Abstract

Contemporary usage of addiction is contradictory and confusing; the term is highly stigmatizing but popularly used to describe almost any strong desire, passion or pursuit. Does current usage involve a recent corruption of the term or is there a history of conflicting meanings? 

Method: A diachronic etymological study of the terms ‘addict,’ ‘addicted’ and ‘addiction,’ informed by contemporary linguistic theory and utilizing primary and secondary sources in Archaic and Classical Latin and in English. We examine three periods: Early Roman Republic, Middle and Late Roman Republic, and Early Modern England. 

Findings: ‘To speak to,’ its earliest meaning, is explained by legal and augural technical usage (5th cent. BCE). As addicere and addictus evolved in the Middle and Late Roman Republic, the notion of enslavement, a secondary derivation from its legal usage, persisted as descriptive and no longer literal. In the Early Modern period, the verb addict meant simply ‘to attach.’ The object of that attachment could be good or bad, imposed or freely chosen. By the 17th century, addiction was mostly positive in the sense of devoting oneself to another person, cause or pursuit. We found no evidence for an early medical model. 

Conclusion: Gambling appears to be the only behavior that could satisfy both original uses; it had a strongly positive meaning (its association with divination), and an equally negative, stigmatizing one. Historically, addiction is an auto-antonym, a word with opposite, conflicting meanings. Recent applications are not a corruption of the word but are rooted in earliest usage.

Abstract

Background and Aims

Considerable variation of outcome variables used to measure recovery in the gambling treatment literature has precluded effective cross-study evaluations and hindered the development of best-practice treatment methodologies. The aim of this systematic review was to describe current diffuse concepts of recovery in the gambling field by mapping the range of outcomes and measurement strategies used to evaluate treatments, and to identify more commonly accepted indices of recovery.

Methods

A systematic search of six academic databases for studies evaluating treatments (psychological and pharmacological) for gambling disorders with a minimum 6-month follow-up. Data from eligible studies were tabulated and analysis conducted using a narrative approach. Guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adhered to.

Results

Thirty-four studies were reviewed systematically (RCTs = 17, comparative designs = 17). Sixty-three different outcome measures were identified: 25 (39.7%) assessed gambling-specific constructs, 36 (57.1%) assessed non-gambling specific constructs, and two instruments were used across both categories (3.2%). Self-report instruments ranged from psychometrically validated to ad-hoc author-designed questionnaires. Units of measurement were inconsistent, particularly in the assessment of gambling behaviour. All studies assessed indices of gambling behaviour and/or symptoms of gambling disorder. Almost all studies (n = 30; 88.2%) included secondary measures relating to psychiatric comorbidities, psychological processes linked to treatment approach, or global functioning and wellbeing.

Conclusions

In research on gambling disorders, the incorporation of broader outcome domains that extend beyond disorder-specific symptoms and behaviours suggests a multi-dimensional conceptualization of recovery. Development of a single comprehensive scale to measure all aspects of gambling recovery could help to facilitate uniform reporting practices across the field.

Adolescence is a period of time where young people are more likely to seek independence and novel experiences, experiment with their expression and identity and have less regard for risk. Given the natural surge in sensation-seeking behaviours, gambling and stimulant use may increase these effects and have potentially negative consequences to a young person's wellbeing and development. 

A recent study has examined the relationship between stimulant drug use and gambling in over 7000 high-school students. 

The results from the study found that the use of any stimulant drug increased the likelihood of problem gambling in both male and female students. Crack cocaine and methamphetamines​​​​​​ use were particularly associated with high risk and frequent gambling.

Factors that may contribute to an adolescent’s likelihood of substance use and gambling include family structure, parental support, peer influence, feelings of alienation, anxiety, low self-esteem, and impulsivity. It may be useful in some cases to regard high-risk behaviours as functional for an adolescent to achieve goals in their social environment.

Given that there is a positive relationship between gambling and substance use, it is possible that the involvement in gambling or stimulant use may motivate individuals to seek a similar state of psychological arousal. 

The apparent relationship that exists between substance use and gambling in adolescents highlights the importance of being mindful of the overlap between common high-risk behaviours when designing interventions.