Grant et al. (2008) Flashcards
What do endorphins bind to?
What does this allow?
Endorphins bind to opioid receptors, inhibit GABA and allow dopamine to increase.
What do opioid antagonists do?
Block opioid receptors and reduce euphoria.
What does a lack of reinforcement (euphoria) lead to?
The extinction of compulsive behaviours.
Aim & hypothesis
To investigate opiate antagonists as a treatment for gambling disorder.
Opiate antagonists are more effective in reducing gambling disorder in people with a family history of alcoholism, strong urges and euphoric response to alcohol compared to people who do not fit into these categories.
Method
Experiment/randomised control trials, independent measures, double-blind.
Participants
- 284 pathological gamblers.
- Had all gambled in the past 2 weeks.
- Outpatients from 15 psychiatric centres.
- Equal no. of males/females
- From the USA.
What conditions were ppts assigned to?
Low, moderate or high dose of nalmefene, naltrexone or placebo.
What technique was used to assign ppts to their condition?
Random allocation.
How many trials took place?
What style were they?
How long did they last?
2 double-blind placebo clinical trials which lasted either 16 or 18 weeks.
How did Grant measure the severity of ppts’ gambling?
Yale-Brown obsessive compulsive scale modified for pathological gambling (PG-YBOCS).
Yale-Brown Obsessive Compulsive Scale Modified for Pathological Gambling (PG-YBOCS)
A clinician-administered scale to assess gambling severity by assessing symptoms over the previous 7 days, in terms of both gambling urges/thoughts and gambling behaviour.
Apart from using the PG-YBOCS, how was data gained from ppts?
What was the data about?
Semi-structured interviews were used to gather family history, particularly relating to first-degree relatives with alcoholism.
When were the measures taken?
After the 16-18 week long trials.
What 3 factors were associated with positive treatment outcomes?
- Family history of alcoholism
- Stronger baseline urges
- Aged (reduced placebo effect in older ppts)
What was a treatment response operationalised as?
At least a 35% reduction in PG-YBOCS total score, for at least 1 month following treatment.