criminal behavior—e.g., forgery, embezzlement, or fraud—is typically nonviolent. There is a conscious intent to return or repay the money.

Associated features. These individuals most often are overconfident, somewhat abrasive, very energetic, and "big spenders"; but there are times when they show obvious signs of personal stress, anxiety, and depression.

Age at onset and course. The disorder usually begins in adolescence and waxes and wanes, tending to be chronic.

Impairment. The disorder is extremely incapacitating and results in failure to maintain financial solvency or provide basic support for oneself or one's family. The individual may become alienated from family and acquaintances and may lose what he or she has accomplished or attained in life.

Complications. Suicide attempts, association with fringe and illegal groups, and arrest for nonviolent crimes that may lead to imprisonment are among the possible complications.

Predisposing factors. These may include: loss of parent by death, separation, divorce, or desertion before the child is 15 years of age; inappropriate parental discipline (absence, inconsistency, or harshness); exposure to gambling activities as an adolescent; a high family value on material and financial symbols; and lack of family emphasis on saving, planning, and budgeting.

Prevalence. No information.

Sex ratio. The disorder is apparently more common among males than females.

Familial pattern. Pathological Gambling and Alcoholism are more common in the fathers of males and in the mothers of females with the disorder than in the general population.

Differential diagnosis. In social gambling, gambling with friends is engaged in mainly on special occasions and with predetermined acceptable losses.

During a manic or hypomanic episode loss of judgment and excessive gambling may follow the onset of the mood disturbance. When manic-like mood changes occur in Pathological Gambling they typically follow winning.

Problems with gambling are often associated with Antisocial Personality Disorder and in Pathological Gambling antisocial behavior is frequent. However, in Pathological Gambling any



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