Problem Gambling Flashcards
Understand the clinical presentation of gambling disorder as well as its epidemiology Learn about the neuroscience of gambling disorder Understand the evidence base for psychological treatment of gambling disorder Know the pharmacological interventions for gambling disorder
How many individuals in the UK are pathological gamblers?
500,000
Name some disease-related causes of pathological gambling
TBI, Lewy body dementia, ADHD, autism spectrum disorder, schizophrenia
How much more prevalent is gambling disorder amongst the homeless than the general population?
10x
How are gambling disorder patients useful for studying addiction?
They can provide broader insights into the core brain processes of addictive disorders as their brains are ‘pure’ - not affected by drugs which affect brain function
Why do pathological gamblers often not present to health services?
They often see themselves as weak, undeserving of attention, and shameful - especially if they have committed crimes for their habit
How does the DSM-V define gambling disorder?
A persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress
What percentage of adults in the UK have gambled in the past year? (2017 data)
63%
What are the 2 most common forms of gambling?
The National Lottery and scratchcards
Which population group is most likely to gamble?
Young adults
Name the 3 most problematic forms of gambling (most common in problem gamblers)
Spread betting, betting exchange, poker in pubs or clubs
Give at least 4 risk factors for problem gambling
Male gender, young adult, homelessness, impulsivity, impaired decision making, family history
Why is the standard test for reward not appropriate in problem gamblers?
Because it is a gambling task (The Cambridge Gamble Task) and gambling is the problem, which biases the results
Which brain areas are dysfunctional in problem gamblers?
Ventral striatum and dorsolateral prefrontal cortex (dopaminergic reward circuitry)
State some behavioural abnormalities seen in problem gamblers
Impaired delay discounting, impaired delayed gratification, higher impulsivity
State some problems associated with pathological gambling
Loss of employment, crime, physical health difficulties, social isolation, family pressure
What are the most common psychiatric comorbidites with gambling disorder? (Loraines et al, 2011)
Substance use disorders (nicotine dependence, alcohol dependence, illicit drug abuse), mood disorders, anxiety disorders, antisocial personality disorder
How does comorbid substance abuse affect gambling disorder? (Lsdd et al, 2003)
It correlates with more severe gambling and psychosocial problems
What is the prevalence of domestic violence amongst problem gamblers? (Dowling et al, 2014)
33.9%
State some barriers for female problem gamblers in seeking treatment (Suurvali et al, 2009)
Wanting to handle problems by themselves; shame, embarrassment, and stigma; lack of willingness to admit it is a problem; issues with the treatment
What is the first-line treatment for gambling disorder?
Specialist CBT
State some components of CBT for gambling disorder
Psychoeducation, stimulus control, tracking and rewards, replacing gambling with new activities, coping with cravings, identifying triggers, understanding lapses, challenging thoughts and beliefs (e.g. gamblers fallacy), planning for the future (including crisis plans)
Define gambler’s fallacy
A perceived ability to predict or control random events - e.g. runs of bad luck must be followed by good luck
Define attribution bias in gambling
Attributing wins to personal skills and losses to external factors
State some triggers for gambling (Petry, 2005)
Needing money for something (e.g. rent), having spare money, seeing a bet as obvious or easy money
State some symptoms of going ‘cold turkey’ from gambling
Anxiety, irritability, difficulty sleeping
