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Clinical Features and Treatment Prognosis of Pathological Gamblers With and Without RecentGambling-Related Illegal Behavior

At the time of this study, Dr. Ledgerwood was Instructor, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT. Dr. Weinstock is Post-Doctoral Fellow, and Dr. Petry is Professor, Department of Psychiatry, University of Connecticut Health Center, Farmington, CT. Dr. Morasco is Staff Psychologist, Behavioral Health and Clinical Neurosciences Division, Portland VA Medical Center, Portland, OR. Preparation of this report was supported in part by NIH Grants R01-MH60417, R01-MH60417-suppl, R01-DA13444, R01-DA016855, P50-AA03510, and P50-DA09241 and the Patrick and Catherine Weldon Donaghue Medical Research Foundation. Address correspondence to: David M. Ledgerwood, PhD, Department of Psychiatry and Behavioral Neurosciences, Wayne State School of Medicine, 2761 E. Jefferson Avenue, Detroit, MI 48207. E-mail: dledgerw{at}med.wayne.edu

A substantial proportion of pathological gamblers engage in gambling-related illegal behavior. We examined differences in baseline characteristics and treatment outcomes in two groups: pathological gamblers who did and did not commit gambling-related illegal acts in the year before treatment. Participants were 231 pathological gamblers enrolled in a randomized study of treatment that included cognitive behavior therapy and referral to Gamblers Anonymous (GA). Participants reporting recent illegal behavior (n = 63) endorsed more severe lifetime and recent (past-year) gambling disorder symptoms and higher gambling-related debt than did gamblers who denied illegal behavior (n = 168). Those who reported illegal behavior also maintained a significantly higher severity of gambling disorder throughout treatment, although both groups experienced similar improvements in gambling symptoms over time. While pathological gamblers with or without gambling-related illegal behavior appeared to improve at a similar rate regardless of the treatment provided, more intensive treatment may be warranted for individuals with gambling-related illegal behavior, as they demonstrated greater gambling severity throughout treatment and follow-up.

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				J. E. Grant and M. N. Potenza Commentary: Illegal Behavior and Pathological Gambling J Am Acad Psychiatry Law, September 1, 2007; 35(3): 302 - 305. [Abstract] [Full Text] [PDF]