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Section 1
Pathological Gambling Disorder

Question 1 | Answer Booklet | Table of Contents | Introduction

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In this section, we will discuss pathological gambling.  Our discussion will focus on the cost of gambling, co-occurring disorders, and denial. 

Pathological gambling is placed in a category of its own by the American Psychiatric Association.  As you are aware, clients who are commonly called compulsive gamblers are preoccupied with gambling, and they get edgy and nervous if they cannot place bets.  Compulsive gamblers may believe money is both the solution to and the cause of all of the problems in their lives.

Three Factors of Pathological Gambling

♦ Factor #1 - Cost of Gambling
Often, clients bet larger amounts of money than they intended to, and these amounts grow even larger over time.  Not surprisingly these clients usually lose their money, but that does not stop them.  Pathological gamblers may return the next day to try to win back their losses.  As you know, over time, gambling becomes a bigger and bigger part of their lives, interfering with work, relationships, and other interests.  Often at this point compulsive gamblers try to stop gambling, but they cannot even though they may have to borrow money to support the habit.  Some clients may even break the law to obtain money so they can gamble.

The DSM estimates that between two and three percent of the adult population in the United States are compulsive gamblers.  Male compulsive gamblers often begin during adolescence.  However, women tend to start to gamble later in life.  By the time a compulsive gambler seeks help, clients generally have an average debt running from $55,000 to $92,000. 

♦ Factor #2 - Co-Occurring Disorders:  Pathological gambling usually occurs along with other problems.  About three quarters of compulsive gamblers in one study suffered from ADD, as well as hyperactivity. About half of those gamblers with ADD reported that they also had trouble controlling the amount of alcohol they drank. Some researchers believe that compulsive gamblers place bets as self-medicating behavior because gambling temporarily makes clients feel better.

♦ Factor #3 - Denial 
Denial, as you know, is refusing to acknowledge something to oneself, thereby getting oneself to actually believe that there is no danger at all.  However, it is not only the gambler who often flounders in denial, but the spouse and family, as well. Would you agree that regardless of the form of denial, it is a technique used to explain away, minimize, justify, and rationalize the problem gambling?  The simplest form of denial is to insist the gambling is not happening.  I find that this is sometimes done despite clear evidence or firm testimony to the contrary from friends or relatives.

More complex is the rationalization that admits that he gambles but discounts the severity of the gambling.  Although, in the short run, denial serves the purpose of keeping the family harmony intact and permits the family to conduct their daily lives in a semi normal way without anxiety, depression, shame, or anger overwhelming them. 

However, as you know, in the long run denial is counterproductive.  The gambling client takes solace in the fact that he can fool his spouse, that he can get away with his gambling. When the spouse takes his side, in effect going along with him in his gambling behavior by denying reality, she is only encouraging him. 

In the next section, we will discuss enabling.  Four categories of enabling we will discuss are covering up and covering for the gambler, attempting to control the gambler’s behavior, bailing him out, and cooperating with him.

Peer-Reviewed Journal Article References:
Kim, H. S., Sears, C. R., Hodgins, D. C., Ritchie, E. V., Kowatch, K. R., & McGrath, D. S. (2021). Gambling-related psychological predictors and moderators of attentional bias among electronic gaming machine players. Psychology of Addictive Behaviors. Advance online publication.

Leonard, C. A., Williams, R. J., & McGrath, D. S. (2021). Gambling fallacies: Predicting problem gambling in a national sample. Psychology of Addictive Behaviors. Advance online publication.

Rogier, G., Beomonte Zobel, S., Marini, A., Camponeschi, J., & Velotti, P. (2021). Gambling disorder and dissociative features: A systematic review and meta-analysis. Psychology of Addictive Behaviors35(3), 247–262.

Vizcaino, E. J. V., Fernandez-Navarro, P., Blanco, C., Ponce, G., Navio, M., Moratti, S., & Rubio, G. (2013). Maintenance of attention and pathological gambling. Psychology of Addictive Behaviors, 27(3), 861–867. 

Winfree, W. R., Ginley, M. K., Whelan, J. P., & Meyers, A. W. (2014). Psychometric evaluation of the Gambling Self-Efficacy Questionnaire with treatment-seeking pathological gamblers. Psychology of Addictive Behaviors, 28(4), 1305–1310.

What is a commonly held belief among compulsive gamblers? To select and enter your answer go to Answer Booklet.