UNIVERSIDAD DEL SALVADOR

FACULTAD DE PSICOLOGÍA Y PSICOPEDAGOGÍA

Gambling Disorder (Compulsive Gambling, Pathological

Gambling)
Reviewed by Psychology Today Staff
Betting the farm can actually be a serious problem for some people. Compulsive
and habitual gambling can destroy people's lives. They may suffer personal
problems and financial ruin, with problem gambling sometimes leading to a life
of crime.
A compulsive, or pathological, gambler is someone who is unable to resist their
impulses. This can lead to severe consequences. The urge to gamble becomes
so great that tension can only be relieved by gambling more and more.
Sufferers are often unaware, or in denial, of having a problem. The first step
toward addressing gambling is admitting there is a problem. For some people,
this awareness comes only when they reach rock-bottom.
This condition was formerly a compulsive disorder and is now considered
an addiction disorder in the DSM-5.

Symptoms

How do you know if you are a compulsive, or pathological, gambler?

Although some people gamble occasionally, the pathological gambler usually
progresses from occasional gambling to habitual gambling. As this progresses,
the gambler will risk more and more, leading to severe personal problems,
financial ruin, and possibly criminal behavior.
Signs and symptoms as cataloged by the DSM-5; persistent and recurrent
problematic gambling behavior leading to clinically significant impairment or
distress, is indicated by the individual exhibiting four (or more) of the
fol­lowing in a 12-month period:
 Needs to gamble with increasing amounts of money to achieve the desired
excitement.
 Is restless or irritable when attempting to cut down or stop gambling.
 Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
 Is often preoccupied with gambling (for example, having persistent thoughts of
reliving past gambling experiences, handicapping or planning the next venture,
thinking of ways to get money with which to gamble).
 Often gambles when feeling distressed (for example, helpless, guilty, anxious,
depressed).
 After losing money gambling, often returns another day to get even (“chasing”
one’s losses).
 Lies to conceal the extent of involvement with gambling.
 Has jeopardized or lost a significant relationship, job, or educational
or career opportunity because of gambling.
 Relies on others to provide money to relieve desperate financial situations
caused by gambling.
 The gambling behavior is not better explained by a manic episode.
Gambling addiction affects 1 to 3 percent of adults of all ages, men more often
than women. It normally begins in adolescence in men and later in women.
People with pathological gambling behavior often have problems with alcohol and
other substances, depression, and anxiety. People with this behavior do
sometimes consider suicide.
People with pathological gambling behavior tend to have personal, financial, and
legal problems, including bankruptcy, divorce, job loss, and prison time.
The stress of gambling can also lead to heart attacks in people at risk for them.
The right treatment can help prevent many of these problems.

Course of the Disorder

The onset of gambling disorder can occur during adolescence or young

adulthood, but in other individuals, it manifests during middle or even older
adulthood. Generally, gambling disorder develops over the course of years,
although the progression appears to be more rapid in females than in males. Most
individuals who develop a gambling disorder demonstrate a pattern of gambling
that gradually increases in both frequency and amount of wagering. Certainly,
milder forms can develop into more severe cases.
Most individuals with gambling disorder report that one or two types of gambling
are most problematic for them, although some individuals participate in many
forms of gambling. Individuals are likely to engage in certain types of gambling
(buying scratch tickets daily) more frequently than others (playing slot machines
or blackjack at the casino weekly). The frequency of gambling can be related
more to the type of gambling than to the severity of the overall gambling disorder.
For example, purchasing a single scratch ticket each day may not be problematic,
while less frequent casino, sports, or card gambling may be part of a gambling
disorder. Similarly, amounts of money spent wagering may not be necessarily
indicative of gambling disorder. Some individuals can wager thousands of dollars
per month and not have a problem with gambling, while others may wager much
smaller amounts but experience substantial gambling-related difficulties.
Gambling patterns may be regular or episodic, and gambling disorder can be
persistent or in remission. Gambling can increase during periods of stress or
depression and during periods of substance use or abstinence. There may be
periods of heavy gambling and severe problems, times of total abstinence, and
periods of non-problematic gambling. Gambling disorder is sometimes
associated with spontaneous, long-term remissions. Nevertheless, some
individuals underestimate their vulnerability to develop gambling disorder or to
 return to gambling disorder following remission. When in a period of remission,
they may incorrectly assume that they will have no problem regulating gambling
and that they may gamble on some forms non-problematically, only to experience
a return to gambling disorder.
There are age and gender variations in the type of gambling activities and the
prevalence rates of gambling disorder. Gambling disorder is more common
among younger and middle-aged people than among older adults. Among
adolescents and young adults, the disorder is more prevalent in males than in
females. Younger individuals prefer different forms of gambling (sports betting),
while older adults are more likely to develop problems with slot machines and
bingo gambling. Although the proportions of individuals who seek treatment for
gambling disorder are low across all age groups, younger individuals are
especially unlikely to seek treatment.
Males are more likely to begin gambling earlier in life and have a younger age at
the onset of gambling disorder than females, who are more likely to begin
gambling later in life and to develop gambling disorder in a shorter time frame.
Females with gambling disorder are more likely than males with gambling
disorder to have depressive, bipolar, and anxiety disorders. Females also have a
later age at onset of the disorder and seek treatment sooner, although rates of
treatment-seeking are low among individuals with gambling disorder regardless
of gender.
Can adolescents and young adults grow out of the gambling habit?

Early expression of gambling disorder is more common among males than

among females. Individuals who begin gambling in youth often do so with family
members or friends. The development of early-life gambling disorder appears to
be associated with impulsivity and substance abuse. Many high school and college
students who develop gambling disorder grow out of the disorder over time,
although it remains a lifelong problem for some. Mid- and later-life onset
of gambling disorder is more common among females than among males.

Treatment

Prevention may not always be possible. Limiting exposure can be helpful for
people who are at risk. But with easy access to lotteries, online gambling, and
casinos, prevention is difficult. Early intervention helps the individual from getting
worse. People with close family and friends at high risk should remain attentive.

Compulsive gambling is treatable. Recognizing the problem is the first step

toward treatment.

 Therapy or support groups: Psychotherapy in the form of individual or group

settings can help. For some people, support groups such as the 12-step
 Gamblers Anonymous are useful. This program adheres to abstinence
principles similar to that of substance use and alcohol use.
 Medications: In combination with psychotherapy, the individual may benefit
from antidepressants, mood stabilizers, opioid antagonists, or narcotic
antagonists.
Compulsive gambling is much like alcohol or drug addiction, it tends to worsen
after the start of treatment. Pathological gambling is a chronic disorder,
and relapse does happen. But with the right treatment, the chronic gambler can
gain control over their life.

Has access to gambling increased?

While casino and sports betting had been limited to only a few states, other
gambling venues have proliferated, including riverboat and Indian casinos, state
and national lotteries, and Internet access to offshore sports and parlor betting.
Access has increased dramatically. Older adults are often more vulnerable than
other age groups, because of their dependence on fixed incomes and limited
ability to recover from gambling losses.

Source: Gambling Disorder (Compulsive Gambling, Pathological Gambling) | Psychology Today