Abstract
To examine the underlying dimensionality and structure of problem gambling using a comprehensive range of problem gambling assessments from an international online survey of gamblers. A total of 12,521 gamblers from 105 countries were recruited through banner advertising placed on a popular online gambling portal to take an online survey. Although participants were recruited online, the majority of the sample (71.6%) gambled only at land-based venues in the past 12 months. A total of 5081 individuals completed all items from the four problem gambling assessments. Participants were allocated to answer one of the four problem gambling assessments and the remaining unique items from the three other problem gambling assessments. The order of assessments were counterbalanced. Two optimal scaling procedures were independently employed to estimate the number of dimensions within the data: exploratory categorical principal component bootstrap analysis and multidimensional scaling. Nonlinear canonical correlation was then used to establish how well each of the four assessment instruments captured the identified dimensions. A final confirmatory principal component analysis was run to understand and characterise the nature of the dimensions that were identified. Both the categorical principal component bootstrap analysis and multidimensional scaling indicated the data was multidimensional, with four dimensions (including a single dominant dimension) providing the best characterisation of the data. The nonlinear canonical correlation analysis found that the Problem and Pathological Gambling Measure and the National Opinion Research Center DSM-IV Screen for Gambling Problems operationalization of the Diagnostic and Statistical Manual of Mental Disorders Four (DSM-IV) criteria best captured these multiple dimensions. Confirmatory principal component analysis suggest a core experience of generic problem gambling symptomology and three other components: “financial problems”, “health and relationship issues”, and “difficulty controlling gambling”. Problem gambling symptomology appears to be multi-dimensional. Certain assessments capture this heterogeneity better than others and thereby provide a more complete and accurate assessment of this construct.
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Notes
DSM-5’s psychometric scale approach to selecting diagnostic items is also a deviation from the historical intent of the DSM which is to accurately identify all manifestations of a disorder rather than just people who fit the normative profile. For example, catatonia would not be removed as a criterion for schizophrenia simply because it is an uncommon manifestation.
The same four significant dimensions were estimated using only English-speaking countries.
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Darren R. Christensen: Dr. Christensen reports no conflicts of interest. In the last 3 years Dr. Christensen has received funding from the Alberta Gambling Research Institute, the CRISM Prairie Node, and the Cancer Council of Victoria. Robert J. Williams: Dr. Williams has no financial or other conflict of interest associated with the present research. Virtually all of his research funding in the past several years has come from independent research agencies and government entities. However, he has received a small amount of research funding from Unibet Ltd, an online gambling provider with headquarters in Malta. Samuel M. Ofori-Dei: Mr. Ofori Dei has no financial or other conflicts of interest related to the research. However, he has received funding from Alberta Gambling Research Institute. This funding has nothing to do with the present research.
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Appendix A
Appendix A
This is a list of the questions employed for the PGSI, SOGS-R, PPGM, and NODS. The order in which the instruments were presented in the survey was counterbalanced. Each question identifies whether the question was administered and scored for a single instrument (e.g., PGSI1), or used in the scoring for more than one instrument (e.g., PGSI2/SOGS6; PGSI3/PPGM11/NODS2; etc.). In the latter case, in the section covering the second, third, or fourth instrument, the normal wording and response options for the question are presented in italics.
For example, the question ‘PGSI2/SOGS6’ has a counterpart in the SOGS section of the survey labelled ‘SOGS6/PGSI2’. The survey question and response options are very similar to the original SOGS6 question (seen in italics), but they are not identical. If the PGSI was presented prior to the SOGS, the PGSI2/SOGS6 was administered but the SOGS6/PGSI2 was not, and vice versa if the SOGS was presented prior to the PGSI. For the PGSI, the normal scoring of the question would apply (i.e., never = 0, sometimes = 1, most of the time = 2, almost always = 3). However, for the SOGS, a different scoring would apply to correspond to the yes/no response options in the original SOGS question: i.e., never = 0, sometimes = 1, most of the time = 1, almost always = 1).
Problem Gambling Severity Index (PGSI)
PGSI1. Thinking about the past 12 months, have you bet more than you could really afford to lose? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI2/SOGS6. Thinking about the past 12 months, have you felt guilty about the way you gamble or what happens when you gamble? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI3/PPGM11/NODS2. In the past 12 months, have you needed to gamble with larger amounts of money to get the same feeling of excitement? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI4/SOGS1/PPGM8b/NODS6. In the past 12 months, when you gambled, did you go back another day to try to win back the money you lost? Would you say
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI5/PPGM1a/NODS10. In the past 12 months, have you borrowed money or sold anything to get money to gamble? Would you say
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI6/PPGM1b. In the past 12 months, has your gambling caused any financial problems for you or your household? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI7. In the past 12 months, has your gambling caused you any health problems, including stress or anxiety? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI8/SOGS5. In the past 12 months, have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
PGSI9/SOGS3. In the past 12 months, have you felt that you might have a problem with gambling? Would you say
-
never (0)
-
sometimes (1)
-
most of the time (2)
-
almost always (3)
South Oaks Gambling Screen-Revised (SOGS-R)
SOGS1/PGSI4/PPGM8b/NODS6. In the past 12 months, when you gambled, did you go back another day to try to win back the money you lost? Would you say
-
never (0)
-
sometimes (0)
-
most of the time (1)
-
almost always (1)
SOGS1. In the past 12 months, when you gambled, how often did you go back another day to win back money you lost?
-
never (0)
-
some of the time (less than half the time I lost) (0)
-
most of the time I lost (1)
-
every time I lost (1)
SOGS2. In the past 12 months, have you ever claimed to be winning money gambling when you were, in fact, losing? Would you say
-
never (or never gamble) (0)
-
yes, less than half the time I lost (1)
-
yes, most of the time (1)
SOGS3/PGSI9. In the past 12 months, have you felt that you might have a problem with gambling? Would you say
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
SOGS3. In the past 12 months, do you feel that you have had a problem with betting money or gambling?
-
no (0)
-
yes (1)
SOGS4/PPGM8a. In the past 12 months, have you often gambled longer, with more money or more frequently than you intended to?
-
no (0)
-
yes (1)
SOGS4. In the past 12 months, did you ever gamble more than you intended to?
-
no (0)
-
yes (1)
SOGS5/PGSI8. In the past 12 months, have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
SOGS5. In the past 12 months, have people criticized your gambling, or told you that you had a gambling problem, regardless of whether or not you thought it was true?
-
no (0)
-
yes (1)
SOGS6/PGSI2. Thinking about the past 12 months, have you felt guilty about the way you gamble or what happens when you gamble? Would you say:
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
SOGS6. In the past 12 months, have you ever felt guilty about the way you gamble or what happens when you gamble?
-
no (0)
-
yes (1)
SOGS7. In the past 12 months, have you ever felt like you would like to stop gambling, but you didn’t think you could?
-
no (0)
-
yes (1)
SOGS8. In the past 12 months, have you ever hidden betting slips, lottery tickets, gambling money, IOUs or other signs of betting or gambling from your partner, children or other important people in your life?
-
no (0)
-
yes (1)
SOGS9/PPGM3a/NODS9a. In the past 12 months, has your gambling resulted in arguments with people you live with over how you handle money?
-
no (0)
-
yes (1)
SOGS9. In the past 12 months, have you ever argued with people you live with over how you handle money? (not counted in score)
-
no (go to next question)
-
yes
Have money arguments centered on your gambling?
-
no (0)
-
yes (1)
SOGS10. In the past 12 months, have you ever borrowed from someone and not paid them back as a result of your gambling?
-
no (0)
-
yes (1)
SOGS11/PPGM5/NODS9b&NODS9c. In the past 12 months, have you missed time from work or school due to gambling?
-
no (0)
-
yes (1)
SOGS12. Did you borrow money to gamble or to pay gambling debts in the past 12 months
-
no (0) (Skip SOGS 13abcdefghi)
-
yes (1)
SOGS13. Did you borrow from….
-
(a)
household money (no = 0; yes = 1)
-
(b)
your partner (no = 0; yes = 1)
-
(c)
other relatives or in-laws (no = 0; yes = 1)
-
(d)
banks, loan companies or credit unions (no = 0; yes = 1)
-
(e)
credit cards (no = 0; yes = 1)
-
(f)
loan sharks (no = 0; yes = 1)
Did you…
-
(a)
cash in stocks, bonds or other securities (no = 0; yes = 1)
-
(b)
sell personal or family property (no = 0; yes = 1)
-
(c)
write cheques for more money than you had in your chequing account (no = 0; yes = 1)
Problem and Pathological Gambling Measure (PPGM) (There are a few minor question numbering and wording differences in this version of the PPGM relative to the later published version in Williams and Volberg (2010, 2014), as the PPGM was still being refined at this stage). Italics indicates wording in the 2010 PPGM.
PPGM1a./PGSI5/NODS10. In the past 12 months, have you borrowed money or sold anything to get money to gamble?
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
PPGM1a. Has your involvement in gambling caused you either to borrow a significant amount of money or sell some of your possessions in the past 12 months?.
-
no (0)
-
yes (1)
PPGM1b/PGSI6. In the past 12 months, has your gambling caused any financial problems for you or your household?
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
PPGM1b. Has your involvement in gambling caused significant financial concerns for you or someone close to you in the past 12 months? (Note: do not score 1 for 1b if 1 has already been scored for 1a).
-
no (0)
-
yes (1)
PPGM2. Has your involvement in gambling caused significant mental stress in the form of guilt, anxiety, or depression for you or someone close to you in the past 12 months?
-
no (0)
-
yes (1)
PPGM3a/SOGS9/NODS9a. In the past 12 months, has your gambling resulted in arguments with people you live with over how you handle money?
-
no (0)
-
yes (1)
PPGM3a. Has your involvement in gambling caused significant problems in your relationship with your spouse/partner, or important friends or family in the past 12 months?
-
no (0)
-
yes (1)
PPGM3b. Has your involvement in gambling caused you to neglect your children or family in the past 12 months?
-
no (0)
-
yes (1) (do not score 1 if it has already been scored a 1 in 3a)
PPGM4. Has your involvement in gambling caused significant health problems for you or someone close to you in the past 12 months?
-
no (0)
-
yes (1)
PPGM5/SOGS11/NODS9b&NODS9c. In the past 12 months, have you missed time from work or school due to gambling?
-
no (0)
-
yes (1)
PPGM5. Has your involvement in gambling caused significant work or school problems for you or someone close to you in the past 12 months or caused you to miss a significant amount of time off work or school? (NOTE: score ‘no’ for people who do not work or go to school).
-
no (0)
-
yes (1)
PPGM6/NODS8. Has your involvement in gambling caused you or someone close to you to write bad cheques, take money that didn’t belong to you or commit other illegal acts to support your gambling in the past 12 months?
-
no (0)
-
yes (1)
PPGM7. Is there anyone else who would say that your involvement in gambling has caused any significant mental, financial, family, health, school, work, or legal concerns/problems for you or someone close to you in the past 12 months?
-
no (0)
-
yes (1)
PPGM8a/SOGS4. Have you often gambled longer, with more money or more frequently than you intended to in the past 12 months?
-
no (0)
-
yes (1)
PPGM8b/PGSI4/SOGS1/NODS6. In the past 12 months, when you gambled, did you go back another day to try to win back the money you lost?
-
never (0)
-
sometimes (0)
-
most of the time (1)
-
almost always (1)
PPGM8b. In the past 12 months, have you often gone back to try and win back the money you lost?
-
no (0)
-
yes (1)
PPGM8c/NODS3a. In the past 12 months, have you made attempts to either cut down, control or stop gambling?
-
no (0) (go to PPGM9)
-
yes (1)
PPGM8d/NODS4. Were you successful in these attempts?
-
no (1)
-
yes (0)
PPGM9/NODS3b. In the past 12 months, when you did try cutting down or stopping did you find you were very restless or irritable or that you had strong cravings for it?
-
no (0)
-
yes (1)
PPGM10/NODS1a & NODS1b. In the past 12 months, would you say you have been preoccupied with gambling?
-
no (0)
-
yes (1)
PPGM11/PGSI3/NODS2. In the past 12 months, did you find you needed to gamble with larger and larger amounts of money to achieve the same level of excitement?
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
PPGM11. In the past 12 months, did you find you needed to gamble with larger and larger amounts of money to achieve the same level of excitement?
-
no (0)
-
yes (1)
PPGM12. In the past 12 months, is there anyone else who would say that you were either preoccupied with gambling; or had a loss of control; or had withdrawal symptoms; or that you needed to gamble with larger amounts of money to achieve the same excitement?
-
no (0)
-
yes (1)
PPGM12. In the past 12 months, is there anyone else who would say that you have had difficulty controlling your gambling, regardless of whether you agreed with them or not?
-
no (0)
-
yes (1)
National Opinion Research Center DSM-IV Screen For Gambling Problems (NODS)
NODS1ab/PPGM10. In the past 12 months, would you say you have been preoccupied with gambling?
-
no (0)
-
yes (1)
NODS1a. In the past 12 months, have there been any periods lasting 2 weeks or longer when you spent a lot of time thinking about your gambling experiences or planning future gambling ventures or bets?
-
no (0)
-
yes (1)
NODS1b. In the past 12 months, have there been periods lasting 2 weeks or longer when you spent a lot of time thinking about ways of getting money to gamble with?
-
no (0)
-
yes (1) (unless already have a 1 for NODS1a)
NODS2/PGSI3/PPGM11. In the past 12 months, have you needed to gamble with larger amounts of money to get the same feeling of excitement?
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
NODS2. In the past 12 months, have there been periods when you needed to gamble with increasing amounts of money or with larger bets than before in order to get the same feeling of excitement?
-
no (0)
-
yes (1)
NODS3a/PPGM8c. In the past 12 months, have you tried to stop, cut down, or control your gambling?
-
no (0) (go to NODS 5a)
-
yes (1)
NODS3b/PPGM9. In the past 12 months, when you did try cutting down or stopping did you find you were very restless or irritable or that you had strong cravings for it?
-
no (0)
-
yes (1)
NODS3b/PPGM9. In the past 12 months, on one or more of the times when you tried to stop, cut down, or control your gambling, were you restless or irritable?
-
no (0)
-
yes (1)
NODS4/PPGM8d. Were you successful in these attempts to stop, cut down, or control your gambling?
-
no (1)
-
yes (0)
NODS4a. In the past 12 months, have you tried but not succeeded in stopping, cutting down, or controlling your gambling?
-
no
-
yes
NODS4b. In the past 12 months, has this happened three or more times?
-
no (0)
-
yes (1)
NODS5a. In the past 12 months, have you gambled as a way to escape from personal problems?
-
no (0)
-
yes (1)
NODS5b. In the past 12 months, have you gambled to relieve uncomfortable feelings such as guilt, anxiety, helplessness, or depression?
-
no (0)
-
yes (1; unless already have a 1 for 5a)
NODS6/PGSI4/SOGS1/PPGM8b. In the past 12 months, when you gambled, did you go back back another day to try to win back the money you lost?
-
never (0)
-
sometimes (0)
-
most of the time (1)
-
almost always (1)
NODS6. In the past 12 months, has there ever been a period when, if you lost money gambling on 1 day, you would often return another day to get even?
-
no (0)
-
yes (1)
NODS7. In the past 12 months, have you lied to family members, friends, or others 3 or more times about how much you gamble or how much money you lost on gambling?
-
no (0)
-
yes (1)
NODS7a. In the past 12 months, have you more than once lied to family members, friends, or others about how much you gamble or how much money you lost on gambling?
-
no
-
yes
NODS7b. Has this happened three or more times?
-
no (0)
-
yes (1)
NODS8/PPGM6. Has your involvement in gambling caused you or someone close to you to write bad cheques, take money that didn’t belong to you or commit other illegal acts to support your gambling in the past 12 months?
-
no (0)
-
yes (1)
NODS8. In the past 12 months, have you written a bad cheque or taken money that didn’t belong to you from family members of anyone else in order to pay for your gambling?
-
no (0)
-
yes (1)
NODS9a/SOGS9/PPGM3a. In the past 12 months, has your gambling resulted in arguments with people you live with over how you handle money?
-
no (0)
-
yes (1)
NODS9a. In the past 12 months, has your gambling caused serious or repeated problems in your relationships with any of your family members or friends?
-
no (0)
-
yes (1)
NODS9bc/SOGS11/PPGM5. In the past 12 months, have you missed time from work or school due to gambling?
-
no (0)
-
yes (1)
NODS9b. In the past 12 months, has your gambling caused you any problems in school, such as missing classes or days of school or getting worse grades?
-
no (0)
-
yes (1; unless already scored 1 for NODS9a)
NODS9c. In the past 12 months, has your gambling caused you to lose a job, have trouble with your job, or miss out on an important job or career opportunity?
-
no (0)
-
yes (1; unless already scored 1 for NODS9a or NODS9b)
NODS10/PGSI5/PPGM1a. In the past 12 months, have you borrowed money or sold anything to get money to gamble?
-
never (0)
-
sometimes (1)
-
most of the time (1)
-
almost always (1)
NODS10. In the past 12 months, have you needed to ask family members or anyone else to loan you money or otherwise bail you out of a desperate money situation that was largely caused by your gambling?
-
no (0)
-
yes (1)
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Christensen, D.R., Williams, R.J. & Ofori-Dei, S.M. The Multidimensional Structure of Problem Gambling: An Evaluation of Four Gambling Categorization Instruments from an International Online Survey of Gamblers. J Gambl Stud 35, 1079–1108 (2019). https://doi.org/10.1007/s10899-019-09832-5
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DOI: https://doi.org/10.1007/s10899-019-09832-5