Gambling involves risking something of value, usually money, in order to predict the outcome of an event involving chance. Traditionally this has included activities such as card games, fruit machines, two-up and casino games like roulette and baccarat; betting on events such as horse or greyhound races or football accumulators; and lotteries and instant scratch cards. However, emerging technology has blurred the boundaries to include simulated gambling on social media games such as Farmville or Words with Friends and the use of virtual items called ‘skins’ in video games that can be purchased or won in loot boxes and have a real-world value based on their rarity (‘Skin Gambling’).
Gambling is a widespread activity and for many people it is an enjoyable pastime, providing an opportunity to relax and potentially win some money. However, for a small number of people, it can become an obsession that negatively impacts their lives and those around them. Often, it leads to debt and even homelessness, and can have serious implications for mental health and relationships. It can also impact career prospects and work performance.
Many people gamble in order to relieve unpleasant feelings, such as loneliness or boredom. However, there are healthier and more effective ways of doing this, such as spending time with friends who don’t gamble or engaging in physical activities that don’t involve any risks. There is also a strong link between gambling and stress, so if you find yourself gambling to relieve stress it may be time to seek help.
People who struggle with gambling often develop a compulsive urge to continue gambling, despite the negative consequences. This is known as Pathological Gambling and is an impulse control disorder. It is a recognised illness and is included in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. In the past, the psychiatric community generally regarded it as a form of kleptomania or pyromania, but in an attempt to move away from this ‘lazy’ label it was classified as an addiction.
In addition, those with a gambling problem are more likely to be unemployed, be in poorer health and have lower levels of education. They are also more likely to spend money on other things, such as alcohol or cigarettes, than those without a gambling problem.
Getting help for a gambling problem can be difficult and takes time, but it is possible to overcome it with the right support. There are a variety of treatments available, including individual and group therapy, cognitive behavioral therapy and medication. However, it is important to remember that the treatment of a gambling problem is different for every person, and the most successful approaches combine a variety of elements.
It is important to recognise that there are a range of behaviors that could be considered gambling, from those at higher risk for developing more serious problems (subclinical) to those who meet the diagnostic criteria of Pathological Gambling in the DSM-5. The aim of this chapter is to describe the range of these gambling behaviors and to discuss why they are problematic.