- The Washington Times - Thursday, March 27, 2003

The battle in Annapolis over whether to approve a proposal that would increase legalized gambling in the form of slots has become a maelstrom, fueled by a variety of issues, but none so basic as the question of whether gambling via slot machines can lead to a psychiatric disease called pathological or compulsive gambling.
Maryland House Speaker Michael E. Busch, the leader of the opposition to slots he wants to "study" the gambling issue for a year first is motivated, he says, by his father's "alcohol and gambling problems which devastated the family."
Thus Mr. Busch becomes the equivalent of the reformed addict in this case the son of the addict who is going to make all of Maryland pay for his misperceptions regarding the cause of his family's problems.
The frustration of arguing the proposition that compulsive gambling is a myth is this: So many people who have become accustomed to the term "compulsive gambling" believe that to say it is a myth is to deny there are people who destroy their lives through heavy gambling.
So what is the issue? The issue, simply put, is whether it is by conscious choice that some people devastate their lives by gambling and losing amounts they just cannot afford.
The assumption that compulsive gambling gambling over which the gambler has no control is measurable by behavioral scientists is crucial to the understanding of its mythology. There have been a variety of measures that have purported to measure the compulsivity of gambling. Years ago there was the South Oaks Gambling Screen (sample question: "Have people criticized your gambling?") and now, comparably, there is the Diagnostic Interview Schedule (DIS) which is based on the American Psychiatric Association's Diagnostic and Statistical Manual Version IV (DSM IV). The latter gauge has been cited to "prove" the existence of compulsive gambling, but most people do not know that it is simply a question-and-answer test that assesses how much misery respondents have suffered through gambling.
In an oft-cited study in the Journal of Gambling Studies last year, it is explained that the DIS contains 13 items that correspond to 10 criteria for alleged compulsive gambling. It should be noted that the DIS makes specific reference to lotteries, which Maryland already has. Typical of such surveys this one is administered through the telephone, not a good way to infer lack of control. Endorsing 3 criteria qualifies one as a "problem gambler" and endorsing 5 criteria equals "pathological gambling." But the criteria of the DSM-IV and the DIS do not and can not measure volition.
Questions in the DIS include "Have you ever spent a lot of time thinking about ways to get money together so you could gamble?" The only question relating to self-control is this one: "Have you more than once tried to quit or cut down on your gambling without [sic] being able to?" How is it validated that the subject was unable to? It is not.
The DSM-IV diagnostic criteria for pathological gambling refer to the intensity of subjects' urges to win back losses as well as the commission of crimes and anti-social acts allegedly as the result of gambling losses. Those criteria, too, include as one criterion of self-control: the claimed inability to stop gambling. But the psychiatric manual offers no way to measure it either.
To call heavy gambling an "addiction" falsely loads the argument against slots; there is no neurochemical or neurophysiological change causally linked to heavy gambling, only some changes that occur as the result of its excitement (increased adrenaline, temporary rise in blood pressure, etc.). People who gamble too much and suffer significant losses whether through lotteries or slots or other means choose to gamble irresponsibly. No force extrinsic to willpower forces people to gamble.
To the extent that people cite pathological or compulsive gambling as their reasons for opposing slots reduces their objection to desire for a "nanny state," one in which the state acts in loco parentis to prevent its citizens from hurting themselves..

Richard Vatz is professor at Towson University in Maryland and associate psychology editor of USA Today Magazine.

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