Do Gambling Disorder’s Effects Vary With Age at Onset?

Gambling disorder is an officially defined form of behavioral addiction centered on a range of symptoms that indicate a life-disrupting level of involvement in gambling activities. Some people develop this disorder relatively early in life, while others develop it at a later age. In a study published in May 2014 in the journal Addiction, a team of Spanish and American researchers attempted to determine if the effects of diagnosable gambling problems that arise before the age of 26 differ in any important way from the effects of such problems that arise after affected individuals turn 26. These researchers also wanted to know if the groups of people who develop “early-onset” gambling disorder have different underlying characteristics than the groups of people who develop “late-onset” gambling disorder. Behavioral addictions are non-substance-based illnesses that stem from uncontrolled participation in everyday activities that most people engage in without experiencing any particular harm. The American Psychiatric Association (APA), an organization that produces the most widely accepted definitions for mental health conditions in the U.S., refers to these illnesses as addictive disorders. Currently, gambling disorder is the sole behavioral addiction/addictive disorder with terms officially recognized by the APA. However, mounting scientific evidence indicates that other commonplace activities that can lead to addictive patterns of behavior in significant numbers of people include sex, food consumption, Internet use and shopping. Prior to 2013, the American Psychiatric Association did not consider serious gambling problems to be a manifestation of addiction. Instead, the organization grouped such problems in a category of conditions known as impulse control disorders. In addition, before 2013, the APA did not use the term gambling disorder; instead, it used the somewhat controversial (and potentially demeaning) term pathological gambling. Most of the symptoms once used to diagnose pathological gambling are now used to diagnose gambling disorder. These symptoms include such things as loss of control over gambling participation, an increasing preference for high-risk gambling situations, a preoccupation with gambling-related matters, use of gambling to compensate for unpleasant feelings or emotions, and prioritization of gambling over previously established obligations. However, unlike the pathological gambling definition, the gambling disorder definition does not include the financing of gambling through illegal acts as a potential symptom. In addition, the diagnosis of gambling disorder requires the presence of fewer symptoms than the diagnosis of pathological gambling.

Does Age at Onset Matter?

In the study published in Addiction, researchers from five Spanish institutions and two U.S. institutions used data from a U.S.-based project called the National Epidemiologic Survey on Alcohol and Related Conditions to determine if people with diagnosable, early-onset gambling problems differ significantly from people with diagnosable, late-onset gambling problems. Participants from this project submitted detailed information on their demographic backgrounds (age, racial/ethnic background, income level, gender, etc.), as well as information on their age when they first experienced gambling problems, their mental health histories and their involvement in problematic substance use. Since the study was begun before 2013, the researchers used the term pathological gambling in their work, not gambling disorder. In line with the practices of previous research teams, the researchers involved in the current project used the study participants’ 26th birthdays as the cutoff point between early-onset gambling problems and late-onset gambling problems. After establishing this cutoff, they gauged the impact that age at the onset of problems has on the likelihood that any given individual will prefer certain types of gambling or seek treatment to address the effects of his or her condition. The researchers concluded that, in these two important respects, people with early-onset gambling problems don’t differ substantially from people with late-onset problems. However, they did conclude that individuals with early-onset gambling problems tend to share certain underlying characteristics, including such things as being male and relatively young, making less than $70,000 a year, remaining unmarried and having certain types of diagnosable personality disorders. Conversely, individuals with late-onset gambling problems have greater chances of being diagnosed with some sort of mood disorder (depression or bipolar disorder). Based on their findings, the authors of the study published in Addiction concluded that, while people with early-onset gambling problems tend to have different underlying characteristics than people with late-onset gambling problems, individuals in both groups still typically gamble in the same formats. They note that, compared to past generations, people from more recent generations seem to have heightened odds of developing diagnosable gambling issues before reaching the age of 26.        

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