Journal of Gambling Studies

, Volume 31, Issue 3, pp 787–806 | Cite as

An Examination of a Proposed DSM-IV Pathological Gambling Hierarchy in a Treatment Seeking Population: Similarities with Substance Dependence and Evidence for Three Classification Systems

  • Darren R. Christensen
  • Alun C. Jackson
  • Nicki A. Dowling
  • Rachel A. Volberg
  • Shane A. Thomas
Original Paper


Toce-Gerstein et al. (Addiction 98:1661–1672, 2003) investigated the distribution of Diagnostic and Statistical Manual for Mental Disorders, 4th edition (DSM-IV) pathological gambling criteria endorsement in a U.S. community sample for those people endorsing a least one of the DSM-IV criteria (n = 399). They proposed a hierarchy of gambling disorders where endorsement of 1–2 criteria were deemed ‘At-Risk’, 3–4 ‘Problem gamblers’, 5–7 ‘Low Pathological’, and 8–10 ‘High Pathological’ gamblers. This article examines these claims in a larger Australian treatment seeking population. Data from 4,349 clients attending specialist problem gambling services were assessed for meeting the ten DSM-IV pathological gambling criteria. Results found higher overall criteria endorsement frequencies, three components, a direct relationship between criteria endorsement and gambling severity, clustering of criteria similar to the Toce-Gerstein et al. taxonomy, high accuracy scores for numerical and criteria specific taxonomies, and also high accuracy scores for dichotomous pathological gambling diagnoses. These results suggest significant complexities in the frequencies of criteria reports and relationships between criteria.


DSM-IV DSM-V Pathological gambling Disordered gambling Substance related and addictive disorders Behavioral addiction Classification systems Taxonomy Severity 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Darren R. Christensen
    • 1
    • 6
  • Alun C. Jackson
    • 1
  • Nicki A. Dowling
    • 4
    • 1
    • 5
  • Rachel A. Volberg
    • 2
  • Shane A. Thomas
    • 3
  1. 1.Problem Gambling Research and Treatment CentreUniversity of MelbourneMelbourneAustralia
  2. 2.Gemini ResearchNorthamptonUSA
  3. 3.Problem Gambling Research and Treatment CentreMonash UniversityMelbourneAustralia
  4. 4.School of PsychologyDeakin UniversityMelbourneAustralia
  5. 5.School of Psychological SciencesMonash UniversityMelbourneAustralia
  6. 6.Faculty of Health SciencesUniversity of LethbridgeLethbridgeCanada

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