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Terms Related to Problem Gambling

Abstinence: The theory that a pathological gambler in recovery must completely abstain from all gambling. Abstinence is the goal of Gamblers Anonymous and most, though not all, treatment professionals. See also controlled gambling.

Affective disorder: A category of disorders in which the individual experiences excessive depression or elation. Examples include depression and bipolar disorder (manic-depression). Affective disorders are often found among pathological gamblers.

Anti-social personality disorder (ASPD): A disorder characterized by extreme anti-social behavior, usually beginning in childhood and often accompanied by a lack of remorse and a disregard of punishment. Also referred to as a sociopathic personality and psychopathic personality.

Anxiety disorder: A category of disorders in which the individual experiences extreme anxiety. Examples include phobias, post-traumatic stress disorder and obsessive-compulsive disorder.

Attention deficit hyperactivity disorder (ADHD): A disorder of childhood and adolescence characterized by lack of impulse control, inability to concentrate and hyperactivity. Also called attention deficit disorder (ADD). The existence of ADHD in adults is a question still debated in the mental health field.

Aversion therapy: A behavior modification technique that seeks to eliminate a behavior by providing punishment when that behavior occurs.

Bad beat: A term used by gamblers to describe a run of bad luck.

Bailout: Money given to a gambler that allows them to pay debts without suffering adverse consequences.

Behavioral disinhibition: The inability or unwillingness to inhibit behavioral impulses.

Behavioral therapy: A therapeutic method that focuses on modifying or "unlearning" a maladapive behavior without consideration of any underlying causes.

Benzodiazepines: A family of anti-anxiety drugs. Valium is a prominent example.

Bipolar disorder: An affective disorder in which both manic and depressive episodes occur. Bipolar disorders are sometimes diagnosed in pathological gamblers.

Brief Symptom Inventory (BSI): An assessment device sometimes used in gambling treatment. The BSI is not concerned with gambling per se.

California Personality Inventory (CPI): An assessment device sometimes used in gambling treatment. The CPI is not directly concerned with gambling.

Chasing: The attempt by a gambler to make up previous losses through additional gambling, a common symptom of a pathological gambler. Chasing often involves making larger bets and/or taking greater risks.

Chronic: Long-lasting.

Cognitive behavioral therapy: An approach to treatment that extends behavioral therapy to the modification of cognitive processes such as self-image and fantasy.

Cognitive disorders: Faulty thinking, as when gamblers "know" their luck is about to change.

Cognitive therapy: A treatment method focusing on changing an individual's inaccurate beliefs. Cognitive therapy for a gambler might involve challenging the patient's perceived odds of winning or ability to control the outcome.

Comorbidity: The presence of multiple disorders in one individual. Pathological gambling has high rates of comorbidity with disorders such as alcoholism and depression.

Compulsion: An irresistible urge to do something against one's better judgment. Compulsive behaviors are often repetitive in nature, and the person recognizes that the compulsion is irrational. Whether or not problem gambling is considered a compulsion is a topic of debate within the mental health profession; the prevailing opinion is that it is not.

Compulsive gambling: The term most commonly used by the public to describe someone with a gambling disorder, but generally rejected by the therapeutic community in favor of pathological gambling. The term disordered gambling is also sometimes used.

Controlled gambling: A theory of treatment for pathological gambling in which the patient is allowed to gamble on a limited basis. Controlled gambling currently has few adherents in North America but is somewhat more popular overseas. See also abstinence.

Cumulative Clinical Signs Method (CCSM): An instrument for the assessment of gambling problems developed by Robert Cullerton. The CCSM has been used very infrequently for estimating the extent of problem gambling.

Depression: An affective disorder characterized by extreme and intense sadness, pessimism, sense of inadequacy, etc.

Desensitization: A therapeutic technique that exposes persons to stressful situations under relaxed conditions, over time reducing the stress associated with the situation. A gambler, for example, might be asked by a therapist to imagine walking by a casino without going in. Sometimes referred to as "imaginable desensitization" or "systematic desensitization."

Diagnostic and Statistical Manual of Mental Disorders (DSM): A manual produced by the American Psychiatric Association that catalogs mental disorders. The fourth edition (DSM-IV), published in 1994, characterizes pathological gambling as an impulse disorder and lists 10 characteristics of a pathological gambler. Five of the ten must be present for a diagnosis of pathological gambling to be made. In addition to its use in clinical assessments, the DSM-IV criteria have been used in studies to determine the prevalence of pathological gambling in the general population. The DSM-IV criteria are generally considered to be more conservative than those used in the South Oaks Gambling Screen (SOGS).

DSM-IV: Literally, the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. However, in the gambling literature, a reference to the 10 characteristics presented in the manual as indicative of pathological gambling.

Diagnostic Interview for Gambling Severity (DIGS): A structured interview consisting of 20 questions used to determine if the DSM-IV criteria for pathological gambling are met. It was devised by Dr. Ken Winters, Dr. Sheila Specker, and Dr. Randy Stinchfield in 1997 and to date has been used for clinical evaluation rather than prevalence estimates.

Disordered gambling: A term coined by Howard Shaffer, Matthew Hall, and Joni Vander Bilt in 1997 to encompass the range of pathological, problem and excessive gambling. In their lexicon, level 1 of disordered gambling includes those with no gambling problems; level 2 includes people with gambling problems who do not meet the criteria for pathological gambling, while level 3 includes pathological gamblers.

Dopamine: A neurotransmitter, or chemical that transmits signals between nerve cells. Dopamine appears to function as an inhibitor. It has been associated with schizophrenia, and there is some evidence linking dopamine levels with pathological gambling. (See also serotonin)

Dual diagnosis: See comorbidity.

Dysphoria: An unpleasant mood characterized by anxiety or discontent, such as the shame and guilt often experienced by problem and pathological gamblers.

Dysthymia: Despondency or depression.

Dysthymia disorders: An affective disorder involving a prolonged depressed mood, less severe than depression.

Emotionality: Observable behaviors thought to be indicative of underlying emotions.

Epidemiology: The study of the occurrence of a disease in a population.

Etiology: The study of the causes of disease.

Familial: Pertaining to the family.

Gam-Anon: A fellowship for the families of pathological gamblers with chapters throughout North America.

Gamblers Anonymous (GA): An international network of groups for people attempting to recover from pathological gambling. Gamblers Anonymous is a 12-step program modeled after Alcoholics Anonymous. Local chapters provide fellowship in which people share their experiences, support, and hopes in order to stop gambling.

Gamblers Anonymous 20 Questions (GA-20): A list of 20 questions devised by Gamblers Anonymous to help individuals decide if they have a gambling problem. According to GA, most people with gambling problems will answer "yes" to at least seven of the 20 questions. The questions have not been scientifically validated.

Hypomanic: A mild form of bipolar disorder in which the person displays mildly yet persistent manic behaviors talking too much, spending money wildly, etc.

Imaginable desensitization: See desensitization.

Impulse control disorder: A class of disorders characterized by the inability to resist certain acts, usually with harmful consequences. Pathological gambling is considered in the DSM-IV as an impulse control disorder, as are kleptomania, pyromania, and other "addictive" behaviors.

Incidence: The rate of new cases of a disorder over a specified period of time. See also prevalence.

Locus of control: The perception of the factors responsible for the outcome of an event. An individual with an internal locus of control believes their actions caused the outcome. Conversely, an individual with an external locus of control believes the outcome was determined by outside forces.

Mania: A mood disorder characterized by pathological over-excitement.

Manic-depressive disorder: An affective disorder characterized by mania, depression, or, in the case of bipolar disorder, both.

Massachusetts Gambling Screen (MAGS): An instrument for the assessment of pathological or problem gambling based on the DSM-IV criteria.

Minnesota Multiphasic Personality Inventory (MMPI): A widely used instrument for assessing personality, the MMPI is often used as part of the initial assessment of pathological gamblers.

Mood disorders: See affective disorders.

Neurotransmitter: A chemical substance that naturally occurs in the brain and is responsible for communication among nerve cells.

NORC DSM Screen for Gambling Problems (NODS): A structured interview used to determine the prevalence of problem gambling in a population. The NODS consists of 17 questions designed to reflect the DSM-IV criteria and was devised by the National Opinion Research Center (NORC) for the 1999 National Survey of Gambling Behavior. The NODS classifies respondents as non-gamblers, low-risk (gamblers with no adverse effects), at-risk (gamblers meeting one or two of the DSM criteria), problem (gamblers meeting three or four criteria), and pathological (gamblers meeting five or more criteria.)

Norepinephrine: A neurotransmitter within the central nervous system that is widely studied in both affective disorders and substance abuse.

Obsessive-compulsive disorder: A type of anxiety disorder typified by persistent thoughts and ideas and repetitive behavior. Pathological gambling is not an obsessive-compulsive disorder though it is often confused with one (hence the professional dissatisfaction with the term compulsive gambling). "Obsessive-compulsive" is more properly applied to behaviors such as repetitive handwashing from which the person gets no pleasure.

Pathological gambling: A chronic inability to resist the impulse to gamble. The term is usually limited to cases where the gambling causes serious damage to a person's social, vocational, or financial life. Often referred to as compulsive gambling and less frequently as disordered gambling, it is considered by most to be an impulse control disorder. It is not synonymous with problem gambling.

Personality disorder: Generally, any disorder characterized by behavior that causes impaired social functioning. The term, however, has been used to describe a very wide range of psychological disorders in both more general and more specific ways than the definition given above.

Pharmacotherapy: The use of drugs to treat a disorder.

Prevalence: The proportion of a population having a condition at a given point in time or over a fixed period of time. See also incidence.

Problem gambling: Gambling activity that causes difficulty for the individual but does not meet the standards for pathological gambling. Sometimes referred to as "at-risk," "in-transition" or "potential pathological" gambling, though it is not known at what rate problem gamblers become pathological gamblers. Referred to by Shaffer, Hall and Vander Bilt (1997) as level 2 of disordered gambling.

Professional gambling: One who gambles as a way to make part or all of their living. Often confused with pathological gamblers, professional gambling is characterized by limited risks, discipline, and restraint, items all lacking in the pathological gambler. Professional gamblers wager on games with skill elements rather than games of chance, and wait to bet until the odds are more in their favor. Professional gamblers can, however, lose control and exhibit chasing behavior, at which time they become problem or pathological gamblers.

Recreational gambling/gambler: See social gambling.

Research Diagnostic Criteria (RDC): A list of criteria where a certain number must be met for a diagnosis to be made. For example, the DSM-IV enumerates 10 criteria for pathological gambling, five of which must be met before a diagnosis can be made.

Schizophrenia: A general term for a wide range of mental disorders characterized by a disassociation of sensory input, feelings and emotions on one hand and thoughts on the other. Symptoms can include hallucinations, hearing voices, a feeling that one's thoughts or actions are under someone else's control, and many others. Schizophrenia is found in pathological gamblers, though not as commonly as depression.

Schizoaffective disorder: A disorder with symptoms of both schizophrenia and manic-depressive disorder.

Serotonin: A neurotransmitter within the central nervous system widely studied in affective disorders and substance abuse. (See also dopamine.)

Social gambler/gambling: Gamblers who exhibit few or none of the difficulties associated with problem or pathological gambling. Social gamblers will gamble for entertainment, typically will not risk more than they can afford, often gamble with friends, chase losses briefly, gamble for limited periods of time, and are not preoccupied with gambling. Synonymous with recreational gambling. Level 1 on Shaffer et al's typology of disordered gambling.

South Oaks Gambling Screen (SOGS): A series of questions used to determine the presence of a gambling problem. Developed by Henry Lesieur and Sheila Blume of the South Oaks Psychiatric Hospital, the instrument consists of 20 items, with a score of five or higher considered evidence of pathological gambling. The South Oaks Gambling Screen has been the most widely used instrument in assessing the prevalence of pathological gambling among the general public, though it has not been specifically validated for that use.

SOGS-RA: A modified version of the South Oaks Gambling Screen used in assessing adolescents.

Spontaneous remission: The lessening or abatement of a disorder (such as pathological gambling) without assistance from a therapist, counselor, or medical practitioner.

Tilt: A term used by gamblers to refer to the process of losing control over gambling.

Twelve-step program: A program for treating an addiction, based on the 12 steps first espoused by Alcoholics Anonymous.

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