GAMBLING ADDICTION (GAMBLING DISORDER)

Gambling addiction is a non-substance-related disorder, characterized by loss of control over gambling.

Overview Of Gambling Addiction

Gambling addiction - also known as pathological gambling, compulsive gambling, or gambling disorder - is a non-substance-related disorder. This disorder is characterized by loss of control over gambling, excessive preoccupation with gambling or making money to gamble, and continued gambling behavior regardless of the consequences. A compulsive gambler cannot control the urge to gamble, even when it causes negative consequences for themselves or their loved ones. Gambling addiction can affect people of all ages, genders, and socioeconomic groups.

Sociocultural influences on gambling addiction disorder. In the United States, African Americans have a higher rate of this disorder than European Americans. The rate of Mexican Americans addicted to gambling is approximately the same as that of European Americans. In addition, gambling addiction is also a problem among Southeast Asian refugees, especially the Laotian group.

Why Are Some People Unable To Stop Gambling?

The dream of winning money in a gambling game is not always the cause of gambling addiction. When a person gambles, the neurotransmitter that produces a feeling of excitement (dopamine) is released in the brain, creating a sense of exhilaration, whether the bet is won or lost.

Combined with other elements of gambling, such as the likelihood of winning, the joy of playing, and social engagement, dopamine activates the brain's reward system. In some people, this reward system may force them to continue betting beyond their intended limits to experience those positive feelings. Over time, this can lead to gambling addiction - which can alter the brain's reward system and change the individual's overall behavior.

Signs And Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition Text Revision (DSM-5 TR), persistent and recurrent problematic gambling behavior that results in clinically significant impairment or distress, is diagnosed when the individual has four (or more) of the following signs within a 12-month period:

1. Need to gamble with increasing amounts of money to achieve the desired excitement.

2. Be restless or irritable when trying to reduce or stop gambling.

3. Has made repeated attempts to control, cut back, or stop gambling have been unsuccessful.

4. Be often preoccupied with gambling (e.g., frequently thinking or reliving past gambling experiences, planning the next act of chance, and thinking of ways to earn money to gamble).

5. Often gamble when feeling distressed (such as helpless, guilty, anxious, depressed).

6. After losing money gambling, often come back another day to get the capital back (“chasing” the loss).

7. Lie to hide the extent of gambling involvement.

8. Have jeopardized or lost an important relationship, job, educational, or career opportunity because of gambling.

9. Relying on others to provide money to solve desperate financial situations caused by gambling.

Note: The gambling behavior is not better explained by a manic episode.

Severity is assessed based on the number of criteria endorsed. People with mild gambling disorder may exhibit only 4 - 5 of the criteria, with the most frequently endorsed criteria typically relating to a preoccupation with gambling and “chasing” losses. Individuals with moderate gambling disorder have more of the criteria (6 - 7). Individuals with severe gambling disorder will exhibit all or most of the criteria (8 - 9), jeopardizing relationships or career opportunities because of gambling and relying on others to provide money when losing gambling.

WARNING: The symptoms listed are for reference only. If you suspect that you have a gambling disorder, see a psychologist for an accurate diagnosis.

Who May Have Compulsive Gambling Disorder?

Gambling disorder can have an onset in adolescence or young adulthood, it can also manifest in middle age or even older adulthood. In general, gambling disorders can develop at any age and continue to worsen over the years without proper interventions. However, progression in women tends to be more rapid than in men. National data from the United States and Canada shows that most people with gambling disorders have a progressive increase in both frequency and quantity of wagering. Gambling habits can be regular or episodic, and gambling disorders can be persistent or in remission. Gambling may increase during times of stress or depression and periods of substance use or abstinence. There can be periods of heavy gambling and serious problems, periods of total abstinence, and periods of non-problematic gambling. Gambling disorder is sometimes associated with spontaneous and long-term remission. However, some individuals underestimate their vulnerability to develop gambling disorder or relapse following remission. When in remission, they may assume that they will have no problems managing their gambling and that they can engage in some forms of gambling without problems, only to experience a relapse of gambling disorder.

Gambling that begins in childhood or early adolescence is associated with increased rates of gambling addiction. Psychological disorders, including attention-deficit/hyperactivity disorder (ADHD), anxiety disorder, antisocial personality disorder, depressive and bipolar disorder, as well as substance use disorders, especially alcohol use disorders, are associated with an increased risk of the onset of gambling disorder among those who gamble and with the persistence of gambling disorder symptoms over time. Additionally, gambling disorders can run in families, and this effect appears to be related to both environmental and genetic factors. Research shows that gambling problems are more common in monozygotic than in dizygotic twins. Gambling disorder is also more common in first-degree relatives of people with moderate to severe alcohol use disorder than in the general population.

Mental Health Implications In Compulsive Gamblers

Gambling addiction may be linked to mental health conditions such as bipolar disorder, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD). Studies also show that up to 34% of problem gamblers suffer from post-traumatic stress disorder (PTSD). These people are also more likely to have other problems such as depression, anxiety, or substance abuse. Although gambling disorder is not necessarily the cause of these conditions, it can worsen the symptoms and effects of these disorders.

In addition, gambling disorder can cause a range of emotional and physical symptoms, as well as life-altering incidents. Over time, this disorder can disrupt an individual's relationships and force them to turn to alcohol or drugs as an unhealthy coping mechanism.

Treating Gambling Addiction With Psychotherapy

Psychotherapy can help individuals gain control over their gambling activities; handle stress in a healthy way; heal relationships with loved ones; maintain recovery and avoid triggers; and address other mental health conditions that may affect gambling behaviors.

Specific types of therapy for gambling disorder include:

  • Cognitive Behavioral Therapy (CBT): CBT is the most common psychological intervention for treating gambling disorders. Through CBT, individuals can eliminate negative and obsessive thoughts and behaviors and learn to adopt healthier thinking patterns and habits. 

  • Motivational Interviewing: Through this technique, the individual analyzes his or her problem gambling behavior, comparing it with the gambling habits of the general population. This helps motivate individuals to make behavioral changes. 

  • Psychodynamic therapy: This therapy examines the unconscious processes that influence behavior, thereby enhancing self-awareness and understanding of how past behavior affects current behavior.

  • Group therapy: Group therapy is a valuable source of motivation and emotional support for people with gambling disorders, especially if they have lost contact with friends or family due to gambling addiction.

Support For Compulsive Gamblers

Sometimes realizing that your loved one is facing a gambling disorder can be difficult and stressful. Below are some helpful tips so you and your loved ones can deal with this disorder effectively.

Seek Help As Soon As Possible

A person with a gambling addiction needs treatment as soon as possible. Therefore, encouraging your relatives to access treatment is extremely important. You can suggest that they call support organizations, seek professional advice, or join support groups. You must be a supportive partner without judgment.

Show Empathy

Even if you disagree with your loved one, listen to them respectfully and kindly. The more your loved one feels heard, the more trusting and willing they will be to candidly share their struggles with you.

Be Patient

Don't expect an action or therapy to immediately fix your loved one's addiction. Gambling disorder is a complex chronic condition and requires a complex and long-term treatment process. Most importantly, the addicted person needs to be constantly aware of their behaviors and monitor the temptation to partake in any form of gambling.

Take Care Of Yourself

Don't forget yourself in the process. Stress, grief, anxiety, or depression not only affect the person with gambling disorder but also affect you. Take care of your mental health and seek support when needed.

If you feel you are having symptoms of a gambling disorder, go to a medical facility for a timely examination and diagnosis, or contact the Vietnam-France Psychology Institute via Hotline: 0979.158.463 for specific advice. Early intervention is key to improving health and quality of life.

References:

[1] Tâm bệnh học. Đặng Hoàng Minh

[2] Gambling Addiction and Problem Gambling. https://www.helpguide.org/articles/addictions/gambling-addiction-and-problem-gambling.htm

[3] Gambling addiction. https://www.healthdirect.gov.au/gambling-addiction

[4] Gambling Addiction: Resources, Statistics, and Hotlines. https://onlinedegrees.unr.edu/blog/gambling-addiction-resources/

[5] Gambling Disorder. https://my.clevelandclinic.org/health/diseases/17881-gambling-disorder-gambling-addiction

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