Pathological gambling disorder Health Article

Definition

Pathological gambling disorder occurs when a person gambles compulsively to such an extent that the wagering has a severe negative effect on his or her job, relationships, mental health, or other important aspects of life. The person may continue to gamble even after they have developed social, economic, interpersonal, or legal problems as a result of the gambling.

Description

Pathological gambling disorder is characterized by uncontrollable gambling well beyond the point of a social or recreational activity, such that the gambling has a major disruptive effect on the gambler's life. People who are pathological gamblers may lose their life savings, and may even commit crimes (stealing, embezzling, or forging checks) to get money for their "habit." Relationships and jobs may also be lost as a result of the disorder.

Pathological gambling disorder is an example of a process, or behavioral, addiction, as distinct from an addiction to such substances as food, drugs, tobacco, or alcohol. In process addictions, the characteristic "rush" or "high" comes from the series of steps or actions that are involved in the addictive behavior. With gambling, the "high" may be stimulated by the social atmosphere or group setting of the casino, race track, or bingo hall as well as by the excitement of risk-taking. Some gamblers have a "lucky" outfit, item of clothing, or accessory that they wear or take along when gambling; sometimes putting on the outfit or item in question is enough to start the "rush."

People with pathological gambling disorder may engage in many different types of gambling activities. These may include games of chance that are found in casinos, such as slot machines, card games, and roulette. Many of these games are now available on the Internet, the chief difference being that the bettor uses a credit card instead of cash or chips. Other gambling activities may include the state lottery, horse or dog racing, or even bingo. The person may place bets on the outcome of an election, baseball or football games, or even the weather on a particular day. Pathological gambling usually develops slowly over time; people tend to begin with acceptable levels of social or recreational gambling and slowly progress to pathological gambling. In most cases the disorder develops slowly over a period of years; however, there are cases of patients who gambled socially for decades and then began to gamble compulsively under the impact of a major life stressor, such as divorce or being laid off from work.

Causes

There are no known biological causes of pathological gambling disorder. Some studies have found interesting differences between compulsive gamblers and the general population on the biological level, but none that are thought to be an actual cause of pathological gambling. Many people, however, have significant psychological causes for excessive gambling. They may use gambling as an emotional escape from depression; this pattern appears more often in females with the disorder than in males. Some people who are pathologic gamblers are seeking the mood alteration associated with gambling— specifically the excitement and energy that they find in the activity— more than the money involved. In other words, the person with the disorder is reinforced by an emotional "high" rather than by the money itself. Some researchers have found that males diagnosed with pathological gambling disorder were more likely to have been diagnosed with attention-deficit/hyperactivity disorderas children than males in the general population. Other researchers have described compulsive gamblers in general as highly competitive people who are restless and easily bored.

Other theories about the causes of pathological gambling emphasize cognitive distortions rather than mood problems. Pathological gambling has been associated with dysfunctional thinking patterns; many people with this disorder are highly superstitious or believe that they can control the outcome of events when they are gambling. Many people diagnosed with the disorder also have distorted beliefs about money, tending to see it at the same time as the source of all their problems and the answer to all their problems. Patients diagnosed with pathological gambling disorder have an increased risk of either having or developing histrionic, narcissistic, or borderline personality disorder.

One social change that has been linked with the rise in the number of adults diagnosed with pathological gambling disorder in the United States is the increased availability of legalized gambling.