Gambling disorder (compulsive gambling) is the name of an officially recognized non-substance-based addiction that features problematic and dysfunctional involvement in one or more types of gambling. As is true with other forms of addiction, many of the people affected by this disorder never seek or receive treatment for their condition. In a study published in April 2014 in the journal European Addiction Research, researchers from two German institutions sought to determine which individuals with diagnosable gambling problems are most likely to seek professional help. These researchers identified several factors that increase the odds that a given affected person will enter treatment. The Basics Doctors and researchers once believed that only substance use\/misuse can lead to the distinctive changes in behavior and brain function that mark the onset and continuing course of addiction. However, they now know that many of the changes commonly associated with substance addiction can also arise in people who participate in certain activities not related to the use of mind-altering substances. In addition to gambling, these activities include food consumption, shopping, Internet use and sex. Addiction specialists commonly refer to these non-substance-related forms of addiction as process addictions or behavioral addictions. The American Psychiatric Association (APA) uses another term, addictive disorder, to identify the same phenomena. As of 2014, gambling disorder is the only addictive disorder diagnosable under guidelines established in the widely use APA handbook, The Diagnostic and Statistical Manual of Mental Disorders, or DSM. However, the scientific evidence for other forms of behavioral addiction is steadily accumulating, and the APA has already designated a condition called Internet gaming disorder for future consideration as the second diagnosable addictive disorder. Before creating the gambling disorder diagnosis in 2013, the APA classified serious gambling problems as a non-addiction-based condition called pathological gambling. However, this term is now considered both outdated and somewhat belittling. People diagnosed with gambling disorder have symptoms that can include loss of the ability to rein in gambling participation, use of gambling to offset unwanted emotions, disproportionate devotion of time or resources to gambling, involvement in increasingly risky gambling situations, the perception of risky forms of gambling as enticing or exciting, and the need to rely on borrowed or stolen money to fund gambling participation. Some people start to develop these symptoms from the beginning of their gambling involvement; however, problems usually develop much more slowly. Which People Seek Help? Forms of treatment used to help people affected by gambling disorder include several types of psychotherapy known collectively as behavioral therapy, several medications adapted from the treatment of substance-related problems or other forms of mental illness and participation in a mutual self-help organization. In the study published in European Addiction Research, researchers from Germany\u2019s University of Lubeck and University Medicine Greifswald used information gathered from three sources\u2014a telephone survey, a gambling hotline and people recruited at gambling facilities\u2014to determine which individuals are most likely to seek treatment for their gambling-related symptoms (identified by the researchers under the old term pathological gambling). All told, 395 people with diagnosable gambling problems were enrolled in the study; each of these individuals submitted detailed information on their demographic backgrounds (age, gender, racial\/ethnic background, etc.), history of other mental illnesses and history of involvement in gambling-related treatment. After examining a range of potential factors, the researchers concluded that the people most likely to seek treatment for diagnosable gambling problems are those individuals with higher numbers of possible symptoms. Other groups with more than an average chance of seeking treatment include those individuals who experience a larger number of negative consequences from gambling participation, older adults and those individuals who receive strong pressure from their intimate partners to enter treatment. After analyzing the impact of multiple factors, the researchers found that the combined group most likely to seek help is older adults with a large number of gambling-related symptoms who have experienced substantially negative outcomes from their gambling involvement. Significance and Considerations The authors of the study published in European Addiction Research initially thought that the simultaneous presence of a mood disorder (bipolar disorder or depression) also increases the odds that a given individual will seek treatment for his or her gambling problems. However, further analysis did not confirm this initial finding. The authors point toward a need for additional research to identify the best interventions for helping affected individuals before they get older, experience more symptoms and\/or experience more negative consequences from gambling involvement.