Hodgins, David CarsonKim, Andrew Hyounsoo2020-08-182020-08-182020-08Kim, H. S. (2020). Addiction substitution and concurrent recovery in gambling disorder: evidence from multiple studies (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.http://hdl.handle.net/1880/112406The dissertation aimed to increase our understanding of addiction substitution and concurrent recovery in gambling disorder. In Study 1, a systematic review was conducted to identify empirical studies on addiction substitution. A total of 79 studies met the inclusion criteria. Of the studies that provided statistical results, relatively few studies (18.18%) found support for addiction substitution. The majority of studies (50.91%) found support for a concurrent model of recovery. Addiction substitution was associated with worse treatment outcomes and increased risk of relapse. Males, younger age, greater substance use severity, and the presence of mental health disorders were associated with addiction substitution. In Study 2, a mixed-method study was conducted with 185 people who were recovered from gambling disorder and engaged in addiction substitution, concurrent recovery, or neither (i.e., controls). Semi-structured interviews were used to assess the processes (e.g., reasons, emotional state, helpfulness) associated with engaging in addiction substitution and concurrent recovery. Participants also completed a survey assessing their demographic, gambling, and psychological characteristics. The most frequently reported reason for increasing another addictive behavior was as a substitute coping mechanism, whereas a connection between the addictions (i.e., simultaneous use) was most commonly reported as the reason for engaging in concurrent recovery. Addiction substitution was associated with greater underlying psychological vulnerabilities. In Study 3, co-occurring patterns of problem gambling and addiction severity as well as their predictors were examined in a secondary analysis of a 5-year prospective longitudinal study of gambling and problem gambling (N= 4,121 participants). Predictors included demographics, mental health disorders, personality, stress, life satisfaction, happiness and social support. Six co-occurring patterns were identified. The largest co-occurring pattern was characterized by concurrent recovery. Several co-occurring patterns were characterized by moderate to severe problem gambling and addiction severity that remained stable over time. No co-occurring pattern represented addiction substitution. The presence of mental health disorders, stress, and life satisfaction significantly predicted the different co-occurring patterns. Taken together, the results suggest that individuals are more likely to engage in concurrent recovery compared to addiction substitution. However, addiction substitution is associated with greater severity of problems and worse treatment outcomes.University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Addiction substitutionConcurrent recoveryGambling disorderSystematic reviewMixed-methodBehavioural AddictionsPsychology--Clinicaldoctoral thesis10.11575/PRISM/38093