Gambling Addiction
Escape gamblers
-Gambling usually starts as a recreation, a means of socialization, or as a method of distraction in order to escape from problems. -They like games of "luck" that do not require skill: slot machines, video poker, bingo, etc. -May enter a "trancelike" state, and end up spending excessive amount of time "lost" in gambling.
What are some examples of other environmental risk factors that can make someone vulnerable to gambling?
-Social modeling (gambling of parents/peers) -Accessibility (easily finding gambling opportunities) -Co-morbidity w/other disorders (substance use disorders, antisocial personality, ADHD, depression, and bipolar disorder.
Adolescents and gambling
-Society's permissive attitude toward gambling + increased online gambling opportunities = teen gambling rising. -60-80 % of adolescents have engaged in some form of gambling -BUT only 10-15 % are at risk of developing gambling problems -Most people are protected from addiction by their prefrontal cortex. -In a relatively small percent, genetics and/or early development may lead to prefrontal weakness; hence the vulnerability to addictive disorders.
Action gamblers
-Usually prefer games requiring skill -Highly competitive; often have backgrounds in sports. -Gamble in order to beat another individual or the casino. -Believe it's possible to develop a system in order to achieve their goal (i.e., winning). -Gambling may begin in adolescence and then continue into adulthood. -Preferred games include: poker, blackjack, craps, dice games, horse racing, stock market trading, or sports betting.
Gender in gambling
-Women are now making up the fastest growing group seeking help for problem gambling -1/3 of problem gamblers are women -"Telescope" effect (like in substance use disorder): women are more resistant to gambling disorders and acquire it at a later age. BUT, once they acquire the disorder, they spiral down and deteriorate much faster than men.
Types of gamblers (2)
ACTION gamblers and ESCAPE gamblers
Seniors and gambling
Fastest growing segment of the population for problem gambling. Most vulnerable population b/c: -More time at hand. -Desire to escape from life stress: death of a spouse, financial and/or health problems, loneliness, depression. -Accessibility: bus trips and travel packages are often organized around casino visits. -Living at fixed income and strong desire for more wealth. -Prefrontal cortex decline (prefrontal cortex is the latest region to mature, but it is also the FIRST REGION TO DECLINE with older age
Losing Phase
Gambler becomes preoccupied with gambling and the need for making larger bets more frequently. Losses increase, but they are rationalized as "losing streak". Here, gamblers begin to "chase" their losses, lie about the extent of their involvement, start having difficulties stopping to gamble, and begin to break promises to self and others to quit gambling.
Desperation Phase
Gambler may experience onset of health problems and relationships may begin to deteriorate. Feelings of desperation and hopelessness (dopamine depletion), and clinging to the fantasy of winning, the gambler may begin to steal, write bad checks, commit other crimes in order to finance gambling.
Hopeless Phase
Gambler stops believing there is hope or help. The gambler becomes indifferent about living or dying, going to jail or not. Depression is common, and suicide is a real risk.
Vulnerabilities to pathological gambling
Genetics, developmental trauma, other environmental risk factors
2 groups of people w/excessive involvement in gambling
PROBLEM gamblers and PATHOLOGICAL gamblers
What does neurobiology of gambling look like in addicted gamblers?
Very similar to neural systems involved in addiction to substances: 1. A reward circuit: mesolimbic dopamine 2. A decision-making and self control circuit: prefrontal cortex. 3. Memory and learning circuit: amygdala and hippocampus. 4. Motivational drive and urge/craving circuit: insula
Phases of gambling (4)
Winning Phase, Losing Phase, Desperation Phase, Hopeless Phase
Gambling used to be classified (in DSM-IV) as...? Currently classified (in DSM-V) as...?
an impulse control disorder - now it's considered on addiction
Winning Phase
betting is fun, exciting, social, or a way to escape daily stress. Occasionally, individuals win a large sum, which then could lead to larger betting and spending more time gambling
disorder
characterized by loss of control over gambling, despite incurring negative consequences such as deception regarding the extent of one's involvement w/gambling, family and job disruption, theft, and "chasing" losses
Other terms used to describe pathological/problem gambling
compulsive gambling, disordered gambling
What are some examples of dvlptal trauma that can make someone vulnerable to gambling?
coping with trauma, abuse (physical and sexual), and emotional abuse especially in women.
Level 3 gambling
gambling to a degree with severe problems. Clinically this may meet criteria for "pathological gambling."
problem gambling
generally refers to individuals who meet at least 3 of the 10 diagnostic criteria from DSM
pathological gambling
generally refers to individuals who meet at least 5 of the 10 diagnostic criteria from DSM
Why is gambling called a "hidden" disorder?
manifests no physical signs (needle marks, slurred speech, alcohol on breath...)
Definition of gambling
placing something of value at risk in the hopes of gaining something of greater value
Level 1 gambling
social or recreational gambling. No significant problems are associated w/behavior. (Majority of ppl who gamble fall into this category.)
Level 0 gmabling
someone who never gambles
What is gambling linked to, specifically, in our genes?
the D2A1 allele (dopamine) receptor gene
Similarities w/substance use disorders criteria
tolerance, withdrawal, repeated unsuccessful attempts to quit, interference in major areas of life function
Level 2 gambling
wagering to such an extent that some gambling related problems have developed. Clinically this may be defined as "problem gambling."
