Gambling is a popular recreational activity in which participants place wagers with materials of value (typically money) on an event with uncertain outcome. Although most individuals gamble on occasion and have fun doing so, a small number become excessively involved, making it impossible for them to stop gambling, resulting in significant negative personal, family, and financial consequences. Unlike many other recreational activities, such as sports or movies, which require minimal skill, gambling is a high-stakes, psychologically intense activity, which can lead to serious psychiatric disorders.
Gambling disorders are highly complex and difficult to treat, as gambling is a culturally acceptable and socially widespread activity. Furthermore, the prevalence of pathological gambling has increased dramatically since the early 1970s, and the dollar amount wagered annually has more than doubled. The increase in gambling is due not only to the increased availability of gambling opportunities but also to changes in society that have resulted in increased awareness and accessibility.
The most common form of gambling is betting on sporting events or horse races, but it may also involve casino games and lottery tickets. The monetary values of the wagers differ, but all gambling activities are inherently risky, and any individual who gambles can win or lose. Some individuals, however, appear to be particularly susceptible to gambling disorders, and are more likely to become addicted to certain types of gambling than others.
Those with gambling disorders exhibit a variety of symptoms that can interfere with their daily functioning, including an inability to control their urges or stop gambling even when they are losing large amounts of money. Symptoms can be physical, emotional, or behavioral.
In addition, individuals with gambling disorders often feel a need to hide their behavior or lie about how much they are spending. They may even attempt to win back the money they have lost by increasing their bets. They also experience cognitive distortions, which include elevated confidence and an overestimation of their chances of winning.
While there are many possible causes of gambling disorders, psychologists and psychiatrists typically attribute them to an individual’s personal psychological factors. These factors usually become apparent in adolescence or following a traumatic life event.
It is important for primary care providers to evaluate their patients for signs and symptoms of gambling disorder, as the activity has significant health risks and can be a sign of underlying problems. Fortunately, there are several clinical guidelines available to help physicians identify and treat problem and pathological gambling. In addition, a growing role exists for the evaluation of gambling behaviors in general medical settings.