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


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.


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



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.


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)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018
Corrected publication May/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

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