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 antagonists bind to mu-opioid receptors, blocking the effects of endorphins (brain’s natural opioids) which are released during rewarding, pleasurable behaviours like gambling and drinking
• by blocking these receptors, the drug
  reduces the pleasure and reinforcement the person gets from these behaviours- reducing cravings/ desire to repeat behaviour.

Question 8

Naltrexone?

Answer 8

• Blocks mu-opioid receptors, reducing pleasure and cravings

Side effects-Nausea, headache, liver concerns

Question 9

Nalmefene?

Answer 9

Blocks mu-opioid receptors, reducing pleasure and cravings
How it’s taken: About 1–2 hours before a high-risk situation (e.g., going near a casino or planning to drink).
Best for:

People who are not ready to quit completely but want to reduce harmful behaviour/ specific triggers.

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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.

Question 12

Why is there a link between gambling and alcholism?

Answer 12

shared neurobiology-Both may involve dysregulation of the opioid system, which is why opioid antagonists (like naltrexone) can treat both conditions.
High comorbidity- Studies show that 30–50% of individuals with gambling disorder also have a substance use disorder, most commonly alcohol.