Psychopathology in pathological gamblers seeking treatment

Abstract

High rates of psychiatric symptoms have been reported in pathological gamblers. This study of psychiatric comorbidity in pathological gamblers is the first to use structured psychiatric interviews assessing DSM-III-R Axis I and II disorders. The Structured Clinical Interview for DSM III-R (SCID-P, SCID-II) was administered to 40 (25 male, 15 male) pathological gamblers seeking outpatient treatment in Minnesota for gambling, and 64 (41 male, 23 female) controls. High lifetime rates of Axis I (92%) but not Axis II (25%) psychopathology were found in pathological gamblers as compared to controls. No differences between male and female gamblers were found in rates of affective, substance use or personality disorders. Females had higher rates of anxiety disorders and histories of physical/sexual abuse. Possible associations between psychiatric disorders and pathological gambling are discussed along with gambler typologies and implications for future research.

Beyond description: Understanding gender differences in problem gambling

“…First, higher rates of internalizing/affective disorders push women towards non-social games like video lottery terminals (VLTs) (Boughton & Falenchuk, 2007;Grant et al, 2002). Second, the monotony and minimal effort required by VLTs provide an easy and desired dissociative effect in the face of stress and negative emotions (Ibanez et al, 2003;Specker et al, 1996). Third and finally, women who hold lower (real or perceived) status prefer "equal/random chance" games because they can participate on equal terms to the person next to them, regardless of social status or demographics (Bunkle, 2009).…”

“…Often, they experience instability or trauma during childhood, abusive or troublesome relationships in adulthood, and low (real or perceived) social status (Boughton & Falenchuk, 2007;Bunkle, 2009;Petry & Steinberg, 2005;Specker, Carlson, Edmonson, Johnson & Marcotte, 1996). As a result, another reason women often turn to gambling is for a temporary sense of empowerment (Bunkle, 2009;Casey, 2008).…”

The association between gambling pathology and personality disorders

“…Earlier research has also reported high percentages of the Cluster A and Cluster C disorders among treatment seeking gamblers (Steel & Blaszczynski, 1998). Various researchers have identified a relationship between Cluster C diagnoses and PGD in treatment samples (Specker et al, 1996;Steel et al, 1998), particularly for Avoidant Personality (Specker et al, 1996) and Obsessive-Compulsive Personality Disorder (Black & Moyer, 1998). For example, in a study of psychiatric outpatients, Henderson (2004) found that those with PGD displayed elevated scores on Avoidant, Compulsive, and Self-Defeating Personality Scales.…”

“…Similarly, treatment studies have also demonstrated an association between ASPD and gambling, showing ASPD rates of 14.5% (Ibanez et al, 2001) to 16.5% (Pietrzak & Petry, 2005). However, one study of PGD treatment seekers contradicted the ASPD connection in that it failed to identify any individuals with ASPD; their findings were potentially a result of methodological issues related to sample size, regional variation, and high levels of education (Specker et al, 1996).…”

GPs and Problem Gambling: Can they Help with Identification and Early Intervention?

“…The Productivity Commission 1 identified a number of characteristics shared by people experiencing gambling problems: Research has identified the extent of psychiatric comorbidity with pathological gambling [4][5][6] , and to a lesser extent other health concerns 7 . DeCaria et al 4 found that among an outpatient sample of pathological gamblers 28% met criteria for major depressive disorder, 24% bipolar disorder and 28% anxiety disorders.…”