Are Treatment Outcomes Determined by Type of Gambling? A UK Study

  • Silvia Ronzitti
  • Emiliano Soldini
  • Neil Smith
  • Andrew Bayston
  • Massimo Clerici
  • Henrietta Bowden-Jones
Original Paper


One of the main difficulties faced in treating gambling disorder is compliance with psychological treatment. Gambling takes many forms and can differ greatly in its features such as speed of play and skill requirements. The type of gambling a pathological gambler opts for may play a key role in treatment compliance. The aim of the present study was to determine whether within treatment seeking sample of gambling disorder clients, gambling activity has any correlation with their resultant treatment outcomes. The study incorporated 524 treatment-seeking individuals who are clients of the National Problem Gambling Clinic in London. All of the clients were assessed prior to treatment and fulfilled the Problem Gambling Severity Index criteria for problem gambling. Data concerning clients’ gambling behavior over the previous year was gathered using self-reports. Subsequently, the data was fitted to a multinomial logistic regression model, with the treatment outcome (i.e. pre-treatment dropouts, during treatment dropouts, and completed treatment) as the dependent variable and gambling behavior as the independent variable, whilst controlling for socio-demographic factors. The use of gaming machines was a significant predictor of dropping out pre-treatment (p < 0.05, RRR 1.616), whilst betting on sports events was a significant predictor of dropping out during treatment (p < 0.01, RRR 2.435). Treatment outcomes have been found to significantly differ based on participation in certain gambling activities. Further research into the salient features of these gambling activities may help to further explain pre-treatment and during treatment dropouts within this population.


Gambling disorder Pathological gambling Type of gambling Treatment outcome Dropout 


Authors’ Contribution

SR: study concept and design, interpretation of data, Drafting of manuscript; ES: analysis and interpretation of data; NS: Acquisition of data; AB: interpretation of data, manuscript reviewing; MC: study supervision; HBJ: interpretation of data, study supervision, critical revision.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Alvarez-Moya, E. M., Ochoa, C., Jiménez-Murcia, S., Neus Aymamí, M., Gómez-Peña, M., Fernández-Aranda, F., et al. (2011). Effect of executive functioning, decision-making and self-reported impulsivity on the treatment outcome of pathologic gambling. Journal of Psychiatry and Neuroscience, 36, 165–175.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Aragay, N., Jiménez-Murcia, S., Granero, R., Fernández-Aranda, F., Ramos-Grille, I., Cardona, S., et al. (2015). Pathological gambling: Understanding relapses and dropouts. Comprehensive Psychiatry, 57, 58–64.CrossRefPubMedGoogle Scholar
  3. Braun, B., Ludwig, M., Sleczka, P., Bühringer, G., & Kraus, L. (2014). Gamblers seeking treatment: Who does and who doesn’t? Journal of Behavioral Addictions, 3, 189–198.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Breen, R. B., & Zimmerman, M. (2002). Rapid onset of pathological gambling in machine gamblers. Journal of Gambling Studies, 18, 31–43.CrossRefPubMedGoogle Scholar
  5. Cantinotti, M., & Ladouceur, R. (2008). Harm Reduction and electronic gambling machines: Does this pair make a happy couple or is divorce foreseen? Journal of Gambling Studies, 24, 39–54.CrossRefPubMedGoogle Scholar
  6. Challet-Bouju, G., Hardouin, J. B., Renard, N., Legauffre, C., Valleur, M., et al. (2015). A gamblers clustering based on their favorite gambling activity. Journal of Gambling Studies, 31, 1767–1788.CrossRefPubMedGoogle Scholar
  7. Choliz, M. (2010). Experimental analysis of the game in pathological gamblers: Effect of the immediacy of the reward in slot machines. Journal of Gambling Studies, 26, 249–256.CrossRefPubMedGoogle Scholar
  8. Clarke, D., Tse, S., Abbott, M., Townsend, S., Kingi, P., & Manaia, W. (2006). Key indicators of the transition from social to probelm gambling. International Journal of Mental Health and Addiction, 4, 247–264.CrossRefGoogle Scholar
  9. Echeburua, E., Fernandez-Montalvo, J., & Baez, C. (2001). Predictors of therapeutic failure in slot-machine pathological gamblers following behavioural treatment. Behavioural and Cognitive Psychotherapy, 29, 379–383.CrossRefGoogle Scholar
  10. Griffiths, M. (1999). Gambling technologies: Prospects for problem gambling. Journal of Gambling Behavior, 15, 265–283.CrossRefGoogle Scholar
  11. Griffiths, M., & Barnes, A. (2008). Internet gambling: An online empirical study among student gamblers. International Journal of Mental Health and Addiction, 6, 194–204.CrossRefGoogle Scholar
  12. Hodgins, D. C., Stea, J. N., & Grant, J. E. (2011). Gambling disorders. Lancet, 378, 1874–1884.CrossRefPubMedGoogle Scholar
  13. Holtgraves, T. (2009). Evaluating the problem gambling severity index. Journal of Gambling Studies, 25, 105–120.CrossRefPubMedGoogle Scholar
  14. Jimenez-Murcia, S., Aymamí, N., Gómez-Peña, M., Santamaría, J. J., Alvarez-Moya, E., Fernández-Aranda, F., et al. (2012). Does exposure and response prevention improve the results of group cognitive-behavioural therapy for male slot machine pathological gamblers? British Journal of Clinical Psychology, 51, 54–71.CrossRefPubMedGoogle Scholar
  15. Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38, 1351–1360.PubMedPubMedCentralGoogle Scholar
  16. Krishnan-Sarin, S., Reynolds, B., Duhig, A. M., Smith, A., Liss, T., McFetridge, A., et al. (2007). Behavioral impulsivity predicts treatment outcome in a smoking cessation program for adolescent smokers. Drug and Alcohol Dependence, 88, 79–82.CrossRefPubMedGoogle Scholar
  17. Lahti, T., Halme, J., Pankakoski, M., Sinclair, D., & Alho, H. (2013). Characteristics of treatment seeking finnish pathological gamblers: Baseline data from a treatment study. International Journal of Mental Health and Addiction, 11, 307–314.CrossRefPubMedGoogle Scholar
  18. LaPlante, D. A., Nelson, S. E., LaBrie, R. A., & Shaffer, H. J. (2011). Disordered gambling, type of gambling and gambling involvement in the British Gambling Prevalence Survey 2007. European Journal of Public Health, 21, 532–537.CrossRefPubMedGoogle Scholar
  19. Leblond, J., Ladouceur, R., & Blaszczynski, A. (2003). Which pathological gamblers will complete treatment? British Journal of Clinical Psychology, 42, 205–209.CrossRefPubMedGoogle Scholar
  20. Lopez-Torrecillas, F., Perales, J. C., Nieto-Ruiz, A., & Verdejo-García, A. (2014). Temperament and impulsivity predictors of smoking cessation outcomes. PLoS ONE, 9, e112440.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Loree, A. M., Lundahl, L. H., & Ledgerwood, D. M. (2015). Impulsivity as a predictor of treatment outcome in substance use disorders: Review and synthesis. Drug and Alcohol Review, 34, 119–134.CrossRefPubMedGoogle Scholar
  22. McBride, J., & Derevensky, J. (2012). Internet gambling and risk-taking among students: An exploratory study. Journal of Behavioral Addictions, 1, 50–58.CrossRefPubMedGoogle Scholar
  23. McDaniel, S. R., & Zuckerman, M. (2003). The relationship of impulsive sensation seeking and gender to interest and participation in gambling activities. Personality and Individual Differences, 35, 1385–1400.CrossRefGoogle Scholar
  24. Melville, K. M., Casey, L. M., & Kavanagh, D. J. (2007). Psychological treatment dropout among pathological gamblers. Clinical Psychology Review, 27, 944–958.CrossRefPubMedGoogle Scholar
  25. Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18, 207–229.CrossRefPubMedGoogle Scholar
  26. Petry, N. M., & Weinstock, J. (2007). Internet gambling is common in college students and associated with poor mental health. American Journal of Addiction, 16, 325–330.CrossRefGoogle Scholar
  27. Phillips, J. G., Ogeil, R., Chow, Y. W., & Blaszczynski, A. (2013). Gambling involvement and increased risk of gambling problems. Journal of Gambling Studies, 29, 601–611.CrossRefPubMedGoogle Scholar
  28. Reith, G., & Dobbie, F. (2011). Beginning gambling: The role of social networks and environment. Addiction Research & Theory, 19, 483–493.CrossRefGoogle Scholar
  29. Ronzitti, S., Soldini, E., Lutri, V., Smith, N., Clerici, M., & Bowden-Jones, H. (2016). Types of gambling and levels of harm: A UK study to assess severity of presentation in a treatment-seeking population. Journal of Behavioral Addictions, 5, 439–447.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Ronzitti, S., Soldini, E., Smith, N., Clerici, M., & Bowden-Jones, H. (2017). Gambling disorder: Exploring pre-treatment and in-treatment dropout predictors. A UK study. Journal of Gambling Studies, 33, 1277–1292.CrossRefPubMedGoogle Scholar
  31. Rossini-Dib, D., Fuentes, D., & Tavares, H. (2015). A naturalistic study of recovering gamblers: What gets better and when they get better. Psychiatry Research, 227, 17–26.CrossRefPubMedGoogle Scholar
  32. Smith, D., Harvey, P., Battersby, M., Pols, R., Oakes, J., & Baigent, M. (2010). Treatment outcomes and predictors of drop out for problem gamblers in South Australia: A cohort study. Australian and New Zealand Journal of Psychiatry, 44, 911–920.CrossRefPubMedGoogle Scholar
  33. Suomi, A., Dowling, N. A., & Jackson, A. C. (2014). Problem gambling subtypes based on psychological distress, alcohol abuse and impulsivity. Addictive Behaviors, 39, 1741–1745.CrossRefPubMedGoogle Scholar
  34. Sylvain, C., Ladouceur, R., & Boisvert, J. M. (1997). Cognitive and behavioral treatment of pathological gambling: A controlled study. Journal of Consulting and Clinical Psychology, 65, 727–732.CrossRefPubMedGoogle Scholar
  35. Wardle, H., Sproston, K., Orford, J., Erens, B., Griffiths, M., Constantine, R., et al. (2011). British gambling prevalence survey 2010. London: The Stationery Office.Google Scholar
  36. Welte, J. W., Barnes, G. M., Tidwell, M. C., & Hoffman, J. H. (2009). The association of form of gambling with problem gambling among American youth. Psychology of Addictive Behaviors, 23, 105–112.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Wulfert, E., Blanchard, E. B., Freidenberg, B. M., & Martell, R. S. (2006). Retaining pathological gamblers in cognitive behavior therapy through motivational enhancement: A pilot study. Behavior Modification, 30, 315–340.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Yale School of MedicineNew HavenUSA
  2. 2.Department of Medicine and SurgeryUniversity of Milano-BicoccaMonzaItaly
  3. 3.Methodology and Statistics Laboratory, Department of Business Economics, Health and Social CareUniversity of Applied Sciences and Arts of Southern SwitzerlandMannoSwitzerland
  4. 4.NPGC, National Problem Gambling ClinicCentral North West London NHS Foundation TrustLondonUK
  5. 5.Department of Mental HealthSan Gerardo HospitalMonzaItaly
  6. 6.Department of MedicineImperial College LondonLondonUK

Personalised recommendations