Risk Reduction Helps Tame Teen Gambling: Adolescents with Pathological Gambling Problems May Have Comorbid Psychiatric Conditions

Article excerpt

HOUSTON -- Relatively few adolescents develop a serious problem with gambling, so the issue may be one of "harm reduction" rather than the treatment of an addiction, said Gagan Dhaliwal, M.D., at the annual meeting of the American Society for Adolescent Psychiatry.

For most people, gambling is a form of entertainment without serious negative consequences, since it lacks the element of physical harm to the body caused by substance abuse. Yet some adolescents develop a preoccupation with gambling and find themselves unable to stop despite repeated attempts and a desire to do so. Those teens may need treatment similar to that used for other addictions, said Dr. Dhaliwal, of the University of South Alabama, Mobile.

At any age, problem gambling involves complex dynamic interactions among psychophysiologic, developmental, cognitive, and behavioral components. Given that adolescence is a developmental period marked by risk-taking behaviors, adolescents generally do not seek treatment for gambling. They have a sense of invincibility and they think they can stop anytime they choose.

Adolescents with pathological gambling problems may have comorbid psychiatric conditions, and they use gambling as a coping strategy. Common comorbidities include depression, substance abuse, anxiety, and poor academic performance.

"Gambling is considered to be a way of escaping their problems, whether it is depression, anxiety, or relationship problems in their family," Dr. Dhaliwal said. Peer pressure often plays a role as well.

Some evidence suggests that adolescents with antisocial and impulsive risk factors who become involved in gambling are more likely to develop a serious gambling problem later in life. However, someone who does not perceive that he or she has a problem won't seek treatment, and someone who is forced into treatment won't be motivated to change. Dr. Dhaliwal noted.

Cognitive-behavioral therapy is the first-line treatment of choice for adolescents who exhibit severe gambling problems. …