A study on pathological gambling as an addiction

A topic on diseased period of play as an addictionIt has been implant that between 70 to ninety percent of adults gamble at around point in their life. (Ladoucer, 1991). These figures are from Canada but butt be genralised to to the highest degree developed civilisations. According to the DSM criteria pathologic free rein is am drift restrain disorder, which is displayed by a persistent and uncontrolled dramatic play, failure to stop play, face drug withdrawal symptoms and uneasiness when not aloud to deplete part in a period of play activity and finally increased gambling. (ref). The increased accessibility of gambling opportunities often makes this a hard condition to recover from, as well as increasing the amount of people suffering from ghoulish gambling(ref). Pathological gambling causes the obvious financial problems (ref), but like any other addiction it causes social problems as well (ref). Along with this morbid gambling has been contact up in some ca ses to higher rates of suicide attempts (ref).Pathological gambling is classified as a behavioural addiction, kind of than a chemical addiction. Although seemingly disparate these some(prenominal) manifest in the same way, that is the enduring engagement in uncontrolled self-destructive behaviour, scorn its negative consequences (ref).There are many different theories of behavioural addiction, in particular pathological gambling and how it should be treated, which ordain be critically re contemplateed and considered.It would seem that in the seemingly distant past psychodynamic neares such as those put forward by Freud and Bergler were prevalent. Since then many approaches and theories to the causes of pathological gambling strike been found, these mildews include the medical model, some behavioural models, psychological models, cognitive behavioural approaches and of coarse biologic, physiological and models of personality. Some of these models are reviewed and considere d in great depth.To start with psychodynamic approaches will be looked at. As is commonly known amongst faculty member community, these approaches are relatively old, aroundly carried out in the early 1900s. imputable to the age of these theories and the pace at which theories are changed these psychodynamic approaches may seem quite irrelevant. It is important to gain an understanding of this area as some theories take a basis from psychodynamic approaches. According to the psychodynamic approach, gambling is a way of expressing notionings machine-accessible with the pre-genital psychosexual stages (Greenson). In true psychodynamic style pathological risk takers often feel that they have been denied the attention and love they deserved from their parents and as a termination need erotic satis situationion, which in tern seems to create a need for fervidness and pleasure, as well as a promise of gain. According to psychodynamic theories gambling caters for these needs (Simme l 1920). So in a nut shell gambling is a substitute for feelings of subconscious sexual counterpoints. Arguably the founder of psychodynamics, Freud (1928), account that gamblers do not play to win money, quite the opposite. In fact Freud states that gamblers gamble to loose in order to provide a self-inflicted penalization for the guilt carried with an over compulsion to masturbate, which croupe be related to an Oedipal conflict. This imagination put forward by Freud seems quite masochistic, in the way that that the gambler is actually taking part to loose and in that respect for punish themselves. Bergler (1967) agree with Freud in the respect that a gambler unconscious mind(p)ly desires to lose. Bergler had a different opinion on why compulsive gamblers get addicted. This is that in their unconscious they dislike authority figures, who during childhood, made them consider the reality pleasure rather of the pleasure principle. These could be parental figures or teachers. This unconscious feeling causes them to give and almost rebel against the people who support the reality principle as well as he principle its self, this in turn causes a need to punish themselves as a bi-product of having too oftentimes make up unconscious aggression.So utmost only the very go on of the psychodynamic approach towards pathological gambling has been looked at. In summary according to the psychodynamic approach there seems to be three ideas to apologise pathological gambling an unconscious substitute for pre-genital libidinal and aggressive outlets associated with Oedipal conflicts, a desire for punishment in reaction to the guilt, and a means for recurrent re-enactments, but not resolutions, of the conflict (Allcock, 1986, p. 262). So these being the main ideas a word plan give notice be called upon.Treatments of pathological gamblers offered by the psychodynamic approach are concerned with the egotistic personality and the related characteristics. Psychoan alysis has been employ in an attempt to smack and help pathological gamblers, but in most cases have failed. Berglers (1957) instruct is one of the more unspotted studies and showed a 75% rate of success. This though was only based on 30% of the overall group looking for for treatment, meaning that it was in fact a lot lower than 75%. Another issue is the lack of espouse up treatment given, with no information given about possible relapses. This is not the only study where this is the case. In a review Greenberg (1980) stated Effectiveness rates of gamblers treated psychoanalytically have ranked from poor to guarded optimism. This simply means that results are not very sober or are shadowed by other factors, such as selection bias and lack of follow ups. It would seem that a lot of the studies and journals available to view for the psychodynamic approach fight with slight taste sizes and do not have important observational factors, such as control groups. This causes prob lems with generalisability and also shows why the psychodynamic approach was treat as a treatment for behavioural conditions, this coupled with their lack of rumination for social factors.The next theory that will be looked at is the disease or medical model. This is often seen as a very sour and white model (Blume, 1987), meaning that its ether on or off, psyche either has a condition or they dont, there is no in-between. all condition is viewed as a disease. So in terms of pathological gambling, the gambler is pathological or quite simply is not. The disease model, as the holler suggests, views pathological gambling as a disease and so the cause is physiological, and pathological gamblers are often predisposed. According to Blume, being a disease, addictive conditions, such as gambling, manifests through stages of development, has signs characteristic to the condition and has symptoms, much like a disease. This is all out of the persons conscious control, not so different t o the psychodynamic ideas.This concept of a disease suggest that the condition worsens, which will eventually require treatment in order to prevent worsening. It is perspective that the physiological underpinning means that there is no out right remedy and that it is irreversible. This means that according to the disease model that the most appropriate treatment is abstinence, similar to that of alcohol (ref). This seems like an odd treatment, as it would suggests that there is in fact no real way of recovering, just a treatment.This model is not used so much now(refbig paper), but is more of a halfway house with other theories, such as the biological explanations of pathological gambling.The biological approach to pathological gambling is, in relative terms a rather new theory. It is made up of many components to strain and explain different aspects of pathological gambling. These all make the same self-reliance that a physiological cause is behind addiction, much like both the psychodynamic and the disease model.The first aspect with in the biological approach to be considered is that of hemispheric dysregulation (Goldstein et al, 1985). By comparing EEG patterns of recovered pathological gamblers, Goldstein defend that pathological gamblers EEG readings where similar to those of patients suffering with ADHD (Carlton and Goldstein, 1987). This means that they had a shorter attention span, frontal lobe lesions. This is also very similar to findings of alcoholism which have also led to more reported symptoms of ADHD symptoms with in the tribe of problem gamblers (Rugle and Melamed, 1993). This all seems very convincing, but the original 1985 study by Goldstein was only carried out on eight participants, such a small study provides problems with generalisability.Other suggestions are that it is connected to faults in the neurotransmitter systems (Blanco et al, 2000). This includes the Serotoneric system, which as the name suggests holds the function of se rotonin release. If this is not functioning, to a healthy level, then psychiatric syndromes, such as impaired impulse control, can become present. This has been linked with pathological gambling (Blanco et al, 1996). Later research by Berg et al (1997) failed to support these findings, stating in the following wel used quote, risk-taking does not have a unitary neurochemical correlate. If risk-taking is a form of loss of control over impulse, it follows that impulse control is not merely a simple function of the queasy serotonin systems. (p.475).Links have also be found in DNA, supporting the biological idea Perez de Castro (1999). According to Brunner et al (1993) these is a link between genetic deficit coding and impulsivity, possibly providing a good explanation.The increased release of Dopamine has also been linked to pathological gambling (Berg et al 2007), this is much like a domineering reinforcement. It can though also be linked to a negative inforcment, with more gambling causing a withdrawal, which creates the release of more dopamine, not unlike that of an opiate withdrawal (Berg, 1997).The evidence for the biological approach seems quite strong. There is a some outstanding issues that need to be looked at. For example almost all of the above studies use male participants. This creates an issue as whether they can be used with women. The samples are also very small in most cases. The main problem that can be observed in all the studies in this area is whether the biological processes cause the addiction of the addiction its self, causes these biological processes.So as can be seen the medical/disease model and the biological model are both very similar but can be separated in the way that the biological model believes that pathological gambling can be treated with certain drugs.So far all models, with the exception of psychodynamic, have been based on biological ingrained processes. The cognitive social schooling and behavioural theories are b ased on external and behavioural processes. The learning theories suggest that gambling is a wise(p) behaviour that has resulted from both operant and classical conditioning. According to the behavioural view point there are a mixture of different positive reinforcement these are, the amount of money that is won (Moran, 1979), excitement gained (Brown, 1986). Obviously there are also negative reinforcement, namely the escapism that gambling can produce (Diskin, 1997). Some how though theses models dont seem complete. They can not explain punishments, like the cost of gambling, as discouraging to the gambler, which using a classic behavioural model it would be.Despite this, studies into using behavioural theories of addiction as treatment have been very successful.Behavioral treatment studies have, however, provided some of the most comprehensive treatment literature on PG. Treatments based on learning principles (i.e., behavior modification) have involved aversion therapy using phy sical or imaginal stimuli (Barker Barker and Goorney), controlled gambling/behavioral counseling (Dickerson Weeks, 1979), positive reinforcement of gambling abstinence, paradoxical intention (Victor Krug, 1967), covert sensitization (Bannister and Cotler), and imaginal desensitization (McConaghy, Armstrong, Blaszczynski, Allcock, 1983). These have been administered singularly or in combination. However, due to methodological shortcomings in such studies, it is tricky to assess how effective these treatments are. Most of these treatment studies have small sample sizes and limited follow-up periods. They have unspecified or poorly operationalized qualified variables/criteria for successful outcome or treatment objectives (Allcock, 1986). Also, there is usually a lack of controlled comparisons of one treatment with another or with a placebo procedure, or combinations of several techniques are used concurrently so that identification of the agile component is impossible (Blaszczyn ski Silove, 1995).