Gambling involves staking something of value (money or another good) with awareness of risk and hope of winning a prize. It can be done in a wide variety of ways, including games of chance and games of skill. Some forms of gambling are illegal in some countries and others require licensing and regulation. Many people who gamble do so without experiencing significant negative consequences, while others may experience a variety of problems that range from mild to severe. These problems can have a major impact on family and social life, employment, health, and financial stability. In some cases, these problems are associated with co-occurring psychiatric disorders, substance use, and other medical conditions.
A small percentage of people who gamble develop a gambling disorder, also called pathological gambling or compulsive gambling. This problem is usually a chronic and recurrent pattern of maladaptive behaviors, often starting in adolescence or young adulthood and persisting over time. People with pathological gambling experience negative effects on their lives at a higher rate than people who do not have a problem with gambling. The proportion of men and women who develop a gambling disorder is nearly equal. People with lower incomes are more likely to develop a gambling disorder than those with greater wealth.
People who have a gambling disorder are more likely to suffer from other mental health problems, such as depression and anxiety. They are also more likely to have a history of illicit drug or alcohol use and to be involved in domestic violence. In addition, people with a gambling disorder are more likely to commit illegal acts, such as forgery, fraud, theft, embezzlement, or other crimes to finance their gambling. They may also lie to family members and therapists in an attempt to conceal their involvement with gambling or have serious legal problems related to gambling.
Psychiatric treatments for gambling disorders have proven to be effective, although the results vary. The reasons for this variation are not well understood. One possibility is that different underlying assumptions about the etiology of gambling disorder lead to different conceptualizations of treatment and the choice of therapeutic procedures.
Some of the most promising new approaches to treating gambling disorders involve combining cognitive-behavioral therapy with medication. However, these methods have not yet been tested against placebos in large-scale clinical trials. Other research is needed to better understand the underlying processes that lead to gambling disorder and to identify specific interventions that are most likely to be efficacious. Longitudinal studies are especially important because they allow researchers to examine the impact of gambling on people over time and in a controlled setting. These studies have the potential to yield a rich database that can be used to evaluate the effectiveness of treatment interventions. In particular, longitudinal data may help investigators to differentiate between the impact of environmental and physiologic factors on gambling behavior. These data may also clarify how these factors interact to produce and exacerbate gambling disorder.