Internet-Based Treatment of Pathological Gambling with a Three-Year Follow-Up

Figures & data

Figure 1 Participant flow, reasons for exclusion and number of participants providing data at different assessment points throughout the trial.

Table 1 Treatment outcome at pre-, post-, 6-, 18-, and 36-month follow-up for the collapsed group (n = 284) as well as the five different subtypes of primary problematic game using mixed effects model

			p Difference (overall)	Mean estimates (SE), type of game					p Differences		p Interaction
Time	Mean estimates (SE) across all types of games	Significant pair wise comparisons between time points	Time	Poker (n = 102)	VLT (n = 76)	Casino (n = 34)	Betting (n = 43)	Bingo (n = 29)	Type of game	Significant differences between each type of game at each time point	Time × type of game
Gambling (NORC DSM-IV Screen for gambling problems)
Pre	8.1 (0.1)	Pre>all times	< 0.01	8.2 (0.1)	8.5 (0.2)	8.0 (0.2)	8.0 (0.2)	7.7 (0.3)	0.042	VLT>Betting, Bingo	0.748
Post	1.8 (0.2)			2.0 (0.2)	2.3 (0.2	1.8 (0.3)	1.8 (0.3)	1.4 (0.3)		VLT>Betting, Bingo
6 mo	2.0 (0.2)			2.1 (0.2)	2.4 (0.2)	1.9 (0.3)	1.9 (0.3)	1.5 (0.3)		VLT>Betting, Bingo
18 mo	2.1 (0.2)			2.2 (0.2)	2.5 (0.3)	2.0 (0.3)	2.0 (0.3)	1.7 (0.3)		VLT>Betting, Bingo
36 mo	2.0 (0.2)			2.1 (0.2)	2.4 (0.3)	1.9 (0.3)	1.9 (0.3)	1.5 (0.3)		VLT>Betting, Bingo
Anxiety (Hospital anxiety and depression scale)
Pre	11.0 (0.3)	Pre>all times	< 0.01	10.7 (0.4)	11.7 (0.4)	11.7 (0.6)	10.5 (0.6)	10.5 (0.7)	0.169	No difference	0.425
Post	7.2 (0.3)	Post>6, 18		6.8 (0.4)	7.9 (0.5)	7.8 (0.6)	6.6 (0.6)	6.7 (0.7)		No difference
6 mo	6.4 (0.3)			6.1 (0.4)	7.1 (0.5)	7.1 (0.6)	5.9 (0.6)	5.9 (0.7)		No difference
18 mo	6.3 (0.3)			5.9 (0.4)	7.0 (0.5)	7.0 (0.7)	5.8 (0.6)	5.8 (0.7)		No difference
36 mo	6.5 (0.4)			6.1 (0.4)	7.2 (0.5)	7.1 (0.7)	5.9 (0.6)	6.0 (0.7)		No difference
Depression (Hospital anxiety and depression scale)
Pre	9.3 (0.3)	Pre>all times	< 0.01	8.8 (0.4)	9.3 (0.4)	10.6 (0.6)	9.3 (0.5)	8.6 (0.6)	0.061	Casino>Poker, VLT, Bingo	0.483
Post	5.5 (0.3)	Post>6		5.0 (0.3)	5.5 (0.4)	6.8 (0.6)	5.6 (0.5)	4.8 (0.6)		Casino>Poker, VLT, Bingo
6 mo	4.8 (0.3)			4.3 (0.4)	4.8 (0.4)	6.1 (0.6)	4.8 (0.5)	4.1 (0.6)		Casino>Poker, VLT, Bingo
18 mo	5.0 (0.3)			4.5 (0.4)	5.0 (0.4)	6.3 (0.6)	5.0 (0.5)	4.3 (0.6)		Casino>Poker, VLT, Bingo
36 mo	5.0 (0.3)			4.6 (0.4)	5.1 (0.4)	6.4 (0.6)	5.2 (0.5)	4.4 (0.6)		Casino>Poker, VLT, Bingo
Overall life satisfaction (quality of life inventory)
Pre	0.3 (0.1)	Pre < all times	< 0.01	0.4 (0.2)	0.2 (0.2)	− 0.2 (0.3)	0.5 (0.2)	0.4 (0.3)	0.286	No difference	0.960
Post	1.3 (0.1)	Post < 6, 18		1.5 (0.2)	1.3 (0.2)	0.9 (0.3)	1.5 (0.2)	1.5 (0.3)		No difference
6 mo	1.6 (0.1)			1.7 (0.2)	1.5 (0.2)	1.2 (0.3)	1.8 (0.2)	1.7 (0.3)		No difference
18 mo	1.6 (0.1)			1.7 (0.2)	1.5 (0.2)	1.2 (0.3)	1.8 (0.2)	1.7 (0.2)		No difference
36 mo	1.4 (0.1)			1.5 (0.2)	1.3 (0.2)	1.0 (0.3)	1.6 (0.2)	1.5 (0.3)		No difference
Note. VLT, video lottery terminal.

Table 2 Factors associated with responder status at post-treatment (n = 218)

			ORs, 95 CI (p value)
	Number of individuals	Responder (%)	Unadjusted		Adjusted
Work-life satisfaction
Very poor	46	30.4	Ref.	(p = 0.09)		(p = 0.42)
Poor	51	35.3	1.2	0.5–2.9	1.0	0.4–2.7
Moderate	67	37.3	1.4	0.6–3.0	1.3	0.5–3.2
Good	54	53.7	2.7	1.2–6.0	2.0	0.7–5.6
Primary gambling
Poker	79	38.0	Ref.	(p = 0.38)		(p = 0.57)
VLT	56	32.1	0.8	0.4–1.6	0.5	0.2–1.2
Casino	25	36.0	0.9	0.4–2.3	1.1	0.3–3.2
Betting	33	51.5	1.7	0.8–3.9	0.8	0.3–2.3
Bingo	25	48.0	1.5	0.6–3.7	1.1	0.3–3.2
Debts due to gambling
No	58	37.9	Ref.	(p = 0.80)		(p = 0.75)
Yes	158	39.9	1.1	0.6–2.0	0.9	0.4–1.9
Social support
No	65	32.3	Ref.	(p = 0.24)		(p = 0.29)
Moderate	100	40.0	1.4	0.7–2.7	1.8	0.8–4.0
Yes	50	48.0	1.9	0.9–4.1	1.7	0.7–4.2
Personal yearly salary (Swedish krona)
0–150,000	48	37.5	Ref.	(p = 0.85)		(p = 0.54)
151,000–210,000	52	44.2	1.3	0.6–2.9	1.5	0.5–4.0
211,000–300,000	57	36.8	1.0	0.4–2.2	0.9	0.3–2.3
301,000 or greater	53	41.5	1.2	0.5–2.6	0.7	0.3–2.1
Number of standard drinks during a typical drinking day
0–2 drinks	51	54.9	2.7	1.4–5.4	2.7	1.2–6.3
3–4 drinks	48	35.4	1.2	0.6–2.5	1.3	0.6–2.9
5 drinks or more	103	31.1	Ref.	(p = 0.02)		(p = 0.06)
Stage of change
Contemplation	173	37.0	Ref.	(p = 0.14)		(p = 0.31)
Action	38	50.0	1.7	0.8–3.5	1.5	0.7–3.5
Dissociative gambling
Never	18	66.7	7.0	1.6–30.8	9.8	1.4–65.8
Sometimes	83	43.4	2.7	0.8–8.8	3.0	0.7–12.7
Often	93	33.3	1.7	0.5–5.8	1.9	0.5–8.2
Always	18	22.2	Ref.	(p = 0.03)		(p = 0.08)
Notes. The total number of participants does not always add up to 218 for all factors owing to partly missing data. The goodness-of-fit test was positive (Hosmer and Lemenshow: p = .74).

Table 3 Evaluation of the ability to predict responder status at post-treatment for different predictor variables and models

AUC
				Asymptotic 95% CI
Test result variable(s)	Area	SE^a	Asymptotic sig.^b	Lower bound	Upper bound
1. Work-life satisfaction	0.596	0.042	0.023	0.515	0.678
2. Primary gambling	0.582	0.042	0.054	0.500	0.663
3. Debts due to gambling	0.510	0.042	0.812	0.427	0.593
4. Social support	0.548	0.042	0.257	0.466	0.630
5. Personal yearly salary	0.526	0.042	0.547	0.442	0.609
6. Standard drinks	0.597	0.042	0.023	0.514	0.679
7. Stage of change	0.548	0.043	0.262	0.464	0.631
8. Dissociative gambling	0.609	0.041	0.010	0.528	0.691
Model with all eight predictors	0.718	0.038	0.000	0.643	0.793
Note. Results are expressed by the area under the ROC.
^a Under the nonparametric assumption.
^b Null hypothesis: true area = .5.

Table 4 Factors associated with responder status at 36-month follow-up (n = 196)

			ORs, 95 CI (p value)
	Number of individuals	Responder (%)	Unadjusted		Adjusted
Work-life satisfaction
Very poor	43	37.2	Ref.	(p = 0.39)		(p = 0.29)
Poor	45	37.8	1.0	0.4–2.4	0.8	0.3–2.1
Moderate	60	38.3	1.0	0.5–2.4	0.9	0.4–2.4
Good	48	52.1	1.8	0.8–4.2	1.9	0.7–5.1
Primary gambling
Poker	75	38.7	Ref.	(p = 0.78)		(p = 0.40)
VLT	51	45.1	1.3	0.6–2.7	1.8	0.8–4.3
Casino	27	48.1	1.5	0.6–3.6	1.2	0.4–3.5
Betting	27	33.3	0.8	0.3–2.0	0.6	0.2–1.9
Bingo	16	43.8	1.2	0.4–3.7	1.5	0.4–5.8
Debts due to gambling
No	51	29.4	Ref.	(p < 0.05)		(p < 0.05)
Yes	143	45.5	2.0	1.0–3.9	2.2	1.0–4.9
Social support
No	59	35.6	Ref.	(p = 0.09)		(p = 0.20)
Moderate	89	38.2	1.1	0.6–2.2	1.1	0.5–2.3
Yes	45	55.6	2.3	1.0–5.0	2.2	0.9–5.7
Personal yearly salary (Swedish krona)
0–150,000	47	40.4	Ref.	(p = 0.88)		(p = 0.90)
151,000–210,000	46	41.3	1.0	0.5–2.4	0.7	0.3–2.1
211,000–300,000	51	47.1	1.3	0.6–2.9	1.1	0.4–2.8
301,000 or greater	43	39.5	1.0	0.4–2.2	0.9	0.3–2.7
Number of standard drinks during a typical drinking day
0–2 drinks	44	36.4	Ref.	(p = 0.49)		(p = 0.34)
3–4 drinks	39	35.9	1.0	0.4–2.4	1.0	0.3–2.7
5 drinks or more	98	44.9	1.4	0.7–3.0	1.7	0.7–3.8
Stage of change
Contemplation	160	39.4	Ref.	(p = 0.16)		(p = 0.94)
Action	30	53.3	1.8	0.8–3.9	1.5	0.6–3.7
Dissociative gambling
Never	14	42.9	1.2	0.3–5.4	1.7	0.2–12.3
Sometimes	76	38.2	1.0	0.3–3.1	1.2	0.3–4.9
Often	85	44.7	1.3	0.4–4.0	1.1	0.3–4.5
Always	16	37.5	Ref.	(p = 0.84)		(p = 0.95)
Notes. The total number of participants does not always add up to 196 for all factors owing to partly missing data. Hosmer and Lemenshow: p = .65.

Table 5 Evaluation of the ability to predict responder status at post-treatment for different predictor variables and models

AUC
				Asymptotic 95% CI
Test result variable(s)	Area	SE^a	Asymptotic sig.^b	Lower bound	Upper bound
1. Work-life satisfaction	0.558	0.045	0.189	0.471	0.646
2. Primary gambling	0.566	0.044	0.135	0.481	0.652
3. Debts due to gambling	0.567	0.044	0.129	0.482	0.653
4. Social support	0.577	0.044	0.084	0.490	0.664
5. Personal yearly salary	0.529	0.045	0.516	0.441	0.616
6. Standard drinks	0.552	0.044	0.242	0.466	0.638
7. Stage of change	0.532	0.045	0.478	0.444	0.619
8. Dissociative gambling	0.526	0.044	0.552	0.440	0.613
Model with all eight predictors	0.702	0.041	0.000	0.622	0.781
Note. Results are expressed by the area under the ROC.
^a Under the nonparametric assumption.
^b Null hypothesis: true area = .5.