Works in Progress

Tim and the Gambling Gang

a.k.a. GAG(gambling addiction group)

12.2.04

UCLA Gambling Studies Program

Program Building:

Research

Treatment

Education / Prevention

Policy Making

Visibility

Our current Gambling Team

• Alice Davis on Project Coordination

• Candace Oto on Work Study

• Richard Rosenthal on Ideas / Senior Leadership

Current climate

• Few gambling treatment providers in LA

• No state-funded treatment (coming soon)

• No insurance reimbursement

• Few gambling researchers out West

• Gambling grows in CA - $10 bill/decade

• Poker rising: fad with consequences

• Many alarmists but small voices

Main research interests

• Understanding what makes PG tick (why can’t they stop?)– Impulsivity– Stress– Psychological / Social Contributors

• Developing a treatment system in CA that works• Understanding what PG does do the body and

brain?– Medical , psychological consequences

Ongoing Studies

Pre-pulse inhibition and pathological gambling

N= 12 gamblers

Prelim results = impaired acoustic startle (less PPI, suggesting altered dopamine processes)

Recruiting matched controls

Brian and Alice are working on it . .

Ongoing Studies

• Delayed Discounting and Gamblers

• N=12 gamblers

• Within-subject effect of context showing more impulsivity in the casino vs. lab

• Controls being recruited

• POMS and VAS data to be analyzed

Ongoing Studies

• Neuropsychological Performance of Gamblers

• Same Gamblers as PPI

• Prelim look shows impaired frontal lobe processing – reaction time, Trails

• Matched controls coming. . .

Ongoing Studies

• Topiramate in Pathological Gambling

• Expected start date: Jan 2005

• N= 16, double –blind placebo controlled, 16 weeks

• Sponsored by Ortho McNeil, multi-site. Non-competitive enrollment

Piggybacks to Topiramate

• Health Status Questionnaire

• Life stress measures

• Cognitive Battery: Baseline, during and post trial

Pending Grants

• Awaiting K award comments (submitted 6/04), for “Impulsivity and Pathological Gambling”. Round One

• Awaiting NARSAD comments for “Depression and pathological gambling”

• PNI Seed Grant: Gambling arm of Tom and Rich’s Yohimbine Project

Grants In Preparation

Institute for Research on Pathological Gambling and Related Disorders (Harvard)

“The impact of chronic and acute stress on pathological gamblers”

Due: Feb 2005

Specific Aims:

I. To compare the number of chronic stressful life events between machine pathological gamblers, non-machine pathological gamblers and non-gambling controls.

 II. To evaluate the impact of chronic stress on machine pathological gamblers,

non-machine pathological gamblers and non-gambling controls through assessments of psychological distress, psychological coping strategies to stress, perceived responses to stress and measurements of health status

 III. To demonstrate the differential objective and subjective responses to stress

between machine pathological gamblers, non-machine pathological gamblers and non-gambling controls on an acute, experimental stressor (a public speaking task).

MethodsMachine PG Non-

Machine PGControls

Chronic Stress Measures

SF 36

Life Events

Coping Scales

SF 36

Life Events

Coping Scales

SF 36

Life Events

Coping Scales

Acute Stressor Tasks

HR, BP, Cortisol, Cytokines

HR, BP, Cortisol, Cytokines

HR, BP, Cortisol, Cytokines

Grants In Preparation

• Anxiety Disorders Association of America

• Junior Faculty Research Award

• “Impact of Stress Between OCD and PG”

Main idea: Are OCD and PG the same animal? How do they respond to stress?

Specific Aims

1. To characterize the neurophysiological and neuropsychological responses of patients with obsessive-compulsive disorder (OCD) to an acute stressor task.

 We hypothesize that subjects with OCD will demonstrate an amplified stress response as compared

to control subjects without OCD. 2. To differentiate neurophysiological and neuropsychological responses to an acute stressor task

between subjects with pathological gambling and subjects with obsessive-compulsive disorder We hypothesize that pathological gamblers will respond similarly to obsessive-compulsive

disordered subjects in some but not all of the stress response measurements.  3. To examine which subtypes of pathological gamblers, specifically machine gamblers versus non-

machine gamblers, demonstrate similar characteristics to patients with obsessive-compulsive disorder.

 We hypothesize that machine gamblers will more closely obsessive-compulsive disorder than non-

machine gamblers in terms of personality features, cognitions and symptomatology.

MethodsOCD PG Controls

Chronic Stress Measures

SF 36

Life Events

Coping Scales

SF 36

Life Events

Coping Scales

SF 36

Life Events

Coping Scales

Acute Stressor Tasks

HR, BP, Cortisol, Cytokines

HR, BP, Cortisol, Cytokines

HR, BP, Cortisol, Cytokines

Grants To Consider

American Psychiatric Foundation

education/media project?

SAMHSA

partnering with MATRIX on college prevention

Alcohol Beverage Medical Foundation

“Alcohol and PG”

examine mechanisms of how alcohol affects impulsivity or gambling

Grants to consider

• R21 – Collaborations with Monterosso/London on

imaging and using stop-signal task?

• Conference Grants– On “impulsivity” and “risk-taking behaviors”

Recent Publications

Situational Needs Assessment of Problem Gambling Services in California. Prepared for California Department of Alcohol and Drug Programs. November 2004

The etiology of pathological gambling. Ready for launch

Topiramate and compulsive sex. Submitted.

Ongoing Manuscripts

• Biopsychosocial Consequences of PG (invited)

• Review of Outcome Instruments of PG

• Olanzapine and PG

• Motivations and Expectations of PG

• Screening for PG in SUD Research (commentatry)

Political Networking

StateOffice of Problem Gambling (DADP)

Future RFPs: prevention/treatment.

Courts: Gambling Courts?

Insurance Commissioner

Political Networking

Casino IndustryCard Clubs

Self-Exclusion Project: On-line but not action

Native AmericansHow do we make then an offer that they cannot refuse?

Political Networking

• Asian Coalition– Grass-roots organization

• Churches, lawmakers, asian substance abuse providers, families, interested civilians