A systematic review and meta-analysis by Maynard et al. (2018) «Maynard BR, Wilson AN, Labuzienski E ym. Mindfulne...»1 examined the effects of mindfulness-based interventions on gambling behavior and symptoms, urges, and financial outcomes.

The included studies assessed the effects of mindfulness-based interventions in the treatment of adults with disordered gambling. Thirteen studies between 1980 and 2014 met criteria for the review and seven met criteria for meta-analysis. 7 RCTs, 6 other (single-group pre–posttest design; quasi-experimental design; single-subject design; multiple baseline across participants). Control groups included a wait-list control, group CBT, TAU, GA, imaginal relaxation and aversive therapy. Participants included a total of 463 gamblers. Most studies included either pathological gamblers (69%) or problematic gamblers (23%), with only one study including both pathological and problem gamblers. A larger proportion of RCT studies included in the meta-analyses (86%) included pathological gamblers compared to other study designs (50%).

Effects were moderate to large for gambling behaviors/symptoms (g = 0.68, 95% CI = [0.39, 0.98], p < .01), gambling urges (g = 0.69, 95% CI = [0.18, 1.20], p < .01), and financial outcomes (g = 0.75, 95% CI = [0.24, 1.26], p < .01). Heterogeneity was low and nonsignificant.

It is important to note that when study findings were examined individually, effects of several interventions were not significantly different from zero. When combined, however, the pooled effect size was significant. Given the small sample sizes within each study, it is possible that primary studies failed to demonstrate significant effects because they were underpowered.

The findings provide support for mindfulness-based interventions in the treatment of disordered gambling. However, these results are necessarily tentative, limited by the number and quality of eligible studies, and differing conceptualizations of mindfulness.

• Quality of study: high
• Appliccability: Patients in Finland may differ from patients included in international studies.
• Comment: For the purposes of this study, mindfulness-based interventions included methods where participants were encouraged to focus their attention either on covert activity (e.g., thoughts, feelings, and urges) or on overt activity (e.g., lights, sounds, and smells) as a primary or adjunctive intervention. Mindfulness-based interventions included present-moment work, meditation, relaxation skills (including muscle relaxation procedures), breathing techniques, and awareness of moment techniques delivered in vivo, via formal meditation practices or informal mindfulness exercises, mindfulness-based stress reduction (MBSR), MBCT, DBT, ACT, and ID. ID was included given similarities to mindfulness-based procedures (e.g., visualizing exposure to gambling-related activities, muscle relaxation, and present-moment focus on in vivo experiences of gambling activities).