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ORIGINS OF PATHOLOGICAL & PROBLEM GAMBLING

Multiple Professional Theories

I.Psychoanalytic/psycho-dynamic theories

All behavior has meaning and function, even self-destructive behavior can serve a defensive or adaptive purpose.

Pathological gambling is a symptom or expression of an underlying psychological condition.

Pathological gambling is rooted in childhood and involves defective relations with parents.

Gambling is a means by which one can recreate the love and acceptance of mother, a means which is punishment to the father.

The Psychoanalytic approach helps the gambler understand underlying sources of distress and conflict or else:

Symptom substitution

Depression

Relapse

There are two major types of gamblers:

Narcissistic, characterized by:

Grandiosity

Sense of entitlement

Pseudo-independence

Defense against feelings of smallness & helplessness

Masochistic characterized by:

Guilt

Self-punishment

Views pathological gambling as an addiction like alcohol or drug dependence, or seen as an obsessive/compulsive disorder. Due to an early sense of deprivation from the parents, the gambler turns to fate or lady luck for the love, approval, and acceptance they were denied. Parental over indulgence can lead to a sense of omnipotence.

Thus gambling can be:

A defense against helplessness & smallness

A defense against impending depression

A need for self-punishment to expiate guilt

Identification with parents

A WIN IS AN UNCONDITIONAL SUPPLY OF GRATIFICATION

A LOSS LEADS TO RIGHTEOUS, JUSTIFIABLE RAGE, AND GUILT AND PUNISHMENT

Stressed the functional aspect of gambling

Emphasized the role of omnipotent thinking

Addressed deficiencies in self-regulation

II.Behavioral Viewpoint

Pathological gambling seen as a behavior learned via processes of operant & classical conditioning

The behavior is maintained by intermittent schedules of reinforcement: Variable Rate.

Variable rate schedules lead to:

High response rates

Resistance to extinction

The greater the reward, the more resistance to extinction: Thus the role of the early “big win”

Gambling behavior is also classically conditioned to states of arousal, excitement and relief.

“Near misses” are also reinforced because of increased excitement.

The process can be quite complex if one considers:

Generalization

Higher order conditioning

Derived treatment techniques

Aversion therapy

Desensitization

Imaginal

In vivo

Relaxation

III General Theory of Addiction

Addiction is defined as a dependant state acquired over time by a predisposed person in an attempt to relieve a chronic stress condition.

There are two interacting sets of factors:

  1. Abnormal state of physiological arousal (hypo or hyper)
  2. Childhood history leading to a deep sense of personal inadequacy & rejection

The “state” must:

  • Blur reality by temporarily diverting the persons attention from the chronic aversive arousal state
  • Lower self-criticism & self-consciousness via deflecting preoccupation with one’s perceived inadequacies
  • Permit complimentary daydreams about oneself viz. self-induced dissociative process

The goal is an altered state of identity. It is a deliberately chosen means of entering and maintaining a dissociative like state. It is the “best solution” to a chronic problem.

IV Cognitive View

Gambling is a result of and maintained by a number of flawed beliefs

Core belief of many gamblers:

  • Through persistence, knowledge and skill it is possible to make money gambling.
  • While many will fail, the gambler posses the resources to win.
  • Persistence in applying oneself to the task will ultimately pay off.

Cognitive Distortions

  • Misunderstanding probabilities:

Availability heuristic: probability based on salience of event

Most people just don’t know the real odds in gambling games.

Representative heuristic: the probability of an event is based on the extent to which that event is similar to the population. (strings of adjacent numbers are less likely to win.)

The irrational thinking is that past results will effect the next outcome i.e. if heads has come up ten times in a row, the true probability of heads coming up on the next flip of the coin is still 50%

Irrational Thinking:

  • Gamblers fallacy
  • Entrapment: gone to far to give up now
  • Belief in “hot & cold” numbers
  • Superstitions:

Talismanic (certain objects increase the probability of a win)

Cognitive (certain states of mind or thought can increase winning)

Behavioral (rituals and actions can increase winning)

  • Illusion of control: can manipulate luck & probability
  • Selective memory (recall of wins and losses)
  • Magnification of skill (I have a system)
  • Near misses
  • Hindsight bias (I knew I should have bet on the other horse).

Treatment implications: challenge the irrational underlying beliefs.

  • Gambling vs. gaming
  • Understanding randomness
  • Understanding that erroneous beliefs maintain gambling
  • Awareness of erroneous beliefs
  • Correction of erroneous beliefs

  1. Neurobiological Viewpoint

There are genetic/biological pre-dispositions to addictions in general and gambling in specific.

Reward deficiency syndrome: alterations in chemistry can interfere with brain’s reward process.

  • Genetic commonalties in spectrum of behavioral disorders based on underlying cause of chemical imbalances that alter the signaling in the brain’s reward process.
  • DRD2 variant…. D2A1 allele Dopaminergic dysfunction
  • D1, D2, D4 receptor genes

Serotonergic system:

  • Impulse control
  • Mood disorders

Resulting in:

  • Cognitive dysregulation
  • Emotional dysregulation
  • Disinhibition/impulsivity
  • Rewards deficits

Resulting in:

  • Low frustration tolerance
  • Low affect tolerance
  • Poor problem solving/coping
  • ADD
  • Poor delay of gratification
  • Diminished response to punishment

Other traits contributing to gambling

  • Sensation-seeking
  • Extraversion
  • Impulsiveness

IV Gamblers Anonymous Theory

What is compulsive gambling?

Compulsive gambling is an illness, progressive in its nature which can never be cured but can be arrested.

Before coming to Gamblers Anonymous many compulsive gamblers thought of themselves as morally weak, or at times just plain “no good”. The Gamblers Anonymous concept is that compulsive gamblers are really very sick people who can recover if they will follow to the best of their ability a simple program that has proved successful for thousands of other men and women with a gambling or compulsive gambling problem

-taken from Gamblers Anonymous “Combo Booklet”

PROBLEMS WITH THEORETICAL POSITIONS:

They do not account for the full range of gambling behaviors

They are not comprehensive

Research results are inconsistent

Trouble accounting for such factors such as:

  • Age
  • Gender
  • Demographics
  • Availability
  • Heterogeneity of problem gamblers
  • Varying forms of gambling (preferences)

What is needed is the development of typologies and subtypes of gamblers. An eclectic model of the biopsychosocial view