Pathways

Question 1

4 distinct theoretical approaches to gambling and problem gambling

Answer 1

• Psychodynamic account
• Behavioural account (conditioning, learning)
• Cognitive account
• Biological accounts

Question 2

what does the pathways model do?

Answer 2

• Proposes 3 subgroups of (and routes into) problem gambling
• • one for behaviourally conditioned problem gamblers
• • one for emotionally vulnerable problem gamblers
• • one for antisocial impulsivist problem gamblers

Question 3

psychodynamic theory

Answer 3

• Bergler (1957) Problem gambling as masochism – the unconscious desire to lose
• Driven by denial / rebellion against parental authority
• Did foresee notion that PG is not necessarily about winning money

Question 4

Pathways Model 1: behaviourally conditioned problem gamblers

Answer 4

• Ecological factors: accessibility/availability is necessary in order to create a gambling problem (ex. Having a casino near your house) ->
• Conditioning factors: experiencing excitement/arousal and irrational beliefs (ie. That you’re more likely to win) when you’re at the casino ->
• Habit formation: you return to casino more and more because of those feelings of excitement and/or irrational beliefs ->
• Chasing: you start to loss-chase (this crosses the threshold into problem gambling) ->
• Problem gambling symptoms: Causes difficulty at home/work, you lie about where you are, etc.

Question 5

why doesn’t everyone become a problem gambler?

Answer 5

• The “Early Big Win” hypothesis:
• • Vast majority of problem gamblers report early “big wins”
• • Retrospective data shows that a quarter of pathological gamblers remember winning big on their first time (compared to 0% of social gamblers and 12% of subclinical gamblers)
• • Acts as a powerful conditioning event that skews expected value calculations

Question 6

Pathways Model 2: emotionally vulnerable problem gamblers

Answer 6

• Ecological factors: accessibility/availability is necessary in order to create a gambling problem (ex. Having a casino near your house) -> +
• Emotional vulnerabilities that predispose you: depression, trauma, stress, etc. (you gamble to escape/cope with these) ->
• Conditioning factors: experiencing excitement/arousal and irrational beliefs (ie. That you’re more likely to win) when you’re at the casino ->
• Habit formation: you return to casino more and more because of those feelings of excitement and/or irrational beliefs ->
• Chasing: you start to loss-chase (this crosses the threshold into problem gambling) ->
• Problem gambling symptoms: Causes difficulty at home/work, you lie about where you are, etc.

Question 7

Pathways Model 3: antisocial impulsivist problem gamblers

Answer 7

• Ecological factors: accessibility/availability is necessary in order to create a gambling problem (ex. Having a casino near your house) -> +
• Emotional vulnerabilities that predispose you: depression, trauma, stress, etc. (you gamble to escape/cope with these) -> +
• Impulsive vulnerabilities: being highly impulsive, antisocial, having executive dysfunction, substance use, etc. (impulsivity typically present in childhood and predates problem gambling… naturally drawn to risky stuff) ->
• Conditioning factors: experiencing excitement/arousal and irrational beliefs (ie. That you’re more likely to win) when you’re at the casino ->
• Habit formation: you return to casino more and more because of those feelings of excitement and/or irrational beliefs ->
• Chasing: you start to loss-chase (this crosses the threshold into problem gambling) ->
• Problem gambling symptoms: Causes difficulty at home/work, you lie about where you are, etc.

Question 8

Issue with Pathways Theory

Answer 8

• Difficult to test:
• • Requires measuring many different components
• • Cluster analysis is a stat technique to identify subgroups in data, but has only been somewhat successful (not a 3-cluster solution)

Question 9

Clinical implications of Pathways theory

Answer 9

• For pathway 2 gamblers, vital to also treat underlying mood disorder as well as the gambling
• For pathway 3 gamblers, poor attention and problem-solving may create difficulties engaging with treatment (e.g. not doing “homework)” & high risk of drop-out
• Pathways 2 and 3 may require medications to balance their neurochemistry