Written Assignment: Students will be asked to complete a writing assignment on mental health issue (7-10 pages of written work). In DSM-V significant changes are being proposed to revise diagnostic...

Gambling Disorder: An Addiction in the New DSM-5
Gambling Disorder is a new addition to the revised chapter of ―Substance-Related and
Addictive Disorders‖ in the fifth edition of the Diagnostic and Statistical Manual for Mental
Disorders (DSM-5). The DSM-5 that was released in May 2013 changed the category of
Pathological Gambling and gave it a new name—Gambling Disorder. Gambling Disorder is
new to the category of Addictive Disorders, however, ‗Pathological Gambling‘ was a part of

the chapter on ―Impulse Control Disorders Not Elsewhere Classified,‖ in the earlier versions
of the DSM starting from DSM-III. The DSM-5 has come out with a revised diagnosis of
Gambling Disorder and has grouped it with substance use disorders. This was done after
noting the many similarities between gambling addiction and substance use addiction in the
clinical presentation, brain reward system changes, co-occurring disorders, and most
importantly treatment.
Dependence has traditionally only been associated with the intake and misuse of
substances. According to The World Health Organization (WHO) dependence can be defined
as a mental state, and usually also a physical state, that‘s results when an organism interacts
with a substance. Dependence leads to a state in which there are changes in the individual‘s
behaviour, and urge to use the substance that seems irresistible and the individual does this in
order to experience the effects of the substance or to avoid the unpleasant withdrawal
symptoms that result when not using the substance.
However, an addiction may be acquired and the individual may engage repeatedly and
maladaptively in certain behaviours in an addictive fashion. Thus, addictions may be
substance addictions, in which a psychoactive substance is causing the dependence, or non-
substance addictions towards activities like working, eating, sex, shopping, and gambling.
This current understanding of addictions can also be found in common language and
literature and we do call many habitual activities as addictions and dependences. This
categorization of behavioural addictions has been controversial as traditionally these
behaviours have been associated with Obsessive –compulsive disorder or categorized under
impulse control disorders like gambling was until DSM-5.
Gambling Disorder
Gambling Disorder is the reclassified version of Pathological Gambling. The DSM-IV
listed pathological gambling disorder under the category of impulse control disorders.
Pathological Gambling has been associated with persistent and recurrent gambling
episodes that are maladaptive and cause not only economic problems, but also significantly
disturb the individual‘s personal, social or occupational functioning.
Pathological Gamblers often seems overconfident, abrasive, free-spending and
energetic. Stress, anxiety as well as depression are often visible in gamblers. In it not
uncommon that they would see money as their biggest problem, but unfortunately they also
see money as the solution to their problems. Money issues are bound to come in when they
are in a state of loss of control and no longer have the money to gamble. They are then forced
to lie so that they can get the money to be able to continue gambling. When borrowing does
not remain a viable option, they turn to stealing and fraud. Usually their criminal behaviour is
limited to embezzlement, fraud, etc. and they may consciously intend to return any money
they take though practically that does not work out. Alienation from friends, family and
social life, financial loss, loss of other accomplishments, illegal associations and suicide
attempts are frequent complications.
There is a dearth of worldwide epidemiological data on PG, but according to local
studies the expected prevalence in the general population is of about 3 to 5 percent problem
gamblers and 1 percent who can be diagnosed with DSM IV criterion for Pathological
Gambling.
Pathological Gambling has been considered a disorder by the DSM since 1980 when
it was first classified by the efforts of Dr. Robert Custer. The first diagnostic criterion was
based on the clinical experience of Custer and other professionals rather than on research. PG
had been classified under the category of impulse control disorders. The criterion comprised
of seven items revolving around disruption and damage to the individual and his or her
personal life, family life or vocational life and other financial issues.
In DSM IV, revisions were made that reflected the similarity between pathological
gambling and substance dependence–―repeated unsuccessful attempts to control, cut back or
stop gambling‖—was added. The DSM IV has ten diagnostic criterion that carry an equal
weight, and five criterion need to be met for a diagnosis of pathological gambling. However,
DSM IV also pointed out there is a comorbidity of PG with...