abstinence versus moderation) in brief motivational treatment for pathological gambling via secondary analyses from a randomized controlled trial. The results demonstrated that the pattern of goal selection over time could be characterized by both fluidity and stability, whereby almost half of participants switched their goal at least one time, over 25% of participants selected an unchanging goal of 'quit most problematic type of gambling', almost 20% selected an unchanging goal of 'quit all types of gambling', and approximately 10% selected an unchanging goal of 'gamble in a controlled manner.' The results also demonstrated that pretreatment goal selection was uniquely associated with three variables, whereby compared to participants who selected the goal to 'cut back on problem gambling', those who selected the goal to 'quit problem gambling' were more likely to have greater gambling problem severity, to have identified video lottery terminal play as problematic, and to have greater motivation to overcome their gambling problem. Finally, the results demonstrated that goal selection over time had an impact on the average number of days gambled over the course of treatment, whereby those with abstinence-based goals gambled significantly fewer days than those with moderation-based goals. Nevertheless, goal selection over time was not related to dollars gambled, dollars per day gambled, or perceived goal achievement. The findings do not support the contention that abstinence-based goals are more advantageous than moderation goals and are discussed in relation to the broader alcohol treatment literature.
本研究通过对一项随机对照试验的二次分析,考察了在病理性赌博的简短动机治疗中参与者目标选择(戒赌与适度赌博)的性质和影响。结果表明,随着时间推移,目标选择模式既具有流动性又具有稳定性,近一半的参与者至少改变过一次目标,超过25%的参与者选择了“戒除最成问题的赌博类型”这一不变目标,近20%的参与者选择了“戒除所有类型的赌博”这一不变目标,约10%的参与者选择了“以可控方式赌博”这一不变目标。结果还表明,治疗前的目标选择与三个变量存在独特关联,与选择“减少问题赌博”目标的参与者相比,选择“戒除问题赌博”目标的参与者更有可能具有更严重的赌博问题、将视频彩票终端游戏视为有问题以及有更强的克服赌博问题的动机。最后,结果表明随着时间推移的目标选择对治疗过程中赌博的平均天数有影响,以戒赌为目标的参与者赌博天数明显少于以适度赌博为目标的参与者。然而,随着时间推移的目标选择与赌博金额、每日赌博金额或感知到的目标达成情况无关。这些发现不支持基于戒赌的目标比适度赌博目标更具优势这一观点,并结合更广泛的酒精治疗文献进行了讨论。