School of Psychology, College of Social Science, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire, LN6 7TS, UK.
School of Applied Psychology, UCC Enterprise Centre, University College Cork, North Mall, Cork, Ireland.
J Gambl Stud. 2020 Mar;36(1):373-386. doi: 10.1007/s10899-019-09876-7.
Within the cohort of individuals who seek treatment for disordered gambling, over half fail to complete treatment. The current study sought to identify predictors of treatment dropout in a sample of gamblers attending a residential treatment facility for disordered gamblers in the UK and to report differences in voluntary and enforced dropout. Data on 658 gamblers seeking residential treatment with the Gordon Moody Association (GMA) was analysed, collected between 2000 and 2015. Measurements included demographic data, self-reported gambling behavior, (including the Problem Gambling Severity Index), mental and physical health status, and a risk assessment. Binary logistic regression models were used to examine predictors of treatment termination. Results confirm a high percentage of treatment dropout among disordered gamblers (51.3%). Significant predictors of treatment dropout included older age of the client, higher levels of education, higher levels of debt, online gambling, gambling on poker, shorter duration of treatment, higher depression, experience of previous treatment programmes and medication, and adverse childhood experiences. Within non-completers, significant predictors of enforced dropout included lifetime homelessness, less debt, sports gambling, depression and lifetime smoking. Those who were on a longer treatment programme and had previously received gambling treatment or support were less likely to be asked to leave. Clinicians working in inpatient support need to be aware of the increased psychopathogical and psychosocial problems in those who are at risk of termination and make attempts to retain them in treatment and increase patient compliance.
在寻求治疗赌博障碍的人群中，超过一半的人未能完成治疗。本研究旨在确定参加英国一家赌博障碍住院治疗机构的赌徒样本中治疗脱落的预测因素，并报告自愿和强制脱落之间的差异。该研究分析了 658 名寻求 Gordon Moody Association（GMA）住院治疗的赌徒的数据，数据收集于 2000 年至 2015 年期间。测量包括人口统计学数据、自我报告的赌博行为（包括赌博问题严重程度指数）、心理健康和身体健康状况以及风险评估。使用二元逻辑回归模型来检验治疗终止的预测因素。结果证实，赌博障碍患者的治疗脱落率很高（51.3%）。治疗脱落的显著预测因素包括客户年龄较大、受教育程度较高、债务水平较高、在线赌博、扑克赌博、治疗时间较短、抑郁程度较高、有过之前的治疗方案和药物治疗经历以及童年逆境经历。在未完成治疗的患者中，强制脱落的显著预测因素包括终生无家可归、债务较少、体育赌博、抑郁和终生吸烟。那些接受了较长治疗方案、之前接受过赌博治疗或支持的人，被要求离开的可能性较小。在住院支持机构工作的临床医生需要意识到那些有终止风险的人存在更多的心理和社会问题，并努力让他们继续接受治疗并提高患者的依从性。
