Gambling has been defined as playing a game of chance for money. Gambling occurs in many forms, most commonly paramutual (horse and dog tracks), lotteries, casinos (slot machines, table games), bookmaking (sports betting), Internet gambling (cyber gambling), stock market gambling, bingo, etc. In 1980, the American Psychiatric Association listed pathological gambling as a "disorder of impulse control." It is an "addictive illness" that is chronic and progressive. It can be diagnosed and treated.

Unlike chemical addiction, addicted gamblers have what has been described as a hidden disease. Gamblers don’t stumble, have needle marks in their arms or become visibly ill. Gambling resources are rather limited because most people do not perceive gambling as potentially addicting. Yet, the identification of pathological (addicted) gamblers is an important first step in their recovery.

Estimates indicate that three percent of the adult U.S. population will experience a serious gambling problem that will result in significant debt, family disruption, job loss, criminal activity or suicide. Pathological gambling is characterized by remorse, blaming others and alienating family and friends. Gamblers often engage in illegal acts to finance their gambling. They also experience feelings of hopelessness, suicidal thoughts and attempts, divorce, substance (alcohol and other illicit substances) abuse and emotional problems.

With this gambler addiction background, we can identify areas of inquiry that would help our understanding of gamblers and their cur-rent life situation. For example:

Truthfulness: Gamblers are notorious liars. Addicted gamblers typically minimize their gambling and associated losses. They rationalize their motivation and lifestyle. When assessing a gambler’s life situation, it is important to determine whether or not the gambler is telling the truth. Consequently, a meaningful gambler test must incorporate a Truthfulness Scale. The Gambler Addiction Index (GAI) has a Truthfulness Scale built-in.

Gambling: Is the person being assessed pre-occupied with or addicted to gambling? If so, is it pathological or compulsive gambling? Many compulsive gamblers spend most of their time thinking about gambling or how they will get enough money to gamble. The severity of a person’s gambling involvement becomes a focal issue. The Gambler Addiction Index (GAI) has a Gambling Scale to measure gambling severity.

Suicide: Pathological gamblers experience wide mood swings that vary with winning, losing and what Robert Custer, M.D. termed the "desperation" phase. This helps explain why addicted gamblers have a higher incidence of suicide than most other clinical groups. This (suicide) is an important area of inquiry when screening gamblers and explains why the Gambler Addiction Index (GAI) has a Suicide Scale.

Attitude: It’s important to know if the gambler is open and receptive to help. Many pathological gamblers are in denial and resist attempts to help. Resistance often masks denial, problem minimization and a refusal to accept the realities inherent in pathological gambling. Successful intervention and treatment require resistance identification and, when present, facing it and working it through. Resistance often varies with winning, losing and desperation. At the outset, it’s helpful for staff to know if the client is cooperative or resistant to help. Many mental health professionals believe that attitude change (from negative to positive) precedes behavioral change. The Gambler Addiction Index (GAI) contains an Attitude Scale.

Alcohol: It is an understatement to say that much gambling occurs in settings serving beer, wine or other liquors. Many pathological gamblers have drinking problems. Identifying drinking problems and, when they exist, determining their severity is important. The Gambler Addiction Index (GAI) has an Alcohol Scale designed for this purpose.

Drugs: Illicit drug use is becoming more prevalent in gamblers’ lives. Here, we are referring to marijuana, cocaine, barbiturates, amphetamines, heroin, etc. When present, drug problems can become focal treatment issues. The GAI has a Drugs Scale that is independent of the Alcohol Scale. The Drugs Scale measures the severity of drug abuse when it is present. This allows substance (alcohol and other illicit drugs) abuse screening and identification of codependency, when present.

Stress Coping Abilities: Impaired stress handling abilities require treatment. And, we now understand that impaired stress handling abilities contribute to emotional and mental health symptomatology. The GAI’s Stress Coping Abilities Scale determines the presence and/or severity of stress-related problems. High scores identify the presence of mental health problems. In these cases, the gambler should be referred for a more comprehensive evaluation by a licensed/certified mental health professional. Few, if any, other gambler tests screen mental health problems.

In summary, for most people, gambling can be fun and harmless entertainment. But, for four to six percent of people that gamble, gambling is problematic or even pathological (addictive or compulsive). Pathological gambling is a devastating illness that negatively affects every aspect of a gambler's life.

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