Etiological Considerations in Undertaking Research on Pathological Gambling

Etiological research is complex, and a number of aspects are essential to consider in undertaking it. They include the accuracy of diagnostic labels, the associations and causal relationships among potential risk factors, the uniqueness of risk factors, and age and cohort effects. In order to review the available evidence, the committee developed criteria to determine a causal association between a given risk factor and pathological gambling.

Diagnostic Labels

Considerable discussion has already been devoted to the definition, measurement, and prevalence of pathological gambling. When discussing the etiology of an illness, it is useful to revisit its label, because a label, as suggested by Nathan (1967), reflects the state of knowledge about the illness at the time it is labeled. In addition, etiological explanations keen on identifying causal pathways necessarily take labels into consideration, because they often describe the clinical site and clinical picture of an illness. For example, lung cancer, myocardial infarction, and lymphatic leukemia are medical labels that describe both the clinical site and the clinical picture of those illnesses. Medical labels such as tuberculosis and human immunodeficiency virus (HIV) can also specify the diagnosis, cause, or etiology of a physical illness.

Precise diagnostic labels are less common in psychiatry. However, with the American Psychiatric Association's introduction of the Diagnostic and Statistical Manual of Mental Disorders (DSM), research on the more common mental disorders has flourished and has led to a concomitant explosion in research on risk factors (Goodwin and Guze, 1974). Research on the diagnostic classification of pathological gambling has lagged behind, and it has been identified as an area in serious need of etiological research.

Associations and Causal Relationships

As with other areas of research, when designing, undertaking, or evaluating etiological research on pathological gambling,



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