Effects of a depression-focused internet intervention in slot machine gamblers: a randomized controlled trial
Open accessAbstract
BACKGROUND: Problematic and pathological gambling have been linked to depression. Despite a high demand for treatment and negative financial consequences, only a small fraction of problematic and pathological gamblers seek professional help. The existing treatment gap could be narrowed by providing low-threshold, anonymous internet-based interventions. The aim of the present study was to examine the acceptance and efficacy of an online-intervention for depression ("Deprexis") in a sample of problematic and pathological slot-machine gamblers. We hypothesized that the intervention group would show a greater reduction in both depressive and gambling-related symptoms compared to a wait-list control group. METHOD: A total of 140 individuals with self-reported gambling and mood problems were randomly allocated either to the intervention group or to a wait-list control group. After 8 weeks, all participants were invited for re-assessment. The Patient Health Questionnaire - 9 (PHQ-9) served as the primary outcome assessment. Problematic gambling was measured with the Pathological Gambling Adaptation of Yale-Brown Obsessive Compulsive Scale (PG-YBOCS) and the South Oaks Gambling Screen (SOGS). The trial is registered with the German Registry for Clinical Studies (DRKS00013888). RESULTS: ITT analyses showed that the intervention led to a significant reduction in depressive symptoms as well as gambling-related symptoms compared to the control group, with moderate to strong effect sizes. PP analyses failed to yield significant results due to high rates of non-completion and limited statistical power. Moderator analyses indicated that Deprexis was particularly beneficial in reducing problematic gambling for those scoring high on baseline gambling-related symptoms and for those who gamble due to loneliness. DISCUSSION: Results of the present study suggest that Deprexis might be a useful adjunct to traditional interventions for the treatment of problematic gambling. The potential of internet-based interventions that are more targeted at issues specific to gambling should be evaluated in future studies. TRIAL REGISTRATION: German Registry for Clinical Studies DRKS00013888.
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Bücker et al. (2018) found significant reductions in depressive and gambling-related symptoms, with moderate to strong effect sizes, using an intervention based on CBT, acceptance, mindfulness, and positive psychology techniques.
“Bücker et al. (2018) designed an intervention based on CBT, acceptance, mindfulness, and positive psychology techniques, and they found significant reductions in depressive and gambling-related symptoms, with moderate to strong effect sizes.”
From Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial (2021) · cites this paper as Bücker et al. (2018)
The Methods (Intervention) describe Deprexis as combining CBT-based content with acceptance, mindfulness, and positive psychology techniques. The Abstract (Results) reports significant reductions in depressive and gambling-related symptoms with moderate to strong effect sizes in intention-to-treat analyses. But the paper describes Deprexis as an existing program used in this trial, not an intervention Bücker et al. designed. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA German two-arm RCT of Deprexis found significant reductions in depressive and gambling symptoms with moderate to large effects.
“Significant reductions were found in depressive and gambling symptoms, with moderate to large effects (Bücker et al., 2018).”
From Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial (2021) · cites this paper as Bücker et al., 2018
Problematic attrition rates in RCTs of online interventions for gambling disorders vary from 6% to 65% in the first follow-up assessment (between 6 and 12 weeks).
“However, it is important to consider the problematic attrition rates in RCTs of online interventions for gambling disorders, which vary from 6% to 65% in the first follow-up assessment (between 6 and 12 weeks) (Bücker et al., 2018; Carlbring and Smith, 2008; Casey et al., 2017; Cunningham et al., 2009; Hodgins et al., 2019; Magnusson et al., 2019).”
From Efficacy of an internet-based psychological intervention for problem gambling and gambling disorder: Study protocol for a randomized controlled trial (2021) · cites this paper as Bücker et al., 2018
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- Authors
- Bücker, L., Bierbrodt, J., Hand, I., Wittekind, C., & Moritz, S.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Corresponding author
- Bücker, Lara
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-06-08
- Volume
- 13
- Issue
- 6
- Pages
- e0198859
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5993308
- OpenAlex
- W2807136791
- Cited by
- 50
- References
- 84
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 9 · 2018: 3
- FWCI
- 7.91
- Type
- journal article
- Language
- en
- Update notices
- correction (2018-08-23)
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- online intervention, depression, gambling addiction, problem gambling, slot machine gambling, Deprexis, online therapy, loneliness, treatment gap, PHQ-9, South Oaks Gambling Screen
- MeSH terms
- Adult, Depression, Female, Gambling, Humans, Male, Middle Aged, Psychotherapy, Treatment Outcome, Telemedicine, Internet, Young Adult, Self Report
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