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Compulsive gambling, known formally as pathological gambling, is a psychiatric disorder that involves a persistent fixation with gambling that continues in the face of seriously negative personal or social consequences. Along with a varied range of other conditions that feature impulsive behavior, it’s officially categorized as an “impulse disorder not otherwise specified.” Current guidelines group all compulsive gamblers together. However, according to the results of a study published in 2010 in the Canadian Journal of Psychiatry, compulsive gamblers actually belong to one of four different sub-types, two of which include features of certain personality-based mental illnesses called personality disorders.
The American Psychiatric Association, a professional organization responsible for creating the standard definitions for mental illness in the United States, recognizes 10 distinct symptoms in compulsive or pathological gamblers. These symptoms include a fixation on gambling that persists outside of actual gambling situations, a repeated inability to control one’s gambling behaviors, increased moodiness when not involved in gambling, repeated lying about gambling activities, increased excitement when betting higher and higher amounts of money, a recurring need for help to recover from gambling debts, a rapid return to gambling after a big loss, use of gambling as a “mood lifter,” commission of crimes to sustain gambling activities and levels of gambling involvement that permanently damage one’s social or personal standing. In order to receive a diagnosis, any given individual must have a minimum of five of these symptoms.
As is true with a number of other non-substance-based impulsive or compulsive behaviors, mental health professionals increasingly view pathological gambling through the lens of mental/biological addiction. In the initial stages of his or her involvement, a given individual may feel entirely free to choose how he or she behaves in response to the gambling urge. However, over time, that sense of freedom and voluntary action starts to fade and gets replaced by an involuntary need for gambling that gradually supersedes all other relevant priorities. Specific problems that can increase the probability of a shift from voluntary to pathological gambling behaviors include substance addiction and the presence of antisocial personality disorder or various forms of schizophrenia.
Since the introduction of pathological gambling as a form of defined mental illness, a key feature of diagnosing the condition has been the identification of an inability to control the gambling impulse. However, according to the authors of the study published in the Canadian Journal of Psychiatry, this criterion does not accurately reflect the mental status of all people who otherwise meet the criteria for a pathological gambling diagnosis. Instead, after examining the psychological profiles of more than 1,100 compulsive gamblers, they concluded that people affected by the disorder actually fall into one of four separate personality-based sub-types.
According to the study authors’ classifications, people with Type 1 pathological gambling have personality traits that resemble the traits in people who have a condition called schizotypal personality disorder. People with this disorder are well oriented toward reality, but exhibit dysfunctional degrees of emotional disorganization, emotional instability and impulsivity; typically these traits first arise early on in life. People with Type 2 pathological gambling have personality traits associated with another condition called schizoid personality disorder. This condition closely resembles schizotypal personality disorder; however, unlike schizotypal individuals, schizoid individuals are not bothered by any personal or social disruptions caused by their illness.
People with Type 3 pathological gambling (as defined by the scheme presented in the Canadian Journal of Psychiatry) gamble out of an impulsive desire/need for a “rush” of sensation; typically, they don’t have symptoms of any particular sort of personality disorder. People with Type 4 pathological gambling also have no traits that correspond with a specific personality disorder; instead, they have what’s known as a “globally adaptive” personality, which allows them to change their behaviors according to their local surroundings.
The authors of the study in the Canadian Journal of Psychiatry believe that only people with Type 2 pathological gambling have a combination of personality disorder-related traits and impulsive or uncontrolled behavior that make them truly “pathological” (that is to say, extremely or excessively abnormal in some way). According to their findings, other people classified as pathological gamblers have definite, identifiable problems, but don’t rise to the same level of mental illness. Despite the results of this study, guidelines for compulsive or pathological gambling remain unchanged in 2013 and do not reflect the sort of symptom breakdown undertaken by the study’s authors.