title: Does exposure and response prevention improve the results of group cognitive-behavioural therapy for male slot machine pathological gamblers?
abstract: BACKGROUND
  Cognitive-behavioural therapy (CBT) seems to offer effective treatment for pathological gambling (PG). However, it has not yet been established which techniques yield the best results, or whether exposure and response prevention (ERP) techniques are of additional use.
  
  
  OBJECTIVE
  To evaluate clinical and socio-demographic characteristics of a PG sample at baseline, comparing cognitive-behavioural group intervention, with and without exposure, with response prevention (CBT + ERP vs. CBT), to compare the results of therapy and to assess pre-post changes in psychopathology between both groups.
  
  
  METHODS
  We applied a quasi-experimental design comprising intervention on the independent variable, but without random assignment.
  
  
  METHODS
  The sample comprised 502 males with PG, consecutively admitted to a specialist unit, who received standardized outpatient CBT group therapy in 16 weekly sessions. Scores on the Symptom Checklist-Revised (SCL-90-R), the Temperament and Character Inventory-Revised (TCI-R), the South Oaks Gambling Screen (SOGS), and other clinical and psychopathological scales were recorded.
  
  
  RESULTS
  Pre-post changes did not differ between groups, except for SCL paranoid ideation, being greater in the CBT therapy group. The risk of relapse during treatment was similar in the CBT + ERP and CBT patients. However, compliance with treatment was poorer in the CBT + ERP group, who presented higher drop-out rates during treatment. Drop-out during therapy was associated with shorter disorder duration and higher scores on the TCI-R novelty seeking scale.
  
  
  CONCLUSIONS
  Although the two CBT programs elicited similar therapy responses, patients receiving CBT alone showed higher adherence to therapy and lower drop-out rates.
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain. sjimenez@bellvitgehospital.cat
authors.forename: Susana
authors.initials: S
authors.lastname: Jimenez-Murcia
authors.forename: Neus
authors.initials: N
authors.lastname: Aymamí
authors.forename: Mónica
authors.initials: M
authors.lastname: Gómez-Peña
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Santamaría
authors.forename: Eva
authors.initials: E
authors.lastname: Alvarez-Moya
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
authors.forename: Roser
authors.initials: R
authors.lastname: Granero
authors.forename: Eva
authors.initials: E
authors.lastname: Penelo
authors.forename: Blanca
authors.initials: B
authors.lastname: Bueno
authors.forename: Laura
authors.initials: L
authors.lastname: Moragas
authors.forename: Katarina
authors.initials: K
authors.lastname: Gunnard
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
mesh_terms: D000328:Adult; D002605:Character; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005715:Gambling / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011615:Psychotherapy, Group / Q000379:methods*; D012008:Recurrence; D013694:Temperament; D016896:Treatment Outcome