naturalhistory - The Journal of Social Psychology 2002...

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405 The Journal of Social Psychology, 2002, 142 (4), 405–424 The Natural History of Gambling and Drinking Problems Among Casino Employees HOWARD J. SHAFFER MATTHEW N. HALL Division on Addictions Harvard Medical School ABSTRACT. From an eligible population of 9,943 casino employees, 6,067 volunteered to participate in this study. Of this sample, 1,176 provided data at 3 observation points approximately 12 months apart. Using the South Oaks Gambling Screen (SOGS; H. R. Lesieur & S. B. Blume, 1987) and the CAGE (J. A. Ewing, 1984) questionnaire, the authors prospectively examined the prevalence and patterns of alcohol and gambling prob- lems among those employees. Among the casino employees with gambling and drinking problems, a segment displayed the capacity to diminish those problems even when the dif- ficulties had reached disordered levels. The authors also examined the comorbidity of gam- bling and drinking as well as the relationships among changes in SOGS scores and CAGE scores and changes in demographic and biological variables. The women were more like- ly to decrease their problem-drinking scores, but not their gambling scores, when com- pared with the men. In addition, 2 key variables (i.e., disabling depression and dissatis- faction with one’s personal life) emerged as predictors of transitions to healthier levels of disordered gambling. The authors cautiously suggest, in light of the results taken togeth- er, that more fluctuation is associated with gambling and drinking problems than previ- ously thought and that the conventional wisdom about disordered gambling as “always progressive” needs reconsideration. Key words: alcohol abuse, casino employees, comorbidity, pathological gambling THE NATIONAL ACADEMY OF SCIENCES (National Research Council, 1999) and the National Gambling Impact Study Commission (1999) have encour- aged the use of prospective longitudinal designs in the study of gambling-related problems. Empirical evidence on the natural history of this disorder is extreme- ly sparse. Intemperate gambling often has been cast as an addiction (e.g., Brig- gs, Goodin, & Nelson, 1996; Cook, 1987; Jacobs, 1989; Korn & Shaffer, 1999; Lorenz, 1998; Orford, 1985; Rosenthal, 1997; Shaffer, 1999b). From this per- spective, the conventional wisdom has portrayed gambling-related problems as
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progressive, implying that, once gambling is problematic, it is progressive and chronic (e.g., American Psychiatric Association, 1994; Custer, 1982). Using prospective, longitudinal research, Vaillant and Zinberg revised some of the conventional wisdom associated with alcohol and heroin abuse and depen- dence by demonstrating that substance-related problems may shift over time and influence the expression of psychopathology (Vaillant, 1983; Zinberg & Fraser, 1979; Zinberg & Jacobson, 1976). In previous work, Shaffer and his associates encouraged the development and implementation of prospective research designs to monitor the movement of gamblers through the various transitional stages that might be associated with gambling disorders (Shaffer & Hall, 1996; Shaffer, Hall, & Vander Bilt, 1997). In addition, Shaffer and associates have suggested that
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naturalhistory - The Journal of Social Psychology 2002...

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