©2008 The GPPC Initiative 1
Pathological Gambling
An “Invisible” Addiction
©2008 The GPPC Initiative 2
Treatment Issues
Generally the same, particularly with other co-occurring disorders:– Assess– Diagnose– Plan/Initiate Treatment– Evaluate the effectiveness of
method
©2008 The GPPC Initiative 3
Pathological Gambling
• Largely “Invisible”• Largely ignored / overlooked / tolerated
until some precipitating crisis• Personal calamity with collateral damage• High Incidence of Co-Occurring Disorders• High vulnerability at outer edges of the
age spectrum (i.e., Teens and Elders)
©2008 The GPPC Initiative 4
Behavioral Addiction
• Deflection / Displacement• Sub-optimal Stimulation• The gambler becomes
emotionally unavailable to family, friends, and associates
©2008 The GPPC Initiative 5
Diagnostic Spectrum
• Spectrum– Low Risk– At Risk– Problem Gambling– Pathological Gambling
©2008 The GPPC Initiative 6
Types of Gamblers
• Casual Social• Serious Social• Relief & Escape• Compulsive (Problem, Pathological)• Professional• Anti-social Personality
adapted from SAMHSA, 2005
©2008 The GPPC Initiative 7
Risk Factors
• Age at onset of gambling• Gender• Ethnicity• Access• Co-occurring disorders• Family history• Biochemical imbalance
©2008 The GPPC Initiative 8
Direct Risk Factors
• Risk Practices• Risk Cognitions• Risk level can increase based on:
– Number of risk practices and cognitions– The extent of involvement in each
©2008 The GPPC Initiative 9
Thinking Errors (adapted from Ciarrocchi, 2001)
• Negative Winning Expectancy• Independence of Turns• Illusion of Control• Superstition• Recuperating Losses• The “Near-Miss”
©2008 The GPPC Initiative 10
Indirect Risks
• Social Predisposition• Emotional Predisposition• Biological Predisposition• Environmental Conditions
©2008 The GPPC Initiative 11
Health Problems
• Hypertension / Angina• Heart Attack / Stroke• Obesity• Alcoholism / Cirrhosis• Tobacco use
©2008 The GPPC Initiative 12
Co-Morbidity
• Mood Disorders• Substance Abuse
(e.g.,“MethGamblers”)• Anxiety Disorders• Personality Disorders• ADHD• High Risk of Suicidality
©2008 The GPPC Initiative 13
Prevalence / Incidence• 85% of Americans report having
gambled at least once• 60% report having gambled
within the last year• More men than women• More young people than seniors• More African-Americans than
other ethnic groups
©2008 The GPPC Initiative 14
Gambling Population
3% 7%
90%
Problem
At Risk
Ever
Compulsive Gambling affects up to
6 Million Americans
©2008 The GPPC Initiative 15
Nevada vs. The World
• 6.5% General U.S. Population “At Risk”– NV = 9.9%
• 2.5% General U.S. Population “Problem”– NV = 6.4%
©2008 The GPPC Initiative 16
So What’s the Problem?
Gambling Population (% )
2.5
6.56.4
9.9
0
2
4
6
8
10
12
Problem At Risk
U.S.NV
©2008 The GPPC Initiative 17
Addiction as a Maladaptive Behavior
• Addiction is a learned behavior• Most appropriate treatment
approach is to teach skills to prevent relapse
• Cognitive-Behavioral approach can work
©2008 The GPPC Initiative 18
Gambling (Gaming)
Any betting or wagering, for self or others, whether for money or
not, no matter how slight or
insignificant, where the outcome is uncertain or depends upon
chance or “skill”
Gamblers Anonymous
©2008 The GPPC Initiative 19
Substance Abuse
Antisocial Behavior
School/Work Problems
Problem Gambling
Psychological Problems
Poor Health Practices
Interpersonal Problems
Gambling is part of an inter-related set of high risk/problem behaviors
(adapted from Williams & Connolly, 2003)
©2008 The GPPC Initiative 20
Self-Controlled Impulsive
Risk aversive Risk seeking
Stress resilient Stress vulnerable
Strong intellect/skills Weak intellect/skills
Caused by a common set of factors (adapted from Williams & Connolly, 2003)
Abusive/neglectful Nurturing/disciplined
upbringing upbringing
Antisocial parental Prosocial parental
modelling modelling
Deviant peer group Prosocial peer group
Poor schools/ Good schools/teachers teachers
Biological Environmental
©2008 The GPPC Initiative 21
Decisional Balancefor Addictions
If one’s use / behavior creates more
problems than it relieves, seek
assistance
Top Related