Figure D-18. Diagnostic Criteria for Pathological Gambling Compared to Substance Dependence Criteria

Diagnostic Criteria for Pathological GamblingComparable Substance Dependence Criteria
Persistent and recurrent maladaptive gambling behavior as indicated by five (or more) of the following: Maladaptive pattern of substance use, leading to clinically significant impairment of distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
• Is preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble)• A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain smoking), or recover from its effects
• Needs to gamble with increasing amounts of money to achieve the desired excitement• Tolerance
• Has repeated unsuccessful efforts to control, cut back, or stop gambling• There is a persistent desire or unsuccessful efforts to cut down or control substance use
• Is restless or irritable when attempting to cut down or stop gambling• Withdrawal
• Gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)• N/A
• After losing money gambling, often returns another day to get even (“chasing” one's losses)• The substance is often taken in larger amounts or over a longer period than was intended
• Lies to family members, therapist, or others to conceal the extent of involvement with gambling• The substance use is continued despite knowledge of having persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance
• Has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling
• Relies on others to provide money to relieve a desperate financial situation caused by gambling
• Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling• Important social, occupational, or recreational activities are given up or reduced because of substance use

Source: APA 2000.

From: Appendix D: Specific Mental Disorders: Additional Guidance for the Counselor

Cover of Substance Abuse Treatment for Persons With Co-Occurring Disorders
Substance Abuse Treatment for Persons With Co-Occurring Disorders.
Treatment Improvement Protocol (TIP) Series, No. 42.
Center for Substance Abuse Treatment.

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