Statistics and research release
Problem gambling screens
We regularly collect data on the prevalence of those experiencing problem gambling.
Summary
Also published recently
There are various ways to measure the prevalence of those experiencing problem gambling. The Gambling Survey for Great Britain (GSGB) uses the Problem Gambling Severity Index (PGSI). This page provides more detail about how the PGSI is used to measure experiences of problem gambling, as well as providing details of other screens that are available.
Details
Problem Gambling Severity Index (PGSI)
Used in the GSGB, Health Survey for England, Scottish Health Survey and the Welsh Problem Gambling Survey.
The PGSI was specifically developed for use among the general population rather than within a clinical context by Ferris and Wynne (2001) (opens in new tab).
The PGSI consists of 9 items and each item is assessed on a four-point scale: 'never' to 'almost always'. The following PGSI questions are asked to all participants of a survey who have gambled at least once in the last 12 months:
Thinking about the last 12 months...
- Have you bet more than you could really afford to lose?
- Have you needed to gamble with larger amounts of money to get the same feeling of excitement?
- When you gambled, did you go back another day to try to win back the money you lost?
- Have you borrowed money or sold anything to get money to gamble?
- Have you felt that you might have a problem with gambling?
- Has gambling caused you any health problems, including stress or anxiety?
- Have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
- Has your gambling caused any financial problems for you or your household?
- Have you felt guilty about the way you gamble or what happens when you gamble?
Scoring instructions
Each item is assessed on a four-point scale ranging from: never, sometimes, most of the time, almost always. Responses to each item are given the following scores:
- never = 0
- sometimes = 1
- most of the time = 2
- almost always = 3
When scores to each item are summed, a total score ranging from 0 to 27 is possible. Scores are grouped into the following categories:
PGSI score 0 | Representing a person who gambles (including heavily) but does not report experiencing any of the 9 symptoms or adverse consequences asked about. |
PGSI score 1 to 2 | Representing low risk gambling by which a person is unlikely to have experienced any adverse consequences from gambling but may be at risk if they are heavily involved in gambling. |
PGSI score 3 to 7 | Representing moderate risk gambling by which a person may or may not have experienced any adverse consequences from gambling but may be at risk if they are heavily involved in gambling. |
PGSI score 8 or more | Representing problem gambling by which a person will have experienced adverse consequences from gambling and may have lost control of their behaviour. Involvement in gambling can be at any level, but it is likely to be heavy. |
Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV)
Used in the Health Survey for England, Scottish Health Survey and the Welsh Problem Gambling Survey but it is not included within the GSGB.
The DSM-IV screening instrument is based on criteria from the fourth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV) (opens in new tab). The DSM-IV criteria form a tool created for diagnosis by clinicians of pathological gambling, and were not intended for use as a screening instrument among the general population in its original format.
An adapted version of the DSM-IV to use in a survey setting was developed for the British Gambling Prevalence Survey (BGPS) series and was subject to a rigorous development and testing process, including cognitive testing and piloting.
Each DSM-IV item is assessed on a four-point scale, ranging from ‘never’ to ‘very often’. Responses to each item can either be categorised to show whether a person meets the criteria or not, or allocated a score and a total score is produced.
Respondents are asked whether they:
- Are preoccupied with gambling (for example preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble).
- Need to gamble with increasing amounts of money in order to achieve the desired excitement.
- Have repeated unsuccessful efforts to control, cut back, or stop gambling.
- Are restless or irritable when attempting to cut down or stop gambling.
- Gamble as a way of escaping from problems or of relieving a dysphoric mood (for example feelings of helplessness, guilt, anxiety, depression.
- After losing money gambling, often return another day in order to get even ('chasing' one’s losses).
- Lie to family members, therapist, or others to conceal the extent of involvement with gambling.
- Have committed illegal acts, such as forgery, fraud, theft, or embezzlement, in order to finance gambling.
- Have jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
- Rely on others to provide money to relieve a desperate financial situation caused by gambling.
Scoring instructions
Each DSM-IV item is assessed on a four-point scale, ranging from ‘never’ to ‘very often.’ This is with the exception of ‘chasing losses’ which is rated on a scale ranging between ‘never’ and ‘every time I lost’. Responses to each item are categorised (that is, given a score of 0 or 1) to show whether a person meets the criteria or not. A total score between 0 and 10 is possible.
A threshold of meeting at least 3 of the DSM-IV criteria is used to identify people who are experiencing problem gambling. This cut-off point has been found to give good discrimination between criterion groups and has provided the closest match to prevalence estimated by other screening instruments.
Clinicians currently use an additional threshold of a DSM-IV score of 5 or more to represent pathological gambling.
The DSM-IV does not have recognised thresholds for low risk and moderate risk gambling.
The short-form Problem Gambling Severity Index (PGSI mini-screen)
The short-form Problem Gambling Severity Index (PGSI mini-screen) was developed for the Gambling Commission from the full 9-item PGSI by Dr. Rachel Volberg (Developing a Short Form of the PGSI (opens in new tab) (PDF), 2012). Though this scale has been developed, we use the full 9-item PGSI within the GSGB for our official statistics. This instrument is formed of 3 questions from the PGSI, which are scored on a four-point scale from 'never' to 'almost always'. It is asked to all participants of a survey who have gambled at least once in the last 12 months.
In the last 12 months...
- Have you bet more than you could really afford to lose?
- Have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
- Have you felt guilty about the way you gamble or what happens when you gamble?
Scoring instructions
PGSI score 0 | Representing a person who gambles (including heavily) but does not report experiencing any of the 9 symptoms or adverse consequences asked about. |
PGSI score 1 | Representing low risk gambling by which a person is unlikely to have experienced any adverse consequences from gambling but may be at risk if they are heavily involved in gambling. |
PGSI score 2 to 3 | Representing moderate risk gambling by which a person may or may not have experienced any adverse consequences from gambling but may be at risk if they are heavily involved in gambling. |
PGSI score 4 or more | Representing moderate risk gambling by which a person may or may not have experienced any adverse consequences from gambling but may be at risk if they are heavily involved in gambling. |
The scores are analysed to provide overall problem gambling rates, as well as by gender and age. As advised by Volberg following the development of the PGSI mini-screen, the screen must not be used to report or track changes in any further sociodemographic characteristics or gambling behaviour. Due to small base sizes in the above surveys the data should be treated with caution.
DSM-IV-MR-J screen - A revised version of the adult DSM-IV screening instrument as developed by Dr S. Fisher, 2000.
Using the DSM-IV-MR-J (Diagnostic and Statistical Manual of Mental Disorders 4th Edition - Multiple Response Juvenile) screen, a child who confirms that they had undertaken 4 or more of the behaviours or actions (from the overall screen of 9 components outlined as follows) is identified as experiencing problem gambling, a score of 2 or 3 is used to identify those ‘at-risk’ from gambling and a score of 0 or 1 represents those who gamble but do not report experiencing problem gambling.
If any of the following answer criteria are ticked, 1 point is given:
How often have you found yourself thinking about gambling or planning to gamble? | ‘Often’ |
How often have you gambled to help you escape from problems or when you were feeling bad? | ‘Sometimes’ or ‘often’ |
Have you felt bad or fed up when trying to cut down on gambling? | ‘Sometimes’ or ‘often’ |
Have you needed to gamble with more and more money to get the amount of excitement you want? | ‘Sometimes’ or ‘often’ |
Have you ever spent much more than you planned to on gambling? | ‘Sometimes’ or ‘often’ |
Have you ever taken money from any of the following without permission to spend on gambling:
|
If any one or more of these options are ticked, then qualifies for one point in total |
Has your gambling ever led to the following:
|
If any of the following are ticked, then qualifies for one point in total: ‘once or twice’, ‘sometimes’ or ‘often’ |
Has your gambling ever led to the following:
|
‘Once or twice’ ‘sometimes’ or ‘often’ |
After losing money by gambling, have you returned another day to try to win back the money you lost? | ‘More than half the time’ or ‘every time’ |
Limitations
As with any screening instrument, there are a number of caveats that need to be considered when interpreting estimates from the PGSI or any of the other screening instruments listed here.
One thing that should also be considered is the confidence intervals associated with each of the estimates. We have published some guidance about how to use the estimates generated by the GSGB, which uses the PGSI alongside other questions to understand the consequences of gambling amongst adults in Great Britain.
Where estimates of people experiencing problem gambling have been measured by either the DSM-IV or the PGSI, these should not be combined with PGSI categories 1 to 2 or 3 to 7 to create an overall ‘at-risk’ figure. This is because these groups are not mutually exclusive (for example an individual could be classified as experiencing problem gambling according to the DSM-IV and subject to moderate risk gambling according to PGSI and would therefore be counted twice in a combined ‘risk’ figure).
Screening instruments like the PGSI fail to capture a wider range of adverse consequences, including the experiences of those who do not directly gamble themselves, but know someone close to them who does gamble.
The term ‘at-risk’ can imply that people who have a PGSI score of 1 to 2 or 3 to 7 (representing low or moderate risk gambling) are not experiencing harm now but will do in the future when in fact they are showing some signs of problematic behaviour now but remain below the threshold for ‘problem’ gambling.
The term ‘at-risk’ can also imply that people who have a PGSI score of 1 to 2 or 3 to 7 (representing low or moderate risk gambling) will progress up the scale to a PGSI score of 8 or more and will experience problem gambling. However evidence from existing longitudinal studies (such as the Quinte Longitudinal Study of Gambling and Problem Gambling (opens in new tab) (PDF) and the New Zealand National Gambling Study (opens in new tab)) suggests that some do and some do not.
In order to better understand the consequences of gambling, we have now incorporated the PGSI and wider questions assessing the adverse consequences from gambling in the GSGB Annual report (2023).
Data and downloads
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