The Dual Pathology Foundation has organized a training day for the media to raise awareness of the need for authorities to approach this problem from a health and scientific perspective, with special attention to vulnerability and the prism of Dual Pathology, beyond measures exclusively punitive or restrictive.
In recent times, compulsive gambling (a term that stigmatizes the vulnerable subject who suffers from gambling disorder) has generated deep controversy at the social, media and political level. This situation of alarm has led to the promotion of an outstanding number of regulatory measures, both at the national and regional levels. However, the scientific vision of this public health problem has usually been ignored in the debate and public discourse.
For this reason, the Dual Pathology Foundation (FPD) has organized an informative workshop aimed at providing the media with the necessary tools to begin to address gambling disorder from a scientific perspective focused on prevention, information and treatment. Thus, Dr. Néstor Szerman, president of the FPD, has pointed out that gaming must be understood from an evolutionary perspective as one more recreational activity of the human condition, necessary for survival and only in some vulnerable people, it becomes a mental disorder with addictive characteristics.
Dr. Szerman has added that this occurs when gaming ceases to be playful and negatively impacts personal, family, emotional, economic and academic relationships, while having a behavioral impact. In severe cases, its impact on people is as severe as other serious mental disorders can be. Thus, gambling behavior should not be classified as addictive based on its type, frequency or quantity, but based on whether the excess has a negative impact on other areas of the person's life. “Problematic gambling and gambling addiction are terms found on a dimensional continuum in which 'gambling addiction' is at the extreme end of the scale and 'problem gambling' is a condition and does not necessarily lead to problems at all areas of a person's life,” Szerman stressed.
The scientific community estimates that only one in 10 people who are exposed to potentially addictive situations will end up developing an addiction. Thus, the paradigm of Dual Pathology, in which the Spanish Society of Dual Pathology (SEPD) and the FPD work, is based on Neurosciences and Precision Psychiatry to treat the person instead of the substance or the game, since the evidences indicate that the one who wants is not an addict, but the one who presents the vulnerability to have an addiction and another mental disorder.
On the other hand, approximately 95% of cases of gambling addiction are also associated with other mental disorders such as social phobia, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), borderline personality disorder, psychosis and other mental problems when marked impulsivity traits are added.
It would be people who suffer from dual pathology, that is, who have an addiction and another mental disorder at the same time. Social situations put people in contact with substances or games of chance, but these are individual, genetic, neurobiological, personality traits and environmental factors that determine the vulnerability to develop addictive behavior.
Impulsiveness and gambling disorder
Since the brain develops slowly beyond the second decade of a person's life, adolescents are more vulnerable to developing an addictive disorder to games of all kinds, because their brain is immature and has less capacity for control. For this reason, Dr. Ignacio Basurte, from the Gregorio Marañón Institute of Psychiatry and Mental Health, has indicated that it is necessary to promote measures aimed at informing and educating young people about the risk of developing a gambling addiction, with awareness actions in schools and educational centers that go beyond the current regulatory trend, which forgets the rehabilitation and awareness of this problem.
Dr. Pablo Vega, director of CAD Tetuán, of the Madrid Addiction Institute, has highlighted the importance of parental control and family communication, since promoting a suitable family and social environment is key to helping or mitigating this series of disorders. However, according to Dr. Szerman, efforts to protect young people have focused almost exclusively on regulating gambling.
Vega has pointed out that scientific evidence has not shown that the proximity of an educational center to a gambling establishment has a decisive influence on the addictions of minors, just as it is not that the bars that are near schools promote a problem of alcohol, especially if there are effective restrictive and control measures.
On the contrary, an effective solution should not divert the adolescent's attention as a vulnerable subject. In these vulnerable people, social factors or situations such as that generated by the current pandemic, allow contact with potentially addictive behaviors, not only gambling, but also others such as video games, abuse of social networks, eating disorders or use of substances such as alcohol.
Gender differences
When it comes to sex, Dr. Szerman has explained that there are also singularities when it comes to gambling disorder, since women who suffer from it often indicate that they gamble due to stressful life situations or depressive states. Men, on the other hand, do not associate it with emotional changes. In addition, differences are observed in the type of game chosen, since men choose strategic or action-oriented and risk-oriented games when betting money and women, although they bet money, generally do so in games with less personal decision. like bingo halls, roulettes in casinos, etc.
One of the most accepted explanations, which could be the key to explain the observations of these emotional and behavioral inequalities in men and women, is associated with the sexual dimorphism of the brain and also consequently with the hormonal differences present between them. The existence of environmental factors that impact on this sexual dimorphism and affect men and women differently is evident.
Most studies agree that approximately two-thirds of people with gambling disorder are male. However, in recent years, an increase in women affected by this disorder has begun to be appreciated. For this reason, Dr. Pablo Vega has highlighted that it is urgent to study the differences between both sexes, contextualizing them within the framework of dual pathology and precision psychiatry. "This will allow us to delve into new forms of treatment focused on the particulars of each sex, always keeping the focus on the patient as a vulnerable subject", he concluded.
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