Objective:to examine short and middle-term effectiveness of a group cognitive-behavioral intervention (CBT) in pathological gambling (PG) and to analyze predictors of therapy outcome.Method:Two hundred and ninety PG patients consecutively admitted to our Unit participated in the current study. All participants were diagnosed according to DSM-IV-criteria. Manualized outpatient group CBT [16 weekly sessions] was given. Specific assessment before and after the therapy and at 1, 3 and 6 months follow-up was conducted. Logistic regression analyses and survival analysis were applied.Results:outpatient group CBT was effective with abstinence rates by the end of therapy of 76.1%, and 81.5% at 6 months follow-up. The dropout rate during treatment decreased significantly after the fifth treatment session. Psychopathological distress (p = 0.040) and obsessive-compulsive symptoms were identified as factors predicting relapses and drop-outs respectively.Conclusions:our findings suggest that group CBT is effective for treating PG individuals. Several psychopathological and personality traits were identified as outcome predictors.

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ResumenEl universo oncológico, aparentemente, constituye un ámbito de profundos consensos; aliviar el sufrimiento de pacientes y familias, la búsqueda de una cura efectiva o erradicar el estigma asociado al diagnóstico son objetivos que generan un amplio acuerdo social. Desde una perspectiva cultural, sin embargo, se constata la presencia de ciertas áreas de tensión y disidencia en torno al cáncer. En este artículo, aplicando conceptos analíticos de Gramsci y Foucault, se define en forma de decálogo lugares comunes que como el pensamiento positivo, la feminidad, la prevención o el espíritu de lucha conforman una cultura hegemónica en cáncer de mama enfrentada a los discursos de culturas subalternas como la feminista o ambientalista. Frente a la idea de unidad y consenso, el análisis de la literatura antropológica proporciona una imagen compleja donde la vivencia del cáncer, resignificando la enfermedad como un espacio de conflicto ideológico, es construida en términos de lucha de intereses y proyectos de control social.Palabras clave: Antropología médica, cán-cer de mama, cultura hegemónica, movimientos sociales, identidad de superviviente. AbstractThe oncology universe apparently is an area of deep consensus; alleviate the suffering of patients and families, the search for an effective cure or eradicate the stigma associated with the diagnosis are objectives that generate broad societal agreement. From a cultural perspective, however, we note the presence of certain areas of tension and dissent around the cancer. In this paper, applying analytical concepts of Gramsci and Foucault, as defined Decalogue common places like positive thinking, femininity, preventing or fighting spirit form a hegemonic culture in facing breast cancer cultures speeches subaltern as feminist or environmentalist. Faced with the idea of unity and consensus, the analysis of the anthropological literature provides a complex picture where the cancer experience resignifying disease as a space of ideological conflict, is constructed in terms of conflict of interests and projects of social control.

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