Browsing by Author "Hodgins, David Carson"

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    Addiction Substitution and Concurrent Recovery in Gambling Disorder: Evidence from Multiple Studies
    (2020-08) Kim, Andrew Hyounsoo; Hodgins, David Carson; McGrath, Daniel S.; von Ranson, Kristin M.; Mudry, Tanya E.; Ledgerwood, David M.
    The dissertation aimed to increase our understanding of addiction substitution and concurrent recovery in gambling disorder. In Study 1, a systematic review was conducted to identify empirical studies on addiction substitution. A total of 79 studies met the inclusion criteria. Of the studies that provided statistical results, relatively few studies (18.18%) found support for addiction substitution. The majority of studies (50.91%) found support for a concurrent model of recovery. Addiction substitution was associated with worse treatment outcomes and increased risk of relapse. Males, younger age, greater substance use severity, and the presence of mental health disorders were associated with addiction substitution. In Study 2, a mixed-method study was conducted with 185 people who were recovered from gambling disorder and engaged in addiction substitution, concurrent recovery, or neither (i.e., controls). Semi-structured interviews were used to assess the processes (e.g., reasons, emotional state, helpfulness) associated with engaging in addiction substitution and concurrent recovery. Participants also completed a survey assessing their demographic, gambling, and psychological characteristics. The most frequently reported reason for increasing another addictive behavior was as a substitute coping mechanism, whereas a connection between the addictions (i.e., simultaneous use) was most commonly reported as the reason for engaging in concurrent recovery. Addiction substitution was associated with greater underlying psychological vulnerabilities. In Study 3, co-occurring patterns of problem gambling and addiction severity as well as their predictors were examined in a secondary analysis of a 5-year prospective longitudinal study of gambling and problem gambling (N= 4,121 participants). Predictors included demographics, mental health disorders, personality, stress, life satisfaction, happiness and social support. Six co-occurring patterns were identified. The largest co-occurring pattern was characterized by concurrent recovery. Several co-occurring patterns were characterized by moderate to severe problem gambling and addiction severity that remained stable over time. No co-occurring pattern represented addiction substitution. The presence of mental health disorders, stress, and life satisfaction significantly predicted the different co-occurring patterns. Taken together, the results suggest that individuals are more likely to engage in concurrent recovery compared to addiction substitution. However, addiction substitution is associated with greater severity of problems and worse treatment outcomes.
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    Attitudes Toward Evidence-Based Practices and Their Influence on Beliefs about Contingency Management: A Survey of Addiction Treatment Providers Across Canada
    (2019-09-13) Cowie, Megan Elizabeth; Hodgins, David Carson; Brache, Kristina; von Ranson, Kristin M.
    Contingency management (CM) is an evidence-based treatment for addictive disorders that is often underused in clinical practice. The attitudes and beliefs of frontline staff are frequently reported as barriers to the uptake and use of evidence-based treatments, including CM. Understanding these barriers are an important step in implementation and could impact an intervention’s efficacy. Thus, we investigated the influence of attitudes toward evidence-based practices (EBP) on beliefs about CM. Our sample included 74 (19.58% response rate) substance use disorder treatment providers from 33 programs across six Canadian provinces. Most providers were not familiar with CM and reported largely neutral attitudes toward CM. However, providers also endorsed a desire for additional training in CM. In our multilevel modelling (MLM) analysis, we found that providers who believed that clinical experience was more important than EBPs reported more general barriers toward CM and fewer positive beliefs about CM. Providers with more openness and greater overall positive attitudes toward the adoption of EBPs were more likely to endorse positive beliefs about CM. Certain demographic characteristics were also associated with beliefs about CM. Providers in recovery from a substance use disorder reported greater barriers to adopting CM. In addition, those with higher levels of education held more positive beliefs about CM. Our findings provide evidence to support the consideration of provider-level characteristics in the implementation of EBPs in Canadian settings. Further, our results highlight the importance of integrating psychoeducation and training into implementation efforts to support the success of CM interventions in Canadian clinical settings.
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    Augmenting an Online Self-Directed Intervention for Gambling Disorder with a Single Motivational Interview: A Randomized Controlled Trial 3-Month Follow-Up
    (2021-08-16) Brazeau, Bradley Wayne; Hodgins, David Carson; Konnert, Candace; von Ranson, Kristin; Dimitropoulos, Georgina
    Despite the success of gold standard cognitive-behavioural therapy for problem and disordered gambling, most individuals with gambling problems do not seek or receive professional treatment. Thus, the development of less intrusive interventions has been encouraged. A two-arm randomized controlled trial was conducted. Eligible participants (N = 123) were randomly assigned to complete an online self-directed workbook either alone or in combination with a digital motivational interview completed upon enrollment. Gambling severity, frequency, and expenditures were assessed along with other mental health outcome data at baseline and 3-month follow-up time points. Participant retention (83.7%) was very high compared to similar prior trials. Gamblers in both groups experienced similar reductions across all primary and secondary outcomes, with the exception of alcohol consumption. A number of methodological limitations and theoretical explanations could account for the overall lack of differential improvement by group, including inadequate interview completion rate and short duration of intervention. Participants’ use of the online program was limited but their ratings were generally positive; they emphasized information quality as a strength and program engagement as a weakness. Given that time spent on the program and number of logins were positively associated with reductions in gambling problems, future research should examine ways to enhance online intervention engagement and uptake.
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    The Effect of Alcohol Cue Exposure on Gambling-Related Attentional Biases and Cravings among Poker Players who Drink
    (2019-08-29) Ritchie, Emma Victoria; McGrath, Daniel S.; Hodgins, David Carson; von Ranson, Kristin M.
    Alcohol is one of the most common substances used in conjunction with gambling, but the impact it has on gambling cravings and behaviours is poorly understood. The present study sought to determine whether exposure to an alcohol cue increased gambling cravings and preferential attention to gambling images in an eye-tracking task. Male poker players (n = 59) and non-gamblers (n = 59) were randomly assigned to an alcohol or neutral cue condition. All participants completed the same eye-tracking task, which featured pairs of gambling, alcohol, and neutral images. Alcohol and gambling cravings were measured before and after cue expose and after the eye-tracking task. Contrary to hypotheses, gamblers in the alcohol cue condition did not experience an increase in gambling cravings compared to gamblers in the neutral cue condition. Additionally, there were no differences in the way that gambling images were viewed by gamblers based on condition. However, participants in the alcohol cue condition preferentially attended to alcohol images more than participants in the neutral cue condition. Limitations and future directions are discussed.
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    The Technical Hypothesis of Motivational Interviewing: An Examination of Change Language in Traditional and Computer-based MI for Disordered Gamblers
    (2019-04-12) Swan, Jennifer L.; Hodgins, David Carson; McGrath, Daniel S.; Currie, Shawn R.; Mudry, Tanya E.; Goldstein, Abby L.
    Background: Motivational interviewing (MI) has shown promise as a brief treatment for disordered gamblers. The technical hypothesis of MI purports that MI-consistent therapist behaviours result in greater change language on the part of the client, which in turn leads to a more favourable outcome. The present research builds on existing literature examining client change language as the mechanism by which MI promotes behaviour change among disordered gamblers in telephone MIs (Study 1), a web-based MI program (Study 2), and in a controlled, computerized task (Study 3). Method: Transcription and coding of 50 brief MIs with disordered gamblers and path analyses was used to examine the links between therapist and client behaviours and outcome (Study 1). Multiple regression was used to examine 45 transcripts from the web-based program (Study 2). Linear mixed models were used to examine the effect of a brief, controlled, MI-consistent task on 335 participants’ self-reported importance and confidence of gambling-related behaviour change. Results: Results broadly supported previous findings that therapist MI-consistent behaviours were significantly associated with higher rates of both sustain and change language. Commitment language did not significantly predict outcome; however, the relationship between outcome and the proportion of change to sustain language approached significance. For the web-based program, only the negative relationship between participants’ sustain language and outcome approached significance. The controlled task in Study 3 did not significantly affect participant outcome; all conditions reported changes in importance, confidence, and gambling behaviour. Conclusions: Implications for treatment of disordered gambling, web-based treatments, and future research in MI are discussed.