![]() The Yale Center has also investigated gender-related differences in gambling behaviors and disorders. Yale Medicine research has made advances in understanding the effects of such opioid antagonist medications. These have found that the brain acts similarly during monetary reward processing in individuals with gambling disorder as it does in people with binge-eating, alcohol-use and tobacco-use disorders. The Center, directed by Yale Medicine psychiatrist Marc Potenza, MD, PhD, has conducted the first brain imaging studies on people with gambling problems. Yale’s Center of Excellence in Gambling Research, one of two such centers in the nation, is supported by the National Center for Responsible Gaming and conducts groundbreaking research into gambling disorder. Some people with gambling disorder find help with such groups as Gamblers Anonymous, a 12-step program dedicated to abstinence. Participants meet and share experiences, supporting each other in their efforts to abstain from gambling. However, most medication trials have been relatively short-term and have involved small sample sizes. The antidepressant escitalopram may help decrease anxiety and problem-gambling severity in people with co-occurring anxiety and gambling disorders. Certain opioid antagonists, which may reduce cravings for alcohol, have been found in randomized clinical trials to be superior to placebo in the treatment of gambling disorders. There are multiple potential pharmaceutical approaches to treatment, although no medication has an FDA indication for gambling disorder. Another method is motivational interviewing, which helps to turn ambivalence about quitting into motivation to quit and can help patients combat urges to gamble. Individual and group approaches such as cognitive behavioral therapy, which helps to identify and modify damaging thinking and behavior, can help people overcome the problem. There are three main forms of interventions:
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