Works in Progress

1. Works in Progress Tim and the Gambling Gang a.k.a. GAG (gambling addiction group) 12.2.04

2. UCLA Gambling Studies Program Program Building: Research Treatment Education / Prevention Policy Making Visibility

3. Our current Gambling Team • Alice Davis on Project Coordination • Candace Oto on Work Study • Richard Rosenthal on Ideas / Senior Leadership

4. Current climate • Few gambling treatment providers in LA • No state-funded treatment (coming soon) • No insurance reimbursement • Few gambling researchers out West • Gambling grows in CA - $10 bill/decade • Poker rising: fad with consequences • Many alarmists but small voices

5. Main research interests • Understanding what makes PG tick (why can’t they stop?) • Impulsivity • Stress • Psychological / Social Contributors • Developing a treatment system in CA that works • Understanding what PG does do the body and brain? • Medical , psychological consequences

6. Ongoing Studies Pre-pulse inhibition and pathological gambling N= 12 gamblers Prelim results = impaired acoustic startle (less PPI, suggesting altered dopamine processes) Recruiting matched controls Brian and Alice are working on it . .

7. Ongoing Studies • Delayed Discounting and Gamblers • N=12 gamblers • Within-subject effect of context showing more impulsivity in the casino vs. lab • Controls being recruited • POMS and VAS data to be analyzed

8. Ongoing Studies • Neuropsychological Performance of Gamblers • Same Gamblers as PPI • Prelim look shows impaired frontal lobe processing – reaction time, Trails • Matched controls coming. . .

9. Ongoing Studies • Topiramate in Pathological Gambling • Expected start date: Jan 2005 • N= 16, double –blind placebo controlled, 16 weeks • Sponsored by Ortho McNeil, multi-site. Non-competitive enrollment

10. Piggybacks to Topiramate • Health Status Questionnaire • Life stress measures • Cognitive Battery: Baseline, during and post trial

11. Pending Grants • Awaiting K award comments (submitted 6/04), for “Impulsivity and Pathological Gambling”. Round One • Awaiting NARSAD comments for “Depression and pathological gambling” • PNI Seed Grant: Gambling arm of Tom and Rich’s Yohimbine Project

12. Grants In Preparation Institute for Research on Pathological Gambling and Related Disorders (Harvard) “The impact of chronic and acute stress on pathological gamblers” Due: Feb 2005

13. Specific Aims: I. To compare the number of chronic stressful life events between machine pathological gamblers, non-machine pathological gamblers and non-gambling controls. II. To evaluate the impact of chronic stress on machine pathological gamblers, non-machine pathological gamblers and non-gambling controls through assessments of psychological distress, psychological coping strategies to stress, perceived responses to stress and measurements of health status III. To demonstrate the differential objective and subjective responses to stress between machine pathological gamblers, non-machine pathological gamblers and non-gambling controls on an acute, experimental stressor (a public speaking task).

14. Methods

15. Grants In Preparation • Anxiety Disorders Association of America • Junior Faculty Research Award • “Impact of Stress Between OCD and PG” Main idea: Are OCD and PG the same animal? How do they respond to stress?

16. Specific Aims 1. To characterize the neurophysiological and neuropsychological responses of patients with obsessive-compulsive disorder (OCD) to an acute stressor task. We hypothesize that subjects with OCD will demonstrate an amplified stress response as compared to control subjects without OCD. 2. To differentiate neurophysiological and neuropsychological responses to an acute stressor task between subjects with pathological gambling and subjects with obsessive-compulsive disorder We hypothesize that pathological gamblers will respond similarly to obsessive-compulsive disordered subjects in some but not all of the stress response measurements. 3. To examine which subtypes of pathological gamblers, specifically machine gamblers versus non-machine gamblers, demonstrate similar characteristics to patients with obsessive-compulsive disorder. We hypothesize that machine gamblers will more closely obsessive-compulsive disorder than non-machine gamblers in terms of personality features, cognitions and symptomatology.

17. Methods

18. Grants To Consider American Psychiatric Foundation education/media project? SAMHSA partnering with MATRIX on college prevention Alcohol Beverage Medical Foundation “Alcohol and PG” examine mechanisms of how alcohol affects impulsivity or gambling

19. Grants to consider • R21 • Collaborations with Monterosso/London on imaging and using stop-signal task? • Conference Grants • On “impulsivity” and “risk-taking behaviors”

20. Recent Publications Situational Needs Assessment of Problem Gambling Services in California. Prepared for California Department of Alcohol and Drug Programs. November 2004 The etiology of pathological gambling. Ready for launch Topiramate and compulsive sex. Submitted.

21. Ongoing Manuscripts • Biopsychosocial Consequences of PG (invited) • Review of Outcome Instruments of PG • Olanzapine and PG • Motivations and Expectations of PG • Screening for PG in SUD Research (commentatry)

22. Political Networking State Office of Problem Gambling (DADP) Future RFPs: prevention/treatment. Courts: Gambling Courts? Insurance Commissioner

23. Political Networking Casino Industry Card Clubs Self-Exclusion Project: On-line but not action Native Americans How do we make then an offer that they cannot refuse?

24. Political Networking • Asian Coalition • Grass-roots organization • Churches, lawmakers, asian substance abuse providers, families, interested civilians