Gambling involves risking money or something of value to predict the outcome of an event involving chance, such as a football game or a scratchcard. It can also involve betting on other people, such as friends or family members, who are also playing the game or event. The resulting winnings can be used for enjoyment or as income. Problem gambling is associated with a range of adverse consequences including debt and loss of money, property, or other valuables, and with emotional and social difficulties such as alienation from family and friends. Problem gambling may also be related to a number of mental health difficulties such as impaired judgment, cognitive distortions, and depression.
Despite the widespread acceptance of gambling as an enjoyable recreational activity, some people develop an addiction to gambling. This disorder is known as pathological gambling. It is characterized by repeated and unsuccessful attempts to control, cut back, or stop gambling. It is accompanied by preoccupation with gambling, irritability when attempting to cut down or stop, and restlessness. It is a serious problem that can cause significant harm to an individual’s life, family, and work.
Some researchers and clinicians have suggested that pathological gambling should be recognized as a medical disorder in its own right, comparable to substance dependence. To support this position, they proposed a set of 10 criteria for the diagnosis: damage or disruption, loss of control, and dependence. These criteria were heavily influenced by the DSM-III-R criteria for substance dependence and included the following:
Repeatedly unsuccessful efforts to control, cut down, or stop gambling. Needs to gamble with increasing amounts of money in order to achieve desired excitement. Often returns another day to get even (chasing losses). Lie to conceal the extent of involvement in gambling. Has jeopardized or lost a relationship, job, educational opportunity, or business; or has committed illegal acts (forgery, fraud, theft, embezzlement) to finance gambling. Relies on others to provide money to relieve desperate financial situations caused by gambling. (American Psychiatric Association, 2000).
It is important that there be a common nomenclature for gambling behavior and problems to facilitate communication between research scientists, psychiatrists, other treatment clinicians, and policy makers. However, the development of such a nomenclature is complicated by the fact that different groups approach this issue from a variety of paradigms or world views. These different perspectives have led to a great deal of controversy and debate over the nature of gambling and problems associated with it. In particular, differences have emerged over whether a gambling problem is due to poor judgment, recreational interest, diminished mathematical skills, psychosocial factors, cognitive distortions, or mental illness. These differences are reflected in the differing theories about the origin and development of pathological gambling. Several models have been advanced in an attempt to explain pathological gambling, including behavioral-environmental reasons, the general theory of addictions, and the reward deficiency syndrome. However, none of these has been fully supported by empirical evidence.
