Gambling Addiction or Greed?
An article in today's Boston Globe questions the link between the gambling industry and Harvard Medical School. Rightfully so. I read the article with a critical eye but kept my mind open. After all, pathological gambling (it is not recognized as an addiction, though) has been around as an official, recognized disorder diagnosis for over a decade (and known by researchers before that).
But Harvard researchers affiliated with the Institute for Research on Pathological Gamling and Related Disorders take it one step further -- they believe gambling is an addiction, like alcoholism or a coke addict. This is a hotly contested topic within the addictions field. Many researchers feel that behavior disorders, such as pathological gambling, should not be classified as addictions -- ever -- because it's confusing the terminology and clouds what most people consider an "addiction." Harvard researchers believe, however, that gambling is indeed an addiction and point to the studies they've funded that back up their assertion.
There is a lot at stake here. As the article illustrates, the gambling industry funds the Institute 100%. (A little like the cigarette industry funding the National Institute of Cancer 100%.) If the industry shows that "problem gambling" is only affecting a tiny percentage of the general population, then it becomes more palpable for new communities and states considering legalizing gambling (or existing ones that need to renew it).
As the Boston Globe article notes, over 4% of adults who gamble have a problem with gambling (and as the researchers well know, the actual rate could be twice as high because of under reporting). That may not seem like a large number, but it is. Only a few other mental health disorders come with such a higher incidence rate, such as depression, anxiety, and bipolar disorder. In the article, Howard Shaffer, M.D., the Institute's director claims, "While there is a genetic predisposition for [gambling] addiction, the predisposition isn't specific." The Institute's research also claim that perhaps there is some underlying addictive personality, an idea that's been kicking around in the literature for more years than I can count, but still with limited empirical support.
This is all well and good. I was with the article and the Institute's side while reading the article, thinking, "What's the big deal here?i This is how some research gets done in the world, because other grant-giving organizations don't think much about gambling as a legitimate area of study." But then the article threw out a statistic that completely lost me on the Institute's side.
Teenagers are at Five Times Greater Risk than Adults
More than 20% of teenagers were pathological or at-risk gamblers. Furthermore, the problem gambling rate has doubled between 1977 and 1997. No other mental health disorder has measured such a significant increase.
The real problem, however, is with the first finding, that 20% of teenagers are at-risk or have a pathological gambling problem. This is a simple logic equation (which any undergraduate Logic 101 student can do!). If 20% of teenagers have a problem or "at-risk", how do you go from 20% to 4% in the adult population and still make the claim that this is the result of an "addictive personality" or that there's some sort of predisposition? If it's genetics, how does that explain the drop in pathological gambling behavior between teenagers and adulthood? If it's personality, again, how come teenagers exhibit such a higher risk of this problem than adults? It is certainly generally accepted that teenagers have personalities, so it is unfathomable how your personality could be so malleable as to move from being "addicted" as a teen, but losing that addiction as you age one or two years.
Frankly, I don't get it, and I'm a psychologist. So if I don't get it, I can understand why others might also have an issue with this institute. I've never heard of a legitimate research institute funded entirely by the industry it is meant to study. On so many levels, this not only seems odd and like an obvious conflict of interest, but just poor planning and poor policy. Surprisingly, Harvard Medical School defended this institute and didn't even think about examining it further after the Globe's inquiry. Odd. I would think a respected medical school such as Harvard might look into what, on the surface of things, seems a little quanky.
Pathological gambling (I won't call it an addiction, since that's not what it's called in the diagnostic criteria reference manual) is a real disorder and a real problem with Americans. With gambling being more prevalent in many Americans' everyday lives, it's only natural that it will become more of a problem as well. But calling it an "addiction" serves no legitimate purpose, other than apparently to help the gambling industry itself.
In the meantime, I'll stick with the facts and what the research does show -- as gambling becomes more prevalent, it becomes more of a problem in American society. Communities should seek to limit gambling if it's a choice open to them, as the research shows it will impact your healthcare costs in the long run.Last reviewed: By John M. Grohol, Psy.D. on 27 Jan 2007
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The art of medicine consists in amusing the patient while nature cures the disease.