Problem Gambling Definitions and Problem Gambling Joanna Franklin

Problem Gambling: Definitions and Problem Gambling Joanna Franklin MS NCGC II Maryland Council on Problem Gambling Jfranklin. ipg@gmail. com Trimeridian

Types of Gamblers ► Continuum “Disordered Gambling” Bungler ? ? No Gambling 0 Social Gam. Serious Social Gam. Problem Gam. 1 2 ? ? Professional Gambler Trimeridian Pathological 3 ? ? Antisocial Gambler

Types of Gamblers ► 1. Social Gambler- Gambles occasionally, for fun, sticks to limits ► Serious Social Gambler-Gambles regularly, hobby, avocation, still does not spend more time or money than can afford, sticks to limits ► Professional Gambler- Gambles as a way of earning a living, very rare. ► 2. Problem Gambler- Beginning to have problems due to gambling. Has 3 or 4 on the SOGS, has 3 or 4 of DSM IV criteria. Trimeridian

Types of Gamblers ► 3. Pathological Gambler- Major life problems due to gambling. 5 or more on SOGS, 5 or more of DSM IV criteria) ► Anti-social Gambler – gambles as part of antisocial life style. However, can be both ASPD and pathological gambler. ► Client must meet clinical criteria. Trimeridian

DEFINING PROBLEM AND PATHOLOGICAL GAMBLING ► 1980 – American Psychiatric Assoc. – DSM III § Disorder of Impulse Control Not Elsewhere Classified § 312. 31 ► 1994 – DSM-IV § “The essential feature of Pathological Gambling is persistent and recurrent maladaptive gambling behavior that disrupts personal, family or vocational pursuits Trimeridian

Pathological Gambling: DSM-IV Criteria ► Preoccupation § Is preoccupied with gambling (e. g. , reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble ► Tolerance § Needs to gamble with increasing amounts of money in order to achieve the desired excitement ► Withdrawal § Is restless or irritable when attempting to cut down or stop gambling Trimeridian

Pathological Gambling: DSM-IV Criteria ► Escape § Gambles as a way of escaping from problems or relieving dysphoric mood (feelings of helplessness, guilt, anxiety or depression ► Chasing § After losing money gambling, often returns another day in order to get even ► Lying § Lies to family members, therapists, or others to conceal the extent of involvement with gambling Trimeridian

Pathological Gambling: DSM-IV Criteria § Loss of control ► Has made repeated unsuccessful efforts to control, cut back, or stop gambling § Illegal acts ►Has committed illegal acts (forgery, fraud, theft, or embezzlement) to finance gambling § Risked significant relationship ► Has jeopardized or lost a significant relationship, job, education or career opportunity because of gambling § Bailout ► Has relied on others to provide money to relieve a desperate financial situation caused by gambling Trimeridian

Subtypes of Pathological Gamblers ► Action § § § § ► Escape Early Onset Narcissistic MDE - Current Games of Skill Competition/Power Winning Phase More likely to be male § § § Trimeridian Later Onset Dysthymia Machine Games (Slots/VP) Relief/Dissociation No Winning Phase Gender Bias?

Progression of Problem Gambling Winning/Social Losing Desperation Hopelessness Trimeridian

Progression of Problem Gambling Growth Rebuilding Critical Trimeridian

Winning/Social Phase ► Gambling for Pleasure § Action and Escape Gamblers Differ § Escape – may not have “winning phase” § Gambling is a social activity § Action gamblers may be good at the game or strategy of gambling § Action gamblers enjoy the competition § Escape gamblers enjoy relaxation, relief Trimeridian

Winning/Social Phase ► There may be a “Big Win” ► Recognition for early successes boosts self-esteem ► Increasing involvement in gambling § Size of bets § Time § Preoccupation § Enjoy “reputation” § Increasing self-esteem or stress relief dependent on gambling Trimeridian

Winning/Social Phase ► Increasing involvement with fantasies or use of gambling for escape § Need for spectacular, fast success § Playing the big shot, impressing others § Need for relief, avoidance, self-soothing § Gambling to exclusion of other social and recreational activities § Money viewed as solution to problems Trimeridian

Losing Phase ► May begin with a prolonged losing streak, bad beat or big loss ► Chasing begins and progresses from short to long term ► Social aspect decreases § Gambling becomes increasingly solitary § Covering up, lying Trimeridian

Losing Phase ► Borrowing begins (Spiral of Options) § Credit cards, friends § Legal Loans, family § Progressively more outrageous stories § Illegal sources ► Losing becomes increasingly intolerable § Depression following losses § Irritability, anger, blaming others Trimeridian

Losing Phase ► Bailouts can take place at any time § Lead to upsurge of omnipotence, greater loss of control § Personal or institutional Trimeridian

Desperation Phase ► Begins with “crossing the line” § May involve illegal activities § Differs for each gambler § When this occurs depends on social, reality factors, exhaustion of other options § Happens repeatedly Trimeridian

Desperation Phase ► Theft initially viewed as short term loan § May keep records § Intent to repay with winnings § Becomes easier each time § Stops keeping track Trimeridian

Desperation Phase ► Paradox of Desperation § Leads to false sense of optimism § More loses – closer to next big win § Sense of conviction, knows how bet will turn out Trimeridian

Desperation Phase ► Depression and withdrawal progress § Sleeping, eating poorly § Unconcerned about others § Often suicidal ► Common fantasy of starting over Trimeridian

Hopelessness Phase ► Begins § § § Stops chasing, but doesn’t stop gambling Doesn’t care if wins or loses Playing is all that matter ► Playing § § with awareness will never get even to “get it over with” Often knows will lose Can’t seem to get rid of money fast enough Play sloppily Relief when money gone Trimeridian

Hopelessness Phase ► Playing just to “stay in action” for arousal or energy ► Like lab rats with electrodes in pleasure center, gambling to point of physical and emotional exhaustion ► Gambles because doesn’t know what else to do Trimeridian