Gambling Disorders


In gambling, a person stakes something of value with the intention to win something else of value. This wager may be with real money or “convertible” assets (such as collectible game pieces, such as marbles or pogs). In a more technical sense, a person engages in gambling when they stake an item of value on the outcome of an uncertain event whose result is determined by chance. Examples include a football match, or a scratchcard. This type of betting is contrasted with bona fide business transactions valid under the law, such as the purchase of shares or commodities and contracts of indemnity or guaranty (including life, health, or accidental insurance).

Many people gamble because they enjoy the feeling of winning. The brain releases dopamine, a feel-good neurotransmitter, when you win. This chemical response is one of the reasons why people find it difficult to stop gambling. Other reasons include the desire to relieve unpleasant feelings, socialize, or escape from reality. Gambling problems can also be a result of family, financial, or emotional difficulties. Gambling disorders can start in adolescence or during adulthood. They can affect men and women equally, but they tend to run in families.

The psychiatric community once regarded pathological gambling as more of a compulsion than an addiction, but in the 1980s, while updating its Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association officially classified it as an impulse-control disorder—a fuzzy label that also included kleptomania, pyromania, and trichotillomania (“hair pulling”). This move made it seem more like an addiction, and indeed it is now recognized that some people become addicted to gambling in the same way that they can be addicted to substances such as drugs or alcohol.

Behavioral researchers have developed an array of interventions to treat pathological gambling. These interventions have produced varying degrees of success. In part, this variation is due to differences in conceptualizations of the etiology of pathological gambling. This article reviews some of the theoretical and empirical work on this topic.

It also discusses the use of integrated approaches in the treatment of gambling disorder and identifies some of their limitations. It argues that the failure of these approaches to produce consistent results is probably due to their insufficient attention to the fundamental differences between normal and problem gambling. The chapter concludes by considering several alternative theoretical frameworks for understanding the development and maintenance of pathological gambling behavior.

In addition to research on the prevalence and impact of gambling disorders, longitudinal data are needed to identify factors that moderate or exacerbate a person’s participation in gambling. Longitudinal studies offer the advantage of providing large, deep datasets that can be analyzed by researchers from a wide range of disciplines. They can help identify factors that influence or predict gambling participation and thus allow the inference of causality. They can also be used to compare the effects of different interventions. Ultimately, the goal of longitudinal research is to develop more effective interventions for gambling disorder.