Gambling Disorder 587
gage in “bailout” behavior, turning to family or others for help with  a desperate financial
situation that was caused by gambling (Criterion A9). 
Associated Features Supporting Diagnosis 
Distortions in thinking (e.g., denial, superstitions, a sense of power and control over the
outcome of chance events, overconfidence) ma y be present in individuals with gambling
disorder. Many individuals with gambling diso rder believe that money is both the cause
of and the solution to their problems. Some individuals with gambling disorder are im-
pulsive, competitive, energetic, restless, an d easily bored; they may be overly concerned
with the approval of others and may be gene rous to the point of extravagance when win-
ning. Other individuals with gambling disord er are depressed and lonely, and they may
gamble when feeling helpless, guilty, or depres sed. Up to half of individuals in treatment
for gambling disorder have suicidal ideati on, and about 17% have attempted suicide.
Prevalence 
The past-year prevalence rate of gambling di sorder is about 0.2%–0.3% in the general pop-
ulation. In the general population, the lifetim e prevalence rate is about 0.4%–1.0%. For fe-
males, the lifetime prevalence rate of gambling disorder is about 0.2%, and for males it is
about 0.6%. The lifetime prevalence of path ological gambling among African Americans is
about 0.9%, among whites about 0.4% , and among Hispanics about 0.3%. 
Development and Course 
The onset of gambling disorder can occur du ring adolescence or young adulthood, but in
other individuals it manifests during middle  or even older adulthood. Generally, gam-