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Examination of Proposed DSM‐5 Changes to Pathological Gambling in a Helpline Sample
Author(s) -
Weinstock Jeremiah,
Rash Carla,
Burton Steve,
Moran Sheila,
Biller Warren,
O'Neil Kathleen,
Kruedelbach Norman
Publication year - 2013
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.22003
Subject(s) - helpline , gambling disorder , psychology , subclinical infection , pathological , psychiatry , dsm 5 , clinical psychology , addiction , medicine , emergency medicine
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.