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Jeremy Frank Ph.D. CAC

Gambling

Information

“Compulsive Gambling” from the Mayo Clinic
This overview takes you from a definition, to symptoms, causes, risk factors, complications, preparing for your appointment, tests and diagnosis, treatments and drugs, coping and support, and prevention.

“FAQs – Problem Gamblers” from the National Council on Problem Gambling

 

Problem Gambling vs. Pathological (Compulsive) Gambling

Gambling addiction is often referred to as the “hidden illness” because there are no physical signs or symptoms that accompany it as is the case with many alcohol or drug abusers. Problem gamblers tend to minimize their problem or deny that their gambling has become uncontrolled. Often they will hide their gambling from friends and family. They will lie about it, sneak around, or withdrawal completely in an effort to hinder anyone from interfering with their behavior.

In a broad sense, problem gambling – much like substance abuse – is characterized by gambling tendencies causing harm to the gambler or others. Problems include limited money, increased time spent gambling, avoidance behaviors, a preoccupation with gambling, the loss or strain of relationships with friend and family, and more. If problem gambling is determined to occur in the absence of other mood, thought, or impulsive disorders, a DSM-5 diagnosis of Gambling Disorder is made.  (Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association)

According to the DSM- 5 (Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association) a diagnosis of Gambling Disorder is made when one meets at least four of the following nine criteria:

 

  1. Tolerance – Needing larger wagers to experience the same “rush” (similar to the “rush” felt by drug users).

  2. Withdrawal – Restlessness or irritability when attempting to reduce or cease gambling.

  3. Loss of Control – Repeated unsuccessful attempts cut down or stop on his/her own.

  4. Preoccupation – Frequent thoughts about gambling experiences; whether past, future, or fantasy.

  5. Escape – Gambling to improve mood or escape problems.

  6. Chasing – Trying to win back gambling losses with more gambling.

  7. Lying – Hiding the extent of the behavior by lying to friends, family, or a therapist.

  8. Risked a Significant Relationship – Gambling despite damaging or losing an important relationship, job, or other significant opportunity.

  9. Bailout – Turning to friends, family, or a third party for financial assistance resulting from gambling activities.

A manic episode does not do a better job of explaining the gambling behavior.

 

Do I Have a Gambling Problem?

As is the case with drug and alcohol abuse, it is not normal to question whether or not you may have a gambling problem. If you answer yes to any of these questions, there is a good chance that your gambling has become problematic:

1 – Do you feel the need to hide or lie about your gambling?

2 – Do you feel like others will not understand your gambling habit or that that you will soon surprise them with a big win?

3 – Do you have trouble walking away from a game once you have started playing? Do you continue until you have spent your last dollar and continue to up your bets in a bid to reclaim lost money?

4 – Have you ever gambled when you did not have the money to spend? Are you coming up short on your rent or mortgage payments, credit card bills, or things for your children?

5 – Have you borrowed money, sold your belongings, or stolen for gambling money?

6 – Are your friends and family worried about you?

 

Gambling Screens

The South Oaks Gambling Screen (SOGS)
The South Oaks Gambling Screen (SOGS) was developed by Henry Lesieur, Ph.D., and Sheila Blume, M.D., to evaluate pathological gambling addiction.

Gambling Screens – Adolescents

The South Oaks Gambling Screen – Revised for Adolescents (SOGS-RA)
A gambling assessment for adolescents authored by Randy D. Stinchfield, Ph.D.and Ken Winters, Ph.D. Includes scoring instructions.

Personal Accounts

My Son’s Gamble (Lucy Ferriss, The New York Times Magazine, 6/24/09)
The author relates how her son dropped out of college to devote more time to online and professional face-to-face poker playing and her process in coming to terms with his decision.

Expressions of Addiction (Howard J. Shaffer, Ph.D., C.A.S., 2006)
Photographic exhibit with stories of each person featured. Shaffer is a professor and clinician as well as a photographer. After clicking on individual pictures, click on “next expression” underneath the picture, and you will be able to read their full story and see additional pictures.

Other Articles

Internet Gambling Stays Low Among Youth Ages 14 to 22 But Access to Gambling Sites Continues; Sports Gambling Makes Resurgence (Annenberg Public Policy Center, 11/26/08)
Results of a National Annenberg Survey of Youth.

Betting on a Cure (Mary Carmichael, Newsweek, 6/25/08)
Research on drugs that could block gambling addiction.

Center for Current Research: The Compulsive Gambling File
Compiles abstracts on different subjects (in this case, gambling) from the National Library of Medicine which patients can use to either find the whole article or bring to their doctor on a type of treatment or prevention that they’re interested in. Their doctor may have access to the full-text article.

Consults Blog: Seeking Help for Gambling Addiction (The New York Times, 11/01/10)
Dr. Timothy Fong, co-director of the gambling studies program and an associate professor of psychiatry at the University of California, Los Angeles, responds to questions about gambling addiction including treatment options.

Hit Me Again! The Gambling Brain (Begley, Sharon, Newsweek, 05/11/10)
This article focuses on a study at the University of Cambridge which tested the brain’s reaction when playing a slot machine. The study found that not only wins activated the brain’s reward system, but so did near-misses. Since the surge in dopamine is similar with a win and a near-miss, the study suggests an explanation for how near-misses are a powerful tool used to keep people gambling.

Website Blockers and Self-Exclusion

ProblemPoker
A filtering service that blocks all wagering websites.

Optenet PC
Gambling website filter.

Pennsylvania Gaming Control Board: Compulsive and Problem Gambling: Self-exclusion Program
The self-exclusion program is a voluntary program that allows a person to be banned from all licensed gaming facilities in Pennsylvania and from collecting any winnings, recovering any losses, or receiving any gifts, services, or anything else of value from these facilities for 1 to 5 years. Self-exclusion for other states and casinos must be done individually by contacting the states and/or casinos you wish to be banned from. There is no uniform or national program.

New Jersey Casino Control Commission: Problem Gambling: Self-exclusion
Self-exclusion from all Atlantic City casinos. Can be for 1 year, 5 yrs, or lifetime.

Delaware Video Lottery Facilities: Self-exclusion
Self-exclusion from all Delaware Video Lottery Facilities. Can be for 1 year, 5 years, or lifetime.

Resources

Gamblers Anonymous
Self-help organization for compulsive gamblers. Phone: 213-386-8789

Gambler’s Anonymous is a 12-step, community based support group for those with gambling addictions and they offer a comprehensive online quiz for anyone questioning whether or not their gambling habit has become problematic.

Their quiz can be accessed by following this link: http://GamblersAnonymous.org/gna.html

Gam-Anon
Self-help organization for spouses, family and close friends of compulsive gamblers. Phone: 718-352-1671

National Council on Problem Gambling
National advocacy, research, treatment, and resource clearinghouse. They have state affiliates and offer a 24-hour helpline in each state where there are affiliates as well as a national number: 800-522-4700. For Pennsylvania: 800-848-1880.

Council on Compulsive Gambling of Pennsylvania
Pennsylvania affiliate of the National Council on Problem Gambling. Aims to educate and disseminate information and help with referrals. Also provides speakers, workshops, seminars, and information to business, industry and labor groups, schools and colleges, healthcare and treatment facilities, and community and religious organizations.

Pennsylvania Department of Health, Bureau of Drug and Alcohol
Has a 24-hour hotline: 877-565-2112 which refers gamblers to local Gamblers Anonymous meetings and one-on-one counseling, if available in their area. Has links to self-exclusion from Pennsylvania gaming facilities, treatment providers, and information.

Gambling Behaviour Self-Study Workbook (Responsible Gambling Council, Addictions Foundation of Manitoba, n.d.)
Designed to help you look at your gambling behavior, decide if it is a problem for you, manage finances, identify patterns and triggers, and develop new behaviors and make permanent changes to replace gambling.

Massachusetts Council on Compulsive Gambling: Prevention Resource Library
Extensive catalog of literature that can be ordered in various media (pamphlets, posters, CD-ROMs, and more).

National Center for Responsible Gaming
National organization exclusively devoted to funding research that helps increase understanding of pathological and youth gambling and find effective methods of treatment for compulsive gambling. Although most of the NCRG’s materials have a scientific, technical focus, some of the publications, including these monographs, may be useful to the layperson as well as the clinician.

UCLA Gambling Studies Program
The UCLA Gambling Studies Program (UGSP) is devoted to understanding pathological gambling, its causes, natural history, cultural factors, and the obstacles to successful treatment. The mission of the program is to translate research findings into cost-effective, evidence-based methods of prevention, education, and treatment.

Intervention

Mayo Clinic: Intervention: help a loved one overcome addiction (Mayo Clinic Staff, Aug. 27, 2009)
Yeah, yeah, I know there is that show on A&E, but I want more information on how to do one of my own. This tells you exactly how to do it, including when you can I do it yourself, and when you need a professional, and how to find one.

Videos

Gambling Addiction
In this video from Britain’s National Health Service a young man named Jake describes his struggles with gambling addiction and experts explain how a gambling problem is just as serious as a drug or alcohol problem.

NIH On the Inside: Gambling Addiction
This video aimed at teenagers from the National Institutes of Health discusses gambling addiction and why teenagers are more likely to take risks.

Audio

How Gamblers Lose Track of Time
Radio interview with Dr Jeremy Frank on NPR/WHYY by Maiken Scott on how gamblers can lose track of time and the devastating consequnces that can ensue following several incidents at the Parx Casino where parents left children in cars unattended while the parent gambled for hours.

Jeremy Frank Ph.D. CAC