What is disordered gambling?

By William “Ted” Hartwell

This is the first of a series of articles that will discuss the issue of disordered gambling, an addiction that affects millions of individuals and their families, friends and co-workers, often with devastating consequences. Future articles will focus on legal aspects, advocacy, building public awareness, informational resources, and treatment of disordered gambling, among other topics.

Disordered gambling, also variously referred to as gambling addiction, problem gambling, compulsive gambling, and pathological gambling, is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as:

“Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

1. Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
2. Is restless or irritable when attempting to cut down or stop gambling.
3. Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
4. 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).
5. Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
6. After losing money gambling, often returns another day to get even (“chasing” one’s losses).
7. Lies to conceal the extent of involvement with gambling.
8. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
9. Relies on others to provide money to relieve desperate financial situations caused by gambling.”

Key indicators of a gambling problem

For most people, gambling is harmless entertainment, but for a small percentage of individuals, gambling can become an obsession that creates persistent and recurring problems that significantly impact many areas of their lives, including personal and professional relationships. As with other addictions, problem gambling does not discriminate with regards to age, race, ethnicity, or gender, although there is substantial evidence that family history and genetic factors do play a role in determining a person’s predisposition toward developing a gambling or other addiction.

The amount of money, frequency of gambling episodes, or types of games played are not necessarily in and of themselves indicators of who may have a gambling problem. Rather, it is inability of an individual to control their gambling behavior, despite persistent and growing negative consequences as defined by the criteria above, that is indicative of a gambling disorder. While four (4) or more of the criteria above are required to meet the clinical definition of a gambling disorder, the presence of any of these criteria over any significant length of time may be indicative of an emergent problem and should be treated seriously.

What are outcomes of disordered gambling?

Q: Can problem gambling ruin your life?

A: The consequences for the individual suffering from a gambling addiction, as with any other addiction, can include:

• financial difficulties
• the loss of relationships
• the loss of jobs
• theloss of opportunities
• the loss of freedom as a result of criminal activities conducted in furtherance of a gambling addiction
• the loss of life

Disordered gambling has among the highest suicide rates of any mental disorders, including other addictions, with treatment-seeking individuals reporting rates of actual suicide attempts as high as 1 in 4-5, with the majority of the remainder reporting suicidal ideation.

What treatments are effective for disordered gambling?

Fortunately, the illness of disordered gambling is very treatable, though the issue of stigma associated with seeking treatment for a gambling problem is high, and individuals are often significantly progressed in their addiction before treatment is sought, if at all. 12-Step programs such as Gambler’s Anonymous have been shown to be effective for many in helping keep their gambling addiction in remission, especially when used in combination with individual or other group therapies facilitated by a certified gambling counselor, but there are many potential paths to recovery from gambling.

It is important to realize that the disordered gambler often affects many other individuals in their sphere of influence, particularly family members, as a result of the inability to control their gambling. Usually family members need, and can significantly benefit from, their own treatment regimen following the impact of a loved one’s gambling behavior on their finances and lives. Gam-Anon is a 12-Step program that exists for the family and friends impacted by the gambling of another, individual and family therapy is often available through certified gambling counselors.

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About the Author: William “Ted” Hartwell is an Associate Research Scientist with the Desert Research Institute (http://www.dri.edu) of the Nevada System of Higher Education in Las Vegas, Nevada, and facilitates Community Engagement for the Nevada Council on Problem Gambling. He also serves on the Nevada State Advisory Committee for Problem Gambling, and was the 2014 recipient of the Shannon L. Bybee Award. He is a disordered gambler in long-term recovery and advocates for public awareness and understanding of problem gambling.

Comments

• January 23, 2016, Colin, PhD writes: Very nice post: balanced and informative. I would add that DSM-5 classifies Gambling Disorder as an Addictive Disorder. The World Health Organization's International Classification of Disease (ICD-10) still classifies disordered gambling as Pathological Gambling, an Impulse Control Disorder. Thanks for including the very real threat of suicidality among problem gamblers.
• January 25, 2016, Lydia @ Addiction Blog writes: Thanks for the lovely words, d-r Colin. We really appreciate it.