To examine the effects of mindfulness-based interventions on gambling behavior and symptoms, urges, and financial outcomes.
Method:
Systematic review and meta-analytic procedures were employed to search, select, code, and analyze studies conducted between 1980 and 2014, assessing the effects of mindfulness-based interventions in the treatment of disordered gambling with adults.
Results:
Thirteen studies met criteria for this review and seven met criteria for meta-analysis. Effects were moderate to large for gambling behaviors/symptoms (g = 0.68, 95% CI = [0.39, 0.98], p < .01), gambling urges (g = 0.69, 95% CI = [0.18, 1.20], p < .01), and financial outcomes (g = 0.75, 95% CI = [0.24, 1.26], p < .01). Heterogeneity was low and nonsignificant.
Conclusions:
The findings provide support for mindfulness-based interventions in the treatment of disordered gambling. However, these results are necessarily tentative, limited by the number and quality of eligible studies, and differing conceptualizations of mindfulness.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM 5. Arlington, TX: American Psychiatric Publishing.
2.
ArchJ. J.EifertG. H.DaviesC.VilardagaJ. C. (2012). Randomized clinical trial of cognitive behavioral therapy versus acceptance and commitment therapy for mixed anxiety disorders. Journal of Consulting and Clinical Psychology, 80, 750–765.
3.
BaerR. A.SmithG. T.HopkinsJ.KrietemeyerJ.ToneyL. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.
*BlaszczynskiA.MaccallumF.JoukhadorJ. (2001). A comparative evaluation of imaginal desensitisation and group cognitive therapy in the treatment of pathological gambling. In ComanG. (Ed.), Lessons of the past: Proceedings of the 10th conference of the National Association for Gambling Studies (pp. 40–49). Victoria, Australia: National Association for Gambling Studies.
6.
BlaszczynskiA.NowerL. (2002). A pathways model of problem and pathological gambling. Addiction, 97, 487–499.
BowenS.ChawlaN.CollinsS. E.WitkiewitzK.HsuS.GrowJ.…MarlattA. (2009). Mindfulness-based relapse prevention for substance use disorders: A pilot efficacy trial. Substance Abuse, 30, 295–305. doi:10.1080/08897070903250084
9.
BowenS.ChawlaN.MarlattG. A. (2010). Mindfulness-based relapse prevention for addictive behaviors: A clinician’s guide. New York, NY: Guilford Press.
CardN. A. (2012). Applied meta-analysis for social science research. New York, NY: Guilford Press.
12.
ChiesaA.SerrettiA. (2014). Are mindfulness-based interventions effective for substance use disorders? A systematic review of the evidence. Substance Use and Misuse, 49, 492–512.
13.
ChristensenD. R.DowlingN. A.JacksonA. C.BrownM.RussoJ.FrancisK. L.UmemotoA. (2013). A proof of concept for using brief dialectical behavior therapy as a treatment for problem gambling. Behaviour Change, 30, 117–137.
14.
ClarkL.SharmanS. (2014). Commentary on Dixon et al. (2014): Understanding the abuse liability of modern electronic gaming machines. Addiction, 109, 1929–1930.
15.
CowlishawS.MerkourisS.DowlingN.AndersonC.JacksonA.ThomasS. (2012). Psychological therapies for pathological and problem gambling (review). Cochrane Database of Systematic Reviews, Art. No.: CD008937. doi:10.1002/14651858.CD008937.pub2
16.
*de LisleS. M.DowlingN. A.AllenJ. S. (2011). Mindfulness-based cognitive therapy for problem gambling. Clinical Case Studies, 10, 210–228.
17.
de VibeM.BjorndalA.TiptonE.HammerstromK.KowalskiK. (2012). Mindfulness based stress reduction (MBSR) for improving health, quality of life, and social functioning in adults. Campbell Collaboration Systematic Reviews, 3. doi:10.4073/csr.2012.3
18.
DixonM. R.WilsonA. N. (2014). Acceptance and commitment therapy for pathological gambling. Carbondale, IL: Shawnee Scientific Press.
19.
*DowlingN.SmithD.ThomasT. (2006). Treatment of female pathological gambling: The efficacy of a cognitive-behavioural approach. Journal of Gambling Studies, 22, 355–372.
20.
GoodingP.TarrierN. (2009). A systematic review and meta-analysis of cognitive-behavioural interventions to reduce problem gambling: Hedging our bets?Behaviour Research and Therapy, 47, 592–607.
21.
*GrantJ. E.DonahueC. B.OdlaugB. L.KimS. W.MillerM. J.PetryN. M. (2009). Imaginal desensitisation plus motivational interviewing for pathological gambling: Randomised controlled trial. The British Journal of Psychiatry, 195, 266–267.
22.
HayesS. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665.
23.
HayesS. C.StrosahlK. D.WilsonK. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York, NY: Guilford Press.
24.
HigginsJ.ThompsonS. G. (2002). Quantifying heterogeneity in meta-analysis. Statistics in Medicine, 21, 1539–1558.
25.
HodginsD. C.ChingL. E.McEwenJ. (2009). Strength of commitment language in motivational interviewing and gambling outcomes. Psychology of Addictive Behaviors, 23, 122. doi:10.1037/a0013010
26.
IbanezA.BlancoC.MoreryraP.Saiz-RuizJ. (2003). Gender differences in pathological gambling. Journal of Clinical Psychiatry, 64, 295–301.
27.
*KormanL.CollinsJ.Littman-SharpN.SkinnerW.McMainS.MercadoV. (2008). Randomized control trial of an integrated therapy for comorbid anger and gambling. Psychotherapy Research, 18, 454–465.
28.
LaddG. T.PetryN. M. (2002). Disordered gambling among university-based medical and dental patients: A focus on Internet gambling. Psychology of Addictive Behaviors, 16, 76. doi:10.1037//0893-164X.16.1.76
29.
LadouceurR. (2005). Controlled gambling for pathological gamblers. Journal of Gambling Studies, 21, 49–57. doi:10.1007/s10899-004-1923-9
30.
LadouceurR.GosselinP.LabergeM.BlaszczynskiA. (2001). Dropouts in clinical research: Do results reported in the field of addiction reflect clinical reality?The Behavior Therapist, 24, 44–46.
31.
LadouceurR.LachanceS.FournierP. M. (2009). Is control a viable goal in the treatment of pathological gambling?Behavior Research and Therapy, 47, 189–197. doi:10.1016/j.brat.2008.11.004
32.
LakeyC. E.CampbellW. K.BrownK. W.GoodieA. S. (2007). Dispositional mindfulness as a predictor of the severity of gambling outcomes. Personality and Individual Differences, 43, 1698–1710.
33.
LevinM. E.HildebrandtM. J.LillisJ.HayesS. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741–756. doi:0005-7894/43/741–756/$1.00/0
34.
LinehanM. M.DimeffL. (2001). Dialectical behavior therapy in a nutshell. The California Psychologist, 34, 10–13.
35.
LipseyM. W.WilsonD. B. (2001). Practical meta-analysis. Thousand Oaks, CA: Sage.
36.
Lopez-VietsV. C.MillerW. R. (1997). Treatment approaches for pathological gamblers. Clinical Psychology Review, 17, 689–702.
37.
MaynardB. R.WilsonA. N.LabuszienskiE. (2014). Mindfulness based approaches to the treatment of pathological gambling: A systematic review and meta-analysis. PROSPOERO: International prospective register of reviews. ID # CRD42014010748. Available fromhttp://www.crd.york.ac.uk/PROSPERO/
38.
*McConaghyN.ArmstrongM. S.BlaszczynskiA.AllcockC. (1983). Controlled comparison of aversive therapy and imaginal desensitization in compulsive gambling. The British Journal of Psychiatry, 142, 366–372.
39.
*McConaghyN.ArmstrongM. S.BlaszczynskiA.AllcockC. (1988). Behavior completion versus stimulus control in compulsive gambling: Implications for behavioral assessment. Behavior Modification, 12, 371–384.
40.
NastallyB. L. (2010). Functional investigation of and treatment strategies for the near miss effect in gamblers (Order No. 3426715). Available from ProQuest Dissertations & Theses Global. (792603809). Retrieved fromhttp://search.proquest.com/docview/792603809?accountid=8065
41.
*NastallyB. L.DixonM. R. (2012). The effect of a brief acceptance and commitment therapy intervention on the near-miss effect in problem gamblers. Psychological Record, 62, 677–690.
Oakley-BrowneM. A.AdamsP.MobberlyP. M. (2003). Interventions for pathological gambling. Cochrane Database of Systematic Reviews, 2000, Art. No. CD001521. doi:10.1002/14651858.CD001521.pub.2
44.
OkudaM.BalánI.PetryN. M.OquendoM.BlancoC. (2009). Cognitive behavioral therapy for pathological gambling: Cultural considerations. The American Journal of Psychiatry, 166, 1325–1330. doi:10.1176/appi.ajp.2009.08081235
45.
OstL.-G. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy, 46, 296–321.
46.
PallesenS.MitsemM.KvaleG.JohnsenB. H.MoldeH. (2005). Outcome of psychological treatments of pathological gambling: A review and meta-analysis. Addiction, 100, 1412–1422. doi:10.1111/j.1360-0443.2005.01204.x
47.
PetryN. M. (2005). Pathological gambling: Etiology, comorbitidy, and treatment. Washington, DC: American Psychological Association.
48.
PetryN. M.AmmermanY.BohlJ.DoerschA.GayH.KaddenR.…SteinbergK. (2006). Cognitive-behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74, 555–567. doi:10.1037/0022-006X.74.3.555
49.
PetryN. M.StinsonF. S.GrantB. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on alcohol and related conditions. Journal of Clinical Psychiatry, 66, 564–574.
50.
PigottT. D. (2012). Advances in meta-analysis. New York, NY: Springer.
51.
PotenzaM. N.BalodisI. M.FrancoC. A.BullockS.XuJ.ChungT.GrantJ. E. (2013). Neurobiological considerations in understanding behavioral treatments for pathological gambling. Psychology of Addictive Behaviors, 27, 380–392.
52.
PowersM. B.Zum Vorde Sive VordingM. B.EmmelkampP. M. G. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78, 73–80.
53.
ReidR. L. (1986). The psychology of the near miss. Journal of Gambling Studies, 2, 32–39.
54.
RickwoodD.BlaszczynskiA.DelfabbroP.DowlingN.HeadingK. (2010). The psychology of gambling. InPsych, 32, 11–21.
55.
RileyB. (2014). Experiential avoidance mediates the association between thought suppression and mindfulness with problem gambling. Journal of Gambling Studies, 30, 163–171.
56.
RuizF. J. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy, 12, 333–357.
57.
SegalZ. V.WilliamsJ. M. G.TeasdaleJ. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York, NY: Guilford Press.
58.
SharmaM. G.SharmaV. (2012). Effect of psychotherapy on pathological gamblers. SIS Journal of Projective Psychology & Mental Health, 19, 56–60.
59.
ShoninE.Van GordonW.GriffithsM. D. (2014). Cognitive behavioral therapy (CBT) and meditation awareness training (MAT) for the treatment of co-occurring schizophrenia and pathological gambling: A case study. International Journal of Mental Health and Addiction, 12, 181–196.
60.
SwainJ.HancockK.HainsworthC.BowmanJ. (2013). Acceptance and commitment therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review, 33, 965–978.
61.
*ToneattoT.PillaiS.CourticeE. L. (2014). Mindfulness-enhanced cognitive behavior therapy for problem gambling: A controlled pilot study. International Journal of Mental Health and Addiction, 12, 197–205.
62.
ToneattoT.VetteseL.NguyenL. (2007). The role of mindfulness in cognitive-behavioural treatment of problem gambling. Journal of Gambling Issues, 19, 91–100.
63.
ValentineJ. C.PigottT. D.RothsteinH. (2010). How many studies do you need? A primer on statistical analysis for meta-analysis. Journal of Educational and Behavioral Statistics, 35, 215–247.
64.
WelteJ.BarnesG. M.WieczorekW.TidwellM. C.ParkerJ. (2001). Alcohol and gambling pathology among U.S. adults: Prevalence, demographic patterns and comorbidity. Journal of Studies on Alcohol, 62, 706–712.
65.
WelteJ. W.WieczorekW. F.BarnesG. M.TidwellM. C. (2006). Multiple risk factors for frequent and problem gambling: Individual, social, and ecological. Journal of Applied Social Psychology, 36, 1548–1568.
66.
WestphalJ. R. (2008). How well are we helping problem gamblers? An update to the evidence base supporting problem gambling treatment. International Journal of Mental Health and Addiction, 6, 249–264.
67.
WhitingS. W.DixonM. R. (2013). Effects of mental imagery on gambling behavior. Journal of Gambling Studies, 29, 525–534.
68.
WilliamsR. J.VolbergR. A.StevensR. M. (2012). The population prevalence of problem gambling: Methodological influences, standardized rates, jurisdictional differences, and worldwide trends. Ontario, Canada: Ontario Problem Gambling Research Centre.
69.
WilsonA. N.Salas-WrightC. P.VaughnM. G.MaynardB. R. (2015). Gambling prevalence rates among immigrants: A multigenerational examination. Addictive Behaviors, 42, 79–85.
70.
ZgierskaA.RabagoD.ChawlaN.KushnerK.KoehlerR.MarlattA. (2009). Mindfulness mediation for substance use disorders: A systematic review. Substance Abuse, 30, 266–294.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
