Suicide Ideation and Behaviour in People with Pathological Gambling Attending a Treatment Service
This study aimed to describe the 12-month period prevalence and risk factors for suicidal ideation and behaviour in a cohort of patients with pathological gambling attending a treatment service. Seventy-nine people with a diagnosis of pathological gambling received a mail out survey that included questions on postulated risk factors for suicidal ideation and behaviour, the modified Suicide Ideation Scale (SIS), the South Oaks Gambling Screen (SOGS), the Beck Depression Inventory (BDI) and the CAGE. A total of 54.4% of the surveys were returned completed. There were 81.4% who showed some suicidal ideation and 30.2% reported one or more suicide attempts in the preceding 12 months. Suicidal ideation and behaviours were positively correlated with the gambling severity (SOGS scores), the presence of debt attributed to gambling, alcohol dependence and depression (BDI). Suicidal ideation/behaviour was not significantly associated with gender and living arrangements, nor a history of receiving treatment for depression during the preceding 12 months. People with pathological gambling attending a treatment service had higher levels of suicidal ideation and behaviour than previous studies. Pathological gambling should be seen as a chronic condition with a similar risk for suicidal ideation and behaviour as other mental illnesses. Counselling services, general practitioners and mental health services should screen for gambling problems when assessing risk after suicide attempts and for suicide risk in patients presenting with gambling problems and co-morbid depression, alcohol abuse and a previous suicide attempt.
Staff's Perceptions of Obstacles to Quality Management Systems in High- and Low-Performing Hospitals, Jordan
Implementing a Quality Management System (QMS) is important in order for hospitals to deliver high-quality services. Hospitals in Jordan vary greatly in terms of the quality of their services, with some providing high-quality services and others providing low-quality services. This study aimed to explore QMS obstacles in high- and low-performing hospitals in Jordan using the framework of systems and organizational theories. The study employed a Mixed Method-Sequential Exploratory design. In this sequential explanatory design, data collection utilised the strengths of both quantitative and qualitative methods (i.e. mixed method). A set of questionnaire (yielding quantitative data) was used to explore the QMS obstacles and then interviews (yielding qualitative data) were conducted to identify ways to address these obstacles.
The Effectiveness of Gambling Exclusion Programs in Queensland
This study assessed the effectiveness of Queensland gambling exclusion programs as a mechanism to minimise gambling-related harm, whether these effects are sustained over time and whether self exclusion is more effective when combined with counselling and support. Research methods comprised a literature review, desktop review of Australian and international exclusion programs, interviews with peak gambling industry associations, interviews with 18 Queensland Gambling Help counsellors, and interviews and surveys with 103 problem gamblers at three assessment periods approximately six months apart. In contrast to recent international trends, Australian self-exclusion programs including those in Queensland are typically venue-administered, require on-site exclusion from individual venues, do not enable exclusion from multiple venues in one application, rely on photographs for detection, impose penalties for excluders for breaches and for venues that fail to detect breaches, and provide comparatively minimal connections to counselling.
Cognitive-Behaviour Therapy for problem gamblers: characteristics of treatment completer's and non-completer's
Gambling before CBT: • Freud - gamblers were trying to punish themselves for their unresolved oedipal urges and that this meant they were deliberately trying to lose • Bergler - "...the gambler is not a weak person who wants to gain money [easily] ...but a neurotic with an unconscious wish to lose" Cognitive-Behavioural Theories (CBT) of gambling: • A number CBT models have been described - e.g., Petry, 2005; Sylvain, et al., 1997; Toneatto, 2002 - no single unified approach has been tested and the efficacy of CT continues to be debated • Sharpe and Tarrier (1993)--CBT model - incorporating relaxation, exposure and cognitive restructuring - while cited frequently - reservations must exist lack of empiricism - generalisation to all gambling problems is limited