Gambling addiction is a complex condition in which individuals continue gambling despite experiencing negative consequences. It was recognised as a behavioural addiction in the DSM-5, with growing evidence that addictive behaviours do not necessarily require the use of a substance (American Psychiatric Association, 2013). However, understanding why people develop gambling problems is not as straightforward as it may seem. While some research focuses on biological vulnerabilities and changes in the brain's reward system, other studies highlight cognitive distortions, emotional difficulties and the influence of the social environment, particularly from peers. This raises an important question, is gambling addiction mainly a problem of individual self-control, or are there other factors that make it difficult for people to stop?
Biology at Work
The role of dopamine in gambling addiction has received significant attention. Dopamine is involved in reward and motivation, particularly when rewards are uncertain, which is the case in gambling. That anticipation of winning, alone, can activate the brain's reward system, even when the individual does not actually win (Linnet, 2014). Potenza (2013) highlighted the involvement of brain regions such as the mesolimbic pathway (referred as reward system) and prefrontal cortex associated with decision-making, in gambling disorder. This may explain why some individuals continue gambling despite repeated losses, as the anticipation of a possible reward can maintain the behaviour.
However, explaining gambling addiction mainly through dopamine can be problematic. The brain's reward system is involved in many everyday activities, and dopamine activity alone does not necessarily explain why someone develops an addiction. Research findings are also not always consistent, suggesting that gambling addiction cannot be reduced to a single biological mechanism (Fauth-Bühler et al., 2017). Another important aspect is individual vulnerability. Some people may be more sensitive to rewards or have difficulties regulating impulses, making them more vulnerable to developing gambling problems. However, having these vulnerabilities does not mean that someone will necessarily become addicted. This raises the question of whether biological explanations are sufficient, especially when gambling behaviours are also influenced by personal experiences and environmental factors.
Cognitive Biases
Cognitive processes play an important role in the development and maintenance of gambling addiction. One of these is attentional bias, where individuals become more sensitive to information and cues related to gambling. For example, gambling advertisements, casino environments or electronic gaming machines may attract greater attention among individuals experiencing gambling problems compared to people who don't. Brevers et al. (2011) found evidence of attentional bias towards gambling-related information, suggesting that these cues may contribute to maintaining gambling behaviour. Similarly, Limbrick-Oldfield et al. (2017) research indicates that the desire to gamble may be triggered by environmental reminders, even when the individual is trying to stop. Nonetheless, it is important to consider whether attentional bias is a cause of gambling addiction or a consequence of repeated gambling experiences. Someone who gambles frequently is naturally more exposed to gambling cues and triggers, which may strengthen their attention towards them over time.
Another cognitive mechanism involves distorted beliefs about probability and control. Some individuals believe that previous losses increase their chances of winning, commonly known as the gambler's fallacy. Others may overestimate their ability to influence outcomes that are largely determined by chance (Matarazzo et al., 2019). These beliefs may encourage continued gambling, particularly when individuals are trying to recover money they have already lost. Sancho et al. (2021) examined the relationship between emotional regulation and cognitive distortions among individuals with gambling disorder, and he founds that gambling may also become a way of dealing with negative emotions. Individuals might continue gambling not necessarily because they expect to win, but because the activity provides temporary relief from stress, guilt or other difficult feelings.
This suggests that gambling addiction is not simply a matter of misunderstanding probability or making irrational decisions. Emotional experiences may also influence why individuals continue gambling despite knowing the risks. Therefore, focusing only on correcting cognitive distortions may not be enough if the emotional reasons behind gambling remain unaddressed.
Social Influence
While biological and cognitive explanations focus mainly on the individual, social influences also play an important role in gambling addiction. Gambling is widely accepted in many societies and is often presented as a normal form of entertainment. People are exposed to gambling through sports, advertisements, social media and their relationships with others. Zhai et al. (2017) suggests that when gambling becomes common within a social group, individuals may be less likely to recognise its potential consequences. What begins as a social activity can gradually become problematic, particularly when repeated gambling is encouraged or normalised. Russell et al. (2018) also highlighted in his research paper how social constructs and culture can normalise gambling-related harm among high risk gamblers. However, social exposure alone cannot explain addiction, as many people participate in gambling activities without developing serious problems. This indicates that social factors may interact with individual vulnerabilities rather than acting as independent causes.
Another concern is the role of gambling advertising and accessibility as it is no longer limited to casinos or betting shops. Online platforms have made it possible for individuals to gamble almost anywhere and at any time. The constant availability of gambling opportunities may make it more difficult for some individuals to control their behaviour. Advertising also raises concerns, particularly when gambling is presented as exciting, rewarding or closely connected to sporting events and social success. Pitt et al. (2024) explored young people's views on celebrity and social media influencers and online streamers involvement in gambling marketing, highlighting concerns around how gambling is promoted. This brings another question, if individuals are continuously exposed to environments that encourage gambling, can we place the responsibility for addiction entirely on them? Although personal responsibility remains important, overlooking the influence of gambling environments may lead to an incomplete understanding of the problem.
Treatment and recovery
The complexity of gambling addiction also creates challenges for treatment. CBT, which stands for cognitive behavioural therapy, is commonly used to address distorted beliefs and difficulties managing urges. Research reviewed by Yip and Potenza (2014) suggests that those psychological interventions targeting beliefs, identity and urges can be beneficial for individuals experiencing gambling problems. However, treatment effectiveness can vary, and not everyone responds to the same approach. For example, an individual who gambles mainly to escape emotional distress may have different needs from someone whose gambling is strongly influenced by impulsivity or social pressure, so therapy can help uncover those underlying problems that perpetuate the behaviour of gambling.
This distinction in people's motive to gamble highlights the importance of understanding the specific experiences behind gambling behaviour rather than assuming that all individuals with gambling disorder require the same intervention. Recovery may also become difficult when people return to environments where gambling is easily accessible and socially encouraged. Therefore, psychological treatment alone may not address all the factors contributing to gambling addiction, and wider measures like reducing exposure, improving awareness and regulating gambling environments may also play a role in recovery and prevention as well.
Gambling addiction cannot be fully explained by one biological, cognitive or social mechanism. The critical review of literature aims to provide an overview of gambling behaviour, however, each one of the perspectives discussed above has its limitations when considered alone. Thus, understanding this non substance addiction, requires considering how these factors interact and influence each other, rather than treating them as separate explanations. Perhaps the important question is not only why some individuals struggle to stop gambling, but also how their body and environments around them perpetuate the situation.