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Comparison of imaginal desensitization with other behavioural treatments of pathological gambling: a two- to nine-year follow-up

Article Abstract:

Compulsive gambling can be a serious problem, provoking a number of personal and family difficulties. There are various ways of treating the behavior, which achieve different degrees of success. To evaluate the most effective therapeutic approaches to pathological gambling, 120 patients were assigned to receive either imaginal desensitization, aversive therapy, imaginal relaxation, or brief or prolonged in vivo exposure. The first method involves a relaxation methodology that is invoked in anticipation of imagining a gambling scene; the second involves administration of mild electrical shocks in association with encounters with descriptions of gambling scenes; the third is basically a method of imagining relaxing scenes; and the last two methods involve observation of, but not participation in, actual gambling in the company of a therapist. Of the original 120 patients, only 63 participated in the follow-up between two and nine years later. At follow-up, 18 of the patients had quit gambling, while 25 felt they had the problem under control, although they continued to gamble. If control of gambling and cessation of gambling can both be considered successful outcomes, then imaginal desensitization was the most successful therapy, leading to 26 such outcomes (79 percent). Only 53 percent of those undergoing other methods achieved the same outcome. On the basis of the results, it is observed that brief interventions using imaginal desensitization can produce lasting effects, and this should be considered when treatment resources are limited. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Care and treatment, Gambling, Behavior therapy, Compulsive gambling

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Magnetic resonance imaging and its applications in neuropsychiatry

Article Abstract:

In magnetic resonance imaging (MRI), atomic nuclei (protons) are exposed to rotating magnetic fields in the radio-frequency range. When the frequency is stopped, the protons emit energy as they return to their former state. Computer analysis of this emitted energy portrays a spatial image of the distribution of specific elements (e.g., hydrogen or phosphorus). An important measure obtained during MRI is the time it takes for protons to return to a resting state after excitation (T-1). For example, T-1 has been found to increase significantly during alcohol withdrawal in chronic alcoholics. MRI has been available since about 1980. It has been shown to be particularly useful in the study of patients with neurological disease who present with psychiatric symptoms. For instance, MRI techniques have shown brain-stem white-matter lesions in patients with multiple sclerosis. The degree of severity of the lesions found has been shown to be significantly related to degree of cognitive impairment. MRI has also demonstrated that infarcts (tissue death due to loss of blood supply) can be characterized by T-1 changes. Identifying structural changes with MRI along with the assessment of cerebral blood flow in adjoining areas - either using single photon emission computerized tomography (SPECT) or position-emission tomography (PET) - has led to an increased understanding of the nature of pathological changes within specific brain regions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Brain, Magnetic resonance imaging, Neuropsychiatry

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