PATHOLOGICAL GAMBLING - 06/09/11
Résumé |
Pathological gambling (PG) is a major psychiatric disorder and public health issue that is just beginning to receive public and scientific attention. Early Egyptian, Japanese, and Persian societies first introduced gambling,18 and it remains a popular activity in societies around the world. For many individuals who gamble, the activity is an occasional form of entertainment that does not negatively influence their lives, but PG is different. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) first recognized PG as a psychiatric disorder in 1980. PG has been categorized as an impulse-control disorder not elsewhere classified since that time.
Pathological gamblers exhibit an uncontrollable impulse to gamble that progressively increases in intensity. PG is chronic and has a negative effect on personal, social, and occupational functioning. It has high comorbidity rates with substance abuse, mood disorders,35 attention deficit hyperactivity disorder (ADHD),46 and antisocial personality disorder.5
Gambling involves chance and results in the exchange of resources between two parties: winner and loser. It includes lotteries, stocks and commodities, sports betting, horse racing, card games, dice games, and bingo. The media indirectly promotes gambling. Media coverage of sports in the United States publishes lines, spreads, and favorites despite the fact that sports betting is illegal. With computer technology advances, gambling has developed on the Internet, including card games and roulette. The Internet provides continuous access to gambling activities with no consumer protection laws. US legislators are economically motivated to legalize gambling activities because the gambling industry generates substantial tax revenues. Over the past 2 decades, the number of state-licensed gambling enterprises, including lotteries and casinos, has increased significantly. Forty-eight states in the United States have legalized gambling.31 The Federal Indian Gaming Regulatory Act of 1900 allowed casinos to be built on Native American land. Casinos use the following incentives to attract consumers: free accommodation for high spenders, free alcohol, easy credit access, enticing shopping malls, family entertainment, and child care.
Concern for minors' access to gambling is increasing. Recent surveys found many adolescents who gamble who are at risk for gambling-related problems.52, 54 Toy and game manufacturers that simulate gambling and market creatively may encourage gambling behaviors in youth.
With the booming growth of the gambling industry, individuals vulnerable to gambling problems are increasingly at risk for exposure and encouragement to gamble. Evidence clearly indicates that increased accessibility to gambling facilities leads to a higher prevalence of PG.54
PG is a significant public health issue, but only recently has its high personal and social costs received attention. The ramifications of PG are widespread. For example, the stress of gamblers' financial demands destroys families, relationships, and careers. Often, society feels the financial burden of increasing rates of personal bankruptcy. Also, alarming numbers of pathological gamblers become caught in a downward spiral and commit suicide. Despite extensive gambling-related problems, federal and state governments provide little financial support to mental health services specifically aimed toward the mental health care needs of pathological gamblers.
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| Address reprint requests to Alison J. Buchalter, MA, Department of Psychiatry, The Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029 Supported in part by grants from the NIDA 1R01DA10234-01A2 and the PBO Foundation. |
Vol 23 - N° 3
P. 629-642 - septembre 2000 Retour au numéro
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