Problem gambling


Problem gambling, also known as pathological gambling, gambling disorder, or ludomania, is repetitive gambling behavior despite harm and negative consequences. Problem gambling may be diagnosed as a mental disorder according to DSM-5 if certain diagnostic criteria are met. Pathological gambling is a common disorder associated with social and family costs.
The DSM-5 has re-classified the condition as an addictive disorder, with those affected exhibiting many similarities to those with substance addictions. The term gambling addiction has long been used in the recovery movement. Pathological gambling was long considered by the American Psychiatric Association to be an impulse-control disorder rather than an addiction. However, data suggests a closer relationship between pathological gambling and substance use disorders than exists between PG and obsessive–compulsive disorder, mainly because the behaviors in problem gambling and most primary substance use disorders seek to activate the brain's reward mechanisms, while the behaviors characterizing obsessive–compulsive disorder are prompted by overactive and misplaced signals from the brain's fear mechanisms.
Problem gambling is an addictive behavior with a high comorbidity with alcohol problems. A common tendency shared by people who have a gambling addiction is impulsivity.

Signs and symptoms

Research by governments in Australia led to a universal definition for that country which appears to be the only research-based definition not to use diagnostic criteria: "Problem gambling is characterized by many difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or for the community." The University of Maryland Medical Center defines pathological gambling as "being unable to resist impulses to gamble, which can lead to severe personal or social consequences".
Most other definitions of problem gambling can usually be simplified to any gambling that causes harm to the gambler or someone else in any way; however, these definitions are usually coupled with descriptions of the type of harm or the use of diagnostic criteria. The DSM-5 has since reclassified pathological gambling as gambling disorder and has listed the disorder under substance-related and addictive disorders rather than impulse-control disorders. This is due to the symptomatology of the disorder resembling an addiction not dissimilar to that of a substance use disorder. To be diagnosed, an individual must have at least four of the following symptoms in 12 months:
  • Needs to gamble with increasing amounts of money to achieve the desired excitement
  • Is restless or irritable when attempting to cut down or stop gambling
  • Has made repeated unsuccessful efforts to control, cut back, or stop gambling
  • Is often preoccupied with gambling
  • Often gambles when feeling distressed
  • After losing money gambling, often returns another day to get even
  • Lies to conceal the extent of involvement with gambling
  • Has jeopardized or lost a significant relationship, job, education, or career opportunity because of gambling
  • Relies on others to provide money to relieve desperate financial situations caused by gambling

    Risk factors

specialists and other studies state that compulsive gambling may result from biological, genetic, and environmental factors such as:

Biology

Evidence indicates that pathological gambling is an addiction similar to chemical addiction. It has been observed that some pathological gamblers have lower levels of norepinephrine than normal gamblers. New studies regarding this link show that norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their under-dosage. Studies have compared pathological gamblers to substance addicts, concluding that addicted gamblers display more physical symptoms during withdrawal. Deficiencies in serotonin might also contribute to compulsive behavior, including a gambling addiction.
The findings in one review indicated that behavioral disorders such as problem gambling and substance use disorder are closely linked; sensitization theory indicates that these disorders are marked by a compulsive drive towards unhealthy behaviors and an inability to control against them. Dopamine dysregulation syndrome has been observed in the aforementioned theory in people with regard to such activities as gambling. A limited study was presented at a conference in Berlin, suggesting opioid release differs in problem gamblers from the general population, but in a very different way from people with a substance use disorder.
Some medical authors suggest that the biomedical model of problem gambling may be unhelpful because it focuses only on individuals. These authors point out that social factors may be a far more important determinant of gambling behavior than brain chemicals, and they suggest that a social model may be more useful in understanding the issue. For example, an apparent increase in problem gambling in the UK may be better understood as a consequence of changes in legislation which came into force in 2007 and enabled casinos, bookmakers, and online betting sites to advertise on TV and radio for the first time and which eased restrictions on the opening of betting shops and online gambling sites.
There have also been studies that showcase how factors like gender and age can affect how a person is affected by gambling; examples include the probability of addiction being 11% stronger in men than in women, and the fact that the age range of 19–29 has the highest risk of developing problem gambling or pathological gambling habits.

Psychology

Several psychological mechanisms are thought to be implicated in the development and maintenance of problem gambling. First, reward processing seems to be less developed in problem gamblers. Second, some individuals use problem gambling as an escape from the problems in their lives. Third, personality factors such as narcissism, risk-seeking, sensation-seeking, and impulsivity play a role. Fourth, problem gamblers have several cognitive biases, including the illusion of control, unrealistic optimism, overconfidence and the gambler's fallacy. Fifth, problem gamblers represent a chronic state of a behavioral spin process, a gambling spin, as described by the criminal spin theory.
Some gamblers often develop learned helplessness—a psychological state in which a person believes they have no control over their situation. This belief is then reinforced through the unpredictable and repeated financial losses that are intrinsic to gambling. This mechanism is significant because it serves to reinforce the cycle of addiction. This phenomenon can shift a gambler's locus of control toward the external. The gambler then begins to perceive outcomes as being determined by uncontrollable external systems, rather than from their own volitional behavior. The theory of learned helplessness was first researched by psychologists Martin Seligman and Steven Maier in the 1960s.
Spain's gambling watchdog has updated its 2019–2020 Responsible Gaming Program, classifying problem gambling as a mental disorder.

Similarities to other disorders

Pathological gambling is similar to many other impulse-control disorders such as kleptomania. According to evidence from both community- and clinic-based studies, individuals who are pathological gamblers are highly likely to exhibit other psychiatric problems concurrently, including substance use disorders, mood and anxiety disorders, or personality disorders.
There is a partial overlap in diagnostic criteria between problem gambling and substance use disorders; pathological gamblers are also likely to have a substance use disorder. The "telescoping phenomenon" reflects the rapid development from initial to problematic behavior in women compared with men. This phenomenon was initially described for alcoholism, but it has also been applied to pathological gambling. Also, biological data support a relationship between pathological gambling and substance use disorder. A comprehensive UK Gambling Commission study from 2018 has also hinted at the link between gambling addiction and a reduction in physical activity, poor diet, and overall well-being. The study links problem gambling to a myriad of issues affecting relationships, and social stability.

Evolutionary psychology

Some researchers propose that human gambling behavior reflects evolved tendencies toward risk-taking that historically conferred adaptive benefits. For example, gambling can be understood as a form of "risky reward-seeking," where individuals overestimate potential gains—an inclination that modern gambling industries exploit. From this view, men tend to gamble more and engage in higher-stakes bets because male reproductive success is often linked to risk-based competition, paralleling other risky activities like big-game hunting or physical aggression. Younger adults may also be more prone to gambling due to the evolutionary advantage of status-seeking during peak reproductive years.
Other evolutionary accounts highlight the role of reward uncertainty. Researchers suggest that unpredictability itself motivates animals to persevere in reward-seeking despite repeated failures, which can foster persistent gambling behaviour. Life History Theory further explains why some individuals are more vulnerable to problem gambling, proposing that those with a "fast" strategy may be especially drawn to high-risk, high-reward scenarios. In this framework, personality traits favoring present-oriented decision-making increase susceptibility to gambling addiction, mirroring risk-taking behaviors seen in other species.