This May, the Diagnostic and Statistical Manual of Mental Disorders (DSM) proposed that the disorder of gambling be considered an addiction (Andrews, 2012). The DSM came out with a series of proposed revisions for the next DSM edition which will come out in 2013, the DSM – 5. The DSM proposed switching pathological gambling from the Impulse Control Disorders section (Fong, 2009) to the Substance-Related Disorders, which will be renamed Addiction and Related Disorders (DSM – 5 Development, 2012). The proposal is open to comments.
Pathological gambling includes a dependence upon the behavior, a built up tolerance in which individuals bet larger and larger sums, decreased control, and from the new DSM proposals, gambling when feeling negative emotions, lying about gambling, and unsuccessful attempts to decrease gambling. While a problem gambler may experience some of these characteristics, a pathological gambler or an individual with gambling disorder experiences many of these symptoms and often more (DSM – 5 Development, 2012) (Fong, 2009). The excessive gambling and associated behaviors cannot be explained by an instance of mania that would attribute the gambling to a different psychopathology. Problem gamblers may find that their gambling negatively affects their interpersonal relationships. They also may experience insomnia, decreased self-care, and increased stress. Furthermore, clinicians often observe suicidal ideation in pathological gamblers (Fong, 2009). The effects on family and work relationships can be catastrophic.
Gambling treatment programs with cognitive-behavior therapy and encouragement to join 12-step groups often have positive results. On the Gamblers Anonymous website (a 12 step program), they introduce themselves as, “a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from a gambling problem” (Gamblers Anonymous). One cognitive-behavior therapy approach for gambling is to change the individual’s beliefs and feelings about gambling through 1) relabeling, 2) re-attributing, 3) refocusing, and 4) revaluing (Joanna Saisan, 2012). While quitting gambling is difficult, staying away from gambling by finding other interests, allowing others to oversee or at least keep an eye on your finances, and surrounding yourself with supportive individuals allows for continued recovery (Joanna Saisan, 2012).
Despite the fact that pathological gambling is approximately as common as schizophrenia or bipolar disorder, healthcare providers often overlook it, focusing instead on the fatigue and stress pathological gambling patients often present with. According to an article on National Public Radio, “Problem gambling isn’t considered a true addiction in medical circles” (Andrews, 2012). Many healthcare providers are not trained to screen for it. Including gambling as a well-defined addiction would increase the likelihood of it being adequately screened for. The implications of gambling being considered an addiction would also affect insurance coverage. Additionally, the concept of a behavior being considered addictive within the medical community and potentially accepted into the DSM could open the gate for a slew of other behavioral addictions, like sex addiction or internet addiction, to enter the DSM and gain attention within the medical community (Andrews, 2012).
Andrews, M. (2012, May 29). Psychiatric Manual May Soon Include ‘Gambling Disorder’. Retrieved 2012, from NPR: http://www.npr.org/blogs/health/2012/05/29/153911046/gambling-disorder-being-added-to-psychiatric-manual
DSM – 5 Development. (2012, May 1). R 37 Gambling Disorder. Retrieved 2012, from DSM – 5 Development: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=210
Fong, T. W. (2009, August 27). Pathological Gambling: Update on Assessment and Treatment. Retrieved 2012, from Psychiatric Times: http://www.psychiatrictimes.com/display/article/10168/1443158
Gamblers Anonymous. (n.d.). About Us. Retrieved 2012, from Gamblers Anonymous: http://www.gamblersanonymous.org/ga/content/about-us
Joanna Saisan, J. S. (2012, May). Gambling Addiction and Problem Gambling. Retrieved 2012, from Help Guide: http://www.helpguide.org/mental/gambling_addiction.htm