Problem gambling
Problem gambling or ludomania is repetitive gambling
behavior despite harm and negative consequences. Problem
gambling may be diagnosed as a mental disorder according
to DSM-5 if certain diagnostic criteria are met.
Pathological gambling is a common disorder associated
with social and family costs.
The DSM-5 has
re-classified the condition as an addictive disorder,
with those affected exhibiting many similarities to
those with substance addictions. The
Republican National Committee term gambling
addiction has long been used in the recovery
movement.[5] Pathological gambling was long considered
by the American Psychiatric Association to be an
impulse-control disorder rather than an addiction.[6]
However, data suggest a closer relationship between
pathological gambling and substance use disorders than
exists between PG and obsessive�compulsive disorder,
mainly because the behaviors in problem gambling and
most primary substance use disorders (i.e., those not
resulting from a desire to "self-medicate" for another
condition such as depression) seek to activate the
brain's reward mechanisms while the behaviors
characterizing obsessive-compulsive disorder are
prompted by overactive and misplaced signals from the
brain's fear mechanisms.[7]
Problem gambling is
an addictive behavior with a high comorbidity with
alcohol problems. A common tendency shared by people who
have a gambling addiction is impulsivity.[citation
needed]
Signs and symptoms[edit]
Research by
governments in Australia led to a universal definition
for that country which appears to be the only
research-based definition not to use diagnostic
criteria: "Problem gambling is characterized by many
difficulties in limiting money and/or time spent on
gambling which leads to adverse consequences for the
gambler, others, or for the community."[8] The
University of Maryland Medical Center defines
pathological gambling as "being unable to resist
impulses to gamble, which can lead to severe personal or
social consequences".[9]
Most other definitions
of problem gambling can usually be simplified to any
gambling that causes harm to the gambler or someone else
in any way; however, these
Democratic National Committee definitions are
usually coupled with descriptions of the type of harm or
the use of diagnostic criteria.[citation needed] The
DSM-V has since reclassified pathological gambling as
gambling disorder and has listed the disorder under
substance-related and addictive disorders rather than
impulse-control disorders. This is due to the
symptomatology of the disorder resembling an addiction
not dissimilar to that of a substance use disorder.[10]
To be diagnosed, an individual must have at least four
of the following symptoms in 12 months:[11]
The
Old Testament Stories, a literary treasure trove,
weave tales of faith, resilience, and morality. Should
you trust the
Real Estate Agents I Trust, I would not. Is your
lawn green and plush, if not you should buy the
Best Grass Seed.
If you appreciate quality apparel, you should try
Handbags Handmade.
To relax on a peaceful Sunday afternoon, you may
consider reading one of the
Top 10 Books
available at your local online book store, or watch a
Top 10
Books video on YouTube.
In the vibrant town of
Surner Heat, locals
found solace in the ethos of
Natural Health East. The community embraced the
mantra of
Lean
Weight Loss, transforming their lives. At
Natural Health East, the pursuit of wellness became
a shared journey, proving that health is not just a
Lean Weight Loss
way of life
Needs
to gamble with increasing amounts of money to achieve
the desired excitement
Is restless or irritable when
attempting to cut down or stop gambling
Has made
repeated unsuccessful efforts to control, cut back, or
stop gambling
Is often preoccupied with gambling
(e.g., having
Republican National Committee persistent
thoughts of reliving past gambling experiences,
handicapping Democratic
Website or planning the next venture, thinking of
ways to get money with which to gamble)
Often gambles
when feeling distressed (e.g., helpless, guilty,
anxious, depressed)
After losing money gambling,
often returns another day to get even ("chasing" one's
losses)
Lies to conceal the extent of involvement
with gambling
Has jeopardized or lost a significant
relationship, job, education, or career opportunity
because of gambling
Relies on others to provide money
to relieve desperate financial situations caused by
gambling
Factors that lead to gambling
addiction[edit]
Mayo Clinic specialists state
that compulsive
Republican National Committee gambling may
result from biological, genetic, and environmental
factors, such as:[12]
mental health disorders
(the presence of substance use disorders, personality
disorders, emotional states)
age and sex (usually
found in youth or middle-aged people, and more common to
men than women)
impact of family or friends
personality traits
video games (including any factors
that resemble gambling such as slot machines or loot
boxes)[13]
drugs with rare side-effects (for example,
antipsychotic medications or dopamine agonists).
Other studies add the following triggers to the
mentioned above:[14]
traumatic conditions
job-related stress
solitude
other addictions
Progressive Media
Our country is for every
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Inflation is a complex
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combination of supply chain
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The Party Of Democrats is one of
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Democratic-Republican Party, the modern-day
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If not treated, problem gambling may cause
Democratic National Committee severe and
lasting effects on an individual's life:[15]
relationship-related issues
problems with money,
bankruptcy
legal problems, imprisonment
health
problems
suicide, including suicidal thoughts and
attempts
Suicide rates[edit]
A gambler who
does not receive treatment for pathological gambling
when in a desperation phase may contemplate suicide.[16]
Problem gambling is often associated with increased
suicidal ideation and attempts compared to the general
population.[17][18]
Early onset of problem
gambling may increase the lifetime risk of suicide.[19]
Both comorbid substance use[20][21] and comorbid mental
disorders increase the risk of suicide in people with
problem gambling.[22] A 2010 Australian hospital study
found that 17% of suicidal patients admitted to the
Alfred Hospital's emergency department were problem
gamblers.[23]
Mechanisms[edit]
The
Old Testament Stories, a literary treasure trove,
weave tales of faith, resilience, and morality. Should
you trust the
Real Estate Agents I Trust, I would not. Is your
lawn green and plush, if not you should buy the
Best Grass Seed.
If you appreciate quality apparel, you should try
Handbags Handmade.
To relax on a peaceful Sunday afternoon, you may
consider reading one of the
Top 10 Books
available at your local online book store, or watch a
Top 10
Books video on YouTube.
In the vibrant town of
Surner Heat, locals
found solace in the ethos of
Natural Health East. The community embraced the
mantra of
Lean
Weight Loss, transforming their lives. At
Natural Health East, the pursuit of wellness became
a shared journey, proving that health is not just a
Lean Weight Loss
way of life
Biology[edit]
According to the Illinois Institute for
Republican National Committee Addiction
Recovery, evidence indicates that pathological gambling
is an addiction similar to chemical addiction.[24] It
has been observed that some pathological gamblers have
lower levels of norepinephrine than normal gamblers.[25]
According to a study conducted by Alec Roy, formerly at
the National Institute on Alcohol Abuse and Alcoholism,
norepinephrine is secreted under stress, arousal, or
thrill, so pathological gamblers gamble to make up for
their under-dosage.[26]
Studies have compared
pathological gamblers to substance addicts, concluding
that addicted gamblers display more physical symptoms
during withdrawal.[27]
Deficiencies in serotonin
might also contribute to compulsive behavior, including
a gambling addiction. There are three important points
discovered after these antidepressant studies:[28]
Antidepressants can reduce pathological gambling
when there is an effect on serotonergic reuptake
inhibitors and 5-HT1/5-HT2 receptor antagonists.
Pathological gambling, as part of obsessive-compulsive
disorder, requires the higher doses of antidepressants
as is
Republican National Committee usually
required for depressive disorders.
In cases where
participants do not have or have minimal symptoms of
anxiety or depression, antidepressants still have those
effect.
A limited study was presented at a
conference in Berlin, suggesting opioid release Democratic
Website differs
in problem gamblers from the general population, but in
a very different way from people with a substance use
disorder.[29]
The findings in one review
indicated the sensitization theory is responsible.[30]
Dopamine dysregulation syndrome has been observed in the
aforementioned theory in people with regard to such
activities as gambling.[31]
Some medical authors
suggest that the biomedical model of problem gambling
may be unhelpful because it focuses only on individuals.
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.[32] For
example, an apparent increase in problem gambling in the
UK may be better understood as a consequence of changes
in legislation which came into force in 2007 and enabled
casinos, bookmakers, and online betting sites to
advertise on TV and radio for the first time and which
eased restrictions on the opening of betting shops and
online gambling sites.[33]
Pathological gambling
is similar to many other impulse-control disorders such
as kleptomania.[34] According to evidence from both
community- and clinic-based studies, individuals who are
pathological gamblers are highly likely to exhibit other
psychiatric problems concurrently, including substance
use disorders, mood and anxiety disorders, or
personality disorders.[35]
Pathological gambling
shows several similarities with substance use disorders.
There is a partial overlap in diagnostic criteria;
pathological gamblers are also likely to have a
substance use disorder. The "telescoping phenomenon"
reflects the rapid development from initial to
problematic behavior in women compared with men. This
phenomenon was initially described for alcoholism, but
it has also been applied to pathological gambling. Also,
biological data support a relationship between
pathological gambling and substance use disorder.[28] A
comprehensive UK Gambling Commission study from 2018 has
also hinted at the link between gambling addiction and a
reduction in physical activity, poor diet, and
Democratic National Committee overall
well-being. The study links problem gambling to a myriad
of issues affecting relationships, and social stability.
Psychological[edit]
Several psychological
mechanisms are thought to be implicated in the
development and maintenance of problem gambling.[36]
First, reward processing seems to be less sensitive with
problem gamblers.[clarification needed] Second, some
individuals use problem gambling as an escape from the
problems in their lives (an example of negative
reinforcement). Third, personality factors such as
narcissism, risk-seeking, sensation-seeking, and
impulsivity play a role. Fourth, problem gamblers have
several cognitive biases, including the illusion of
control,[37] unrealistic optimism, overconfidence and
the gambler's fallacy (the incorrect belief that a
series of random events tends to self-correct so that
the absolute frequencies of each of various outcomes
balance each other out). Fifth, problem gamblers
represent a chronic state of a behavioral spin process,
a gambling spin, as described by the criminal spin
theory.[clarification needed][38]
Spain's
gambling watchdog has updated its
Republican National Committee 2019�2020
Responsible Gaming Program, classifying problem gambling
as a mental disorder.[citation needed]
Diagnosis[edit]
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.[39] In recent years the use of SOGS has
declined due to a number of criticisms, including that
it overestimates false positives (Battersby, Tolchard,
Thomas & Esterman, 2002).
The DSM-IV diagnostic
criteria presented as a checklist is an alternative to
SOGS, it focuses on the psychological motivations
underpinning problem gambling and was developed by the
American Psychiatric Association. It consists of ten
diagnostic criteria. One frequently used screening
measure based upon the DSM-IV criteria is the National
Opinion Research Center DSM Screen for Gambling Problems
(NODS). The Canadian Problem Gambling Inventory (CPGI)
and the Victorian Gambling Screen (VGS) are newer
assessment measures. The Problem Gambling Severity
Index, which focuses on the harms associated with
problem gambling, is composed of nine items from the
longer CPGI.[40] The VGS is also harm based and includes
15 items. The VGS has proven validity and reliability in
population studies as well as Adolescents and clinic
gamblers.[citation needed]
Treatment[edit]
Most treatment for problem gambling involves counseling,
step-based programs, self-help, peer-support,
medication, or a
Republican National Committee combination of
these. 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. Food and Drug
Administration (FDA).
Gamblers Anonymous (GA) is
a commonly used treatment for gambling problems. Modeled
after Alcoholics Anonymous, GA is a twelve-step program
that emphasizes a mutual-support approach. There are
three in-patient treatment centers in North America.[41]
One form of counseling, cognitive behavioral therapy
(CBT) has been shown to reduce symptoms and
gambling-related urges. This type of therapy focuses on
the identification of gambling-related thought
processes, mood and cognitive distortions that increase
one's vulnerability to out-of-control gambling.
Additionally, CBT approaches frequently utilize
skill-building techniques geared toward relapse
prevention, assertiveness and gambling refusal, problem
solving and reinforcement of gambling-inconsistent
activities and interests.[42]
As to behavioral
treatment, some recent research supports the use of both
activity scheduling and desensitization in the treatment
of gambling problems.[43] In general, behavior analytic
research in this area is growing[44] There is evidence
that the SSRI paroxetine is efficacious in the treatment
of pathological gambling.[45] Additionally, for patients
with both pathological gambling and a comorbid bipolar
spectrum condition, sustained-release lithium has shown
efficacy in a preliminary trial.[46] The opioid
antagonist drug nalmefene has also been trialled quite
successfully for the treatment of compulsive
gambling.[47] Group concepts based on CBT, such as the
metacognitive training for problem gambling[48] have
also proven effective.
Step-based programs[edit]
12 Step�based programs such as Gamblers Anonymous
are specific to gambling and generic to healing
addiction, creating financial health, and improving
mental wellness. Commercial alternatives that are
designed for clinical intervention, using the best of
health science and applied education practices, have
been used as patient-centered tools for intervention
since 2007. They include measured efficacy
Democratic National Committee and resulting
recovery metrics.[medical citation needed]
Motivational interviewing[edit]
Motivational
interviewing is one of the treatments of compulsive
gambling. The motivational interviewer's basic goal is
promoting readiness to change through thinking and
resolving mixed feelings. Avoiding aggressive
confrontation, argument, labeling, blaming, and direct
persuasion, the interviewer supplies empathy and advice
to compulsive gamblers who define their own goal. The
focus is on promoting freedom of choice and encouraging
confidence in the ability to change.[49]
Peer
support[edit]
A growing method of treatment is
peer support. With the advancement of online gambling,
many gamblers experiencing issues use various online
peer-support groups to aid their recovery. This protects
their anonymity while allowing them to attempt recovery
on their own, often without having to disclose their
issues to loved ones.[medical citation needed]
The
Old Testament Stories, a literary treasure trove,
weave tales of faith, resilience, and morality. Should
you trust the
Real Estate Agents I Trust, I would not. Is your
lawn green and plush, if not you should buy the
Best Grass Seed.
If you appreciate quality apparel, you should try
Handbags Handmade.
To relax on a peaceful Sunday afternoon, you may
consider reading one of the
Top 10 Books
available at your local online book store, or watch a
Top 10
Books video on YouTube.
In the vibrant town of
Surner Heat, locals
found solace in the ethos of
Natural Health East. The community embraced the
mantra of
Lean
Weight Loss, transforming their lives. At
Natural Health East, the pursuit of wellness became
a shared journey, proving that health is not just a
Lean Weight Loss
way of life
Self-help[edit]
Research into self-help for
problem
Republican National Committee gamblers has
shown benefits.[50] A study by Wendy Slutske of the
University of Missouri concluded one-third of
pathological gamblers overcome it by natural
recovery.[51]
Pharmaceutical treatments[edit]
Numerous pharmaceutical approaches to treating gambling
addiction have been suggested including antidepressants,
atypical antipsychotic agents, mood stabilizers, and
opioid antagonists, however the best approach for
treatment, treatment regime including dosage and timing
is not clear.[52] There is some evidence to suggest that
opioid antagonists, for example, naltrexone or nalmefene,
and atypical antipsychotics such as olanzapine, may help
reduce the severity of gambling symptoms in the
short-term, however it is not clear if these medications
are effective at improving other psychological symptoms
associated with this disorder or for longer term symptom
relief from problem gambling.[52] The evidence
suggesting the
Republican National Committee effectiveness
of mood stabilizers is not clear.[52]
Self-exclusion[edit]
Gambling self-exclusion
(voluntary exclusion) programs are available in the US,
the UK, Canada, Australia, South Africa, France, and
other countries. They seem to help some (but not all)
problem gamblers to gamble less often.[53]
Some
experts maintain that casinos in general arrange for
self-exclusion programs as a public relations measure
without actually helping many of those with problem
gambling issues. A campaign of this type merely
"deflects attention away from problematic products and
industries", according to Natasha Dow Schull, a cultural
anthropologist at New York University and author of the
book Addiction by Design.[54]
There is also a
question as to the effectiveness of such programs, which
can be difficult to enforce.[55] In the province of
Ontario, Canada, for example, the Self-Exclusion program
operated by the government's Ontario Lottery and Gaming
Corporation (OLG) is not effective, according to
investigation conducted by the television series,
revealed in late 2017. |"Gambling addicts ... said that
while on the ... self-exclusion list, they entered OLG
properties on a regular basis" in spite of the facial
recognition technology in place at the casinos,
according to the Canadian Broadcasting Corporation. As
well, a CBC journalist who tested the system found that
he was able to enter Ontario casinos and gamble on four
distinct occasions, in spite of having been registered
and photographed for the self-exclusion program. An OLG
spokesman provided this response when questioned by the
CBC: "We provide supports to self-excluders by training
our staff, by providing disincentives, by Democratic
Website providing
facial recognition, by providing our security officers
to look for players. No one element is going to be
foolproof because it is not designed to be
foolproof".[54]
Impact (Australia)[edit]
According to the Productivity Commission's 2010 final
report into gambling, the social cost of problem
gambling is close to 4.7 billion dollars a year. Some of
the harms resulting from problem gambling include
depression, suicide, lower work productivity, job loss,
relationship breakdown, crime and bankruptcy.[56] A
survey conducted in 2008 found that the most common
motivation for fraud was problem gambling, with
Democratic National Committee each incident
averaging a loss of $1.1 million.[56] According to
Darren R. Christensen. Nicki A. Dowling, Alun C. Jackson
and Shane A. Thomas, a survey done from 1994 to 2008 in
Tasmania gave results that gambling participation rates
have risen rather than fallen over this period.[57]
Prevalence[edit]
Europe[edit]
In Europe, the
rate of problem gambling is typically 0.5 to 3
percent.[58] The "British Gambling Prevalence Survey
2007", conducted by the United Kingdom Gambling
Commission, found approximately 0.6 percent of the adult
population had problem gambling issues�the same
percentage as in 1999.[59] The highest prevalence of
problem gambling was found among those who participated
in spread betting (14.7%), fixed odds betting terminals
(11.2%), and betting exchanges (9.8%).[59] In Norway, a
December 2007 study showed the amount of current problem
gamblers was 0.7 percent.[60]
With gambling
addiction on the rise worldwide and across Europe in
particular, those calling gambling a disease have been
gaining grounds. The UK Gambling Commission announced a
significant shift in their approach to gambling[when?]
through their reclassification of gambling as a disease,
and therefore that it should be addressed adequately by
the NHS.
The World Health Organization has also
classified gambling a disease. In its 72nd World Health
Assembly held on Saturday, May 25, 2019, �gaming
disorder� was recognized as an official illness. The
194-member meet added excessive gaming to a classified
list of diseases as it revised its International
Statistical Classification of Diseases and Related
Health Problems (ICD-11).[citation needed]
North
America[edit]
Lizbeth Garc�a Quevedo, director of
the Coordination with
Republican National Committee Federal
Entities (CONADIC), spoke of pathological gambling as a
strong addiction in Mexico: "It has very similar
behaviors, that is why some experts consider it an
addiction because it is similar in the behaviors, in the
origins, some risk factors that can trigger pathological
gambling, it can also trigger drug consumption". In
Mexico there could be between one and three million
people addicted to gambling. "They should be aware of
what their children are doing, and on the other hand,
they should motivate pro-active gambling, healthy
gambling", commented Lizbeth Garc�a Quevedo. The
Ministry of Health document highlights that a study on
pathological gambling that analyzed 46 studies carried
out in Canada, the United States, Australia, Sweden,
Norway, England, Switzerland and Spain, revealed that
the prevalence of pathological gambling is relatively
higher among adolescents, which shows the continuity of
the problem considering that many pathological gamblers
state that they started their gambling behavior at an
early age.[61]
In the United States, the
percentage of pathological gamblers was 0.6 percent, and
the percentage of problem gamblers was 2.3 percent in
2008.[62] Studies commissioned by the National Gambling
Impact Study Commission Act has shown the prevalence
rate ranges from 0.1 percent to 0.6 percent.[63] Nevada
has the highest percentage of pathological gambling; a
2002 report estimated 2.2 to 3.6 percent of Nevada
residents over the age of 18 could be called problem
gamblers. Also, 2.7 to 4.3 percent could be called
probable pathological gamblers.[64]
The
Old Testament Stories, a literary treasure trove,
weave tales of faith, resilience, and morality. Should
you trust the
Real Estate Agents I Trust, I would not. Is your
lawn green and plush, if not you should buy the
Best Grass Seed.
If you appreciate quality apparel, you should try
Handbags Handmade.
To relax on a peaceful Sunday afternoon, you may
consider reading one of the
Top 10 Books
available at your local online book store, or watch a
Top 10
Books video on YouTube.
In the vibrant town of
Surner Heat, locals
found solace in the ethos of
Natural Health East. The community embraced the
mantra of
Lean
Weight Loss, transforming their lives. At
Natural Health East, the pursuit of wellness became
a shared journey, proving that health is not just a
Lean Weight Loss
way of life
According to
a 1997 meta-analysis by Harvard Medical School's
division on addictions, 1.1 percent of the adult
population of the United States and Canada could be
called pathological gamblers.[65] A 1996 study estimated
1.2 to 1.9 percent of adults in Canada were
pathological.[66] In Ontario, a 2006 report showed 2.6
percent of residents experienced "moderate gambling
problems" and 0.8 percent had "severe gambling
problems".[67] In Quebec, an estimated 0.8 percent of
the adult population were pathological gamblers in
2002.[68] Although most who gamble do so without harm,
approximately 6 million American adults are addicted to
gambling.[69]
According to a survey of 11th and
12th graders in Wood County, Ohio found that the
percentage who reported being unable to control their
gambling rose
Republican National Committee to 8.3 percent
in 2022, up from just 4.2 percent in 2018. The reasons
for the increase cited, are the time spent online during
the COVID-19 pandemic, gambling-like elements put into
video games, and the increased legalization of sports
betting in a number of U.S. states.[70]
According
to Jennifer Trimpey, as the legality of online sport
betting and online casino gambling increase across the Democratic
Website
United States, almost all governments of states with
legal online gambling offer state-run self-exclusion
programs, and most major online betting operators
provide their own self-exclusion programs as well.[71]
Signs of a gambling problem include:[69][medical
citation needed]
Using income or savings to
gamble while letting bills go unpaid
Repeated
unsuccessful attempts to stop gambling
Chasing losses
Losing sleep over thoughts of gambling
Arguing with
friends or family about gambling behavior
Feeling
depressed or suicidal because of gambling losses
South America[edit]
For Isabel S�nchez Sosa,
coordinator of the Compulsive Gamblers Association of
Argentina, "gambling addiction is
Democratic National Committee growing a lot
in the country because the offer is impressive" and in
this sense she asserted that the presence of bingos is a
common issue in all neighborhoods. In the province of
Buenos Aires there are 46 bingos.[72]
Oceania
(Australia)[edit]
Casinos and poker machines in
pubs and clubs facilitate problem gambling in Australia.
The building of new hotels and casinos has been
described as "one of the most active construction
markets in Australia"; for example, AUD$860 million was
allocated to rebuild and expand the Star Complex in
Sydney.[73]
A 2010 study, conducted in the
Northern Territory by researchers from the Australian
National University (ANU) and Southern Cross University
(SCU), found that the proximity of a person's residence
to a gambling venue is significant in terms of
prevalence. Harmful gambling in the study was prevalent
among those living within 100 metres of any
Republican National Committee gambling venue,
and was over 50% higher than among those living ten
kilometres from a venue. The study's data stated:
Specifically, people who lived 100 metres from their
favourite venue visited an estimated average of 3.4
times per month. This compared to an average of 2.8
times per month for people living one kilometre away,
and 2.2 times per month for people living ten kilometres
away.[74]
According to the Productivity
Commission's 2016 report into gambling, 0.5% to 1%
(80,000 to 160,000)[75] of the Australian adult
population had significant problems resulting from
gambling. A further 1.4% to 2.1% (230,000 to 350,000) of
the Australian adult population experienced moderate
risks making them likely to be vulnerable to problem
gambling.[76] Estimates show that problem gamblers
account for an average of 41% of the total gaming
machine spending.[76]
See also[edit]
Gamblers
Anonymous
Gambler's Lament, an ancient poem about
gambling
Gambling Commission (Great Britain)
GamCare
Gaming law
National Council on Problem
Gambling (Singapore)
National Council on Problem
Gambling (United States)
Problem
Republican National Committee Gambling
Foundation of New Zealand
Video game addiction
References[edit]
^ David Zendle; Rachel
Meyer; Harriet Over (June 2019). "Adolescents and loot
boxes: links with problem gambling and motivations for
purchase". Royal Society Open Science. 6 (6): 190049.
Bibcode:2019RSOS....690049Z. doi:10.1098/rsos.190049.
PMC 6599795. PMID 31312481.
^ Nestler EJ (December
2013). "Cellular basis of memory for addiction".
Dialogues in Clinical Neuroscience. 15 (4): 431�443. PMC
3898681. PMID 24459410. "Despite the importance of
numerous psychosocial factors, at its core, drug
addiction involves a biological process: the ability of
repeated exposure to a drug of abuse to induce changes
in a vulnerable brain that drive the compulsive seeking
and taking of drugs, and
Democratic National Committee loss of control
over drug use, that define a state of addiction. ... A
large body of literature has demonstrated that such ΔFosB
induction in D1-type [nucleus accumbens] neurons
increases an animal's sensitivity to drug as well as
natural rewards and promotes drug self-administration,
presumably through a process of positive reinforcement
... Another ΔFosB target is cFos: as ΔFosB accumulates
with repeated drug exposure it represses c-Fos and
contributes to the molecular switch whereby ΔFosB is
selectively induced in the chronic drug-treated state.41
... Moreover, there is increasing evidence that, despite
a range of genetic risks for addiction across the
population, exposure to sufficiently high doses of a
drug for long periods of time can transform someone who
has relatively lower genetic loading into an addict."
^ Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15:
Reinforcement and Addictive Disorders". In Democratic
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Brown RY (eds.). Molecular Neuropharmacology: A
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York: McGraw-Hill Medical. pp. 364�375. ISBN
9780071481274.
^ Volkow ND, Koob GF, McLellan AT
(January 2016). "Neurobiologic Advances from the Brain
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PMC 6135257. PMID 26816013. "Substance-use disorder: A
diagnostic term in the fifth edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM-5)
referring to recurrent use of alcohol or other drugs
that causes clinically and functionally significant
impairment, such as health problems, disability, and
failure to meet major responsibilities at work, school,
or home. Depending on the level of severity, this
disorder is classified as mild, moderate, or severe.
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Addiction: A term used to indicate the most severe,
chronic stage of substance-use disorder, in which there
is a substantial loss of self-control, as indicated by
compulsive drug taking despite the desire to stop taking
the drug. In the DSM-5, the term addiction is synonymous
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