Chunk #52 — Issues Not Related To Substances — Should Gambling Disorder and Other Putative Behavioral “Addictions” Be Added to the Substance Disorders Chapter? — Gambling
In DSM-IV, pathological gambling is in the section entitled “Impulse-Control Disorders Not Elsewhere Classified.” Pathological gambling is comorbid with substance use disorders (187–189) and is similar to substance use disorders in some symptom presentations (190), biological dysfunction (191), genetic liability (192), and treatment approaches (193–195). The work group therefore concurred with a DSM-5 Task Force request to move pathological gambling to the substance use disorders chapter. The work group also recommended other modifications (196). The name will be changed to “Gambling Disorder” because the term pathological is pejorative and redundant. The criterion “illegal acts to finance gambling” was removed for the same reasons that legal problems were removed from substance use disorders (197–200; B. Grant, unpublished 2010 data). The diagnostic threshold was reduced to four or more criteria to improve classification accuracy (200–203). A further reduction in the threshold was considered, but this greatly increased prevalence (189, 197) without evidence for diagnostic improvement. Future research should explore whether gambling disorder can be assessed using criteria that are parallel to those for substance use disorders (200).
