Gambling is taking a risky action in the hopes of gaining something of an even greater value. Traditionally, gambling included lotteries, wagering in casinos, and card games. According to Rash et al. (2016), gambling disorder is a mental illness associated with recurrent, maladaptive gambling behavior that causes clinically significant distress. Although gambling is harmless for most people who engage in it, individuals with gambling disorder experience cognitive distortions such as impulsive behavior, illusions of control, and dysfunctional personal traits such as high novelty seeking or high harm avoidance. This paper discusses DSM-5 Diagnostic criteria, risk factors, early warning signs, and treatment options for gambling disorder.
DSM-5 Diagnostic Criteria for Gambling Disorder
According to Menchon et al. (2018), in DSM-5, gambling is classified in the “Substance-Related and Addictive Disorders” category. The DSM-5 diagnostic criteria for gambling disorder is problematic gambling behavior which is persistent, recurrent, and not explained by a manic episode, leading to clinically significant distress experienced by the individual manifesting four or more of these symptoms in 12 months. First, to achieve the desired excitement, the person needs to gamble with higher amounts of money. Secondly, when trying to cut down or stop gambling, the person is irritable or restless. Third, the person has made repeated unsuccessful efforts to control, limit, or quit gambling. Fourth, the person is preoccupied with gambling and fifth, when feeling helpless, distressed, anxious, guilty, or depressed, the individual often gambles. Sixth, the individual often returns another day to get even after losing money gambling. Seven, the individual deceives to hide the level of their gambling involvement. Eight, the individual has lost or jeopardized an important relationship, educational or career opportunity, job due to gambling. Lastly, the person relies on other people to provide money to ease distressed financial situations due to gambling.
Risk Factors for Gambling Disorder
There are various risk factors for gambling disorder; first, substance abuse disorder. Individuals with substance abuse disorder are at increased risk of developing a gambling disorder. Secondly, family history of gambling where individuals whose family members gamble are at an increased risk. Early exposure to gambling may lead adolescents to try gambling and potentially develop a gambling disorder. Third, personality traits such as impulsivity. Impulsivity is the inclination of a person to act on urge rather than thought with decreased regard for consequences. Impulsivity has been reported to increase the likelihood of gambling in youths.
Warning Signs of Gambling Disorder
There are various early warning signs of gambling disorder; first financial signs such as money missing from bank accounts or wallets, household items missing, borrowing money regularly, unpaid bills, regularly being short of cash. Secondly, mood and behavior warning signs include becoming withdrawn from family or other people, seeming worried and agitated for no apparent reason, reporting feeling depressed, hopeless, or frustrated, using threats, charm, or lies to manipulate others. Lastly, time-related early warning signs include spending more and more time gambling, being late to commitments, being secretive about unexplained absences, and taking many days off.
Treatment options for Gambling Disorder
Treatment options for gambling disorder include psychosocial and pharmacotherapy treatments. Psychosocial treatments include cognitive behavior therapy, which combines behavioral and cognitive techniques. Cognitive approaches focus on biased information processing and erroneous beliefs, while behavioral techniques assume that problems are learned maladaptive behaviors. Cognitive behavior therapy is the primary psychological therapy for gambling disorder, and its targets are corrective reward processing, decision making, cognitive distortion, and psychological or physical responses associated with gambling disorders. It involves social skills and problem solving training, cognitive correction, and prevention of relapse.
The second psychosocial treatment for gambling disorder is motivational interviewing, which aims at helping individuals to work through ambivalence and commit to change. Motivational interviewing explores the patient’s arguments for change in a supportive and empathic manner. Motivational interviewing techniques explore the positive and negative consequences of gambling, personalized feedback about gambling, and motivational enhancement therapy (Rodda et al., 2018). Motivational interviewing utilizes two phases: the first phase increases motivation for change, and the second phase consolidates the commitment.
Pharmacotherapy is another treatment option for gambling disorders. To date, no medication has been approved by the Food and Drug Authority for the treatment of gambling disorder. According to Choi et al. (2017), medications commonly used to treat gambling disorder include opioid receptor antagonists and mood stabilizers. In patients with gambling disorder, opioid receptor agonists can reduce the urge to gamble and increase periods of abstinence. Mood stabilizers such as lithium have been used to treat gambling urges in patients with gambling disorder.
Conclusion
Gambling is taking a risky action in the hopes of gaining something of an even greater value. In the DSM-5, gambling disorder is classified in the “Substance-Related and Addictive Disorders” category. The risk factors for gambling disorder include substance abuse disorder, family history of gambling, and personality traits such as impulsivity. The warning signs include financial signs such as missing money, mood and behavior signs such as becoming withdrawn from family or other people, and time-related early warning signs include gambling more and more. The main treatments for gambling disorders include psychosocial therapies and pharmacotherapy. Psychosocial treatments include CBT and motivational interviewing. Cognitive behavior therapy is the primary psychological therapy for gambling disorder, and its targets are corrective reward processing, decision making, cognitive distortion, and psychological or physical responses associated with gambling disorders. Pharmacological treatments include the use of opioid receptor antagonists and mood stabilizers.
References
Choi, S. W., Shin, Y. C., Kim, D. J., Choi, J. S., Kim, S., Kim, S. H., & Youn, H. (2017). Treatment modalities for patients with gambling disorder. Annals of general psychiatry, 16(1), 1-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410060/
Rash, C. J., Weinstock, J., & Van Patten, R. (2016). A review of gambling disorder and substance use disorders. Substance abuse and rehabilitation, 7, 3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803266/
Rodda, S., Merkouris, S. S., Abraham, C., Hodgins, D. C., Cowlishaw, S., & Dowling, N. A. (2018). Therapist-delivered and self-help interventions for gambling problems: A review of contents. Journal of behavioral addictions, 7(2), 211-226. https://akjournals.com/view/journals/2006/7/2/article-p211.xml
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