Abstract
While most pathological gamblers, like most alcohol abusers, recover on their own, it seems likely that they are at greater risk for relapse than those who have been through successful treatment. Accordingly, a substantial increase in treatment resources for pathological gamblers, along with greater efforts to establish the effectiveness of these treatments, ought to receive national priority. If the data on alcohol-abusing self-changers are generalizable to self-changing pathological gamblers, the prognosis for gamblers who stop gambling all together is better than for those who aspire to controlled or nonproblem gambling. While pathological gamblers with comorbid substance abuse are more difficult to treat than those without it, the impact of comorbid substance abuse on the decision by pathological gamblers to change has not yet been explored, although it should be. Similarly, the impact of other Axis I pathology on pathological gambling self-change, especially depression and anxiety, should be thoroughly explored. The most pressing problem in this field appears to be definitional. As a consequence, until consensus is reached on a reliable, valid, and useful classification scheme for pathological gambling, both research and clinical efforts will continue to suffer.
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Alterman, A.I., O'Brien, C.P., McLellan, T., & McKay, J.R. (2001). Cocaine and opioid abuse/dependence disorders, In H.E. Adams & P.B. Slutker (Eds.), Comprehensive handbook of psychopathology (623-640). New York: Kluwer Academic/Plenum Publishers.
Armor, D.J., & Meshkoff, J.E. (1983). Remission among treated and untreated alcoholics. Advances in Substance Abuse, 3, 239-269.
Bandura, A. (in press). Health promotion from the perspective of social cognitive theory. Psychology and Health: An International Journal.
Davidson, R. (1992). Prochaska and DiClemente's model of change: A case study? British Journal of Addiction, 87, 821-822.
Dawson, D.A. (1996). Correlates of past-year status among treated and untreated persons with former alcohol dependence: United States. Alcoholism: Clinical and Experimental Research, 20, 771-779.
Haenninen, V., & Koski-Jaennes, A. (1999). Narratives of recovery from addictive behaviours. Addiction, 94, 1837-1848.
Hodgins, D.C., Wynne, H., & Makachuk, K. (1999). Pathways to recovery from gambling problems: Follow-up from a general population survey. Journal of Gambling Studies, 15, 93-104.
King, M.P., & Tucker, J.A. (2000). Behavior change patterns and strategies distinguishing moderation drinking and abstinence during the natural resolution of alcohol problems without treatment. Psychology of Addictive Behaviors, 14, 48-55.
Knupfer, G. (1972). Ex-problem drinkers. In M. Roff, L.N. Robins, & M. Pollack (Eds.), Life history research in psychopathology (Vol. 2, pp. 256-280). Minneapolis: University of Minnesota Press.
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (1997). Ninth special report to the US. Congress on alcohol and health. Washington, DC: National Institute on Alcohol Abuse and Alcoholism (NIAAA).
Petry, N.M., & Armentano, C. (1999). Prevalence, assessment, and treatment of pathological gambling: A review. Psychiatric Services, 50, 102 1-1027.
Prochaska, J.O., DiClemente, C.C., & Norcross, J.C. (1992). In search of how people change. American Psychologist, 47, 1102-1114.
Rosenthal, R.N. & Westreich, L. (1999). Treatment of persons with dual diagnoses of substance use disorder and other psychological problems. In B.S. McCrady & E.E. Epstein (Eds.), Addictions: A comprehensive guidebook (pp. 439-476). New York: Oxford University Press.
Sobell, L.C., Sobell, M.B., & Toneatto, T. (1992). Recovery from alcohol problems without treatment. In N. Heather, W.R. Miller, & J. Greely (Eds.), Self-control and the addictive behaviors (pp. 198-242). New York: Maxwell Macmillan.
Timko, C., Moos, R.H., Finney, J.W., & Lesar, M.D. (2000). Long-term outcomes of alcohol use disorders: Comparing untreated individuals with those in alcoholics anonymous and formal treatment. Journal of Studies on Alcohol, 61, 529-540.
Timko, C., Moos, R.H., Finney, J.W., Moos, B.S., & Kaplowitz, M.S. (1999). Long-term treatment careers and outcomes of previously untreated alcoholics. Journal of Studies on Alcohol, 60, 437-447.
Tucker, J.A., Vuchinich, R.E., & Pukish, M.M. (1995). Molar environmental contexts surrounding recovery from alcohol problems by treated and untreated problem drinkers. Experimental and Clinical Psychopharmacology, 3, 195-204.
Vaillant, G.E. (1995). The natural history of alcoholism revisited. Cambridge, MA: Harvard University Press.
Watson, A.L. & Sher, K.J. (1998). Resolution of alcohol problems without treatment: Methodological issues and future directions of natural recovery research. Clinical Psychology: Science and Practice, 5, 1-18.
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Nathan, P.E. The Role of Natural Recovery in Alcoholism and Pathological Gambling. J Gambl Stud 19, 279–286 (2003). https://doi.org/10.1023/A:1024255420820
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DOI: https://doi.org/10.1023/A:1024255420820