Active clinical trials for "Gambling"

This study will implement a brief intervention with text messaging and will test its effectiveness in reducing gambling behavior and improving financial well-being among credit counseling clients who seek services. Financial counseling organizations provide a community-based environment for screening and brief intervention for gambling-related problems as gambling problems are fundamentally about financial losses. The study holds the promise of expanding brief interventions for gambling to individuals outside the health care system and in so doing, help those at-risk who do not present for formal treatment.

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 is a public health risk. The wide panel of games available (poker, sport bets, scratch card games, slot machines, stock speculation …) and the advent of the Internet means that this behaviour is increasingly monitored on an epidemiological level, to the point where its pathological practice is now recognized in the DSM-5. Indeed, the scientific literature suggests a bidirectional link between use disorders and sleep disorders. Sleep deprivation is known to lead to impaired judgment (risk-taking), increased sensitivity to reward, attentional difficulties and poor emotional management. The reverse has also been demonstrated: for example, playing at night has an impact on sleep quality, particularly in terms of difficulty falling asleep, ruminations about the game and a delay in the sleep-wake phase. Sleep disorders also affect patients undergoing withdrawal and/or cessation of a substance or behavior. This established link between addictions and circadian rhythms is important, since it is suggested that patients who are more impaired in both respects are more likely to relapse and respond less well to treatment. In addictology, Behavioral and Cognitive Therapy for Insomnia (CBT-I) has proved effective in alcohol-dependent subjects in four studies. All reported a better quality of life (less depressive cognitions, better lifestyle) after CBT-I, although only one study reported a numerical reduction in consumption.The treatment of substance use disorders (AUD) remains limited : no pharmacological treatment has proved its worth, and the reference treatment remains mainly CBT. Despite the indisputable effectiveness of CBT, between 14% and 50% of patients are reported to have broken off from follow-up and care, and almost 90% of patients end up relapsing.

The aim of this observational study is to get a better understanding of the association between problem gambling psychotic disorders among young adults with firs-episode psychosis. The main questions to be answered are: What are the incidence and risk factors for problem gambling in this population? How effective are the current treatments for problem gambling in adults with first-episode psychosis? To do so, comparisons will be made among the study cohort for various factors: Use of dopamine partial agonists; Psychiatric comorbidities; Socioeconomic status; Sex; Gender; Gambling history. The nature of the treatments for problem gambling offered and received by the subjects, as well as their effectiveness, will also be documented.

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 aim of this study is to assess the efficacy of an online CBT-based intervention combined with an Ecological Momentary Intervention (EMI) and different complementary tools for the treatment of problem gambling and gambling disorder. The main hypothesis is that the Internet-based psychological intervention group will obtain better results than the waiting list control group.

The aim of the study is to compare couple-based treatment to individual treatment (treatment as usual) for addiction (gambling or substance use disorder).

Qualitative interview study addressing the effects and limitations of a unique, government-based, nationwide self-exclusion service for the reduction of gambling-related harm. This service, which allows for individuals at risk of gambling problems (and for anyone) to self-exclude from all licensed gambling in the country, is unique in its nationwide, non-gambling-operator-dependent and multi-operator design. It is a promising tool for the prevention and harm reduction in relation to problem gambling and gambling disorder, but emerging research data report considerable limitations including high access to non-licensed gambling allowing users to breach the voluntary self-exclusion and relapse into hazardous gambling practices. This study will examine effects and limitations of the system, for gamblers and for concerned significant others of gamblers, through qualitative interviews addressing their experience of the system.

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.

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.