Gambling is an activity where people risk something of value (money or other goods and services) in the hope of winning more money or a prize. It is a form of entertainment and is legal in most jurisdictions, but some people develop problems that may lead to addiction or severe distress and impairment. People who have gambling disorders are at a higher risk for developing other forms of substance abuse and mental health problems.
Most people have some experience with gambling in the form of placing a bet on a sporting event, horse race, or game of chance within their social circle. For example, people often make informal bets on the outcome of card games like poker, blackjack, spades, and bridge played for fun with friends. Some people also play for cash in arcades and video poker machines. These are all forms of private gambling. A small subset of people who gamble go on to develop serious gambling disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
While research on gambling and problem gambling has improved since the publication of DSM-III-R, there are still no standardized instruments that can be used to reliably determine whether an individual is a pathological gambler. This is because different researchers, psychiatrists, and other treatment clinicians have a variety of paradigms or world views from which they consider these issues. These differing viewpoints, in turn, shape how the problem is framed and what criteria are used to assess it.
A defining characteristic of gambling disorder is repeated unsuccessful attempts to control, cut back, or stop gambling. This criterion was included in the DSM-IV criteria after consulting with many gambling researchers and treatment professionals. It is considered important by them because of the difficulty that people with gambling problems have in stopping or controlling their gambling behavior.
Other criteria that are included in the definition of gambling disorder include a significant loss, repeated uncontrollable urges to gamble, and a lack of satisfaction with other activities when gambling is not involved. People with gambling problems are also more likely to gamble when they are upset or depressed, and to have other psychiatric symptoms such as poor judgment, cognitive distortions, and mood swings.
In order to help someone with a gambling disorder, it is helpful for family members and friends to remove temptations by reducing access to financial resources. This can be done by removing credit cards, putting a trusted friend in charge of those resources, closing online betting accounts and keeping only a small amount of cash on hand. It is also useful to talk about the problem with a trusted family member or counsellor. Lastly, finding an alternative recreational or social activity to replace gambling is beneficial to people with problems. In addition, inpatient or residential gambling treatment and rehabilitation programs are available to those who cannot avoid gambling without round-the-clock support. These programs are usually covered by insurance and can be very cost-effective.