title: DSM-5 criteria for gambling disorder: Underlying structure and applicability to specific groups of gamblers.
abstract: OBJECTIVE
  DSM-5 provides nine diagnostic criteria for gambling disorder. All criteria have a pre-assumed equal diagnostic impact and are applied to all individuals and groups in an equal manner. The aims of the study are to analyse the structure underlying the diagnosis and to assess whether DSM-5 is equally applicable to different groups of gamblers.
  
  
  METHODS
  Data from the 2009 German Epidemiological Survey of Substance Abuse and from a study on slot machine gamblers were used. Item Response Theory analysis was applied to estimate discrimination and severity parameters of the criteria. With the use of Differential Item Functioning analysis, potential criterion biases were analysed. We analysed data from 107 participants from the general population sample and 376 participants from the slot machine gamblers' sample who answered a 19-item diagnostic questionnaire based on the DSM criteria for gambling disorder.
  
  
  RESULTS
  A single underlying factor, the severity of gambling disorder, was identified in both samples. In the general population sample the criteria of preoccupation and chasing were least severe and showed low discriminatory power. Bailout, withdrawal and jeopardized matters criteria had highest severity and discriminatory power. The comparison of the two samples revealed two criterion biases in the preoccupation and tolerance criteria.
  
  
  CONCLUSIONS
  The structure underlying the criteria is unidimensional but the disorder is manifested differently depending on disorder severity. The assumed equal impact of each criterion lacks support in the findings. The DSM-5 criteria measure a partially different construct in slot machine gamblers than in gamblers in the general population.
authors.affiliation: IFT Institut für Therapieforschung , München, Germany.
authors.forename: Pawel
authors.initials: P
authors.lastname: Sleczka
authors.affiliation: IFT Institut für Therapieforschung , München, Germany.
authors.forename: Barbara
authors.initials: B
authors.lastname: Braun
authors.affiliation: IFT Institut für Therapieforschung , München, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Piontek
authors.affiliation: IFT Institut für Therapieforschung , München, Germany.|Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden , Dresden, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bühringer
authors.affiliation: IFT Institut für Therapieforschung , München, Germany.|Centre for Social Research on Alcohol and Drugs, Stockholm University , Stockholm, Sweden.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Kraus
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: DSM-5; IRT; criterion bias; gambling disorder