Gambling Disorder in the DSM-5: Opportunities to Improve Diagnosis and Treatment Especially in Substance Use and Homeless Populations

Abstract

In the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), gambling disorder (GD) underwent several changes. This paper reviews recent research related to the revisions, including the elimination of the illegal acts criterion and the newly lowered diagnostic threshold. These studies suggest the removal of the illegal acts criterion has little impact in terms of prevalence or loss of diagnostic status among gamblers, especially when considered in combination with the newly lowered diagnostic threshold. Overall prevalence rates will increase modestly with the lowered threshold in community samples of gamblers. However, increases in GD prevalence rates may be more notable in settings that serve individuals at higher risk for gambling problems (e.g., substance abuse treatment clinics and homeless persons). GD is now aligned more closely with substance use addictions in DSM-5. This re-categorization, along with the lower threshold for diagnosis under DSM-5 diagnostic criteria, may lead to increased recognition of gambling problems, particularly in settings that serve high risk populations. These changes also may necessitate the training of more clinicians in the delivery of efficacious gambling treatments.

The impact of casino proximity on northeast urban communities: a literature review

“…Gambling disorder and its apparent relationship to casino proximity warranted discussion in this literature review. Gambling disorder, previously termed pathological gambling was renamed to gambling disorder and reclassified from an impulse control disorder to the category of "Substance-related and Addictive Disorders" in the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition ([DSM-5], American Psychiatric Association, 2013; Hodgins and Petry, 2016;Rash and Petry, 2016;Stinchfield et al, 2016;Temcheff et al, 2016).…”

The Prevalence of Problem Gambling and Gambling Disorder Among Homeless People: A Systematic Review And Meta-Analysis

“…So far, most of the utilized screening instruments relied on dated editions of DSM and it remains to be seen how the criteria of DSM-5 impact prevalence estimates. It has been argued that increased rates are to be expected particularly in high-risk populations like the homeless (Rash & Petry, 2016). Future researchers should focus on GD as a preferred outcome.…”

A Comparison of DSM-IV-TR and DSM-5 Diagnostic Criteria for Gambling Disorder in a Large Clinical Sample

“…This is in line with the opinion of some authors who consider the illegal acts criterion to be essential for clinical practice (Mitzner et al, 2011). They suggest that the underreporting of criminal behaviors in a clinical assessment, possibly associated to the social desirability bias, may partially explain the low prevalence rates of this criterion, which was one of the motives for eliminating this criterion in the DSM-5 (Rash and Petry, 2016).…”