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

Susana Jiménez-Murcia,Anne Sauvaget,Àngel Cuquerella,Fernando Fernández-Aranda,Amparo Del Pino-Gutiérrez,José M Menchón,Mónica Gómez-Peña,Trevor Steward,Roser Granero,Andreas Fransson,Neus Aymamí,Marta Baño,Maria-Teresa Talón-Navarro,Ester Codina,Laura Moragas,Zaida Agüera,Anders Hakansson,Gemma Mestre-Bach,Randy Stinchfield

doi:10.3389/fpsyg.2019.00931

Abstract

Background and Aims: Gambling-related crimes are known to be associated with gambling disorder (GD). Due to a lack of consensus in the scientific community regarding the relevance of this diagnostic criterion, it was removed from the DSM-5. The primary aim of this study was to investigate through structural equation modeling (SEM) whether higher GD severity in treatment-seeking GD patients with a criminal record is mediated through the illegal acts criterion itself, or whether it can be better explained by other related clinical factors.Methods: An initial sample of 2,081 patients seeking treatment for gambling problems was included in the sample. SEM was used to evaluate the mediational role of the illegal acts criterion between the sex, age and personality traits, gambling severity, and comorbid depression levels. Comparisons between patients with coinciding and divergent DSM criterion for GD diagnosis were carried out.Results: Illegal acts mediated the relationship between personality traits and GD severity: younger age, high levels of novelty seeking, and low levels of self-transcendence increased the risk of endorsing the illegal acts criterion. No differences between coincident-divergent groups in terms of DSM-IV and DSM-5 diagnosis were found with regards to sex (p = 0.878), education level (p = 0.387), or civil status (p = 0.792).Discussion and Conclusion: The results obtained in the present study offer new insights into the utility of using a history of illegal acts, their different personality characteristics, and psychopathology to categorize GD patients. Our findings suggest that patients who engage in criminal behavior may require a more comprehensive intervention.

Highlights

Gambling-related crimes are known to be associated with gambling disorder (GD), allowing individuals with this disorder to obtain funding to continue with the gambling behavior or to solve financial problems stemming from it (Petry et al, 2013; Laursen et al, 2016; May-Chahal et al, 2017; MestreBach et al, 2018a)
Research related to the removal of the illegal acts criterion have demonstrated that this has had little impact on the number of patients being diagnosed with the disorder, that the illegal acts criterion was the criterion least commonly endorsed by patients, and that patients who met this criterion in the DSM-IV-TR generally met a sufficient number of other criteria to meet diagnosis without the presence of illegal acts (Zimmerman et al, 2006; Strong and Kahler, 2007; McBride et al, 2010; Weinstock et al, 2013; Granero et al, 2014)
In order to delve into the repercussions of this change at a clinical level, the primary aim of the present study was to investigate through path analysis implemented in structural equation modeling (SEM) whether higher GD severity seen in treatment-seeking GD patients with a criminal history is mediated through the illegal acts criterion itself, or whether it can be better explained by other related clinical factors

Summary

Introduction

Gambling-related crimes are known to be associated with gambling disorder (GD), allowing individuals with this disorder to obtain funding to continue with the gambling behavior or to solve financial problems stemming from it (Petry et al, 2013; Laursen et al, 2016; May-Chahal et al, 2017; MestreBach et al, 2018a) Some risk factors, such as sociodemographic features (Abbott and McKenna, 2005), personality disorders (e.g., antisocial personality disorder) and traits (Turner et al, 2009; Pastwa-Wojciechowska, 2011) and the co-occurrence of substance use (Gorsane et al, 2017) have been highlighted when taking GD, and criminal behavior into account. The primary aim of this study was to investigate through structural equation modeling (SEM) whether higher GD severity in treatment-seeking GD patients with a criminal record is mediated through the illegal acts criterion itself, or whether it can be better explained by other related clinical factors

Objectives

Methods

Conclusion