DSM

The American Psychiatric Association (APA) has proposed new criteria for a diagnosis of pathological gambling (PG) in the next edition of the Diagnostic and Statistical Manual of Mental Disorders, slated for publication in 2013.  As reported in Issues and Insights and discussed at the 2010 NCRG Conference on Gambling and Addiction, the proposed revisions included moving PG from the impulse control category into a new classification, “addiction and related disorders.” It also proposes dropping illegal acts from the 10 criteria and possibly reducing the number of criteria needed for a diagnosis from five to four. A new review article by Howard J. Shaffer and Ryan Martin in the 2011 Annual Review of Clinical Psychology (Shaffer & Martin, 2011) provides a critical review of these recommendations.

Scientists have proposed an understanding of pathological gambling (PG) as an expression of an underlying addiction syndrome (Shaffer et al., 2004). A syndrome, by definition, is expected to have generally predictable signs and symptoms, though they will vary and may not always be present. Are there definable “types” of people with PG? The most recent edition of The WAGER (Worldwide Addiction Gambling Education Report) reviews a study focused on this issue.

The recently proposed changes to the definition of pathological gambling for the next edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) prompted us to think about the dizzying pace of change within the field over the past 30 years.

In this month’s Issues & Insights, four researchers reflect on the progress of the field by answering the question, “What has been the most significant change in how scientists look at disordered gambling over the past 30 years?” Their conclusions range from the inclusion of pathological gambling in the DSM-III in 1980 to advances in understanding the neurobiology of disordered gambling behavior. All agree that there have been tremendous advances in the field in the past three decades. You can read their full comments in June’s Issues & Insights.

What do you think has been the most significant change in gambling research during the past 30 years? Share your thoughts with us in the comments section below.

The American Psychiatric Association currently is in the process of updating the Diagnostic and Statistical Manual of Mental Disorders to its fifth edition (DSM-V). The DSM is the handbook of mental disorders in the United States, used daily by health care providers, researchers, insurance companies and government agencies. The DSM-V Work Group that reviewed the diagnosis for pathological gambling has proposed several changes to the diagnostic definition of the disorder. Revisions in diagnostic codes are typically driven by evolving research that transforms our understanding of a disorder, and so this month’s Issues & Insights summarizes several studies that question the current definition of pathological gambling and, in some cases, might inform the final recommendations for the DSM-V.