Introduction
Excessive gambling has long been recognized as a source of problems worldwide. It was in the year 1980, with the inclusion of pathological gambling, gambling disorders were formerly classified as mental conditions in the third edition of the Diagnostic and Statistical Manual of Mental Disorders. Approximately one percent of the world's population fulfills the disorder's criteria, and its implications on the person's loved ones and society are significant.
The Diagnostic and Statistical Manual of Mental Disorders recently categorized gambling disorders as "substance-related and addictive disorders.” The comparisons between clinical disease and drug use disorders led to the reclassification of gambling disorders. Furthermore, treating gambling disorders (GD) as a behavioral addiction raises concerns about the disorder's perceived risks and views about recovery and responsibility for causing and resolving problems related to gambling.
Although most gamblers consider gambling a harmless hobby, individuals with GD frequently exhibit cognitive distortions such as illusions of control, impulsive actions, and dysfunctional personality features (for example, high harm avoidance or high novelty seeking). Cognitive behavioral therapy (CBT) is the most often used psychological strategy for treating GD and has been shown to help decrease gambling behavior.
What Are the Classifications of Gambling Disorders?
In literature, two types of gambling disorders are there:
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Pathological gambling.
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Problem gambling.
Pathological Gambling: According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) and the International Classification of Diseases, 10th revision (ICD-10). Both classification systems describe pathological gambling from an atheoretical standpoint (that is, only objective and behavioral diagnostic criteria are listed), and both classify problematic gambling inside an impulsive disorder section.
Problem Gambling: Problem gambling is an informally defined category that is frequently reported in prevalence surveys and is generally regarded as a less severe type of gambling disorder.
What Is the Prevalence of Gambling Disorders?
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A national survey reported the prevalence of compulsive and problem gambling to differ globally. For example, problem gambling rates in the previous 12 months varied from 0.2 percent in Norway to 53 percent in Hong Kong.
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Pathological gambling affects four percent to eleven percent of individuals in the United States, with an additional one to two percent categorized as problem gamblers.
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Data from epidemiological surveys show that rates of gambling disorders vary not only due to differences in survey methods like the use of different screening techniques, time scales (for example, disclosed past year problems, challenges of life), administration format, and response rates but also because of variation caused by the availability and accessibility of gambling opportunities.
What Are the Diagnostic Criteria for Gambling Disorders?
Pathological Gambling Criterion, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) and the International Classification of Diseases, 10th revision (ICD-10):
Person has continuous and recurring maladaptive gambling behavior if they have five (or more) of the following:
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The individual is obsessed with gambling.
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Requires increasing sums of money to bet.
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Has made several failed attempts to restrict, reduce, or quit gambling.
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Is irritated or distressed when trying to reduce or quit gambling.
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Gambling is a method of preventing trouble or soothing a depressed mood.
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After losing a lot of money gambling, many people go back the next day to make amends (that is, "chasing one's losses").
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Lies to disguise the depth of the gambling addiction.
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Has engaged in unlawful activities to support gambling.
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Gambling has jeopardized or lost a significant relationship, employment, educational, or career opportunity.
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It depends heavily on others for money to get out of a bad financial position created by gaming.
The manic episode does not explain the gambling behavior.
Pathological Gambling Criterion, According to International Classification of Diseases (ICD-10):
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Persons have frequent and repeated episodes of gambling despite negative consequences.
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Individuals have frequent and consistent episodes of gambling despite negative consequences.
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Individuals jeopardize their work, take large debts, and lie or break the law.
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Individuals have personal compulsions to gamble that are difficult to resist.
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Individuals are preoccupied with concepts and images of the act of gambling.
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It should be separated from gambling and betting (regular gambling for enjoyment or in an attempt to earn money), excessive gambling by manic individuals, and gambling by sociopathic types.
Pathological Gambling Criterion, According to International Classification of Diseases (ICD-11):
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Disorders of Intellectual development, which include - mild, moderate, severe, and profound.
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Developmental speech or language disorders.
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Developmental learning disorder.
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Attention deficit hyperactivity disorder.
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Stereotyped movement disorder.
Pathological Gambling Criterion, According to Diagnostic and Statistical Manual (DSM-5-TR )
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Major or mild neurocognitive disorder due to traumatic brain injury.
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Diffuse traumatic brain injury with loss of consciousness of unspecified duration, sequela.
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Major or mild neurocognitive disorder due to unknown etiology.
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Unspecified neurocognitive disorder.
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Current suicidal behavior, initial and subsequent encounters.
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Other specified delirium.
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Major neurocognitive disorder due to medical etiology, mild, with agitation.
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Major neurocognitive disorder due to medical etiology, mild, with anxiety.
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Major neurocognitive disorder due to medical etiology, mild, with mood symptoms.
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Major neurocognitive disorder due to medical etiology, mild, with psychotic disturbance.
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Major neurocognitive disorder due to medical etiology, mild, with other behavioral or psychological disturbances.
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Major neurocognitive disorder due to medical etiology, mild, without accompanying behavioral or psychological disturbance.
What Are the Treatment Strategies?
1. Psychological Treatment Approaches:
Despite medication possibilities for symptom relief in GD, multiple assessments of the evidence indicate that psychosocial therapy is the most effective choice for this illness, with considerable short and long-term benefits.
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Motivational Interviewing: The motivational interview is one of the most promising therapy alternatives for GD, either as a solo treatment or in conjunction with other approaches. This directed intervention enables patients to recognize and successfully address their fear of transformation.
Normative feedback is a key component of this strategy. Individuals use this approach to assess their problematic gambling habit, which is often misunderstood, and compare it to gambling tendencies in the broader population to induce behavioral change.
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Cognitive Behavioral Therapy (CBT): CBT has proven helpful in treating this behavioral addiction. The research in this area emphasizes the importance of motivational components and cognitive restructuring in CBT programs to help patients understand cognitive distortions related to gambling behavior and to impair, among other concerns, perseveration patterns, delusions, and superstition linked to this disorder.
2. Pharmacological Treatment:
- There is currently no authorized medicine for GD, while clinical practice guidelines normally include a section on the use of psychopharmacology in this condition. For example, the GD guideline produced in Australia in 2011 acknowledged that Naltrexone might lower gambling severity in adults with gambling issues.
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Based on clinical criteria and neuropharmacological activity, three major pharmacological therapies have been used: antidepressants, opioid antagonists, and mood stabilizers. Associations have supported the use of these drugs for certain groups of mental disorders, primarily.
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Compulsive-impulsive disorders.
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Substance use disorders, given that GD may be regarded as a behavioral addiction, as suggested by DSM-5.
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Bipolar disorder has similar clinical features to GD.
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Conclusion
The analysis gives insight into current efforts to design more inclusive GD treatment options. In the short to medium term, psychological and, more especially, cognitive behavioral techniques have shown excellent outcomes. Moreover, combining these programs with additional treatment tactics such as brief motivational interventions, mindfulness, or new technology is a potentially cost-effective approach.
