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Health Risks & Behaviors
Gambling & Other Process Addictions
Process addictions such as pathological gambling,
Internet addiction, food addiction, etc., show
neurobiological, stimulus-reward patterns similar
to substance addictions. In addition, process
addictions show similarities in the progression
from social use to abuse and dependency. And
just like substance dependence, process addictions
may result in compulsive behaviors and craving,
continuing the behavior in spite of adverse
consequences, and loss of control over the behavior.
Scientists now acknowledge the similarities
between substance dependence and pathological
gambling.
The National Council on Problem Gambling
(NCPG, 2012) estimated that 85% of all U.S.
adults have gambled at least once in their lives
and 60% have gambled in the past year. Of these,
approximately 1%, or 2 million adults, met the
diagnostic criteria for pathological gambling, and
2-3%, or 4-6 million, were problem gamblers
(NCPG, 2012). In a nationally representative study
of U.S. households between 2001 and 2003, 78.4%
of participants reported gambling at least once in
their lifetime; the prevalence estimate for lifetime
problem gambling was 2.3%; and the estimate
for lifetime pathological gambling was 0.6%
(Kessler et al, 2008). Age of onset for those who
eventually became problem gamblers (median age
= 21) was later than for non-problem gamblers
(median age = 18; p. 1354). Rank-order popularity
of different types of gambling did not differ across
pathological and non-problem gamblers. However,
the percentage of pathological gamblers who chose
specific types of gambling was higher than for all
gamblers (see Figure HR12).
Fig. HR12: Popularity of Gaming by
Gambler Type
Speculating on High Risk Investments
Internet Gambling
Sports Betting: Bookie/Parlay Card
Office Sports Pools
Gambling at a Casino
Slot Machines or Bingo
Numbers/Lotto
All Gamblers
8.4%
26.9%
1.0%
7.5%
5.8%
45.3%
44.3%
85.1%
44.7%
78.5%
48.9%
77.3%
62.2%
86.5%
Pathological Gamblers
In addition, the odds of developing a pathological
gambling disorder increased by type of gaming.
Games requiring mental skill (card games such
as poker, bridge, etc.) posed the highest risk of
association with pathological gambling. Further,
Kessler et al.’s (2008) study supported previous
research showing comorbidity between pathological
gambling and bipolar disorder, substance use
disorders, and panic disorder. These mental health
disorders preceded the onset of pathological
gambling.
Gambling studies of adults 50 and older also
indicated an increase in prevalence of lifetime
gambling, from 35% in 1975 to 80% in 1998
(National Opinion Research Center, 1999, in Tse,
Hong, Wang & Cunningham-Williams, 2012,
p. 639). Prevalence rates of lifetime pathological
gambling varied widely based on the populations
selected (e.g., older adults in nursing facilities
versus those in casinos or bingo establishments),
the gambling-assessment instruments used, and
the types of gambling assessed (Tse et al, 2012).
However, all studies consistently reported lower
prevalence of problem/pathological gambling
in older adults than in younger adults, and that
gambling disorders were more prevalent among
older males than older females (Tse et al, 2012, p.
645).
Stitt, Giacopassi and Nichols’ (2003) study of older
adults and gambling in casinos suggests that casino
gambling might not be a major threat to older adults.
In a survey of 2,768 individuals, these researchers
found that adults 63 and older were more likely
to visit casinos than were adults 62 and younger;
however, there were no age differences in the time
spent in the casinos. A greater percentage of older
females (43.7%) indicated they gambled than older
males (33.3%). Older adults tended to spend less
money gambling than younger adults, and fewer
older adults reported losing more money than they
could afford.
100
(Kessler, Hwang, LaBrie, Petukhova, Sampson, Winters, &
Shaffer, 2008)