Transcript 3b. Gambling within the Biopsychosocial framework

Gambling within the
Biopsychosocial framework
Biological Factors
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.
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:
1. Preoccupation with gambling (salience): At least two
weeks or more thinking about gambling.
6. Chasing: A pathological gambler will chase their
loses and not walk away.
2. Tolerance: Increasing size of bets or time spent
gambling.
7. Lying: To conceal the extent of gambling. There are
two types:
a)
Reactive lying-Being dishonest in response to
questions that may expose one’s gambling.
b) Deceptive lying: Dishonesty planned in advance.
3. Loss of control: Individual has tried several
unsuccessful attempts to stop gambling.
8. Illegal activity: In order to obtain money for addiction.
4. Withdrawal: Unpleasant psychological and/or
physical reactions when activity is reduced such as
irritability or insomnia.
9. Risked relationships: Such as leaving a child in the
car to place a bet.
5. Escape: Some psychologists propose that all
gamblers do so for escape from the hassles that daily
life creates. When the gambler is addicted, gambling
then becomes an escape from the problems associated
with it creating a ‘vicious cycle’.
10. Bailout: Receive money from family or friends to bail
them out.
The Biopsychosocial Model
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.
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’.
The dopamine reward system
• Is located in the medial forebrain bundle
that ascends from the midbrain through
the hypothalamus into the nucleus
accumbens.
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.
The dopamine reward system
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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 social environmental cues resulting in the
development and maintenance of a strong response that is very resistant to
extinction.
Classical conditioning and
Gambling.
CS
Gambling (anticipation of reward)
UCS
Receiving Reward
UCR
Dopamine released
CR
Dopamine released
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.