Gambling Addiction

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Introduction
Gambling is deeply rooted in American culture (Findlay, 1986). In precolonial times, the proceeds from lotteries authorized by the ruling English monarchy were used to subsidize explorations to, and settlements within, the New World (Ezell, 1960). As colonial America matured, government and private lotteries, as well as social gambling, were common. The colonial era of gambling ended with the spread of Jacksonian morality, aided by numerous well-publicized scandals. Civil War reconstruction introduced a second era of gambling, as lotteries were employed as a form of voluntary taxation to rebuild the wartorn South (Rose, 1998; Ezell, 1977). Gambling continued to spread until 1890, when a scandal involving the Louisiana lottery resulted in federal legislation that effectively banned state lotteries and prohibited other forms of gambling for nearly 70 years (Rose, 1998; Ezell, 1977). The United States is now in the midst of a third era of widespread legalized gambling, which began in 1931 when Nevada relegalized casinos (Rose, 1986, 1995). Initially, Americans in this era limited legal gambling opportunities to the Nevada casinos, charitable bingo, and pari-mutuel gambling, such as horse and dog track racing. Popular forms of illegal gambling, such as offtrack betting, back room casino games, and numbers, were associated with organized crime and were treated as vice crimes by law enforcement institutions. Then, beginning in 1964, gambling expanded greatly after New Hampshire initiated the first modern state lottery, signifying a change in traditional social and moral barriers. As of this writing, some form of gambling is legal in all but 3 states, casino or casino-style gambling is available in 21 states, and 37 states have lotteries (National Opinion Research Center, 1999). In 1988, Congress passed the Indian Gaming Regulatory Act, which allows tribes to operate any form of gambling currently legalized in the state in which the tribe resides. Resistance by many state legislatures to casino gambling and state-sanctioned sports betting continues, but in numerous jurisdictions other forms of gambling have become institutionalized, with state budgets increasingly dependent on gambling revenues. The advent of state-sponsored lotteries marked a significant policy shift in which the states moved from tolerance to active sponsorship and aggressive marketing of their own games. Public support of this shift is beyond question, with over 80 percent of adults in the United States participating in various forms of commercial or state-sponsored gambling sometime during their lives. Collectively Americans wagered over $551 billion in 1997 in legal gambling activities (International Gaming and Wagering Business, 1998). Although gambling is popular and has social and economic benefits, there are also costs involved for individuals, families, and communities stemming from pathological and problem gambling. Link..http://www.nap.edu/openbook.php?record_id=6329&page=120

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Research on the Origins of Pathological and Problem Gambling Etiology is the study of causal pathways. Because of the complex analyses and study designs that must be used, this type of research represents the crown jewel of health research. The outcomes of such research often lead to successful treatments and preventive interventions. The process of discovering causal associations and pathways to understand how different factors, exposures, or disease-causing situations relate to each other usually involves multidisciplinary teams of psychiatrists, psychologists, statisticians, sociologists, economists, and epidemiologists. This chapter begins by describing considerations for undertaking or evaluating etiological research on pathological gambling, as well as the current state of knowledge regarding the causal pathways of pathological gambling. Risk factors for and correlates of pathological gambling, including psychosocial, environmental, genetic, and...
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