Who is at Risk of Gambling Disorders?
Gambling involves risking something of value (typically money) on an event that is primarily a matter of chance in the hope of winning a larger amount. It has existed in virtually every society since prerecorded history and is woven into local customs and rites of passage. It is an important source of income for some people, and for others it provides a form of entertainment or an escape from everyday life.
There are many reasons why people gamble. Some do it for social reasons – to meet friends and colleagues, or because they enjoy thinking about what they could do with the money they might win. Others do it for the thrill or to try and get that ‘rush’ that is often described as being similar to the feeling one gets from taking drugs. The media reinforces this notion by portraying gambling as fun, sexy and glamorous.
Some people are particularly vulnerable to developing problems with gambling. This group includes people who have low incomes, as well as young men and boys. Up to 5% of these individuals develop gambling disorder, which is a condition that meets the diagnostic criteria for pathological gambling in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Other people who are at risk include those who have an underlying mood problem – such as depression or anxiety – which may be triggered by gambling or make it worse. The same is true for alcohol misuse, which can also trigger or make gambling disorders worse.
People who have a history of childhood abuse or trauma are also at increased risk for developing gambling disorders. In some cases, these disorders can even appear in adulthood. It is important for healthcare professionals to identify those who have a history of childhood abuse or neglect, and who may be at risk for developing gambling problems.
A growing role is being played for primary care providers in assessing patients for addictive behaviours. This is largely because the majority of people who gamble are not receiving any treatment for their gambling disorder.
The way to approach the issue is to frame it as a health issue rather than a lifestyle issue. This will reduce resistance and increase the likelihood of the individual being offered help.
Those who have difficulty quitting gambling should be offered support – this is usually more effective than telling them to stop. They should also be monitored on a regular basis, particularly for symptoms of depression, suicidal ideation and substance misuse, as these can all be triggers or exacerbated by gambling. Gambling is a complex issue and addressing the needs of those who have problems with it will require careful thought and planning. This will need to involve not only the healthcare professions, but also those who work in the industry, as well as local communities. This will be necessary if progress is to be made in reducing the number of people who develop a gambling disorder.