Gambling Disorders

Gambling involves staking or risking something of value on the outcome of a contest of chance, a future contingent event not under one’s control or influence, with the hope of gain. This activity can take many forms, from the staking of small sums of money on lottery tickets to elaborate casino gambling activities and sports betting. The potential for problem gambling varies from person to person.

Although gambling is a popular form of entertainment and a common social activity, the chances of winning are slim. Individuals who have problems with gambling often report that they feel a strong urge to gamble, that they cannot stop gambling or that their gambling has caused them personal or family problems. The number of people with a serious gambling disorder is estimated to be 2.5 million in the United States. Another 5-8 million people may have a mild or moderate gambling problem. Problem gambling can be influenced by age, gender, and education. It can affect people from all races and religions, in small towns or big cities.

A person may be more prone to developing a gambling disorder if they have other impulse control issues or if they are exposed to family members who have problem gambling behaviors. It is also possible for gambling to become a way to self-soothe unpleasant emotions or to relieve boredom, particularly when the individual does not have other healthy ways of doing so.

Those who have trouble controlling their gambling often feel the need to be secretive about it or lie about how much they gamble, thinking that others will not understand or that they might surprise them with a large win. They may also feel the need to increase their bets in an attempt to recover lost funds.

People with a gambling disorder tend to be more preoccupied with gambling and less interested in other leisure activities. They may not sleep well and have difficulty concentrating at work. Their family life may suffer, and they may become irritable or argumentative. Some individuals who have a gambling disorder become suicidal.

There is debate over the extent to which impulsivity contributes to pathological gambling. Some researchers believe that the tendency to gamble is mainly due to sensation-and novelty-seeking, while others argue that there are other factors involved as well, including a lack of self-control, low emotional intelligence and/or a history of childhood trauma or neglect.

Regardless of how it is described, there is agreement that pathological gambling is similar to substance abuse in clinical expression, brain origin, comorbidity, and physiology. It is important to establish agreed-on nomenclature so that research scientists, psychiatrists, and other treatment care clinicians use the same terms when discussing gambling and gambling disorders. This will facilitate comparisons across studies and the development of more effective interventions. To this end, DSM-5 places pathological gambling in a category with behavioral addictions. Until there is further scientific evidence of the existence and validity of this distinction, it is appropriate to consider gambling disorder a subtype of impulse control disorder.