***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract This study evaluated an integrated treatment for comorbid problem gambling , anger , and substance use . Problem gamblers with comorbid anger problems ( N=42 ) , half of whom also had substance use disorders , were r and omized to either a 14-week integrated treatment targeting anger and addictions ( i.e. , both gambling and substance use ) or a specialized treatment-as-usual ( TAU ) for gambling and substance use . Participants were assessed at baseline ( Tl ) , 14 weeks ( T2 ) , and 12 weeks follow-up ( T3 ) . Relative to the TAU , participants in the integrated anger and addictions treatment reported significantly less gambling at T2 and T3 and less trait anger and substance use at T3 . Findings suggest that it is important to screen gambling clients for the presence of comorbid anger and substance use problems and that , when present , these problems need to be addressed concurrently in gambling treatment in order to optimize treatment outcomes Relapse rates among pathological gamblers are high with as many as 75 % of gamblers returning to gambling shortly after a serious attempt to quit . The present study focused on providing a low cost , easy to access relapse prevention program to such individuals . Based on information collected in our ongoing study of the process of relapse , a series of relapse prevention booklets were developed and evaluated . Individuals who had recently quit gambling ( N = 169 ) were recruited ( through media announcements )  and r and omly assigned to a single mailing condition in which they received one booklet summarizing all of the relapse prevention information or a repeated mailing condition in which they received the summary booklet plus 7 additional booklets mailed to them at regular intervals over the course of a year period . Gambling involvement over the course of the 12-month follow-up period , confirmed by family or friends , was compared between the two groups . Results indicated that participants receiving the repeated mailings were more likely to meet their goal , but they did not differ from participants receiving the single mailing in frequency of gambling or extent of gambling losses . The results of this project suggest that providing extended relapse prevention bibliotherapy to problem gamblers  does not improve outcome . However , providing the overview booklet may be a low cost , easy to access alternative for individuals who have quit gambling Pathological gambling is a widespread problem with major implication s for society and the individual . There are effective treatments , but little is known about the relative effectiveness of different treatments . The aim of this study was to test the effectiveness of motivational interviewing , cognitive behavioral group therapy , and a no-treatment control ( wait-list ) in the treatment of pathological gambling . This was done in a r and omized controlled trial at an outpatient dependency clinic at Karolinska Institute ( Stockholm , Sweden ) . A total of 150 primarily self-recruited patients with current gambling problems or pathological gambling according to an NORC DSM-IV screen for gambling problems were r and omized to four individual sessions of motivational interviewing ( MI ) , eight sessions of cognitive behavioral group therapy ( CBGT ) , or a no-treatment wait-list control .  Gambling-related measures derived from timeline follow-back as well as general levels of anxiety and depression were administered at baseline , termination , and 6 and 12 months posttermination . Treatment showed superiority in some areas over the no-treatment control in the short term , including the primary outcome measure . No differences were found between MI and CBGT at any point in time . Instead , both MI and CBGT produced significant within-group decreases on most outcome measures up to the 12-month follow-up . Both forms of intervention are promising treatments , but there is room for improvement in terms of both outcome and compliance Few studies have evaluated efficacy of psychotherapies for  pathological gambling . Pathological gamblers ( N = 231 ) were r and omly assigned to ( a ) referral to Gamblers Anonymous ( GA ) , ( b ) GA referral plus a cognitive- behavioral ( CB ) workbook , or ( c ) GA referral plus 8 sessions of individual CB therapy .  Gambling and related problems were assessed at baseline , 1 month later , posttreatment , and at 6- and 12-month follow-ups . CB treatment reduced gambling relative to GA referral alone during the treatment period and result ed in clinical ly significant improvements , with some effects maintained throughout follow-up ( ps = .05 ) . Individual CB therapy  improved some outcomes compared with the CB workbook . Attendance at GA and number of CB therapy sessions or workbook exercises completed were associated with gambling abstinence . These data suggest the efficacy of this CB therapy approach The relationship between individuals ' choice of abstinence or moderate drinking during  outpatient behavioral management treatment  and outcome over 12 months ' posttreatment was examined . At the initial assessment , 46 % of 106 chronic alcoholic subjects chose abstinence , 44 % chose moderate drinking , and 9 % were unsure . Over the course of treatment , subjects were more likely to move from moderation to abstinence goals , and after the first 4 weeks of treatment , two-thirds chose abstinence . These subjects were older , had more severe alcohol problems ( i.e. , higher MAST scores ) , and were more likely to maintain their weekly alcohol consumption goals during the 16-week treatment period . Moreover , these subjects reported less alcohol use in the 12 month follow-up period , and a greater proportion were judged as having successful outcomes . The implication s of these findings are discussed Abstract Cognitive-behavioral therapy for pathological gambling has a long-term success rate of more than 50 % . This study evaluated the effect of self-hypnosis in cognitive-behavioral treatment of pathological gamblers . Forty-nine participants were assigned to 2 groups . Both groups received a cognitive-behavioral protocol , and Group 1 , the no-hypnosis group , received an 11-session intervention and Group 2 , the hypnosis group , received 7 sessions that included self-hypnosis . Both groups were equal in gambling chronicity , frequency , intensity , change motivation , and problems derived from gambling . All participants reported significant improvement in gambling behavior and consequences at both treatment end and 6-month follow-up . Data show no differences between the interventions in abstinence , therapeutic compliance , fulfillment , and satisfaction . Results suggest that self-hypnosis reinforces treatment and can be a supportive technique for future brief interventions BACKGROUND Pathological gambling ( PG ) , a disabling disorder experienced by approximately 1 % of adults , has few empirically vali date d treatments . A recent study demonstrated that 6 sessions of imaginal desensitization plus motivational interviewing ( IDMI ) was effective in achieving abstinence for a majority of individuals with PG . This study sought to examine whether those benefits were maintained 6 months post-treatment . METHODS Sixty-eight individuals who met DSM-IV criteria for PG were r and omly assigned to 6 sessions of IDMI or Gamblers Anonymous ( GA ) referral over an 8-week period . Participants who failed to respond to GA were offered IDMI after the 8-week acute treatment period . All individuals who responded to IDMI were contacted after 6 months and assessed with measures of gambling severity and psychosocial functioning . RESULTS Forty-four participants completed 6 sessions of IDMI ( 25 initially assigned to IDMI and 19 to GA ) . Thirty-five of the 44 ( 79.5 % ) responded during acute treatment , and all 35 were available for a 6-month evaluation . All gambling severity scales maintained statistically significant gains from baseline , although some measures showed significant worsening compared with post-IDMI treatment . CONCLUSIONS Six sessions of IDMI result ed in statistically significant reductions in PG urges and behavior , which were largely maintained for 6 months This study evaluated the influence of 12-month affective and anxiety disorders on treatment outcomes for adult problem gamblers in routine cognitive – behavioural therapy . A cohort study at a state-wide gambling therapy service in South Australia . Primary outcome measure was rated by participants using victorian gambling screen ( VGS ) ‘ harm to self ’ sub-scale with vali date d cut score 21 + ( score range 0–60 ) indicative of problem gambling behaviour . Secondary outcome measure was Work and Social Adjustment Scale ( WSAS ) . Independent variable was severity of affective and anxiety disorders based on Kessler 10 scale . We used propensity score adjusted r and om-effects models to estimate treatment outcomes for sub- population s of individuals from baseline to 12 month follow-up . Between July , 2010 and December , 2012 , 380 participants were eligible for inclusion in the final analysis . Mean age was 44.1 ( SD = 13.6 ) years and 211 ( 56 % ) were males . At baseline , 353 ( 92.9 % ) were diagnosed with a gambling disorder using VGS . For exposure , 175 ( 46 % ) had a very high probability of a 12-month affective or anxiety disorder , 103 ( 27 % ) in the high range and 102 ( 27 % ) in the low to moderate range . For the main analysis , individuals experienced similar clinical ly significant reductions ( improvement ) in gambling related outcomes across time ( p < 0.001 ) . Individuals with co-varying patterns of problem gambling and 12 month affective and anxiety disorders who present to a gambling help service for treatment in metropolitan South Australia gain similar significant reductions in gambling behaviours from routine cognitive – behavioural therapy in the mid-term Effective therapies for pathological gambling exist , but their use is limited to about 10 % of the target population . In an attempt to lower the barriers for help , Internet-based cognitive behavioural therapy ( ICBT ) has been shown to be effective when delivered to a non-depressed sample with pathological gambling . This study sought to extend this finding to a larger , more representative population , and also test a model to predict responder status . Following advertisement , a total of 284 participants started an 8-week  ICBT programme  with minimal therapist contact via e-mail and weekly telephone calls of less than 15 min . The average time spent on each participant , including telephone conversations , e-mail , and administration , was 4 h. In addition to a mixed effects model to evaluate the effectiveness of the treatment , two logistic regression analyses were performed with the following eight pre-defined response predictor variables : work-life satisfaction , primary gambling activity , debts due to gambling , social support , personal yearly salary , alcohol consumption , stage of change , and dissociative gambling .  ICBT result ed in statistically significant reductions in the scores of pathological gambling , anxiety , and depression as well as an increase in quality of life compared to pre-treatment levels . Follow-ups carried out in the treatment group at 6 , 18 , and 36 months indicated that treatment effects were sustained . Using the eight predictor variable model rendered an acceptable predictive ability to identify responders both at post-test ( AUC = .72 , p < .01 ) and at 36-month follow-up ( AUC = .70 , p < .01 ) . We conclude that ICBT for pathological gamblers , even if depressed , can be effective and that outcome can partly be predicted by pre-treatment characteristics BACKGROUND Problem gambling-specific cognitive therapy ( CT ) and behavioural ( exposure-based ) therapy ( ET ) are two core cognitive-behavioural techniques to treating the disorder , but no studies have directly compared them using a r and omised trial . AIMS To evaluate differential efficacy of CT and ET for adult problem gamblers at a South Australian gambling therapy service . METHODS Two-group r and omised , parallel design . Primary outcome was rated by participants using the Victorian Gambling Screen ( VGS ) at baseline , treatment-end , 1 , 3 , and 6 month follow-up . FINDINGS Of eighty-seven participants who were r and omised and started intervention ( CT = 44 ; ET = 43 ) , 51 ( 59 % ) completed intervention ( CT = 30 ; ET = 21 ) . Both groups experienced comparable reductions ( improvement ) in VGS scores at 12 weeks ( mean difference -0.18 , 95 % CI : -4.48 - 4.11 ) and 6 month follow-up ( mean difference 1.47 , 95 % CI : -4.46 - 7.39 ) . CONCLUSIONS Cognitive and exposure therapies are both viable and effective treatments for problem gambling . Large-scale trials are needed to compare them individually and combined to enhance retention rates and reduce drop-out This study examined the efficacy of two group treatments for pathological gambling , a node-link mapping-enhanced cognitive-behavioral group therapy ( CBGT-mapping ) and twelve-step facilitated ( TSF ) group treatment .  Forty-nine participants meeting criteria for pathological gambling were recruited from local newspaper advertisements . These participants were r and omly assigned to one of three conditions : TSF ( n = 11 ) , CBGT-mapping ( n = 18 ) , and Wait-List control ( n = 9 ) ; 11 refused treatment prior to r and omization . Outcome measures included number of DSM-IV criteria met , perception of control/self-efficacy , desire to gamble , and frequency of gambling episodes . Analyses revealed a significant treatment group × time interaction ( η²partial = .39 ) . Specifically , the group treatments result ed in significant improvements in the dependent measures , while the Wait-List group remained relatively stable . Overall , CBGT-mapping and TSF had no significant differences on any outcome measure at follow-up assessment s. Analysis of post-treatment and 6-month follow-up reveal a significant improvement in gambling outcomes ( i.e. , fewer DSM-IV criteria met , 
    Output:
    
Units of measurement were inconsistent , particularly in the assessment of gambling behaviour .
CONCLUSIONS In research on gambling disorders , the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery .