Pathological Gambling Diagnostic Form

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Addictive Behavior
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Persistent and recurrent maladaptive gambling behavior as indicated by five (or more) of the following criteria:IN THE PAST YEAR…

YES NO
Have you often found yourself thinking about gambling [e.g., reliving past gambling experiences, planning the next time you will play or thinking of ways to get money to gamble]?
Have you needed to gamble with more and more money to get the amount of excitement you are looking for?
Have you become restless or irritable when trying to cut down or stop gambling?
Have you gambled to escape from problems or when you are feeling depressed, anxious or bad about yourself?
After losing money gambling, have you returned another day in order to get even?
Have you lied to your family or others to hide the extent of your gambling?
Have you made repeated unsuccessful attempts to control, cut back or stop gambling?
Have you been forced to go beyond what is strictly legal in order to finance gambling or to pay gambling debts?
Have you risked or lost a significant relationship, job, educational or career opportunity because of gambling?
Have you sought help from others to provide the money to relieve a desperate financial situation caused by gambling?