Pathological gambling is one of the most rapidly growing, but largely ignored, mental health problems in South Africa.
Definition
Pathological gambling, also called compulsive gambling, is the most common type of impulse control disorder worldwide. With the rapid expansion of legalised gambling avenues such as casinos, lotteries and online gambling, abnormal gambling behaviours are on the rise.
This disorder can be defined as repeated maladaptive gambling that is associated with other problems, such as repeated unsuccessful efforts to stop gambling, restlessness or irritability when trying to stop gambling, lying to family members and friends to conceal the extent of gambling and committing crimes to finance gambling.
Prevalence
Pathological gambling typically appears in early adolescence for males and later in life for females. Although some individuals become hooked with their very first bet, for most people the process evolves more gradually. Years of social gambling with friends can be followed by an abrupt onset of pathological gambling that may be precipitated by more exposure to gambling or by stress. There is usually a progression in the frequency of gambling, the amount wagered and finding money with which to gamble. The desire to gamble generally increases during periods of stress or depression.
Surprisingly enough, the people who usually become pathological gamblers tend to be intelligent, well-educated, competitive people who enjoy the challenges and risks involved in betting. When not gambling, pathological gamblers are frequently labelled as workaholics and they may be prone to developing medical conditions associated with stress, such as hypertension or migraines. Distortions in thinking, such as denial, superstitions and overconfidence, are not uncommon.
Causes
Studies have shown that people that were drug or alcohol dependent had rates of pathological gambling ranging from 13 to 33%, leading researchers to conclude that the co-occurrence of substance use disorders and pathological gambling may be due to an underlying personality trait such as impulsivity. Impulsivity can be defined as the choice of a small, short-term gain at the expense of a larger, long-term loss, which seems to describe both substance abuse and excessive gambling fairly well.
Other studies of men and women with pathological gambling suggest that a history of inattentive and hyperactive symptoms in childhood may be a risk factor for developing this disorder.
A family pattern can also be seen: pathological gambling and alcohol dependence are both more common among the children of parents with pathological gambling problems than among the general population. The gender differences may some day help explain the origin of pathological gambling.
Treatment for pathological gambling
Treatment for problem gambling involves counselling, step-based programmes, self-help methods, peer-support or a combination of all of these.
Counselling
Gambling counselling is usually delivered by professional counsellors who are often either qualified psychologists or social workers. Telephone counselling services are also available in South Africa.
Step-based programmes
One of the step-based programmes for gambling issues is Gamblers Anonymous. Gamblers Anonymous uses a 12-step programme adapted from Alcoholics Anonymous and also places emphasis on peer support. Other step-based programmes (some commercially operated) that are both specific to gambling and generic to addiction have also been used to treat problem gamblers.
Peer-support
A method of treatment that is becoming more popular is peer support. With the advancement of online gambling, many gamblers experiencing problems use various online peer-support groups to help with their recovery. This protects their anonymity while allowing self-recover attempts often without having to disclose their issues to loved ones.
Self-help
Research into self-help methods for problem gamblers is showing promising results, including the use of workbooks followed up with telephone support.
Prevention
As with any condition, prevention is the best medicine. It is crucial to educate your children about the dangers of pathological gambling. Since the prevalence rate of pathological gambling is positively correlated with the availability of gambling, and the availability of gambling continues to increase, the public needs to understand the potential costs to society. Pathological gambling represents distress, a loss of control and lost productivity for millions of people.
Sources
Compulsive gambling. Retrieved from https://medlineplus.gov/ency/article/001520.htm
Pathological gambling disorder. Retrieved from http://www.minddisorders.com/Ob-Ps/Pathological-gambling-disorder.html
(Revised by M van Deventer)