COPING IN THOSE WITH PATHOLOGICAL-GAMBLING PARTNERS

有病态赌博伙伴的人通常会经历高度的抑郁和其他心理困扰。越来越多的人从家庭压力和应对理论的角度来看待这种痛苦。换句话说，个人的情绪和身体问题是他或她在应对伴侣赌博造成的破坏时受挫的结果。然而，对这一人群的应对努力还没有进行系统的评估。此外，针对病态赌博伙伴的个人治疗方案的内容缺乏强有力的经验基础。这个测量和治疗发展项目通过(a)系统地开发赌徒情况量表（GSI）来解决这些方法上的问题，GSI是一种对病态赌博伙伴的个体应对技能的角色扮演测量，以及(b)使用临床相关的量表内容，为这一人群设计和试点测试应对技能培训计划。该项目分三期完成。在第一阶段，开发了一组具有代表性的赌博相关问题的情况。然后将内容区域内的情况分配到平行形式，并系统地制定认知和行为反应评分标准。在第二阶段，GSI的心理测量特性在治疗人群和非治疗人群中有病态赌博伙伴的个体中进行评估。这些心理测量属性包括：(a) GSI的概率性分析，对人、情境、形式和评分者的方差成分进行估计；(b)备选形式可靠性分析；(c)重测信度分析；(d) GSI在实际赌博相关应对、个人功能和赌徒功能方面的同时有效性分析。在第三阶段，为有病态赌博伙伴的个人制定应对技能培训计划，并进行试点测试。该计划的内容将基于第一阶段制定的材料和反应标准。在该试点中，受试者被随机分配到应对技能培训或等候名单控制条件。培训计划的效果是根据受试者应对技能的变化（使用替代GSI表格）以及受试者和赌徒的功能来评估的。GSI的发展和基于GSI的培训计划的试点将填补赌博治疗文献中的严重空白，并作为建立未来临床试验的坚实基础，评估面对伴侣病态赌博的个人的技能培训计划。

Individuals with pathological-gambling partners often experience a high degree of depression and other psychological distress. Increasingly this distress has been viewed from within family stress and coping theory. In other words, the emotional and physical problems of the individual are the result of his or her frustrated efforts to cope with disruption caused by the partner's gambling. Systematic assessment of coping efforts in this population, however, have not occurred. Also, the content of treatment programs for individuals with pathological-gambling partners have lacked a strong empirical base. This measurement and therapy development project addresses these methodological problems by (a) systematically developing the Gambler Situation Inventory (GSI), a role-play measure of coping skills in individuals with pathological-gambling partners, and (b), using clinically-relevant inventory content, designing and pilot-testing a coping skills training program for this population. The project is completed in three phases. In Phase I, a pool of representative gambling-related problem situations experienced by this population is developed. Situations within content area then are assigned to parallel forms, and cognitive and behavioral response scoring criteria systematically developed. In Phase II, the psychometric properties of the GSI are evaluated in individuals with pathological-gambling partners from treatment and nontreatment populations. These psychometric properties include: (a) generalizability analyses of the GSI with estimation of variance components for persons, situations, forms, and raters; (b) analysis of alternate form reliability; (c) analysis of test-retest reliability; and (d) analysis of concurrent validity of the GSI with respect to actual gambling-related coping, individual functioning, and the gambler's functioning. In Phase III, a coping skills training program for individuals with pathological-gambling partners is developed and pilot-tested. The content of this program will be based on material and response criteria developed during Phase I. In this pilot, subjects are randomly assigned to either a coping skills training or wait-list control condition. The effect of the training program is assessed with respect to changes in subject coping skills (using alternate GSI forms), and subject and gambler functioning. GSI development and piloting of the GSI-based training program will fill a serious void in the gambling treatment literature, and serve as a strong foundation upon which to build future clinical trials evaluating skill training programs for individuals confronted with a partner's pathological gambling.