Pathological Gambling

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., feelings of helplessness, guilt, anxiety, depression).

• After losing money gambling, often returns another day to get even ("chasing" one's losses).

• Lies to family members, therapist, or others to conceal the extent of involvement with gambling.

• Has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling.

• Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.

• Relies on others to provide money to relieve a desperate financial situation caused by gambling.

The gambling behavior is not better accounted for by a Manic Episode.

Associated Features

Distortions in thinking (e.g., denial, superstitions, overconfidence, or a sense of power and control) may be present in individuals with Pathological Gambling. Many individuals with Pathological Gambling believe that money is both the cause of and solution to all their problems. Individuals with Pathological Gambling are frequently highly competitive, energetic, restless, and easily bored. They may be overly concerned with the approval of others and may be generous to the point of extravagance. When not gambling, they may be workaholics or "binge" workers who wait until they are up against deadlines before really working hard. They may be prone to developing general medical conditions that are associated with stress (e.g., hypertension, peptic ulcer disease, migraine).

Course

Pathological Gambling typically begins in early adolescence in males and later in life in females. Although a few individuals are "hooked" with their very first bet, for most the course is more insidious. There may be years of social gambling followed by an abrupt onset that may be precipitated by greater exposure to gambling or by a stressor. The gambling pattern may be regular or episodic, and the course of the disorder is typically chronic.

There is generally a progression in the frequency of gambling, the amount wagered, and the preoccupation with gambling and obtaining money with which to gamble. The urge to gamble and gambling activity generally increase during periods of stress or depression.

Diagnostic criteria summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.