NCRG Updates Research &Amp; Resources And Publishes The Sixth Volume Of The Monograph Series

The NCRG is excited to announce the release of two publications: an updated version ofResearch & Resources: A Guide to Gambling Disorders and Responsible Gamingand the sixth volume ofIncreasing the Odds: A Series Dedicated to Understanding Gambling Disorders.We strive to provide useful resources, both published and available online, to be used by researchers, academicians, clinicians, gaming industry professionals, legislators and other non-profit organizations. These two resources are available online for you to download. You can also request printed copies by emailing Amy Martin, communications and outreach manager of the NCRG, atamartin@ncrg.org.

Research & Resources: A Guide to Gambling Disorders and Responsible Gaming

Research and Resourcesis a one-of-a-kind publication that gives quick and easy access to a library of the most significant research findings on gambling disorders. The NCRG has updated it with the most recent research findings, showing the growing body of research on gambling disorders. This publication provides an overview of key studies by leading researchers in the field and also includes:

– A glossary of commonly used terms in research on gambling disorders

– A directory of online publications and resources

– Information about online screening instruments

– Resources for getting help and recovery

– A list of experts in the field of gambling disorders categorized by their areas of expertise

– Responsible gaming education and outreach initiatives of the NCRG and the gaming industry

A downloadable copy ofResearch & Resourcesis available in thePress Roomsection of the NCRG website.

Increasing the Odds: A Series Dedicated to Understanding Gambling Disorders

The NCRG’s monograph series provides easy-to-understand summaries of seminal peer-reviewed research on gambling disorders, as well as implications for future research and prevention efforts. The sixth volume ofIncreasing the Odds: A Series Dedicated to Understanding Gambling Disordersis titled“Gambling and the Brain: Why Neuroscience Research is Vital to Gambling Research”and includes the following research summaries:

– Jon E. Grant, M.D., J.D., M.P.H., describes the neurobiological link between behavioral addictions and substance use disorders

– Marc Potenza, M.D., Ph.D., explains how brain imaging technology can be used to observe brain function and better understand the role that urges play in the development and maintenance of a gambling disorder

– Anna E. Goudriaan, Ph.D., details how various types of imaging are used to investigate the role that the reward system, reactivity to cues and impulsivity play in pathological gambling

– Catharine A. Winstanley, Ph.D., reviews the drugs that impact dopamine and serotonin levels and how they influence impulsivity and addiction

Researchers have shown that studying the brain’s functions is crucial to the understanding and treatment of addiction and gambling disorders. While the recognition that gambling disorders have a neurobiological component is not new, research has made significant technological advances in areas such as brain imaging and genetics. The NCRG chose to focus on those key findings in this issue ofIncreasing the Oddsto provide a better understanding of the complex biological factors at play in gambling disorders.

A downloadable copy of the sixth volume ofIncreasing the Odds,along with the first five volumes, is available in theMonographsection of the NCRG website.

Are there resources or publications that you would like to see on the NCRG website? Please leave your suggestions in the comments section below.

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NCRG Workshop For Treatment Providers Addresses Ptsd And Gambling Disorders

According to a 2008 analysis of the National Comorbidity Survey Replication (NCS-R), respondents with a psychiatric disorder are 17.4 times more likely to develop pathological gambling than those without such problems (Kessler et al., 2008). To address the interaction between post-traumatic stress disorder (PTSD) and problem gambling, the NCRG presented training for Boston-area treatment providers entitled, “PTSD and Problem Gambling,” led by Lisa Najavits, Ph.D., professor of psychiatry at Boston University School of Medicine. Dr. Najavits presented information on her program “Seeking Safety,” an evidence-based treatment for PTSD and substance use disorders, and her research on problem gambling in PTSD populations. This session launched the2011 NCRG Treatment Provider Workshop Seriesand was a part of this year’sNCRG Road Tour.

“Seeking Safety”

“Seeking Safety” was developed by Dr. Najavits and her colleagues more than 15 years ago and has been shown to be efficacious in the treatment of PTSD and substance abuse in many diverse groups of individuals. A complete listing of the validation studies, as well as copies of the studies themselves, is available on theSeeking Safety website. “Seeking Safety” is designed to be a flexible treatment that can be used in individual or group settings, and with both homogenous and diverse groups.

Seeking Safety was developed to address the present needs of clients, as opposed to focusing on either the past or future. The program has five key principles:

1)Safety:The overarching goal of helping clients to attain safety in their relationships, thinking, behavior and emotions.

2)Integratedtreatment:Clinicians are able to address both PTSD and substance abuse at the same time.

3)An Ideal-focused Approach:Patients learn tocounteract the loss of ideals in both PTSD and substance abuse.

4)Four Specific Content Areas: Clinicians can address the cognitive, behavioral, interpersonal and case management aspects of treatment simultaneously.

5)Attention to Clinician Processes: “Seeking Safety” is not always led by mental health professionals. For this reason, the program provides tools to help the group leader avoid some common pitfalls of mental health treatment and take care of their own needs.

In addition to these five key areas, the “Seeking Safety” program is broken up into 25 specific topics, including: Safety; PTSD: Taking Back Your Power; When Substances Control You; Honesty; Asking for Help; and Setting Boundaries in Relationships. A more complete description of the 25 topics is available in pdf formon the Seeking Safety website.

Research on PTSD and Pathological Gambling

Dr. Najavits also discussed the findings of a study she authored involving 106 people with current pathological gambling (PG), current PTSD or with both PG and PTSD (Najavits, Meyer, Johnson, & Korn, 2010). These individuals were evaluated for several clinical traits, such as addiction severity and personality disorders.

Dr. Najavits and her colleagues found that those with either PTSD or PG/PTSD had significantly more severe symptoms than people with only PG. This suggests that the underlying PTSD may be driving the symptoms of people with comorbid PG and PTSD more than the PG seems to influence the comorbid disorder. A more complete review of this study was published by researchers at the Division on Addictions at Cambridge Health Alliance, and it is available ontheir website. Also, you can download the study directly from theSeeking Safety websiteas the 29thstudy in their list.

The free NCRG treatment provider workshop was co-sponsored by theMassachusetts Council on Compulsive Gambling. Do you have thoughts or questions about PTSD and disordered gambling? Leave them in the comments section below.

References

Kessler, R.C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N.A., Winters, K.C., & Shaffer, H. J. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication.Psychological Medicine,38(9), 1351-1360.

Najavits, L. M., Meyer, T., Johnson, K. M., & Korn, D. (2010). Pathological Gambling and Posttraumatic Stress Disorder: A Study of the Co-Morbidity versus Each Alone.Journal of Gambling Studies / Co-Sponsored by the National Council on Problem Gambling and Institute for the Study of Gambling and Commercial Gaming. doi:10.1007/s10899-010-9230-0

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Announcing The 2011 NCRG Treatment Provider Workshop Series

A core mission of the NCRG is to encourage the application of new research findings to improve prevention, diagnostic, intervention and treatment strategies. One of the ways we are fulfilling that mission is to launch the NCRG Treatment Provider Workshop Series. This year, the NCRG will host five regional workshops this year that will allow treatment providers to better understand the most up-to-date research on gambling disorders and apply those findings to their clinical practice. Each training session will feature leading researchers and clinicians in the field of gambling disorders, and topics will range from screenings and assessments for pathological gambling to new manuals detailing behavioral treatment strategies.

Most sessions are free of charge and are open to all mental health clinicians, practitioners and researchers who would like to attend. Participants will receive between 1.5 and two continuing education units from our accrediting bodies, such as the American Psychological Association (APA), the National Board for Certified Counselors and NAADAC, The Association for Addiction Professionals.

We officially launched the workshop series in Boston last month with a presentation of“Post-traumatic Stress Disorder and Problem Gambling,”led by Dr. Lisa Najavits of Boston University School of Medicine. Our regional co-sponsors were theMassachusetts Council on Compulsive Gambling, and we had a great turnout for the training. We will post a recap of that workshop on Gambling Disorders 360˚ this week. We will continue

Everyone is welcome to register for the remaining 2011 NCRG Treatment Provider Workshop sessions:

Iowa City, Iowa –“Update on Gambling Disorders: Advanced Training on Predictors, Comorbidity and Course”

Date and Location:August 30, 2011, 9:00 – 11:00 a.m. CST, University of Iowa Carver College of Medicine
Speaker:Dr. Donald Black, University of Iowa Carver College of Medicine
Co-sponsor:Iowa Department of Public Health and Iowa Gambling Treatment Program

San Diego, Calif. – “Screening and Assessment of Pathological Gambling” **

Date and Location:September 20, 4:00 – 6:00 p.m. PST, National Conference on Addictive Disorders
Speaker:Dr. Randy Stinchfield, University of Minnesota
Co-sponsor:NAADAC, The Association For Addiction Professionals
**This workshop is available to those who are registered for the National Conference on Addictive Disorders

Las Vegas, Nev. – “Overcoming Impulse Control – A Guide for Therapists”

Date and Location:October 1, 2011, 2:00 – 4:00 p.m. PST, The Sands Expo and Convention Center at the Venetian
Speaker:Dr. Jon Grant, University of Minnesota
Co-sponsor:Nevada Council for Problem Gambling

Detroit, Mich. – “Brief Motivational Interventions for Problem Gambling”

Date and Location:October 21, 2011, 9:00 – 11:00 a.m. CST, The Virtual Center for Excellence at the Guidance Center, Southgate Campus
Speaker:Dr. Matthew Martens, University of Missouri, Columbia
Co-sponsor:Neighborhood Service Organization, Michigan Association for Problem Gambling and the Virtual Center for Excellence, Detroit – Wayne County Community Mental Health Agency

For more information or to register for any of these workshops, contact Amy Martin, communications and outreach manager for the NCRG, atamartin@ncrg.orgor 202-552-2689. The NCRG also plans to host workshops in other cities in the years ahead. Those interested in hosting a workshop in their community should contact Amy Martin with additional information.

As always, we will be live-tweeting and placing photos on Facebook during the sessions so that everyone can stay connected. Make sure to follow to Gambling Disorders 360˚, @theNCRG on Twitter and the NCRG’s Facebook page for more information. Questions or comments? Let us know what you think in the comment section below!

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Overcoming Impulse Control Problems – NCRG Pre-conference Workshop With Dr. Jon Grant

At the12thannual NCRG Conference on Gambling and Addiction, we are privileged to have four distinguished researchers leading pre-conference workshops to give mental health treatment providers and researchers an extra helping of best practices to bring back to their work. One of the sessions will be led by Dr. Jon Grant, J.D., M.D., Ph.D., professor of psychology at the University of Minnesota and co-director of the Impulse Control Disorders Clinic at the University of Minnesota Medical Center. Dr. Grant is also the principal investigator for theNCRG Center for Excellence in Gambling Researchat the University of Minnesota.

Dr. Grant’s extensive research on impulse control disorders (ICDs) led him to co-author a workbook with Christopher B. Donahue, Ph.D., and Brian L. Odlaug, University of Minnesota Medical Center, titledOvercoming Impulse Control Problems: A Cognitive-Behavioral Therapy Program. This workbook takes the reader through various approaches to resist urges to engage in pathological gambling behaviors, as well as those behaviors demonstrated in other ICDs. Dr. Grant’s pre-conference workshop will lead clinicians through this manual.

According to the authors,Overcoming Impulse Control Problemsrepresents the treatment they have found to be the most effective at controlling urges to gamble and will also help the reader to better understand the true nature of impulse control problems, and help to prevent future problems.

The manual is intended for use in conjunction with supervised therapy and includes various self-assessments and exercises designed to help individuals realize the truth behind their actions and to reach the ultimate goal of changing their impulsive behaviors.

The goal of Dr. Grant’s pre-conference workshop is to give participants a better understanding of effective treatment strategies to use during therapy sessions with ICD patients, andOvercoming Impulse Control Problemsexplains one of these various treatment approaches. To register for this pre-conference workshop and the NCRG Conference on Gambling and Addiction, you candownload the conference registration formorregister online. The deadline for receiving early bird registration rates is September 12! For more information, visit the NCRG Conference website atwww.ncrg.org/conference.

Do you have questions about the pre-conference workshops or comments about effective techniques to address ICDs? Please leave them in the comments below.

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NCRG Conference Scholarships Are Now Available!

Deadline to apply: Friday, August 26

The NCRG is thrilled to announce that a record number of need-based scholarships are now available to help offset the cost of attending the annual NCRG Conference on Gambling and Addiction. This year, based on response and availability, the NCRG will provide between 20 and 30 individual sponsorships to attend the NCRG Conference. Up to 10 of these scholarships may also include travel assistance of $200. Scholarships are available to all interested attendees, especially those in the clinical and public health sectors. A notable percentage of scholarships have been reserved for residents of Nevada.

Click here to download the application form.

To Apply:

–Click hereto download the NCRG Need-based Scholarship Program form

– Provide answers to the application questions by number on a separate document or in the body of your email

– Submissions can be made by email tocreilly@ncrg.orgor faxed to 978-552-8452 by Friday, August 26

– In return for their scholarship, recipients will be asked to submit a (minimum one-page) letter to the NCRG following the conference describing their experience at the event.

For more information, contact Christine Reilly, senior research director for the NCRG, atcreilly@ncrg.org, or 978-338-6610. All of the materials are also available on theNCRG Conference scholarship webpage. You can find more information about the 12thAnnual NCRG Conference on Gambling and Addiction visitwww.ncrg.org/conference.

Make sure you apply today for the NCRG Conference scholarships! Did you receive a scholarship last year? Let us know in the comments below!

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Celebrating Responsible Gaming Education Week In Louisiana

The 14thannualResponsible Gaming Education Week(RGEW) was in full swing last week with casinos, manufacturers and other non-profit organizations are implementing creative ideas to educate their employees and patrons about the odds of casino games. To see some of the many activities that the RGEW participants did last week, you can view theAmerican Gaming Association’s (AGA) press release, as well as theirFacebookandTwitterfeeds.

The National Center for Responsible Gaming (NCRG) is partnering with the AGA to help provide resources to many other organizations and continue promoting responsible gaming efforts through this blog, as well as ourFacebookandTwitteraccounts. The NCRG caught up with Reece Middleton, executive director for the Louisiana Association on Compulsive Gambling, to see how he is celebrating RGEW this year. The Louisiana Association on Compulsive Gambling is a non-profit organization dedicated to advocating for and/or providing cost effective quality assistance for all individuals in the State of Louisiana who may be affected by gambling problems.

NCRG:What has been one of the more exciting parts of your RGEW so far?

Middleton:At our open house and news conference on August 2, both Cedric B. Glover, mayor of Shreveport, and Lorenz Walker, mayor of Bossier City, issued a proclamation that this week is officially known as Responsible Gaming Education Week in our area. We were delighted that they could attend, as well as the many media outlets that were there to understand more about the education we hope to provide this week, as a continuation of our efforts to promote responsible gaming.

On August 1, we were excited to be on KSLA TV (CBS affiliate) in Shreveport, La. to talk about responsible gaming programs and how someone in the state could access free help if they were unable to gamble responsibly. We talked about the “Know the Odds” curriculum so that everyone could learn more about the odds of winning and losing when gambling. I’m sure we’ll be on the news more throughout the week talking about responsible gaming.

NCRG:What do you hope that the public will learn during this year’s RGEW?

Middleton:I think that “The House Advantage: A Guide to Understanding the Odds”, this year’s RGEW brochure, is a great tool for everyone to learn the facts and figures about the odds of casino games. Education is an important part of responsible gaming, and we’re including that information in all of our meetings and distributing it to area counselors.

We expect people to learn the many programs and brochures that can use as resources to better understand ways to gamble responsibly. We also want them to know that if a problem develops, as it sometimes does in a small percentage of players, there is help available at no charge. They can receive the information in various ways, whether it is through educational programs from the NCRG and the AGA or from the residential care facilities, intensive outpatient care programs and individual counseling we have available in Louisiana.

For more on RGEW or the many fun activities to help encourage everyone to “know the odds,” you can visit theNCRG’s websiteor theAGA’s RGEW page. Do you know of any great ways that responsible gaming is being promoted in your area? Please let us know in the comments below!

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Register Today For The August NCRG Webinar Session On Adolescent Brain Development And Youth Gambling

Parents of teenagers often question what their children think as they make important life choices and engage in potentially dangerous behaviors. Dr. Ken C. Winters, professor of psychiatry and director of the Center for Adolescent Substance Abuse and Research at the University of Minnesota, is going to explore that parental concern one step further by explaining the latest research on adolescent brain development and why young adults sometimes make decisions to participate in risky behaviors, such as gambling.

Register todayfor the next free session in the NCRG Webinar Series,“Adolescent Brain Development: Implications for Understanding Youth Gambling,”on August 24 from 2:00 – 3:00 p.m. EST. This session is free for all attendees and you can earn one hour of continuing education units.

Dr. Winters is a leader in the field of on the assessment, prevention and treatment of adolescent drug abuse and problem gambling. He is also a member of the NCRG Scientific Advisory Board, the group that plays a vital role in overseeing the NCRG’s grant-making efforts, ensuring grants are awarded only to those research proposals that meet the most rigorous standards for scientific integrity.

This webinar will be an exciting look at the new scientific discoveries about the brain that have put a much different perspective on our understanding of adolescent behavior. Research now suggests that the human brain is still maturing during the adolescent years, with significant changes continuing into the early 20s. The developing brain of the teenage years may help explain why adolescents and young adults sometimes make decisions that seem to be quite risky and may lead to safety or health concerns such as gambling excessively. And it may add insights into unique vulnerabilities and opportunities associated with youth.

Christine Reilly, senior research director of the NCRG will moderate this session, as well as explain many of the NCRG’s resources and programs that are geared toward adolescents and young adults.

This session has been approved for one hour of continuing education by:

– NAADAC, the Association for Addiction Professionals (provider #737)

– The California Foundation for Advancement of Addiction Professionals (provider #OS-02-26-1111)

– The California Board of Behavioral Sciences (for MFT and LCSW licensure requirements in California) (Approval #PCE 4619)

– The National Board for Certified Counselors (provider #6474)

– The NCRG is also approved by the American Psychological Association (APA) to sponsor continuing education for psychologists. The NCRG maintains responsibility for this program and its contents.

The sixth volume of theNCRG’s monograph series,Increasing the Odds: A Series Dedicated to Understanding Gambling Disorders, will be also available online at the same time as the webinar. Its title, “Gambling and the Brain: Why Neuroscience Research is Vital to Gambling Research,” is another look into the neurobiological science behind gambling disorders.

We look forward to seeing you on August 24 for this NCRG webinar session! Do you have questions or comments? Please leave them in the comments section below.

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Bridging The Gap Between Research And Clinicians On Treatment Options

How do clinicians determine an appropriate treatment plan for clients with gambling problems? The current dearth of research on treatment outcomes and the lack of a treatment standard make this a challenge for treatment providers. However, Dr. Jon Grant argues that new research will bridge the gap, allowing clinicians to select the most effective treatment options based on cognitive, neuroimaging and genetic data. Dr. Grant, professor of psychiatry at the University of Minnesota and principal investigator of the NCRG Center of Excellence in Gambling Research at the University of Minnesota, delivered a keynote address on this topic at the 8thAnnual Midwest Conference on Problem Gambling and Substance Abuse on July 20 in Kansas City, Mo.

In his address, Dr. Grant focused on a few treatment options that researchers are studying that might be applicable for treatment providers as they assess the best options for their patients. First, researchers are looking at various medications that might best help those with gambling disorders who are driven by cravings and urges to gamble. Studies have shown that Naltrexone, a drug approved for treatment of alcoholism, can help remove the desire to gamble by reducing cravings. Genetic research indicates that the best responders to Naltrexone are individuals with a family history of alcohol use disorders. One clinical study cited by Dr. Grant found that urges were reduced by 40 percent of this population but not fully eliminated. It is apparent, he observed, that by themselves such drugs are not totally effective and that an approach that also includes a behavioral treatment such as cognitive-behavioral therapy is vital.

Dr. Grant mentioned another alternative approach that researchers are beginning to investigate called “imaginal exposure.” Borrowed from the scientific literature on obsessive-compulsive disorder, the objective is to desensitize the individual to gambling cues by exposing the person repeatedly to typical symptoms that triggers their problem gambling behavior. Dr. Grant cited a study in which the combination of Motivational Interviewing therapy and imaginal exposure helped participants abstain from gambling after two years.

Dr. Grant’s talk was one of the various keynote addresses at the Midwest Conference on Problem Gambling and Substance Abuse. Christine Reilly, senior research director for the NCRG, also spoke about college gambling statistics and the NCRG’s newest online resource, CollegeGambling.org. To view her entire presentation,click here. To see the other various keynote addresses, you can visithttp://www.888betsoff.org/links/midwest_conference.shtm.

Questions or comments about the NCRG’s many summer activities? Leave your thoughts in the comments section below! Also make sure to check out our upcoming blog posts on the NCRG Road Tour in Boston, Mass.

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Revolutions In The Study Of Gambling Disorders: Howard Shaffer At The Ncpg Conference, Part 2

Part two of the series recapping Dr. Howard Shaffer’s keynote address at the 25thNational Conference on Problem Gambling in Boston, Mass. To read part one of the Gambling Disorders 360° series,click here.

After laying the foundation for his presentation by outlining the theoretical revolutions that have defined our understanding of gambling disorders, Dr. Howard Shaffer then proposed that the next revolution in understanding gambling disorders will come from the way online gambling behavior can now be studied. Until recently, information about people’s gambling behavior has come almost exclusively from self-report (asking a person questions about their past gambling behaviors). Self-report is considered to be acceptably accurate by the scientific community, but it relies on recollections of individuals that may be influenced by a variety of factors such as desire to please interviewers or to downplay losses. For years these problems with self-reported data have presented a challenge to researchers studying gambling disorders. However, Dr. Shaffer suggested that new innovations in research methods will decrease the role of self-report and allow researchers to look directly at the gambling behavior of online gamblers.

To examine gambling behavior directly, researchers need to have access to all of the games played, bets made, wins and losses and other behaviors of those who gamble. In the online environment, those actions and more are being automatically stored by the online casino operator, as was the case in Dr. Shaffer’s study. Dr. Shaffer and his colleagues at the Division on Addictions partnered with European online casino operatorbwin(owned by bwin.party digital entertainment plc)and were given access to a record of the actual gambling activities of more than 40,000 people over a six-year period. (We have discussed this partnership in more detail in previous blog posts, including theSeptember 2010 edition of Issues & Insights).

This partnership has allowed the researchers to focus their efforts on groups that they would not otherwise be able to study, such as people who have closed their accounts because they have said they personally feel that they have “gambling problems”. This group consists of only 215 people out of the 47,000 who used the website during this period (LaBrie & H. J. Shaffer, 2011). The ability see the actual behaviors of this desired population (even when they make up only 1 out of every 218 users, as in this case) is, according to Dr. Shaffer, a revolution in gambling disorder research.

Dr. Shaffer suggested that access to data on the actual behaviors of gamblers creates the opportunity for several potential breakthroughs. For example, it may someday be possible for online casinos to use betting patterns to identify gamblers who are at risk for developing gambling problems before the problems manifest. (We discussed this possibilityin an interviewwith Division on Addictions researcher Dr. Sarah Nelson last year.)

It may also be possible to give firm answers to long standing questions, like “Are people who play certain games more likely to develop problems than others?” by examining the actual betting behavior of groups of gamblers. Only time will tell whether the research being done by groups like the Division on Addictions will be the next great leap forward in gambling disorder research, or just another small step towards some future revolution that is not yet kown.

What do you think the next revolution in gambling disorder research will be? Let us know in the comments section below!

References

LaBrie, R., & Shaffer, H. J. (2011). Identifying behavioral markers of disordered Internet sports gambling.Addiction Research & Theory,19(1), 56 – 65.

Shaffer, H. (2011, July 1).Scientific Revolutions: Understanding Gambling Disorders. Presented at the National Conference on Problem Gambling, Park Plaza Hotel, Boston MA.

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Revolutions In The Study Of Gambling Disorders: Howard Shaffer At The Ncpg Conference

As we have mentioned on Gambling Disorders 360˚, the NCRG staff has been attending and speaking at various conferences and meetings this summer. The first one of the summer was the National Conference on Problem Gambling on July 1-2.

This is the first post in a two-part series about the July 1 keynote address by Dr. Howard Shaffer. Dr. Shaffer, whosepublicationsandresearch reviewswe have featured previously on Gambling Disorders 360˚, is an associate professor of psychiatry at Harvard Medical School and director of the Division on Addictions at The Cambridge Health Alliance, a Harvard Medical School teaching affiliate. His talk was entitled “Scientific Revolutions: Understanding Gambling Disorders” in the spirit of the conference theme, “Celebrating 25 Years: Revolutionary Changes and Emerging Innovations” (Shaffer, 2011).

Dr. Shaffer began his remarks with a quotation by Thomas Paine that started, “Perhaps the sentiments contained in the following pages, are not YET sufficiently fashionable to procure them general favour…” With this opening line from the pamphletCommon Sense, Dr. Shaffer highlighted the appropriateness of the theme of revolutions at a conference scheduled for the July Fourth holiday weekend in Boston, Mass., a city rich with revolutionary history. Dr. Shaffer suggested that some of the founding principles of America, such as freedom of thought and freedom of speech, are also important scientific principles.

Dr. Shaffer then presented the audience with a history of the revolutionary researchers and ideas that have shaped our understanding of gambling disorders over the past 40 years:

– The pioneering work of Monsignor Joseph Dunne in the 1960s and 1970s that led to recognizing harmful gambling activities as a disordered behavior, similar to alcohol abuse and other addictive disordersrather than a moral failure.

– The work of Drs. Robert Custer, Henry Lesieur and Richard Rosenthal to quantify and validate gambling disorders, ultimately winning their inclusion in the Diagnostic and Statistical Manual of Mental Disorders in 1980 (American Psychiatric Association, 1980).

– The development of the South Oaks Gambling Screen (SOGS) by Drs. Henry Lesieur and Sheila Blume, the first widely used diagnostic instrument that appeared in many of the early prevalence studies (Lesieur & Blume, 1987).

– The national epidemiological studies conducted by Dr. Maureen Kallick-Kaufmann and colleagues in the 1970s that established a baseline understanding of gambling behavior in the United States and brought the tools of epidemiology to gambling disorders.

– The work of Dr. David Korn to frame gambling and gambling disorders as a public health issue.

Dr. Shaffer followed this tour of gambling research history with an explanation of how scientific revolutions occur, referencing the classic bookThe Structure of Scientific Revolutionsby Thomas Kuhn (Kuhn, 1962). The pattern of science begins, he said, in a pre-paradigm period with several paradigms being suggested and tested for validity. This gives way to an accepted paradigm (“normal science”) that becomes generally prevalent and forms the basis for research and theory. Over time the accepted paradigm is challenged by new research. If the new research supports the paradigm, then the paradigm is confirmed and expanded. However, some studies will not support the paradigm. If these dissenting studies are few, then they will be rejected as outliers – those that do not add to the current body of knowledge on the subject. But, if there are enough studies that challenge normal science, then there will be a scientific revolution, and new paradigms will be proposed to account for the findings of the previous paradigm and the new findings.

Dr. Shaffer described this pattern of paradigm, revolution, and paradigm shift as one of the fundamental ways that scientific theory progresses. He went on to present his thoughts about recent revolutions and paradigm shifts in the research of disordered gambling, ideas that we will discuss in the second part of this post.

What do you think of the ideas Dr. Shaffer presented? We welcome your thoughts and questions in the comments section below.

References

American Psychiatric Association. (1980).Diagnostic and Statistical Manual of Mental Disorders (DSM-III). Washington, DC: American Psychiatric Association.

Kuhn, T. (1962).The Structure of Scientific Revolutions(1st ed.). Chicago, IL: University of Chicago Press.

Lesieur, H. R., & Blume, S. B. (1987). The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers.American Journal of Psychiatry,144(9), 1184-8.

Shaffer, H. (2011, July 1).Scientific Revolutions: Understanding Gambling Disorders. Presented at the National Conference on Problem Gambling, Park Plaza Hotel, Boston MA.

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