title: Stability and progression of disordered gambling: lessons from longitudinal studies.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  We reviewed 5 recent prospective studies of gambling behaviour among nontreatment samples for evidence related to the stability and progression of disordered gambling.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Research Faculty, Division on Addictions, Cambridge Health Alliance, Harvard Medical School, Medford, Massachusetts, USA. debi_laplante@hms.harvard.edu
authors.forename: Debi A
authors.initials: DA
authors.lastname: LaPlante
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Nelson
authors.forename: Richard A
authors.initials: RA
authors.lastname: LaBrie
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Shaffer
mesh_terms: D018450:Disease Progression; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000453:epidemiology* / Q000523:psychology*; D005500:Follow-Up Studies; D005715:Gambling / Q000523:psychology*; D006801:Humans; D011446:Prospective Studies; D012944:Social Support