What is Problem Gambling?

Problem gambling–or gambling addiction–includes all gambling behavior patterns that compromise, disrupt or damage personal, family or vocational pursuits.

The symptoms include increasing preoccupation with gambling, a need to bet more money more frequently, restlessness or irritability when attempting to stop, “chasing” losses, and loss of control manifested by continuation of the gambling behavior in spite of mounting, serious, negative consequences. In extreme cases, problem gambling can result in financial ruin, legal problems, loss of career and family, or even suicide. For more information on the American Psychiatric Association’s criteria for gambling disorder, please see the DSM-5 below.

The continuum generally spans from No Problem to having Severe Problems, and meeting the clinical criteria for a Gambling Disorder.

DSM-5 DEFINITION

The Diagnostic and Statistical Manual, 5th edition, is used to diagnose psychological issues, including gambling disorder. According to the DSM-5, an individual must have four of more of the following symptoms within the last year:

  • Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
  • Is restless or irritable when attempting to cut down or stop gambling.
  • Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
  • Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
  • Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
  • After losing money gambling, often returns another day to get even (‘chasing’ one’s losses).
  • Lies to conceal the extent of involvement with gambling.
  • Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
  • Relies on others to provide money to relieve desperate financial situations caused by gambling.

In addition, any of the above symptoms experienced cannot be caused or explained by another disorder. Finally, the severity of the gambling type is identified:

MILD:

4–5 Symptoms

MODERATE:

6–7 Symptoms

SEVERE:

8–9 Symptoms

Please note that VCPG is listing these criteria to help readers better understand gambling disorders. This information is not intended to help individuals self-diagnose. If you or a loved one suffers from any of the symptoms above, please seek the assistance of a licensed clinician.

ADDICTION AND CO-OCCURRING PROBLEMS

Gambling is considered an addictive disorder in which the Three C’s are present: crave, continue behavior, lose control. In this regard, gambling is very similar to substance use disorder – it is a behavioral addiction that has similar symptoms as other addictions. The main difference is that gambling addiction itself will not cause the same physical harm to the body from foreign substances (e.g., drugs or alcohol) that other addictions cause. However, people who suffer from a gambling disorder tend to have many other disorders that can cause additional problems. These are called co-occurring problems, and include the following:

  • Alcohol misuse
  • Nicotine use/dependence
  • Suicidal ideation (thoughts of suicide, but no attempts)
  • Substance misuse
  • Certain personality traits
  • Certain psychosocial factors (personal relative deprivation)
  • Distorted thought patterns
  • Bipolar Disorder

Further, gambling disorder in general has been associated with having any co-occurring problem, and specific problems/disorders put individuals more at risk of developing a form of gambling disorder. For example, one study found that 37.9% of individuals with a gambling disorder had a mood disorder, 37.4% had an anxiety disorder, 60.1% were dependent on nicotine, and 57.5% suffered from substance misuse.

TYPES OF GAMBLERS

Gamblers come in all shapes and sizes, however, recent research has begun to notice differences among gamblers of differing gender, age, race, immigration status, and co-occurring problems. Please see our Education section for more information about these differences. Below, please find general types of gamblers and their prevalence among gamblers in a specific study, regardless of the individual factors listed above:

35

% of sufferers with co-occurring psychological problems

27

% of sufferers without any co-occurring problems

25

% of sufferers with co-occurring alcohol abuse

13

% of sufferers with multiple co-occurring problems

MODES OF GAMBLING

The world is always changing, and thus ways of accessing gambling activities are increasingly common. Generally, gambling activities can be divided into three types: internet-only (IG), land-based only (LBG), and mixed-mode (MMG). Specific types of activities can include: casino games, card games, scratch cards, sports betting, skilled betting, other betting, electronic video machines, games of skill, lottery, office pools, charitable gambling, internet games, slots machines.

References

  1. Reilly C, Smith N. The evolving definition of pathological gambling in the DSM-5. National Center for Responsible Gaming. 2015.
  2. Korn DA, Shaffer HJ. Gambling and the health of the public: Adopting a public health perspective. J Gamb Stud. 1999;15:289-365.
  3. National Center for Responsible Gambling. Gambling and Health in the Workplace. Available at http://www.ncrg.org/sites/default/files/uploads/docs/publiceducation_outreach/hrflyer_final.pdf.
  4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. American Psychiatric Press. 2013.
  5. Blanco C, Garcia-Anaya M, Wall M, Perez de los Cobos, JC, Swierad E, Wang S, Petry NM. Should pathological gambling and obesity be considered addictive disorders? A factor analytic study in a nationally representative sample. Drug Alc Dep. 2015;150:129-134.
  6. Grant JE, Odlaug BL. Diagnosis and treatment of gambling disorder. Chapter 3. Pages 35-59. In Behavioral Addictions: Criteria, Evidence, and Treatment.
  7. Potenza MN. The neural bases of cognitive processes in gambling disorder. Trends Cog Sci. 2014;18:429-438.
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  9. Lorains FK, Cowlishaw S, Thomas SA. Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction. 2011;106;490-498.
  10. Bischof A, Meyer C, Bischof G, et al. Suicidal events among pathological gamblers: The role of comorbidity of axis I and axis II disorders. Psychiat Res. 2015;225:413-419.
  11. MacLaren V, Ellery M, Knoll T. Personality, gambling motives, and cognitive distortions in electronic gambling machine players. Personal Indiv Diff. 2015;73:24-28.
  12. Ramos-Grille I, Goma-i-Friexanet M, aragay N, Valero S, Valles V. Predicting treatment failure in pathological gambling: The role of personality traits. Addic Beh. 2015;43:54-59.
  13. Callan MJ, Shead NW, Olson JM. The relation between personal relative deprivation and the urge to gamble among gamblers is moderated by problem gambling severity: A meta-analysis. Add Beh. 2015;45:146-149.
  14. Di Nicola M, De Risio L, Pettorruso M, et al. Bipolar disorder and gambling disorder comorbidity: Current evidence and implications for pharmacological treatment. J Addic Dis. 2014;167:285-298.
  15. Suomi A, Dowling NA, Jackson AC. Problem gambling subtypes based on psychological distress, alcohol abuse, and impulsivity. Addic Beh. 2014;39:1741-1745.
  16. Gainsbury SM, Russell A, Blaszcynski A, Hing N. The interaction between gambling activities and modes of access: A comparison of Internet-only, land-based only, and mixed-mode gamblers. Addic Beh. 2015;41:34-40.

VCPG maintains a neutral stance on gambling.