Cambridge Health Alliance

Dr. Howard Shaffer, director of the Division on Addiction at Cambridge Health Alliance, a Harvard Medical School teaching affiliate, spoke on the subject of research revolutions in gambling disorders at last year’s National Council on Problem Gambling annual conference. Although he was discussing new trends in gambling research, “revolution” is also an apt term to describe the work of Dr. Shaffer and his colleagues at the Division on Addiction, which is celebrating its 20th anniversary this year.

Part two of the series recapping Dr. Howard Shaffer’s keynote address at the 25^th National 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.

The American Psychiatric Association (APA) has proposed new criteria for a diagnosis of pathological gambling (PG) in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, slated for publication in 2013.  As reported in Issues and Insights and discussed at the 2010 NCRG Conference on Gambling and Addiction, the proposed revisions included moving PG from the impulse control category into a new classification, “addiction and related disorders.” It also proposes dropping illegal acts from the 10 criteria and possibly reducing the number of criteria needed for a diagnosis from five to four. A new review article by Howard J. Shaffer and Ryan Martin in the 2011 Annual Review of Clinical Psychology (Shaffer & Martin, 2011) provides a critical review of these recommendations.