The Wiley-Blackwell Handbook of Disordered Gambling E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1053

Veröffentlichungsjahr: 2013

Beschreibung

The Wiley-Blackwell Handbook of Disordered Gambling is a complete guide to the current empirical literature relating to the conceptualization, assessment, and treatment of disordered gambling. The international contributors are all experienced, practicing clinicians who discuss gambling within a global context. * Best-practice guidelines for the clinical management of problem and disordered gambling * Contains empirically derived findings that translate research into practical clinical applications that clinicians and counselors can use in understanding and treating problem gamblers * Brings together a distinguished international group of scholars whose contributions discuss gambling as it occurs around the globe * Clearly organized into sections that cover conceptualization, research, assessment, treatment, and special topics

Leseprobe

Contents

Cover

Title Page

Copyright

Editors' Foreword

Foreword

Shifting Ideas Have Encouraged the Emergence of Gambling Ghosts, Shadows, and Taxonomies

Youthful Fields of Inquiry

Toward an Epidemiological Dynamics of Gambling

Measuring Taxonomies: Creating Gambling Ghosts and Shadows

Toward a More Mature Gambling Field: Developing Gambling Ghosts, Shadows, and Taxonomies

References

Contributors

Chapter 1: The Conceptualization and Diagnosis of Disordered Gambling

Introduction

Who is a disordered gambler?

Diagnosis

Epidemiology

The DSM-5 Conceptualization: Why An Addiction Model Prevailed

Looking ahead

References

Chapter 2: Epidemiology

Introduction

Defining Our Terms

Measuring Problem and Disordered Gambling

The Prevalence of Problem and Disordered Gambling

Changes in Problem Gambling Prevalence Over Time

Where Will Prevalence Rates Go From Here?

Patterned Inequality in Problem Gambling

The Emergence of Online Gambling

Issues in Conducting Epidemiological Research on Problem and Disordered Gambling

Conclusion

References

Glossary

Chapter 3: Contributions from Neuroscience and Neuropsychology

Introduction

Methods in neuroscientific studies in disordered gambling

What is going on in your brain when you gamble?

Motivational functions

Reward sensitivity, punishment sensitivity and decision-making

Cognitive functions

Methodological issues and future directions

References

Chapter 4: Behavioral Risk Factors in Disordered Gambling and Treatment Implications

Introduction: Disordered gambling as a behavioral disorder

Part A Behavioral and situational triggers and maintenance factors

Part B: Addressing behavioral factors in interventions

References

Chapter 5: Dopamine and Learning

Introduction

Schedules of Reinforcement

Schedules of reinforcement and gambling cognitions

Dopamine

Summary

References

Chapter 6: Disordered Gambling and Personality Traits

Introduction

Conceptualizing Personality

Relationships between Affective Traits and Disordered Gambling: Toward a Model of Personality Mechanisms

Personality Heterogeneity among Disordered Gamblers

Directions for Future Research on Personality and Disordered Gambling

Summary

References

Chapter 7: Case Conceptualization with Clients Presenting with Disordered Gambling

Integrative Disordered Gambling Case Conceptualization (IDGCC) – Definition

Key Features

Case Example

Summary and Conclusions

References

Chapter 8: A Review of Problem Gambling Assessment Instruments and Brief Screens

Introduction

Instruments

Gambling Behavior Interview (GBI)

Brief PG Screens

Conclusions and Future Research Directions

References

Chapter 9: Cognitive-Behavioral Therapy

Mechanisms of change in cognitive therapy

Treatment clientele: A heterogeneous population

Assessing clients for cognitive-behavioral interventions

The Pathways Model of Gambling: Identifying subtypes

Conclusions

References

Chapter 10: The Cognitive-Behavioral Treatment of Female Problem Gambling

Explanations for female problem gambling

Gender differences in problem gambling

The gender-as-proxy hypothesis

Gender differences in recovery and treatment

A cognitive-behavioral treatment program for female problem gambling

Case study

Treatment implications of gender differences

References

Chapter 11: Understanding Gamblers Anonymous – A Practitioner's Guide

Mutual Aid in a Broad Context

An Overview of GA – Designed by and for gamblers

A Flexible Approach to the twelve steps – Tailor-made for gamblers

GA’s reliance on spousal support – well ahead of its time

Concluding Remarks

References

Appendix

Chapter 12: The CARE Model

What Has Been Done to Reduce Harm and By Whom?

The CARE Model: Facilitating coordination through RGICs

Potential Implementation Barriers: Road Bumps and Possible Solutions

Conclusion

References

Chapter 13: Predictors of Treatment Outcome in Disordered Gambling

Individual predictors of treatment outcome

Social and Environmental Predictors of Treatment Outcome

Treatment-Related Predictors of Treatment Outcome

Conclusions and Future Directions

References

Chapter 14: Gambling Among Teens, College Students and Youth

Introduction

The changing face of gambling

Prevalence of youth gambling

Adolescent gambling involvement

College student and young adult involvement

Problem gambling in adolescents, college students, and young adults

Measuring problem gambling

Correlates and risk factors associated with problem gambling: Our current knowledge

Biological and physiological factors

Academic, behavioral, cognitive, mental health and personality factors

Factors related to initiation and progression of gambling involvement

Familial factors

Cultural factors

Protective factors

New gambling opportunities, new policy challenges

The prevention of gambling addictions

References

Chapter 15: The Technological Convergence of Gambling and Gaming Practices

Gambling and video gaming

Gambling and social networking

Gambling and mobile phones

Gambling and interactive television games

Conclusions

References

Chapter 16: Gambling and Older Adults

Introduction

Prevalence and Profile

Gambling Preferences and Motivations

Etiology

Physical, Mental Health and Addictive Disorders

Treatment

Conclusion

References

Chapter 17: Internet Gaming and Disordered Gambling

Introduction

Types of Internet gambling

Characteristics of Internet gamblers

Internet gambling and problem gambling

Problems relevant to Internet gambling

Factors to consider in case formulation and treatment plan

Self-management strategies to stabilize gambling

Psychoeducation

Limiting Internet gambling

Internet-based treatment options

Conclusions

References

Chapter 18: Legal and Financial Issues and Disordered Gambling

Gambling and Crime

Gamblers and Crime

Gambling-Related Legal Defenses

Debt and Bankruptcy

Conclusion

References

Chapter 19: Effects of Nutrition on Mental Health Conditions Associated with a Gambling Disorder

The Nutritional Hypothesis, Psychopathology, and Disordered Gambling

References

Chapter 20: Research Directions and Unanswered Questions in the Treatment of Disordered Gambling

Introduction

Procedure

Participant Recruitment and Demographics

Survey Procedure

Findings

Improving Treatment Attendance and Service Utilization

Developing Manualized Treatments and Brief Interventions

Addressing Comorbidity

Family and Couples Counseling

Self-Help Groups

Telephone and Hotline Service

Natural Recovery

Summary

Acknowledgements

References

Index

This edition first published 2014 © 2014 John Wiley & Sons, Ltd

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Library of Congress Cataloging-in-Publication Data

The Wiley-Blackwell handbook of disordered gambling / edited by David C. S. Richard, Alex Blaszczynski, Lia Nower.   pages cm  Includes bibliographical references and index.  ISBN 978-0-470-71071-5 (cloth) 1. Gambling–Psychological aspects. I. Richard, David C. S. II. Title: Handbook of disordered gambling.  HV6710.W55 2013  616.85′841–dc23

2013021884

A catalogue record for this book is available from the British Library.

Cover image: Craps table © Lise Gagne/iStock Cover design by Cyan Design

Editors' Foreword

The Wiley-Blackwell Handbook of Disordered Gambling was designed, first and foremost, with the reader in mind. Our intention was to develop an accessible overview of the extant research in disordered gambling with an eye toward offering a transformation of research findings into clinical practice for the practicing clinician and new students to the field. To that end, many of the chapters include material properly considered as introductory in order to establish a foundation for understanding of the more complex topics that follow.

The structure of the book is designed to help students in this regard. Richard and Humphrey provide a broad overview of the field in the first chapter and touch on many of the topics the reader will find later in the book. Their introduction is designed to assist the reader in understanding the scope of research in disordered gambling while also highlighting some of the more critical findings that shape our understanding of the population. Their chapter is followed by a series of chapters that touch on epidemiology, neuroscience, behavioral risk factors, brain–behavior relationships, and personality factors. Taken together, this first section provides a solid foundation for the reader in terms of understanding the hallmarks of disordered and problem gambling, as well as many of the current research debates.

The second section focuses on case conceptualization, assessment, and treatment. This section is avowedly clinical in its orientation and considers many of the best practices in the treatment of disordered gamblers. Cognitive-behavioral treatment is emphasized, given the weight of empirical evidence in its support, and its widespread application globally. However, group approaches (e.g., Gamblers Anonymous) are also reviewed at some length as well, given both the long history of this peer-counselling intervention and evidence that it represents an important adjunct to specialized professional mental health services targeting gamblers. Ledgerwood's chapter on predictors of treatment outcome in disordered gambling will be a welcome addition to any practicing clinician's library and rounds out the section. Although treatment is effective, predicting who will respond and to what extent is important in determining which clients should be monitored closely over time for clinicians keen on providing longer term support for disordered gamblers.

The final section expands the reader's sights on the diversity of the field and covers broad terrain: older adults, internet gambling, legal and financial issues, technological convergence, and even the effect of nutrition on symptoms associated with disordered gambling. The role of nutrition is rarely if ever considered in a clinical context but this chapter provides informative, innovative and challenging perspectives. Nower closes the book with a timely discussion of future research directions.

One last note. In the DSM-5, the American Psychiatric Association adopted a change in nomenclature when it abandoned the term “pathological gambling” in favor of “gambling disordered.” The diagnosis of pathological gambling included a facet that is no longer included in its successor – engaging in criminal activities in support of gambling. To reduce confusion, we refer to the disorder in most cases using the DSM-5 terminology as either disordered gambling or gambling disorder. However, the extant research largely utilizes prior diagnostic conceptualizations. The reader should simply keep this in mind.

Our hope is that the Handbook will become an accessible and useful reference for clinicians working with this population and students keen to gain a solid grasp over diverse aspects of the condition. As one might expect, disordered gamblers do not form the core of most clinicians' practices and do not seek treatment the way patients with an anxiety disorder or major depression might. In fact, many disordered gamblers enter treatment not for a gambling problem, but for some other reason (e.g., marital problems, substance abuse, bipolar disorder, and so forth). Even though the pace of research has quickened over the past 15 to 20 years, it remains a relatively underdeveloped field when compared to many other major psychiatric disorders that receive more attention from private and governmental funding agencies. We hope that the handbook will contribute to a greater understanding of this population.

David C. S. Richard, PhD Dean, Hamilton Holt SchoolProfessor of PsychologyRollins CollegeWinter Park, Florida

Alex Blaszczynski, PhD Editor, International Gambling StudiesDirector, Gambling Treatment Clinic & Research UnitHonorary Professor, School of PsychologyUniversity of Sydney

Lia Nower, JD, PhD Director, Center for Gambling StudiesSchool of Social WorkRutgers University

Foreword

Gambling Ghosts, Shadows, and Taxonomies

Howard J. Shaffer, phD1

Harvard Medical School; The Division on Addiction, The Cambridge Health Alliance2

When I received the manuscript for the Wiley-Blackwell Handbook of Disordered Gambling from David Richard, Alex Blaszczynski and Lia Nower, I initially wondered whether the field really needed another book about disordered gambling? I questioned whether there is a sufficient body of new science to warrant publishing another review of the gambling field. At first glance, I thought that we already had a well-established body of gambling-related knowledge. What could this book add? Then I recalled US President John F. Kennedy's commencement speech at Yale University during 1962, when he reminded the audience “The great enemy of the truth is very often not the lie – deliberate, contrived, and dishonest – but the myth – persistent, persuasive, and unrealistic.” The study and treatment of intemperate gambling is a fledgling field and many beliefs about gambling reflect persistent myths. Recently, people have started to confront early myths that shaped the field. For example, now it is common to find stakeholders that accept the research showing that gambling problems are not always progressive, people with gambling problems often recover without formal treatment, and exposure to gambling doesn't necessarily mean more gambling harms. Unfortunately, the rapidly growing body of research that surrounds this nascent field inadvertently implies that our collective understanding of gambling and excessive gambling is more mature than it really is. Taken together, these circumstances encourage more carefully constructed, thoughtful considerations of gambling and gambling-related problems. There is much to learn about gambling disorders, and Richard et al. have delivered a Handbook that represents an important step in that direction.

Shifting Ideas Have Encouraged the Emergence of Gambling Ghosts, Shadows, and Taxonomies

During my almost 40 years of studying and treating various patterns of excessive behavior, including gambling, interest in gambling research and treatment has shifted from a topic that attracted little interest to one that stimulates considerable scientific, clinical, and public policy debate. Years ago, there was little attention to the concept of disordered gambling and less concern about treating it, in part, because the public and professionals alike thought that gamblers were responsible for their own suffering. After all, people did not have to gamble; they wanted to gamble. Now, interest in intemperate gambling and explanations for this excessive pattern dot the public health and public policy radar screens. The volume of scientific and scholarly research has increased exponentially (Eber & Shaffer, 2000; Shaffer, Stanton, & Nelson, 2006). Gambling-specific treatment programs are emerging, and existing programs that concentrate on alcohol and other drug addiction services are beginning to integrate gambling-focused clinical activities into their assessment and treatment protocols. Public policies and industry regulations alike now require gambling proprietors to include responsible gambling programs as part of their industry at every level. What influenced this sea change?

A dramatic shift in our collective thinking about gambling and the causes of intemperate gambling transformed the gambling landscape. Now the minority of adults considers gambling as immoral. Instead, the majority accepts gambling as a recreational activity, and most stakeholders view disordered gambling as an adverse consequence that can emerge when vulnerable players become too involved with gambling at an unpropitious time. This new understanding has encouraged the growing financial and social support that scientists, regulators, and clinicians needed to study and manage gambling-related activities.

This conceptual shift from immorality to morbidity is no small matter. How we think about an issue determines what we will do about it. Ideas have consequences. For example, to classify gamblers, gambling, and gambling disorders, contemporary explanations for gambling morbidity infer the presence of latent variables (e.g., craving, addiction) from visible variables (e.g., self-report; gambling behavior). Observers think that these latent psychological forces guide the decisions of recreational gamblers as well as those who gamble too much. This invisible internal set of forces represents a psychological “ghost” or consciousness (e.g., Kipnis, 1997). Similarly, as interest in the social setting within which people gamble increased, stakeholders began to think that there also was a technological set of ghosts that influenced the extent of gambling. This growing interest in the games that people play has led to new ideas about the dangers associated with the technological “contingency ghosts” that direct how electronic devices deliver gambling opportunities and schedules of wins and losses. Some gambling observers tend to think that, like the taxonomies of human disorders, these technological ghosts also should be classified (e.g., keno is safer than slot machines).

As the moral model of gambling began to fade during the twentieth century, and gambling research began to bifurcate between gambling and gambling disorders, the idea of gambling-focused psychopathology as a driving force toward intemperance captured the imagination of clinicians and researchers alike. However, identifying this psychopathology proved a complex and difficult task. It was a challenge to distinguish gamblers who failed to resist their impulses to gamble from those with overwhelming impulses to gamble. It was difficult to distinguish gamblers with disorders from those without such problems. Armed with new diagnostic criteria (e.g., American Psychiatric Association, 1980), the latter part of the last century saw a growing cottage industry of taxonomists who began to classify gamblers and gambling into various types; these taxonomies implicitly suggested that some kind of “ghost”, either within the player or the game, was responsible for gambling excess. Classification is a central activity of scientific inquiry, particularly in a youthful field. Kipnis (1997) reminds us about that “… without classification there would be no theories, reasoning, data analysis, or, in fact, social science research. In other words, before relationships can be searched out, it is necessary first to classify what we wish to study. Only then can we ask about the extent to which these classified units are causally related” (p. 205). For the field of gambling studies, this natural interest in classification gradually became an epidemiology of the distribution of gambling throughout the population; nevertheless, it is important to remember that this distributive understanding of gambling has not yet evolved to provide an adequate analysis of the determinants of this distribution.

The newest iteration of the diagnostic and statistical manual, DSM-5, is leading us toward a new taxonomy by suggesting that there is an addiction syndrome (Shaffer, LaPlante, et al., 2004; Shaffer, LaPlante, & Nelson, 2012a, 2012b) with many expressions. Like AIDS, addiction evidences a common etiological vulnerability that gets expressed (e.g., gambling, drugging, etc.) in many different ways; there are not many addictions. From this perspective, instead of a ghost driving intemperance, there is a set of dynamic factors that interact to shift the risk matrix associated with addiction in general and excessive gambling in particular.

This new taxonomy of addiction implies that there are diagnostic shadows. (Boudreau, LaBrie, & Shaffer, 2009; Boyd & Metcalf, 2012; Ratey & Johnson, 1997). These ghostly shadows reflect subclinical symptom clusters; that is, symptom patterns that do not cluster sufficiently to satisfy diagnostic criteria. Because of the current tradition of conducting epidemiological research primarily at the diagnostic rather than the symptom level, shadow syndromes and neurotic styles (Shapiro, 1965) have received insufficient attention within the extant literature (Boudreau et al., 2009). The newly revised diagnostic criteria suggest a shifting tapestry of ghosts and shadows. In turn, these conceptual and clinical changes imply that a new and more specific taxonomy of gambling-related ghosts and shadows will emerge. New research is just beginning to move in this direction (e.g., Yip, White, Grilo, & Potenza, 2010).

Youthful Fields of Inquiry

Unfortunately, one characteristic of youthful fields – traditionally guided by presumption rather than scientific evidence – is that workers in that field accept a variety of assumptions about the central constructs and the array of possible relationships among those constructs. These preliminary assumptions can lead stakeholders in the wrong direction by focusing their attention and blinding them to alternative points of view. Consequently, debate often characterizes the science and scholarship of a youthful field. As a scientific field matures, these debates diminish and a shared view of the target phenomenon (e.g., gambling) emerges – only to be disturbed later by new findings that fail to support the shared view (Cohen, 1985; Kuhn, 1970).

Despite its growing body of knowledge, the field of gambling studies is in its early developmental stages, with an attendant array of camps debating the issues and competing for attention. This competition sets the stage and the need for more scholarly discursions. After all, each of the competing camps offers the opportunity for new and different ideas that, in turn, transiently will stimulate and influence new and different approaches for dealing with gambling and its consequences.

As the American Psychiatric Association readies the fifth version of its diagnostic manual – a version that likely will shift how we think about addiction and gambling disorders – Richard, Nower, and Blaszczynski have assembled a timely collection of contributions that represents an important occasion for new dialogue, debate, and the emergence of innovative ideas.

Debates play an important role in the development of science. Though it does not always seem like it will happen, ongoing conceptual controversy inevitably leads to periods of resolution. For example, there have been watershed conceptual moments in the field of gambling study and treatment that have led to a shared perspective. During the late twentiethth century, there was a dramatic shift in our collective view toward gambling. Instead of considering gambling simply as ghost driven, that is, as an individually motivated and potentially harmful decision, or as a simple consequence of game features, the public began to adopt a population-based public health perspective (Korn & Shaffer, 1999; Korn & Skinner, 2000; Shaffer, 2003; Shaffer & Kidman, 2004; Shaffer & Korn, 2002); this view emerged on the historical heels of the first epidemiological studies that focused on gambling (e.g., Kallick-Kaufmann, 1979; Volberg, 1994). The confluence of these events led to a new vantage point. Observers had a widely shared framework for considering population trends as well as the risks and protective factors that might be associated with various population segments. This perspective offered the opportunity for scientists to construct new taxonomies – both of gamblers and the many contexts within which they gambled. New research began to focus the public's attention on the gambling patterns of various population segments (e.g., youth, elderly, minorities, etc.). Similarly, researchers began to develop interest in the technological features of the games that people played, often arguing that some games were more “addictive” than others. These first order taxonomies are characteristic of young fields. Aristotelian list makers dominate immature taxonomies (Lewin, 1931). Conspicuously absent from the early taxonomies of gamblers and the games they play have been Galilean perspectives: interactive and dynamic descriptions of gambling taxonomies (i.e., gambler characteristics, games and their features, and the context within which these games are played).

Toward an Epidemiological Dynamics of Gambling

Recently, Anthony (2012) described a more Galilean epidemiology, recognizing that traditional epidemiology is too static to accurately represent the movement and interactive forces associated with how people develop, maintain, and recover from addiction. For example, as gambling opportunities expanded and access to gambling became commonplace, traditional epidemiologists assumed that the rate of gambling disorder would increase in proportion to the downstream exposure, as if other upstream forces were not exerting influence on the prevalence of gambling and gambling-related problems. Encouraging this downstream dominated view (i.e., exposure), during the early stages of gambling expansion, there were apparent increases in the rate of gambling-related problems. Nevertheless, as my colleagues and I often noted—and an epidemiological dynamics perspective suggests—the prevalence of gambling-related harms would, like other social and biological trends (e.g., epidemics and pandemics), gradually succumb to upstream forces. Then, gambling problems would return to lower levels. All around the world, this pattern of dynamic adaptation has become evident (e.g., Bondolfi, Jermann, Ferrero, Zullino, & Osiek, 2008; LaPlante & Shaffer, 2007; Shaffer, 2005; Stinchfield, 2011). Currently, despite some evidence that it increased during the turn of the century, the prevalence of gambling disorders is about the same as it was almost 40 years ago – before the last dramatic wave of gambling expansion.

Examining the epidemiology of gambling from a dynamic perspective encourages new opportunities for gambling studies to examine this adjustment process. It provides the template for beginning to investigate the array of countervailing (i.e., downstream and upstream) forces that limit and encourage adaptation to potential social toxins such as gambling (Shaffer, LaBrie, & LaPlante, 2004). In addition, considering epidemiological dynamics encourages researchers to integrate ideas such as hormesis (Calabrese, 2005) into our understanding of gambling. Hormesis is a very important dose response model that describes a process whereby low levels of a contaminant can enhance health despite the observation that higher levels of the same toxin yield morbidity and mortality. This dose response curve reflects a dynamic process that cannot be captured by a static epidemiology.

Measuring Taxonomies: Creating Gambling Ghosts and Shadows

If ideas do, in fact, have consequences as I am suggesting, then how we think about gambling will also influence how we measure it. In turn, these measurement approaches will influence how we think about gambling. Unfortunately, in an effort to develop instruments that can measure gambling and gambling-related problems, investigators have risked construct validity to gain reliability. The end result is that we now have measures of disordered gambling that reflect a unitary underlying dimension, but we are not certain what that factor represents. For example, different measures of gambling disorder tend to correlate with each other, implying some modicum of construct validity; however, upon analysis, this agreement rests upon the non-cases. Because of the low base rate of gambling disorders, the correlation between different measures of gambling disorder reflects the association between the large numbers of non-cases. In addition, different measures, while yielding similar population prevalence rates, tend to identify different people. Despite the often-observed single factor underlying disparate measures, I don't think that gambling disorders are one-dimensional. Therefore, I don't think that these different measures are measuring the same thing. I suspect that most critical observers agree and think that gambling disorders are multidimensional and complex. If so, we still need a new taxonomy of gamblers and gambling.

Our current taxonomy of gambling disorders suggests that it is a categorical problem. That is, once gambling disorders entered the diagnostic nosology as a unique taxon (i.e., disordered gambling), observers began to assume that people with this disorder evidenced different characteristics compared to those who were without this disorder. Observers assumed that they could distinguish disordered gamblers from recreational gamblers because the disordered patterns of gambling were qualitatively and, therefore, perceptibly different. Research, however, raises important questions about this matter. For example, my colleagues and I conducted the first taxometric study of Internet sports gamblers (Braverman, Labrie, & Shaffer, 2011). This research failed to identify a unique taxon or group of heavy gamblers who were characteristically different from other gamblers. In the absence of qualitative differences, it is likely that, similar to many other patterns of behavior, gamblers reside on a continuum. Even gamblers who satisfy diagnostic criteria engage in the same behaviors as recreational gamblers, but just participate in these behaviors more (e.g., frequently, intensely, financially). Consequently, it is difficult for lay and professional observers alike to determine with precision who is and who is not struggling with a gambling disorder. Where do we draw the line along these dimensions?

This classification problem is particularly magnified for youth, in part, because they have been gambling for less time compared to their adult counterparts. Without the qualitative features to guide an identification process, prevention efforts become even more challenging than usual. It is difficult for public health programs to target high risk and vulnerable population segments. As Richard et al. demonstrate in this Handbook, like other expressions of addiction (Shaffer, LaPlante, et al., 2004; Shaffer, LaPlante, et al., 2012b), disordered gambling reflects multifactorial etiology (e.g., genetic, psychological, and social influences).

Toward a More Mature Gambling Field: Developing Gambling Ghosts, Shadows, and Taxonomies

Scientists have noticed that “ontogeny recapitulates phylogeny.” This notion suggests that developing organisms progress through stages resembling or representing successive stages in the evolution of their remote ancestors. Similarly, philosophers of science have noted that fledgling fields of scientific inquiry, such as gambling studies, develop through similar stages as the more developmentally advanced scientific fields. For example, gambling studies is replicating the developmental patterns of other areas of study that have been focusing on excessive behavior patterns (e.g., alcohol and other drug studies). We should not be surprised that, at this developmental stage, there is a paucity of Galilean ideas. The study of substance use disorders was more mature than the study of gambling disorders when Zinberg introduced an enduring interactive taxonomy for understanding drug effects: drug, set and setting (Zinberg, 1974, 1975, 1984).

Gambling studies are on the threshold of Galilean models of excess. However, to achieve this developmental stage, the field must carefully evaluate its presumed gambling ghosts and their many shadows. To illustrate, since its integration into the Diagnostic and Statistical Manual during 1980, stakeholders have presumed that psychopathology was the driving force behind intemperate gambling. This ghostly idea has had many consequences, not the least of which is the growth of a taxonomic cottage industry designed to provide the confirmation that public policy makers need to shape gambling-related regulations. From a clinical perspective, this idea has implied, incorrectly, that self-directed recovery was not possible (Shaffer, Martin, Kleschinsky, & Neporent, 2012). Despite the epidemiological findings that reveal gambling patterns among various population segments and the tendency for gamblers to self-direct their recovery, few treatments or regulations are evidence-based. If they were, gambling-related regulations would emphasize broad issues associated with mental health in general, recognizing that the majority of intemperate gambling is driven by the interaction of psychological ghosts and their shadows within the social setting that gambling exists (e.g., culture, technology, social mores and folkways, etc.).

The study, treatment, and regulation of gambling are now, for better or worse, overwhelmingly conducted from a public health perspective. Whether accurate or not, this template has been useful; whether it continues to be useful will depend upon how we interact with public health constructs and methods – gambling ghosts and shadows. Instead of presuming that ghosts within the player or the machine sufficiently explain gambling, I want to encourage stakeholders to begin moving toward more dynamic and interactive taxonomies of gambling. This Handbook of Disordered Gambling provides a comprehensive review of the central issues related to gambling disorders and, therefore, it provides a substantial foundation to move in this direction.

I began this foreword wondering whether we needed another book about gambling and gambling disorders. Given the breadth and depth of issues facing the field of gambling studies, and the contributions in this volume, I believe that the answer is yes. These ideas continue the spirited dialogue that is necessary to advance the field of gambling studies, treatment and policy. Richard et al. have provided us with a collection of ideas that most certainly will have consequences for many years to come.

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1. Thanks to Dr. Debi LaPlante for her helpful comments on earlier versions of this foreword.

2. Please direct correspondence to: Dr. Howard J. Shaffer, Division on Addiction, 101 StationLanding, Medford, MA 02155; [email protected]

Contributors

Paul Antze, PhD, Associate Professor, Department of Social Science, York University, 4700 Keele Street, Toronto, Ontario, Canada M3J 1P3

Alex Blaszczynski, PhD, Honorary Professor, School of Psychology A18, The University of Sydney, Sydney NSW 2006, Australia

Paul H. Delfabbro, PhD, School of Psychology, Room 410, Hughes Building, University of Adelaide, South Australia 5005, Australia

Dr. Jeffrey L. Derevensky, PhD, Professor, School/Applied Child Psychology, Professor, Psychiatry, Co-Director, International Centre for Youth Gambling Problems and High-Risk Behaviors, McGill University, 3724 McTavish Street, Montreal, Quebec H3A 1Y2, Canada

Nicki A. Dowling, PhD, Senior Research Fellow/Clinical Psychologist, Problem Gambling Research and Treatment Centre, University of Melbourne, Level 5, 100 Leicester Street, Victoria 3010, Australia

Peter Ferentzy, PhD, Scientist 1, Centre for Addiction and Mental Health, 45 Wynford Heights Cr. #1901, Toronto, ON, Canada, M3C 1L3

Sally Gainsbury, PhD, School of Psychology, Brennan MacCallum Building (A18), The University of Sydney, NSW 2006, Australia

Anna E. Goudriaan, PhD, Department of Psychological Sciences, University of Missouri, 200 South 7th Street, Room 123, Columbia, MO 65211, USA

Mark D. Griffiths, PhD, Professor, International Gaming Research Unit, Psychology Division, Nottingham Trent University, Burton Street, Nottingham, NG1 4BU, UK

Dr. Christopher J. Hopwood, PhD, Department of Psychology, Michigan State University, 231 Psychology Building, East Lansing, MI 48824, USA

Julia Humphrey, MA, Arizona State University, Department of Psychology, Box 871104, Tempe AZ 85287-1104, USA

Daniel L. King, PhD, School of Psychology, The University of Adelaide, SA 5005, Australia

David M. Ledgerwood, PhD, Assistant Professor, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Tolan Park Medical Building, 3901 Chrysler Service Drive, Detroit, MI 48201, USA

Jamey J. Lister, MSW, Center for Gambling Studies, School of Social Work, Rutgers University, The State University of New Jersey, 360 Martin Luther King, Jr. Blvd., Newark, NJ 07102, USA

Amy Loree, MA, Merrill Palmer Skillman Institute, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 71 E. Ferry St., Detroit, MI 48202, USA

Leslie H. Lundahl, PhD, LP, Assistant Professor, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 5401 Cass Avenue, Detroit, MI 48202, USA

Molly A. Nikolas, PhD, Assistant Professor, Department of Psychology, University of Iowa, E11 Seashore Hall, Iowa City, IA 52242-1409, USA

Lia Nower, JD, PhD, School of Social Work, Rm 117, College Avenue Campus (CAC), 536 George Street, New Brunswick, NJ 08901-1167

David C. S. Richard, PhD, Dean, Hamilton Holt School, Professor, Department of Psychology, Rollins College, 1000 Holt Avenue, Winter Park, FL 32789

Dr. Lori Rugle, PhD, Director of Problem Gambling Services, Connecticut Department of Mental Health and Addiction Services, 410 Capitol Ave., P.O. Box 341431, Hartford, Connecticut 06134, United States

Wayne Skinner, MSW, RSW, Clinical Director, Concurrent Disorders Program, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, M5S 2S1

Renee A. St-Pierre, MA, Doctoral Student International Centre for Youth Gambling, Problems and High-Risk Behaviors, McGill University, 3724 McTavish Street Montreal, Quebec, H3A 1Y2, Canada

Randy Stinchfield, PhD, Psychiatry Department, F282/2A West-B 8393, 2450 Riverside, Minneapolis, MN 55454

Travis Sztainert, MA, Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada

Caroline E. Temcheff, PhD, Assistant Professor, Department of Psychoeducation, Université de Sherbrooke, 2500, boul. de l'Université, Sherbrooke (Quebec) CANADA, J1K 2R1

Wim van den Brink, MD, PhD, Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam

Ruth J. van Holst, PhD, Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Department of Experimental Psychology, University of Cambridge

Dick J. Veltman, MD, PhD, Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, VU Medical Center, Vrije Universiteit Amsterdam, Amsterdam

Rachel A. Volberg, PhD, GEMINI RESEARCH, PO Box 1390, Northampton MA, 01061-1390, USA

Robert J. Williams, PhD, RPsych, Professor, Faculty of Health Sciences, Coordinator, Alberta Gambling Research Institute, University of Lethbridge, Lethbridge, Alberta, Canada

Michael J. A. Wohl, PhD, Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada

Matthew M. Young, PhD, Adjunct Research Professor, Department of Psychology, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada

1

The Conceptualization and Diagnosis of Disordered Gambling

David C. S. Richard and Julia Humphrey

Introduction

This is an introductory chapter designed to provide a broad overview of conceptual, diagnostic, and epidemiological topics for the treatment professional who may have limited experience with this population. As such, the chapter discusses competing conceptualizations of disordered gambling in the context of recent empirical work and discusses implications for the upcoming publication of the DSM-5. Research discussed in later chapters is touched on here to provide a foundation. Clinicians with significant experience with this population may wish to bypass this chapter and move directly to more specialized foci.

To be consistent with the DSM-5, we use the term “gambling disorder” or “disordered gambling” throughout this volume rather than the archaic terms “pathological gambling” or “pathological gambler.” However, the reader should keep in mind that studies published prior to 2012 used the DSM-IV-TR diagnostic criteria to identify research participants. It is not known at this time how much effect the DSM-5 diagnostic criteria changes will have on the subsequent composition of research samples, although a significant effect is not expected. The vast majority of individuals who would have met the criteria for a DSM-IV-TR diagnosis of “pathological gambling” will also meet the DSM-5 criteria for a diagnosis of “disordered gambling.”