Withdrawal and Tolerance Phenomenon in Problem Gambling

Abstract

The phenomenological similarities between gambling and substance dependence have led to the conceptualization of pathological gambling as an addictive disorder. Tolerance and withdrawal are important features of both disorders, suggesting commonalities in the neurobiological processes associated with neuroadaptational underpinnings. However, there are few empirical studies supporting the presence of tolerance and withdrawal reported in the gambling literature. Moreover, there are no studies comparing the equivalence of tolerance and withdrawal between gambling and alcohol dependence. This study compared tolerance and withdrawal features in samples of gamblers, alcoholics and gamblers who also met criteria for alcohol dependence. In contrast to the addiction model, findings indicate that, while a majority of participants increased bet size, the motivation to do so was not for excitement or to maintain arousal levels as indicated by the DSM-IV-TR but because of cognitive factors related to winning. Results supported the notion that pathological gamblers experienced similar levels of withdrawal symptom severity as alcohol-dependent participants. Further research is needed to evaluate whether those symptoms result from the inability to gamble or from the loss of an avoidant stress coping strategy.

Acknowledgements

Financial assistance for this project was provided by the New South Wales Government from the Casino Community Benefit Fund. The views expressed in this report, however, are those of the authors. The authors wish to extend their grateful appreciation for the support provided by the trustees and administrative staff of the Casino Community Benefit Fund in funding this research. The authors would also like to thank the following organizations for participating in the research project by distributing questionnaire protocols to their clients: Wesley Gambling Counselling Services at Penrith and Surry Hills (gambling); Wesley Rehabilitation Services Ashcroft (alcohol and gambling); Maryfields Day Recovery Service Campbelltown (alcohol and gambling); Langton Clinic Surry Hills (alcohol and gambling); Gambling Care, Lifeline Canberra (gambling); the University of Sydney Gambling Treatment Clinic.