activity increase during periods of stress. Problems that arise as a result of the gambling lead to an intensification of the gambling behavior. Characteristic problems include extensive indebtedness and consequent default on debts and other financial responsibilities, disrupted family relationships, inattention to work, and financially motivated illegal activities to pay for gambling.

Associated features. Generally, people with Pathological Gambling have the attitude that money causes and is also the solution to all their problems. As the gambling increases, the person is usually forced to lie in order to obtain money and to continue gambling. There is no serious attempt to budget or save money. When borrowing resources are strained, antisocial behavior in order to obtain money is likely.

People with this disorder are often overconfident, very energetic, easily bored, 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 in males, and later in life in females. It waxes and wanes, but tends 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 person may become alienated from family and acquaintances.

Complications. Psychoactive Substance Abuse and Dependence, suicide attempts, association with fringe or illegal groups (more common in males), civil actions, and arrest for typically nonviolent crimes involving only property are among the possible complications.

Predisposing factors. Among the predisposing factors are inappropriate parental discipline (absence, inconsistency, or harshness); exposure to gambling activities as an adolescent; and a high family value placed on material and financial symbols and a lack of family emphasis on saving, planning, and budgeting. Females with this disorder more likely than others to have a husband with Alcohol Dependence or who is absent from the home.

Prevalence. Recent estimates place prevalence at 2%-3% of the adult population.



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