Second, some individuals use problem gambling as an escape from the problems in their lives (an example of negative reinforcement). Several psychological mechanisms are thought to be implicated in the development and maintenance of problem gambling. These authors point out that social factors may be a far more important determinant of gambling behavior than brain chemicals, and they suggest that a social model may be more useful in understanding the issue. Some medical authors suggest that the biomedical model of problem gambling may be unhelpful because it focuses only on individuals. A limited study was presented at a conference in Berlin, suggesting opioid release differs in problem gamblers from the general population, but in a very different way from people with a substance use disorder.
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Modeled after Alcoholics Anonymous, GA is a twelve-step program that emphasizes a mutual-support approach. However, no one treatment is considered to be most efficacious and, in the United States, no medications have been approved for the treatment of pathological gambling by the U.S. The most common instrument used to screen for “probable pathological gambling” behavior is the South Oaks Gambling Screen (SOGS) developed by Lesieur and Blume (1987) at the South Oaks Hospital in New York City.
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Deficiencies in serotonin might also contribute to compulsive behavior, including a gambling addiction. New studies regarding this link show that norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their under-dosage. It has been observed that some pathological gamblers have lower levels of norepinephrine than normal gamblers. Pathological gambling was long considered by the American Psychiatric Association to be an impulse-control disorder rather than an addiction.
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