Item Specification in the Development of a Diagnostic Gambling Instrument: A Focus Group Approach
Pathological Gambling Disorder (PGD) is internationally prevalent and contributes to significant disruption and impairment in a gambler’s life. For accurate diagnosis and treatment planning, clinicians require standardized criteria as in commonly used DSM and ICD-10 taxonomies, which are conceptually clear, valid, and culturally appropriate. We aimed to describe clinical issues, other than DSM criteria, that may be potentially clinically meaningful to PGD assessment and treatment planning. Participants from St. Louis, Missouri, USA, who self-identified as problem or pathological gamblers or who had a friend or relative with a gambling problem, as well as clinicians with addictions and PGD diagnostic expertise, participated in one of ten focus groups as part of a larger psychometric study aimed at developing and refining a structured, diagnostic gambling assessment tool, the Gambling Assessment Module (GAM©). A content-driven immersion-crystallization qualitative approach yielded insight into gambling behaviors, terminology, and diagnostic issues. While complementary to existing diagnostic taxonomies, these findings provide additional item specification for in-depth clinical assessment.
KeywordsPathological gambling disorder Diagnostic instrument Focus groups
This project was supported by grants to the first author from the National Center for Responsible Gaming (NCRG #12) and the National Institute on Drug Abuse of the National Institutes of Health (#K01 DA00430). An earlier draft of this paper fulfilled the partial requirements for a Washington University School of Medicine Master in Psychiatric Epidemiology (MPE) degree awarded to Samantha J. Books. The authors wish to acknowledge the invaluable facilitator training and/or feedback on the earlier version of this draft from Norma Ware, Ph.D. and MPE faculty members Wendy Reich, Ph.D. and Anne L. Glowinski, M.D. Administrative, technical, and/or consultation services were provided by the Center for Mental Health Services Research through a grant from the National Institute of Mental Health of the National Institutes of Health (#5P30 MH068579). This study would not have been possible without the contributions of all of the project staff members, clinicians, and research participants who provided invaluable data for this study.
- American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
- American Psychiatric Association (1987). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
- American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
- Ben-Tovim, D. I., Esterman, A., Tolchard, B., & Battersby, M. (2001). The Victorian gambling screen. Project report prepared in association with Flinders Technologies Pty Ltd, Flinders University. Melbourne Victoria: Gambling Research Panel October.Google Scholar
- Borkan, J. (1999). Immersion/crystallization. In B. F. Crabtree, & W. L. Miller (Eds.) Doing qualitative research (pp. 179–194). Thousand Oaks, CA: Sage.Google Scholar
- Carlson, E. B., & Putnam, F. W. (2000). Dissociative Experience Scale (DES). In A. John Rush Jr. (Ed.) Handbook of psychiatric measures (pp. 621–623). Washington, DC: American Psychiatric Association.Google Scholar
- Cunningham-Williams, R. M., Cottler, L. B., Compton, W. M., & Books, S. J. (2003a). Gambling Assessment Module (GAM © ). St. Louis, MO: Washington University September.Google Scholar
- Cunningham-Williams, R. M., Cottler, L. B., Compton, W. M., & Books, S. J. (2003b). Computerized-Gambling Assessment Module (GAM ©). St. Louis, MO: Washington University September.Google Scholar
- Cunningham-Williams, R. M., Grucza, R. A., Cottler, L. B., Womack, S. B., Books, S. J., Przybeck, T. R., et al. (2005). Prevalence and predictors of pathological gambling: results from the St. Louis personality, health, and lifestyle (SLPHL) study. Journal of Psychiatric Research, 39(4), 377–390.PubMedCrossRefGoogle Scholar
- Gerstein, D., Murphy, S., Toce, M., et al. (1999). Gambling impact and behavior study: Final Report to the National Gambling Impact Study Commission. Chicago, IL: National Opinion Research Center April.Google Scholar
- Krueger, R. A. (1994). Focus groups: A practical guide for applied research (2nd ed.). Thousand Oaks, CA: SAGE.Google Scholar
- Missouri Alliance to Curb Problem Gambling. (2006). Annual report 2006. Retrieved August 11, 2007 from http://www.888betsoff.org/alliance/06_annual_report.pdf.
- Morgan, D. L. (1997). Focus groups as qualitative research (2nd ed.). Thousand Oaks, CA: Sage.Google Scholar
- National Research Council (1999). Pathological gambling: A critical review. Washington, DC: National Academy.Google Scholar
- Nassar-McMillan, S. C., & Borders, L. D. (2002, March). Use of focus groups in survey item development. The Qualitative Report, 7(1). Retrieved August 10, 2007 from http://www.nova.edu/ssss/QR/QR7-1/nassar.html.
- Neighbors, C., Lostustter, T. W., Cronce, J. M., & Larimaer, M. E. (2002). Exploring college student gambling motivation. Journal of Gambling Studies, 18, 364–369.Google Scholar
- Petry, N. M. (2003). A comparison of treatment-seeking pathological gamblers based on preferred gambling activity. Addiction, 98, 649–650.Google Scholar
- Petry, N. M. (2004). Pathological gambling: Etiology, comorbidity, and treatment. Washington, D.C.: American Psychological Association.Google Scholar
- Richards, L., & Richards, T. (2000). Using N5 in qualitative research and the reference guide. Bundoora, AU: QSR International.Google Scholar
- Shaffer, H. J., LaBrie, R. A., LaPlante, D. A., & Kidman, R. C. (2002). The Iowa Department of Public Health Gambling Treatment Services: Four years of evidence (Technical Report #101102-200). Boston, MA: President and Fellows of Harvard College, Division of Addictions.Google Scholar
- Stinchfield, R., Govoni, R., & Frisch, G. (2001). An evaluation of diagnostic criteria for Pathological gambling. Windsor, Ontario: Problem Gambling Research Group, University of Windsor.Google Scholar
- World Health Organization (1993). The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva, Switzerland: Author.Google Scholar