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, whose publications and research reviews we 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 pamphlet Common 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 book The Structure of Scientific Revolutions by 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.
