Gambling involves betting something of value on an event whose outcome is determined at least in part by chance. It requires three elements: consideration, risk, and a prize. Most people think of casinos and slot machines when they hear the word gambling, but many other activities are also forms of gambling. These include buying lottery or scratch tickets, playing bingo, and placing bets on office football pools.
There is a worldwide industry supporting gambling, with annual turnover estimated at $10 trillion (illegal betting may exceed this). In the United States, 0.4-1.6% of the population meets criteria for pathological gambling, an estimated 1.7 million adults. Typically, PG develops in adolescence or early adulthood and becomes problematic several years later. PG is more common in men than in women, and it tends to be more severe for males. Males are more likely to report problems with strategic or “face-to-face” forms of gambling, such as blackjack or poker, and females are more likely to have trouble with nonstrategic, less interpersonally interactive forms of gambling, such as slot machines or bingo.
Most people who gamble do so for a variety of reasons, such as the desire to win money, the feeling of euphoria associated with gambling, and socializing with friends. In addition, some people who have a gambling disorder have underlying psychological disorders, such as impulsivity and mood instability. Often, the onset of a problem is triggered by stress or loss of a job or by a change in living circumstances.
People who gamble are exposed to large amounts of advertising designed to persuade them to play, including the promotion of a variety of products and services by various companies. In addition, the availability of betting sites on the Internet has increased and makes it easier for people to place wagers without having to travel or spend a lot of money.
The most effective treatment for pathological gambling is cognitive-behavioral therapy, a type of psychotherapy that focuses on changing maladaptive thought patterns and behaviors. Research has shown that CBT can decrease the frequency of occurrences of gambling-related distress and increase adherence to antigambling interventions. However, the success of CBT for PG is still limited by our understanding of its etiology and of the factors that contribute to its development and maintenance.
In order to understand the etiology of PG, more long-term, longitudinal studies are needed. These would help identify the mechanisms that underlie this psychiatric disorder, and allow comparisons between individuals who have PG and those who do not. The goal of longitudinal studies is to identify and test hypotheses about the underlying causes and processes that lead to a person developing a gambling disorder. Currently, these types of studies are rare. Longitudinal data can be difficult to collect because of the cost and logistical difficulties of maintaining research teams over a long time period; the difficulty of obtaining accurate behavioral reports; and the possibility that aging and other variables may influence outcomes.