Grant et. al

• This study aimed to identify clinical variables that could influence the treatment outcome of those with PG taking opiate antagonists.
• PG stands for pathological gambling
• Opiate antagonists are drugs that are commonly used to treat substance abuse.
• Opiate antagonists work by blocking reward centres in the brain that are activated when someone uses drugs or consumes alcohol.
• Researchers had two hypothesis.
• • Researchers hypothesised that those with a family history of PG and alcoholism would respond better to the opiate antagonists' treatment.
  • They also hypothesised that those with less severe PG would respond better to the placebo than those with severe PG.
• Two double blind clinical trials
• It lasted between 16 and 18 weeks
• 284 participants were used.
• The participants were made up of people with PG who had gambled in the last two weeks.
• The participants were made up of equal amounts of men and women; all participants were from the USA.
• Independent group study was used, this means that participants were only tested in one condition of the study.
• Participants were randomly assigned to one of four conditions.
• The conditions consisted of two medications and placebos.

  • The first medication was Nalmefene in 25mg, 50mg, and 100mg doses.
  • The second medication was Naltrexone in 50mg, 100mg, and 150mg doses.
• The two medications used:

  • Nalmfene
  • Naltrexone
• 25% of the participants were given a placebo.
• The trails were double-blind so both the participants and researchers did not know who was taking the actual medication or the placebo.
• Clinical-administered scales and semi-structured interviews were used.
• The main clinical administered scale used was the Yale-Brown Obsessive Compulsive Scale Method for Pathological Gambling.
• The PG-YBOCS is a clinically administered scale that assesses gambling severity by assessing symptoms over the last 7 days; in terms of both gambling thoughts and gambling behaviour.
• Semi-structured interviews were used to gather family history especially first-degree relatives with alcoholism.
• Other scales assessed the participant's psychological functioning, anxiety, and depression.
• They found that the treatment was able to achieve a 35% reduction in total PG-YBCOS scores for at least a month after the treatment.
• They found that the variable that led to a positive reaction to the opiate antagonist treatment was a family history of alcoholism.
• They found evidence that suggests that there may be a genetic influence on response to opiate antagonists.
• They found that for those taking the placebo, younger people had a better response to the placebo.
• They also found that the second hypothesis was wrong. Those with less severe PG did not respond better to the placebo.
• The study concluded that a family history of strong gambling urges and alcoholism determined how well the individual responded to the opiate antagonists.
• Strengths:

  • The study gathers quantitative data.
  • Double-blind technique was used which improved the validity of the study.
  • It has real-world applications.
• Weaknesses:

  • Ethical considerations (deception).