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A study on pathological gambling as an addiction

It has been discovered that between 70 to ninety percent of men and women gamble at some point in their life. (Ladoucer, 1991). These information are from Canada but can be genralised to many developed civilisations. Based on the DSM standards pathological gaming is am impulse control disorder, which is displayed by a continual and uncontrolled playing, failure to avoid gambling, feeling withdrawal symptoms and uneasiness when not aloud to take part in a playing activity and finally increased playing. (ref). The increased option of playing opportunities often makes this a hard condition to recuperate from, as well as increasing the amount of people suffering from pathological gambling(ref). Pathological gambling causes the evident financial problems (ref), but like any other "dependency" it triggers public problems as well (ref). Additionally pathological gaming has been connected in some cases to higher rates of suicide makes an attempt (ref).

Pathological gambling is classified as a behavioural dependency, rather than chemical dependency. Although apparently different these both express just as, that is "the long lasting engagement in uncontrolled self-destructive behavior, despite its negative results" (ref).

There are numerous different ideas of behavioural obsession, in particular pathological gambling and exactly how it should be treated, which will be critically analyzed and considered.

It would seem to be that in the apparently faraway past psychodynamic strategies such as those submit by Freud and Bergler were common. Since then many techniques and ideas to the causes of pathological gambling have been found, these models include; the medical model, some behavioural models, psychological models, cognitive behavioural approaches and of coarse biological, physiological and models of personality. A few of these models are evaluated and considered in greater depth.

To focus on psychodynamic techniques will be looked at. As is often known amongst academic community, these solutions are relatively old, usually completed in the first 1900's. Due to the age of the theories and the speed at which theories are altered these psychodynamic methods may seem to be quite irrelevant. It is important to gain a knowledge of this area as some theories have a basis from psychodynamic strategies. Based on the psychodynamic approach, gambling is a means of expressing feelings linked with the pre-genital psychosexual periods (Greenson). In true psychodynamic style pathological gamblers often feel that they are denied the attention and love they deserved of their parents and therefore need erotic satisfaction, which in tern appears to create a need for excitement and pleasure, as well as a "promise of gain. " Corresponding to psychodynamic ideas gambling attracts these needs (Simmel 1920). So in a nut shell gaming is a substitute for emotions of subconscious erotic conflicts. Probably the founder of psychodynamics, Freud (1928), reported that gamblers do not play to succeed money, quite contrary. In fact Freud states that gamblers gamble to loose to be able to provide a self-inflicted consequence for the guilt transported with an over compulsion to masturbate, which can be related to a Oedipal conflict. This idea submit by Freud seems quite masochistic, in the manner that that the gambler is actually taking part to loose and there for punish themselves. Bergler (1967) decided with Freud in the esteem a gambler unconsciously desires to lose. Bergler had a different judgment on why compulsive gamblers get addicted. This is that in their unconscious they dislike power numbers, who during youth, made them consider the "reality pleasure" rather than the "pleasure process. " These could be parental characters or instructors. This unconscious feeling causes them to almost rebel contrary to the people who support the "reality principle" as well as he principle it's self applied, therefore triggers a need to punish themselves as a bi-product of experiencing too much built up unconscious hostility.

So significantly only the surface of the psychodynamic procedure towards pathological gaming has been looked at. In summary according to the psychodynamic procedure there seems to be three suggestions to explain pathological gaming "an unconscious replacement for pre-genital libidinal and competitive retailers associated with Oedipal issues, " a desire "for punishment in a 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 cure plan can be called upon.

Treatments of pathological gamblers offered by the psychodynamic procedure are worried with the narcissistic personality and the related characteristics. Psychoanalysis has been found in an attempt to try and help pathological gamblers, but in most circumstances have failed. Bergler's (1957) research is one of the most classic studies and confirmed a 75% rate of success. This though was only based on 30% of the entire group looking for treatment, and therefore it was in fact a lot lower than 75%. Another concern is having less follow-up treatment given, with no information given about possible relapses. This isn't the only analysis where this is actually the case. In an assessment Greenberg (1980) mentioned "Effectiveness rates of gamblers treated psychoanalytically have ranked from poor to guarded optimism. " This simply means that results are of low quality or are shadowed by other factors, such as selection bias and lack of follow ups. It could seem that a lot of the studies and journals open to view for the psychodynamic procedure offer with small sample sizes, nor have important experimental factors, such as control categories. This causes problems with generalisability and also shows why the psychodynamic way was disregarded as cure for behavioural conditions, this in conjunction with their insufficient consideration for sociable factors.

The next theory which will be viewed is the condition or medical model. This is seen as a very black and white model (Blume, 1987), meaning that it's ether on or off, someone either has a problem or they don't really, there is no in-between. Every condition can be regarded as a disease. So in conditions of pathological playing, the gambler is pathological or quite simply is not. The condition model, as the name suggests, views pathological playing as a disease and so the cause is physiological, and pathological gamblers tend to be predisposed. Matching to Blume, being a disease, addictive conditions, such as gaming, manifests through phases of development, has signals characteristic to the condition and has symptoms, much just like a disease. This is all out of the person's conscious control, not so dissimilar to the psychodynamic ideas.

This concept of a disease suggest that the problem worsens, which will eventually require treatment in order to prevent worsening. It is thought that the physiological underpinning means that there is no out right treatment and that it is irreversible. Which means that according to the disease model that the most appropriate treatment is abstinence, similar compared to that of alcohol (ref). This seems as an odd treatment, as it would shows that there is actually no real way of recovering, simply a treatment.

This model is not used a great deal now(refbig newspaper), but is more of the halfway house with other theories, including the biological explanations of pathological gambling.

The biological approach to pathological playing is, in comparative terms a fairly new theory. It is made up of many components to try and explain different aspects of pathological playing. These all make the same assumption that a physiological cause is behind cravings, much like both the psychodynamic and the disease model.

The first aspect with in the natural approach to be considered is that of hemispheric dysregulation (Goldstein et al, 1985). By comparing EEG habits of recovered pathological gamblers, Goldstein discover that pathological gambler's EEG readings where comparable to those of patients battling with ADHD (Carlton and Goldstein, 1987). Which means that they had a shorter attention span, frontal lobe lesions. This is also nearly the same as studies of alcoholism that have also resulted in more reported symptoms of ADHD symptoms with in the populace of problem gamblers (Rugle and Melamed, 1993). This all seems very convincing, but the original 1985 research by Goldstein was only carried out on eight individuals, such a little study provides issues with generalisability.

Other recommendations are that it's linked to faults in the neurotransmitter systems (Blanco et al, 2000). This includes the Serotoneric system, which as the name advises supports the function of serotonin release. If this is not functioning, to a wholesome level, then psychiatric syndromes, such as impaired impulse control, can become present. It has been linked with pathological gambling (Blanco et al, 1996). Later research by Berg et al (1997) didn't support these results, stating in the following wel used quotation, "risk-taking doesn't have a unitary neurochemical correlate. If risk-taking is a kind of lack of control over impulse, it employs that impulse control is not merely a simple function of the neural serotonin systems. " (p. 475).

Links have also be found in DNA, assisting the natural idea Perez de Castro (1999). Regarding to Brunner et al (1993) these is a connection between genetic deficit coding and impulsivity, possibly providing a good description.

The increased release of Dopamine has also been linked to pathological playing (Berg et al 2007), this is similar to a positive encouragement. It could though also be linked to a poor inforcment, with an increase of gambling leading to a withdrawal, which creates the discharge of more dopamine, not unlike that of an opiate drawback (Berg, 1997).

The facts for the natural approach seems quite strong. There is a few outstanding conditions that have to be looked at. For instance the vast majority of the aforementioned studies use male individuals. This creates a concern as if they can be used with women. The samples are also really small in most cases. The main problem that may be observed in all the studies in this field is if the biological operations cause the craving of the craving it's self, triggers these biological techniques.

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 gaming can be treated with certain drugs.

So very good all models, with the exception of psychodynamic, have been based on biological internal procedures. The cognitive cultural learning and behavioural theories derive from exterior and behavioural techniques. The learning theories suggest that playing is a learned behaviour that has resulted from both operant and traditional conditioning. Based on the behavioural view point there are a mixture of different positive reinforcement these are, the money that is won (Moran, 1979), excitement gained (Dark brown, 1986). Obviously there are also negative reinforcement, specifically the escapism that gaming can produce (Diskin, 1997). Some how though theses models don't seem to be complete. They are able to not describe punishments, like the price of playing, as discouraging to the gambler, which utilizing a traditional behavioural model it might be.

Despite this, studies into using behavioural ideas of craving as treatment have been very successful.

Behavioral treatment studies have, however, provided some of the most comprehensive treatment books on PG. Treatments based on learning concepts (i. e. , tendencies changes) have involved aversion remedy using physical or imaginal stimuli (Barker; Barker and Goorney), handled gambling/behavioral guidance (Dickerson & Weeks, 1979), positive support of gambling abstinence, paradoxical intention (Victor & Krug, 1967), covert sensitization (Bannister and Cotler), and imaginal desensitization (McConaghy, Armstrong, Blaszczynski, & Allcock, 1983). These have been given singularly or in mix. However, anticipated to methodological shortcomings in such studies, it is difficult to assess how effective these treatments are. Many of these treatment studies have small test sizes and limited follow-up durations. They have unspecified or improperly operationalized dependent variables/criteria for successful outcome or treatment targets (Allcock, 1986). Also, there is usually a lack of manipulated comparisons of one treatment with another or with a placebo treatment, or combinations of several techniques are being used concurrently so that id of the active aspect is impossible (Blaszczynski & Silove, 1995).

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