Problem gambling among adolescents can be conceptualized as belonging to a larger constellation of developmental addictions. Data support a relationship between behavioral and drug addictions in both adults and adolescents. For example, high rates of both problem gambling and substance use disorders have been reported during adolescence (Chambers & Potenza, 2003; Wagner & Anthony, 2002), with gambling, substance use, and other risk behaviors frequently co-occuring during this developmental stage (Proimos, DuRant, Pierce & Goodman 1998; Romer, 2003). The co-aggregation of risky behaviors appears particularly strong in adolescent males. Arguably the most consistent and robust finding across youth gambling studies is that boys are more involved in gambling and have higher rates of problem gambling than girls (e.g., Gupta & Derevensky, 1998; Stinchfield, 2001; Wallisch, 1993; Wynne, Smith & Jacobs, 1996). Similarly, adolescent males have a greater likelihood of developing a substance use disorder than adolescent females. Nonetheless, the observation that these age-specific trends are observed in both males and females in epidemiological studies performed during different eras and involving different cultures suggests the existence of factors in the developmental onset of addictive disorders that impact both boys and girls (Chambers, Taylor & Potenza, 2003). In this chapter, we will review a neurodevelopmental model for motivated behaviors, describe changes that occur during adolescence in brain structure and function in regions thought to underlie motivated behaviors, and describe the implications for the pharmacological treatment of adolescent gambling problems. Given that no studies have directly investigated the safety and efficacy of pharmacological treatments for pathological gambling in adolescents, we will briefly review the literature on effective treatments in adults, describe safety data for the use of these drugs in adolescents, and provide a rationale for future investigative studies on the efficacy and tolerability of pharmacotherapies for pathological gambling in adolescents.
ASJC Scopus subject areas