PCN 605 Topic 8 DQ 1
In the DSM-5, Gambling Disorder was moved from the “Impulse Control Disorders” category to the “Substance-Related and Addictive Disorders” category. Do you think that this was a good decision? Why or why not?
One of the many interesting shifts in DSM-5 was the reclassification of pathological gambling from the impulse control disorders category to substance addictions (“substance-related and addictive disorders”). The shift effectively recognized (the now re-labeled) “gambling disorder” as the first behavioral addiction. This is a fascinating construct in psychiatry. The other diagnoses in this category involve the compulsive administration of exogenous drugs. Much of our knowledge of addiction comes from studying the pharmacology of these drugs and their ability to “hijack” reward-oriented behavior in animal models. In the case of gambling disorder, there is no exogenous substance; rather, there is excessive engagement in a behavior in which money is wagered on the uncertain prospect of a larger monetary prize. Even the role of money is unclear in this equation. While money is self-evidently a potent incentive, at a psychological level, it is a complex, learned reinforcer (as distinct from a natural reward, such as food or sex). For at least some gamblers, winning money appears to play a negligible role in maintaining their behavior.
http://www.psychiatrictimes.com/special-reports/impulsivity-addiction-gambling-disorder-and-beyond
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