title: Reliability, Validity, and Classification Accuracy of the DSM-5 Diagnostic Criteria for Gambling Disorder and Comparison to DSM-IV.
abstract: The DSM-5 was published in 2013 and it included two substantive revisions for gambling disorder (GD). These changes are the reduction in the threshold from five to four criteria and elimination of the illegal activities criterion. The purpose of this study was to twofold. First, to assess the reliability, validity and classification accuracy of the DSM-5 diagnostic criteria for GD. Second, to compare the DSM-5-DSM-IV on reliability, validity, and classification accuracy, including an examination of the effect of the elimination of the illegal acts criterion on diagnostic accuracy. To compare DSM-5 and DSM-IV, eight datasets from three different countries (Canada, USA, and Spain; total N = 3247) were used. All datasets were based on similar research methods. Participants were recruited from outpatient gambling treatment services to represent the group with a GD and from the community to represent the group without a GD. All participants were administered a standardized measure of diagnostic criteria. The DSM-5 yielded satisfactory reliability, validity and classification accuracy. In comparing the DSM-5 to the DSM-IV, most comparisons of reliability, validity and classification accuracy showed more similarities than differences. There was evidence of modest improvements in classification accuracy for DSM-5 over DSM-IV, particularly in reduction of false negative errors. This reduction in false negative errors was largely a function of lowering the cut score from five to four and this revision is an improvement over DSM-IV. From a statistical standpoint, eliminating the illegal acts criterion did not make a significant impact on diagnostic accuracy. From a clinical standpoint, illegal acts can still be addressed in the context of the DSM-5 criterion of lying to others.
authors.affiliation: Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA. stinc001@umn.edu.
authors.forename: Randy
authors.initials: R
authors.lastname: Stinchfield
authors.affiliation: Healthy Horizons Consulting, Toronto, ON, Canada.
authors.forename: John
authors.initials: J
authors.lastname: McCready
authors.affiliation: Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Nigel E
authors.initials: NE
authors.lastname: Turner
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain.|CIBEROBN, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Jimenez-Murcia
authors.affiliation: University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Petry
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
authors.forename: Jon
authors.initials: J
authors.lastname: Grant
authors.affiliation: Research Institute on Addictions, Buffalo, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Welte
authors.affiliation: Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Chapman
authors.affiliation: Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: Ken C
authors.initials: KC
authors.lastname: Winters
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D016739:Behavior, Addictive / Q000134:cerebrospinal fluid* / Q000145:classification* / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000145:classification* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D015588:Observer Variation; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Classification accuracy; DSM-5; DSM-IV; Diagnosis; Gambling disorder