Disordered Gambling: Etiology, Trajectory and Clinical Considerations

Gambling-related research has advanced rapidly during the past 20 years. As a result of expanding interest toward pathological gambling (PG), stakeholders (e.g., clinicians, regulators, and policy makers) have a better understanding of excessive gambling, including its etiology (e.g., neurobiological/neurogenetic, psychological, and sociological factors) and trajectory (e.g., initiation, course, and adaptation to gambling exposure). In this article, we will examine these advances in PG-related research and then consider some of the clinical implications of these advances. We will consider the DSM-V Impulse Control Work Group’s recently proposed changes to the DSM criteria for PG. We also will review how clinicians can more accurately and efficiently diagnose clients seeking help for gambling-related problems by utilizing brief screens. Finally, we consider the importance of future research that can identify behavioral markers for PG. We suggest that identifying these markers will allow clinicians to make earlier diagnoses, suggest targeted treatments, and advance secondary prevention efforts. Original version available at http://www.annualreviews.org/toc/clinpsy/7/