Understanding Gambling Disorders


Gambling is the wagering of something of value on a random event with the intent of winning something else of value. It may involve the use of money, paper tickets, collectible game pieces (such as marbles or pogs), or items of lesser monetary value. In a casino, gamblers wager chips or cash in return for a chance to win real money.

While most people have gambled, some develop a gambling disorder that causes significant distress and impairment. In the past, a variety of reasons have been attributed to pathological gambling, including recreational interest, diminished mathematical skills, poor judgment, cognitive distortions, mental illness, or moral turpitude. However, a recent shift in understanding gambling disorders has led to a more holistic view of the problem.

Research suggests that a key element in the development of a gambling disorder is an individual’s predisposition to engage in risk-taking behavior. The predisposition is usually based on personality traits, temperament, and genetics. It also may be influenced by environmental factors such as family problems and exposure to gambling or other forms of risk-taking. Some people are particularly vulnerable to developing a gambling disorder, such as those who start gambling as adolescents or those with low incomes, who have more to lose than those with greater wealth. Vulnerability is also higher among males than females.

Another factor that influences gambling disorders is the adolescent brain’s susceptibility to reward and punishment. This is why psychologists and psychiatrists believe that the majority of pathological gamblers begin gambling during adolescence or after a traumatic life event.

Some of the most challenging aspects of a gambling disorder are the social and emotional consequences that often result. The compulsion to gamble can interfere with daily functioning, disrupt relationships, and impair quality of life. In addition, gambling can lead to feelings of shame and guilt. Many individuals feel that they cannot tell their family and friends about their gambling problems because they fear they will be judged or be accused of being a hypocrite. This often results in secretive behavior.

Ultimately, a person who has a gambling disorder should seek help from a counselor or support group. It is also important for family members to set boundaries in managing money and not fund a loved one’s gambling habit. Lastly, it is helpful to learn healthier ways of relieving unpleasant emotions and boredom. For example, a person who is feeling lonely or stressed can try exercising, spending time with friends who don’t gamble, or practicing relaxation techniques.

Generalist physicians should be aware of the relationship between gambling behaviors and health outcomes. They should be familiar with the available screening tools, data regarding health associations, and treatment and intervention options for problem gambling. They should also be prepared to recognize and evaluate underlying mood disorders such as depression, stress, or anxiety that may trigger or be made worse by compulsive gambling. Additionally, they should be familiar with inpatient and residential treatment programs for gambling addiction.