An empirical evaluation of proposed changes for gambling diagnosis in the DSM-5.
An empirical evaluation of proposed changes for gambling diagnosis in the DSM-5.
复制标题
对 DSM-5 中赌博诊断拟议变更的实证评估。
DOI：
10.1111/j.1360-0443.2012.04087.x
复制
发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Volberg,Rachel
中科院分区：
文献类型：
--
作者：
Petry,NancyM;Blanco,Carlos;Stinchfield,Randy;Volberg,Rachel
《精神疾病诊断与统计手册》（DSM）第五版关于病态赌博的建议是取消与违法行为有关的标准，并将诊断门槛从5个标准减少到4个标准。本研究评估了这些变化对患病率和分类准确性的影响。DesignData从五个样本中分析了赌博问题的严重程度。环境和参与者：随机选择的美国家庭居民（n= 2417）、赌博顾客（n= 450）、短期干预研究中的个体（n= 375）、社区赌博治疗项目中的患者（n= 149）和随机干预研究中的参与者（n= 319）。测量方法：对所有参与者进行国家意见研究中心DSM - IV赌博问题筛查（NODS）。内部一致性和因子结构采用10和9标准进行评估。以DSM - IV分类为标准，比较不同分类系统的基本率、命中率、敏感性、特异性和总体一致性。发现取消违法行为标准不影响内部一致性，适度改善了因子结构中的方差。在比较使用10个标准中的4个的分类系统与使用9个标准中的4个的分类系统时，9个标准中的4个系统在所有比较和所有样本中产生相同或稍好的分类准确性。在拟议的DSM - V病态赌博诊断中纳入非法行为标准似乎对病态赌博的诊断是没有必要的，如果它被消除，相对于目前的分类系统，将切割点减少到4会导致更一致的诊断。
AimsRecommendations related to pathological gambling for the fifth edition of the Diagnostic and Statistic Manual for Mental Disorders (DSM) are to eliminate the criterion related to committing illegal acts and reduce the threshold for diagnosis from five to four criteria. This study evaluated the impact of these changes on prevalence rates and classification accuracy.DesignData were analyzed from five samples, varying in severity of gambling problems.Settings and participantsSurveys of randomly selected household residents in the United States (US) (n= 2417), gambling patrons (n= 450), individuals in brief intervention studies (n= 375), patients in community‐based gambling treatment programs (n= 149) and participants in randomized intervention studies (n= 319).MeasurementsThe National Opinion Research Center DSM‐IV Screen for Gambling Problems (NODS) was administered to all participants. Internal consistency and factor structure were evaluated using both 10 and nine criteria. Base rates, hit rates, sensitivity, specificity and overall agreement were compared across classification systems, using DSM‐IV classification as the standard.FindingsEliminating the illegal acts criterion did not impact internal consistency and modestly improved variance accounted for in the factor structure. In comparing a classification system using four of 10 criteria versus one using four of nine, the four of nine system yielded equal or slightly better classification accuracy in all comparisons and across all samples.ConclusionsThe inclusion of the illegal acts criterion in the proposed DSM‐V pathological gambling diagnosis does not appear necessary for diagnosis of pathological gambling and, if it is eliminated, reducing the cut‐point to four results in more consistent diagnoses relative to the current classification system.