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      Harmonizing Screening for Gambling Problems in Epidemiological Surveys – Development of the Rapid Screener for Problem Gambling (RSPG)

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          Abstract

          Background and aims

          The aim of this study was to test the screening properties of several combinations of items from gambling scales, in order to harmonize screening of gambling problems in epidemiological surveys. The objective was to propose two brief screening tools (three items or less) for a use in interviews and self-administered questionnaires.

          Methods

          We tested the screening properties of combinations of items from several gambling scales, in a sample of 425 gamblers (301 non-problem gamblers and 124 disordered gamblers). Items tested included interview-based items (Pathological Gambling section of the DSM-IV, lifetime history of problem gambling, monthly expenses in gambling, and abstinence of 1 month or more) and self-report items (South Oaks Gambling Screen, Gambling Attitudes, and Beliefs Survey). The gold standard used was the diagnosis of a gambling disorder according to the DSM-5.

          Results

          Two versions of the Rapid Screener for Problem Gambling (RSPG) were developed: the RSPG-Interview (RSPG-I), being composed of two interview items (increasing bets and loss of control), and the RSPG-Self-Assessment (RSPG-SA), being composed of three self-report items (chasing, guiltiness, and perceived inability to stop).

          Discussion and conclusions

          We recommend using the RSPG-SA/I for screening problem gambling in epidemiological surveys, with the version adapted for each purpose (RSPG-I for interview-based surveys and RSPG-SA for self-administered surveys). This first triage of potential problem gamblers must be supplemented by further assessment, as it may overestimate the proportion of problem gamblers. However, a first triage has the great advantage of saving time and energy in large-scale screening for problem gambling.

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          Most cited references 28

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          Index for rating diagnostic tests.

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            A hierarchy of gambling disorders in the community.

            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 'chasing their losses'. 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, 'chasing'. 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.
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              Addiction: definition and implications

               AVIEL GOODMAN (1990)
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                Author and article information

                Journal
                jba
                JBA
                Journal of Behavioral Addictions
                J Behav Addict
                Akadémiai Kiadó (Budapest )
                2062-5871
                2063-5303
                27 June 2016
                June 2016
                : 5
                : 2
                : 239-250
                Affiliations
                [1 ]CHU Nantes, Clinical Investigation Unit BALANCED “BehaviorAL AddictioNs and ComplEx mood Disorders,” Department of Addictology and Psychiatry , France
                [2 ]EA 4275 SPHERE “bioStatistics, Pharmacoepidemiology and Human sciEnces Research tEam,” Faculties of Medicine and Pharmaceutical Sciences, University of Nantes , France
                [3 ]Unit of Methodology and Biostatistics, University Hospital of Nantes , France
                [4 ]EA 4430 CLIPSYD “CLInique PSYchanalyse Développement,” University of Paris Ouest Nanterre La Défense , France
                [5 ] Louis Mourier Hospital of Colombes, Assistance Publique – Hôpitaux de Paris (APHP) , France
                [6 ]Psychotherapies Unit, Sainte-Anne Hospital – Psychiatry and Neurosciences , Paris, France
                [7 ] Marmottan Medical Center, GPS Perray-Vaucluse , Paris, France
                [8 ]Department of Adult Psychiatry, Sainte-Marguerite University Hospital of Marseille , France
                [9 ]Psychiatry Laboratory, Sanpsy CNRS USR 3413, University of Bordeaux and Charles Perrens Hospital , Bordeaux, France
                [10 ]Psychiatry Department, University Hospital of Clermont-Ferrand , France
                [11 ]Psychiatry and Addictology Department, Paul Brousse University Hospital of Villejuif, Assistance Publique – Hôpitaux de Paris (APHP) , France
                Author notes
                [* ]Corresponding author: Gaëlle Challet-Bouju; Unité d’Investigation Clinique “Addictions comportementales et Troubles Complexes de l’Humeur,” Institut Fédératif des Addictions Comportementales (IFAC), CHU de Nantes–Hôpital Saint Jacques, Bât. Louis Philippe, 85 rue de Saint Jacques, 44093 Nantes Cedex 1, France; Phone: +33 2 40 84 76 20; Fax: +33 2 40 84 61 18; E-mail: gaelle.bouju@ 123456chu-nantes.fr
                Article
                10.1556/2006.5.2016.030
                5387775
                27348558
                © 2016 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited.

                Page count
                Figures: 0, Tables: 7, Equations: 0, References: 32, Pages: 12
                Funding
                Funding sources: This study was supported by both the joint support of the French Inter-departmental Mission for the fight against drugs and drug addiction (MILDT) and the French National Institute of Health and Medical Research (INSERM), as part of the call for research projects launched by these two organizations in 2007, and a grant from the French Ministry of Health (PHRC 2009 – RCB 2008-A01188-47). There were no constraints on publishing.
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