Problem Gambling:
Definitions and Problem Gambling
Joanna Franklin MS NCGC II
Maryland Council on Problem
Gambling
[email protected]
Trimeridian
Types of Gamblers
► Continuum
“Disordered Gambling”
Bungler
??
No Gambling
0
Social Gam. Serious Social Gam. Problem Gam.
1
2
??
Professional Gambler
Trimeridian
Pathological
3
??
Antisocial Gambler
Types of Gamblers
► 1.
Social Gambler- Gambles occasionally, for fun,
sticks to limits
► Serious
Social Gambler-Gambles regularly, hobby,
avocation, still does not spend more time or money
than can afford, sticks to limits
► Professional
Gambler- Gambles as a way of
earning a living, very, very rare.
► 2.
Problem Gambler- Beginning to have problems
due to gambling. Has 3 or 4 on the SOGS, has 3 or
4 of DSM IV criteria.
Trimeridian
Types of Gamblers
► 3.
Pathological Gambler- Major life problems due
to gambling. 5 or more on SOGS, 5 or more of
DSM IV criteria)
► Anti-social
Gambler – gambles as part of
antisocial life style. However, can be both ASPD
and pathological gambler.
► Client
must meet clinical criteria.
Trimeridian
DEFINING PROBLEM AND
PATHOLOGICAL GAMBLING
► 1980
– American Psychiatric Assoc. – DSM III
 Disorder of Impulse Control Not Elsewhere
Classified
 312.31
► 1994
– DSM-IV
 “The essential feature of Pathological Gambling is
persistent and recurrent maladaptive gambling
behavior that disrupts personal, family or
vocational pursuits
Trimeridian
Pathological Gambling: DSM-IV
Criteria
► Preoccupation
 Is preoccupied with gambling (e.g., reliving past gambling
experiences, handicapping or planning the next venture, or
thinking of ways to get money with which to gamble
► Tolerance
 Needs to gamble with increasing amounts of money in
order to achieve the desired excitement
► Withdrawal
 Is restless or irritable when attempting to cut down or stop
gambling
Trimeridian
Pathological Gambling: DSM-IV
Criteria
► Escape
 Gambles as a way of escaping from problems or relieving
dysphoric mood (feelings of helplessness, guilt, anxiety or
depression
► Chasing
 After losing money gambling, often returns another day in
order to get even
► Lying
 Lies to family members, therapists, or others to conceal the
extent of involvement with gambling
Trimeridian
Pathological Gambling: DSM-IV
Criteria
 Loss of control
► Has
made repeated unsuccessful efforts to control, cut
back, or stop gambling
 Illegal acts
►Has committed illegal acts (forgery, fraud, theft,
or embezzlement) to finance gambling
 Risked significant relationship
► Has
jeopardized or lost a significant relationship, job,
education or career opportunity because of gambling
 Bailout
► Has
relied on others to provide money to relieve a
desperate financial situation caused by gambling
Trimeridian
Subtypes of Pathological Gamblers
► Action
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► Escape
Early Onset
Narcissistic
MDE - Current
Games of Skill
Competition/Power
Winning Phase
More likely to be male
 Later Onset
 Dysthymia
 Machine Games
(Slots/VP)
 Relief/Dissociation
 No Winning Phase
 Gender Bias?
Trimeridian
Progression of Problem Gambling
Winning/Social
Losing
Desperation
Hopelessness
Trimeridian
Progression of Problem Gambling
Growth
Rebuilding
Critical
Trimeridian
Winning/Social Phase
► Gambling
for Pleasure
Action and Escape Gamblers Differ
Escape – may not have “winning phase”
Gambling is a social activity
Action gamblers may be good at the game or
strategy of gambling
 Action gamblers enjoy the competition
 Escape gamblers enjoy relaxation, relief
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Trimeridian
Winning/Social Phase
► There
may be a “Big Win”
► Recognition for early successes boosts self-esteem
► Increasing involvement in gambling
 Size of bets
 Time
 Preoccupation
 Enjoy “reputation”
 Increasing self-esteem or stress relief
dependent on gambling
Trimeridian
Winning/Social Phase
► Increasing
involvement with fantasies or use
of gambling for escape
Need for spectacular, fast success
Playing the big shot, impressing others
Need for relief, avoidance, self-soothing
Gambling to exclusion of other social and
recreational activities
 Money viewed as solution to problems
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Trimeridian
Losing Phase
► May
begin with a prolonged losing streak,
bad beat or big loss
► Chasing begins and progresses from short
to long term
► Social aspect decreases
 Gambling becomes increasingly solitary
 Covering up, lying
Trimeridian
Losing Phase
► Borrowing




begins (Spiral of Options)
Credit cards, friends
Legal Loans, family
Progressively more outrageous stories
Illegal sources
► Losing
becomes increasingly intolerable
 Depression following losses
 Irritability, anger, blaming others
Trimeridian
Losing Phase
► Bailouts
can take place at any time
 Lead to upsurge of omnipotence, greater loss of
control
 Personal or institutional
Trimeridian
Desperation Phase
► Begins
with “crossing the line”
 May involve illegal activities
 Differs for each gambler
 When this occurs depends on social, reality
factors, exhaustion of other options
 Happens repeatedly
Trimeridian
Desperation Phase
► Theft




initially viewed as short term loan
May keep records
Intent to repay with winnings
Becomes easier each time
Stops keeping track
Trimeridian
Desperation Phase
► Paradox
of Desperation
 Leads to false sense of optimism
 More loses – closer to next big win
 Sense of conviction, knows how bet will turn
out
Trimeridian
Desperation Phase
► Depression
and withdrawal progress
 Sleeping, eating poorly
 Unconcerned about others
 Often suicidal
► Common
fantasy of starting over
Trimeridian
Hopelessness Phase
► Begins
with awareness will never get even
 Stops chasing, but doesn’t stop gambling
 Doesn’t care if wins or loses
 Playing is all that matter
► Playing




to “get it over with”
Often knows will lose
Can’t seem to get rid of money fast enough
Play sloppily
Relief when money gone
Trimeridian
Hopelessness Phase
► Playing
just to “stay in action” for arousal
or energy
► Like lab rats with electrodes in pleasure
center, gambling to point of physical and
emotional exhaustion
► Gambles because doesn’t know what else to
do
Trimeridian