Pathological Gambling

Gambling addiction, or pathological gambling, has become a significant problem in the United States, impacting teenagers and adults of all ages and their families. Pathological gambling is defined as an urge or addiction to gamble despite harmful or negative consequences or a desire to stop. Due to recent changes in gaming laws, accessibility to gambling has become more widespread, thus increasing the prevalence of gambling related addictions. Previously, legal casinos and sports betting were limited to two states. The widespread growth of riverboat and Native American casinos, state and national lotteries, and easy availability of internet on-line betting has dramatically increased gambling access for everyone, including senior citizens. Older adults are, perhaps, even more vulnerable than other age groups given their greater dependence on fixed incomes and limited ability to recover from large gambling losses.

Gambling is a widespread activity and most people are able to gamble responsibly for enjoyment. However, somewhere between one and five percent of the people who gamble are unable to control their behavior and are considered to have a gambling addiction.

Diagnosis

Pathological gambling is considered a psychiatric disorder in the area of impulse control group and is included in the American Psychological Diagnostic and Statistical Manual (DSM IV) as a recognized disorder when the individual meets at least five of the ten criteria listed below:

  1. The individual is preoccupied with gambling (i.e. preoccupied with reliving past gambling experiences, thinking of ways to get money to gamble or planning their next gambling trip)

  2. The individual needs to gamble with increasing amounts of money in order to achieve the same effect.

  3. The individual has repeated unsuccessful efforts at stopping.

  4. The individual is restless or irritable with attempting to cut down.

  5. The individual gambles as a way of escaping from problems or relieving a dysphoric mood (i.e. feelings of helplessness, guilt, anxiety and depression).

  6. The individual, after losing money gambling, often returns another day to get even (“chasing” one’s losses).

  7. The individual lies to family members, therapist or others to conceal gambling.

  8. The individual has committed illegal acts such as forgery, fraud, theft or embezzlement to finance gambling.

  9. The individual has jeopardized or lost a significant relationship, job, education or career opportunity because of gambling.

  10. The individual relies on others to provide money or relieve a desperate financial situation caused by gambling.

If the answer to any of these questions is “yes”, seeking help from a professional is strongly advised before it can develop into a psychiatric impulse control disorder. A “yes” to just one of these behaviors can spell disaster to the prospect of living a balanced, healthy life. Available research seems to indicate that problem gambling is an internal problem. Problem gamblers will risk money on whatever game is available as opposed to the availability of a particular game in otherwise “normal” individuals. However, research also indicates that pathological gamblers tend
to risk money on fast-paced games. Thus, a problem gambler is much more likely to become addicted to and lose more money on games such as poker, blackjack and slot machines, where rounds end quickly and there is constant temptation to play again or increase bets, as opposed to state lotterieswhere the gambler must wait until the next drawing to see results. In fact, slot machines and video card games have become known as the “crack cocaine” of gambling because of their fast-paced, “bells and whistles” approach which can easily become addictive.

Treatment

Pathological gambling is very similar in definition and symptoms to substance abuse and treatment is often modeled on drug and alcohol treatment models. Treatment generally consists of the use of a 12-step program, behavior modification and counseling, including individual, group and family therapy. Participation in Gambler’s Anonymous programs which advocate abstinence principles and group support has been found to be helpful for some individuals.

Treatment for the person with pathological gambling begins with the recognition of the problem, which can be difficult since the person is often in denial and does not see the reason for treatment or change in their behavior. Most addicted gamblers enter treatment under pressure from others because of relationship, financial or legal difficulties. They may already have accumulated large debts or be facing criminal charges by the time they recognize their need for professional intervention. As with any addiction, recovery takes discipline, self-control and understanding of the reasons for the maladaptive behavior. Pathological gamblers must be committed to make big changes in their lives for treatment to be successful. The chance of relapse with gambling, as with other addictions, is very high given the prevalence and accessibility of gambling whether at a casino or on-line betting.

For further information contact:

Gamblers Anonymous: www.gamblersanonymous.org
National Center for Responsible Gaming: www.ncrg.org
Michigan Department of Community Health website: www.gambleresponsibly.org
Michigan Problem Gambling Helpline: Toll free (800) 270-7117
Local Community Mental Health Center

Written by: Marsha Phillips, M.A., L.P.C.

Reference: Phillips, M. (September 2006). Pathological gambling. Mental Health Matters.
3(11). Gratiot Medical Center: An Affiliate of MidMichigan Health.