Gambling involves betting something of value (money) on an event whose outcome is primarily a matter of chance. It has existed in virtually every society since prerecorded history and is incorporated into local culture, customs, and laws. The majority of individuals who gamble do so in a social and recreational manner, but there is a small percentage that becomes more seriously involved and continues to gamble despite significant negative personal, family, and financial consequences. These individuals are described as pathological gamblers.
There are many types of gambling activities and games, from scratchcards to lottery tickets to sports betting. A common characteristic is that each has a ‘prize’, which can be money or something else of value. A prize is determined by the ‘odds’, which are the chances of winning or losing based on previous events or the experience of betting companies. The odds are often published on the ticket or booklet.
The number of people who develop a gambling problem varies depending on the study and country, but is estimated to be around 2% of the population. Rates are higher for people with other addictions or mental health conditions. For example, 4% of people treated for substance use disorders also have gambling disorder, as do up to 7% of those in psychiatric inpatient units and nearly 7% of people with Parkinson’s disease.
People in their early 20s are the fastest-growing group of gamblers, and researchers believe they are most at risk of developing gambling problems. They are more likely to play video and online games with a gambling component, and they tend to start earlier in life than other age groups. This increases the likelihood of developing a gambling problem later in life, and it makes them more susceptible to the pressures of high-stakes gambling.
Understanding the causes and characteristics of gambling problems has undergone a major shift. Historically, individuals who experienced adverse consequences of gambling were considered to have gambling-related problems, but today we understand that they may have psychological problems. This shift has been reflected, or at least stimulated, by changes in the way that gambling is classified and described in the various editions of the Diagnostic and Statistical Manual of Mental Disorders, or DSM.
In the past, DSM-IV listed six criteria for pathological gambling: a loss of control over the amount or frequency of gambling, increased amounts wagered, impaired judgment, distortions in thinking (e.g., irrational beliefs or false assumptions), a preoccupation with gambling, and involvement in illegal activities to finance gambling. The current edition of the DSM, published in 1994, included a tenth criterion: a substantial decrease in functioning or well-being resulting from gambling problems.
Different researchers and professionals have developed a variety of nomenclatures to describe gambling disorders, reflecting their disciplinary training, special interests, and world views. These varied perspectives have stimulated debate and controversy, especially about what defines a disorder and who is at risk for gambling problems. The following list of ten criteria represents a consensus among researchers and clinicians.