Gambling Addiction free essay sample

In precolonial times, the proceeds from lotteries authorized by the ruling English monarchy were used to subsidize explorations to, and settlements within, the New World (Ezell, 1960). As colonial America matured, government and private lotteries, as well as social gambling, were common. The colonial era of gambling ended with the spread of Jacksonian morality, aided by numerous well-publicized scandals. Civil War reconstruction introduced a second era of gambling, as lotteries were employed as a form of voluntary taxation to rebuild the wartorn South (Rose, 1998; Ezell, 1977). Gambling continued to spread until 1890, when a scandal involving the Louisiana lottery resulted in federal legislation that effectively banned state lotteries and prohibited other forms of gambling for nearly 70 years (Rose, 1998; Ezell, 1977). The United States is now in the midst of a third era of widespread legalized gambling, which began in 1931 when Nevada relegalized casinos (Rose, 1986, 1995). Initially, Americans in this era limited legal gambling opportunities to the Nevada casinos, charitable bingo, and pari-mutuel gambling, such as horse and dog track racing. We will write a custom essay sample on Gambling Addiction or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Popular forms of illegal gambling, such as offtrack betting, back room casino games, and numbers, were associated with organized crime and were treated as vice crimes by law enforcement institutions. Then, beginning in 1964, gambling expanded greatly after New Hampshire initiated the first modern state lottery, signifying a change in traditional social and moral barriers. As of this writing, some form of gambling is legal in all but 3 states, casino or casino-style gambling is available in 21 states, and 37 states have lotteries (National Opinion Research Center, 1999). In 1988, Congress passed the Indian Gaming Regulatory Act, which allows tribes to operate any form of gambling currently legalized in the state in which the tribe resides. Resistance by many state legislatures to casino gambling and state-sanctioned sports betting continues, but in numerous jurisdictions other forms of gambling have become institutionalized, with state budgets increasingly dependent on gambling revenues. The advent of state-sponsored lotteries marked a significant policy shift in which the states moved from tolerance to active sponsorship and aggressive marketing of their own games. Public support of this shift is beyond question, with over 80 percent of adults in the United States participating in various forms of commercial or state-sponsored gambling sometime during their lives. Collectively Americans wagered over $551 billion in 1997 in legal gambling activities (International Gaming and Wagering Business, 1998). The process of discovering causal associations and pathways to understand how different factors, exposures, or disease-causing situations relate to each other usually involves multidisciplinary teams of psychiatrists, psychologists, statisticians, sociologists, economists, and epidemiologists. This chapter begins by describing considerations for undertaking or evaluating etiological research on pathological gambling, as well as the current state of knowledge regarding the causal pathways of pathological gambling. Risk factors for and correlates of pathological gambling, including psychosocial, environmental, genetic, and biological ones, are discussed and evaluated in terms of commonly accepted criteria for determining the strength of an association. Cooccurring disorders and their similar risk factors are also discussed. Throughout the chapter, substantial deficiencies in current research on pathological gambling are noted. Etiological Considerations in Undertaking Research on Pathological Gambling Etiological research is complex, and a number of aspects are essential to consider in undertaking it. They include the accuracy of diagnostic labels, the associations and causal relationships among potential risk factors, the uniqueness of risk factors, and age and cohort effects. In order to review the available evidence, the committee developed criteria to determine a causal association between a given risk factor and pathological gambling. Diagnostic Labels Considerable discussion has already been devoted to the definition, measurement, and prevalence of pathological gambling. When discussing the etiology of an illness, it is useful to revisit its label, because a label, as suggested by Nathan (1967), reflects the state of knowledge about the illness at the time it is labeled. In addition, etiological explanations keen on identifying causal pathways necessarily take labels into consideration, because they often describe the clinical site and clinical picture of an illness. For example, lung cancer, myocardial infarction, and lymphatic leukemia are medical labels that describe both the clinical site and the clinical picture of those illnesses. Medical labels such as tuberculosis and human immunodeficiency virus (HIV) can also specify the diagnosis, cause, or etiology of a physical illness. Precise diagnostic labels are less common in psychiatry. However, with the American Psychiatric Associations introduction of the Diagnostic and Statistical Manual of Mental Disorders (DSM), research on the more common mental disorders has flourished and has led to a concomitant explosion in research on risk factors (Goodwin and Guze, 1974). Research on the diagnostic classification of pathological gambling has lagged behind, and it has been identified as an area in serious need of etiological research. Associations and Causal Relationships As with other areas of research, when designing, undertaking, or evaluating etiological research on pathological gambling, one must understand and distinguish between associations and causal relationships among many potential risk factors. A risk factor is something that has a possible role in the initiation of a disease, the progression of a disease to a further state, or in the waning of a disease (which is then a protective factor). Demographic, biological, personality, family, peer, and genetic factors, among other possible risk factors, may interact over time to influence the course of outcomes, symptoms, and behaviors. Risk factors are most useful for research when they refer to a specific phenomenon that provides a feasible point of intervention. Some factors may be related exclusively to initiation; others may be related only to subsequent progression into problem or pathological gambling. Although important, such etiological distinctions have been rarely made in the relatively recent and limited iterature on pathological and problem gambling. The literature on posttraumatic stress disorder (PTSD) offers an analytic model for distinguishing risk factors. Breslau and Davis (1987) demonstrated that it was the original exposure to a precipitating event, and not reexposure, that led to symptoms of PTSD among Vietnam veterans. In another study, Breslau and colleagues (1991), in an examination of young urban adults, identified risk factors for exposure to traumatic events (i. e. low education levels, being male, early conduct problems, and extraversion) that were distinct from risk factors for the actual disorder once exposed (i. e. , early separation from parents, neuroticism, preexisting anxiety or depression). Distinguishing risk factors is crucial in etiology research, as is identifying common risk factors for the progression of an illness. In the study just described, a family history of a psychiatric disorder or a substance abuse problem was identified as a common risk factor for exposure to traumatic events and acquiring PTSD. Unique Risk Factors Equally important to consider in etiological research on pathological and problem gambling is which factors for chronic, long-term gambling are unique to this disorder and not just predictors of excessive deviant behavior of all kinds. Again, the PTSD literature provides a template for research on pathological Age and Cohort Effects Etiological research must also consider how the effects of age and being in a cohort (a group of people born in the same year or decade) increase or decrease ones risk for initiating gambling or developing a gambling problem. Although these effects are infrequently considered in existing pathological and problem gambling research, Eriksons stages of development (Erickson, 1963, 1968, 1982) are one explanatory model that accounts for aging effects and could potentially be applied when investigating gambling behaviors. Specifically, the model hypothesizes that, as people age, they move through several developmental stages that correspond to certain stage-related tasks. When applied to gambling behavior, the implication is that, at certain developmental stages, the motivation for and expectations about gambling might change. A recent review demonstrated that gambling among young people occurs on a developmental continuum of gambling involvement ranging from no gambling experimentation to gambling with serious consequences (Stinchfield and Winters, 1998). These effects pertain to how risk factors and outcomes change with age and differ among groups of people (Mok and Hraba, 1991). Cohort effects pertain to specific events that affect groups of people born during the same time period (Mok and Hraba, 1991). When applied to gambling behavior, this means that increases in gambling opportunities during a certain period in history may affect a certain age group of people. For example, a cohort of same-age people who are passing through the age of risk for gambling problems when gambling opportunities are expanding may experience greater and increasing exposure to, involvement in, and social acceptance of gambling during their lifetimes than a cohort of same-age people at risk during periods of fewer gambling opportunities. In addition, circumstances can affect more than one cohort in the same way or in different ways. A classic example of an event that changed the trajectory of same-age people is the drug revolution of the late 1960s and early 1970s. During this period, expanded drug use affected both teens and young adults, marking this time period as a historical risk factor for drug abuse. As opportunities to gamble continue to increase throughout most of the United States, it is likely that certain birth cohorts will be affected differently, perhaps in unanticipated ways.