Questions on pathological gambling 1) the characteristics of gambling. Since 1980 the American Psychiatric Association recognized gambling as a manifestation of mental illness.
syndrome is a subtle, gradual, occurring without the person becoming aware. It 'almost impossible to expect to identify a pathological gambler by simply calling it by its appearance, its class, the' age or from work as it affects men indiscriminately, women, young, old, rich and poor. The scenario is further varied, since any type of gambling can lead to this dependence not only on slot machines or poker or roulette, but also horse racing and betting of all types. If we were to make a first generalization we could probably identify the "games" that seem to predispose to this greater risk are those that have greater spatial and temporal proximity between challenge and reward, such as slot machines and casino games, video poker and also the Bingo.
In the general population the most vulnerable segments of women are represented by housewives and employed women between forty and fifty years while among the men from unemployed or self-employed workers who have frequent contact with money or by selling and around age forty. The latest studies are showing that this disease appears to be closely linked to the ongoing economic crisis in our country, so that there is an increasing incidence of addiction with the progressive impoverishment of the population. Another aspect of this
meaningful psychopathology is represented by the indescribable suffering that provides both to those who are affected both the household; represents an earthquake that affects vital areas of life as the economic, personal, family, relationships, and social work. This occurs because individuals classified as compulsive gamblers are chronically and progressively unable to resist the urge to play.
The causes may be numerous but generally people tend to develop a drug addiction or certain behaviors do it because they think they can get better through their use. fact normally take analgesics to relieve pain so people drink or take street drugs to satisfy an unwanted state of mind. The truth is that when one enters the dependency, eg to exit a routine, not to be sad or to solve an emotional problem, the relief is only temporary. As a result the person feels worse than before.
Therefore the people who carried out the abuse tend to use the situation that is created to "solve" unpleasant sensation, pain and emotional states because they think that this conduct is the cure. Traditionally it is believed that the addiction to substances or behaviors there is an alteration of brain mechanisms involved in reward and motivation involving meso-cortico-limbic circuits.
These mechanisms are regulated by the interaction of different systems including neurotrasmittitoriali primarily involved are the dopaminergic system that controls the motivational in search of rewarding stimuli, and the opioid system that mediates the processes of reward derived from consumption of the substance.
2) What causes pushing an increasing number of individuals groped in the streets of the game? Although we can not find a single factor predisposing to the development of this syndrome, surely there are several elements that interact among themselves explain, at least in part, as the individual may seek a fulfillment through a compulsive addiction. In this case, the paradigm that is used takes into account the interrelationships between various elements detectable in
Bio-Psycho-Social Model. For this interaction di Aspetti Biologici, come, ad esempio, uno squilibrio nel funzionamento del sistema di neurotrasmettitori cerebrali atti a produrre serotonina, di Aspetti Psicologici connessi alla presenza di tratti di personalità di tipo dipendente e/o ossessivo; interagiscono con Aspetti Ambientali-Educativi. Tali aspetti sono rappresentati dall’educazione ricevuta, da situazioni problematiche presenti, da una tendenza a stimolare le possibilità di felicità unicamente legate al possesso del denaro o la presenza di difficoltà economiche. Quindi la dipendenza patologica risulta essere la somma di questa serie di fattori predisponenti bio-psico-sociali che, in presenza di uno stimolo scatenante, danno origine alla patologia compulsiva conclamata. Solo la concomitanza of these factors, and others, may explain the onset of the disease. Systematic studies have also shown that only one of the predisposing factors is not an adequate indicator of the development of this syndrome. At the same time when the disease manifests itself appears to be characteristic of all forms of addiction. For this there are signs of addiction (the player must play more and more), loss of control (the player can not avoid playing and stop when it starts), the withdrawal syndrome (the player is physically ill and / or mentally if he does not play) craving (compulsive need to play). All these elements allow the player to differentiate pathological from the "Normoid. Ultimately, the way the game is put in parentheses and are lacking the essential preconditions for that activity is a game like the freedom of the subject, now a slave to the compulsion of the rules of space and time and the opportunity to exit the game when so wishes.
3) The media to promote its view on gambling? Although at times the media play an important role in prevention and health information in regard to these diseases, at other times conflicting messages are constantly encouraging the culture of pleasure and play until you get to emphasize the stereotype of winning as one that with a bold bet may change in the blink of an eye his life.
Instead the media could play an 'important function to contain the spread of gambling because the disease is the expression of a combination of genetic, environmental and psychological. We must consider that the proliferation of games introduced by the state monopoly and widely advertised, creating a contradictory and ambiguous situation in which one part is trying to encourage a behavior that at the same time you try to contain.
4) Public awareness campaigns are carried out with sufficient effort? Today access to the game is more easier and more widespread and consequently increases the percentage of pathological gamblers. E ', therefore, evident that there is greater demand for help, there is a need for a' proper awareness campaign to abandon dependence on slavery through greater awareness on the services they represent a form of aid for those affected. In Italy you have not yet managed to make a clear policy to raise awareness about various aspects of the problem nor to create appropriate action plans varied.
This is because there is a discrepancy between ethics and moral ethics which is the conclusion on what is deemed an individual right or wrong, not based on scholarly citations or hearsay, but always trying to use their experience and the moral is all the personal conclusions of each added to those of all others who in fact to define the social assumptions of what is right and what is wrong for society. Objective awareness campaigns should therefore be to promote an understanding of gambling as a form of entertainment rather than as a means to obtain money and support patterns of game-controlled rather than argue its complete prohibition. The state actually offers a diverse amount of regular opportunities for play by a glimpse through advertising the possibility of easy wins, so the game encourages one hand and the other promotes awareness campaigns that do not slow to take effect at the level of ethics but only a moral level because they never show the considerable difference between victory and return rates participants. So by implementing a policy of only a moral and ethical fails to produce necessary behavioral changes in the citizen as a reduction of the phenomenon. In conclusion, if one part of the education campaigns are moving to reduce the most problematic situations on the other there's pressing need to promote a culture that enhances the game without underestimating the potential the components of risk through information campaigns, awareness and prevention of inappropriate behavior. This represents, in my view, the challenge they will face in the years the various awareness campaigns.
5) What signs manifest those who fall into addiction? E 'duty to make a distinction between gamblers and pathological gamblers. Generally, many games of chance are pleasant pastimes for people and are not necessarily descriptive of a disease. One aspect often overlooked is the amount of time spent playing, this is configured as a primary factor in the problem of discriminating vi è una graduale perdita della capacità di autolimitare il proprio comportamento di gioco, che finisce per assorbire, direttamente o indirettamente, sempre più tempo quotidiano, creando problemi secondari gravi che coinvolgono diverse aree importanti della propria vita. Il giocatore diviene così compulsivo nel suo agire e sviluppa un impulso per il gioco assimilabile ad un bisogno irrefrenabile e incontrollabile al quale si accompagna una forte tensione emotiva ed una incapacità, parziale o totale, di ricorrere ad un pensiero riflessivo e logico. Spesso nelle storie dei giocatori d’azzardo patologici si sentono affermazioni che rappresentano un autoinganno ed un ricorso a ragionamenti apparentemente razionali che assumono la funzione di strumenti Control of guilt and engage and feed a vicious self-destructive. Through these thoughts employee loses the player and at the same time justifying his game with the persistent attempt to rebuild and "at least be able to take back the money lost." Then the thought
becomes dysfunctional, "If I win I justify saying that it is my lucky day and I have to take advantage of it," and this highlights a temporary victory because it supports through a true reality but rather unstable and temporary. Is to emerge as a state of mind very different from that of a normal player, but not too frequent disease in which there is a slowdown or even a block of time stems from a tendency to reach an altered state of consciousness from the game completely. These modes of thought, moreover, are supported by other conduct of addiction as the consumption of alcohol or other psychoactive substances, which is associated with the game feed you lose control of his conduct.
The most common signs of this problem must exclude other medical or psychiatric disorders highlights: excessive absorption in direct or indirect activities (programs, games, thoughts about how to obtain money, etc..) Related to gambling need increase the amount of money with which to play to achieve desired levels of arousal, repeated but unsuccessful attempts to stop, reduce or control their gambling behavior, anxiety or irritability when attempting to control or reduce the gambling tendency to use the use of gambling to reduce negative affective states (guilt, helplessness, depression, etc..) or to escape problems, tendency to return to the game to make up for losses from previous propensity to lie about their gambling behavior, loss of real or serious risk of loss as a result of gambling, one or more reports or significant impairment of work or educational opportunities, use of illegal conduct such as theft, fraud, cheating, forgery, more demanding of money required to remedy to their financial situation more or less desperate because of gambling debts.
We can speak of a true "addiction to gambling" if there are symptoms of tolerance, such as the need to increase the amount of play, withdrawal symptoms such as irritability, anxiety and discomfort related to problems associated with growing or criminal behavior and impulsive symptoms of loss of control manifested by an inability to stop playing.
In general, according to the classification criteria of traditional psychiatry, we can summarize that we are in the presence of "pathological gambling" when there is a "persistent behavior, applicant and maladaptive gambling, "meaning in this case that the game can have some heavy negative impact on personal, social and work of the player (AA.VV., 1994).
6) Support groups can help? must specify that there are many support groups and according to their composition, target of intervention and rehabilitation objectives take different names. Basically any sort of psycho-education, information, sharing and retrieval when used within an integrated rehabilitation process of the person is an effective therapeutic tool in order to be able to make significant changes individual. Two types of groups have proved extremely effective as an adjunct to the process of personal growth. These are represented by groups of self-mutual-aid consists of people united by the fact that you have all the same problem, which is dealt with helping each other. These people meet in groups once a week in a local sitting in a circle can speak freely coagevolati of communication experts and can meet on their daily problems related to the trend for gambling. The appearance is the basis for mutual assistance. Another group is formed by the players' family members and represents the opportunity to receive attraverso il confronto con altre persone con difficoltà identiche, un sostegno emotivo utile nell’affrontare le difficili situazioni che i giocatori eccessivi creano. Il coinvolgimento dei familiari parte dalla costatazione che il giocatore trascina nelle proprie perdite l’intera famiglia (con conseguenti problematiche economiche, sociali e relazionali). L’analisi e l’obiettivo del cambiamento non sono rivolti al solo portatore del sintomo ma a tutto il nucleo familiare che prenda coscienza che il gioco d’azzardo non è solo del giocatore ma di tutti componenti. Gradatamente, con l’analisi delle relazioni, la famiglia consegue dei cambiamenti ”permettendo” al giocatore di far fronte alle proprie difficoltà.
7) what are the steps for rehabilitation? The therapeutic practice in the rehabilitation of patients dependent on d game 'pathological gambling must take into account a working network, within which to operate the institutions, voluntary associations and many other professionals such as doctors, psychiatrists, specialists and psychologists. The latter important to restore a normal situation occurring around the subject if there are changes, such as discomfort or unpaid should be restored if the relationships within the family and social context of the patient. A fundamental aspect is that all these figures should work jointly recognizing the equal dignity to each one in different professional contributions in respect of each other's wealth and operational characteristics. So all the operators are a key therapeutic resource.
On a practical level and operating the patient in the healing process goes through several stages which are described by two authors: JO Prochaska and JC Norcross to represent you are: Precontemplation : where there is little or no awareness or you do not want to change ( need to do little work and awareness of the problem). Contemplation: tip the balance towards action. Working on the positive aspects of dysfunctional behavior (the person is not always clear what the behavior disfunzionale nell'economia psicologica), utilizzare la bilancia motivazionale e valutare costi e benefici associati ad entrambi gli aspetti cioè status quo e cambiamento. Preparazione/determinazione: costruire un piano accurato per la gestione di tutte le circostanze o difficoltà che la persona potrebbe incontrare nel ridurre il comportamento problematico. Azione: modificazione del comportamento. Sostenere il paziente sull'importanza del cambiamento che sta attuando e sulle capacità che sta utilizzando. Mantenimento e ricadute: preventivare le probabili ricadute senza colpevolizzare la persona. Evidenziare ciò che si può prendere di positivo dalla ricaduta. Il processo di guarigione del giocatore patologico prevede un trattamento che utilizzi accurati recognize, that no reference to the modern psychology, psychiatry and drug therapy, they will use the occurrence of those conditions that lead to think that we are dealing with a person whose gambling addiction is likely to cause serious mental illness when it is not able to satisfy the need.
Dr. Lorenzo Flori
"E' bellissimo!" 
