As states have moved from merely tolerating gambling to running their own games, as communities have increasingly turned to gambling for an economic boost, important questions arise. Has the new age of gambling increased the proportion of pathological or problem gamblers in the U.S. population? Where is the threshold between "social betting" and pathology? Is there a real threat to our families, communities, and the larger society? Pathological Gambling explores America's experience of gambling, examining:

• The diverse and frequently controversial issues surrounding the definition of pathological gambling.
• Its co-occurrence with disorders such as alcoholism, drug abuse, and depression.
• Its social characteristics and economic consequences, both good and bad, for communities.
• The role of video gaming, Internet gambling, and other technologies in the development of gambling problems.
• Treatment approaches and their effectiveness, from Gambler's Anonymous to cognitive therapy to pharmacology.

How do pathological gamblers perceive and misperceive randomness and chance? What are the causal pathways to pathological gambling? What do genetics, brain imaging, and other studies tell us about the biology of gambling? Is there a bit of sensation-seeking in all of us? Who needs treatment? What do we know about the effectiveness of different policies for dealing with pathological gambling? The book reviews the available facts and frames the intriguing questions yet to be answered.

Pathological Gambling will be the odds-on favorite for anyone interested in gambling in America: policymakers, public officials, economics and social researchers, treatment professionals, and concerned gamblers and their families.

Contents

• Committee on the Social and Economic Impact of Pathological Gambling
• Committee on Law and Justice
• Acknowledgments
• [The National Academies]
• Executive Summary
• 1. Introduction
  • Committee Charge
  • Brief History of Pathological and Problem Gambling
  • Organization of the Report
  • References
• 2. Gambling Concepts and Nomenclature
  • Role of Risk-Taking in the Gambling Experience
  • Medicalization of Pathological Gambling
  • Contemporary Pathological Gambling
  • Classifications and Controversies
  • Measuring Pathological Gambling
  • Conclusions
  • References
• 3. Pathological and Problem Gamblers in the United States
  • Limitations of Prevalence Research
  • Determining National Prevalence
  • Pathological and Problem Gamblers in the U.S. Adult Population
  • Vulnerable Populations
  • Conclusions
  • References
• 4. Research on the Origins of Pathological and Problem Gambling
  • Etiological Considerations in Undertaking Research on Pathological Gambling
  • Psychosocial and Environmental Risk Factors
  • Pathological Gambling and Other Disorders
  • Conclusions
  • References
• 5. Social and Economic Effects
  • Costs to Individuals
  • Financial Problems and Crime
  • Issues and Challenges in Benefit-Cost Analyses of Gambling
  • Assessment of Studies Measuring the Costs and Benefits of Gambling
  • Conclusions
  • References
• 6. Treatment of Pathological Gamblers
  • Defining Treatment and Challenges to Treatment
  • Characteristics of Treatment Seekers
  • Treatment Approaches and Effectiveness
  • Health Care Services and Prevention
  • Conclusions
  • References
• 7. Organization and Technology of Gambling
  • History
  • Nature and Structure of Games
  • Legalization and Social Influence
  • Effects of Changing Technology
  • Conclusions
  • References
• Appendixes
  • A Gamblers Anonymous Twenty Questions
  • B Diagnostic and Statistical Manual of Mental Disorders Criteria for Pathological Gambling
  • C Legal-Age Gambling Opportunities and Restrictions
  • D Summary of Treatment Literature
  • E Gamblers Anonymous Meetings by State
  • F Biographical Sketches

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by the National Gambling Impact Study Commission. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.