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Pathological Gambling- Is it an addiction? Part II

Michael Campos, Ph.D.

This is part II in Michael’s series on pathological gambling (click the preceding for part I):

The risk factors for pathological gambling

There are a number of factors that are important in pathological gambling including types and number of games played, alcohol use, and socio-demographic factors. Some research suggests that casino gambling, pull tabs, card playing outside a casino, bingo, and sports betting are associated with increased risk for gambling problems. In addition, the number of different types of games played is associated with gambling problems such that the more different types of games a person plays, the greater the risk for gambling problems. Alcohol abuse/dependence is associated with increased risk for gambling problems as well. Finally, socio-demographic factors (e.g., low socio-economic status, minority ethnicity) are associated with gambling problems even after controlling for gambling behavior.

Pathological gambling’s impact on health

Pathological gambling disorder is associated with a number of other mental and physical health problems. Major depression and anxiety are more common among pathological gamblers relative to general population samples. Substance use disorders including alcohol-, drug-, and tobacco-related disorders are also more common among individuals with pathological gambling. Medical conditions such as hypertension, chronic fatigue, heart disease, and obesity often exist among individuals with pathological gambling.

How to tell if you have a gambling problem

There are a number of screening tests that can be used to determine if you may have a problem with gambling. One set of three questions known as the NODS CLiP was developed as a quick screen to determine the need for more formal assessment. The NODS CLiP items include:

1. Have there ever been periods lasting 2 weeks or longer when you spent a lot of time thinking about your gambling experiences or planning out future gambling ventures or bets?

2. Have you ever tried to stop, cut down, or control your gambling?

3. Have you ever lied to family members, friends, or others about how much you gamble or how much money you lost on gambling?

If an individual gives a positive response (yes) to any of these items, it suggests the need for further assessment to determine whether or not they are a problem or pathological gambler.

The effectiveness of treatment for pathological gambling

The literature on the treatment of gambling problems is relatively new and many issues make it difficult to determine the effectiveness of specific components of treatment; however, data suggest that, among those who complete treatment, significant reductions in gambling behavior and gambling-related problems occur. Often times, treatment for gambling problems involves addressing co-occurring disorders such as mood, anxiety, and substance use disorders. Treating co-occurring disorders is important because these disorders may sustain gambling behavior. Family involvement in treatment is recommended in order to address the relationship problems that often occur among families with a member who has a gambling problem.

Pathological gambling may be best conceptualized as a chronic disease with a relapsing remitting course. The majority of individuals don’t seek treatment – the estimates are that only 10% of individuals do seek treatment for their gambling problems. Many times individuals with gambling problems seek treatment for other psychological or behavioral problems and gambling problems are not discovered until much later on.

To date, the most empirical evidence has been collected on the treatment of gambling problems using cognitive behavioral approaches in both individual and group formats; however, psychodynamic and purely behavioral approaches like systematic desensitization have also been employed. In addition Gambler’s Anonymous is available, it has been in existence since 1957 and is a self-help fellowship dedicated to aiding individuals to stop gambling and stay stopped.

Getting help for gambling problems?

There are a number of sources for help with gambling problems including Gambler’s Anonymous, mental health treatment providers, and addiction treatment providers.

Gamblers Anonymous (GA) is the second oldest of the twelve-step programs. It was founded in 1957 by two dually-addicted, alcoholic gamblers who were already attending AA but found themselves unable to abstain from gambling. They began meeting regularly and adapted the structure and organization of AA, as well as its literature, to compulsive gambling. Today the organization has an estimated 35,000 members and meetings in forty-nine countries.

In addition to GA, there are a number of state-funded treatment programs for gambling problems. For example, in the state of California, the Office of Problem Gambling of the California Department of Alcohol and Drug Programs offers state-funded residential, intensive outpatient, outpatient, and telephone-based brief interventions for gambling problems to individuals with gambling problems and their family members.

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