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Gambling Addiction

Gambling involves placing a wager on the outcome of a game or event, such as a card game, roulette wheel, slot machine, sporting event or the lottery. The fundamental principle is the risking of something of value with the hope of winning something of greater value. Once referred to as compulsive or pathological gambling, gambling disorder is characterized by a persistent need to bet on an outcome to a degree that causes significant disruption of one’s personal life, relationships or job, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 is the handbook of psychiatric disorders used by mental health clinicians.

Gambling is an incredibly popular pastime. An October 2014 report by the American Gaming Association found that the casino gaming industry alone contributes $240 billion to the U.S. economy (and that doesn’t include online gambling). More than 75% of adults in the U.S. will gamble at least once in their lifetime; the vast majority will do so without becoming addicted. However, about 1% will develop a gambling addiction, betting with growing urgency and placing larger and larger bets to offset or recoup losses, says the Substance Abuse and Mental Health Services Administration. While many casual gamblers will attempt to win back what

they’ve lost, those with the disorder do so to a much more serious degree, engaging in this “chasing” behavior frequently and over long periods of time. Someone with an addiction to gambling may attempt to minimize or hide the extent of the problem to loved ones, as well as borrow money or even steal to cover losses.

It’s important to make the distinction between professional gambling and an addiction to gambling. Professional gamblers are disciplined and pay close attention to the ways in which they can limit their risk, whereas people with gambling disorder simply don’t have that level of self-control.

Gambling Addiction 101

Gambling disorder was once considered an impulse control disorder, until research found that people who are addicted to gambling shared many of the same characteristics of alcoholics and substance abusers, both in terms of their brains and their behavior. Gambling disorder became fully recognized as an addictive disorder when the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) came out in 2013.

Here are some facts you should know about gambling addiction:

  • As common as gambling is, developing an addiction to gambling remains fairly rare. Someone’s lifetime risk of developing it is only about 0.4%-1.0%. The average rate of “problem gambling” – a broad category that includes individuals with varying degrees of the disorder – is 2.2% across all U.S. states, according to a 2012 report.

  • Men are likelier than women to have the disorder and they bet differently; men are more apt to wager on cards, sports and horse racing, while women are more likely to work the slot machines and play bingo.

  • People who are addicted to gambling are more likely to be in poor health and have chest pain or arthritis. They may also be struggling with depression and loneliness. And though studies aren’t conclusive, some 17% to 24% will attempt suicide. Research suggests that compulsive gamblers tend to show disordered and superstitious thinking, impulsivity and competitiveness.

  • Certain medications, such as drugs used for Parkinson’s and restless legs syndrome, can actually cause an urge to gamble. (This isn’t the same as having a gambling disorder, unless the urge to wager continues after the medication is stopped.)


There’s strong evidence that gambling runs in families. Researchers at the University of Iowa found that first-degree relatives of compulsive gamblers are eight times more likely to develop the disorder than those with no close familial relationship to a compulsive gambler. This and other studies suggest that problem gambling most likely has both genetic and environmental causes:

  • Environment: Several studies have found that early exposure to gambling likely contributes to the development of a gambling addiction. In one creative investigation, researchersdiscovered that teenagers who’d received scratch-off lottery tickets as gifts were more likely to report symptoms of problem gambling later in life.

  • Genes: Researchers have found that the disorder is more common among identical twins than it is among fraternal twins, suggesting that an addiction to wagering and betting also has a strong genetic component.

Symptoms of Gambling Addiction

Like all addictions, gambling addiction happens on a continuum. Its signature characteristics are similar to substance addiction, too: increasing preoccupation with the “drug” of choice, experiencing an emotional response to gambling and behavior that has a detrimental impact on finances, job and/or relationships. The DSM-5 has identified nine symptoms of gambling disorder; these are listed below. If a person shows four or five of these symptoms in a year, they’re believed to have a mild gambling disorder; six or seven symptoms suggest a moderately severe case and eight or nine symptoms indicate the most severe form of gambling addiction. Symptoms include:

  • Gambling with bigger and bigger sums in order to attain the same thrill

  • Becoming irritable when attempting to reduce gambling

  • Making repeated attempts to cut back or stop gambling

  • Being preoccupied with gambling and constantly thinking about past experiences and upcoming opportunities

  • Gambling when depressed or anxious

  • Returning to gamble after a bad outing, to recoup losses

  • Concealing or mischaracterizing the extent of the gambling

  • Losing or being close to losing a valued relationship, job or opportunity because of gambling

  • Seeking financial help from others after gambling losses

It’s possible to have difficulties stemming from gambling without those problems rising to the level of having a diagnosable disorder. People who fall into this category are considered at risk of developing an addiction to gambling, says the National Center for Responsible Gaming.

Risk Factors

Anyone can develop a gambling addiction, but it’s most often associated with being young, male and African-American. As with other addictions, having another mental health issue or someone in the family with a history of problem gambling or substance abuse raises the odds of developing the problem. Here’s more information on risk factors:

  • Gender Men are substantially more likely to gamble than women, although with the growing trend among states toward expansion of legalized gambling in casinos and lotteries, the gender gap is decreasing. And while men bet and wager more, women are likelier to develop a gambling problem at a later age.

  • Mental or emotional problems Nearly one-half of problem gamblers have a co-occurring disorder, meaning the person also has a mental illness. Some of the mental health problems most often seen in people with a gambling issue include narcissistic personality disorder, antisocial personality disorder, avoidant personality disorder, obsessive-compulsive disorder and borderline personality disorder. Problem gamblers are also more likely than the general population to suffer from chronic depression and anxiety.

  • Drug or alcohol problems Perhaps it doesn’t come as a surprise, then, to hear that gambling addicts are often struggling with substance abuse as well, reports the Substance Abuse and Mental Health Services Administration. More than 70% of those with gambling disorder have an alcohol problem, and nearly 40% have a drug abuse problem.

  • Personality traits Researchers have found that pathological gamblers tend to be more impulsive by nature. One 30-year study noted that children with behavioral problems such as extreme restlessness at age three were more than twice as likely to have a gambling disorder as an adult compared to kids who’d been considered well-adjusted.

  • Family As mentioned above, gambling addiction tends to run in families. Children who are exposed to gambling at an early age appear to be more likely to develop a problem later in life, and studies of twins suggest that compulsive gambling is, in part, an inherited disorder.

  • Military For reasons that aren’t clear, military service appears to double the likelihood of developing a gambling disorder. A Veterans Administration study of nearly 2,000 vets found that the rate of gambling addiction was twice the national average and four times that number had a lifetime probability of developing a problem with gambling. The researchers also found that male and female veterans had about the same rates of problem gambling, but female vets had higher rates of pathological gambling than male veterans.

  • Age Young adulthood and middle age seem to be the peak times for developing a problem with gambling. That said, if someone starts wagering early – as a child or teen – they’re likelier to develop the disorder; and adolescents who use marijuana are at higher risk. In addition, seniors who are lonely, depressed or in pain seem to be at higher risk than those who are healthy and socially active.

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