{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:08:40Z","timestamp":1786975720050,"version":"build-2736575974"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Most individuals with problem gambling or gambling disorder remain untreated due to barriers to treatment. Limited research exists on alternative treatments.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the efficacy of a self-guided internet-based intervention for individuals with gambling problems and to identify potential outcome moderators.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n This single-center randomized clinical trial was conducted from July 13, 2021, to December 31, 2022, at the University Medical Center Hamburg-Eppendorf. Participants were recruited across Germany for 2 assessments (before intervention [t\n 0<\/jats:sub>\n ] and 6 weeks after intervention [t\n 1<\/jats:sub>\n ]). Eligible participants were individuals aged 18 to 75 years with gambling problems, internet access, German proficiency, and willingness to participate in 2 online assessments.\n <\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The self-guided internet-based intervention was based on cognitive behavioral therapy, metacognitive training, acceptance and commitment therapy, and motivational interviewing.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n The primary outcome was change in gambling-related thoughts and behavior as measured with the pathological gambling adaption of the Yale-Brown Obsessive-Compulsive Scale. Secondary outcomes were change in depressive symptoms, gambling severity, gambling-specific dysfunctional thoughts, attitudes toward online interventions, treatment expectations, and patient satisfaction.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 243 participants (154 [63.4%] male; mean [SD] age, 34.73 [10.33] years) were randomized to an intervention group (n\u2009=\u2009119) that gained access to a self-guided internet-based intervention during 6 weeks or a wait-listed control group (n\u2009=\u2009124). Completion at t\n 1<\/jats:sub>\n was high (191 [78.6%]). Results showed a significantly greater reduction in gambling-related thoughts and behavior (mean difference, \u22123.35; 95% CI, \u22124.79 to \u22121.91;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001; Cohen\n d<\/jats:italic>\n \u2009=\u20090.59), depressive symptoms (mean difference, \u22121.05; 95% CI, \u22121.87 to \u22120.22;\n P<\/jats:italic>\n \u2009=\u2009.01; Cohen\n d<\/jats:italic>\n \u2009=\u20090.33), and gambling severity (mean difference, \u22121.46; 95% CI, \u22122.37 to \u22120.54;\n P<\/jats:italic>\n \u2009=\u2009.002; Cohen\n d<\/jats:italic>\n \u2009=\u20090.40) but not in gambling-specific dysfunctional thoughts (mean difference, \u22121.62; 95% CI, \u22123.40 to 0.15;\n P<\/jats:italic>\n \u2009=\u2009.07; Cohen\n d<\/jats:italic>\n \u2009=\u20090.23) favoring the intervention group. Individuals in the intervention group who had a positive treatment expectation and more severe gambling-specific dysfunctional thoughts and gambling symptoms benefited more on the primary outcome relative to the control group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, the effectiveness of a self-guided internet-based intervention for individuals with self-reported problematic gambling behavior was demonstrated when measured 6 weeks after start of the intervention. The study\u2019s findings are particularly relevant given the increasing need for accessible and scalable solutions to address problematic gambling.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n bfarm.de Identifier:\n DRKS00024840<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.17282","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T11:33:58Z","timestamp":1718969638000},"page":"e2417282","source":"Crossref","is-referenced-by-count":8,"title":["A Self-Guided Internet-Based Intervention for the Reduction of Gambling Symptoms"],"prefix":"10.1001","volume":"7","author":[{"given":"Lara","family":"Rolvien","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Buddeberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefine","family":"Gehlenborg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swantje","family":"Borsutzky","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Moritz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"issue":"2","key":"zoi240567r1","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1007\/s10899-013-9370-0","article-title":"An overview of and rationale for changes proposed for pathological gambling in DSM-5.","volume":"30","author":"Petry","year":"2014","journal-title":"J Gambl Stud"},{"issue":"1","key":"zoi240567r2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1038\/s41572-019-0099-7","article-title":"Gambling disorder.","volume":"5","author":"Potenza","year":"2019","journal-title":"Nat Rev Dis Primers"},{"issue":"5","key":"zoi240567r3","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1375\/twin.12.5.425","article-title":"Sex differences in the rates of recovery, treatment-seeking, and natural recovery in pathological gambling: results from an Australian community-based twin survey.","volume":"12","author":"Slutske","year":"2009","journal-title":"Twin Res Hum Genet"},{"issue":"2","key":"zoi240567r4","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1007\/s10899-016-9655-1","article-title":"Barriers in access to the treatment for people with gambling disorders. 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