Prior to 2013, doctors used a diagnosis called pathological gambling to identify people affected by serious, dysfunctional gambling problems. This condition included the funding of gambling participation with illegal activities as one of its potential symptoms.
Doctors now identify serious gambling problems with a diagnosis called gambling disorder, which does not include gambling-related illegal activity on its symptom list.
In a study published in April 2014 in the Journal of Addictive Diseases, researchers from Spain and the U.S. investigated whether dysfunctional gamblers have an increased tendency to fund their gambling participation through illegal means.
Diagnosable gambling problems
The pathological gambling diagnosis was officially recognized by the American Psychiatric Association (APA) from 1980 to 2013. At the time, the research and medical communities did not view dysfunctional gambling as a form of addiction; instead, they classified the presence of serious gambling problems as a deficiency in normal impulse control.
However, a growing body of evidence indicated that dysfunctional gamblers develop many of the brain changes and behavioral changes once exclusively linked to alcohol or drug addiction. These non-substance-based changes in brain function and behavior are now identified collectively as a distinct form of addiction called behavioral addiction.
In May 2013, the APA acknowledged the existence of behavioral addictions and created a category for these conditions called addictive disorders. The APA also transformed the pathological gambling diagnosis into gambling disorder and officially defined this new diagnosis as a behavioral addiction/addictive disorder.
In order to meet the terms of the pathological gambling diagnosis, doctors needed to identify at least five out of 10 potential symptoms in their patients. One of these possible symptoms was the commission of “illegal acts such as forgery, fraud, theft or embezzlement to finance gambling.”
When the gambling disorder diagnosis was established in 2013, the American Psychiatric Association eliminated this symptom from the list of problems that doctors can identify. The APA also reduced the number of symptoms required for a diagnosis from five to four. These changes were made in an attempt to more accurately identify people affected by serious gambling problems and, not coincidentally, to take away some of the stigma that had built up around the presence of such problems.
Illegal activity participation
When the terms used to define addiction or any other serious mental/physical issues change, researchers typically conduct studies to determine how these shifting definitions affect the real-world identification of problems in human populations. In the study published in the Journal of Addictive Diseases, researchers from three Spanish institutions and one U.S. institution used a large-scale project involving 2,155 Spanish adults to investigate whether dysfunctional gamblers commonly use illegal activities to fund their habit. In effect, these researchers wanted to know if the new gambling disorder diagnosis accurately identifies the symptoms that appear in people affected by dysfunctional gambling.
All of the study participants were actively engaged in seeking help for their gambling problems. The researchers took note of the symptoms that occurred in each of these individuals and looked at how often funding of gambling through illegal means appeared on the symptom list. In addition, they used a statistical analysis to determine if the study participants who funded their gambling participation with illegal activity had more overall symptoms than other dysfunctional gamblers or more severe forms of other possible symptoms.
After completing their analysis, the researchers found that younger people diagnosed with dysfunctional gambling problems do have a greater tendency to participate in illegal activities than their older counterparts.
However, on the whole, the researchers concluded that the use of illegal activity to fund gambling participation is the least common symptom of dysfunctional gambling. In addition, they concluded that, when this symptom is removed from the definition of dysfunctional gambling, doctors can still consistently identify people affected by serious gambling-related problems.
Is the gambling disorder diagnosis accurate?
Based on their findings, the authors of the study published in the Journal of Addictive Diseases concluded that participation in illegal activity has only limited relevance as a symptom in people affected by dysfunctional gambling. In turn, they concluded that the American Psychiatric Association’s decision to change the terms used to define dysfunctional gambling appears to make good sense in real-world environments.
However, the study’s authors also note that, in some individuals, involvement in illegal activity does indicate the presence of serious gambling problems. Involvement in such activity also increases the potential for legal repercussions stemming from gambling participation.