Cognitive-Behavioral Therapies and Problem Gambling - Essay Example

Running Head: PROBLEM GAMBLING When It Comes to Gambling, When You Lose You Lose, When You Win You Lose: The Relative Contribution ical and Operant Conditioning to Problem Gambling. [Author's Name] [Institution's Name] Abstract Gambling has become a famous pastime nowadays. However, for many people, it has also become a problem. A large number of people become problem or pathological gamblers. These gamblers not only harm themselves but harm others and the community too. To treat such people, it is necessary to first understand the behavior of normal/social gamblers and problem gamblers. Researchers have proposed various theoretical models to explain gambling behaviors but none of them seems to encompass all the aspects of gambling behavior. Operant and classical conditioning theories are particularly helpful in explaining the behavior of gamblers to a greater extent. This paper will look at various theories and therapies related with gambling behavior with the focus on conditioning theories. When It Comes to Gambling, When You Lose You Lose, When You Win You Lose: The Relative Contribution of Classical and Operant Conditioning to Problem Gambling. As gambling is becoming a popular activity, the problems associated with gambling are also increasing. Because of this, it has become necessary to do extensive research into the different facets of gambling including the behaviors that influence gambling, the negative effects it can have, and treatment of gambling addicts. Researchers have also tried to classify gamblers into various categories using different criteria. For example, Abbott, Palmisano & Dickerson (1995) classify gamblers as excessive of normal gamblers; Fisher (1993) classifies them as social or pathological gamblers; Gupta & Derevensky (1998) classify them as social, problem, or pathological gamblers; Shaffer et al. (1994) classify them as non-pathological, in-transition, or pathological gamblers; and Vitaro, Arseneault & Tremblay (1999) classify them as recreational, low-problem, or high-problem gamblers. (cited in Blaszczynski & Nower, 2002) These differences in the classification of gamblers have also resulted in non-applicability of a single gambling model to the overall population of gamblers, although there are other various reasons too. A single theoretical model of gambling cannot explain and account for the various biological, psychological and social factors that are related with problem gambling. Problem Gambling Problem gambling can be defined as a "gambling behavior which causes disruptions in any major area of life: psychological, physical, social, or vocational." (The National Council , nd. n.p.) Problem gambling also includes what other researchers like Blaszczynski & Nower (2002) have referred to as pathological gambling. Pathological gambling refers to an enduring and repeated maladaptive gambling behavior, in which the gambler cannot control the desire to gamble, which may bring harmful psychosocial results: personal, familial, financial, professional, or legal. (APA, 1994; cited in Blaszczynski & Nower, 2002) Because of his inability to control his gambling behavior, a problem gambler may harm his own self, his family or the community. For example, a problem gambler will give priority to his gambling habits over his family's needs, and therefore, will not care about destroying his familial life as a normal person would care. There are some symptoms that are commonly found in problem gamblers although they do not necessarily mean that a person is involved in problem gambling. These signs include but are not limited to headaches, back pain, insomnia, ADHD, anxiety. (Tessier & Ballon, 2003) It is recommended that when such orders are frequently found in a patient, a physician should test him for problem gambling. Classical and Operant Conditioning Classical conditioning revolves around the concepts of stimulus and response. A stimulus is anything that brings a response in the subject. A response is a reaction that is brought by the stimulus. For example, a kid might become happy (response) when he sees a candy. Hence, the candy is a stimulus and happiness is a response. In this case, candy is an unconditioned stimulus, meaning that it brings the response (happiness) without any effort to train the kid about this. However, a different stimulus (a whistle) can be brought in to condition the kid to happiness (response). To do this, a researcher can blow the whistle each time before giving a candy to the kid. After frequent instances, the kid will learn that when the whistle is blown, he will get a candy. Later, the kid will show happiness when the whistle will blow (even before he sees the candy). However, this conditioned behavior can also diminish if the unconditioned stimulus (candy) is removed in many subsequent instances. On the other hand, operant conditioning involves the use of reinforcements. A reward or a punishment is given to increase or decrease a behavior. For example, casino owners want people to gamble. To increase this behavior, they give monetary rewards to winning gamblers. If a gambler gambles again and again without winning, he is not getting any reward. Hence, chances are that his behavior will not increase and might extinguish. Alternatively, if a gambler wins from time to time, he is more likely to gamble according to the operant conditioning theory (although a research may prove some limitations to this theory). Behaviorist Approaches To understand the behavior of gamblers, various theories and models have been used. In this regard, the classical and operant conditioning theories have also been used. As discussed earlier, operant conditioning involves positive and negative reinforcements. Delfabbro & Winefield (1999a, 1999b) and Dickerson, Hinchy, Legg England, Fabre & Cunningham (1992) have used operant conditioning theories to point out that the recurring behavior of a problem gambler can be due to conditioning through irregular reinforcement periods, probably a variable-ratio schedule. (cited in Griffiths & Delfabbro, 2001) This can mean winning with irregular frequencies without a fixed number of responses in between. The operant approach does account for the enduring behavior of a gambler; however, it does not sufficiently account for the motivational factors underlying the start of a new game of gambling, especially after a gambler has abstained from gambling for a long period. (Griffiths & Delfabbro, 2001) Anderson & Brown (1984) link gambling behavior with classical conditioning. (cited in Griffiths & Delfabbro, 2001) They state that gamblers keep on gambling because they get accustomed to the excitement or arousal that they feel while gambling. Due to this, gamblers may get a feeling of boredom while they do not gamble. As opposed to the operant approach, the classical approach does explain the motivational factors responsible for starting a new game of gambling; nevertheless, this theory is not sufficient in justifying the enduring behavior of a gambler. (Griffiths & Delfabbro, 2001) Hence, it would be appropriate to say that there are some limitations to these theories, and at some situations, these theories fail to explain a gambler's behavior. It must be understood that the classical and operant theoretical approaches cannot fully explain the gambling when they are considered separately. (Griffiths & Delfabbro, 2001) Considering them separately also means that one theory denies other theories. On the other hand, it seems more appropriate to say that where classical conditioning can explain the behavior of some gamblers at some situations, operant conditioning also explains similar or different behaviors at similar or different situations. Moreover, both these conditioning approaches are unable to describe why different individuals given the same stimuli show separate responses; why a number of people gamble and others do not gamble; and why the frequency and the extent of gambling amongst various individuals varies. It is also possible that these theories can explain behaviors in a certain type of gambling activities (like games based purely on chance), whereas they may not be applicable to other types of gambling activities (like games involving some skills too). The Social Learning Model The social learning approach considers gamblers' behaviors in the light of the operant conditioning theory, where the gamblers' behaviors become strong as the behaviors get reinforced. In the beginning, it was believed that the monetary gain was the positive reinforcement; however, with time, researches have revealed that the physiological arousal is highly significant with respect to reinforcement. (Upfold, 2001) Skinner (1953) proposed that a particular gambler's behavior is closely linked with his reinforcement history. (cited in Upfold, 2001) He further pointed out that a gambler's win in the beginning sessions of gambling amplified the probability that the gambler would continue to gamble, even though the reinforcement ratio decreased later (the gambler loses more than he wins). This hypothesis was tested (and proved) on rats and pigeons but not on men. Custer (1984) too mentions that a big success in the preliminary stages of gambling is significant in making a gambler a pathological gambler. (cited in Upfold, 2001) There is still doubt about why problem gamblers may continue with their behavior although they might be experiencing only a few wins. According to Upfold (2001), there can be two possible reasons. Firstly, the 'partial reinforcement extinction effect', also known as the PREE, might be the cause of such a behavior. PREE means that reinforcement schedules that are give rewards from time to time create a greater determination in the behavior after the reward ceases to some, as compared to nonstop reinforcement schedules. Moreover, determination and longevity of a gambler does actually bring reward due to the fact that the gambler's persistent behavior will result in a success if he does not stop gambling. Hence, the determination to gamble becomes even stronger after such a success. (Griffiths, 1995; cited in Upfold, 2001). Secondly, arousal might be the reason for this. According to Brown (1987), arousal plays a significant role in problem gamblers. (cited in Upfold, 2001) Brown mentions that people have diverse psychophysiological arousal desires. Problem gamblers might develop a habit of using gambling to satisfy their arousal desires. Hence, arousal can be the main reinforcer of a gambler's behavior. Brown describes that a person might start to gamble under influence from social and sub-cultural situations. If he does not cease to gamble, then it may be because of reinforcement and his specific psychophysiological arousal desires. In addition, the presence of cognitions might further boost the behavior of a problem gambler. Hence, it can be said that the social learning theory describes the gambler's behavior as a resultant of various factors. Therefore, gambling behaviors can vary from social gambling to pathological and extreme gambling. Moreover, this behavior cannot be said to stick to a particular sequence of stages. Similarly, problem gamblers' behaviors can be changed and are not stable. (Upfold, 2001) The Cognitive-Behavioural Model The cognitive-behavioral approach states that an individual's behavior is commenced and continues due to learning and cognitive factors. (Upfold, 2001) Sharpe & Tarrier (1993) are of the view that conditioning (both operant and classical) is responsible for (and plays a major role in) developing a gambler's specific behavior. (cited in Upfold, 2001) This behavior is said to be strengthened from reinforcement schedules, mainly via an integration of monetary gains and amplified physiological arousal stages. There is a cognition that success will be irregular, but will come if one stays determined and continues to gamble. In case such reinforcements carry on, the gambler may develop relations by means of classical conditioning. "The gambling environment becomes associated with increased arousal, and may generalize to other gambling-related stimuli. These stimuli act as triggers for gambling because they have the ability to increase arousal." (Upfold, 2001, n.p.) In addition, cognitive factors and perception also have a key function in continuing a gambler's behavior. (cited in Upfold, 2001) If a gambler has misperceptions about why he succeeds or loses, then he will be more likely to continue towards problem gambling. Similarly, a perception that one would win/succeed also increases the likelihood that a person will gamble. Sharpe & Tarrier (1993) point out that when a gambler confronts the desire to gamble, the situation depends on "[his] coping skills - the individual's ability to control increased arousal, analyze distorted cognitions, delay reinforcement, and apply problem solving skills". (cited in Upfold, 2001, n.p.) Pathways Model Gambling is a multidimensional activity and causes of problem gambling are diverse and complex in nature. Social, psychological, and biological causes may all play some role in the development of a problem gambling behavior. Hence, to successfully treat such a patient, it is necessary to understand the various factors underlying a gambler's behavior. Blaszczynski (1998) and Blaszczynski & Nower (2002) mention a pathways model that can help in understanding these various aspects that influence or might influence gambling behavior. This model divides problem gamblers into three different subclasses: non-pathological or normal, emotionally vulnerable, or biologically based or impulsive. (Teasell & Ballon, 2003) Regardless of the subclass in which a problem gambler is, a few factors are common in all of them. (Teasell & Ballon, 2003) Firstly, the presence of gambling locations and access to them is common. Secondly, conditioning is common such that gamblers develop associations between gambling and excited emotions, escalating heart rate, etc. Thirdly, cognitive distortions are also commonly found amongst all subclasses of gamblers. (Teasell & Ballon, 2003) Early Aversive Treatments As mentioned throughout this paper, initial researchers had recognized the role of operant conditioning in gambling behavior. Irregular reinforcement schedules are linked with a gambler's behavior; hence, a preliminary treatment was based on lessening the positive reinforcements or the conditioned preferred location for gambling activities. Treatments involved giving (electric) shocks to the sample while they were gambling or were vulnerable to a gambling stimulus. (Petry & Roll, 2001) The research showed significant improvements in a gambler's behavior and more than 50% of the sample stopped gambling whereas others also improved. (Petry & Roll, 2001) Cognitive-Behavioral Therapies The 1980s saw the start of treatments involving cognitive factors. According to Petry & Roll (2001), several researches showed the benefits of using cognitive-behavior therapy (CBT) for treating problem gambling. Petry & Roll (2001) developed their own CBT framework for inducing non-gambling behaviors. This model uses reinforcements to control a gambler's behavior. It uses reinforcers greater than gambling, like dining out at some restaurant, eating dessert, watching a movie, etc. The gamblers are told to keep abstain from these greater reinforcers on the day they gamble. This therapeutic model allows patients to build up their own self-rewarding system. (Petry & Roll, 2001) This CBT model uses a combination of cognitive activities where patients are asked to analyze the situation, and Petry & Roll are quite optimistic about its success. As it was seen throughout this paper, many researchers have tried to develop theoretical models to explain the behavior of gamblers, problem gamblers, pathological gamblers, etc. However, no single theoretical model of gambling explains and accounts for the various biological, psychological and social factors that are related with problem gambling. The pathways model (Blaszczynski & Nower, 2002) is a good step towards integrating the many aspects related with the behavior of gamblers and can help in treatments through CBT, as mentioned by the researchers. However, more empirical research needs to be conducted in this regard to test it on a greater sample and also to compare its effectiveness with other researches. To understand the behavior of problem or pathological gamblers, it is necessary to consider multiple theories, as the gambling behavior is multidimensional in nature. References Abbott, M., Palmisano, B. & Dickerson, M. (1995) Video Game Playing, Dependency and Delinquency, a question of methodology. Journal of Gambling Studies, 11, pp.287-301. Anderson, G. & Brown, R.I.F. (1984). Real and Laboratory Gambling, Sensation-Seeking and Arousal. British Journal of Psychology, 75, pp.405-410. Blaszczynski, A. (1998) Overcoming Compulsive Gambling: A Self-Help Guide Using Cognitive Behavioural Techniques. 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