What is compulsive gambling?

Compulsive gambling (also called pathological gambling, problem gambling or ludomania) is an urge to gamble continuously (casinos, scratch cards, online gambling, etc.) despite negative consequences or a desire to stop. Severe problem gambling may be diagnosed as clinical pathological gambling if the gambler meets certain criteria. Compulsive gambling is recognized as a disorder by the American Psychiatric Association.

Phases of Compulsive Gambling

Problem gambling pioneer Dr. Robert Custer identified three phases to a progressive gambling problem: a winning phase, a losing phase, and a desperation phase:

• Winning phase – in this phase, the player may experience a “big win” or a series of smaller wins that result in unrealistic optimism. They may feel a sense of power and control and they are excited at the prospect of more wins. Gamblers like to bet more and more and usually trust “their luck”. They feel confident and perfectly at ease until, sure as the sun rises, they do lose.
• Losing phase – in this phase, gamblers begin to withdraw from friends and family. As they increase the quantity and amount of their gambling, their debts become a problem and they usually consider borrowing money by legal or illegal means. In addition gamblers start chasing their losses, wanting to return to gambling directly after a loss with the hope that they can win the money back.
• Desperation phase – this phase occurs when gamblers spend more and more time gambling, usually alone. Excessive time spent gambling leads to their feeling guilty, blaming others for their problems, and alienating family and friends. They may begin to engage in illegal acts in order to have gambling money, and turn to alcohol or drug use to address feelings of helplessness. In this phase, gamblers are most at risk of depression, arrest, divorce, and suicidal ideation or attempts.

Adapted from Robert L. Custer MD (1984), former Chief of Treatment Services, Mental Health and Behavioural Sciences, US Veterans Administration.

Compulsive Gambling Treatment

In many cases, people suffering from compulsive or pathological gambling do not feel the need to follow a treatment programme until they have major problems, whether psychologial, financial or social.

The first step you need to make is to recognize your dependence problem. If you do not believe you have a problem, you are not likely to seek treatment.

Dianova can help you overcome your gambling problem by offering a specialized treatment programme with:

• Qualified and personalized care by a team of professionals including: general practitioner, psychiatrist and psychologist
• A coordinated, integral intervention through a multidisciplinary perspective in all the areas of the addiction problem.

Interventions focus on managing impulses (your compulsion or urge to gamble) through individual and group therapy. This can help you improve your self-esteem and manage your emotions. Our treatment programme also comprises relapse prevention tools, as well as methods to build on your inner resources and capabilities. For international clients, the intervention is provided in the English language.

Compulsive Gambling: Diagnostic criteria

Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four or more of the following in a 12-month period:

1. Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
2. Is restless or irritable when attempting to cut down or stop gambling.
3. Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
4. Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
5. Often gambles when feeling distresses (e.g., helpless, guilty, anxious, depressed).
6. After losing money gambling, often returns another day to get even (“chasing” one’s losses).
7. Lies to conceal the extent of involvement with gambling.
8. Has jeopardized or lost significant relationship, job, or educational or career opportunity because of gambling.
9. Relies on others to provide money to relieve desperate financial situations caused by gambling.

• Mild disorder: 4- 5 criteria met
• Moderate: 6- 7 criteria met
• Severe: 8- 9 criteria met

Adapted from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (section 312.31)