among pathological gamblers (Specker et al., 1996). Whereas gambling involvement may serve to manage or attenuate highly uncomfortable emotions, alternatively, gambling may also reflect attempts to regulate or shift emotions from one state to another to satisfy a need for novel experiences or entertainment. The experience of altered emotional states may not predate the onset of gambling problems. It is possible that people shift their emotional states using gambling, and then fall into a gambling pattern that stimulates problems.

There is considerable consensus that gambling involves impulsiveness. In some studies, data do not systematically address the extent to which risk-taking and other dimensions of impulse control (i.e., sensation-and novelty-seeking, arousal, negative emotionality) are interrelated, or how they interact to affect initiation into and progression of gambling behavior. The established relationship between behavioral disinhibition and gambling may be the result of the correlation of each variable with sensation-seeking. Increased heart rates may be more attributable to other causes, like the anticipated outcome of a future event, not the response to an immediate event, such as the excitement of a race (Coventry and Norman, 1997), or verbalizations made by the gambler during gambling (Coulombe et al., 1992; Gaboury and Ladouceur, 1989; Gaboury et al., 1988; Griffiths, 1994; Ladouceur et al., 1988). And although the retrospective study by Rugle and Rosenthal (1993) suggests that, at least in a subgroup of pathological gamblers with high impulsivity, the impulsivity preceded the onset of gambling problems, longitudinal studies have not been conducted to establish that differences in impulse control characteristics predate the onset of gambling disorders, a necessary condition to establish a causal relationship. Interestingly, however, prospective studies are beginning to emerge suggesting that these traits may be transmitted genetically (Comings, 1998).

Preoccupation, tolerance, and other DSM-IV criteria for pathological gambling, such as repeated unsuccessful efforts to stop gambling and becoming restless or irritable when attempting to stop, are indicative of physiological dependence (Wray and