Recovery in pathological gambling: an imprecise concept

Pathological gambling is classified as a disorder of impulse control, though many of its diagnostic criteria parallel those found in substance use disorders. A number of unitary and complex biopsychosocial conceptual models have been postulated to account for the multifactorial nature of gambling pathology. These models have implications for varied treatment approaches in the management of pathological gambling. Recovery is a diffused concept that has been variously and inconsistently determined by the remission or absence of clinical symptoms, the absence of diagnostic criteria, or the achievement of personal development, independence, and function. The lack of conceptual clarity and definitional precision make it difficult to ascertain the actual efficacy of interventions or their relative effectiveness when compared to similar treatments in different population settings or to different treatment approaches. Future investigations should clearly conceptualize the concept of recovery to evaluate the nature and extent of improvement along a spectrum that includes measurement of (a) decreases in frequency of and the time spent gambling, (b) abstinence or controlled gambling that meets financial obligations, (c) absence of symptoms of impaired control and cross-addicted behaviors, and (d) absence of negative consequences and improved quality of life over time.