Gambling disorder subtypes: an updated systematic review

Blaszczynski and Nower established the Pathways model as an integrative theoretical framework for subtyping GD. Within this framework, they propose three etiological subtypes of problem gamblers: (a) behaviorally conditioned, (b) emotionally vulnerable, and (c) antisocial impulsivist gamblers. The current systematic review was conducted to evaluate the validity and clinical utility of the Pathways model and other subtyping models, providing an update to a previous systematic review. A literature search was conducted using the PubMed, PsycINFO, and Web of Science databases. Included articles were written in English, and published in a peer-reviewed journal between 2010 and 2021. The articles used empirical methods to derive subtypes from a sample of individuals who gamble, including both qualitative and quantitative methods. In total, 38 articles were included in this review. Articles are presented as consistent with Pathways or as utilizing another subtyping schema. Evaluation of the literature reveals that use of the Pathways model appears to be influential in efforts to subtype gamblers over the last decade. Other subtyping schemas that emphasize symptom severity and comorbid psychopathology may be incorporated into the Pathways model. Gaps in the current literature and future directions are discussed.