An Overview of and Rationale for Changes Proposed for Pathological Gambling in DSM-5

Abstract

The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in 2013. It will include several changes to the diagnosis of pathological gambling: the name of the disorder will be altered, the threshold for diagnosis will decrease, and one criterion will be removed. This paper reviews the rationale for these changes and addresses how they may impact diagnosis and treatment of the disorder, as well as potential for future research in the field.

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References

  1. Alegria, A. A., Petry, N. M., Hasin, D. S., Liu, S. M., Grant, B. F., & Blanco, C. (2009). Disordered gambling among racial and ethnic groups in the US: Results from the national epidemiologic survey on alcohol and related conditions. CNS Spectrums, 3, 132–142.

    Google Scholar 

  2. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  4. Black, D. W., Monahan, P. O., Temkit, M., & Shaw, M. (2006). A family study of pathological gambling. Psychiatry Research, 141, 295–303.

    PubMed  Article  Google Scholar 

  5. Blanco, C., Hasin, D. S., Petry, N., Stinson, F. S., & Grant, B. F. (2006). Sex differences in subclinical and DSM-IV pathological gambling: Results from the national epidemiologic survey on alcohol and related conditions. Psychological Medicine, 36, 943–953.

    PubMed  Article  Google Scholar 

  6. Blanco, C., Myers, J., & Kendler, K. S. (2012). Gambling, disordered gambling and their association with major depression and substance use: A web-based cohort and twin-sibling study. Psychological Medicine, 42, 497–508.

    CAS  PubMed  Article  Google Scholar 

  7. Blanco, C., Krueger, R. F., Hasin, D. S., Liu, S. M., Wang, S., Kerridge, B. T., Olfson, M. (in press). Mapping common psychiatric disorders: Structure and predictive validity in the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry.

  8. Blaszczynski, A., McConaghy, N., & Frankova, A. (1989). Crime, antisocial personality and pathological gambling. Journal of Gambling Behavior, 5, 35–42.

    Google Scholar 

  9. Block, J. J. (2008). Issues for DSM-V: Internet addiction. American Journal of Psychiatry, 165(3), 306–307.

    PubMed  Article  Google Scholar 

  10. Denis, C., Fatséas, M., & Auriacombe, M. (2012). Analyses related to the development of DSM-5 criteria for substance use related disorders: An assessment of pathological gambling criteria. Drug and Alcohol Dependence, 122, 22–27.

    PubMed  Article  Google Scholar 

  11. Derevensky, J. L., Gupta, R., & Winters, K. (2003). Prevalence rates of youth gambling problems: Are the current rates inflated? Journal of Gambling Studies, 19(4), 405–425.

    PubMed  Article  Google Scholar 

  12. Forrest, D., & McHale, I. G. (2011). Gambling and problem gambling among young adolescents in Great Britain. Journal of Gambling Studies,. doi:10.1007/s10899-011-9277-6.

    Google Scholar 

  13. Gebauer, L., LaBrie, R., & Shaffer, H. J. (2010). Optimizing DSM-IV-TR classification accuracy: A brief biosocial screen for detecting current gambling disorders among gamblers in the general household population. Canadian Journal of Psychiatry, 55(2), 82–90.

    Google Scholar 

  14. Gerstein, D. R., Volberg, R. A., Toce, M. T., Harwood, H., Johnson, R. A., Buie, T., et al. (1999). Gambling impact and behavior study: Report to the national gambling impact study commission. Chicago IL: National Opinion Research Center.

    Google Scholar 

  15. Grant, J. E., Kim, S. W., & Hartman, B. K. (2008). A double-blind, placebo-controlled study of the opiate antagonist naltrexone in the treatment of pathological gambling urges. Journal of Clinical Psychiatry, 69, 783–789.

    CAS  PubMed  Article  Google Scholar 

  16. Hayatbakhsh, M. R., Clavarino, A., Williams, G. M., Bor, W., & Najman, J. M. (2012). Young adults’ gambling and its association with mental health and substance use problems. Australia and New Zealand Journal of Public Health, 36(2), 160–166.

    Article  Google Scholar 

  17. Hodgins, D. C., Currie, S. R., & el-Guebaly, N. (2001). Motivational enhancement and self-help treatments for problem gambling. Journal of Consulting and Clinical Psychology, 69, 50–57.

    CAS  PubMed  Article  Google Scholar 

  18. Hodgins, D. C., Currie, S. R., Currie, G., & Fick, G. H. (2009). Randomized trial of brief motivational treatments for pathological gamblers: More is not necessarily better. Journal of Consulting and Clinical Psychology, 77(5), 950–960.

    PubMed  Article  Google Scholar 

  19. Jiménez-Murcia, S., Stinchfield, R., Alvarez-Moya, E., Jaurrieta, N., Bueno, B., Granero, R., et al. (2009). Reliability, validity, and classification accuracy of a Spanish translation of a measure of DSM-IV diagnostic criteria for pathological gambling. Journal of Gambling Studies, 25, 93–104.

    PubMed  Article  Google Scholar 

  20. Kessler, R. C., Hwang, I., LaBrie, R., Petukhova, M., Sampson, N. A., Winters, K. C., et al. (2008). DSM-IV pathological gambling in the national comorbidity survey replication. Psychological Medicine, 38, 1351–1360.

    CAS  PubMed Central  PubMed  Google Scholar 

  21. Lorains, F. K., Cowlishaw, S., & Thomas, S. A. (2011). Prevalence of comorbid disorders in problem and pathological gambling: Systematic review and meta-analysis of population surveys. Addiction, 106, 490–498.

    PubMed  Article  Google Scholar 

  22. McBride, O., Adamson, G., & Shevlin, M. (2010). A latent class analysis of DSM-IV pathological gambling criteria in a nationally representative British sample. Psychiatry Research, 178, 401–407.

    PubMed  Article  Google Scholar 

  23. Meyer, G., & Fabian, T. (1992). Delinquency among pathological gamblers: A causal approach. Journal of Gambling Studies, 8, 61–77.

    CAS  PubMed  Article  Google Scholar 

  24. Mitzner, G. B., Whelan, J. P., & Meyers, A. W. (2011). Comments from the trenches: Proposed changes to the DSM-V classification of pathological gambling. Journal of Gambling Studies, 27, 517–521.

    PubMed  Article  Google Scholar 

  25. Morasco, B. J., Vom Eigen, K. A., & Petry, N. M. (2006a). Severity of gambling is associated with physical and emotional health in urban primary care patients. General Hospital Psychiatry, 2, 94–100.

    Article  Google Scholar 

  26. Morasco, B. J., Pietrzak, R. H., Blanco, C., Grant, B. F., Hasin, D., & Petry, N. M. (2006b). Health problems and medical utilization associated with gambling disorders: Results from the national epidemiologic survey on alcohol and related conditions. Psychosomatic Medicine, 68, 976–984.

    PubMed  Article  Google Scholar 

  27. Nalpas, B., Yguel, J., Fleury, B., Martin, S., Jarraud, D., & Craplet, M. (2011). Pathological gambling in treatment-seeking alcoholics: A national survey in France. Alcohol and Alcoholism, 46, 156–160.

    PubMed  Article  Google Scholar 

  28. O’Brien, C. (2011). Addiction and dependence in DSM-V. Addiction, 106, 866–867.

    PubMed  Article  Google Scholar 

  29. Orford, J., Sposton, K., & Erens, B. (2003). SOGS and DSMIV in the British Gambling Prevalence Survey: Reliability and facture structure. International Gambling Studies, 3, 53–65.

    Article  Google Scholar 

  30. Petry, N. M. (2005). Pathological gambling: Etiology, comorbidity and treatment. Washington, DC: American Psychological Association Press.

    Google Scholar 

  31. Petry, N. M. (2006). Should the scope of addictive behaviors be broadened to include pathological gambling? Addiction, 101, 152–160.

    PubMed  Article  Google Scholar 

  32. Petry, N. M. (2010). Pathological gambling and the DSM-5. International Gambling Studies, 10, 113–115.

    Article  Google Scholar 

  33. Petry, N. M., & Steinberg, K. (2005a). The women’s problem gambling research group. Childhood trauma and abuse histories in male and female pathological gamblers. Psychology of Addictive Behaviors, 19, 226–229.

    PubMed  Article  Google Scholar 

  34. Petry, N. M., Stintson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and psychiatric disorders: Results from the national epidemiologic survey on alcohol and related conditions. The Journal of Clinical Psychiatry, 66, 564–574.

    PubMed  Article  Google Scholar 

  35. Petry, N. M., Ammerman, Y., Bohl, J., Doersch, A., Gay, H., Kadden, R., et al. (2006). Cognitive-behavioral therapy for pathological gamblers. Journal of Consulting and Clinical Psychology, 74, 555–567.

    PubMed  Article  Google Scholar 

  36. Petry, N. M., Weinstock, J., Ledgerwood, D., & Morasco, B. (2008). A randomized trial of brief interventions for problem and pathological gamblers. Journal of Consulting and Clinical Psychology, 76, 318–328.

    PubMed Central  PubMed  Article  Google Scholar 

  37. Petry, N. M., Weinstock, J., Morasco, B. J., & Ledgerwood, D. M. (2009). Brief motivational interventions for college student problem gamblers. Addiction, 104, 1569–1578.

    PubMed Central  PubMed  Article  Google Scholar 

  38. Petry, N. M., Blanco, C., Stinchfield, R. & Volberg, R. (in press). An empirical evaluation of proposed changes for gambling diagnosis in the DSM-5. Addiction.

  39. Potenza, M. N., Leung, H. C., Blumberg, H. P., Peterson, B. S., Fulbright, R. K., Lacadie, C. M., et al. (2003). An fMRI Stroop task study of ventromedial prefrontal cortical function in pathological gamblers. American Journal of Psychiatry, 160, 1990–1994.

    PubMed  Article  Google Scholar 

  40. Reuter, J., Raedler, T., Rose, M., Hand, I., Gläscher, J., & Büchel, C. (2005). Pathological gambling is linked to reduced activation of the mesolimbic reward system. Nature Neuroscience, 8, 147–148.

    CAS  PubMed  Article  Google Scholar 

  41. Slutske, W. S., Eisen, S., True, W. R., Lyons, M. J., Goldberg, J., & Tsuang, M. (2000). Common genetic vulnerability for pathological gambling and alcohol dependence in men. Archives of General Psychology, 57, 666–673.

    CAS  Article  Google Scholar 

  42. Stinchfield, R. (2003). Reliability, validity, and classification accuracy of a measure of DSM-IV diagnostic criteria for pathological gambling. American Journal of Psychiatry, 160, 180–182.

    PubMed  Article  Google Scholar 

  43. Stinchfield, R., Govoni, R., & Frisch, G. R. (2005). DSM-IV diagnostic criteria for pathological gambling: Reliability, validity, and classification accuracy. American Journal of Addiction, 14, 73–82.

    Article  Google Scholar 

  44. Strong, D. R., & Kahler, C. W. (2007). Evaluation of the continuum of gambling problems using the DSM-IV. Addiction, 102, 713–721.

    PubMed  Article  Google Scholar 

  45. Tao, R., Huang, X., Wang, J., Zhang, H., Zhang, Y., & Li, M. (2010). Proposed diagnostic criteria for internet addiction. Addiction, 105, 556–564.

    PubMed  Article  Google Scholar 

  46. Toce-Gerstein, M., Gerstein, D. R., & Volberg, R. A. (2003). A hierarchy of gambling disorders in the community. Addiction, 98, 1661–1672.

    PubMed  Article  Google Scholar 

  47. Toce-Gerstein, M., Gerstein, D. R., & Volberg, R. A. (2009). The NODS-CLiP: A rapid screen for adult pathological and problem gambling. Journal of Gambling Studies, 25(4), 541–555.

    PubMed Central  PubMed  Article  Google Scholar 

  48. Volberg, R. A., Gupta, R., Griffiths, M. D., Olason, D. T., & Delfabbro, P. (2010). An international perspective on youth gambling prevalence studies. International Journal of Adolescence Medicine and Health, 22, 3–38.

    Google Scholar 

  49. Volberg, R. A., Munck, I. M., & Petry, N. M. (2011). A quick and simple screening method for pathological and problem gamblers in addiction programs and practices. American Journal of Addiction, 20, 220–227.

    Article  Google Scholar 

  50. Welte, J. W., Barnes, G. M., Tidwell, M. C., & Hoffman, J. H. (2008). The prevalence of problem gambling among US adolescents and young adults: Results from a national survey. Journal of Gambling Studies, 24, 119–133.

    PubMed  Article  Google Scholar 

  51. Zimmerman, M., Chelminski, I., & Young, D. (2006). A psychometric evaluation of the DSM-IV pathological gambling diagnostic criteria. Journal of Gambling Studies, 22, 329–337.

    PubMed  Article  Google Scholar 

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Acknowledgments

We acknowledge other members of Substance Use and Related Disorders Workgroup: Alan Budney, Wilson Compton, Walter Ling, and Marc Schuckit, who participated in the discussions and decisions outlined in this report. Preparation of this article was supported in part by grant R01-DA021567.

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Correspondence to Nancy M. Petry.

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The views and opinions expressed in this paper are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or the US government.

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Petry, N.M., Blanco, C., Auriacombe, M. et al. An Overview of and Rationale for Changes Proposed for Pathological Gambling in DSM-5. J Gambl Stud 30, 493–502 (2014). https://doi.org/10.1007/s10899-013-9370-0

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Keywords

  • DSM-5
  • Gambling
  • Pathological gambling
  • Diagnosis