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Book Forum: Compulsive Disorders and Eating Disorders   |    
The Biology of Gambling
RICHARD BALON, M.D.
Am J Psychiatry 2005;162:201-201. doi:10.1176/appi.ajp.162.1.201
View Author and Article Information
Detroit, Mich.

By Mikal Aasved, Ph.D. Springfield, Ill., Charles C Thomas, 2003, 356 pp., $86.95; $57.95 (paper).

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Gambling has attracted and fascinated people for centuries. The first treatise on gambling was probably Gerolamo Cardano’s Book on Games of Chance, published in 1663 (long after Cardano’s death in 1576). The most famous and fascinating literary portrait of a gambling man is Dostoevsky’s The Gambler, based in part on Dostoevsky’s personal experience. A century or two ago, gambling was considered an entertainment and passion of a few, predominantly wealthy, people. However, the growth and spread of the gambling "industry" across the United States during the last seven decades (Nevada legalized gambling in 1931; Bugsy Siegel opened Flamingo Casino on New Year’s Eve 1946) made gambling an entertainment of the masses. As governments and American Indian tribes recognize gambling as a means of generating revenues, casinos, racinos, riverboat casinos, and other gambling ventures are mushrooming around the country. With the increasing number of people who gamble we encounter an increasing number of people for whom gambling poses a problem—pathological gamblers. As the gamblers accumulate their problems and seek help, more professionals from different disciplines, especially from the field of mental health, try to understand and investigate normative and excessive or pathological gambling. The body of literature on gambling has become fairly large.

Mikal Aasved, a research associate at the Center for Addiction Studies in Duluth, Minn., attempts to summarize and synthesize the literature on gambling in this book. The Biology of Gambling is the third volume of the Gambling Theory and Research Series. The first two volumes focused on the psychodynamics and psychology of gambling and on the sociology of gambling.

The book is divided into four parts. Part 1, Medical or Disease Models of Addiction, reviews in three chapters several views, classifications (including Jellinek’s), concepts, and "the quest to discover the biological basis of addiction." Since there are parallels between addiction and gambling, especially in establishing the diagnostic criteria, this part serves as a foundation for part 2, Medical or Disease Models of Pathological Gambling. In seven chapters, the author discusses issues such as gambling and human evolution, Jellinek’s legacy (the disease concept of compulsive gambling), different definitions and diagnoses of pathological gambling, and the treatment goals of abstinence versus moderation (extrapolated from alcohol research). Aasved also provides a critique of the medical and addiction models of gambling. The reader has to get through almost 100 pages before getting to "the quest to discover the biological basis of pathological gambling," which, based on its title, should be the focus of the entire book. Alas, the review of the biology of gambling is a rather (understandably) skimpy hodgepodge of neurotransmitter, comorbidity, intelligence, and family and twin studies.

Part 3, Multicausal Models of Pathological Gambling, contains three chapters that summarize and criticize the general theories of addiction involving relief and escape versus sensation seeking and arousal as well as gambling-specific theories. Part 4, Conclusions, provides a summary of the entire book and a discussion of "where do we stand now and where do we go from here?" An appendix, Summary of Etiological Theories of Gambling, provides brief summaries of psychodynamic, behavioral, psychological, and social science approaches; statistically based theories; medical or disease models; and multicausal theories of gambling. As the author notes, no single theoretical approach has been or probably will ever be able to account for all cases of pathological gambling.

My main issues with this book are its title, wordiness, and lack of synthesis. The book provides very little on the biology of gambling because there is probably not much meaningful evidence of a biological basis of gambling so far. The book would better be called Theories of Etiology of Gambling because that is what the book is about. I am also not sure who the audience of this book could or should be. Those seriously interested in theories of gambling may find it fairly informative and even entertaining. Libraries may add it to their reference book collections. But what about the rest of us?

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