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青年病理性赌徒接受认知行为疗法后赌博严重程度的反应轨迹。

Response trajectories of gambling severity after cognitive behavioral therapy in young-adult pathological gamblers.

机构信息

1 CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona,Spain.

2 Departament de Psicobiologia i Metodologia, Autonomous University of Barcelona, Barcelona,Spain.

出版信息

J Behav Addict. 2020 Apr 1;9(1):140-152. doi: 10.1556/2006.2020.00008.

Abstract

BACKGROUND AND AIMS

The significant increase in the prevalence of gambling disorder (GD) among young adults in recent years has attracted interest in determining therapeutic efficiency in this sector of the population. The aim of this work was to estimate the response trajectories of gambling severity during the six-month follow-up after a cognitive behavioral therapy (CBT) program in young adult patients and to identify the main variables associated with each trajectory.

METHODS

The sample included n = 192 patients, aged 19-35 years old, seeking treatment for GD. Response trajectories were identified through latent class growth analysis.

RESULTS

Three trajectories emerged: T1 (n = 118, 61.5%), composed of patients with severe GD at pre-treatment and good evolution to recovery; T2 (n = 62, 32.3%), with patients with moderate-high GD affectation at baseline and good evolution to recovery; and T3 (n = 12, 6.3%), with participants with severe baseline GD severity and poor evolution after CBT (Abbott, 2019). The highest risk of poor therapeutic outcomes was related to lower social index positions, high emotional distress, high scores in harm avoidance and low scores in self-directedness.

DISCUSSION AND CONCLUSIONS

Differences in the response trajectories at short-term follow-up after CBT reveal heterogeneity in the samples including young and young-adult GD patients. Patients' phenotype at baseline should be considered when developing efficient, person-centered intervention programs, which should comprise strategies aimed at increasing emotional regulation capacities, self-esteem and self-efficacy, with the aim of avoiding relapses in the medium-long term after therapy.

摘要

背景与目的

近年来,年轻人中赌博障碍(GD)的患病率显著增加,这引起了人们对该人群治疗效果的兴趣。本研究旨在评估年轻成年患者在接受认知行为疗法(CBT)后 6 个月的赌博严重程度的反应轨迹,并确定与每个轨迹相关的主要变量。

方法

该样本包括 192 名年龄在 19-35 岁之间寻求 GD 治疗的患者。通过潜在类别增长分析来识别反应轨迹。

结果

出现了三种轨迹:T1(n=118,61.5%),由治疗前患有严重 GD 且病情良好恢复的患者组成;T2(n=62,32.3%),由基线时患有中高度 GD 且病情良好恢复的患者组成;和 T3(n=12,6.3%),由基线 GD 严重程度严重且 CBT 后恢复不佳的参与者组成(Abbott,2019)。较差治疗效果的最高风险与较低的社会指数地位、较高的情绪困扰、较高的回避得分和较低的自我导向得分有关。

讨论与结论

CBT 后短期随访的反应轨迹差异揭示了年轻和年轻成年 GD 患者样本中的异质性。在制定高效、以患者为中心的干预计划时,应考虑患者的基线表型,该计划应包括旨在增加情绪调节能力、自尊和自我效能感的策略,以避免治疗后中长期间的复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b445/8935189/98a7e2d26e16/jba-9-140-g001.jpg

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