Toce-Gerstein, M., Gerstein, D. and Volberg, R. (2003) For Debate: A hierarchy of gambling disorders in the community. Addiction, 98(12), pp. 1661-1672. (doi: 10.1111/j.1360-0443.2003.00545.x)
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Abstract
To help refine the definition and diagnosis of gambling disorders, we investigated the distribution among US gamblers of the 10 DSM-IV criteria for Pathological Gambling. We drew data from two stratified random surveys ( n = 2417, n= 530) of gambling behavior and consequences among community-based samples of US adults. A fully structured questionnaire, administered by trained lay interviewers, screened for the life-time prevalence of problem and Pathological Gambling. Per DSM-IV definitions, anyone meeting five or more of 10 itemized criteria was considered a pathological gambler. We analyzed these criteria among all gamblers who met one or more criteria ( n = 399). Most gamblers who met only one or two criteria reported GÃ chasing their lossesGÃÍ. At subclinical levels (three to four criteria), gamblers also reported elevated rates of gambling-related fantasy: lying, gambling to escape and preoccupation. Pathological gamblers with five to seven criteria reported marked elevations of loss of control, withdrawal symptoms and tolerance (internalizing dimensions of dependence); risking their social relationships and needing to be bailed out financially (externalizing dimensions). Most of the highest-level pathological gamblers (eight to 10 criteria) reported committing illegal acts to support gambling. Dependence in a biobehavioral sense appears to be a hallmark of Pathological Gambling, but it marks only one threshold in a qualitative hierarchy of disorders beginning with a common subclinical behavior, GÃ chasingGÃÍ. Epidemiological assessments and future DSM revisions might consider explicit recognition of a problem gambling disorder, identifying people presenting some cognitive symptoms of Pathological Gambling but not clear signs of dependence. Pathological gamblers in turn appear to have two distinct levels of severity.
| Item Type: | Articles (Editorial) |
|---|---|
| Keywords: | Behavior, Compulsive Gambling, Diagnosis, Gamblers, Gambling, Impulse Control Disorders, Pathological Gambling, Psychology, Psychology, Pathological, Substance Abuse, Substance-Related Disorders, Surveys |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Volberg, Dr Rachel |
| Authors: | Toce-Gerstein, M., Gerstein, D., and Volberg, R. |
| College/School: | College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences |
| Journal Name: | Addiction |
| ISSN: | 0965-2140 |
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