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Understanding gambling addiction's many manifestations.

Pathological Gambling: A Clinical Guide to Treatment

Jon E. Grant, J.D., M.D., M.P.H., Marc N. Potenza, M.D., Ph.D. (eds.)

American Psychiatric Publishing, Inc., Washington, D.C. (800-368-5777), 2004.

ISBN: 1-58562-129-3. Paperback, 288 pages.

Although patients with behavioral health disorders have higher rates of pathological gambling than do members of the general population, clinicians often fail to diagnose gambling disorders. Few behavioral health professionals have understood the phenomenology, epidemiology, neurobiology and psychology of this disastrous disorder.

Pathological gambling is devastating, both on a social and personal level. The personal consequences can include family dysfunction and domestic violence, substance use problems and financial ruin. These problems may then lead to criminal behaviors, such as prostitution, theft, drug trafficking and homicide. Some pathological gamblers are driven to commit suicide.

Fortunately, research in the past five years has significantly advanced the understanding of this disorder. That new understanding is ably described in this volume by 32 authorities whose expertise covers the complete spectrum of gambling disorders. Readers can discover from these experts how to recognize, diagnose and treat this menace. They will gain knowledge of the current clinical approaches most likely to lead to early identification, symptom remission and maintenance.

Co-editors Grant, assistant professor of psychiatry and human behavior at Brown Medical School and director of the Impulse Control Disorders Clinic at Butler Hospital in Providence, R.I., and Potenza, assistant professor of psychiatry at the Yale University School of Medicine, have organized the book into four user-friendly sections:

Public Health and Epidemiology: This section discusses prevalence and definitions of recreational gambling, problem gambling and pathological gambling. In addition, the relationship among the levels of gambling severity is discussed. The effects of gambling on societal, familial and individual health and well-being are explored. The epidemiology portion will help clinicians recognize how likely they are to encounter the problem.

Clinical Characteristics: Here readers will find a comprehensive description of the symptoms of pathological gambling, and how gambling differs in the adolescent population, the older adult population and between men and women. This section also discusses the categorization of pathological gambling and how, rather than being categorized as a single disorder, it shares important features with disorders such as obsessive-compulsive spectrum disorders, affective spectrum disorders, addiction, and impulse-control disorder.


Etiology: Two explanations for the behaviors of pathological gambling are described: psychology (behavioral, cognitive and dispositional theories), and neurobiology (noradrenergic, serotonergic, dopaminergic and opioidergic systems as well as familial and inherited factors). This information may be useful in understanding a range of addictive and impulsive disorders.

Prevention and Treatment: This section highlights the clinician's role in prevention efforts and includes a prevention strategy specifically aimed at adolescents and young adults. There is also discussion of a variety of behavioral and pharmacological interventions for patients, including self-help and professional-based interventions for family members. The concluding chapter on screening and assessment catalogs each instrument currently available for adults. The authors discuss the development, content, intended purpose, psychometric properties (reliability, validity and classification accuracy), norms, administration methods, scoring and interpretation of each instrument. A synopsis of instruments is included at the end of the chapter.

The appendices contain a wealth of practical tools, including the DSM-IV-TR Criteria for Pathological Gambling, the Early Intervention Gambling Health Test (EIGHT), the Gambling Symptom Assessment Scale (G-SAS), the South Oaks Gambling Screen (SOGS), and the Yale-Brown Obsessive-Compulsive Scale Modified for Pathological Gambling (PG-YBOCS).

Behavioral health professionals will find this up-to-date source of information from renowned experts a welcome addition to their bookshelves.
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Author:Jackim, Linda Watts
Publication:Addiction Professional
Article Type:Book Review
Date:Jan 1, 2005
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