Problem Gambling Help
Problem gambling tests are self-administered questionnaires that rely on the gambler to answer 10 or more questions honestly in order to assess their risk of problem gambling. There are many such instruments to be found on the internet. Many of them are attached to gambling websites to act as a quick guide.
The questions on these questionnaires are very similar to each other. They ask subjects if they feel their gambling has been excessive. They ask about efforts to hide gambling behavior from themselves or others. They ask about level of guilt and emotional stress connected to gambling. They also ask about the perception of others regarding their gambling behavior. They also ask about un-realistic persistence.
Most of the available self-assessment problem gambling questionnaires are given on-line. The subject clicks yes or no alternatives to gambling related questions. The score may be automatically tabulated. Then a warning is issued that if the subject’s score surpasses some level, he or she may need help with a gambling problem.
The assumption behind the questions is that gambling is a diagnosable addiction. Most of the text introducing the assessments acknowledge that only professionals can truly diagnose their addiction. The instructions advise people with higher than some minimal score to consult a professional to get help or to contact Gamblers Anonymous, Problem Gambling Helpline or similar addiction programs.
While these assessments have face validity, the questions “look” valid, there are apparently no extensively studied problem gambling assessments. Unless scores on questionnaires are correlated with outcomes or more extensive diagnostic information, they have to be considered speculative.
There has never been a study of the reliability of this kind of questionnaire. We don’t know whether people taking the questionnaire would really get the same score if the test were administered again.
Except for the fact that the questionnaires seem to have approximately the same items, there is no true determination that the questionnaire scores correlate with one another. There is almost no determination of how much response bias, self-esteem, social desirability of the items and other biasing factors determine the final scores.
One of the best problem gambling questionnaires is called the NORC Diagnostic Screen of Gambling Problems-Self Administered (or the NODS-SA). This instrument was developed by staff members at the National Opinion Research Center at the University of Chicago.
The description indicates that this instrument did undergo some validity and reliability study, the authors acknowledge that validity data is incomplete.
When such questionnaires are optional and attached to gambling websites, how useful can such a self-assessment be? Someone who initially takes such self-assessments seriously already has some concerns about his or her gambling behavior. How much do self-assessment questionnaires actually reduce problem gambling?
The National Institutes of Health teams studying impulse control and addiction disorders acknowledge that self-administered assessments could be helpful in diagnosis, but state that real diagnosis can only be linked to treatments from face to face clinical work with a professional.
Problem gambling is a diagnosable behavioral condition. Many professionals relate it to other addictions like alcoholism. There are similar kinds of self-assessment instruments designed to tell someone if they have an alcohol problem.
True addiction or impulse control problems are difficult for people to assess in themselves. The self-assessment questionnaire is designed as a front-line interview in an economical and convenient form. The question is how likely are addicted subjects to lie even to themselves on these instruments?