Pathological Gambling

Gambling is a complex activity that involves placing something of value at risk in the hope of winning a prize. Often the risks involved are financial, but may also involve other forms of value such as reputation or relationships. Although the vast majority of people who gamble do so responsibly, a small group of individuals become too seriously involved and continue gambling despite significant and negative personal, social and family effects. This is referred to as pathological gambling (PG) and is the subject of this article.

The term “gambling” covers a broad range of activities, from games that are truly random and have no skill or strategy involved to those such as chess, poker, sports betting and horse racing in which knowledge of game strategies can improve the odds of success. While the skills involved in these activities are often overlooked, a significant proportion of gamblers use strategies to increase their chances of winning.

Various factors can contribute to the development of a gambling problem, including environmental, biological, and psychological factors. Biological factors include genetic predispositions to reward-seeking behaviors and impulsivity, as well as differences in brain structures that regulate decision-making processes and control impulses. Environmental factors include cultural beliefs about gambling and the prevalence of gambling in society, which can influence how people view gambling as a legitimate pastime or risky pursuit.

Psychological factors related to gambling problems can include: (1) a feeling of being powerless to control one’s gambling; (2) lying to family members, therapists, and others about the extent of involvement with gambling; (3) the compulsion to gamble in spite of negative consequences; and (4) a desire to “get even” after losing money (chasing losses). In addition, there are many psychosocial influences on gambling behavior, including stress and depression that can trigger or worsen problem gambling.

Several behavioral changes can help reduce the likelihood of gambling problems, and a variety of treatment options are available. These treatments can be delivered in outpatient settings, such as individual and group therapy, or in residential or inpatient rehabilitation programs. For those who have severe gambling problems, a combination of these treatments may be necessary to achieve recovery. Other lifestyle changes that can help include avoiding situations where you know you will gamble, seeking out healthier ways to relieve boredom and loneliness, and managing mood disorders (such as depression, anxiety, or substance abuse) that may trigger or worsen gambling problems.