The classification accuracy of four problem gambling assessment instruments in population research

Improved methodology was used to re-examine the weak correspondence between problem and pathological gamblers identified in population surveys and subsequent classification of these individuals in clinical interviews. The SOGS-R, the CPGI, the NODS and the Problem and Pathological Gambling Measure (PPGM), as well as questions about gambling participation and expenditures, were administered to a total of 7272 adults. Two clinicians then assessed each person's status, based on comprehensive written profiles derived from these questionnaire responses. Instrument classification was then compared to clinical classification. All four instruments correctly classified most non-problem gamblers (i.e. had good to excellent sensitivity, specificity and negative predictive power). However, the PPGM was the only instrument with good classification of problem gamblers (i.e. excellent sensitivity and positive predictive power). The CPGI and SOGS-R had weak positive predictive power and the NODS had only adequate sensitivity and positive predictive power. Improvement in the classification accuracy of the CPGI occurred when a 5+ cut-off was used and when a 4+ cut-off was used with the SOGS. In general, the classification accuracy of the NODS, SOGS and CPGI is better than prior research suggested but overall accuracy is still modest. With adjusted cut-offs, all three instruments are reasonably congruent with clinical ratings.     

SOGS and CGPI: Parallel Comparison on a Diverse Population

The Northern Territory of Australia, one of the most demographically and socially diverse jurisdictions in the country, conducted its first population-based gambling and problem gambling prevalence survey in 2005. Both the South Oaks Gambling Screen (SOGS) and the Canadian Problem Gambling Index (CPGI) were administered to the same sample of respondents. Using data from this survey, the current paper presents a parallel comparison of the respective screens with particular reference to gender, region, and the socio-demographic characteristics of respondents. The respective screens produced significantly different groups of problem gamblers as measured by their association with a range of socio-demographic variables. Specifically, the large number of SOGS items related to money issues may cause selective overrepresentation among low socioeconomic groups, including Indigenous people, who exist in relatively high proportions in the Northern Territory. In addition, there existed substantial gender-based differences within screens. Identified female problem gamblers were associated with household level variables (i.e. employment status, household type and marital status), while males were associated with socio-economic variables including language, education, and income. Further research is required to validate the use of problem gambling screens within the Indigenous population and to understand the role of gender in the experience and categorisation of problem gambling.     

SOGS and DSM-IV in the British Gambling Prevalence Survey: Reliability and Factor Structure

This article examines the psychometric performance and reliability of two problem gambling scales (the South Oaks Gambling Screen [SOGS], and a scale based on the Diagnostic and Statistical Manual (4th edn) [DSM-IV]) and their constituent items, based upon data from the first British Gambling Prevalence Survey (Sproston et al ., 2000). Separate factor analyses of SOGS items and DSM-IV items suggested the existence of two independent factors in each case: dependence and gambling-related problems. Scores based upon SOGS and DSM factors correlated only moderately. It is concluded that no single existing screening questionnaire adequately reflects the multi-dimensional nature of problem gambling.     

Explaining the High False Positive Rate of the South Oaks Gambling Screen

The South Oaks Gambling Screen (SOGS) has been used extensively in estimating the prevalence of pathological gambling but produces a large number of false positive classifications. Ladouceur et al. (, Journal of Gambling Studies, 16, pp. 1–24) claim that misunderstanding of SOGS items is responsible for the high false positive rate. However, their study is open to a number of methodological criticisms. The current study, where clinical and non-clinical gamblers complete the SOGS with and without clarification, overcomes these problems. Results suggest that clarification does not have a significant overall effect on SOGS scores. This implies that item misunderstanding is not responsible for the false positive rate of the SOGS.     

Gambling and problem gambling among clients,and staff attitudes,in an alcohol and drug problems treatment service in the English Midlands

A self-completion questionnaire containing items about recent gambling and problem gambling used in the British Gambling Prevalence Survey (BGPS) was completed by 274 clients of alcohol and drug problems services in the English West Midlands. Compared to BGPS data, matched to the client sample for age and sex, clients were significantly more likely in the previous 12 months to have engaged in forms of gambling carrying a high risk of problems, to have engaged in four or more separate forms of gambling, and to have scores on a brief form of the South Oaks Gambling Screen (SOGS) indicating problem gambling. A self-completion scale on attitudes towards working with problem gamblers, with good psychometric properties according to present data, was completed by 91 members of staff of the same services. With the exception of a sub-scale measuring perceived adequacy of knowledge and skills for working with problem gamblers, staff expressed moderately positive attitudes. It is concluded that British substance misuse services are appropriate locations for the development of services for problem gambling.     

Gambling over the life course and treatment-seeking

The purpose of this study is to investigate change in gambling behaviours over the life course, and, correspondingly, the treatment-seeking behaviours of 86 people who met the criteria for at-risk (participants endorsing two to four items on the South Oaks Gambling Screen [SOGS]) and problem gamblers (participants endorsing five or more items on the SOGS) over the last five years. Data were obtained from informants during semi-structured interviews using Structured Clinical Interview for DSM-IV axis I and axis II disorders (SCID I and II), SOGS and treatment-seeking interviews. The results showed three groups of gambling behaviours over the life course. A first group started gambling early on and continued participating in recreational gambling until its participants were between 40 and 50 years of age, during which time they became problem gamblers. A second group transitioned from recreational gambling to problem gambling over a short period of time; its participants were aged between 40 and 50. Lastly, a third group which was exposed to gambling later on in life, mostly after retirement, developed gambling problems quickly. Psychopathology was prevalent in all groups, given that 98% suffered from a mental health problem during their life, and 62% within the last six months. Participants who made use of the services available mostly turned to medical and specialized mental services for brief periods, usually when in crisis. In terms of problem gambling, the results argue in favour of maintaining dedication toward treatment, especially in the presence of co-morbidity.     

Reliability,Validity, and Cut Scores of the South Oaks Gambling Screen (SOGS) for Chinese

We examined the reliability, validity, and classification accuracy of the South Oaks Gambling Screen (SOGS) when adopted for use in Chinese. The DSM-IV criteria for pathological gambling served as the standard against which the classification accuracy of the SOGS was tested. A total of 283 Chinese adults in the community and 94 Chinese treatment-seeking gamblers were recruited. The internal reliability of the SOGS was satisfactory for the general sample and acceptable for the gambling sample. The SOGS was correlated with the DSM-IV criteria items as well as psychosocial and gambling-related problems. Relative to the DSM-IV criteria, the SOGS tended to overestimate the number of pathological gamblers in both samples. In general, we were relatively confident that individuals were not pathological gamblers if the SOGS scores were between 0 and 4 and were pathological gamblers if the SOGS were between 11 and 20. There was about 50–50 chance of being pathological gamblers if the SOGS scores were between 8 and 10. However, the probability of individuals being pathological gamblers was about 0.30 if the SOGS scores were between 5 and 7. We proposed a SOGS cut score of 8 to screen for probable pathological gambling in Chinese societies.     

Psychometric Evaluation of the Problem Gambling Severity Index-Chinese Version (PGSI-C)

The purpose of this study was to examine the psychometric properties of the Chinese 9-item Problem Gambling Severity Index (PGSI) derived from the 31-item Canadian Problem Gambling Index (CPGI) originally developed by Ferris and Wynne (2001). Exploratory factor analysis (EFA; n = 386; Group A data) and confirmatory factor analysis (CFA; n = 387; Group B data) on the Chinese student and community data (Mean age = 25.36 years) showed that a unifactorial model fitted the data with good reliability score (Cronbach’s alpha = 0.77). The concurrent validity of the PGSI-C was good in terms of the Chinese data matching the expected correlation between PGSI-C and other variables or scales such as SOGS, gambling frequency, gambling urge, gambling cognitions, depression, anxiety, and stress. The scale also reported good discriminant and predictive validity. In sum, the PGSI-C has good psychometric properties and can be used among Chinese communities to identify at-risk problem gamblers. Implications and suggestions for future research are discussed.     

Is the SOGS an Accurate Measure of Pathological Gambling Among Children, Adolescents and Adults?

The South Oaks Gambling Screen (SOGS) is widely used to assess the prevalence of pathological gambling. For a variety of reasons, this instrument may not provide an accurate rate of the prevalence of pathological gambling. In this paper, one source of error in data provided by the SOGS is investigated. It is argued that individuals may not fully understand the meaning of some items, and that clarification of the meaning of misunderstood items may in some cases lead to a changed score on the scale. The present study evaluates respondents' understanding of the SOGS items. The results from three studies are reported, each using a different sample: grade school children, adolescents and adults. It was hypothesised that (1) participants would not understand some items of the SOGS, (2) problem gamblers and probable pathological gamblers would be more inclined to interpret items incorrectly than would non-problem gamblers and, (3) consistent with the first two hypotheses, clarification of items would decrease the number of participants identified as problem gamblers or probable pathological gamblers. The data obtained supported hypotheses 1 and 3. Furthermore, hypothesis 2 was supported for grade school children, but not for adolescents or adults. These results are consistent with recent literature on endorsement and acquiescence phenomena, and have implications for prevalence studies of probable pathological gambling.     

Reliability and Validity of the Pathological Gambling Adaptation of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS)

The Yale Brown Obsessive Compulsive Scale adapted for Pathological Gambling (PG-YBOCS) was developed to measure the severity and change in severity of pathological gambling symptoms. The PG-YBOCS is a 10-item clinician-administered questionnaire that measures the severity of PG over a recent time interval (usually within the past one/two week(s)). In order to assess and validate the scale, it was administered to 337 subjects: 188 pathological gamblers and 149 healthy controls. Internal consistency and correlations between individual items and total score were assessed for various permutations of the sample. Other scales were administered to assess convergent, discriminant and content validity. Sensitivity to change was evaluated in treatment studies with fluovoxamine, lithium, and valproate. Each item was frequently endorsed across a range of severity. Good inter-rater reliability and internal consistency were obtained. The PG-YBOCS showed high validity and reliability for total score, item-total correlations, and for each subscale (Thoughts/Urges and Behavior). PG-YBOCS scores correlated with global severity and South Oaks Gambling Screen (SOGS) scores. The scale was also sensitive to change in pathological gambling severity. PG-YBOCS thus appears to be a reliable and valid measure of pathological gambling severity, and can be regarded as an important tool for clinicians and researchers treating pathological gamblers.     

Problem gambling in a federal prison population: results from the South Oaks Gambling Screen

Three hundred and sixty three medium security federal prison inmates were interviewed with the South Oaks Gambling Screen (SOGS) with 5.2% of the sample achieving SOGS scores greater than 4 and another 7.4% attaining scores of 3 or 4, traditional markers of pathological gambling and problem gambling, respectively. Attempts were made to evaluate the relative accuracy of the continuum and dichotomy models of problem gambling by contrasting three groups of subjects (SOGS < 3, SOGS = 3 or 4, SOGS > 4) on a series of gambling-related measures and comparing the relative ability of the SOGS and a dichotomized version of the SOGS to account for residual variance in these same gambling-related measures. Results were consistent with the view that problem gambling embodies features of both a continuum and dichotomy. Nearly half the subjects had desisted from problem gambling on their own, although self-remitters displayed less severe and extensive patterns of problem gambling than non-remitting subjects.     

Rates of pathological gambling in publicly funded outpatient substance abuse treatment

Rates of problem or probable pathological gambling were assessed in substance abusers seeking outpatient treatment in a publicly funded outpatient substance abuse treatment program. The South Oaks Gambling Screen (SOGS) was administered to 467 consecutive admissions at three different sites. Problem gamblers comprised 6.2 percent of the total (n=29), and 4.5 percent scored as probable pathological gamblers (n=21). These rates are two and one-half times greater than would be expected according to a recent state survey using the SOGS. Implications for assessment and treatment of problem gambling are discussed.The author expresses his appreciation to John Ramsay and the staff of Epoch Counseling Center for data collection; to Les Franklin for computational analysis; and Dr. Rachel Volberg for providing supplemental data from her Maryland State Gambling Survey.     

Potential and probable pathological gamblers: Where do the differences lie?

A large proportion of adolescents engage in gambling activities and the prevalence of pathological gambling is high. This study presents a factor analysis of responses from 122 college students who obtained a score of 3 or greater on the South Oaks Gambling Screen (SOGS), the most widely used instrument to identify probable and potential pathological gamblers. The analysis showed five dimensions: Illegal Behaviors, Heavy Gambling, Eating Disorders, Parentally Modelled/Less Impulsive, and Worry. Analyses revealed that except for the Eating Disorders factor, all factors clearly differentiated the probable from potential pathological gamblers, as identified by the SOGS. Results raise important questions about the relationship of pathological gambling to other psychopathological or antisocial behaviors. Thus the probable pathological gambler category represents a wide-ranging behavioral profile that goes beyond gambling per se. Avenues for future research as well as clinical implications are discussed.This research was partially supported by grants from Le Fonds Richelieu, le Conseil Québécois de la Recherche Sociale and the Social Sciences and Humanities Research Council of Canada.     

Gambling Screens: Does Shortening the Time Frame Affect their Psychometric Properties?

Gambling screening tools such as the South Oaks Gambling Screen (SOGS) and a DSM-IV Screen for Gambling Problems (NODS) developed by the National Opinion Research Council have psychometrically validated lifetime and past-year versions. As research questions often dictate shorter time intervals, researchers have adapted the time frames of these instruments to their specific purposes without examining whether changing the time frame affects the psychometric properties. In this study, 3-month versions of SOGS and NODS were administered to a sample of 80 pathological gamblers (59 men, 21 women, mean age 44) seeking treatment at a state-funded facility. The 3-months versions had good internal consistency, good convergent validity with each other, with gambling behaviors assessed via the timeline followback method, and with measures of impulsivity. The 3-month versions also showed good discriminant validity with demographic variables and a measure of verbal IQ. Together the data indicate that shortening the time frame to 3 months does not seem to have adverse effects on the psychometric properties of SOGS and NODS. Thus these adapted versions could profitably be used for shorter time intervals, including as pre/post-treatment and follow-up measures in treatment outcome studies.     

Racial and Ethnic Differences in Problem Gambling among College Students

The college years are a formative period where the risk for development of problematic gambling is high. Research examining racial and ethnic differences in gambling behaviors has been limited and inconsistent. The aims of this study were to examine racial and ethnic differences in problem gambling among a large sample of college students. Undergraduates (N = 3058) from a large southern university completed an online screening questionnaire which included demographics, gambling frequency, gambling expenditure (i.e. money lost) in the previous 6 months, and the South Oaks Gambling Screen (SOGS). Negative binomial regression results indicated that Asian participants gambled less frequently than participants who were Caucasian or Hispanic/Latino(a), but spent more money than participants who were African-American (AA)/Black or Hispanic/Latino(a). A significantly larger proportion of Asian students met probable pathological gambling criteria (SOGS 5+; 7.8 %) and at-risk gambling criteria (SOGS 3+; 16.3 %)) than Caucasian (5.2; 10.1 %), AA/Black (3.9; 10.2 %), or Hispanic/Latino(a) (3.6; 9.4 %) students. Additionally, a significantly larger proportion of Asian students endorsed problematic gambling indicators such as lying about losses, feeling guilty about gambling, feeling like they had a gambling problem, being criticized for their gambling, feeling like they couldn’t stop gambling, losing time from school or work due to gambling, having a family history of problem gambling, and arguing with close others about their gambling than Caucasian, AA/Black or Hispanic/Latino(a) students. Results suggest that Asian students may be a high-risk sub-group of college gamblers, and that there is a critical need for targeted interventions for this population.     

Impulsiveness,Locus of Control,Motivation and Problem Gambling

A questionnaire consisting of demographic items, questions about gambling behavior, the South Oaks Gambling Screen (SOGS), a depression inventory, the Eysenck Impulsiveness Questionnaire, Levensons Internality, Powerful Others and Chance Scales of locus of control and the Gambling Motivation Scale, was completed by a non-random sample of 147 New Zealand university students who gambled for money, median age 24 years. Approximately 17 of the sample was classified as problem gamblers, the rest as non-problem gamblers. Multivariate analysis of variance showed that there were significant differences between problem and non-problem gamblers on gambling frequency, number of activities, parents gambling, depression, impulsiveness and motivation, but not on locus of control. Amotivation (apathy) and motivation towards stimulation correlated with powerful others and chance locus of control, and motivation to impress others with powerful others locus of control. Hierarchical regression analysis showed that: (1) beyond gambling frequency, number of activities and parents gambling, motivation explained a substantial proportion of variance in SOGS scores, with impulsiveness accounting for a lesser amount, and (2) predictors of problem gambling included impulsiveness, amotivation and the motivations for accomplishment and tension release. It was concluded that gambling motivation is a more useful construct than locus of control in explaining problem gambling. Suggestions were made for future research, and aspects of gambling motivation were discussed in terms of a treatment program with groups of problem gamblers.     

Problem Gambling Inside and Out: The Assessment of Community and Institutional Problem Gambling in the Canadian Correctional System

This paper reports on the results of a multi-site survey of gambling behaviour and gambling problems amongst offenders in correctional institutions in Ontario, Canada, conducted between 2008 and 2011. A total of 422 (completion rate 61.5 %) incarcerated offenders (381 male and 41 female) took part in the study including 301 federal offenders and 121 provincial offenders. Based on the Problem Gambling Severity Index of the Canadian Problem Gambling Index (CPGI/PGSI) the prevalence rate of severe problem gambling was 8.9 prior to incarceration and 4.4 % during incarceration. These numbers are substantially higher than rates found among the general public. Thirty-four percent of the sample reported gambling in prison. Half of those who suffered from gambling problems before incarceration continued to have gambling problems during incarceration. People with problems related to slot machines prior to incarceration reported fewer gambling problems during incarceration compared to other problem gamblers.     

The Self-Regulation of Gambling

Despite the prevalence of gambling world-wide, relatively few individuals become problem gamblers. Additionally many problem gamblers recover without professional assistance. The current study aim was to examine how individuals self-manage their gambling through (a) assessing frequency of use of a range of self-regulation strategies (b) examining how these strategies cluster and (c) exploring relationships between strategies, gambling frequency, amount spent and problem gambling severity. A sample of 303 gamblers was recruited, over-sampling for problem gamblers as assessed by the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index (mean age 26.4 years, SD = 10.1 years; 119 males, 184 females; 238 social gamblers, 63 problem gamblers, 2 unclassified). They rated extent of usage of 27 gambling self-management techniques and completed the PGSI and other gambling measures. Factor analysis of items produced five factors, named Cognitive Approaches, Direct Action, Social Experience, Avoidance and Limit Setting. The relationships between these factors and key gambling variables were consistent with hypotheses that problem gamblers trying to reduce their gambling would be more likely to use the strategies than other gambler groups. The potential for developing the factors into a Gambling Self-regulation Measure was explored.     

Psychometric Validation of the Gambling Passion Scale (GPS) in an English-speaking University Sample

The Gambling Passion Scale (GPS) is a recently developed research instrument for assessing individuals' passion for gambling. Because the psychometric properties of the GPS have only previously been examined in French Canadians, the aim of this study was to replicate previous psychometric findings in an English-speaking university sample. Participants (female: n = 58; male: n = 89) were drawn from a university campus based on self-reported experience with gambling indexed by scores on the South Oaks Gambling Screen (SOGS). The two-factor structure reported by Rousseau et al. (Journal of Gambling Studies, 18(1), pp. 45–66, 2002) was largely replicated in this sample, as were relationships between ‘obsessive passion’ and negative consequences stemming from gambling. These results support the validity of the GPS as a measure of gambling passion in English-speaking university gamblers and its potential to contribute to understanding problem gambling.