ducting the studies required by the Commission under section 4(a), and in particular the assessment required under subparagraph (C) of paragraph (2) of such section." In response to a subsequent request from the National Gambling Impact Study Commission, the National Research Council established the Committee on the Social and Economic Impact of Pathological Gambling.

The committee's charge was to identify and analyze the full range of research studies that bear upon the nature of pathological and problem gambling, highlighting key issues and data sources that may provide scientific evidence of prevalence and multiple effects.

In its review and assessment of the contemporary research on pathological and problem gambling, the committee examined the diverse and frequently debated issues regarding the conceptualization of pathological gambling, its prevalence and effects on individuals and society, its causes and cooccurrences with other psychiatric disorders and substance abuse, what we know about preventing and treating it, and the role of technology in the development of gambling. This review included consideration of over 4,000 gambling-related references, of which approximately 1,600 were determined to be related to pathological or problem gambling. Of these, about 300 were found to be empirical research studies. It was this relatively narrow subset of studies, primarily published in peer-reviewed journals, that the committee concentrated on in determining the strength of the available literature in all key areas.

Brief History of Pathological and Problem Gambling

For as long as humans have gambled, there has been apprehension about excessive risk-taking and intemperate gambling. Histories of gamblers who lose control recur through the centuries, and from early times their behavior was labeled an addiction (France, 1902, cited by Wildman, 1997). In early Roman law, the original addict was a debtor (Rosenthal, 1992) who, because he could not pay what he owed, was brought into court and enslaved (Glare, 1982; Wissowa, 1984). Hence, judges pronouncing sentence could make the addict the slave of his creditor. These early



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