Introduction (Psychology and Mental Health)
A gambler is a person who risks something of value based on an uncertain outcome for the possibility of reward: Typically, money is bet in the hope of making more money. Gamblers are classified as recreational, professional, and pathological. Recreational gambling is an enjoyable activity that has no evident adverse effects and may have possible mental health benefits among certain groups, such as the elderly. A few individuals make their living by playing games of chance that involve some level of skill. Pathological gambling has a long history in the psychiatric literature, but it was not defined as a medical problem until 1980, when it was added to the diagnostic nomenclature. It is an impulse control disorder and tends to lead toward increasingly adverse consequences for individuals, their families, and others.
A diagnosis of pathological gambling requires the presence of five out of ten criteria: becoming preoccupied with gambling, exhibiting tolerance and withdrawal, escaping from moods and life’s problems, chasing losses with more gambling, lying about gambling, losing control over the reduction of betting, becoming irritable when trying to stop gambling, committing illegal acts to obtain funds, risking interpersonal relationships and vocation to gamble, and seeking bailouts, such as turning to others for financial assistance. Mania must be ruled out in diagnosing pathological gambling.
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Prevalence, Risk Factors, and Theories (Psychology and Mental Health)
Most people who gamble in a given year (two-thirds of the adult population) are recreational gamblers. Only slightly more than 1 percent of adults (2 million people in the United States) become pathological gamblers (about the same percentage as are diagnosed with schizophrenia). Another 2-3 percent are considered problem gamblers. They show detrimental consequences as a result of their betting but meet fewer than five of the diagnostic criteria. Slightly higher rates of pathological and problem gambling are found among adolescents.
Risk factors for developing pathological gambling include a parental history of gambling problems, male gender, alcohol and tobacco use, and membership in a minority. The most common comorbid conditions with pathological gambling are a personality disorder, which occurs in about half of those diagnosed (antisocial personality disorder is the most frequently found), and substance abuse, which is found in about one-third of pathological gamblers. Whether as a cause or a consequence, anxiety and depressive disorders are often diagnosed as well. When pathological gambling becomes chronic, a major depressive disorder may be present. Pathological gambling invariably affects the spouse and family of the gambler, making marital and family counseling necessary.
Theories explaining the development of pathological gambling are multivariate and address a range of factors,...
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Treatment and Prevention (Psychology and Mental Health)
A treatment program for pathological gambling begins with a comprehensive assessment that examines the individual’s gambling frequency and duration, the extent of negative consequences, personality type, and psychological context. Common assessment tools include theSouth Oaks Gambling Screen (SOGS), along with a general psychiatric symptoms checklist and careful questioning about substance abuse.
Treatment for pathological gambling can take a variety of forms. One effective method is cognitive behavior therapy, which focuses on changing patterns of thought and cognition related to gambling impulses. Another is Gamblers Anonymous, founded in 1957, which provides a free twelve-step program with strong peer support and is patterned after Alcoholic Anonymous. Daily meetings are held in many cities in the United States. Similarly, Gam-Anon offers support and education for spouses, family, and friends of gamblers. Psychopharmacological treatments for gambling—including selective serotonin reuptake inhibitors (SSRIs), opioid antagonists, and mood stabilizers—also have shown some promise.
Many states, including Oregon and Iowa, have Web sites that guide those who might have a problem with gambling to treatment locations. These sites also provide educational information and self-assessments. The National Council on Problem Gambling also provides educational information. Programs to prevent pathological gambling...
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Sources for Further Study (Psychology and Mental Health)
Castellani, B. Pathological Gambling: The Making of a Medical Problem. Albany: State University of New York Press, 2000. Discusses the consequences for the individual and society of defining excessive gambling as a medical disorder.
Grant, J., and M. Potenza. Pathological Gambling: A Clinical Guide to Treatment. Arlington, Va.: American Psychiatric Publishing, 2004. Provides a comprehensive overview of the diagnosis, prognosis, and treatment of pathological gambling with a focus on medically based treatments.
Knapp, T. J., and E. W. Crossman. “Pathways to Betting: Childhood, Adolescent, and Underage Gambling.” In Gambling: Behavior Theory, Research, and Application, edited by P. M. Ghezzi, C. A. Lyons, M. R. Dixon, and G. R. Wilson. Reno, Nev.: Context Press, 2006. Reviews the literature since 2000 on gambling by children and adolescents and the processes that lead to this behavior.
Lesieur, H. R., and S. B. Blume. “The South Oaks Gambling Screen (SOGS): A New Instrument for the Identification of Pathological Gamblers.” American Journal of Psychiatry 144 (1987): 1184-1189. A discussion of SOGS, the most widely used instrument in the diagnosis of pathological gambling.
Petry, N. M. Pathological Gambling: Etiology, Co-morbidity, and Treatment. Washington, D.C.: American Psychological Association, 2004. Reviews the psychology of pathological...
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Gambling (American Indians Ready Reference)
Article abstract: Gambling facilities have brought needed income to some native peoples, but some tribe members protest its presence on reservations
During the late twentieth century, commercial gambling became a major source of income on Indian reservations across the United States. While many Native American cultures practiced forms of gambling as a form of sport (such as the Iroquois peachstone game), there was no prior large-scale experience with gambling as a commercial enterprise. The arrival of gaming has brought dividends to some native peoples, but it has brought controversy culminating in firefights and death to others.
Development of Gambling
The history of reservation gambling begins in 1979, when the Seminoles became the first Indian tribe to enter the bingo industry. As state-run lotteries became legal and proliferated throughout the United States, Indian tribal governments, not subject to state regulations, saw a means of increasing their revenues by offering bingo games with prize money greater than that allowed by the U.S. state’s law. When challenged, the tribes sued in federal court and won (Seminole Tribe v. Butterworth, 1979; California v. Cabazon...
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