screening

The Division on Addiction at Cambridge Health Alliance, a Teaching Hospital of Harvard Medical School, is sponsoring Gambling Disorder Screening Day on Tuesday, March 13, 2018. This year’s Screening Day Toolkit has even more free resources to make hosting Screening Day easier than ever. Any provider or organization can host. Registration is not required to use these free resources.

Did you know that only about 15 percent of disordered gamblers in the US seek treatment or attend self-help groups (Slutske, 2006)? However, nearly half of lifetime disordered gamblers received treatment for some other mental or substance problem (Kessler et al., 2008). According to the National Comorbidity Survey Replication, increased screening for emerging gambling problems in clients already in treatment might be an opportunity to prevent full-blown gambling disorders (Kessler et al., 2008).

Have you ever been screened for a health problem? The answer is probably yes if you’ve ever been questioned by your doctor about symptoms or responded to a telephone survey about health. There are numerous screening instruments used by clinicians to determine if a client has a gambling problem, and some often appear in general population surveys to research the prevalence of the disorder. The Division of Addictions at Cambridge Health Alliance, a teaching affiliate of Harvard Medical School, recently released the Brief Biosocial Gambling Screen (BBGS) to help people decide on their own whether to seek a formal evaluation of their gambling behavior.  Development of the screen was funded by the NCRG.

Measuring addictive behaviors accurately is very difficult. Among the many complications are recruiting subjects, relying on their memory and self-report and quantifying the difference between pathological actions and actions that are merely unusual or uncommon. (Jerome Wakefield, Ph.D., discussed this topic in detail at the NCRG conference 2010.) One particularly difficult aspect of studying addiction is the diagnostic screening instrument (when scored, the instrument shows whether or not a person should be diagnosed with a particular disorder). Diagnostic screens of all kinds pose the problem of advancement versus consistency: It is always possible to make a newer and better instrument, but a new instrument means that studies conducted with the older one cannot be directly compared to studies conducted with the new instrument. This tension dictates that new instruments must be shown as better along several lines to make them worth implementing. Two researchers at the forefront of this discussion for gambling disorders are Erica Fortune and Adam Goodie, Ph.D., at the University of Georgia. Fortune and Goodie recently published a study, partly funded by a grant from the NCRG to Dr. Goodie, that compares the performance of two diagnostic screens in a population of college students (Fortune & Goodie, 2010).