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Biomedical subjects

Robert Ladouceur

Publications and source records attributed to Robert Ladouceur.

At least 37 records · Page 2Linked to original sources
PubMed2005

Prevalence of pathological gambling in Quebec in 2002.

OBJECTIVE: To assess gambling behaviours and the problems associated with pathological gambling among the adult population of Quebec in 2002. METHOD: In Phase 1 of this 2-phase study, a total sample of 8842 adults was assessed. We used the South Oaks Gambling Screen (SOGS), adapted for telephone interview, to assess one-half of the sample; the other one-half was evaluated with the Canadian Problem Gambling Index (CPGI). In the study's second phase, we compared the classifications obtained from these screening instruments with classifications obtained by a psychologist using a semistructured clinical telephone interview. RESULTS: The results indicate that the prevalence of pathological gambling in 2002 (at which time 0.8% of the adult population were classified as probable pathological gamblers) did not differ from the proportion obtained in 1996 (1.0%), despite the significant decrease in gambling participation in 2002 (81% vs 90% in 1996). The most popular gambling activities were buying lottery tickets (68%), participating in fundraising draws (40%), gambling in casinos (18%), playing cards with family or with friends (10%), playing bingo (9%), and playing video lotteries (8%). The findings obtained from the SOGS and the CPGI revealed that the 2 instruments perform similarly when identifying pathological gambling prevalence. However, the results of the semistructured clinical telephone interviews differed from the results obtained with the screening instruments: 82% of the gamblers initially identified as probable pathological gamblers by the SOGS or the CPGI were not confirmed by a clinical interview. CONCLUSION: The discrepancy between the results of the screening questionnaires and the clinical evaluation is significant, and this difference needs to be addressed before further cross-sectional or longitudinal studies are conducted.

Adult↗
PubMed2005

Generalized anxiety disorder and health care use.

OBJECTIVE: To examine self-reported health care use and health care-seeking behaviour of patients meeting DSM-IV's diagnostic criteria for generalized anxiety disorder (GAD). DESIGN: Survey of outpatients recruited at three different times of the day using questionnaires on worry and anxiety (a six-item screening questionnaire based on DSM-IV criteria for GAD), on perceived health problems, and on health care use and health care-seeking behaviour. The assessment package also included well validated assessment instruments for insomnia and depression symptoms. All patients seeking health care were invited to participate. Participants completed the survey as they waited in the reception area. SETTING: Four randomly selected community-based medical clinics of Quebec city's metropolitan area. PARTICIPANTS: A final sample of 1110 patients among 1878 outpatients invited to participate included 219 (19.7%) who tested positive for GAD. MAIN OUTCOME MEASURES: Self-reported worry and anxiety (based on DSM-IV criteria for GAD), self-perceived health problems, health care use and health care-seeking behaviour, insomnia, and symptoms of depression. RESULTS: Participants who tested positive on a screening test for GAD reported more annual medical visits (5.3 versus 3.4) than other patients. Those who reported at least five annual medical visits were nearly four times more likely to have positive results for GAD. Women were 1.6 times more likely to have positive results than men were. Patients who tested positive reported insomnia-type sleep disturbances, depressive symptoms, fatigue, and gastric problems significantly more often than others. Forty-two percent had consulted a family physician in the past year with a complaint of anxiety. Eighty percent of patients who tested positive reported they believed they had an anxiety problem, and this belief predicted positive test results (odds ratio = 20.3). Yet most reported not having sought other types of medical or psychological care specifically for anxiety in the past year. CONCLUSION: Some patients in this sample with symptoms of GAD mainly seek primary care for their symptoms. Questions about excessive worrying and anxiety, as part of routine examination, can increase recognition of GAD.

Adult↗
PubMed2004

Awareness of independence of events and erroneous perceptions while gambling.

The majority of individuals behaves and think irrationally when gambling. The fundamental mistake committed is to rely on previous events to predict the outcome of the game. This study examines if information, reminding the players about independence between events, while gambling influences their perception of the game and their motivation to continue gambling. Thirty-one occasional gamblers, 18 men and 13 women aged 20-64 years old (M=40), participated in the study. The hypotheses predicted that reminders about independence of events would decrease the number of erroneous perceptions and that the motivation to pursue the game would be weaker among participants who received reminders. Results confirmed both hypotheses. Interventions based on these results could significantly increase responsible gambling.

Adult↗
PubMed2004

Perceptions among pathological and nonpathological gamblers.

This study evaluated the perceptions of individuals while gambling on a Video Lottery Terminal. The primary goal was to compare the frequency of erroneous perceptions and of gambling-related perceptions among pathological and nonproblem gamblers. The degree of conviction in these perceptions was also evaluated. Each participant was assessed by a clinical psychologist using the DSM-IV criteria. Results showed that, contrary to the first hypothesis, no significant differences emerged between problem and nonproblem gamblers on the percentage of erroneous perceptions. But, pathological gamblers verbalized significantly more gambling related perceptions and were more convinced in the truth of their perceptions than the nonproblem gamblers. The theoretical and clinical implications of these results are discussed in order to improve the effectiveness of treatment interventions for pathological gamblers.

Adult↗
PubMed2004

Characteristics of illness intrusions in a non-clinical sample.

This study examines whether illness intrusions can be distinguished from obsessional intrusions and worries. It also assesses the relationship between strategies, thought characteristics, and appraisal of illness intrusions. Two hundred and forty-three non-clinical participants identified an obsessive intrusive thought, a worry, and an illness intrusion. They evaluated each thought using items from the Cognitive Intrusions Questionnaire. The comparisons of intrusions showed that illness intrusions share characteristics of worries and obsessional intrusions, but also have their own characteristics. Illness intrusions seem to be particularly egosyntonic. The relationships between the strategies used to counter illness intrusions and their appraisal were also tested. Results support the idea that there are specific links between the evaluation of cognitive intrusions and the way they are processed. It demonstrated that escape/avoidance strategies are associated with the egodystonic nature of the thought and that problem-focused strategies are associated with the thought's basis in reality. Illness intrusions may be conceptualised as either obsessions or worries. This study demonstrated that the category of an intrusive thought might not be as important as the way it is processed. It seems more important to consider appraisal of the disturbing thought and the way in which the person subsequently reacts and behaves.

Adaptation, Psychological↗
PubMed2004

Insomnia and generalized anxiety disorder: effects of cognitive behavior therapy for gad on insomnia symptoms.

Although clinical practice suggests that sleep complaints are frequent among patients with generalized anxiety disorder (GAD), frequency, severity, types of insomnia complaints, and relationship to GAD diagnosis severity in patients diagnosed using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria are not well documented. Clinical data about the impact on insomnia symptoms of treating GAD worries are also lacking. The present study examined these aspects in 44 GAD patients who participated in a treatment study specifically addressing excessive worries through CBT interventions. All patients were assessed using a structured clinical interview and the Anxiety Disorder Interview Schedule-IV (ADIS-IV). They also completed anxiety and insomnia inventories, including the Insomnia Severity Index (ISI), a self-report measure which assesses insomnia type, severity and interference with daily life. Among this sample, 47.7% reported difficulties initiating sleep, 63.6% reported difficulties maintaining sleep, and 56.8% complained of waking too early in the morning. The majority of these patients (86.5%) reported never having experienced insomnia without having excessive worries. However, insomnia severity and GAD severity were not correlated. In this sample, patients with severe GAD did not necessarily report more severe insomnia symptoms. Regarding treatment impact on insomnia complaints, ISI post-treatment scores were significantly lower after treatment. Mean post-treatment scores almost reached ISI's "absence of clinical insomnia" category. Results indicate that this CBT package for GAD does have a significant impact on sleep quality even if sleep disturbances were not specifically addressed during treatment.

Adult↗
PubMed2004

Cognitive-behavioral treatment of generalized anxiety disorder (GAD) for older adults.

BACKGROUND: Generalized Anxiety Disorder (GAD) is one of the most prevalent anxiety disorders among the elderly. Estimates of prevalence vary from around 3% to 12%, depending on the minimum age considered and the assessment instruments. The present study tests a GAD-specific treatment recently validated among adults (Ladouceur et al., 2000) and adapted for older adults. METHOD: Eight older adults (aged from 60 to 71) were included in a single-case experimental multiple-baseline design across subjects. Assessments were conducted at pre-test, post-test and at 6- and 12-months follow-ups. The treatment consisted of awareness training, worry interventions and relapse prevention. The worry interventions targeted intolerance of uncertainty, beliefs about worry, problem-solving and cognitive avoidance. RESULTS: According to daily self-monitoring of worry, ADIS-IV ratings and self-reported questionnaire scores, seven out of eight participants showed clinically significant improvement at post-test. These therapeutic gains were maintained at 6- and 12-month follow-ups. CONCLUSIONS: This study shows that a cognitive-behavioral treatment that targets intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation and cognitive avoidance is effective for treating GAD among elderly people.

Aged↗
PubMed2004

Trajectories of gambling during adolescence.

This study aimed at empirically identifying groups of adolescents with distinct longitudinal trajectories of gambling involvement and validating these groups by comparing them with respect to correlates. 903 low SES boys were followed annually from age 11 to 16 years. Three groups were found: an early-onset high-level chronic group, a late-onset high-level group, and a low gambler group. The Chronic group and the Low group consistently differed on teacher-rated inhibition (i.e., anxiety) during childhood and early adolescence. They also differed on concurrent teacher and self ratings of disinhibition (i.e., impulsivity), while the Late Onset group appeared to lie in between these groups. Compared to the Low group, both high groups subsequently had elevated scores on later gambling related problems.

Adolescent↗
PubMed2004

Awareness promotion about excessive gambling among video lottery retailers.

This paper describes and evaluates "As luck would have it," an awareness program completed by retailers in Quebec Province. This program, which is presented as a two-hour awareness promotion workshop, aimed to inform retailers about excessive gambling. More specifically, it provided answers to the following questions: (1) What is chance and randomness? (2) Is there a link between misunderstanding the concept of chance and excessive gambling? (3) How does one recognise the symptoms of this disorder? (4) How should retailers intervene if they decide to do so? Results showed that retailers developed a better understanding of problem gambling, could recognise its main symptoms, felt more capable of coping with excessive gamblers, and of choosing the most appropriate moment to do so. In the follow-up phase, retailers who had attended the workshop reported that they approached a problem gambler significantly more often than the retailers who had not attended the workshop, and had discussed how to help problem gamblers significantly more often. The practical implications of these results are briefly discussed.

Adult↗
PubMed2004

A science-based framework for responsible gambling: the Reno model.

As social observers increasingly identify gambling-related problems as a public health issue, key stakeholders need to join together to reduce both the incidence and prevalence of gambling-related harm in the community. This position paper describes a strategic framework that sets out principles to guide industry operators, health service and other welfare providers, interested community groups, consumers and governments and their related agencies in the adoption and implementation of responsible gambling and harm minimization initiatives.

Australia↗
PubMed2004

Sports betting: can gamblers beat randomness?

Although skills are not considered relevant in chance-governed activities, only a few studies have assessed the extent to which sport expert skills in wagering are a manifestation of the illusion of control. This study examined (a) whether expert hockey bettors could make better predictions than chance, (b) whether expert hockey bettors could achieve greater monetary gains than chance, and (c) what kind of strategies hockey gamblers rely on when betting. Accordingly, 30 participants were asked to report their state lottery hockey bets on 6 occasions. We suggest that the information used by bettors, along with near-misses, reinforces their perception of expertise. The results of this experiment suggest that the so-called "skills" of the sports bettors are cognitive distortions.

Adult↗
PubMed2003

DSM-IV-J criteria: a scoring error that may be modifying the estimates of pathological gambling among youths.

Previous studies have shown that prevalence rates among youths may be inflated due to a problem in understanding the questions of the SOGS-RA and DSM-IV-MR-J. This article reports another reason why prevalence rates of pathological gambling among youths may be inflated. In 1992, Fisher proposed 9 criteria (the DSM-IV-J) for diagnosing pathological gambling among youths, and formulated 12 questions (the Test questions) to identify the presence of these criteria. An analysis of a sample of studies using the DSM-IV-J reveals that some researchers have incorrectly used the 12 Test questions instead of the 9 criteria, which may have led to overestimated prevalence rates among youths. Other measurement issues may also be contributing to the overestimation of problem gambling in young people. The methodological implications of these issues are discussed.

Adolescent↗
PubMed2003

Near wins prolong gambling on a video lottery terminal.

The purpose of the present study was to evaluate whether near wins can prolong gambling activity on a video lottery terminal. In a three-reel game, near wins were operationally defined as two identical symbols followed by a third different symbol. Players in an experimental condition were exposed to 27% near wins in a series of continuous losses, whereas players in a control group were exposed to none. Participants played as long as they wished, and received real money for their wins. The results showed that players in the near win condition played 33% more games than did the control group. The results of this study suggest that near wins can be added to the list of factors that may motivate people to gamble despite the probability of monetary loss.

Adult↗
PubMed2003

Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up.

A recently developed cognitive-behavioral treatment for generalized anxiety disorder (GAD) targets intolerance of uncertainty by the reevaluation of positive beliefs about worry, problem-solving training, and cognitive exposure. As previous studies have established the treatment's efficacy when delivered individually, the present study tests the treatment in a group format as a way to enhance its cost-benefit ratio. A total of 52 GAD patients received 14 sessions of cognitive-behavioral therapy in small groups of 4 to 6 participants. A wait-list control design was used, and standardized clinician ratings and self-report questionnaires assessed GAD symptoms, intolerance of uncertainty, anxiety, depression, and social adjustment. Results show that the treatment group, relative to the wait-list group, had greater posttest improvement on all dependent variables and that treated participants made further gains over the 2-year follow-up phase of the study.

Adult↗
PubMed2003

Video lottery: winning expectancies and arousal.

AIMS: This study investigates the effects of video lottery players' expectancies of winning on physiological and subjective arousal. DESIGN: Participants were assigned randomly to one of two experimental conditions: high and low winning expectancies. SETTING: Participants played 100 video lottery games in a laboratory setting while physiological measures were recorded. Level of risk-taking was controlled. PARTICIPANTS: Participants were 34 occasional or regular video lottery players. They were assigned randomly into two groups of 17, with nine men and eight women in each group. INTERVENTION: The low-expectancy group played for fun, therefore expecting to win worthless credits, while the high-expectancy group played for real money. MEASUREMENTS: Players' experience, demographic variables and subjective arousal were assessed. Severity of problem gambling was measured with the South Oaks Gambling Screen. In order to measure arousal, the average heart rate was recorded across eight periods. FINDINGS: Participants exposed to high as compared to low expectations experienced faster heart rate prior to and during the gambling session. According to self-reports, it is the expectancy of winning money that is exciting, not playing the game. CONCLUSIONS: Regardless of the level of risk-taking, expectancy of winning is a cognitive factor influencing levels of arousal. When playing for fun, gambling becomes significantly less stimulating than when playing for money.

Adult↗
PubMed2003

Cognitive-behavioral treatment of generalized anxiety disorder among adolescents: a case series.

Seven adolescents received a cognitive-behavioral treatment targeting generalized anxiety disorder. The treatment consisted of awareness training, worry interventions, and relapse prevention. The worry interventions targeted specifically intolerance of uncertainty, beliefs about worry, problem solving, and cognitive avoidance. According to the Anxiety Disorders Interview Schedule for diagnosis of generalized anxiety disorder, self-report questionnaire scores, and time spent worrying every day, three adolescents showed clinically significant change at post-test which was maintained at 6- and 12-month follow-up assessments. Minimal to moderate improvement was observed for other participants. Factors that may explain these differences are discussed.

Adolescent↗
PubMed2003

Erroneous verbalizations and risk taking at video lotteries.

This study examined the effect of erroneous perceptions verbalized by a game accomplice on participants' gambling. The sample consisted of 22 men and 10 women, aged 18 and older, who did not show excessive gambling problems, but who had played video lotteries at least once during the last 6 months. The participants were randomly assigned into one of three groups, where they gambled in the presence of an accomplice who verbalized three types of perceptions: (1) the accomplice emitted erroneous thoughts about gambling, (2) the accomplice verbalized adequate thoughts about gambling, or (3) the accomplice did not speak. Results showed that players exposed to an accomplice's erroneous verbalizations took significantly more risks than players in the other two groups. Erroneous perceptions appear to be easily transmissible and have impacts on gambling behaviour. The practical and theoretical implications of these results are discussed.

Adolescent↗