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May 27, 1968


JAMA. 1968;204(9):820. doi:10.1001/jama.1968.03140220068020

Gambling is one of the most common of man's endeavors. In America it constitutes an extensive pastime, with several billion dollars wagered annually. Illegal forms of gambling are widespread and abundantly finance syndicated crime. A recent communication in the Archives of General Psychiatry1 points out the neglect of this intriguing subject, and the attendant psychosocial problems, by the behavioral sciences. The investigators review psychological, sociolegal, and anthropological literature on gambling, and define the phenomenon of compulsive gambling in terms of psychodynamic criteria, as well as the behavioral criteria of excessive frequency and preoccupation with gambling combined with sustained significant economic losses. Psychodynamically, pathological gambling is an unconsciously motivated and forbidden activity which evokes guilt. Because of this pervasive guilt, the gambler is driven to perpetual play and eventual anticipated punishment in the form of gambling loss. This loss cancels the gambler's guilt and restores his psychic function to equilibrium.