Sarah E. Nelson, PhD

Dr. Sarah E. Nelson is the Associate Director for Research at the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital; as well as an Assistant Professor of Psychiatry at Harvard Medical School. She received her PhD in social psychology from the University of Oregon in 2003, where she studied both social cognition and developmental psychopathology. At the Division, Dr. Nelson has developed two major lines of research. She (1) studies the etiology of addiction, investigating the individual trajectories of people who develop problems with addiction and developing predictive models of that development, and (2) investigates the relationship between DUI offense, psychiatric comorbidity, and other psychosocial factors. The common thread throughout these studies has been the investigation of problem behaviors (e.g., why people act in self- and other- destructive ways): the causes, consequences, and prevention of those behaviors.

To study the interface between addiction and other problem behaviors, Dr. Nelson has focused throughout the past decade on driving under the influence of intoxicants (DUI) behavior. Her DUI work began with her collaboration on an NIAAA-funded R01 grant to study substance abuse and mental health in repeat DUI offenders. Analyses of this sample demonstrated considerable psychiatric comorbidity. Dr. Nelson recently completed analyses of the follow-up data from this project, investigating the relationship between comorbidity and DUI re-offense, and identifying subtypes of repeat DUI offenders distinguished by criminal background and type of psychiatric comorbidity. The findings from these studies have the potential to influence treatment for repeat DUI offenders. Currently, Dr. Nelson is the co-PI for a seven-year grant focused on applying past research to clinical practice. The project involves (1) the development and implementation of a mental health assessment system (the Computerized Assessment and Referral System: CARS) at DUI programs across the state of Massachusetts, (2) a randomized trial of CARS compared to intake as usual at those programs, (3) a prospective study of first-time and repeat DUI offenders enrolled at those programs, and (4) the implementation of CARS at five diverse national pilot sites.

Another way in which Dr. Nelson has attempted to better conceptualize both the etiology of addiction and how addiction relates to other problem behaviors is through the study of gambling as a behavioral addiction. Dr. Nelson’s gambling-related work has focused on the etiology of gambling problems, specifically the development and stability of gambling problems within individuals. Dr. Nelson and her colleagues have found that often-cited gambling problem trajectory differences between men and women can be attributed to other factors, including psychosocial characteristics and age of gambling initiation. In a meta-analysis of longitudinal studies of gambling problems, Dr. Nelson and her colleagues found that longitudinal research fails to support the common speculation that disordered gambling is chronic and progressive. Dr. Nelson has also collaborated on studies of gambling involvement, the effects of exposure on gambling, gambling self-exclusion and self-limitation programs, and internet gamblers, developing predictive models based on early play patterns to detect subscribers who are at risk for gambling problems.

Dr. Nelson has given invited presentations at local, national and international conferences and seminars. Dr. Nelson interweaves all of her presentations with examples and exercises that provide a basic survey of how science progresses and encourage people to think critically about research and practice. More formally, she has developed and co-directed a research methods seminar for health professionals at Cambridge Health Alliance and is the course director for an online Harvard CME course Research Methods 101 for the Provider: A Guide to Critical Research Consumption.

Current Projects

Principal Investigator: Developing a Computerized Assessment and Referral System (CARS)

An Evidence-based Approach to Understanding Fantasy Sports Activities

Assessing Responsible Gambling in Massachusetts

Updating and Refining Problem Gambling Treatment Guidelines for Treatment & Practice

Promoting Cultures of Recovery in Tribal Nations

Selected Publications

In Press

Shaffer, H. J., Gray, H. M., Nelson, S. E., LaPlante, D. A. (In Press). Technology, the Internet, and gambling: How the medium can facilitate addiction, adaptation, and intervention. In D. Faust, Faust, K., & Potenza, N. (Eds.), The Oxford Handbook of Digital Technologies and Mental Health: Second edition (Second ed., Vol. 1, pp. 135-142). Waltham, MA: Academic Press.

2016

Gray, H. M., Shaffer, P. M., Nelson, S. E., & Shaffer, H. J. (2016).Changing social networks among homeless individuals: A prospective evaluation of a job- and life-skills training program. Community Mental Health Journal, 5(7), 799-808. doi:10.1007/s10597-014-9817-5

Martin, R. J., Nelson, S. E., & Gallucci, A. R. (2016).Game on: Past year gambling, gambling-related problems, and fantasy sports gambling among college athletes and non-athletes. Journal of Gambling Studies, 32(2), 567-579. doi:10.1007/s10899-015-9561-y

2015

Nelson, S. E., Belkin, K., LaPlante, D. A., Bosworth, L., & Shaffer, H. J. (2015). A prospective study of psychiatric comorbidity and recidivism among repeat DUI offenders. Archives of Scientific Psychology, 3(1), 8-17.

Nelson, S. E., Van Ryzin, M. J., & Dishion, T. J. (2015). Alcohol, marijuana, and tobacco use trajectories from age 12 to 24 years: Demographic correlates and young adult substance use problems. Development and Psychopathology, 27(1), 253-277. doi:10.1017/S0954579414000650

2014

LaPlante, D. A., Nelson, S. E., & Gray, H. M. (2014). Breadth and depth involvement: Understanding Internet gambling involvement and its relationship to gambling problems. Psychology of Addictive Behaviors, 28(2), 396-403. doi:10.1037/a0033810

Martin, R. J., & Nelson, S. (2014). Fantasy sports, real money: Exploration of the relationship between fantasy sports participation and gambling-related problems. Addictive Behaviors, 39(10), 1377-1382. doi:10.1016/j.addbeh.2014.05.017

2013

Braverman, J., LaPlante, D. A., Nelson, S. E., & Shaffer, H. J. (2013). Using cross-game behavioral markers for early identification of high-risk internet gamblers. Psychology of Addictive Behaviors, 27(3), 868-877. doi:10.1037/a0032818

2012

Albanese, M. J., & Shaffer, H. J. (2012). Addiction: The genesis and evolution of an idea and its consequences. In H. J. Shaffer, LaPlante, D. A., & Nelson, S. E. (Eds.),The APA Addiction Syndrome Handbook (Vol. 1, Foundations, Influences, and Expressions of Addiction, pp. 3-25). Washington DC: American Psychological Association Press.

LaPlante, D. A. (2012). Technology and its relationship to the addiction syndrome. In H. J. Shaffer, LaPlante, D.A., & Nelson, S.E. (Eds.), The APA Addiction Syndrome Handbook (Vol. 2, Recovery, Prevention, and Other Issues, pp. 273-296). Washington DC: American Psychological Association Press.

LaPlante, D. A., Nelson, S.E., LaBrie, R.A., & Shaffer, H.J. (2012). The bwin.party Division on Addiction research collaborative: Challenges for the ‘normal science’ of Internet gambling. In R. J. Williams, Wood, R.T., & Parke, J. (Eds.), Routledge International Handbook of Internet Gambling (pp. 161-179). New York: Routledge.

Nelson, S. E., Gray, H. M., Maurice, I. R., & Shaffer, H. J. (2012). Moving ahead: Evaluation of a work-skills training program for homeless adults. Community Mental Health Journal, 48(6), 711-722. doi:10.1007/s10597-012-9490-5

Nelson, S. E., & Tao, D. (2012). Driving under the Influence: Epidemiology, etiology, prevention, policy, and treatment. In H. J. Shaffer, LaPlante, D. A., & Nelson, S. E. (Eds.), The APA Addiction Syndrome Handbook (Vol. 2, Recovery, Prevention, and Other Issues, pp. 365-407). Washington DC: American Psychological Association Press.

2011

LaPlante, D. A., Nelson, S. E., LaBrie, R. A., & Shaffer, H. J. (2011). Disordered gambling, type of gambling and gambling involvement in the British Gambling Prevalence Survey 2007. European Journal of Public Health, 21(4), 532-537. doi:10.1093/eurpub/ckp177

Martin, R. J., Nelson, S. E., Usdan, S., & Turner, L. (2011). Predicting college student gambling frequency using the theory of planned behavior: Does the theory work differently for disordered and non-disordered gamblers? Analysis of Gambling Behavior, 5(2), 45-62.

2010

Albanese, M. J., Nelson, S. E., Peller, A. J., & Shaffer, H. J. (2010). Bipolar disorder as a risk factor for repeat DUI behavior. Journal of Affective Disorders, 121(3), 253-257. doi:10.1016/j.jad.2009.06.015

Martin, R. J., Usdan, S., Nelson, S., Umstattd, M. R., LaPlante, D., Perko, M., & Shaffer, H. (2010). Using the theory of planned behavior to predict gambling behavior. Psychology of Addictive Behaviors, 24(1), 89-97. doi:10.1037/a0018452

Nelson, S. E., Kleschinsky, J. H., LaBrie, R. A., Kaplan, S., & Shaffer, H. J. (2010). One decade of self exclusion: Missouri casino self-excluders four to ten years after enrollment. Journal of Gambling Studies, 26(1), 129-144. doi:10.1007/s10899-009-9157-5

Peller, A. J., Najavits, L. M., Nelson, S. E., LaBrie, R. A., & Shaffer, H. J. (2010). PTSD among a treatment sample of repeat DUI offenders. Journal of Traumatic Stress, 23(4), 468-473. doi:10.1002/jts.20550

Schuman-Olivier, Z., Albanese, M., Nelson, S. E., Roland, L., Puopolo, F., Klinker, L., & Shaffer, H. J. (2010). Self-treatment: Illicit buprenorphine use by opioid-dependent treatment seekers. Journal of Substance Abuse Treatment, 39(1), 41-50. doi:10.1016/j.jsat.2010.03.014

Shaffer, H. J., Peller, A. J., LaPlante, D. A., Nelson, S. E., & LaBrie, R. A. (2010). Toward a paradigm shift in Internet gambling research: From opioid and self-report to actual behavior. Addiction Research & Theory, 18(3), 270-283.

2009

Kleschinsky, J. H., Bosworth, L. B., Nelson, S. E., Walsh, E. K., & Shaffer, H. J. (2009). Persistence pays off: Follow-up methods for difficult-to-track longitudinal samples. Journal of Studies on Alcohol and Drugs, 70(5), 751-761.

LaPlante, D. A., Kleschinkey, J. H., LaBrie, R. A., Nelson, S. E., & Shaffer, H. J. (2009). Sitting at the virtual poker table: A prospective epidemiological study of actual Internet poker gambling behavior. Computers in Human Behavior, 25(3), 711-717.

Nelson, S. E., Gebauer, L., LaBrie, R. A., & Shaffer, H. J. (2009). Gambling problem symptom patterns and stability across individual and timeframe. Psychology of Addictive Behaviors, 23(3), 523-533. doi:10.1037/a0016053

2008

Broda, A., LaPlante, D. A., Nelson, S. E., LaBrie, R. A., Bosworth, L. B., & Shaffer, H. J. (2008). Virtual harm reduction efforts for Internet gambling: Effects of deposit limits on actual Internet sports gambling behavior. Harm Reduction Journal, 5, 27. doi:10.1186/1477-7517-5-27 

LaBrie, R. A., Kaplan, S. A., LaPlante, D. A., Nelson, S. E., & Shaffer, H. J. (2008). Inside the virtual casino: A prospective longitudinal study of actual Internet casino gambling. European Journal of Public Health, 18(4), 410-416. doi:10.1093/eurpub/ckn021

LaPlante, D. A., Nelson, S. E., LaBrie, R. A., & Shaffer, H. J. (2008). Stability and progression of disordered gambling: Lessons from longitudinal studies. Canadian Journal of Psychiatry, 53(1), 52-60.

LaPlante, D. A., Nelson, S. E., Odegaard, S. S., LaBrie, R. A., & Shaffer, H. J. (2008). Substance and psychiatric disorders among men and women repeat driving under the influence offenders who accept a treatment-sentencing option. Journal of Studies on Alcohol and Drugs, 69(2), 209-217.

Nelson, S. E., LaPlante, D. A., Peller, A. J., Schumann, A., LaBrie, R. A., & Shaffer, H. J. (2008). Real limits in the virtual world: Self-limiting behavior of Internet gamblers. Journal of Gambling Studies, 24(4), 463-477. doi:10.1007/s10899-008-9106-8 

2007

LaBrie, R. A., LaPlante, D. A., Nelson, S. E., Schumann, A., & Shaffer, H. J. (2007). Assessing the playing field: A prospective longitudinal study of Internet sports gambling behavior. Journal of Gambling Studies, 23(3), 347-362. doi:10.1007/s10899-007-9067-3

LaBrie, R. A., Nelson, S. E., LaPlante, D. A., Peller, A. J., Caro, G., & Shaffer, H. J. (2007). Missouri Casino self-excluders: Distributions across time and space. Journal of Gambling Studies, 23(2), 231-243. doi:10.1007/s10899-006-9037-1 

Nelson, T. F., LaBrie, R. A., LaPlante, D. A., Stanton, M., Shaffer, H. J., & Wechsler, H. (2007). Sports betting and other gambling in athletes, fans, and other college students. Research Quarterly for Exercise and Sport, 78(4), 271-283. doi:10.1080/02701367.2007.10599425 

Nelson, S. E., LaPlante, D. A., Peller, A. J., LaBrie, R. A., Caro, G., & Shaffer, H. J. (2007). Implementation of a computerized psychiatric assessment tool at a DUI treatment facility: A case example. Administration and Policy in Mental Health, 34(5), 489-493. doi:10.1007/s10488-007-0125-z 

Shaffer, H. J., Nelson, S. E., LaPlante, D. A., LaBrie, R. A., Albanese, M., & Caro, G. (2007). The epidemiology of psychiatric disorders among repeat DUI offenders accepting a treatment sentencing option. Journal of Consulting and Clinical Psychology, 75(5), 795-804. doi:10.1037/0022-006X.75.5.795 

2006

LaPlante, D. A., Nelson, S. E., LaBrie, R. A., & Shaffer, H. J. (2006). Men & women playing games: Gender and the gambling preferences of Iowa gambling treatment program participants. Journal of Gambling Studies, 22(1), 65-80. doi:10.1007/s10899-005-9003-3 

Nelson, S. E., LaPlante, D. A., LaBrie, R. A., & Shaffer, H. J. (2006). The proxy effect: Gender and gambling problem trajectories of Iowa gambling treatment program participants. Journal of Gambling Studies, 22(2), 221-240. doi:10.1007/s10899-006-9012-x 

Shaffer, H. J., Stanton, M. V., & Nelson, S. E. (2006). Trends in gambling studies research: Quantifying, categorizing, and describing citations. Journal of Gambling Studies, 22(4), 427-442. doi:10.1007/s10899-006-9023-7 

2004

Shaffer, H. J., LaBrie, R. A., LaPlante, D. A., Nelson, S. E., & Stanton, M. V. (2004). The road less travelled: Moving from distribution to determinants in the study of gambling epidemiology. Canadian Journal of Psychiatry, 49(8), 504-516.

Reports

Kleschinsky, J. H., Kaplan, S. A., Nelson, S. E., LaBrie, R. A., & Shaffer, H. J. (2008). The Missouri Voluntary Exclusion Program: Participant Experience Across 10 Years. Boston, MA: Division on Addiction, Cambridge Health Alliance, a teaching affiliate of Harvard Medical School.

Nelson, S. E., Maurice, I. R., Shaffer, H. J. (2008). St. Francis House Moving Ahead Program (MAP): Phase II report. Boston, MA: Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital.

Nelson, S. E., Maurice, I. R., Shaffer, H. J. (2008). St. Francis House Moving Ahead Program (MAP): Phase I report. Boston, MA: Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital.

Shaffer, H. J., LaBrie, R. A., LaPlante, D. A., Kidman, R. C., & Nelson, S. E. (2004). The Iowa Department of Public Health Gambling Treatment Services: Follow-up study(Technical Report #20304-200). Boston: Harvard Medical School. 

Shaffer, H. J., LaBrie, R. A., LaPlante, D. A., & Nelson, S. B. (2004). Disordered gambling in Missouri: Regional differences in the need for treatment. Phase I Report prepared for: The Greater Kansas City Community Foundation in partial fulfillment of the research grant “Evaluation Services with Regard to the Regional Impact of Compulsive Gambling” supported by the Port Authority Problem Gambling Fund.