Gambling is an activity in which people stake something of value (such as money or property) for a chance to win a prize. Skill can also be involved in gambling, such as the use of strategies in card games or the knowledge of horses and jockeys to make predictions about horse races. Depending on the legal context, gambling may occur in casinos, lotteries or privately. In modern societies, gambling is often conducted on the Internet and by telephone.
Problem gambling (PG) is a condition characterized by maladaptive patterns of behavior, including recurrent and persistent gambling-related behaviors that are difficult to control even when the gambler realizes that his or her gambling is causing harm. PG can be caused by genetic, environmental, and cognitive factors, and it typically begins in adolescence or young adulthood. Men are more likely to develop PG than women, and they tend to begin gambling at a younger age. PG is associated with serious problems in family, work and community life, and it can lead to depression, anxiety and substance abuse.
Pathological gambling has long been considered a compulsion, and in the past, it was included in the category of impulse-control disorders along with kleptomania, pyromania and trichotillomania (“hair-pulling”). However, the Psychiatric Association moved PG to the Addictions chapter in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, which was released this year.
Until recently, most research on PG has been based on cross-sectional surveys or case studies. While these methods are useful, longitudinal studies have the potential to provide greater insight into the onset and maintenance of PG. However, implementing longitudinal studies in gambling research has proven challenging. The major barriers include the massive funding required for a multiyear commitment; difficulties in maintaining research team continuity over such a long period; problems with sample attrition; and the awareness that longitudinal data confound aging and period effects (e.g., does a person’s sudden interest in gambling reflect his or her aging or the opening of a casino nearby?).
The best way to help someone who is struggling with a gambling addiction is to seek professional help. There are many resources available, from community support groups to peer recovery programs such as Gamblers Anonymous, a 12-step program modeled after Alcoholics Anonymous. In addition, a therapist can help family members understand the nature of the problem and identify triggers for gambling, and marriage and career counseling can help couples rework their relationship. Finally, a financial counselor can assist in developing budgets and managing debt. For families with children, family therapy is important to teach children about the dangers of gambling. Often, gambling is a coping mechanism for mood disorders such as depression and stress, and treating these disorders can reduce the compulsiveness of gambling.