Self-Directed Gambling Changes: Trajectory of Problem Gambling Severity in Absence of Treatment

  • Vladyslav Kushnir
  • Alexandra Godinho
  • David C. Hodgins
  • Christian S. Hendershot
  • John A. Cunningham
Original Paper

Abstract

Most problem gamblers do not seek formal treatment, recovering on their own through cognitive re-appraisal or self-help strategies. Although barriers to treatment have been extensively studied, there is a paucity of research on self-directed changes in problem gambling and very few studies have examined these changes prospectively. The aim of this study was to examine the trajectory of gambling severity and behavior change over an 18-month period, among a sample of non-treatment seeking/attending problem gamblers recruited from the community (N = 204) interested in quitting or reducing gambling. Separate mixed effects models revealed that in absence of formal treatment, significant reductions in gambling severity, frequency, and amount gambled could be observed over the course of a 6 to 9-month period and that changes experienced within the first 12 months were maintained for an extended 6 months. Problem gambling severity at baseline was significantly associated with changes in severity over time, such that participants with more severe gambling problems demonstrated greater reductions in their gambling severity over time. A total of 11.1% of participants gambled within a low-risk threshold at 18 months, although 28.7% of the sample reported consecutive gambling severity scores below problem levels for the duration of 1 year or longer. The findings suggest that among problem gamblers motivated to quit or reduce their gambling, significant self-directed changes in gambling severity can occur over a relatively short time. Additional prospective studies are needed to document the role of specific self-help tools or thought processes in exacting gambling changes.

Keywords

Self-directed change Natural recovery Gambling severity Problem gambling Prospective study 

Notes

Acknowledgements

This research was funded by Gambling Research Exchange Ontario (formerly the Ontario Problem Gambling Research Centre). The views expressed in this article do not necessarily reflect those of Gambling Research Exchange Ontario. We would also like to thank Marcos Sanches, Statistician at the Centre for Addiction and Mental Health, for assistance with statistical analysis in this study.

Funding

This research was funded by the Ontario Problem Gambling Research Centre.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Supplementary material

10899_2018_9769_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)

References

  1. Abbott, M. W., Bellinger, M., Garrett, N., & Mundy-McPherson, S. (2016). New Zealand national gambling study: Report number 5. Auckland, New Zealand: Auckland University of Technology: Gambling and Addictions Research Centre.Google Scholar
  2. Billi, R., Stone, C. A., Marden, P., & Yeung, K. (2014). The Victorian Gambling Study. A longitudinal study of gambling and health in Victoria, 2008–2012. Victoria, Australia: Victorian Responsible Gambling Foundation.Google Scholar
  3. Cunningham, J. A., Hodgins, D. C., Toneatto, T., & Murphy, M. (2012). A randomized controlled trial of a personalized feedback intervention for problem gamblers. PLoS ONE, 7(2), e31586.  https://doi.org/10.1371/journal.pone.0031586.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Currie, S. R., Hodgins, D. C., & Casey, D. M. (2013). Validity of the Problem Gambling Severity Index interpretive categories. Journal of Gambling Studies, 29(2), 311–327.CrossRefPubMedGoogle Scholar
  5. Currie, S. R., Hodgins, D. C., Wang, J., el-Guebaly, N., Wynne, H., & Chen, S. (2006). Risk of harm among gamblers in the general population as a function of level of participation in gambling activities. Addiction, 101(4), 570–580.CrossRefPubMedGoogle Scholar
  6. el-Guebaly, N., Casey, D. M., Currie, S. R., Hodgins, D. C., Schopflocher, D. P., Smith, G. J., et al. (2015). The Leisure, Lifestyle, and Lifecycle Project (LLLP): A longitudinal study of gambling in Alberta. https://dspace.ucalgary.ca/bitstream/1880/50377/1/LLLP_Final_Report_Feb21_2015_V4.pdf.
  7. Ferris, J., & Wynne, H. (2001). The Canadian problem gambling index: Final report. Canadian Centre on Substance Abuse.Google Scholar
  8. Gainsbury, S., Hing, N., & Suhonen, N. (2014). Professional help-seeking for gambling problems: Awareness, barriers and motivators for treatment. Journal of Gambling Studies, 30(2), 503–519.  https://doi.org/10.1007/s10899-013-9373-x.CrossRefPubMedGoogle Scholar
  9. Hing, N., Nuske, E., & Gainsbury, S. (2011). Gamblers at-risk and their helpseeking behaviour. https://www.gamblingresearch.org.au/publications/gamblers-at-risk-and-their-help-seeking-behaviour-2011. Accessed 6 June 2017.
  10. Hodgins, D. C., & el-Guebaly, N. (2000). Natural and treatment-assisted recovery from gambling problems: A comparison of resolved and active gamblers. Addiction, 95, 777–789.CrossRefPubMedGoogle Scholar
  11. Hodgins, D. C., Fick, G. H., Murray, R., & Cunningham, J. A. (2013). Internet-based interventions for disordered gamblers: Study protocol for a randomized controlled trial of online self-directed cognitive-behavioural motivational therapy. BMC Public Health, 13, 10.  https://doi.org/10.1186/1471-2458-13-10.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Kim, H. S., Wohl, M. J., Salmon, M., & Santesso, D. (2017). When do gamblers help themselves? Self-discontinuity increases self-directed change over time. Addictive Behaviors, 64, 148–153.  https://doi.org/10.1016/j.addbeh.2016.08.037.CrossRefPubMedGoogle Scholar
  13. Klingemann, H., Sobell, M. B., & Sobell, L. C. (2010). Continuities and changes in self-change research. Addiction, 105(9), 1510–1518.CrossRefPubMedGoogle Scholar
  14. Luce, C., Nadeau, L., & Kairouz, S. (2016). Pathways and transitions of gamblers over two years. International Gambling Studies, 16(3), 357–372.CrossRefGoogle Scholar
  15. Responsible Gambling Council. (2016). Responsible Gambling Council Annual Report 2015–2016. http://www.responsiblegambling.org/docs/default-source/rgc-research/rgc-ar-2015-2016.pdf?sfvrsn=abc5193c_14. Accessed 23 February 2018.
  16. Rodda, S., Lubman, D. I., Dowling, N. A., Bough, A., & Jackson, A. C. (2013). Web-based counseling for problem gambling: Exploring motivations and recommendations. Journal of Medical Internet Research, 15(5), e99.  https://doi.org/10.2196/jmir.2474.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two U.S. national surveys. American Journal of Psychiatry, 163, 297–302.CrossRefPubMedGoogle Scholar
  18. Slutske, W. S., Blaszczynski, A., & Martin, N. G. (2009). Sex differences in the rates of recovery, treatment-seeking, and natural recovery from pathological gambling: Results from an Australian community-based twin survey. Twin Research and Human Genetics, 12(5), 425–432.CrossRefPubMedGoogle Scholar
  19. Slutske, W. S., Jackson, K. M., & Sher, K. J. (2003). The natural history of problem gambling from age 18 to 29. Journal of Abnormal Psychology, 112(2), 263–274.CrossRefPubMedGoogle Scholar
  20. Slutske, W. S., Piasecki, T. M., Blaszczynski, A., & Martin, N. G. (2010). Pathological gambling recovery in the absence of abstinence. Addiction, 105(12), 2169–2175.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Suurvali, H., Cordingley, J., Hodgins, D. C., & Cunningham, J. (2009). Barriers to seeking help for gambling problems: A review of the empirical literature. Journal of Gambling Studies, 25(3), 407–424.  https://doi.org/10.1007/s10899-009-9129-9.CrossRefPubMedGoogle Scholar
  22. Toneatto, T., Cunningham, J., Hodgins, D., Adams, M., Turner, N., & Koski-Jannes, A. (2008). Recovery from problem gambling without formal treatment. Addiction Research & Theory, 16(2), 111–120.CrossRefGoogle Scholar
  23. Wandersleben, E. (2015). New Ohio problem gambling awareness campaign launched. http://mha.ohio.gov/Portals/0/assets/News/pressReleases/Be-the-95-percent-press-release-8-25.pdf. Accessed 23 February 2018.
  24. Wiebe, J., Maitland, S. B., Hodgins, D., Davey, A., & Gottlieb, B. (2009). Transitions and stability of problem gambling behaviours. Winnipeg, MB: Addictions Foundation of Manitoba.Google Scholar
  25. Williams, R. J., Hann, R. G., Schopflocher, D., West, B., McLaughlin, P., White, N., et al. (2015). Quinte longitudinal study of gambling and problem gambling. http://hdl.handle.net/10133/3641.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Vladyslav Kushnir
    • 1
    • 2
  • Alexandra Godinho
    • 1
    • 3
  • David C. Hodgins
    • 4
  • Christian S. Hendershot
    • 1
    • 5
    • 6
  • John A. Cunningham
    • 1
    • 6
    • 7
  1. 1.Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Leslie Dan Faculty of PharmacyUniversity of TorontoTorontoCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  4. 4.Department of PsychologyUniversity of CalgaryCalgaryCanada
  5. 5.Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
  6. 6.Department of PsychiatryUniversity of TorontoTorontoCanada
  7. 7.Research School of Population HealthAustralian National UniversityCanberraAustralia

Personalised recommendations