导览式与非导览式聊天机器人提供的认知行为干预对中风险和问题赌博者的效果：一项随机对照试验（GAMBOT2 研究）。

Guided versus unguided chatbot-delivered cognitive behavioral intervention for individuals with moderate-risk and problem gambling: A randomized controlled trial (GAMBOT2 study).

机构信息

Okayama Psychiatric Medical Center, Okayama, Japan; Department of Health Promotion of Human Behavior, Kyoto University Graduate School of Medicine / School of Public Health, Kyoto, Japan; CureApp, Inc, Japan.

Okayama Psychiatric Medical Center, Okayama, Japan.

出版信息

Addict Behav. 2024 Feb;149:107889. doi: 10.1016/j.addbeh.2023.107889. Epub 2023 Oct 13.

DOI:10.1016/j.addbeh.2023.107889

PMID:37857043

Abstract

BACKGROUND

Internet-based interventions can be a promising option for individuals with problem gambling facing barriers to seeking help. This study aimed to directly compare the effects of therapist-guided Internet interventions with unguided ones on gambling-related behavior, cognition, and stage of change including help-seeking intention.

METHODS

We conducted a participant-blinded randomized controlled trial of therapist-guided versus unguided groups with a 12-week follow-up. Both groups received self-help chatbot-delivered cognitive behavioral therapy. Additionally, at baseline and weeks 1, 2, 3, and 4, the guided group received personalized feedback messages from therapists based on their gambling diary and questionnaire responses. The unguided group received reminders of assessments from research assistants. The primary outcome was the change in scores on the Gambling Symptoms Assessment Scale (G-SAS) over 12 weeks. Secondary outcomes included the stage of change including help-seeking intention, money wagered, gambling frequency, and gambling-related cognitions.

RESULTS

We included 139 participants with a mean Problem Gambling Severity Index total score of 14.6 and a mean G-SAS total score of 27.0 who sought information about gambling problems. Both groups demonstrated substantial decreases in their G-SAS scores from baseline to week 12 (-10.2, 95% CI: -7.67 to -12.7 for the guided group, and 11.7, 95% CI: -9.05 to -14.3 for the unguided group). However, we did not find a significant between-group difference (1.49, 95% CI: -2.20 to 5.17). Regarding the stage of change including help-seeking intention, there were also no between-group differences.

CONCLUSIONS

Minimum therapist support did not have an additive effect on the self-help chatbot intervention on gambling symptoms, behavior, and the stage of change including help-seeking intention.

摘要

背景

对于那些因寻求帮助而面临障碍的有问题赌博者来说，基于互联网的干预可能是一种很有前途的选择。本研究旨在直接比较治疗师指导的互联网干预与非指导干预对赌博相关行为、认知和改变阶段（包括寻求帮助的意愿）的影响。

方法

我们进行了一项参与者盲法的随机对照试验，比较了治疗师指导组和非指导组，随访时间为 12 周。两组均接受了基于自助聊天机器人的认知行为疗法。此外，在基线和第 1、2、3 和 4 周，指导组根据他们的赌博日记和问卷回答收到了治疗师提供的个性化反馈信息。非指导组收到了研究助理的评估提醒。主要结局是 12 周内赌博症状评估量表（G-SAS）评分的变化。次要结局包括改变阶段包括寻求帮助的意愿、下注金额、赌博频率和与赌博相关的认知。

结果

我们纳入了 139 名参与者，他们的平均问题赌博严重程度指数总分为 14.6，平均 G-SAS 总分为 27.0，这些参与者寻求了关于赌博问题的信息。两组的 G-SAS 评分均从基线到 12 周显著下降（指导组下降 10.2，95%置信区间：-7.67 至-12.7；非指导组下降 11.7，95%置信区间：-9.05 至-14.3）。然而，我们没有发现组间的显著差异（1.49，95%置信区间：-2.20 至 5.17）。关于改变阶段包括寻求帮助的意愿，两组之间也没有差异。