Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

13. Pathological Gambling and Other “Behavioral” Addictions 313cognitive restructuring, (3) a combination of 1 and 2, and (4) a wait-list control.At 12 months, rates of abstinence or minimal gambling were higher in the individualtreatment (69%) compared with group cognitive restructuring (38%) andthe combined treatment (38%). An independent controlled trial, based on cognitivebehavioral therapies used in the treatment of SUDs and including relapseprevention strategies, is currently underway, with initial results suggesting theefficacy of manually driven cognitive-behavioral therapy (Petry & Roll, 2001).Brief interventions in the form of workbooks have also been studied. Onestudy assigned gamblers to a workbook alone (which included cognitivebehavioraland motivational enhancement techniques) or to the workbook inaddition to one clinician interview (Dickerson, Hinchy, & England, 1990).Both groups reported significant reductions in gambling at a 6-month followup.Similarly, a separate study assigned gamblers to a workbook, a workbookplus a telephone motivational enhancement intervention, or a wait list.Compared to gamblers using the workbook alone, those assigned to the motivationalintervention and workbook reduced gambling throughout a 2-yearfollow-up period (Hodgins, Currie, & el-Guebaly, 2001).Two studies have also tested aversion therapy and imaginal desensitizationin randomized designs. In the first study, both treatments resulted in improvementin a small sample of patients (McConaghy, Armstrong, Blaszczynski, &Allcock, 1983). In the second study, 120 pathological gamblers were randomlyassigned to aversion therapy, imaginal desensitization, in vivo desensitization, orimaginal relaxation. Participants receiving imaginal desensitization reportedbetter outcomes at 1-month and up to 9 years later (McConaghy, Blaszczynski,& Frankova, 1991).KLEPTOMANIAKleptomania (stealing madness) was formally designated a psychiatric disorderin DSM-III, and the core features include (1) a recurrent failure to resist animpulse to steal unneeded objects; (2) an increasing sense of tension beforecommitting the theft; (3) an experience of pleasure, gratification or release atthe time of committing the theft; and (4) stealing that is not performed out ofanger, vengeance, or due to psychosis (American Psychiatric Association,2000).Clinical CharacteristicsKleptomania usually appears first during late adolescence or early adulthood(Goldman, 1991). The course is generally chronic, with waxing and waning ofsymptoms. Women are twice as likely as men to suffer from kleptomania (Grant& Kim, 2002a).