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However, no one treatment is considered to be most efficacious and, in the United States, no medications have been approved for the treatment of pathological gambling by the U.S. Most treatment for problem gambling involves counseling, step-based programs, self-help, peer-support, medication, or a combination of these. The most common instrument used to screen for “probable pathological gambling” behavior is the South Oaks Gambling Screen (SOGS) developed by Lesieur and Blume (1987) at the South Oaks Hospital in New York City.
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From this view, men tend to gamble more and engage in higher-stakes bets because male reproductive success is often linked to risk-based competition, paralleling other risky activities like big-game hunting or physical aggression. For example, gambling can be understood as a form of “risky reward-seeking,” where individuals overestimate potential gains—an inclination that modern gambling industries exploit. Some researchers propose that human gambling behavior reflects evolved tendencies toward risk-taking that historically conferred adaptive benefits. The study links problem gambling to a myriad of issues affecting relationships, and social stability. A comprehensive UK Gambling Commission study from 2018 has also hinted at the link between gambling addiction and a reduction in physical activity, poor diet, and overall well-being. Pathological gambling is similar to many other impulse-control disorders such as kleptomania.
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The DSM-IV diagnostic criteria presented as a checklist is an alternative to SOGS, it focuses on the psychological motivations underpinning problem gambling and was developed by the American Psychiatric Association. In this framework, personality traits favoring present-oriented decision-making increase susceptibility to gambling addiction, mirroring risk-taking behaviors seen in other species. Life History Theory further explains why some individuals are more vulnerable to problem gambling, proposing that those with a “fast” strategy (marked by impulsiveness and short-term planning) may be especially drawn to high-risk, high-reward scenarios. Researchers suggest that unpredictability itself motivates animals (including humans) to persevere in reward-seeking despite repeated failures, which can foster persistent gambling behaviour. Younger adults may also be more prone to gambling due to the evolutionary advantage of status-seeking during peak reproductive years.
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