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There is almost no research that examines the incidence of pathological or problem gambling cases over a representative, recent time period. Topiramate in the Treatment of Pathological Gambling: These values ranged from 3 to 9 percent. Thus, by self-report, pathological and problem gamblers spend approximately 4. These studies provide especially comparable information on other problem behaviors because of the common samples, methods, instruments, and so forth used to collect the data on both issues. Casino Gambling by Underage Patrons:

Limitations of Prevalence Research

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Another important limitation of the available prevalence research pertains to the different facets of the concept of prevalence. A prevalence estimate requires specification of the population or geographical area represented and the time frame over which prevalence is defined Walker and Dickerson, Most of the prevalence research on pathological and problem gambling is specific about the population or area represented, but the time frames within which gambling behavior is assessed vary widely.

This variation is troublesome because the information of greatest policy relevance is generally the prevalence of current pathological or problem gambling, that is, estimates over a relatively recent but behaviorally representative time frame e. The time frame most common in available research, however, is lifetime.

Thus, many of those who are counted in prevalence research as being pathological or problem gamblers may have met screening or diagnostic criteria at some point during their lives, but did not manifest gambling problems at the time of the study.

Measuring pathological and problem gambling also requires distinguishing incidence from prevalence: Incidence is especially pertinent to policy questions involving the effects of increased gambling opportunities and changes in technology, industry practices, and regulation.

There is almost no research that examines the incidence of pathological or problem gambling cases over a representative, recent time period. Finally, literature on pathological and problem gambling rarely distinguishes, in an epidemiological sense, the difference between rates of pathological and problem gambling and proportions of pathological and problem gamblers.

This distinction is made throughout the chapter to the extent allowed by the data available to the committee. Perhaps the most serious limitation of existing prevalence research is that the volume and scope of studies are not sufficient to provide solid estimates for the national and regional prevalence of pathological and problem gamblers, or to provide estimates of changes in prevalence associated with expanded gambling opportunities and other recent secular trends. Only three studies have attempted to measure the prevalence of pathological or problem gambling in the United States for more than one or a few states.

At that time, illegal gambling was believed to be widespread, and the nation was facing the prospect of increased legalization of gambling. Accordingly, the survey concentrated on assessing American gambling practices and attitudes toward gambling.

The scale that attempted to measure "compulsive gambling" was only one small component of the larger gambling survey Commission on the Review of the National Policy Toward Gambling, From the responses of 1, adults about behaviors over their lifetimes, "it was estimated that 0. A combined total of 3. Although the findings of the survey were considered important, the researchers advised caution in interpreting the results because it was not clear that their measures could distinguish compulsive i.

A second attempt to estimate the prevalence of pathological or problem gambling in the United States and Canada was the recent meta-analysis by Shaffer and colleagues Shaffer et al. As opposed to original research, which involves collection of new data, meta-analytic research empirically integrates the findings of previously conducted independent studies. On the basis of predetermined criteria, Shaffer et al. These studies represented adults and youth in the general population, college students, adults and youth in treatment or prison settings, and a variety of other special populations.

To standardize the different terms used in the studies analyzed, Shaffer et al. Level 0 referred to nongamblers; Level 1 described social or recreational gamblers who did not experience gambling problems; Level 2 represented gamblers with less serious levels of gambling problems problem gambling ; and Level 3 represented pathological gambling.

This meta-analysis concluded that combined pathological and problem gambling—what they termed disordered gambling—was a robust phenomenon, although the majority of Americans and Canadians gamble with little or no adverse consequences. The study found that lifetime prevalence rates among adults in the general population for both nations together were estimated at 1. Past-year prevalence rates were estimated at 1. Prevalence rates among youth and other special populations were found to be substantially higher Shaffer et al.

As part of its review of the pathological gambling literature, the committee undertook an analysis of the Shaffer et al. Although these 20 surveys do not represent all states and territories within the United States, or any reasonable purposive sampling of them, they nonetheless provide the best recent information about the prevalence of pathological and problem gambling in the United States that is currently available.

As described in more detail in the following sections, the median prevalence rates found in those studies were as follows:. Most recently, a third national prevalence study was commissioned by the National Gambling Impact Study Commission. Preliminary results, released while this report was in its final stages, estimated the lifetime prevalence rate of Type E i. The past-year prevalence rate for Type E adult gamblers was estimated to be 0.

The NORC study estimates are discussed in more detail later in this chapter. Table identifies the general population studies included in the Shaffer et al.

Table also shows that a variety of survey instruments for identifying pathological and problem gamblers was used in these studies. However, the South Oaks Gambling Screen SOGS and its variants have dominated practice so completely that it has been the de facto standard operationalization of pathological and problem gambling for adult populations.

As discussed in Chapter 2 , the SOGS instrument has been criticized as a measure of pathological or problem gambling in the general population, chiefly because it was originally developed for use in clinical settings Lesieur and Blume, and may produce a high rate of false positives Culleton, In particular, there is some evidence that the threshold values for pathological and problem gambling generally applied to SOGs scores yield overestimates of prevalence relative to the results of classification using the criteria from the DSM Shaffer et al.

Not shown in Table , but relevant to interpretation of the limited available prevalence research, are the uneven methodological characteristics of the prevalence studies.

Response rate, for instance, varied from 36 to 98 percent, with a median of 68 percent. These prevalence studies were also inconsistent in their coverage of the gambling items.

Some surveys asked all questions of all respondents, and others asked certain questions only of those who responded affirmatively to a prior question. For example, if people had never had financial problems from gambling, they might not be asked how much money they lost from gambling.

Finally, the data analysis in these studies consisted chiefly of frequency distributions and simple cross-tabulations, with little examination of missing data or other potentially biasing characteristics. One useful approach for integrating information across studies of varying methodological quality is to use meta-analytic techniques to adjust for methodological differences, in an attempt to minimize any distortion in the cross-study mean that stems from those differences.

For instance, Shaffer et al. They found, however, that there was neither a statistically significant relationship between that score and reported prevalence rates nor meaningful differences between unweighted prevalence means and those weighted by methodological quality. In light of these findings and the relatively small number of recent U.

With the limitations of coverage and methodological quality in mind, the prevalence findings from the studies listed in Table are discussed in the remaining portions of this section. Rather high proportions of the adult populations in the states surveyed have participated in at least some gambling during their lives. Among the 20 surveys identified in Table that were conducted in the past 10 years i. However, there was great variation across the years in which studies were conducted, across different types of gambling activities, and between states.

More indicative of the prevalence of currently active gamblers are the survey data for participation in gambling activities in the past year. Unfortunately, this information was less often collected than lifetime data. Eleven of the studies in Table that were conducted in the past 10 years reported gambling during the prior year.

The proportion of respondents in those studies who reported any type of gambling in the past year ranged from 49 to 88 percent, with a median of 72 percent.

If this is representative, then approximately three-quarters of the adult population in the United States has participated in some form of gambling in any recent year. Table summarizes the information available from studies conducted in the past 10 years regarding the lifetime and past-year participation in various specific forms of gambling.

These findings must be interpreted with some caution, since relatively few studies contributed to each category and the coverage and content of the surveys varied considerably. For example, illegal gambling showed the highest percentages of lifetime participation reported for any gambling activity ranging from 56 percent in Mississippi to 65 percent in New York —a curious finding given legalized forms of gambling in those states—but was reported in only two studies, both conducted in As Table indicates, lottery gambling and illicit gambling were generally reported as having the highest proportions of respondents who have participated sometime during their lifetime.

Following these are charitable games, casino gambling, pari-mutuel betting, sports betting, video lottery, and card games, all with rather similar participation rates. Games of skill and gambling in financial markets i.

The more limited information from these surveys on past-year participation in specific types of gambling is similar to that for lifetime participation, but with lower proportions in all categories.

Lottery participation was highest, with the lowest proportions found among games of skill, pari-mutuel betting, gambling in financial markets, and charitable games. Table summarizes the prevalence rates of Level 2 problem and Level 3 pathological gamblers identified in the general population surveys conducted during the past 10 years, virtually all of which were conducted at the state level.

The lifetime prevalence of pathological gamblers Level 3 across the 18 studies reporting that information ranged from 0. Estimates of combined lifetime problem and pathological gambler prevalence Levels 2 and 3 ranged from 2.

From a policy standpoint, the most relevant data are those reflecting pathological or problem gambling prevalence in the past year, that is, relatively recent activity.

Percentages of past-year pathological and problem gamblers were reported in only 13 studies, all conducted between and The New Mexico data were based on a modified DSM-IV instrument and showed substantially higher rates for both problem and pathological gambling.

If the New Mexico study is set aside as an outlier in the distribution, the remaining prevalence estimates cluster fairly closely. Problem gambling Level 2 ranged from 0. It is possible to calculate the prevalence of pathological and problem gamblers among those who gamble by examining the rates for only those survey respondents who reported any gambling in the past year.

The last two columns in Table show these estimates. The 10 percent prevalence rate reported in Mississippi was notably higher than in other states. If it is set aside as a possible statistical outlier, a more conservative prevalence estimate results, ranging from 2. This indicates that, since , approximately 3 to 7 percent of those who gambled in the year before being surveyed reported Level 2 problem or Level 3 pathological gambling symptoms.

Looking only at pathological gamblers Level 3 among those who reported having gambled in the year prior to being surveyed, the Mississippi estimate of 4. Setting aside that value, the prevalence estimates in the other states surveyed ranged from 0. Thus, approximately 1 to 2 percent of those who gambled in the year prior to being surveyed reported symptoms consistent with pathological gambling. While this report was in its final stages, preliminary results were released from the national survey conducted by NORC for the National Gambling Impact Study Commission.

As only the third national survey of gambling problems ever carried out, this is an important contribution to research on problem gambling. These differences in procedure, instrumentation, and categorization make comparison with the largely SOGS-based surveys in Table questionable.

Nor is the NODS or the procedures by which it was administered and scored sufficiently well validated to accept its estimates of the prevalence of pathological and problem gambling as definitive. Nonetheless, for the category of pathological gambling, the NORC estimates are similar to those reported here. NORC estimated the lifetime prevalence of pathological gamblers at 0.

Since the NORC sample yielded only about 22 respondents classified as lifetime pathological gamblers and about 14 as past-year pathological gamblers, its estimates may not depart from those derived from Table by more than would be expected from sampling error no confidence intervals were reported in the NORC preliminary results.

In the category of problem gambling, however, the NORC estimates are much more discrepant from those derived from the surveys in Table The NORC lifetime prevalence estimate is 1. Again, the numbers of respondents represented in the NORC figures are quite small, so these differing estimates may be within the range of sampling error. If not, however, then additional inquiry will be required to determine why these discrepancies are observed.

Pathological and problem gambling may be associated with certain types of gambling more than others. If so, the proportion of respondents classified as pathological and problem gamblers who participate in some games should be higher than the comparable proportion of gamblers without problems participating in the same games. Eleven of the studies summarized in Table reported the proportions of gamblers who had participated in various types of gambling activities at some time, usually during the past year or in their lifetime.

In general, the percentage of pathological and problem gamblers participating in each gambling activity was larger than the percentage of gamblers without problems for all forms of gambling. However, pathological and problem gamblers were most disproportionately active in bingo and charitable games, lotteries both general and the instant variety , racetrack betting, sports betting, and casino games.

Eight of the studies listed in Table reported the responses of gamblers to questions about their net monthly gambling expenditures. Although expense reporting has dubious accuracy, the data nonetheless provide some indication of the order of magnitude of the gambling expenditures of pathological and problem gamblers relative to other persons who gamble but are not classified as problem gamblers.

Thus, by self-report, pathological and problem gamblers spend approximately 4. To put the pathological and problem gambling prevalence rates in perspective, it is instructive to compare them with the rates for other addictive behaviors. The prevalence of alcohol dependence provides one relevant comparison. Like gambling, many people have access to alcohol and engage in drinking, but most of them do not abuse alcohol or become dependent.

Drug dependence provides a different sort of comparison. Illicit drugs, being illegal, are not as widely available as alcohol and gambling, but many are highly addictive. The National Comorbidity Survey Kessler et al. Table shows the prevalence rates for alcohol and drug dependence compared with those for pathological gambling.

In addition, the prevalence rates for alcohol dependence and abuse combined and for drug dependence and abuse combined are compared with the rates for pathological and problem gambling Levels 2 and 3 combined. As Table shows, the estimated prevalence rates for gambling problems are lower in all categories than those for alcohol and drug problems.

Over the past 20 years, there has been a steady expansion in the availability of legal gambling. Currently, legal forms of gambling are available in all the U. Such rapid expansion in the availability of gambling provides an opportunity to examine the extent to which increased availability is associated with increased prevalence rates for pathological and problem gambling.

When comparing the survey lifetime prevalence estimate of 0. When the national estimate is compared with the committee's lifetime prevalence estimate of 1. However, each of these studies employed different operationalizations or measures of pathological gambling in their estimates. In addition, relatively few prevalence surveys have been conducted in the same state at two points in time so that trends during this period of expansion might be examined.

Table shows that the adult population in six states has been surveyed in different years using similar instruments all SOGS variants: Connecticut , , Iowa , , Minnesota , , New York , , South Dakota , , and Texas , Although the time periods represented and the changes in gambling opportunities in each of these states are different, this set of surveys nonetheless provides the best available evidence about trends in the prevalence of pathological gamblers over a period in which gambling opportunities were generally increasing.

The prevalence rate estimates from these surveys are presented in Table Of these repeated surveys, the cases of Iowa, Minnesota, Texas, and Connecticut are especially interesting. In each of these states, the survey dates straddled the introduction of significant new legal gambling opportunities.

In Iowa, riverboat casinos were opened and slot machines were permitted at the state's race-tracks Cox et al. All the increases were statistically significant in Iowa; all the increases except for pathological gambling were statistically significant in Minnesota; but only the increases for lifetime pathological gambling and past-year problem gambling were statistically significant in Texas. In Connecticut, pathological gambling decreased and problem gambling increased, but only the decrease in pathological gambling was statistically significant.

In the remaining two cases of repeated surveys New York and South Dakota , no major new forms of gambling were introduced between surveys, but there was probably a general increase in the availability of legal gambling because of the national trends in this direction.

In these states, the prevalence of pathological or problem gamblers showed statistically significant increases only in New York. The rates in South Dakota showed some decreases, although these were not statistically significant. Because the differences in the prevalence rates found in surveys done at different times might be due to differences in response rates, sampling procedures, or a host of other such factors, these findings should not be overinterpreted.

There are very few studies that permit an assessment of whether the prevalence of problem and pathological gambling is associated with changes in the availability of legal gambling. The nature of the changes observed in those studies, however, was consistent with the view that increased opportunity to gamble results in more pathological and problem gambling.

In addition, a large majority of the statistically significant differences found in these studies were in the direction of increases in pathological and problem gambling.

This pattern suggests that, during the recent decade, the prevalence of pathological and problem gambling has generally either stayed constant or increased. Further support comes from comparisons made by Volberg a and in the Shaffer et al. Both observed that the results of state-level prevalence studies conducted in more recent years have shown higher prevalence rates than those conducted in the s.

Several populations are of particular interest because of the possibility that they may be especially likely to develop gambling problems or, if such problems develop, because they may be especially vulnerable to their harmful effects. Other populations are of interest because the relative prevalence of pathological and problem gamblers among them may shed light on the risk factors and causes of pathological gambling.

Among the populations of particular interest for one or the other of these reasons are adolescents, the elderly, men, minorities, and the poor. There are substantial numbers of studies of adolescent prevalence, but the research on other possible vulnerable populations is more limited. The discussion below first reviews the studies of adolescent problem gambling and then examines what little has been identified that bears on the other populations of interest. Table provides descriptive information on the studies compiled by Shaffer et al.

Table summarizes the available data on the percentage of gambling behavior among adolescents assessed over the full history of their experience lifetime and for the year prior to the survey past year. The percentage of adolescents who report having ever gambled during their lifetimes ranges from 39 to 92 percent in those surveys, with the 39 percent value being an outlier next highest is 62 percent.

The median is 85, indicating that a high percentage of adolescents have gambled at some time in their lives. The curious fact that estimates in Table for a few lifetime proportions and medians are more uniform across studies than those reported for past-year proportions stems from different subsets of studies and, in some cases, different instruments within studies.

Not all of the studies contributing to Table reported the percentage of adolescents participating in specific types of gambling but, among those that did, card games, lotteries, and games of skill were the most common. Although less frequently collected and reported, data on gambling in the past year give a more meaningful estimate of the prevalence of active adolescent gamblers.

As Table shows, the estimates for any gambling during the past year ranged from 52 to 89 percent over the six studies providing this information. The median value of 73 percent suggests that most adolescents not only gamble, but also have gambled fairly recently. The estimates for specific types of gambling show that the most frequent activities are card games and sports betting.

Appendix C provides information by state on the minimum legal age required to place a bet. Table summarizes the information about the percentage of pathological and problem gamblers among adolescents defined over their lifetimes and for the past year that is available from the studies identified in Table conducted between and and for which reported lifetime proportions necessarily exceed past-year proportions.

The committee urges caution when considering these data, because they stem from different subsets of studies and, in some cases, different instruments within studies. Recognizing these difficulties, nine of the studies conducted in the past 10 years estimated the prevalence of past-year adolescent pathological and problem gambling combined Levels 2 and 3 and reported these as proportions of those sampled.

As shown in column eight of Table , estimates ranged from For pathological gamblers only, these studies presented past-year estimates ranging from 0. Sixteen studies provided estimates of the proportion of lifetime adolescent pathological and problem gamblers. The range of estimates across these studies was from 7. For pathological gamblers only, the estimates ranged from 1. Acknowledging again the difficulty in interpreting these data, we observe that, in comparison to the proportions of adult pathological and problem gamblers presented earlier, by the prevailing operationalizations, the proportion of pathological gamblers among adolescents in the United States could be more than three times that of adults 5.

It is important to emphasize, however, that the proportions reported in the adolescent studies and those found in the adult studies using the prevailing measures and criteria are not always directly comparable. In particular, many of the studies of adolescents use adaptations of the pathological and problem gambling instruments especially tailored for adolescents.

Moreover, even the same survey items may have different meaning for adolescents, for example, regarding debt incurred. These circumstances introduce the possibility that adolescent and adult scales measure different underlying constructs. In addition, there may be different thresholds for youthful and adult gambling problems—the same gambling behavior that might not be problematic for an adult could be considered excessive for an adolescent.

In many studies, therefore, the criteria for classifying adolescents as pathological or problem gamblers are not the same as those used for adult samples. Thus, although studies of adolescents provide credible indications that the proportion of pathological and problem gamblers is higher among adolescents than among adults, the matter of how much higher depends on the definitions and interpretations applied to the respective groups.

Given these problems of comparison, the most direct indication that the prevalence rates among adolescents are indeed greater than those among adults comes from research in which the same instruments and criteria are used to assess adolescents and adults in the same survey.

For instance, the lower age strata in the adult studies should resemble adolescent samples, even though they rarely include people younger than 18 years old. Pathological and problem gambling rates are not generally reported for distinct age groups.

What is reported is the proportion of respondents in each age group among problem gamblers and, separately, among gamblers without problems. These can be compared for a number of the studies listed in Table One study Reilly and Guida, presented a comparison for the age group that showed a disproportionate number of problem gamblers relative to older age groups.

Three other studies Volberg, a, ; New Mexico Department of Health, broke out the age group; in all cases, the proportions were higher for problem gamblers than for those without problems. Another group of studies reported comparisons for the age group Emerson and Laundergan, ; Kallick et al. These age breakouts from the adult studies therefore support the studies of adolescent populations in revealing more gambling problems among younger respondents.

As noted earlier, while this report was in its final stages, preliminary results were released from the national survey conducted by NORC for the National Gambling Impact Study Commission.

One component of that study was a survey of youths ages 16 and Using the instrument and procedures developed for the study, NORC estimated the prevalence among youth of pathological and problem gamblers combined at 1. When this financial limitation was removed, the percentage of pathological and problem gamblers under their categorization increased to about 3 percent.

In both cases, these figures are quite discrepant from the estimates derived from the studies in Table , i. As we have discussed, however, the great variation among studies in procedures, instrumentation, and definitions makes it quite difficult to either compare or integrate findings regarding the prevalence of problem gambling among adolescents. The NORC study adds further variation to this situation. There remains considerable question about how pathological and problem gambling should be defined and measured among youth, and no general consensus on these matters seems to be emerging in the research.

Some perspective on the magnitude of the prevalence rates for pathological and problem gambling among adolescents is provided by comparing them with the rates for other problem behaviors in the same population. Six of the studies identified in Table not only examined the prevalence of gambling problems but also asked respondents about other problem behaviors Volberg, , a; Volberg and Boles, ; Allen, ; Steinberg, ; Westphal et al. These studies provide especially comparable information on other problem behaviors because of the common samples, methods, instruments, and so forth used to collect the data on both issues.

Among these six studies, three reported the percentages of adolescents who said they had used marijuana in the past month Volberg, , a; Volberg and Boles, These values ranged from 3 to 9 percent.

The percentages using other drugs in the past month ranged from 1 to 2. By comparison, in those same studies the proportions found to have the most serious Level 3 gambling problems in the past year ranged from 1 to 4 percent.

Combined with those classified as at-risk or problem gamblers Level 2 , the totals ranged from 10 to 23 percent, although it is important to note that the time periods differ.

Five of these studies reported the percentages of their adolescent samples that used alcohol once a month or more or ever had an alcohol problem Steinberg, ; Volberg, , a; Volberg and Boles, ; Westphal et al. These proportions ranged from 8 to 23 percent. In these same studies, the proportion of pathological gamblers ranged from 1 to 6 percent, and the proportion of problem and pathological gamblers combined ranged from 9 to 23 percent.

Although the number of studies on this issue is limited, it appears that the rates of past-year pathological and problem gambling combined among adolescents in the United States are comparable to the rates of monthly alcohol use among adolescents, and with rates of adolescents ever having had a problem with alcohol.

In addition, the rates of past-year pathological gambling among adolescents are nearly comparable to past-month marijuana use, and they equal or exceed past-month use of other illicit drugs by that population. This study investigated the relationship between sleep disturbances and gambling behavior using data from the National Comorbidity Survey—Replication NCS-R.

Three specific sleep complaints difficulty initiating sleep [DIS], difficulty maintaining sleep [DMS], and early morning awakening [EMA] were examined in relation to gambling behavior. Given the individual and societal ramifications linked with the presence of sleep problems, this study presents another health-related repercussion associated with gambling pathology rarely discussed in the literature.

This investigation is seeking to ascertain a feasibility study with two populations who exhibit impulsivity and emotional dysregulation. Pathological gamblers or hypersexual individuals are invited to participate in order to examine their amenability to this type of intervention as evidenced by a reduction in emotional dysregulation, impulsivity, and stress proneness. Participants received 8 sessions of telephone counseling by a licensed provider using the Chinese-translated version of the self-help workbook.

The goal of this study was to capture gambling patterns and behaviors of Chinese Americans and encourage transition from telephone to outpatient treatment. This project will evaluate the effectiveness of a brief telephone intervention with problem and pathological gamblers. The helpline is managed by the California Council on Problem Gambling.

Results will assist the Office of Problem Gambling OPG in understanding whether problem gamblers benefit from brief interventions or require more intensive treatment. This project will test the efficacy of a self-help workbook in reducing problem gambling behaviors. Results from this study will assist the Office of Problem Gambling OPG in validating and creating cost-effective treatments that will be available to all California residents.

The results of the study will provide an accurate and representative portrait of current gambling behaviors among Korean-American college students, which may inform prevention and treatment practices for ethnic minority college students.

Because this area is relatively understudied, services for them are limited. Participants receive 6 free psychotherapy sessions with a UGSP staff psychologist. Pathological gamblers demonstrate impulsive behavior, especially with regard to risky decision making and the inability to control urges. This project compares pathological gamblers and non-pathological gamblers recruited from the community on various cognitive and personality measures of impulsivity.

The goal of this project is to identify the aspects of impulsivity that are strongly indicated in pathological gamblers in order to target their treatment needs.

Funded by the National Institute of Drug Abuse. Evidence suggests that cognitive-behavioral therapy CBT can be greatly beneficial for pathological and problem gamblers. The purpose of this study was to develop and test the effectiveness of a CBT manual for treatment-seeking pathological gamblers. Participants received 6 free psychotherapy sessions with a UGSP staff psychologist. Data from this study will help to increase the understanding of gambling-related issues in California's Hispanic community.

Final Report for Technical Assistance Project: Neuropsychological Performance, Impulsivity and Pathological Gambling This study compared performance of pathological gamblers versus healthy controls on measures of attention, planning and concentration.

Pre-Pulse Inhibition of Acoustic Startle as a Measure of Behaviorally Induced Changes in Bioactivity of Pathological Gamblers The purpose of this research was to measure how pathological gamblers and non-gamblers differ in their response to noises in the environment also known as sensory perception.

Characterizing the Effect of Context on a Measure of Impulsivity Among Pathological Gamblers The study sought to understand how the environment affects decision making, particularly within aspects of impulsivity. Nalmefene in the Treatment of Pathological Gambling: A Placebo Controlled Dose-Response Study UGSP participated in this week, randomized, dose-ranging, double-blind, placebo-controlled multi-site clinical trial to determine if the opioid antagonist Nalmefene is safe and effective in the treatment of pathological gambling.

Topiramate in the Treatment of Pathological Gambling: A Randomized, Double-Blind, Placebo-Controlled and Flexible-Dose Study UGSP served as one of the investigators in this week, double-blind, placebo-controlled, parallel-group trial, testing the safety and effectiveness of Topiramate in the treatment of pathological gambling.

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