LaPlante Debi A, Nelson Sarah E, LaBrie Richard A, Shaffer Howard J
Research Faculty, Division on Addictions, Cambridge Health Alliance, Harvard Medical School, Medford, Massachusetts, USA.
Can J Psychiatry. 2008 Jan;53(1):52-60. doi: 10.1177/070674370805300108.
Few studies have explicitly examined the stability (that is, the tendency for individuals to stay at one diagnostic level as opposed to moving to another improved or worsened level) or progression of disordered gambling; however, conventional wisdom holds that disordered gambling is intractable and escalating. The objective of this study was to examine these assumptions.
We reviewed 5 recent prospective studies of gambling behaviour among nontreatment samples for evidence related to the stability and progression of disordered gambling.
Our review found no evidence to support the assumption that individuals cannot recover from disordered gambling (that is, the persistence assumption), no evidence to support the assumption that individuals who have more severe gambling problems are less likely to improve than individuals who have less severe gambling problems (that is, the selective-stability assumption), and no evidence to support the assumption that individuals who have some gambling problems are more likely to worsen than individuals who do not have gambling problems (that is, the progression assumption).
Contrary to professional and conventional wisdom suggesting that gambling problems are always progressive and enduring, this review demonstrates instability and multidirectional courses in disordered gambling.
很少有研究明确考察过病态赌博的稳定性(即个体停留在某一诊断水平而非转向另一改善或恶化水平的倾向)或进展情况;然而,传统观点认为病态赌博难以治疗且会不断升级。本研究的目的是检验这些假设。
我们回顾了5项近期针对非治疗样本中赌博行为的前瞻性研究,以寻找与病态赌博的稳定性和进展相关的证据。
我们的回顾没有发现证据支持个体无法从病态赌博中恢复的假设(即持续性假设),没有发现证据支持赌博问题更严重的个体比问题较轻的个体改善可能性更小的假设(即选择性稳定性假设),也没有发现证据支持有一些赌博问题的个体比没有赌博问题的个体更可能恶化的假设(即进展假设)。
与认为赌博问题总是渐进且持久的专业和传统观点相反,本回顾表明病态赌博存在不稳定性和多向性病程。