Problem gambling (ludomania) is an urge to gamble despite harmful negative consequences or a desire to stop. Problem gambling often is defined by whether harm is experienced by the gambler or others, rather than by the gambler’s behavior. Severe problem gambling may be diagnosed as clinical pathological gambling if the gambler meets certain criteria. Although the term gambling addiction is common in the recovery movement, pathological gambling is considered to be an impulse control disorder.
The DSM-IV diagnostic criteria presented as a checklist is an alternative to South Oaks Gambling Screen (SOGS), it focuses on the psychological motivations underpinning problem gambling and was developed by the American Psychiatric Association. It consists of ten diagnostic criteria. One screening measure based upon the DSM-IV criteria is the National Opinion Research Center DSM Screen for Gambling Problems (NODS). This measure is currently used frequently. The Canadian Problem Gambling Inventory (CPGI) is another newer assessment measure. The Problem Gambling Severity Index (PGSI) is composed of nine items from the longer CPGI. The PGSI focuses on the harms and consequences associated with problem gambling.
Most treatment for problem gambling involves counselling, step-based programs, self-help, peer-support, medication, or a combination of these. However, no one treatment is considered to be most efficacious and no medications have been approved for the treatment of pathological gambling by the US Food and Drug Administration (FDA).
Gamblers Anonymous (GA) is a commonly used treatment for gambling problems. Modeled after Alcoholics Anonymous, GA uses a 12-step model that emphasizes a mutual-support approach.
One form of counseling, cognitive behavioral therapy (CBT) has been shown to reduce symptoms and gambling-related urges. This type of therapy focuses on the identification of gambling-related thought processes, mood and cognitive distortions that increase one’s vulnerability to out-of-control gambling. Additionally, CBT approaches frequently utilize skill-building techniques geared toward relapse prevention, assertiveness and gambling refusal, problem solving and reinforcement of gambling-inconsistent activities and interests.
As to behavioral treatment, some recent research supports the use of both activity scheduling and desentization in the treatment of gambling problems. In general behavior analytic research in this area is growing.
There is evidence that the SSRI paroxetine is efficient in the treatment of pathological gambling. Additionally, for patients suffering from both pathological gambling and a comorbid bipolar spectrum condition, sustained release lithium has shown efficacy in a preliminary trial. The opiate antagonist drug nalmefene has also been trialed quite successfully for the treatment of compulsive gambling.
This article contains excerpts from: http://en.wikipedia.org/wiki/Compulsive_gambling
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