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Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review

Cat Hitch, Daniel Leightley Orcid Logo, Dominic Murphy Orcid Logo, Nora Trompeter Orcid Logo, Simon Dymond Orcid Logo

European Journal of Psychotraumatology, Volume: 14, Issue: 1

Swansea University Authors: Cat Hitch, Simon Dymond Orcid Logo

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DOI (Published version): 10.1080/20008066.2023.2178203

Abstract

Background: PTSD and gambling disorder (GD) are frequently comorbid. Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and...

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Published in: European Journal of Psychotraumatology
ISSN: 2000-8066
Published: Informa UK Limited 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63368
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Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and GD outcomes, yet research into the potential effectiveness of ACT for PTSD and/GD in veterans is scarce. Objective: This review aimed to systematically assess and describe the evidence relating to the use of ACT and acceptance-based therapy for military populations with PTSD and/or GD. Method: Six databases were searched. Selection criteria included studies that featured the armed forces/military, delivered ACT/acceptance-based therapy, and aimed to improve PTSD and/or GD outcomes. A narrative synthesis approach was adopted. Results: From 1,117 results, 39 studies were fully screened and 14 met inclusion criteria. All studies originated from the USA and 9 were associated with United States Department of Veterans Affairs. Therapy use within each study produced an improvement in PTSD and/or GD, yet only one study examined GD and no studies considered comorbid PTSD/GD. The broad range of study designs made it difficult to compare the findings or make generalisations from the collective results. It is unclear which method of ACT delivery is superior (app-based, telehealth, face-to-face, groups, one-to-one, manualised, or unstructured), or what the true effect size is of ACT for PTSD and/or GD. Conclusions: These preliminary findings are promising, yet more research is needed on the delivery format and content of ACT sessions, and whether findings generalise beyond USA-recruited military samples. 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spelling v2 63368 2023-05-08 Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review 8e2e86483241ae498d3a6c445736ca22 Cat Hitch Cat Hitch true false 8ed0024546f2588fdb0073a7d6fbc075 0000-0003-1319-4492 Simon Dymond Simon Dymond true false 2023-05-08 HPS Background: PTSD and gambling disorder (GD) are frequently comorbid. Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and GD outcomes, yet research into the potential effectiveness of ACT for PTSD and/GD in veterans is scarce. Objective: This review aimed to systematically assess and describe the evidence relating to the use of ACT and acceptance-based therapy for military populations with PTSD and/or GD. Method: Six databases were searched. Selection criteria included studies that featured the armed forces/military, delivered ACT/acceptance-based therapy, and aimed to improve PTSD and/or GD outcomes. A narrative synthesis approach was adopted. Results: From 1,117 results, 39 studies were fully screened and 14 met inclusion criteria. All studies originated from the USA and 9 were associated with United States Department of Veterans Affairs. Therapy use within each study produced an improvement in PTSD and/or GD, yet only one study examined GD and no studies considered comorbid PTSD/GD. The broad range of study designs made it difficult to compare the findings or make generalisations from the collective results. It is unclear which method of ACT delivery is superior (app-based, telehealth, face-to-face, groups, one-to-one, manualised, or unstructured), or what the true effect size is of ACT for PTSD and/or GD. Conclusions: These preliminary findings are promising, yet more research is needed on the delivery format and content of ACT sessions, and whether findings generalise beyond USA-recruited military samples. The cost-effectiveness of remote-based ACT also warrants investigation. Journal Article European Journal of Psychotraumatology 14 1 Informa UK Limited 2000-8066 Gambling disorder, PTSD, military, acceptance, therapy, ACT 24 2 2023 2023-02-24 10.1080/20008066.2023.2178203 http://dx.doi.org/10.1080/20008066.2023.2178203 COLLEGE NANME Psychology COLLEGE CODE HPS Swansea University SU College/Department paid the OA fee Research Wales Innovation Fund (RWIF) Collaboration Booster – External Engagement Fund. 2023-11-27T16:53:24.3775290 2023-05-08T21:40:06.1022911 Faculty of Medicine, Health and Life Sciences School of Psychology Cat Hitch 1 Daniel Leightley 0000-0001-9512-752x 2 Dominic Murphy 0000-0002-9530-2743 3 Nora Trompeter 0000-0001-5800-8679 4 Simon Dymond 0000-0003-1319-4492 5 63368__27354__1917b41288964f58b29f9476032391d0.pdf 63368.VOR.pdf 2023-05-08T21:52:46.0067018 Output 2392966 application/pdf Version of Record true © 2023 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. true eng http://creativecommons.org/licenses/by-nc/4.0/
title Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
spellingShingle Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
Cat Hitch
Simon Dymond
title_short Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
title_full Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
title_fullStr Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
title_full_unstemmed Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
title_sort Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
author_id_str_mv 8e2e86483241ae498d3a6c445736ca22
8ed0024546f2588fdb0073a7d6fbc075
author_id_fullname_str_mv 8e2e86483241ae498d3a6c445736ca22_***_Cat Hitch
8ed0024546f2588fdb0073a7d6fbc075_***_Simon Dymond
author Cat Hitch
Simon Dymond
author2 Cat Hitch
Daniel Leightley
Dominic Murphy
Nora Trompeter
Simon Dymond
format Journal article
container_title European Journal of Psychotraumatology
container_volume 14
container_issue 1
publishDate 2023
institution Swansea University
issn 2000-8066
doi_str_mv 10.1080/20008066.2023.2178203
publisher Informa UK Limited
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
url http://dx.doi.org/10.1080/20008066.2023.2178203
document_store_str 1
active_str 0
description Background: PTSD and gambling disorder (GD) are frequently comorbid. Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and GD outcomes, yet research into the potential effectiveness of ACT for PTSD and/GD in veterans is scarce. Objective: This review aimed to systematically assess and describe the evidence relating to the use of ACT and acceptance-based therapy for military populations with PTSD and/or GD. Method: Six databases were searched. Selection criteria included studies that featured the armed forces/military, delivered ACT/acceptance-based therapy, and aimed to improve PTSD and/or GD outcomes. A narrative synthesis approach was adopted. Results: From 1,117 results, 39 studies were fully screened and 14 met inclusion criteria. All studies originated from the USA and 9 were associated with United States Department of Veterans Affairs. Therapy use within each study produced an improvement in PTSD and/or GD, yet only one study examined GD and no studies considered comorbid PTSD/GD. The broad range of study designs made it difficult to compare the findings or make generalisations from the collective results. It is unclear which method of ACT delivery is superior (app-based, telehealth, face-to-face, groups, one-to-one, manualised, or unstructured), or what the true effect size is of ACT for PTSD and/or GD. Conclusions: These preliminary findings are promising, yet more research is needed on the delivery format and content of ACT sessions, and whether findings generalise beyond USA-recruited military samples. The cost-effectiveness of remote-based ACT also warrants investigation.
published_date 2023-02-24T16:53:25Z
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