Pathological Gambling

Whether at the casino, in a sports book, or on a scratch card, gambling is a widespread global activity in which people wager something of value against the chance of winning something else. Often, the gambler places a bet with money, but it can also be done with marbles or game pieces such as Magic: The Gathering or Pogs (collectible discs and trading cards). The amount of money legally wagered annually in the world is estimated to be over $10 trillion.

Many people participate in gambling as a form of social entertainment, but there is a small group of individuals who develop serious gambling problems that can have significant personal, social, family and financial consequences. These individuals are referred to as pathological gamblers, and they can range from those who have no apparent problem to those who meet the diagnostic criteria for pathological gambling in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Vulnerability to developing gambling disorders increases with age and the number of hours a person spends gambling per week. It is also more common in lower socioeconomic groups, and among men and young people. However, people with any level of education can be affected. It is estimated that up to 5% of those who have ever gambled develop a disorder.

The underlying cause of a gambling disorder is complex and involves several psychological processes and events. These include an early big win, boredom susceptibility, impulsivity, poor understanding of random events, the use of escape coping, and depression. These factors can interact to keep a person locked in a pattern of behavior that continues to reinforce the expectation of an early big win and compounded losses, all while providing an escape from boredom or stress.

Changing the way we think about gambling and its adverse consequences will allow us to identify people who are at risk of developing problems, and it may help with prevention, treatment and recovery. We need to move away from viewing pathological gambling as a medical problem and start thinking of it as an emotional and behavioral problem.

If you have a loved one who has developed a gambling problem, it is important to recognize that they did not choose to become addicted and that they likely do not understand how gambling works. You can try to support them by talking to them about their issues, encouraging them to find other activities, and seeking professional help. Some people who have severe gambling problems are unable to stop on their own and need round-the-clock assistance. In these cases, residential treatment and rehab programs are available.