Archive | 2019
The Epidemiology of Gambling Disorder
Abstract
This chapter reviews the epidemiology of gambling disorder (GD). Gambling behavior is common and occurs worldwide and is culturally universal. GD has an estimated lifetime prevalence in the USA ranging from 0.42% to 4.0%. Prevalence among youth may be even higher. Most people with GD are male and, while men have an earlier onset, women have a shorter course from onset of gambling to the development of GD. Nonwhite populations appear to be at particular risk for the development of GD, particularly African-Americans. The course of GD was once thought to be progressive and deteriorating, but more recent research suggests that the course oscillates with many individuals spontaneously improving or remitting. Suicidal thoughts and behaviors are common, often prompted by gambling losses. Psychiatric comorbidity is the rule and not the exception. Substance use disorders are highly prevalent in people with GD, followed by mood disorders, anxiety disorders, attention deficit/hyperactivity disorder, and disorders of impulse control. Personality disorders are also common, especially antisocial and borderline personality disorders. Many people with GD are highly impulsive, a personality trait that may serve as a bridge to GD. Subtypes of GD have been proposed, and there is some empirical evidence to support the “pathways” model that suggests the existence of behaviorally conditioned gamblers, emotionally vulnerable gamblers, and impulsive-antisocial gamblers.