Pathological Gambling: Conceptual, Diagnostic and Treatment Issues

Abstract

Conceptual and Diagnostic Issues in the Treatment of Gambling Pathological Gambling: Conceptual, Diagnostic and Treatment Issues Martin C. McGurrin, Ph.D. Sarasota, Florida: Professional Resource Press, 1992, 72 pp., $9.95. For those who have limited experience in working with pathological gamblers, Martin McGurrin's book provides a brief, informative survey of significant issues related to understanding and treating pathological gambling. Prevalence estimates and demographic data pertaining to pathological gambling are presented concisely along with a history of the problem. The background information on Gamblers Anonymous and the National Council on Problem Gambling that is included offers the reader helpful insight into two organizations that have been central to the development of the field of gambling treatment. In the section on "Conceptualization of Pathological Gambling," McGurrin discusses common characteristics of pathological gamblers. A shortcoming of his descriptions is that they are often based on what one must assume is the author's clinical impressions. McGurrin makes generalizations about pathological gamblers often without citing support from research or clinical literature for his statements. For example, he states, "As with Cyclothymic Disorder, the pathological gambler's periods of affective extremes are usually separated by months of normal mood and energy level." (p. 11) No citation is provided for this global observation. The reader might therefore be cautioned to consider that such general descriptions may be based on the author's personal experience. All too often in the field of pathological gambling, writers have presented their clinical observations based on limited samples of gamblers as broad generalizations (Custer, 1984). This unfortunately has often perpetuated stereotypes of pathological gamblers which persist despite subsequent presentation of more accurate, data based descriptions. Early writers such as Custer were perhaps justifiably presenting their impressions to a newly emerging field that had not yet developed a more extensive data base. However, current writers, like McGurrin, should indicate explicitly when they are presenting observations based on personal experience with gamblers as opposed to reporting descriptions based on larger samples. McGurrin presents a clear discussion of several relevant conceptual issues in terms of categorizing pathological gambling. He addresses the distinction between viewing pathological gambling as an impulse control rather than obsessive compulsive disorder. The question of how well pathological gambling fits an addiction model is discussed along with speculation on biological factors that may be contributing factors to this disorder. The section on diagnosis is limited to a listing of DSM-III-R diagnostic criteria and Gamblers Anonymous' Twenty Questions. The diagnosis and assessment of pathological gambling is a complex task, and could have easily been given greater attention than is included in this brief presentation. …