Gambling Disorder DSM-5 Criteria

What is gambling disorder?

When clients seek help because gambling has escalated from occasional entertainment to excessive and uncontrollable behavior, it may be a sign of gambling disorder. Gambling disorder involves persistent betting habits that disrupt personal, financial, and social stability. This compulsive gambling can affect individuals of any age and often creates challenges for families and communities.  

People with gambling disorder typically engage in recurrent gambling behaviors, often escalating in severity, and may experience intense cravings to gamble. Pathological gambling can lead to problematic gambling behaviors that interfere with daily life and responsibilities, resulting in the prioritization of gambling over work, social activities, or personal well-being.

Family members often notice the emotional and financial strain caused by the individual's gambling problems, including losing money gambling, which can lead to a cycle of loss and regret. Despite attempts to stop gambling, individuals with this disorder may struggle to control their impulses, continuing to gamble despite the negative impact on their lives. Addressing gambling disorder is essential to help clients regain control, improve their well-being, and minimize its broader impact.

How is gambling disorder diagnosed?

Gambling disorder can begin in adolescence, young adulthood, or later in life, with women often experiencing a faster progression than men. A mental health professional or clinician diagnoses gambling disorders based on the criteria outlined in the 2013 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

The clinician evaluates the individual's gambling behavior, assessing for patterns that cause significant distress or impairment in daily life. Additionally, the mental health professional ensures that the gambling behavior is not better explained by another mental health condition.

DSM-5 diagnostic criteria for gambling disorder

The DSM-5 outlines the following diagnostic criteria for diagnosing gambling disorder:

A. Persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period:

1. Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
2. Is restless or irritable when attempting to cut down or stop gambling.
3. Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
4. Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).

5. Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
6. After losing money gambling, often returns another day to get even ("chasing" one's losses).
7. Lies to conceal the extent of involvement with gambling.
8. Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
9. Relies on others to provide money to relieve desperate financial situations caused by gambling.

B.  The gambling behavior is not better explained by a manic episode.

Specify if:

• Episodic: Meeting diagnostic criteria at more than one time point, with symptoms subsiding between periods of gambling disorder for at least several months.
• Persistent: Experiencing continuous symptoms, to meet diagnostic criteria for multiple years.

Specify if:

• In early remission: After full criteria for gambling disorder were previously met, none of the criteria for gambling disorder have been met for at least 3 months but for less than 12 months.
• In sustained remission: After full criteria for gambling disorder were previously met, none of the criteria for gambling disorder have been met during a period of 12 months or longer.

Specify current severity:

• Mild: 4–5 criteria met. 
• Moderate: 6–7 criteria met. 
• Severe: 8–9 criteria met.

How is gambling disorder treated and managed?

Gambling affects everyone differently, so what works for one person might not work for another. That's why finding an approach that fits the individual's unique needs and situation is important. A comprehensive evaluation by mental health professionals is essential for diagnosing the disorder accurately and creating a personalized treatment plan. Here are some of the common interventions for gambling disorders:

Cognitive behavioral therapy (CBT)

CBT is one of the most widely used and effective treatments for gambling disorder. This therapy helps individuals recognize and change maladaptive gambling behaviors, as well as the distorted thinking patterns that contribute to gambling. CBT also focuses on helping individuals develop healthier coping strategies and problem-solving skills, ultimately reducing the urge to gamble.

Family therapy

Since gambling disorder often impacts personal relationships, family therapy is an integral part of treatment. This type of therapy helps family members understand the disorder, improve communication, and develop supportive strategies to assist the individual in their recovery process.

Support groups

Support groups like Gamblers Anonymous (GA) provide a vital support network for those struggling with gambling behavior. These groups offer peer support and a sense of community, often following a 12-step program. Members share their experiences, offer encouragement, and work together toward overcoming their addiction. Gambling helplines are also available to offer valuable resources for both individuals and families. These services provide guidance on managing gambling problems and access to further treatment options.

Continuous support and monitoring

Treating gambling disorder requires continuous support, as there is a significant risk of relapse, especially for those who also struggle with substance use disorders or impulse control disorders. Regular follow-ups with healthcare professionals and sustained participation in support groups can help maintain progress. With the right treatment plan, individuals can manage their gambling behaviors, restore personal relationships, and regain financial stability.

Reference

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Pearson.