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This
glossary, originally compiled by the North American Association
of State & Provincial Lotteries (NASPL), is intended as a guide
to help the reader through literature relating to problem and pathological
gambling. Several sources were used in the compilation of this glossary
by NASPL; most notable are The International Dictionary of Psychology
(second edition) by Stuart Sutherland (Crossroad Publishing, 1996)
and The Penguin Dictionary of Psychology (second edition) by Arthur
Reber (Penguin Books, 1995). The reader should note that within
the scientific and treatment communities there is not complete agreement
on the exact definitions of some of these terms.
Abstinence:
The theory that a pathological gambler in recovery must completely
abstain from all gambling. Abstinence is the goal of Gamblers Anonymous
and most, though not all, treatment professionals.
Affective
disorder: A category of disorders
in which the individual experiences excessive depression or elation.
Examples include depression and bipolar disorder (manic-depression).
Affective disorders are often found among pathological gamblers.
Anti-social
personality disorder (ASPD): A disorder characterized by extreme
anti-social behavior, usually beginning in childhood and often accompanied
by a lack of remorse and a disregard of punishment. Also referred
to as sociopathic personality and psychopathic personality.
Anxiety
disorder: A category of disorders in which the individual experiences
extreme anxiety. Examples include phobias, post-traumatic stress
disorder and obsessive-compulsive disorder.
Attention
deficit hyperactivity disorder (ADHD): A disorder of childhood
and adolescence characterized by lack of impulse control, inability
to concentrate and hyperactivity. Also called attention deficit
disorder (ADD). The existence of ADHD in adults is a question still
debated in the mental health field.
Aversion
therapy: A behavior modification technique that seeks to eliminate
a behavior by providing punishment when that behavior occurs.
Bad
beat: A term used by gamblers to describe a run of bad luck.
Bailout:
Money given to a gambler that allows them to pay debts without suffering
adverse consequences.
Behavioral
therapy: A therapeutic method that focuses on modifying or "unlearning"
a maladaptive behavior without consideration of any underlying causes.
Behavioral
disinhibition: The inability or unwillingness to inhibit behavioral
impulses.
Benozodiazepines:
A family of anti-anxiety drugs. Valium is a prominent example.
Bipolar
disorder: An affective disorder in which both manic and depressive
episodes occur. Bipolar disorders are sometimes diagnosed in pathological
gamblers.
Brief
Symptom Inventory (BSI): An assessment device sometimes used
in gambling treatment. The BSI is not concerned with gambling per
se.
California
Personality Inventory (CPI): An assessment device sometimes
used in gambling treatment. The CPI is not directly concerned with
gambling.
Chasing:
The attempt by a gambler to make up previous losses through additional
gambling, a common symptom of a pathological gambler. Chasing often
involves making larger bets and/or taking greater risks.
Chronic:
Long-lasting.
Cognitive
disorders: Faulty thinking, as when gamblers "know"
their luck is about to change.
Comorbidity:
The presence of multiple disorders in one individual. Pathological
gambling has high rates of comorbidity with disorders such as alcoholism
and depression.
Compulsion:
An irresistible urge to do something against one's better judgement.
Compulsive behaviors are often repetitive in nature, and the person
recognizes that the compulsion is irrational. Whether or not problem
gambling is considered a compulsion is a topic of debate within
the mental health profession; the prevailing opinion is that it
is not.
Compulsive
gambling: The term most commonly used by the public to describe
someone with a gambling disorder, but generally rejected by the
therapeutic community in favor of pathological gambling. The term
disordered gambling is also sometimes used.
Controlled
gambling: A theory of treatment for pathological gambling
in which the patient is allowed to gamble on a limited basis. Controlled
gambling currently has few adherents in North America but is somewhat
more popular overseas.
Cumulative
Clinical Signs Method (CCSM): An instrument for the assessment
of gambling problems developed by Robert Cullerton. The CCSM has
been used very infrequently for estimating the extent of problem
gambling.
Depression:
An affective disorder characterized by extreme and intense sadness,
pessimism, sense of inadequacy, etc.
Diagnostic
and Statistical Manual of Mental Disorders (DSM): A manual produced
by the American Psychiatric Association that catalogs mental disorders.
The fourth edition (DSM-IV), published in 1994, characterizes pathological
gambling as an impulse disorder and lists 10 characteristics of
a pathological gambler. Five of the ten must be present for a diagnosis
of pathological gambling to be made. In addition to its use in clinical
assessments, the DSM-IV criteria have been used in studies to determine
the prevalence of pathological gambling in the general population.
The DSM-IV criteria are generally considered to be more conservative
than those used in the South Oaks Gambling Screen (SOGS).
DSM-IV:
Literally, the fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders. However, in the gambling literature,
a reference to the 10 characteristics presented in the manual as
indicative of pathological gambling.
Diagnostic
Interview for Gambling Severity (DIGS): A structured interview
consisting of 20 questions used to determine if the DSM-IV criteria
for pathological gambling are met. It was devised by Dr. Ken Winters,
Dr. Sheila Specker, and Dr. Randy Stinchfield in 1997 and to date
has been used for clinical evaluation rather than prevalence estimates.
Disordered
gambling: A term coined by Howard Shaffer, Matthew Hall, and
Joni Vander Bilt in 1997 to encompass the range of pathological,
problem and excessive gambling. In their lexicon, level 1 of disordered
gambling includes those with no gambling problems, level 2 includes
people with gambling problems who do not meet the criteria for pathological
gambling, while level 3 includes pathological gamblers.
Dual
diagnosis: See comorbidity.
Dysphoria:
An unpleasant mood characterized by anxiety or discontent, such
as the shame and guilt often experienced by problem and pathological
gamblers.
Dysthymia:
Despondency or depression.
Dysthymia
disorders: An affective disorder involving a prolonged depressed
mood, less severe than depression.
Emotionality:
Observable behaviors thought to be indicative of underlying emotions.
Epidemiology:
The study of the occurrence of a disease in a population.
Etiology:
The study of the causes of disease.
Familial:
Pertaining to the family.
Gam-Anon:
A fellowship for the families of pathological gamblers with chapters
throughout North America.
Gamblers
Anonymous (GA): An international network of groups for people
attempting to recover from pathological gambling. Gamblers
Anonymous is a 12-step program modeled after Alcoholics Anonymous.
Local chapters provide fellowship in which people share their experiences,
support, and hopes in order to stop gambling.
Gamblers
Anonymous 20 Questions (GA-20): A list of 20
questions devised by Gamblers Anonymous to help individuals
decide if they have a gambling problem. According to GA, most people
with gambling problems will answer "yes" to at least seven
of the 20 questions. The questions have not been scientifically
validated.
Hypomanic:
A mild form of bipolar disorder in which the person displays mildly
yet persistent manic behaviors ‚ talking too much, spending money
wildly, etc.
Impulse
control disorder: A class of disorders characterized by the
inability to resist certain acts, usually with harmful consequences.
Pathological gambling is considered in the DSM-IV as an impulse
control disorder, as are kleptomania, pyromania, and other "addictive"
behaviors.
Incidence:
The rate of new cases of a disorder over a specified period of time.
See also prevalence.
Mania:
A mood disorder characterized by pathological over-excitement.
Manic-depressive
disorder: An affective disorder characterized by mania, depression,
or, in the case of bipolar disorder, both.
Massachusetts
Gambling Screen (MAGS): An instrument for the assessment of
pathological or problem gambling based on the DSM-IV criteria.
Minnesota
Multiphasic Personality Inventory (MMPI): A widely used instrument
for assessing personality, the MMPI is often used as part of the
initial assessment of pathological gamblers.
Mood
disorders: See affective disorders.
Neurotransmitter:
A chemical substance that naturally occurs in the brain and is responsible
for communication among nerve cells.
NORC
DSM Screen for Gambling Problems (NODS): A structured interview
used to determine the prevalence of problem gambling in a population.
The NODS consists of 17 questions designed to reflect the DSM-IV
criteria and was devised by the National Opinion Research Center
(NORC) for the 1999 National Survey of Gambling Behavior. The NODS
classifies respondents as non-gamblers, low-risk (gamblers with
no adverse effects), at-risk (gamblers meeting one or two of the
DSM criteria), problem (gamblers meeting three or four criteria),
and pathological (gamblers meeting five or more criteria.)
Norepinephrine:
A neurotransmitter within the central nervous system that is widely
studied in both affective disorders and substance abuse.
Obsessive-compulsive
disorder: A type of anxiety disorder typified by persistent
thoughts and ideas and repetitive behavior. Pathological gambling
is not an obsessive-compulsive disorder though it is often confused
with one (hence the professional dissatisfaction with the term compulsive
gambling). "Obsessive-compulsive" is more properly applied
to behaviors such as repetitive handwashing from which the person
gets no pleasure.
Pathological
gambling: A chronic inability to resist the impulse to gamble.
The term is usually limited to cases where the gambling causes serious
damage to a person's social, vocational, or financial life. Often
referred to as compulsive gambling and less frequently as disordered
gambling, it is considered by most to be an impulse control disorder.
It is not synonymous with problem gambling.
Personality
disorder: Generally, any disorder characterized by behavior
that causes impaired social functioning. The term, however, has
been used to describe a very wide range of psychological disorders
in both more general and more specific ways than the definition
given above.
Pharmacotherapy:
The use of drugs to treat a disorder.
Prevalence:
The proportion of a population having a condition at a given point
in time or over a fixed period of time. See also incidence.
Problem
gambling: Gambling activity that causes difficulty for the individual
but does not meet the standards for pathological gambling. Sometimes
referred to as "at-risk," "in-transition" or
"potential pathological" gambling, though it is not known
at what rate problem gamblers become pathological gamblers. Referred
to by Shaffer, Hall and Vander Bilt (1997) as level 2 of disordered
gambling.
Professional
gambling: One who gambles as a way to make part or all of their
living. Often confused with pathological gamblers, professional
gambling is characterized by limited risks, discipline, and restraint,
items all lacking in the pathological gambler. Professional gambliers
wager on games with skill elements rather than games of chance,
and wait to bet until the odds are more in their favor. Professional
gamblers can, however, lose control and exhibit chasing behavior,
at which time they become problem or pathological gamblers.
Recreational
gambling/gambler: See social gambling.
Research
Diagnostic Criteria (RDC): A list of criteria where a certain
number must be met for a diagnosis to be made. For example, the
DSM-IV enumerates 10 criteria for pathological gambling, five of
which must be met before a diagnosis can be made.
Schizophrenia:
A general term for a wide range of mental disorders characterized
by a disassociation of sensory input, feelings and emotions on one
hand and thoughts on the other. Symptoms can include hallucinations,
hearing voices, a feeling that one's thoughts or actions are under
someone else's control, and many others. Schizophrenia is found
in pathological gamblers, though not as commonly as depression.
Schizoaffective
disorder: A disorder with symptoms of both schizophrenia and
manic-depressive disorder.
Serotonin:
A neurotransmitter within the central nervous system widely studied
in affective disorders and substance abuse.
Social
gambler/gambling: Gamblers who
exhibit few or none of the difficulties associated with problem
or pathological gambling. Social gamblers will gamble for entertainment,
typically will not risk more than they can afford, often gamble
with friends, chase losses briefly, gamble for limited periods of
time, and are not preoccupied with gambling. Synonymous with recreational
gambling. Level 1 on Shaffer et al's typology of disordered gambling.
South
Oaks Gambling Screen (SOGS): A series of questions used to determine
the presence of a gambling problem. Developed by Henry Lesieur and
Sheila Blume of the South Oaks Psychiatric Hospital, the instrument
consists of 20 items, with a score of five or higher considered
evidence of pathological gambling. The South Oaks Gambling Screen
has been the most widely used instrument in assessing the prevalence
of pathological gambling among the general public, though it has
not been specifically validated for that use.
SOGS-RA:
A modified version of the South Oaks Gambling Screen used in assessing
adolescents.
Spontaneous
remission: The lessening or abatement of a disorder (such as
pathological gambling) without assistance from a therapist, counselor,
or medical practitioner.
Tilt:
A term used by gamblers to refer to the process of losing control
over gambling.
Twelve-step
program: A program for treating an addiction, based on the 12
steps first espoused by Alcoholics Anonymous.
Our
thanks to the North American Association of State & Provincial Lotteries
for compiling the above definitions and terms.
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