Gambling addiction (known also as gambling disorder and pathological gambling) is described as a disorder characterized by obsession and compulsively gambling, defined as wagering something of value to win something of greater value in an activity that is to some degree determined by chance (American Psychiatric Association [APA], 2013; Hunt & Blaszczynski, 2019).
Features may include:
- Compulsive engagement in gambling with mental obsession
- Urges or cravings to gamble
- Need to gamble more to achieve the desired effect
- Gambles when feeling distressed and/or to avoid feelings (e.g., sad, anxious, jealous)
- Continuing gambling despite negative consequences (e.g., health, work, or relationship issues)
- Continuing to gamble (chasing losses) in hopes of recouping money lost in previous gambling activities
- Loss of control over gambling with failed attempts to cut back or stop use
- Withdrawal symptoms (e.g., restlessness, irritability, anger) when unable to gamble
Diagnostic Considerations:
Clinicians treat people who describe their experiences with gambling disorder. When the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was last revised, pathological gambling was renamed gambling disorder. It was re-conceptualized from an impulse-control disorder to a non-substance related addictive disorder in a chapter titled “Substance-related and Addictive Disorders” (APA, 2013). It such, it was the first behavioral addiction recognized by the American Psychiatric Association, with others expected to be recognized as evidence mounts.
Gambling disorder is included in the International Classification of Diseases, 11th Revision (ICD-11; World Health Organization, 2018) as a “Disorder due to Addictive Behaviours.”
Gambling disorder often co-occurs with adjustment disorders, depressive and anxiety disorders, personality disorders, substance use and non-substance behavioral addictions such as online gaming, cybersex or other disruptive, impulse-control, and conduct disorders. When applicable, counselors often diagnose these other disorders.
Treatment:
Treatment for gambling disorder varies dependent on factors including co-occurring disorders. Common psychotherapeutic approaches support emotion regulation enhancement, coping, calming, and communication skills, self-esteem, relationships, conscious awareness of finances, appropriate responses to physical and psychological cues such as triggers to gamble, and a new relationship with money and finances.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.
Hunt, C.J., & Blaszczynski, A. (2019). Gambling disorder as a clinical phenomenon. In A. Heinz, N. Romanczuk- Seiferth, & M.N. Potenza (Eds.), Gambling disorder (pp. 15-27). Springer Publishing Company.
World Health Organization. (2019). International statistical classification of diseases and related health problems (11th ed.). https://icd.who.int/