Journal of clinical psychology · 2013
Examination of proposed DSM-5 changes to pathological gambling in a helpline sample.
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Weinstock Jeremiah, Rash Carla, Burton Steve, Moran Sheila, Biller Warren, O'Neil Kathleen, Kruedelbach Norman
Аннотация
OBJECTIVES: To examine the effect of proposed the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) changes to pathological gambling relative to DSM-IV criteria in a large gambling helpline sample (N = 2,750). Changes in prevalence rates, the diagnostic utility of the illegal acts criterion, and severity of alternative diagnostic formulation thresholds were examined.
METHOD: Callers to the helpline completed a semistructured interview and DSM-IV criteria were assessed.
RESULTS: Without lowering the diagnostic threshold, removal of the illegal acts criterion resulted in loss of diagnostic status in less than 2% of helpline callers. The DSM-IV prevalence rate in this sample was 81.2%, and DSM-5 formulations with lowered thresholds of 4, 3, and 2 symptoms increased prevalence rates by 9% to 17%. However, item-level symptom endorsement suggested that subclinical gamblers experience significant adverse consequences.
CONCLUSIONS: Lowered thresholds may lead to earlier provision of treatment to gamblers and prevent escalation of the disorder, while being more consistent with diagnostic thresholds of other addiction disorders.
METHOD: Callers to the helpline completed a semistructured interview and DSM-IV criteria were assessed.
RESULTS: Without lowering the diagnostic threshold, removal of the illegal acts criterion resulted in loss of diagnostic status in less than 2% of helpline callers. The DSM-IV prevalence rate in this sample was 81.2%, and DSM-5 formulations with lowered thresholds of 4, 3, and 2 symptoms increased prevalence rates by 9% to 17%. However, item-level symptom endorsement suggested that subclinical gamblers experience significant adverse consequences.
CONCLUSIONS: Lowered thresholds may lead to earlier provision of treatment to gamblers and prevent escalation of the disorder, while being more consistent with diagnostic thresholds of other addiction disorders.