GRANT ET AL (2008) AIM, MAIN CONTEXT, THEORIES

Question 1

Main aim of the Grant et al (2008)- aim

Answer 1

• To identify clinical variables associated with treatment outcomes in pathological gambling.

Clinical variables=measurable factors related to a person’s health that could affect their response to treatment.
So, they wanted to see what factors would affect someones response to the treatments.

Question 2

What is the secondary aim?

Answer 2

• To identify whether ppts would respond would respond well to opioid antagonists (naltrexone, Nalmefene) vs placebo in the treatment of pathological gambling

Question 3

What is the name of the 2 antagonists used as a treatment in this study?

Answer 3

• Naltrexone
• Nalmefene

Question 4

What was the hypothesis of Grant et al (2008) study?

Answer 4

• A family history of alcholism and severe urges to gamble would be associated with positive outcomes (for thoes treated with OAs)
• People with less severe pathological gambling would be MORE LIKELY to respond positively to a placebo than thoes with severe PG.

Low severity (clinical variable) associated with- positive treatment outcomes.
Family history of alcholism (clinical variable) associated with positive ouctomes.

Question 5

Main Context- how has pathological gambling been treated so far?

Answer 5

Different treatments have been used with varying sucess levels:
* Psychological therapies- like covert desensitisation work by changing the thoughts of the client- to facilitate behavioural change.
* Drug therapies- (kim et al 2001)

Question 6

Main context- What did Kim et al (2001) found about the effectiveness of drug therapies in treating pathological gambling?

Answer 6

• Opiate antagonists can be successful treatments for PG.
• BUT! There are individual differences in responses to the antagonists- between 10-30% of patients treated with OA’s did NOT show signficant improvments.

(Though- there had been NO previous research that has been carried out to examine predictors to treatment outcomes in PG).

Question 7

How do opiate antagonists work?

Answer 7

• Opioid receptors are proteins involved in pain regulation, pleasure and reward.
• So, OA’s bind to opioid receptors in the brain, but without activating them (acting as ‘blockers’) to prevent/block them from having an effect (euphoria/pain relief)
• reducing the urge to engage in addictive behaviours.

Question 8

Naltrexone?

Answer 8

• Blocks the rewarding effects of opioids, reducing cravings

Question 9

Nalmefene?

Answer 9

Blocks the rewarding/ pleasurable effects of opioids by blocking mu-opiod receptors

reduces the reward or pleasure people feel from the behaviour, making it easier to control consumption.

Question 10

Abstinece

Answer 10

When the addictive behaviour is not carried out

Both opioid receptors extend the period of abstience

Question 11

What is the link between alcohol dependence and pathological gambling?

Answer 11

• They’re genetically linked and often occur alongside eachother.
• O’Brien (2005)- found that OA’s are effective treatments for alcohol dependence especially in ppl with strong cravings, family history of alcholism + euphoric responses to alcohol.