Research Report: New Studies Funded by the Institute for Research on Pathological Gambling and Related Disorders
The Institute for Research on Pathological Gambling and Related Disorders recently awarded three grants in support of research on gambling disorders. The Institute, supported by a contract from the National Center for Responsible Gaming (NCRG) to Harvard Medical School, funds research through a competitive grants program open to non-Harvard institutions. The focus of the grants program alternates between the domains of neuroscience and the social-behavioral sciences.
In 2002, the Institute convened a panel of distinguished scientists to review proposals submitted in response to the 2001 request for applications for social and behavioral science investigations. Using the rigorous criteria of the National Institutes of Health to ascertain the scientific merit of the proposed investigations, the reviewers selected the following three projects for support:
Title: "Gambling Among Elderly Individuals: Prevalence and Risk Factors"
Award (Year 1): $94,845
Sponsoring Organization: Boston University
Principal Investigator: Edward J. Federman, Ph.D.
As legalized gambling has expanded and as older adults have sought more varied recreational activities, senior citizen center trips to casinos have become increasingly common. However, there is no evidence, contrary to media reports, that the elderly are at an increased risk for developing a gambling problem. To address the need for scientific research on this issue, the Institute's request for application identified the over-65 age group as a subpopulation in need of study. This project will examine whether cognitive impairment or limited social support increase the risk of developing gambling problems in older adults. It will determine the prevalence of problem and pathological gambling in a large sample of elderly individuals. Nine hundred and eighty individuals who attend senior centers that provide bus trips to casinos will be screened for possible gambling problems, and 300 will be further evaluated regarding their cognitive functioning and social support. A neuropsychological battery measuring memory, executive, and visuospatial functions as well as orientation will be administered to these 300 participants. In addition, the perceived availability of social support will be examined in these individuals. The design enables a determination of whether mild cognitive impairment or limited social support increases the probability that individuals who attend senior centers will participate in gambling trips and within that group whether those factors increase the probability of developing gambling problems. Early identification of those at risk can inform policy, prevention and treatment efforts, permitting those who safely enjoy the casino trips to continue the activity while protecting more vulnerable individuals. Identification of high-risk populations enables precise targeting of scarce resources to those most in need, and helps lay the basis for effective primary and secondary prevention strategies.
Title: "Reliability and Validity of an Integrated Gambling Assessment and Treatment Outcome Monitoring System (GAMTOMS)"
Award (Year 1): $ 98,961
Sponsoring Organization: University of Minnesota Medical School
Principal Investigator: Randy Stinchfield, Ph.D.
Treatment providers, payers, clients, and policy-makers are interested in the effectiveness of treatment and how treatment may be improved, in terms of both therapeutic effectiveness and cost effectiveness. However, the dearth of treatment outcome studies has left the field without a standard treatment for gambling disorders. This project will address the need for a reliable and valid treatment outcome assessment tool. Because pathological gambling affects multiple domains of the gambler's life, it is also important for treatment outcome assessment to be multidimensional. The investigators have developed the Gambling Treatment Outcome Monitoring System (GAMTOMS), based upon the most up-to-date treatment outcome monitoring technology as recommended by the Center for Substance Abuse Treatment and the National Institute on Drug Abuse. A sound gambling treatment outcome assessment tool should yield scores that reflect important features of gambling behaviors and related domains, and demonstrate satisfactory estimates of reliability and validity. This study proposes to collect a diverse range of reliability and validity data on 200 adults seeking an intake for problems associated with pathological gambling, with the recognition that the validation process is an ongoing endeavor.
Title: "A Cross-Sectional Study of the Impact of Gambling on Patients with Schizophrenia"
Award (Year 1): $86,239
Sponsoring Organization: Yale School of Medicine
Principal Investigator: Rani A. Desai, Ph.D., M.P.H.
Despite evidence that psychiatric patients have higher than average rates of gambling disorders, no studies have focused on patients with schizophrenia. This study will assess: 1) the prevalence and types of gambling and related behaviors and problems in patients with schizophrenia; and 2) the influence of a co-occurring diagnosis with a substance use disorder on gambling behaviors and problems in patients with schizophrenia. Secondary aims include the assessment of the effect of two treatment variables on gambling behaviors, symptoms, and other problems: 1) treatment with typical vs. atypical antipsychotics; and 2) treatment with specialized dual diagnosis treatment programs as compared with those receiving mental health and substance abuse services in separate settings. The investigators will conduct personal interviews with a sample of 400 outpatients diagnosed with schizophrenia. The interviews will assess comorbid substance abuse, quality of life and functioning, gambling behaviors, and gambling-related problems.
More information can be found on the Web, or contact Christine Reilly at the Institute (617-432-0297).
