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Recent technological advances allow precise and safe radiation delivery in hepatocellular carcinoma. Stereotactic body radiotherapy is a conformal external beam radiation technique that uses a small number of relatively large fractions to deliver potent doses of radiation therapy to extracranial sites. It requires stringent breathing motion control and image guidance. Selective internal radiotherapy or radioembolization refers to the injection of radioisotopes, usually delivered to liver tumors via the hepatic artery. Clinical results for both treatments show that excellent local control is possible with acceptable toxicity. Most appropriate patient populations and when which type of radiation therapy should be best employed in the vast therapeutic armamentarium of hepatocellular carcinoma are still to be clarified.

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Twenty-nine patients with obsessive-compulsive disorder as diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) who did not have overt compulsive rituals were randomly assigned to treatment and waiting-list conditions. Patients in the treatment condition received cognitive-behavioral therapy consisting of a detailed explanation of the occurrence and maintenance of obsessive thoughts, exposure to obsessive thoughts, response prevention of all neutralizing strategies, cognitive restructuring, and relapse prevention. Compared with waiting-list patients, treated patients improved significantly on measures of severity of obsessions, current functioning, self-report obsessive-compulsive symptoms, and anxiety. When waiting-list patients were subsequently treated, the combined group improved on all outcome measures. Treatment gains were maintained at 6-month follow-up. Results indicate that cognitive-behavioral therapy is effective in the treatment of patients with obsessive thoughts, a group that has often been considered resistant to treatment.

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The efficacy of a behavioral treatment for pathological gamblers, including cognitive interventions, problem solving and relapse prevention is examined. Three pathological gamblers meeting DSM-III-R criteria were studied in an experimental multiple baseline design. By the end of treatment the subjects ceased all gambling behaviors, increased their perception of self-control of gambling, and evaluated their problems as less severe. Therapeutic gains were maintained at 6- and 9-month follow-ups. The importance of problem solving and the modification of erroneous perceptions in treatment programs for pathological gambling is discussed.

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The prevalence of pathological gambling and problems associated with it were measured among 1,471 students of three colleges in the Quebec city metropolitan area. Almost 90% of the students had gambled and 21.7% of the students engage in this behaviour once a week or more. The prevalence of pathological gamblers was found to be 2.8% for the entire sample. The percentage of pathological gamblers was much higher among males (5.7%) than females (0.6%). The results indicate that pathological gambling is associated with economic, professional and interpersonal problems. The discussion addresses the implications of the present findings and suggests avenues for future research.

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This study identifies the gambling behavior of 1,320 primary school students aged 8 to 12 of the 4th, 5th and 6th grades. Eighty-six percent admitted to having, at some time or another, bet money. Lotteries are the most popular form of gambling for this age group. Sixty-one percent of these students gamble with lotteries. In descending order of popularity, other games played by students were: bingo, card-playing for money, bets on sports, wagering on specific events, video gambling (video poker and slot machines), and finally betting on games of skill. Gambling behaviors differed according to gender. More than 40% of respondents reported gambling once a week or more for at least one game. Because of the early development of gambling behavior in children, prevention programs for pathological gambling should be implemented as early as the fourth grade.

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This study compared the cognitive and behavioral components of videopoker players under laboratory and natural settings. Twenty regular gamblers (19 men and 1 woman) were matched into two groups on age and on frequency of gambling. Irrational verbalizations during gambling, monetary risk (number of bets doubled and number of tokens bet), and motivation served as dependent variables. Results showed no significant differences between laboratory and natural settings for the number of inadequate verbalizations, bets doubled, and motivation. The amount of money gambled was greater in the laboratory than in the natural setting. The practical and theoretical implications of these results are discussed according to the ecological validity of gambling studies conducted in laboratory settings.