164 Pathological Gambling (312.21)
Pathological gambling (PG) involves being unable to resist the impulse to gamble. The transition from recreational gambling to pathological gambling may occur gradually, or it may transition suddenly in response to a stressful event such as job loss (Bayer, 2000).
Some features associated with pathological gamblers include denial, overconfidence, delusions of grandeur, development of superstitions, highly competitive, and overly concerned with approval from others (Bayer, 2000). In order to be diagnosed as a pathological gambler, the individuals symptoms must be persistent and recurrent, and the individual must be preoccupied with reliving past gambling experiences or planning future gambling excursions (Bayer, 2000). After some time, the individual may feel compelled to take higher risks to produce the desired level of excitement. This disorder can result in a host of occupational, social, and legal problems. Compulsive gamblers often find themselves lying to their family members and friends to hide the severity of their problem. They may even resort to illegal, but typically nonviolent, means of acquiring money to gamble (Bayer, 2000).
Compulsive gamblers are more prone to medical conditions that are brought about by stress such as hypertension, peptic ulcers, and migraine headaches (Bayer, 2000). They may also have comorbid mood disorders, substance-related disorders, antisocial behavior, attention-deficit disorder, or hyperactivity (Bayer, 2000). Compulsive gambling can be confused with bipolar disorder, which sometimes accompanies compulsive gambling (Bayer, 2000).
This impulse-control disorder is more common among men than women. Women who do have this disorder are often hesitant to seek treatment; this may be because society tends to view gambling as less acceptable for women than men.
Pathological gambling typically begins in adolescence for boys and later in life for girls (Bayer, 2000). It may be regular or episodic, but it is often chronic (Bayer, 2000). Environmental stressors or depression may increase the frequency of gambling (Bayer, 2000).
Treatment for compulsive gambling includes inpatient & outpatient programs, residential care, halfway houses, behavior modification, individual and group therapy, and traditional psychoanalysis (Bayer, 2000). Relapses are common.
DSM-IV-TR criteria
A. Persistent and recurrent maladaptive gambling behavior as indicated by five (or more) of the following:
- is preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble)
- needs to gamble with increasing amounts of money in order to achieve the desired excitement
- has repeated unsuccessful efforts to control, cut back, or stop gambling
- is restless or irritable when attempting to cut down or stop gambling
- gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g., fe