Abnormal Psychology - Addictive Disorders: Gambling Disorder

Gambling Disorder: An Overview

Introduction

  • This mini-lecture discusses gambling disorder, covering its diagnosis and treatment.
  • Professor Mark Kebbell (Psychologist) presents the lecture.
  • Reading material: Rieger (2017) Chapter 10. Addictive Disorders.

Historical Context

  • Gambling exists in almost every culture since antiquity.
  • Social acceptability varies across cultures.
  • Gambling is an integral part of the Australian cultural ethos.
  • Numerous anecdotal case histories of problem gambling exist.

Diagnosis of Gambling Disorder (DSM-5)

  • Defined as persistent and recurrent problematic gambling behavior leading to impairment and distress.
  • The need to gamble with increasing amounts of money.
  • Repeated unsuccessful attempts to control gambling.
  • Preoccupation with gambling.
  • Irritability when trying to cut back on gambling.

Addiction Conceptualization

  • The need to gamble with increasing amounts of money is akin to the tolerance criteria for substance use disorder.
  • Restlessness when cutting down gambling is akin to the withdrawal criteria for substance use disorder.
  • Gambling is conceptualized as an addiction on the basis that individuals repeatedly engage in a behavior to achieve a euphoric state.

Epidemiology of Gambling Disorder

  • Approximately 5% of adolescents meet the criteria for pathological gambling—2–5 times the rate for adults.
  • Adolescent and adult males gamble more frequently and intensely than adolescent and adult females.
  • The ratio of male to female problem gamblers seeking treatment is 3:2.
  • Females are motivated by dealing with negative emotional states.
  • Males are motivated by winning, excitement, and chasing losses.
  • 90% of problem gamblers begin before 20 years.

Aetiology of Gambling Disorder

  • Neurochemical Factors:
    • Serotonin, dopamine, and noradrenaline are implicated in inhibitory control, reward mechanisms, and arousal in impulsive and addictive disorders.
  • Personality Factors:
    • Certain personality factors such as impulsivity are associated with problem gambling.
  • Conditioning:
    • Both classical and operant conditioning are important in the aetiology and maintenance of problem gambling.

Cognitive Models

  • Emphasize cognitive errors that are hypothesized to result in problem gambling.

Environmental and Social Factors

  • Parental modeling and early negative childhood experiences can contribute to the development of problem gambling.
  • Cultural attitudes towards gambling and the availability of opportunities to gamble are influential.

Integrated Pathways Model

  • Includes behaviorally conditioned, emotionally vulnerable, and biologically based problem gamblers.

Treatment of Gambling Disorder

  • Psychoanalytic and Psychodynamic Approaches:
    • Primal addiction conceptualization.
  • Gamblers Anonymous:
    • Emphasis on shared common experiences.
  • Behavioral and Cognitive Interventions:
    • Gambling as a learned maladaptive behavior.
    • Challenge dysfunctional beliefs that lead to the behavior.
  • Pharmacological Interventions:
    • SSRIs, opioid antagonists, mood stabilizers.
  • Public Health Model:
    • External societal determinants of gambling.
    • Consumer protection approach.

Summary

  • This mini-lecture covered the diagnostic criteria and treatment of gambling disorders.