International Gambling Studies, Vol. 3, No. 1, June 2003 Binge Gambling: A Neglected Concept LIA NOWER 1 & ALEX BLASZCZYNSKI 2 1 University of Missouri-St Louis, Missouri, USA. 2 University of Sydney, Australia ABSTRACT It is argued that there exists a relatively neglected distinct sub-group of pathological gamblers, described in the clinical literature, who display intermittent episodes of uncontrolled gambling superimposed on a background of prolonged intervening periods of abstinence. This sub-group is characterised by intense bouts of impaired control over gambling that meet core diagnostic features for pathological gambling during such defined episodes. However, they are unlikely to display significant symptoms of pathological gambling if screened during intervening periods of abstinence and report no persistent or progressive urges or preoccupation with gambling between episodes. This article discusses the concept of binge gambling with reference to illustrative case studies and by comparison to two other recognised binge behaviours, binge drinking and binge eating. Introduction Pathological gambling is traditionally classified by the Diagnostic and Statistical Manual (DSM-IV-TR) as a disorder of impulse control, defined by the presence of ‘persistent and recurrent maladaptive gambling behaviour’ that results in significant deleterious psychosocial consequences (APA, 2000, p. 674). The DSM- IV-TR criteria, used internationally by clinicians to detect cases, generally requires no specific duration or frequency of episodes of impaired control, with clinical interview schedules and screening instruments simply designed to elicit the presence of symptoms or behaviours at some stage over the preceding lifetime, 12-month, or one-month timeframe. The implicit assumption is that the condition is unremitting in nature and progressive in course, following a sequential path from the exhilaration gener- ated by early wins to the hopelessness and despair caused by the consequences of gambling losses over time (Lesieur, 1984; Custer and Milt, 1985). Although the strength of the urge and preoccupation is considered to vary in intensity at any given point, it is assumed that the gambler is fundamentally subjected to the constant pressures of a persistent and chronic drive to gamble. At the theoretical level, there is continuing debate as to whether pathological gambling represents a dimensional or categorical condition, incorporating vari- ous discrete typologies or sub-groups of gamblers (Moran, 1970; Custer and Milt, 1985; Blaszczynski and Nower, 2002). However, irrespective of theoretical framework, it is postulated that a group of gamblers variably labelled as ‘in-transition’ (Shaffer and Hall, 1996), ‘problem’ (Pasternak and Fleming, 1999) and ‘at-risk’ (Poulin, 2000) is layered between the population strata of non-prob- lem and pathological gamblers. Gamblers in this group manifest insufficient ISSN 1445-9795 print/1479-4276 online/03/010023-13  2003 Taylor & Francis Ltd DOI: 10.1080/1445979032000093806 Downloaded by [Rutgers University] at 11:59 10 July 2013