Application of the biopsychosocial model to gambling
What is an addiction? What can it cause?
An addiction occurs when an individual 'feels' a constant urge to use a specific substance or engage in a certain activity despite the potentially negative consequences.
Physical dependence: Evident by withdrawals or cravings when activity is unavailable
Psychological dependence: The mental desire to experience the effects of the activity
An activity when something of value is put at risk on an uncertain or chance outcome.
What is a recreational gambler?
Gambles for social reasons and rarely go over limits. Do not experience adverse consequences
What is problem gambling?
Characterised by difficulties in limiting money and/or time on spent gambling which leads to adverse consequencesOn a continuum from recreational gambling to problem gambling. Symptoms vary in severity
What is pathological gambling?
Characterised by continuous gambling behaviour that disrupts personal, family and/or work related activitiesIt is a diagnosable mental disorder if individual shows 5 or more of the 10 symptoms
What are the 10 symptoms for pathological gambling? Brewlclipt
1. Preoccupation with gambling: at least 2 weeks or more thinking about it
2. Tolerance: increasing amount of bets or time spent
3. Loss of control: has tried several unsuccessful attempts to stop
4. Withdrawal: unpleasant physical/psychological reaction to reduction
5. Chasing: chase their losses
6. Lying: conceal information about gambling
7. Escape: Gamble to get away from daily life
8. Illegal activity: to obtain money
9. Risked relationships: puts people and relationships in danger
10. Bailout: receive money from friends or family to bail them out
What is the dopamine reward system?
Refers to a neural pathway in the brain that when stimulated, provides feelings of enjoyment and pleasure, which can reinforce and motivate a person to perform certain activities. It involves the neurotransmitter dopamine
The unpredictability increases the release of dopamine
What is reward deficiency syndrome?
An under active dopamine reward system. They do not experience pleasure and enjoyment from everyday activities. Seek out an extraordinary amount of excitement to feel the way others do normally.
Gambling provides this making them more likely to repeat it to receive the same feeling
How can you treat gambling by targeting the dopamine reward system?
Naltrexone: is an antagonist meaning it Inhibits dopamine at the synapse, by blocking dopamine at the receptor site of the post synaptic neuron
Also produces 'satiety'- feelings of having enough long before when they would normally
Therefore excitement is decreased making the gambler less likely to continue gambling as it no longer gives the same pleasure
How does the social learning theory apply to gambling?
Describes the way in which people acquire certain behaviours by watching and learning from their role models.
Gambling is caused by imitating role models through vicarious reinforcement
How does schedules of reinforcement affect gambling?
Due to the random ratio partial schedule of reinforcement, each act of gambling has an equal chance of reinforcement and thus winning is especially unpredictable
This causes the gambling behaviour to be highly resistant to extinction as play can be maintained for long periods of time without reward as a gambler has a conditioned expectation for an eventual win
Describe the psychodynamic theory
Is based on Freud's theories, gambling behaviour may be influenced by unconscious underlying reasons from the gambler's childhood/past
What is psychodynamic psychotherapy? Describe the different techniques
helps people understand the cause of the emotional distress which the problem of gambling revolves around
Free association: client is encouraged whatever comes to mind
Dream interpretation: client shares dreams as the psychodynamic perspective belives that it symbolises the unconscious mind
Identification of defence mechanisms: necessary as it prevents unconscious conflicts to be explored and resolved
Transference: respond to therapist as though they are a significant person in their life
social permission to gamble
Individual gambles based on social norms.Based on laws, culture and upbringing, gambling is viewed as socially acceptable and thus an individual experiences "permission to gamble"
What is the cognitive aspect of the CBT?(Psychological)
The first step of the cognitive component is to obtain info about the gambler's patterns and distortions. (role plays, diaries)
Gambler's fallacy: false belief that in a series of independent chance events, future events can be predicted from past ones
Illusion of control: the belief (illusion) that the outcomes of random unpredictable events can be influenced by one's thoughts or actions
Outcome: educate and assist the client to develop awareness of the relevant concepts such as randomness, probability, betting systems.
refers to various individuals or groups who maintain a relationship within an individual in different aspects of their lives.
The benefits of a social network is social support in the form of:
Tangible assistance (food, money)
social recovery groups
A group run by and for people who interact on the basis of common interest or experiences to support one another
Recovery is possible and that it can be achieved through a step by step process
What is the behavioural aspect of the CBT?
Assists the individual to manage arousal, anxiety or tension that is associated with the urges to gamble
Imaginal desensitisation: in this technique the gambler is asked to imagine being in a typical gambling situation while in a state of relaxation
Outcome: the goal is to extinguish the arousal and gambling and replace it with relaxation.