DSM-5 criteria for gambling disorder: Underlying structure and applicability to specific groups of gamblers

Background and Aims DSM-5 provides nine diagnostic criteria for gambling disorder. All criteria have a pre-assumed equal diagnostic impact and are applied to all individuals and groups in an equal manner. The aims of the study are to analyse the structure underlying the diagnosis and to assess whether DSM-5 is equally applicable to different groups of gamblers. Methods Data from the 2009 German Epidemiological Survey of Substance Abuse and from a study on slot machine gamblers were used. Item Response Theory analysis was applied to estimate discrimination and severity parameters of the criteria. With the use of Differential Item Functioning analysis, potential criterion biases were analysed. We analysed data from 107 participants from the general population sample and 376 participants from the slot machine gamblers’ sample who answered a 19-item diagnostic questionnaire based on the DSM criteria for gambling disorder. Results A single underlying factor, the severity of gambling disorder, was identified in both samples. In the general population sample the criteria of preoccupation and chasing were least severe and showed low discriminatory power. Bailout, withdrawal and jeopardized matters criteria had highest severity and discriminatory power. The comparison of the two samples revealed two criterion biases in the preoccupation and tolerance criteria. Conclusions The structure underlying the criteria is unidimensional but the disorder is manifested differently depending on disorder severity. The assumed equal impact of each criterion lacks support in the findings. The DSM-5 criteria measure a partially different construct in slot machine gamblers than in gamblers in the general population.

[1]  L. Kraus,et al.  Gambling experiences, problems, research and policy: gambling in Germany. , 2013, Addiction.

[2]  R. Volberg,et al.  A hierarchy of gambling disorders in the community. , 2003, Addiction.

[3]  N. Petry,et al.  Pathological gambling and the DSM-V , 2010 .

[4]  Jason W. Osborne,et al.  Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. , 2005 .

[5]  L. Kraus,et al.  Studiendesign und Methodik des Epidemiologischen Suchtsurveys 2009 , 2010 .

[6]  C. Kahler,et al.  Evaluation of the continuum of gambling problems using the DSM-IV. , 2007, Addiction.

[7]  Adrianna Neagoe,et al.  A Research Agenda for DSM-V , 2003 .

[8]  Carol M. Woods,et al.  Differential Item Functioning of Pathological Gambling Criteria: An Examination of Gender, Race/Ethnicity, and Age , 2011, Journal of Gambling Studies.

[9]  Bruno D. Zumbo,et al.  Assessing the Unidimensionality of Psychological Scales: Using Multiple Criteria from Factor Analysis , 2011 .

[10]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[11]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[12]  Bryce B. Reeve,et al.  Applying item response theory modelling for evaluating questionnaire item and scale properties , 2005 .

[13]  Bengt Muthén,et al.  Should substance use disorders be considered as categorical or dimensional? , 2006, Addiction.

[14]  On the latent structure of problem gambling: a taxometric analysis. , 2014, Addiction.

[15]  Kristopher J Preacher,et al.  On the practice of dichotomization of quantitative variables. , 2002, Psychological methods.

[16]  L. Kraus,et al.  The effect of sample selection on the distinction between alcohol abuse and dependence , 2014 .

[17]  M. Griffiths,et al.  PGSI and DSM-IV in the 2007 British Gambling Prevalence Survey: reliability, item response, factor structure and inter-scale agreement , 2010 .

[18]  Alexander Pabst,et al.  Gambling Among Adults in Germany: Prevalence, Disorder and Risk Factors , 2011 .

[19]  R. Stinchfield.  Reliability, validity, and classification accuracy of a measure of DSM-IV diagnostic criteria for pathological gambling. , 2003, The American journal of psychiatry.

[20]  D. Hendrick,et al.  Introduction , 1998, Thorax.

[21]  L. Kraus,et al.  Differences in pathological gambling prevalence estimates: facts or artefacts? , 2011, International journal of methods in psychiatric research.

[22]  Atta Abbas,et al.  DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION , 2013 .

[23]  S. Currie,et al.  Risk of harm among gamblers in the general population as a function of level of participation in gambling activities. , 2006, Addiction.

[24]  R. Spitzer.  Dsm-IV Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , 1994 .

[25]  N. Carragher,et al.  A latent class analysis of DSM-IV criteria for pathological gambling: Results from the National Epidemiologic Survey on Alcohol and Related Conditions , 2011, Psychiatry Research.