Gambling involves risking something valuable on an event that is determined at least in part by chance. While it is a popular pastime, gambling has the potential to harm health by causing stress and other problems that can affect family, friends, work and school performance and even lead to mental illness or death. It is therefore essential that we understand what gambling is and how it can become a problem.
While people commonly associate gambling with casinos and slot machines, many forms of gambling are commonplace in society, including playing card games like poker and spades, buying lottery tickets, betting on sports events and office pools, or placing bets online. In addition, the availability of gambling-like features on mobile phones and video games has made it easier than ever to gamble, even for children and teens.
In addition to the societal harms, pathological gambling has been linked to impaired cognitive function, diminished mathematical skills, impaired impulse control and moral turpitude. Some individuals with pathological gambling may be at higher risk for alcohol and drug use, depression and suicidal thoughts and behaviors. In addition, gambling can divert consumption expenditures away from other social activities and increase the cost of food, clothing and shelter.
A comprehensive approach to preventing and treating gambling problems includes prevention, harm reduction and treatment. Harm reduction measures include educating the public about gambling and its harms, ending advertising and promotions, implementing centralized account registration to require those who gamble to set binding loss limits, and regulating access and availability (hours, density). Treatment options include self-help support groups, medication and therapy.
The underlying cause of gambling problems is complex and differs among individuals. Research suggests that some people have a genetic predisposition to sensation seeking and impulsivity, which contributes to their propensity for gambling. Some have a less active reward system in the brain, which may also contribute to their desire for excitement and gratification. Finally, many cultures promote gambling as a normal activity and it can be difficult for individuals to recognize their problems or seek help.
Until there are standardized instruments that have demonstrated psychometric properties, diagnosing pathological gambling remains challenging. Different researchers, psychiatrists and other treatment care providers may frame the issues of gambling differently based on their disciplinary training, experience, world views and special interests. As a result, the nomenclature of gambling and gambling disorders is inconsistent. This has contributed to the development of competing theories, models and conceptualizations about the causes of gambling and gambling problems. It is important that we continue to explore these diverse perspectives in order to improve understanding of the complex nature of this disorder.