Gambling disorder

Gambling disorder (GD) is a complex psychiatric disorder which shares similarities with many other disorders including obsessive compulsive disorder (OCD), impulse control disorders and Attention Deficit Hyperactivity Disorder, although it is most closely aligned with substance-based addictive disorders. GD is primarily associated with a loss of self-regulation and control which manifests as urges/cravings, withdrawal symptoms, preoccupation and tolerance, which leads to dysfunction in everyday life. This chapter discusses the symptomatology, onset, prevalence, comorbid disorders and treatment options for GD. It reviews the evidence of genetic, neuropsychological and neurochemical contributions to GD and examines the evidence for fronto-striatal dysfunction in this disorder. Neuropsychological evidence suggests that GD is associated with impairments in certain higher-level executive functions. There is robust evidence of impaired decision making in GD. People with GD make poor decisions under risk and ambiguity and demonstrate an impulsive decision making style despite explicit risk/reward information, and this appears to be associated with abnormal reward processing.