Pathology is a pathology that consists of the progressive alteration of behaviour by which the individual experiences an uncontrollable need to play, over and above any negative consequences. It is recognized as a disease by the World Health Organization and by the American Psychiatric Association (APA).
Pathological gambling occurs in games with an addictive capacity, which are those in which little time passes between the bet and the prize achieved. Jerónimo Saiz, member of the Executive Committee of the Spanish Society of Psychiatry and patron of the Spanish Foundation of Psychiatry and Mental Health, explains that “the game associated with gambling is the one that takes place in bingos casinos and online games”.
According to the specialist, “the gambling addict is like a drug addict who needs to gamble and does whatever it takes to play, in other words, he turns gambling into an urgent first need”.
The Spanish Federation of Rehabilitated Gamblers (Fejar) adds that gambling is pathological when the person thinks, lives and acts according to it, leaving aside or on a second level other objectives and needs. Although gambling is an addiction that does not have a substance as a material reference, the gambler presents the same features as an addict:
- Repetition of a behavior or action that is pleasurable and increasing its frequency to obtain the desired effects. Different chemicals, such as dopamine and endorphins, act as stimulants and reinforce the pathological behaviors.
- Loss of control of the person derived from the failure of cerebral mechanisms of behavior inhibition.
- Appearance of withdrawal if the habit is interrupted.
Pathological gambling does not have a direct relationship with any specific cause, but rather it is a set of factors that can lead to the development of a pathological gambling disorder. Although it is a disease that develops differently depending on the predisposition and environment of the individual, different risk factors are established:
Genetic endowment seems to influence pathological gambling, as it has been found that children of gambling parents have a higher risk of becoming gamblers than children of non-playing parents. However, gambling is not a physical or psychological trait that is passed on from parent to child, but rather what the child inherits is a certain propensity to become addicted if exposed to gambling.
Family and social environment
The most direct environment (parents and educators) represents the model of learning and imitation for many young people. If unrestricted play is encouraged or practised as a normal habit within the environment, there is a risk that the young person will later become a pathological player. On the other hand, the social environment (friendships and social groups in general), together with a problem or lack of assertiveness, can also be a risk factor.
Psychological and social problems
People who are experiencing psychological instability or who have personal and social problems represent a significant risk group for developing pathological gambling. Gambling can be used as an escape from reality and can become a necessary pathological habit.
Game structure and advertising
Most forms of gambling that can cause pathological gambling; slot machines, bingo, casino games, etc., have an addictive component that is based on the repetition of rewarding behavior that creates expectations of being rewarded.
In some cases, there is advertising that is constantly launched and that reinforces the idea that playing can be a means of solving economic problems and other types of conflictive situations derived from economic scarcity.
Pathological gambling is a form of gambling that has consequences. According to Saiz, it becomes visible as a result of the changes that the game produces in the habits and behaviour of the players, who begin a period of self-destruction. The signs that may indicate a case of pathological gambling are.
- Abandonment of work and social life: As Saiz explains, gambling is beginning to occupy a prominent place in the lives of individuals, who are beginning to disregard their work life and social relationships. Sudden passivity and overly secretive behaviour, associated with factors such as frequent visits to the casino or constant gambling on the Internet, may indicate a case of pathological gambling.
- Economic problems: unexpected expenses, loans, lack of money, etc. All this makes that the individual can resort to the lie to avoid responsibilities and to hide the consequences derived from his gambling.
- Anxiety and depression disorders: The gambler needs to keep on gambling, despite the damage it does to him/her. His mind is preoccupied with gambling, with obtaining formulas to win and with getting money to gamble. All this, together with the fact that in many occasions the gambler does not have access to the game, can cause anxiety disorders. On the other hand, the set of economic problems, accumulated lies, deterioration of social and family relationships and the rest of the conflictive situations that pathological gambling entails can lead to depression.
- Personality changes: The problems derived from pathological gambling and the constant need to play can produce changes in behaviour, such as irritability, lack of communication or even aggressiveness.
In many societies gambling is considered a socially accepted act and is part of everyday life. One of the keys to preventing pathological gambling is to find the limit between healthy gambling as a leisure activity and pathological or harmful gambling; information and communication are necessary for this.
Finding leisure alternatives and keeping a busy life can also be a form of prevention.
The types of pathological gambling are determined by the way the individual plays. Each game has its own structure and addictive component:
- Slot machines: Its addictive component is based on reinforcing behavior through prizes. The individual introduces a coin and the machine rewards that behavior; although in most occasions no reward is obtained, whenever the machine awards some prize it will reinforce the behavior of throwing the coin. He also follows other visual and auditory strategies, such as claiming music.
- Games of chance: Although in this type of games (lottery, bingo, betting, etc.) there is an intermittent reinforcement of the behavior (depending on the type of game, it is difficult to get a prize), they are based on chance and the creation of expectations, which sometimes are fulfilled and reward the behavior.
- Role-playing: Responds to a type of pathological gambling that is far from the profile of the traditional gambler. The main addictive component of role-playing games is the escape from reality they offer. Although the economic problems caused by other types of gambling may not be present, it causes the same deterioration and personal and social problems as the rest.
The diagnosis of pathological gambling is possible because of the consequences and symptoms of the pathological game. Nieves Andrés explains that it is most common to diagnose pathological gambling when the degree of illness is such that there are already important consequences derived from bad habits (debts that accumulate, lies, frequent visits to casinos and places where one can gamble, etc.).
The evolution and diagnosis of the illness, says Jerónimo Saiz, “is like entering a spiral where you gamble more than you should”. The spiral begins with having problems with gambling, which leads to economic and social problems, which in turn trigger a series of psychological problems, such as anxiety disorders and depression.