![]() This examination may provide a better understanding of thresholds of GD severity and how best to determine them. Therefore, we sought to examine the three levels of GD severity as determined by the DSM-5 against other clinical measures to determine if the DSM-5 categories of severity are clinically useful and comport with previous research on GD. The use of multiple measures of gambling severity across different samples has made it difficult to compare, and thereby understand, which may be most useful in understanding the severity of this complex disorder. The question remains as to whether simply summing the number of criteria endorsed by an individual accurately reflects GD symptom severity when each is weighted equally. In a sample of gamblers recruited from the general population, endorsement of the item ‘social, financial, or occupational losses due to gambling’ was most indicative of more severe GD. For example, jeopardizing important matters, experiencing withdrawal, and needing financial assistance were all associated with a more severe level of GD than were chasing losses or being preoccupied with gambling (Sleczka et al., 2015). Recent research, however, suggests that the individual criteria may not all be equivalent in terms of their contributions to the severity of the behavior. Thus, this simple criteria sum as an overall severity indicator was used for substance use disorders and then extension for GD: mild (four to five criteria), moderate (six to seven), and severe (eight or nine). The committee responsible for GD in DSM-5 decided that a simple count of the criteria was sufficient to determine level of severity, given that this approach had been successfully applied to substance use disorder risk factors and consequences. In the case of GD, many indicators are available to potentially operationalize clinical severity (e.g., money lost gambling as a percentage of earnings, impairment, or comorbidity). As such, the DSM-5 has used the number of criteria met to define GD severity, mirroring the classification system used for substance use disorders. In the fifth edition of the Diagnostic and Statistical Manual (DSM-5), GD has been classified as a substance-related disorder. GD in turn is associated with impaired functioning, reduced quality of life, and high rates of bankruptcy, divorce, and incarceration. ![]() ![]() Gambling is a commonplace activity across cultures, and for some individuals can develop into gambling disorder (GD), a psychiatric condition characterized by persistent, recurrent maladaptive patterns of gambling behavior. ![]()
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