Gambling Behind the Walls: A Behavior-Analytic Perspective

J. Weatherly, Kevin S. Montes, D. Peters, Alyssa. N. Wilson
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引用次数: 5

Abstract

The field of behavior analysis has done an excellent job of not only raising public awareness about certain disorders (e.g., Autism), but also developing the best treatments for those disorders. The field has not yet, however, done so for many behavioral disorders. For instance, pathological gambling is a major societal issue, but little behavior-analytic work has focused on it despite the fact that the disorder occurs at several times the frequency of other, more publicized, disorders such as Autism (Dixon, Marley, & Jacobs, 2003). One possible reason for the dearth of behavior-analytic research could be B.F. Skinner's (1953) conclusion that gambling behavior could be understood in terms of schedules of reinforcement. Subsequent research, however, suggests that multiple factors likely control gambling behavior (e.g., see Weatherly & Dixon, 2007). According to most prevalence studies, the rate of pathological gambling in the general population likely ranges between 1 -2% (see Petry, 2005, for a review). In terms of absolute numbers, these percentages represent millions of individuals in the United States alone. The numbers do not, however, encapsulate the problem. That is, pathological gamblers are individuals who officially meet diagnostic criteria according to the DSM-IV-TR (American Psychiatric Association, 2000). Other people are labeled as "problem gamblers" because they display some symptoms of pathological gambling, but not enough symptoms to be diagnosed clinically as pathological. The prevalence rates of problem gambling are also difficult to estimate, but it seems reasonable to conclude that the number of problem gamblers exceeds the number of pathological gamblers, possibly another 5% or more of the population (see Petry, 2005). Pathological gambling is currently classified as an impulse disorder that is not otherwise classified. (1) To meet diagnostic criteria for pathological gambling, an individual must display at least five of the ten possible symptoms. Three of these symptoms are generally considered "cognitive" in nature. The possible cognitive symptoms include a preoccupation with gambling, feeling the need to increase one's betting so as to maintain the original level of excitement or arousal, and feeling restless when one attempts to cease gambling. (2) Six of the remaining seven symptoms are descriptive of behaviors in which the gambler might engage. They are trying to cease gambling but failing, increasing one's betting in an attempt to win back what has been lost (i.e., chasing one's bet), lying to others so as to conceal one's gambling, engaging in illegal behavior to finance one's gambling, putting one's opportunities (e.g., job, personal relationships, etc.) in jeopardy because of continued gambling, and turning to other individuals to finance one's gambling or to address financial issues that have resulted from one's gambling. (3) Interestingly, only one of the official symptoms for pathological gambling specifically identifies a contingency that might be controlling the person's gambling behavior; that the person gambles as an escape. It will therefore likely come as no surprise to behavior analysts that this particular symptom may have special relevance, which will be addressed later in the paper. As one might imagine, the research literature on gambling is immense (and beyond the scope of the present paper to review all of it), and many researchers have attempted to identify the factors that lead to pathological gambling. Unfortunately, the vast majority of this research is correlational in nature. As such, associative relationships can be, and have been, identified. However, the causal mechanisms underlying the disorder have not been firmly established. Regardless, research has potentially identified the establishing operations (Michael, 1993) or setting events (Kantor & Smith, 1975) for pathological gambling. As outlined by Petry (2005), there are six major risk factors for pathological gambling, several of which may be intercorrelated. …
墙后的赌博:行为分析的视角
行为分析领域不仅在提高公众对某些疾病(如自闭症)的认识方面做得很好,而且在开发治疗这些疾病的最佳方法方面也做得很好。然而,该领域还没有对许多行为障碍进行这样的治疗。例如,病态赌博是一个主要的社会问题,但很少有行为分析工作关注它,尽管事实上这种疾病的发生频率是其他更广为人知的疾病(如自闭症)的几倍(Dixon, Marley, & Jacobs, 2003)。行为分析研究缺乏的一个可能原因可能是B.F. Skinner(1953)的结论,即赌博行为可以从强化时间表的角度来理解。然而,随后的研究表明,多种因素可能控制赌博行为(例如,参见Weatherly & Dixon, 2007)。根据大多数流行病学研究,一般人群的病态赌博率可能在1% -2%之间(见Petry, 2005年的综述)。就绝对数字而言,这些百分比仅在美国就代表了数百万人。然而,这些数字并不能概括问题。也就是说,病态赌徒是根据DSM-IV-TR(美国精神病学协会,2000)正式符合诊断标准的个体。还有一些人被贴上了“问题赌徒”的标签,因为他们表现出一些病态赌博的症状,但这些症状还不足以在临床上被诊断为病态。问题赌博的流行率也很难估计,但似乎可以合理地得出结论,问题赌徒的数量超过了病态赌徒的数量,可能占人口的5%或更多(见Petry, 2005)。病态赌博目前被归类为一种冲动障碍,没有其他分类。(1)要符合病态赌博的诊断标准,个人必须表现出十种可能症状中的至少五种。这些症状中的三种通常被认为是“认知”性质的。可能的认知症状包括对赌博的专注,感觉需要增加赌注以保持原来的兴奋或觉醒水平,以及当试图停止赌博时感到不安。(2)其余七个症状中的六个是对赌徒可能参与的行为的描述。他们试图停止赌博,但失败了,增加投注,试图赢回已经失去的东西(即追逐自己的赌注),向他人撒谎以隐瞒自己的赌博,从事非法行为以资助自己的赌博,将自己的机会(例如,工作,个人关系等)置于危险之中,因为继续赌博,转向其他人资助自己的赌博或解决因赌博而产生的财务问题。(3)有趣的是,病理性赌博的官方症状中只有一种明确指出了可能控制个人赌博行为的偶然性;这个人赌博作为一种逃避。因此,对于行为分析师来说,这种特殊的症状可能具有特殊的相关性,这一点可能并不奇怪,这将在本文的后面讨论。正如人们可以想象的那样,关于赌博的研究文献是巨大的(并且超出了本文回顾所有这些文献的范围),许多研究人员试图确定导致病态赌博的因素。不幸的是,绝大多数的研究本质上是相关的。因此,联想关系可以被识别,并且已经被识别。然而,这种疾病背后的因果机制还没有得到明确的确立。无论如何,研究已经潜在地确定了病态赌博的建立操作(Michael, 1993)或设置事件(Kantor & Smith, 1975)。正如Petry(2005)所概述的,病态赌博有六个主要风险因素,其中几个可能是相互关联的。…
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