shafferetalCJP2004 - In Review The Road Less Travelled:...

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In Review The Road Less Travelled: Moving From Distribution to Determinants in the Study of Gambling Epidemiology Howard J Shaffer, PhD 1 , Richard A LaBrie, EdD 2 , Debi A LaPlante, PhD 3 , Sarah E Nelson, PhD 3 , Michael V Stanton, BA 4 Key Words: gambling, epidemiology, prevalence, incidence, diagnosis B y primarily focusing on the distribution of gambling and gambling disorders, the epidemiologic study of gambling has progressed along the same initial path as most psychiatric epidemiology. Now, this field faces divergent roads. Down one is the extension of the well-travelled path of prevalence studies in geopolitical areas (for example, nations, states, and provinces) and targets of opportunity (for example, schools, organizations, and local groups). Down the other—the road less travelled—lies a turn toward studies of gambling determinants. A vast assortment of games of chance have existed throughout recorded history; however, the 20th century has seen remark- able growth in gambling’s visibility, availability, and accessi- bility through the proliferation of legalized casinos and gambling houses (1,2). In addition to the potential loss of money, research links gambling with various physical and mental health problems (3–5). As gambling’s availability and popularity have grown, so has the extent of gambling-related problems, leading to increased interest in the study of gambling and its consequences. 504 W Can J Psychiatry, Vol 49, No 8, August 2004 This article reviews the current status of gambling epidemiology studies and suggests that it is time to move from general population-prevalence research toward the investigation of risk and protective factors that influence the onset of gambling disorders. The study of incidence among vulnerable and resilient populations is a road yet to be taken. In this review, we briefly introduce the history of the field and thoroughly review the epidemiologic research on disordered gambling before providing a critical assessment of the current diagnostic tools. Overall, the extant research shows that disordered gambling is a relatively stable phenomenon throughout the world. Given that certain segments of the population (for example, adolescents and substance users) have elevated prevalence rates, we suggest focusing future prevalence studies on groups with apparently increased vulnerability. Moreover, we suggest that, for the field of gambling studies to progress, researchers need to take the road less travelled and examine more carefully the onset and determinants of disordered gambling. That said, given the problems with the current diagnostic screens, investigators need to refine their theoretical concepts and the epidemiologic tools used to examine them before the field can travel down this new road.
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This note was uploaded on 09/08/2010 for the course BUS 186 at San Jose State University .

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shafferetalCJP2004 - In Review The Road Less Travelled:...

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