Gambling within the Biopsychosocial framework

1. Gambling within the Biopsychosocial framework Biological Factors

2. Impulse Control Disorder • Currently in the DSM and ICD there is no category for an ‘addictive disorder’. Gambling comes under a type of impulse control disorder in the DSM-IV-TR. • In the DSM-IV-TR there are six different types of impulse control disorders such as pyromania and trichollomania (pulling one’s hair out for pleasure). • In the new DSM-V it has been proposed that ‘pathological gambling disorder’ will be replaced with the term ‘disordered gambling’ in a new category called addiction and related disorders within the subcategory behavioural addictions.

3. According to the DSM-IV-TR a person must experience at least five of the following ten symptoms to be diagnosed as a pathological gambler:

4. The Biopsychosocial Model

5. Biological Perspective:The dopamine reward system • The effects of dopamine on gambling addiction have become of interest to researchers due to Parkinson’s disease suffers who reported gambling addiction soon after treatment for the disease with dopamine. • Many sufferers of Parkinson’s disease however, have not reported gambling addictions despite taking dopamine. • Research has indicated however that dopamine although found in a few areas of the brain has a role in the development and maintenance of addictive gambling.

6. The dopamine reward system • Dopamine is a neurotransmitter that is involved in pleasure, reward, motivation and emotional arousal. • The release of dopamine also contributes to planning and complex motor movements. • Researchers have identified a pathway in the brain where dopamine is concentrated producing a distinct sense of pleasure. • This pathway is known as the ‘dopamine reward system’.

7. The dopamine reward system • Is located in the medial forebrain bundlethat ascends from the midbrain through the hypothalamus into the nucleus accumbens.

8. The dopamine reward system • Research by Gray 2007 has shown that dopamine is also released in anticipation of receiving a reward. • Research done on animals with the use of classical conditioning and schedules of reinforcement showed that dopamine was released at the presence of light without the UCS (food). • This creates an interaction between psychological and biological perspectives as it is conditioning and schedules of reinforcement that establishes the dopamine reward system.

9. The dopamine reward system • In relation to gambling fMRI imaging has shown that chance monetary rewards activate the brain’s dopamine reward system. • As the reward is never predictable the gambler receives a burst of dopamine into the brain every time they play. • This is also reinforced by socialenvironmental cues resulting in the development and maintenance of a strong response that is very resistant to extinction.

10. Biological Treatment for Gambling • Naltrexone has been used as an antagonist inhibiting the neurotransmitter dopamine at the synapse. • It does not cause physical dependence and can be stopped without withdrawal symptoms at any time. It is also used to treat alcohol dependency and addiction to heroin. • A study conducted by Kim and Grant (2001) showed naltrexone to be very effective in treating participants gambling addiction. • Limitation is side effects that naltrexone causes which is predominately nausea but also can have toxic effects on the liver.