■大多数有问题赌博或赌博障碍的人由于治疗障碍而得不到治疗。关于替代疗法的研究有限。
■研究对有赌博问题的个人进行基于互联网的自我指导干预的有效性,并确定潜在的结果调节者。
■这项单中心随机临床试验于2021年7月13日至2022年12月31日在汉堡-Eppendorf大学医学中心进行。在德国招募参与者进行2次评估(干预前[t0]和干预后6周[t1])。符合条件的参与者是18至75岁有赌博问题的个人,互联网接入,精通德语,并愿意参加2次在线评估。
■基于互联网的自我指导干预是基于认知行为疗法,元认知训练,接受和承诺疗法,和励志面试。
■主要结果是与赌博相关的思想和行为的变化,这是通过耶鲁-布朗强迫量表的病态赌博适应来衡量的。次要结果是抑郁症状的改变,赌博的严重性,特定于赌博的功能失调的想法,对在线干预的态度,治疗期望,患者满意度。
■共有243名参与者(154[63.4%]男性;平均[SD]年龄,34.73[10.33]年)被随机分配到干预组(n=119),该干预组在6周内获得了自我指导的基于互联网的干预措施,或等待名单的对照组(n=124)。在t1时的完成是高的(191[78.6%])。结果显示,与赌博相关的思想和行为显著减少(平均差,-3.35;95%CI,-4.79至-1.91;P<.001;Cohend=0.59),抑郁症状(平均差,-1.05;95%CI,-1.87至-0.22;P=0.01;科恩d=0.33),和赌博严重性(平均差,-1.46;95%CI,-2.37至-0.54;P=.002;Cohend=0.40),但不是针对赌博的功能失调思维(平均差,-1.62;95%CI,-3.40至0.15;P=.07;Cohend=0.23)有利于干预组。与对照组相比,干预组中具有积极治疗期望和更严重的赌博特异性功能失调思想和赌博症状的个体在主要结局上受益更多。
■在这项随机临床试验中,在干预开始后6周测量时,对自我报告有问题赌博行为的个体进行基于网络的自我指导干预的有效性得到证实.鉴于对解决有问题的赌博的可访问和可扩展解决方案的需求日益增加,该研究的发现尤其相关。
■bfarm。de标识符:DRKS00024840。
UNASSIGNED: Most individuals with problem gambling or gambling disorder remain untreated due to barriers to treatment. Limited research exists on alternative treatments.
UNASSIGNED: To investigate the efficacy of a self-guided internet-based intervention for individuals with gambling problems and to identify potential outcome moderators.
UNASSIGNED: This single-center randomized clinical trial was conducted from July 13, 2021, to December 31, 2022, at the University Medical Center Hamburg-Eppendorf. Participants were recruited across Germany for 2 assessments (before intervention [t0] and 6 weeks after intervention [t1]). Eligible participants were individuals aged 18 to 75 years with gambling problems, internet access, German proficiency, and willingness to participate in 2 online assessments.
UNASSIGNED: The self-guided internet-based intervention was based on cognitive behavioral therapy, metacognitive training, acceptance and commitment therapy, and motivational interviewing.
UNASSIGNED: The primary outcome was change in gambling-related thoughts and behavior as measured with the pathological gambling adaption of the Yale-Brown Obsessive-Compulsive Scale. Secondary outcomes were change in depressive symptoms, gambling severity, gambling-specific dysfunctional thoughts, attitudes toward online interventions, treatment expectations, and patient satisfaction.
UNASSIGNED: A total of 243 participants (154 [63.4%] male; mean [SD] age, 34.73 [10.33] years) were randomized to an intervention group (n = 119) that gained access to a self-guided internet-based intervention during 6 weeks or a wait-listed control group (n = 124). Completion at t1 was high (191 [78.6%]). Results showed a significantly greater reduction in gambling-related thoughts and behavior (mean difference, -3.35; 95% CI, -4.79 to -1.91; P < .001; Cohen d = 0.59), depressive symptoms (mean difference, -1.05; 95% CI, -1.87 to -0.22; P = .01; Cohen d = 0.33), and gambling severity (mean difference, -1.46; 95% CI, -2.37 to -0.54; P = .002; Cohen d = 0.40) but not in gambling-specific dysfunctional thoughts (mean difference, -1.62; 95% CI, -3.40 to 0.15; P = .07; Cohen d = 0.23) favoring the intervention group. Individuals in the intervention group who had a positive treatment expectation and more severe gambling-specific dysfunctional thoughts and gambling symptoms benefited more on the primary outcome relative to the control group.
UNASSIGNED: In this randomized clinical trial, the effectiveness of a self-guided internet-based intervention for individuals with self-reported problematic gambling behavior was demonstrated when measured 6 weeks after start of the intervention. The study\'s findings are particularly relevant given the increasing need for accessible and scalable solutions to address problematic gambling.
UNASSIGNED: bfarm.de Identifier: DRKS00024840.