Grant et al.

Question 1

Aim

Answer 1

To investigate factors that predict the effectiveness of opiate antagonists in treating gambling disorder.

Question 2

Hypothesis

Answer 2

Opiate antagonists would be more effective for people who also have a family history of alcoholism (strong urges / euphoria).

Those with less severe urges to gamble may experience placebo effect.

Question 3

Sample

Answer 3

284 P’s w pathological GD (DSM-4)
- scored 5+ on SOGS
- 48% female (none pregnant)

207 outpatients from 15 psychiatric centres participated in 15 week trial of nalmfene
77 participated in a 18 week trial of naltrexone
All gambled in past 2 weeks
No P’s used either drug before

Question 4

Method

Answer 4

P’s randomly allocated (independent m.):
- placebo group
- low, medium, high drug dose group
- daily doses of nalmfene (25, 50,100mg)
- daily doses of naltrexone (50,100,150)

Question 5

Method cont.

Answer 5

Severity of symptoms assessed w YBOCS
Decrease of 35%+ classified as positive response to treatment

Gambling behaviour, daily functioning, anxiety, depression assessed w questionnaires
Semi-structured interviews to collect family info:
- first-degree relative with alcoholism

Question 6

Results

Answer 6

High individual differences contributed to significant decrease in YBOCS scores:
- P’s w family history of alcoholism
- P’s receiving higher dose of opiates

Opiate group had significant decrease of symptoms.

Question 7

Conclusion

Answer 7

Family history of alcoholism is associated with a positive response to opiate treatment of gambling disorder.