Problem Gambling
Conditions
Keywords
Problem Gambling, Gaming Disorder, Psychological Inflexibility
Brief summary
The goal of this randomized clinical trial is to study if Acceptance and Commitment Therapy (ACT) is effective to treat Problem Gambling in young adults.The main questions it aims to answer are: * Does ACT therapy improve health and gambling behavior? * Are the clinical improvements of youth with gambling disorder receiving ACT-based intervention significantly greater than the clinical improvements of youth with gambling disorder on the waiting list? Researchers will assess whether changes in health, gambling behavior, and other psychological variables are observed after eight weeks of therapy. Participants will: * Attend weekly online group sessions for 8 weeks * Learn new tools that they will put into practice after the sessions * Be required to complete evaluation questionnaires before and after the intervention and at the 3- and 6-month follow-up
Detailed description
After being informed about the study, all patients giving written informed consent will be assessed to determine eligibility for study entry. Patients who meet eligibility requirements will receive psychological intervention consisting in an 8-session group on line-delivered ACT-based treatment. The participants will be assessed through self-report instruments before and after treatment and at 3 and 6 months follow-up. The clinical trial will include a control group.
Interventions
Acceptance and Commitment Therapy methods were focused on promoting Values clarification, Acceptance, Cognitive defusion, Committed action and Flexible attention to the present moment, and included methods such as the Garden Metaphor or defusion training.
Sponsors
Study design
Intervention model description
Randomization assigned participants to 2 arms: * ACT group * Waiting list
Eligibility
Inclusion criteria
* Age between 18 and 25 years * Score ≥ 3 on the Problem Gambling Severity Index (PGSI) * Comprehension of Spanish, online connection, and signed consent
Exclusion criteria
* In active psychological or pharmacological treatment for gambling disorder * Having received ACT-based psychological treatment in the last 6 months * Problematic substance use: CAGE Adapted to Include Drugs Questionnaire (CAGE-AID) score ≥ 3 * Difficulty consistently attending online sessions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Problem Gambling Severity Index (PGSI) | Change from Baseline severity of problem gambling at 8 months | The PGSI is a 9-item, 4-point Likert-format self-report scale (0 = never, 3 = almost always) that assesses the severity of problem gambling. Scores range from 0 to 27. A score of 8 or higher is considered indicative of problem gambling. Higher scores indicate greater severity of the disorder. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in General Health Questionnaire (GHQ-12) | Change from Baseline psychological distress and perceived general health at 8 months | The GHQ-12 is a 12-item self-report questionnaire designed to detect general psychological symptoms. It is answered on a 4-point Likert-type scale. Higher scores reflect greater psychological distress and poorer perceived general health. |
| Change in the Comprehensive ACT Process Assessment Questionnaire (CompACT) | Change from Baseline psychological flexibility at 8 months | The CompACT is a 23-item, 7-point Likert-format scale (0 = not at all true, 6 = completely true) that assesses psychological flexibility, a core process of Acceptance and Commitment Therapy. It includes three subscales: openness to experience, awareness, and committed action. Higher scores reflect greater psychological flexibility. |
| Change in Values Living Questionnaire (VLQ) | Change from Baseline value-behavior alignment at 8 months | The Valued Living Questionnaire assesses the degree of perceived importance and consistency of action directed toward personal values in 10 life domains (family, work, health, leisure, etc.). Each item is scored from 1 to 10. A composite index of discrepancy between importance and action is calculated. Higher scores indicate less value-behavior alignment. |
| Change in Difficulties in Emotion Regulation Scale (DERS-28) | Change from Baseline emotion regulation at 8 months | he DERS-28 is a 28-item questionnaire with a 5-point Likert format (1 = almost never, 5 = almost always) that assesses difficulties in emotion regulation. It consists of six subscales: emotional nonacceptance, difficulty achieving goals, impulsivity, emotional awareness, limited strategies, and emotional clarity. Higher scores indicate greater difficulties in emotional regulation and worse clinical outcomes. |
| Change in Gambling-Related Experiential Avoidance scale | Change from Baseline Experiential Avoidance at 8 months | A weekly subjective scale assessing the extent to which the participant has attempted to avoid gambling-related emotions, thoughts, or internal situations. Higher scores indicate greater experiential avoidance and less flexibility. |
| Change in the frequency of self-reported gambling behaviors | Change from Baseline gambling behaviors at 8 months | Daily self-monitoring in which the participant indicates whether they gambled, the duration, type of gambling, emotions before, during, and after, and perceived function of the behavior. Weekly frequency of gambling episodes will be analyzed. Higher frequency is interpreted as worse clinical outcome. |
| Change in the frequency of committed actions | Change from Baseline committed actions at 8 months | Self-monitoring of the frequency with which the participant has acted in accordance with their personal values during moments of desire to gamble. This is considered a positive behavioral indicator of change. |
| Change in Gambling-Related Emotional Distress Scale | Change from Baseline gambling-related distress at 8 months | A weekly subjective scale assessing the frequency and intensity of emotional distress associated with gambling behavior using Likert scales ranging from 0 to 5. Higher scores reflect greater gambling-related distress. |
Countries
Spain