What kind of disorder is pathological gambling?

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The many labels used to describe gambling problems are a source of confusion for the public and frustration for researchers. Commonly used terms include “problem”, “at risk”, “compulsive”, “disordered”, and “pathological” gambling. These various terms reflect the efforts of researchers to describe the different levels of severity observed among people with gambling problems. Labels such as “problem” gambling are used to describe individuals who are experiencing some adverse consequences as a result of their gambling but do not meet the criteria for a diagnosis of pathological gambling.

“Gambling Disorder” is the term used by the American Psychiatric Association in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe the most severe form of the disorder (American Psychiatric Association, 2013). According to the DSM-5, gambling disorder is indicated by four (or more) of the following:

  • Preoccupied with gambling
  • Unable to cut back or control
  • Irritable or restless when attempting to cut down or stop gambling
  • Risks more money to reach desired level of excitement
  • Gambles to escape problems or depressed mood
  • “Chases" losses
  • Lies to family and others about gambling
  • Risks or loses relationships or job because of gambling
  • Relies on others for financial needs caused by gambling

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Overview

What is gambling addiction?

Gambling refers to an activity in which a person risks something valuable to them in order to win something in return. Common forms of gambling include betting in casinos or on sporting events.

Gambling disorder describes a loss of control of gambling behavior that causes significant problems with finances, work, or personal relationships. Sometimes it is also called compulsive gambling or problem gambling. People with a gambling disorder are unable to control their gambling activities.

How common is gambling addiction?

Compulsive gambling affects an estimated two to four percent of the population in the United States.

Symptoms and Causes

What causes gambling addiction?

An uncontrollable desire for the rush or excitement of winning can lead to compulsive gambling. There is no known cause for this disorder. In some cases, the condition runs in families.

What are the symptoms of gambling addiction?

Signs of gambling addiction include:

  • Thinking about gambling more often; having a craving for gambling that grows in intensely
  • Gambling money or possessions you don’t have
  • Needing to make bigger bets more often to achieve the rush of excitement
  • Becoming irritable or restless when trying to stop or slow down gambling
  • Chasing losses (gambling after losing money to win back the loss)
  • Continuing to gamble even when it negatively affects finances, work, or personal relationships
  • Lying to keep gambling activity secret
  • Difficulty controlling gambling activity
  • Gambling when feeling anxious or agitated or to manage other uncomfortable feelings
  • Seeking financial assistance from others due to money problems from gambling

Diagnosis and Tests

How is gambling addiction diagnosed?

A doctor or mental health professional asks about gambling thoughts and behaviors to diagnose compulsive gambling. Doctors may confirm a diagnosis when a person has experienced at least four of its symptoms in the past year.

Management and Treatment

How is gambling addiction managed or treated?

Doctors and mental health professionals successfully treat many people with a gambling disorder with cognitive-behavioral therapy (CBT). With CBT, people with compulsive gambling learn to understand why they gamble. This understanding helps them better manage their gambling problems. Counselors also discuss other options for solving problems as well as how to deal with gambling urges, how to mend family and friend relationships, how to maintain recovery and other related financial and personal issues.

What complications are associated with gambling addiction?

People who do not receive treatment for compulsive gambling can experience many complications. The most dangerous complication is an increased risk of suicide. It is important to seek medical help if you or someone you know with compulsive gambling is thinking about suicide. The National Suicide Prevention Lifeline is 800-273-8255.

Other complications of the disorder include:

  • Significant loss of money or possessions
  • Severe debt
  • Legal problems
  • Damaged relationships with friends and family

Prevention

What are the risk factors for gambling addiction?

In some cases, people are at greater risk for gambling addiction because they have a family history of the disorder.

Can gambling addiction be prevented?

Because doctors do not know what causes compulsive gambling, there is no known way to prevent it except totally abstaining from activities that involve gambling.

Outlook / Prognosis

What is the prognosis (outlook) for people with a gambling addiction?

Many people who receive treatment for compulsive gambling do improve. When they control the gambling compulsion, they often can repair their finances and relationships. Resolving these problems improves their quality of life.

During and after treatment, joining a support group for compulsive gambling, such as Gamblers Anonymous, can help reduce the risk of returning to previous gambling behaviors.

Living With

When should a doctor get involved?

Many people with compulsive gambling issues find it difficult to seek help on their own. Concerned family members and friends often reach out to a medical professional to help a loved one with the condition.

Contact a doctor or mental health professional if compulsive gambling interferes with healthy living for you or someone you know. A health professional can recommend ways to help manage symptoms for a healthier life. Family members and friends who have been affected by the gambling problems of another may consider joining a support group such as Gam-Anon.

What questions should I ask my doctor?

If you have a gambling addiction, some questions you may want to ask your doctor include:

  • How do I know if I have a gambling problem?
  • What are my treatment options?
  • How long does treatment take?
  • What support groups do you recommend?

When can I go back to my regular activities?

Treatment for compulsive gambling does not typically interfere with everyday activities.

Treatment can take months or even years. Many people receive ongoing treatment or support for the rest of their lives. With treatment, they can maintain healthy lifestyles and relationships.

What type of disorder is pathological gambling?

Pathological gambling (PG) is a relatively common disorder associated with significant personal, familial, and social costs. The condition is currently classified as an impulse control disorder, although similarities exist with other disorders, particularly substance addictions.
People who gamble compulsively often have substance misuse problems, personality disorders, depression or anxiety. Compulsive gambling may also be associated with bipolar disorder, obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD).

Is pathological gambling in the DSM?

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) characterizes Pathological Gambling (PG) as persistent and recurrent maladaptive gambling behavior (American Psychiatric Association, 1994).

What section of the DSM 5 is gambling disorder?

Gambling Disorder: Causes, Symptoms, Treatment DSM-5 312.31 (F63. 0) Gambling continuously and repeatedly to the point where it causes problems in a person's life and anxiousness is deemed a Gambling Disorder by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)*.