RESEARCH SYNOPSIS
Ladouceur, R., Sylvain, C., Sévigny, S., Poirier, L., Brisson, L., Dias, C., . . . Pilote, P. (2006). Pathological gamblers: Inpatients’ versus outpatients’ characteristics. Journal of Gambling Studies, 22(4), 443‐450. doi:10.1007/s10899‐006‐9022‐8 RESEARCH QUESTIONS
Do the characteristics of pathological gamblers differ
according to the treatment modality they receive? Do
individuals that succeed, fail or abandon their
treatment share the same characteristics whether
they are treated as inpatients or outpatients?
PURPOSE
No study to date has examined the characteristics of
pathological gamblers seeking inpatient versus
outpatient treatment. The purpose of the current study
is to determine and compare the characteristics of
pathological gamblers receiving inpatient and
outpatient treatment.
HYPOTHESIS
None stated.
PARTICIPANTS
Two hundred thirty three pathological gamblers
(based on DSM-IV criteria) who were receiving
treatment (134 inpatients with mean age = 43 years,
99 outpatients with mean age = 43 years; 75% of
inpatients and 71% of outpatients were male).
PROCEDURE
Participants were recruited from five treatment
centres available in the greater Quebec City area
between October 2002 and May 2004. Participation
was voluntary. Inpatients were treated on-site for 21
to 28 days. Outpatients attended therapy meetings for
1 to 2 hours per week for an average of 15 weeks.
Potential participants were assessed for pathological
gambling using the Structured Clinical Interview for
DSM-IV Disorders (SCID) and the Diagnostic
Interview for Pathological Gambling-Revised. They
also completed self-report measures of perception of
control
over
gambling
problems,
gambling
behaviours, personality, impulsiveness, psychological
distress (e.g., depression/anxiety) and drug and
alcohol use. Participants also completed all interviews
and self-report measures immediately after treatment.
MAIN OUTCOME MEASURES
The number of DSM-IV criteria met (during past week)
for a diagnosis of pathological gambling was
assessed through a clinical interview. Perception of
control over gambling problem, perception of selfefficacy to refrain from gambling in personally relevant
high-risk situations, and urge to gamble were each
rated on a scale from 0 to 100. Frequency of gambling
was assessed based on number of gambling
sessions, number of hours spent gambling, and total
amount of money spent on gambling during the
previous week. Gambling onset, maintenance,
duration, severity and consequences as well as other
addictions and general history were assessed with the
Diagnostic Interview for Pathological GamblingRevised (DIPG-R). Personality disorders were
assessed with the self-report Millon Clinical Multiaxial
Inventory-III (MCMI-III). Impulsiveness was assessed
with the 43-item self-report Eysenck Impulsiveness
Scale (EIS). Anxiety was assessed with the 21-item
self-report Beck Anxiety Inventory (BAI). Depression
was assessed with the 21-item self-report Beck
Depression Inventory (BDI). The DEBA-Alcohol and
DEBA-Drugs questionnaires were used to assess
alcohol consumption/ dependence and drug use
during the last 12 months. The degree of alcohol
dependence was evaluated with the Severity of
Alcohol Dependence Data (SADD).
KEY RESULTS
Pre-treatment characteristics. Total DSM-IV score
was higher for inpatients (M = 8.0) than for outpatients
(M = 6.7). During the week before treatment:
inpatients gambled more frequently (M = 1.96) and
spent more time (M = 7.51 hrs) and more money (M =
$792) than outpatients (M = .94, 2.34 hrs, and $273
respectively). Outpatients reported a greater
perception of control (M = 39%) than inpatients (M =
27.3%). The average amount of money lost by
inpatients (M = $150,258) was higher than that lost by
outpatients (M = $50,500). A higher percentage of
inpatients (22.9%) than outpatients (11%) said that
they lacked the funds to meet their everyday needs. A
greater number of inpatients had declared bankruptcy
(39% vs. 23%). The percentage of patients having
three DSM-IV disorders (e.g., gambling, depression,
anxiety, substance abuse) was higher for inpatients
(58%) than outpatients (21%). The percentage of
participants having a schizoid-related problem was
higher for inpatients (10%) than for outpatients (1%).
The percentage of participants having alcohol abuse
problems was higher for inpatients (33%) than
outpatients (12%). Inpatients reported more drugrelated problems (15%) and alcohol-related problems
(24%) than outpatients (2% and 5% respectively).
Inpatients had higher depression scores (M = 24.5)
and anxiety scores (M = 19.8) than outpatients (M =
17.5 and 14.2 respectively). Inpatients had higher
impulsivity scores (M = 25.1) than outpatients (M =
21.4). Inpatients suffered from a greater number of
personality disorders (including antisocial, borderline
and non-specific) than outpatients but more
outpatients were afflicted with histrionic personality
disorder (e.g., excessive emotionality). Treatment
outcomes. Both inpatient and outpatient treatments
were effective in reducing symptoms of problem
gambling. The perception of control over gambling
problems and perception of efficacy increased and
the urge to gamble decreased for both inpatients and
outpatients.
LIMITATIONS
Participants chose the method of treatment (i.e., they
were not randomly assigned); thus, the differences
between the inpatient and outpatient treatment may
have
resulted
from
individual
participant
characteristics. Additionally, no control condition (i.e.,
no treatment) was used, so it is not clear how
variables such as time are related to (or even caused)
the improvements observed.
CONCLUSIONS
Inpatients had more severe problems than
outpatients; however, treatment resulted in significant
improvements for both groups.
KEYWORDS: inpatient, outpatient, pathological gamblers, demographics, treatment, attrition URL: https://link.springer.com/article/10.1007%2Fs10899‐
006‐9022‐8
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