James Keefer MS LPC NCGC 604 Wilson Street Martinsburg, West Virginia 25401

 I Pathological Gambling ◦ 1 Preoccupied with gambling ◦ 2 Tolerance ◦ 3 Repeated unsuccessful attempts to control, cut back or stop gambling ◦ 4 Restless or irritable when attempting to cut down or stop gambling ◦ 5 Gambles as a way of escaping from problems or relieving dysphoric mood ◦ 6 Chasing losses  CONT’D

◦ 7 Lies to family members, therapists about gambling ◦ 8 Has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling ◦ 9 Has jeopardized or lost a significant relationship, job, or educational career opportunity because of gambling ◦ 10 Relies on others to provide money to relieve a desperate financial situation caused by gambling

Shadow Syndromes and Comorbidity

 There are over 300 different manifestations of mental illness (Medical News Today, 2004).  Each disorder has a number of criteria that an individual has to have to receive that diagnosis.  The diagnosis of Generalized Anxiety Disorder lists 6 criteria, but you need a minimum of 3 symptoms for the diagnosis.

 SITUATION - An individual with a Pathological Gambling Diagnosis, that also has 3 or more of the criteria for GAD, could have a dual diagnosis, also known as (aka) comorbid diagnosis.  If they have less than 3 symptoms it might represent a shadow syndrome (Boudreadu & Shaffer, 2009).  [see next page for visual example].

 Symptoms GAD:  Restlessness  Easily fatigued  Difficulty concentrating  Irritability  Muscle tension  Sleep disturbances  (American Psychiatric Association, 2003)

 What would happen if…? +GA Bipolar -Attention Deficit Hyperactivity Disorder -Dissociative Disorder

Caution – We are still under construction – where do we go from here? Indecision may or may not be my problem. (Jimmy Buffett, nd.)

Diagnoses are important and helpful in Understanding the range of behavioral influences. However, they are somewhat artificial and sometimes we just don’t know what is going on! We sometimes fly by the seat of our pants.

 Tell me why I gamble and then I will stop.  ?

Theories of Addiction Brain Reward Dopaminergic System Frequently similar to theories of drug and alcohol theories

 Brainy Quote. (2012) Indecision quotes.  Retrieved from:   Medical News Today. (2004). How many  mental disorders are there? Retrieved  from: 