Evaluation of the gambling disorder construct

Background: This presentation evaluates the construct of gambling disorder as conceptualised through its diagnostic criteria and description in the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5) to assess possible areas for improvement.

Method: An analysis of the DSM-5 gambling disorder diagnostic criteria and description was conducted, and comparisons were made with other DSM-5 entities alongside a review of literature relating to gambling disorder.

Results: The definition of gambling behaviour is found to be lax and can be taken to include elements of entrepreneurship. The cardinal feature of addiction – loss of behavioural and cognitive control – is not central in making the diagnosis. The motivational aspects of gambling disorder are somewhat contradictory. Lastly, problematic gambling arising from non-pathological factors like financial desperation and greed are not excluded.

Conclusion: Improved clarity in definitions, weighting of cardinal disorder features, and explicit mention of exclusionary criteria is likely to improve maximum sensitivity and specificity of diagnostic criteria of mental disorders, including gambling disorder.