Pathological Gambling
Gambling involves putting something of value (money, possessions, life experiences) at risk for an uncertain outcome. While most people can gamble without negative consequences, a small subset develops pathological gambling, defined in the Diagnostic and Statistical Manual of Mental Disorders as persistent and recurrent problem gambling that is associated with distress or impairment.
The term ‘gambling’ applies to a variety of activities, from betting on horses or a football match to playing slot machines at a casino or online. Skill and knowledge can help improve the odds of winning at some games, such as card games or lottery draws, but in general the outcomes of most gambling events are truly random.
Some activities are organized by commercial enterprises and require significant investment to produce, promote and maintain. Others are part of a kinship or community activity and may be a ritualized way to celebrate or mourn important life events. For some individuals, gambling can become an escape or a way to cope with difficult thoughts or feelings and is often viewed as harmless fun.
A number of different theories and conceptual models have been advanced to explain gambling. These include a medical model, a biopsychosocial model and the reward deficiency syndrome. These models differ in their applicability to a range of research and intervention strategies, public policy and the self-perceptions of those who gamble problematically.
Those who study gambling, and especially pathological gambling, need to be aware of the complexity of the issues involved. It is tempting to adopt a simplified world view or paradigm to guide research and to make assumptions about the causes of pathological gambling, just as it was with our understanding of alcoholism in the past.
For example, many researchers, clinicians and the general public use the concept of ‘addiction’ to explain pathological gambling. The criteria for addiction in the Diagnostic and Statistical Manual of Mental Health Disorders has been used to classify gambling disorders, but this approach can obscure the fact that gambling is a complex behaviour with a wide range of psychological, social and economic impacts.
Research should avoid the temptation to simplify this complexity by focusing on specific research questions that are clearly defined. This will allow us to gain a better understanding of the range of factors that influence gambling, including its harms and benefits. It is also vital to recognize that, just like other addictive behaviours, the onset and cessation of gambling behaviour may be affected by environmental factors.
Strong regulation of gambling products and a clear stance on harm reduction are crucial to minimizing harmful outcomes. This should include ensuring that gambling products are not designed to encourage extended use through so-called dark nudges or the manipulation of cognitive biases. In addition, it is important to provide clear and consistent information on the risks associated with gambling.
