Pathological gambling is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-1V, 1994) as: persistent and recurrent maladaptive gambling behavior" (p. 618) which disrupts personal, family, or vocational pursuits. This condition effects 1.8% of adults.
Pathological gambling is classed as an impulse control disorder. Like substance abuse, 30-40% of gamblers report mild withdrawal characterized by: irritability, agitation, concentration difficulties and even somatic complaints (Wray & Dickerson, 1981). "Substance use disorders and pathological gambling share similarities in terms of diagnostic criteria, epidemiology, and clinical course" (Petry, 2002). And like substance abusers, pathological gamblers jeopardize work, social, and family responsibilities to gamble. Up to 60% of pathological gamblers commit illegal acts to support their gambling, much as the addicted do (Rosenthal & Lorenz, 1992). Additionally, "Comorbidity of gambling and substance abuse is high" (Spunt et al., 1998). This means many gamblers also have a substance abuse disorder.
In treatment of pathological gambling, Gambler's Anonymous (GA) was modeled after Alcoholics Anonymous and is the most commonly used intervention among pathological gamblers. Combining group GA with individual psychotherapy seems to be the most efficacious treatment of all (Petry, 2002). The majority of gamblers were able to maintain abstinence when they participated in both of these interventions. In other studies, 70% of gamblers responded favorably to Cognitive-Behavioral Therapy (individual talk therapy).
In one study (Petry, 2002), Naltrexone was reported to block urges or endorphins released during gambling, thus reducing the "gambler's high." A combination of group therapy (GA), individual psychotherapy (CBT), and psychopharmacology such as Naltrexone, or other impulse-control medications, have been shown effective for treating gambling addiction.
If you have a loved-one struggling with gambling, contact a psychotherapist or psychiatrist, and your local Gambler's Anonymous for support. Odds are good your loved-one will get the help they need!
References:
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-1V). American Psychiatric Association, Arlington, VA
Wray, L., Dickerson, M.G. (1981). Cessation of high frequency gambling and "withdrawl" symptoms. British Journal of Addiction, 76, 401-405
Petry, N.M. (2002). How Treatments for Pathological Gambling Can Be Informed by Treatments for Substance buse Disorders. Experimental and Clinical Psychopharmacology, Vol. 10, No. 3, p. 184-192
Rosenthal, R.J., Lorenz, V.C. (1992). The pathological gambler as criminal offender. Clinical Forensic Psychiatry, 15, 647-660
Spunt, Dupont, LeSieur, Liberty, & Hunt. (1998). Pathological gambling and substance misuse: A review of the literature. Substance Use and Misuse, 33, 2535-256.
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