Gambling is wagering something of value on an event whose outcome is determined at least partly by chance, with the intent of winning something else of value. It has existed in virtually all societies since prerecorded history and has been incorporated into many rituals and rites of passage. It is considered an addictive activity and can lead to serious problems when it becomes out of control.
Although gambling takes a variety of forms, it is characterized by the following general elements: (1) a bet on an event or a specific game with the potential to win something of greater value; (2) an exchange of money or other real goods for a prize; (3) an element of risk, where instances of skill are discounted (e.g., card games involving learning strategies, horse races based on jockey and trainer skills). Insurance is excluded from the definition of gambling because it involves a transfer of risk between individuals; however, the use of actuarial methods to calculate premiums and odds of winning are reminiscent of the mathematical and probability skills involved in gambling.
Problem gambling is often characterized by the following symptoms: (1) a desire to gamble, despite negative consequences; (2) an inability to stop gambling even when the urge is strong; (3) lying to family members or therapists about the extent of involvement with gambling; (4) attempts to get back losses by increasing bets (chasing); and (5) financial difficulties caused by gambling. Some people may also experience depression, anxiety, or substance abuse that can be triggered by gambling or made worse by compulsive gambling.
A growing number of primary care physicians are evaluating patients for gambling behavior disorders.1 In addition, there is a growing body of evidence that pathological gambling is associated with poor health outcomes.1
Traditionally, the diagnosis of gambling disorder has been based on clinical and neurobiological criteria that are consistent across the different types of gambling activities. Nevertheless, a broad spectrum of psychological and neurobiological processes and events underlie all types of gambling and can account for the majority of behavioral abnormalities.
A recent study examined the behavior of players of popular video games in which players open loot boxes with a chance to receive rewards that range from coins to rare weapons and armor. The researchers found that more than half of the games they examined met the criteria for gambling, including Madden NFL 18, Assassin’s Creed Origins, and FIFA 18. The authors concluded that “gambling-like features are present in popular and commercially successful games, despite these games being marketed as family-friendly.” They called for a review of the current definition of gaming to consider whether it should be expanded to include these newer forms of gambling. The full article is available at the journal Nature Human Behavior. Licensed therapists are available through BetterHelp. Take our free assessment and be matched with a therapist in as little as 48 hours.