Gambling

Question 1

Why is it hard to get proper research subjects in gambling?

Answer 1

Problem gamblers are always chasing their losses- they have no time for research projects.

Question 2

What is the DSM gambling disorder?

Answer 2

A persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting 4 or more of the following in 12 months:

• Needs to gamble with INCREASING amounts of money
• Restlessness, irritability when stopping
• Repeated unsuccessful efforts to control or cut back
• Preoccupied with gambling
• Gambles when distressed
• Chase losses
• Lies to conceal extent of addiction

Question 3

What is the prevalence of gambling in the UK 2017?

Answer 3

63% of adults gambled in the past year

most common : National lottery and scratch cards

Question 4

What are the genetics of PG?

Answer 4

Genetic vulnerability

First degree relative with the problem confers much higher risk.

Question 5

What are the dysfunctions found in substance abusers and PGs?

Answer 5

Dysfunctional reward system with reward anticipation

Hyporesponsive reward circuitry

Dopaminergic dysfunction.

Question 6

Which areas have functional neuroimaging studies found to have blunted responses to monetary gains?

Answer 6

Ventral Striatum

Ventromedial/Dorsolateral prefrontal cortex.

Question 7

Which drug can be used to control gambling addiction?

Answer 7

Naltrexone: Modulates mesolimbic dopamine circuitry, diminishes pleasure associated with gambling by inhibiting effects of released dopamine.

Question 8

What are the steps of the CBT programme?

Answer 8

1. Psychoeductation and stimulus control.
   Try and obstruct gambling, reduce access to money, and balance sheet (use cue card to challenge thoughts/urges)

2.Tracking and rewards
Track non gambling days, learn new ways to reward oneself fo not gambling, various tracking apps and written chart.

3. New activities- counteracts boredom, less painful.
4. Coping with cravings and urges (riding wave, urge surfing, breathing techniques)
5. Triggers (prevent relapse).
   Keep a trigger diary.
6. Understanding lapses
7. Challenging gambling thoughts and beliefs.
   Looking at faulty beliefs/cognitive distortions/biases.
8. Future planning- look at future obstacles to recovery. Plan for the coming months/years.

Question 9

What is an example of attribution bias?

Answer 9

‘Jackpot! I knew I could win if I tried hard enough’