HBSE Micro - Chp. 5: Addiction

Boxed Reading: When Knowledge is Not Enough

After an 18 year marriage ended, felt gambling filled hole in heart. "Numbed out" feelings by going to casinos, smoking cigarettes, betting huge amounts of money. Winning/losing was not an issue; needed to rush of slot machine, reaching the bonus round, seeing points add up.

Exercising for Feeling Group Work

Art Therapy reveals feelings that may not be expressed. - brings out perfectionism - clients draw their world prior to treatment, during treatment and after treatment. - do not need to be talented - gives indication of future hopes & fears

Advantages of Gambling for the Community (in terms of the Isle in Waterloo)

Casino donated considerable sums of money to local museums & charities. Strengthens the economy. Creates jobs for thousands of people. (directly-related to the casino, as well as gambling addiction counselors) Gamblers Anonymous (GA) meeting join other self-help groups at the local hospital. Creation of 1-800-Bets-Off

Spending Addiction

Compulsive Buying Disorder - term used by medical authorities. Characteristics: - Making a purchase - Associated mood & anxiety disorders - Family history of similar problems Predominantly affects women. Onset = late teens/early adulthood. Treatment = cognitive approaches + antidepressants and serotonin enhancers. Compulsive shoppers likely to have more than one psychiatric disorder & relatives likely to have depression & use drugs.

Boxed Reading: Social Work Major Working in a Casino

Customers and employees watched at all times. - Microphones in break room to figure out what employees are saying. Customers screaming and swearing at employees because they are losing their money or not getting immediate service. - Casinos unable to keep enough people employed to service enormous number of customers. Customers are not young, excited, partying people like depicted in advertisements. - Customers are elderly people living on social security & pensions. Similar to life in a bar. - Same customers night after night. - Employees told to encourage customers to continue playing using scripted lines.

Anorexia

Eating disorder marked by starvation and skewed perception of self. Closely linked to anxiety, perfectionism and obsessiveness (OCD).

Disadvantages of Gambling for the Community (in terms of the Isle in Waterloo)

Governor tried to raise casino's taxes, so casino threatened to withdraw their donations to local causes. Causes individuals to blow through their retirement, their homes, cars, relationships with their children, etc.

Sexual Addiction

Hypersexual Disorder = clinical term. Not formally recognized in DSM-5. Similar features with substance abuse... - Early onset - Chronic relapsing - Addicts deficient in dopamine receptors If we accept that addiction is along a continuum, we find some of the criteria for diagnoses are met and could still be labeled as an addiction. - However, it is not recognized by American Medical Association as a disorder.

Gender Differences & Gambling

Men = more likely to be pathological or problem gamblers than women. Women = more likely to have later onset gambling problems than men because they don't begin gambling until later in life. Gambling problems associated with... - Men: conduct disorder and impulsivity. - Females: anxiety and depression.

Casino Manipulations

No windows Bright lights No clocks Cheap food/drinks

The Brain & Gambling

Personality trait of making impulsive decisions = key marker in gambling and substance abuse disorder. - Trait = imbalance between overactive reward systems and under active prefrontal cortex control mechanisms. Problem gamblers show reduction of dopamine receptors (specifically D2). - Similar to substance abuse disorders Problem gamblers have heightened level of dopamine release. - Consistent with the notion that dopamine agonist treatments for Parkinson's inducing excessive gambling/other risky behaviors in patients. Genes explain at least 50% of tendency to gamble.

Minorities & Gambling

Problem gambling = concentrated among the poor & poorly educated. Vulnerable groups (i.e. people who are homeless) have elevated rates of gambling. Problem gambling is higher in racial, ethnic, and indigenous minorities than it is among whites in the US. Asians are the least likely to be involved in gambling. Casinos actively target racial & ethnic groups, especially Chinese Americans who have strong gambling traditions.

Internet Gambling

Unique Characteristics... - Anonymity - Accessible by computer/phone - 24 hr availability - Ability to wager electronic funds via credit card Internet gamblers described as... - Having higher rates of disorder gambling - Being male - Having more education - Having a higher socioeconomic status - Being more technology proficient - Being more likely to use alcohol & drugs.

Hoarding

Used to be listed as a category of OCD in the DSM, however, because individuals who hoard do not experience intrusive thoughts, images or impulses, it is no longer is listed. Characterized by: - Difficulty discarding/parting with possessions Have to rule dementia & brain injury out before being diagnosed. Accumulation of clutter can become a public health issue (i.e. fire hazard or unsanitary conditions).

Co-Occurring Disorders & Gambling

Where there is alcohol & drug addiction, there is a co-occurring gambling disorder. - Also see those diagnosed with antisocial personality, depression, mood disorders, other psychiatric disorders with gambling problems. Patients in treatment for schizophrenia are at high risk for gambling disorders.