Who gambles?

People develop gambling problems primarily through two different mechanisms, said Bob Breen, of the Rhode Island Hospital Gambling Treatment Program.

The first method involves largely men, who begin gambling relatively early in life, in their late teens or early 20s, he said. These early-onset gamblers gravitate toward what they perceive as skill-oriented activities such as the casino table, card table, horses or sporting events.

These men typically experience clusters of other problems such as substance abuse, alcoholism and anger control, Breen said.

"This type of compulsive gambler chooses forms of gambling that involve an illusion of skill," he said. "They think they can find an edge but the reality is that the gaming is almost all about chance."

The second mechanism occurs mostly in middle-aged adults. They’ve bought homes, raised children and usually had no major psychiatric problems. Whether it’s marital woes, a midlife crisis or other difficulties, these individuals develop serious gambling problems.

"These late-onset gamblers are almost all machine players and about half of them are women. They usually can’t believe what has happened to them. So they quickly feel guilty and feel in crisis over what they’ve done. These people have a real good prognosis if they get in treatment, and can address issues of depression and gambling, or other problems." — Scott J. Turner