Gamblers’ (mis-)interpretations of Problem Gambling Severity Index items: Ambiguities in qualitative accounts from the Swedish longitudinal gambling study [open-access article]

Abstract: The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify risk and problem gambling. Even though the PGSI has good psychometric properties, it still produces a large proportion of misclassifications. Aims: To explore possible reasons for misclassifications in problem gambling level by analysing previously classified moderate-risk gamblers’ answers to the PGSI items, in relation to their own current and past gambling behaviours.
Methods: Semi-structured telephone interviews were conducted with 19 participants reporting no negative consequences from gambling. They were asked the PGSI questions within an eight-year time frame (2008 to 2016). Ambiguous answers to PGSI items were subject to content analysis.
Results: Several answers to the PGSI items contained ambiguities and misinterpretations, making it difficult to assess to what extent their answers actually indicated any problematic gambling over time. The item about feelings of guilt generated accounts rather reflecting self-recrimination over wasting money or regretting gambling as a meaningless or immoral activity. The item concerning critique involved mild interpretations such as being ridiculed for buying lottery tickets or getting comments for being boring. Similar accounts were given by the participants irrespective of initial
endorsement of the items. Other possible reasons for misclassifications were related to recall bias, language difficulties, selective memory, and a tendency to answer one part of the question without taking the whole question into account.
Conclusions: Answers to the PGSI can contain a variety of meanings based on the respondents’ subjective interpretations. Reports of lower levels of harm in the population should thus be interpreted with caution. In clinical settings it is important to combine use of screening instruments with interviews, to be able to better understand gamblers’ perceptions of the gambling behaviour and its negative consequences.
Article available online

Reference: Samuelsson, E., Wennberg, P., & Sundqvist, K. (2019). Gamblers’ (mis-)interpretations of Problem Gambling Severity Index items: Ambiguities in qualitative accounts from the Swedish longitudinal gambling study. Nordic Studies on Alcohol and Drugs, 36(2), 140–160. DOI: 10.1177/1455072519829407


The “Zone”: a qualitative exploratory study of an altered state of awareness in electronic gaming machine problem gambling [subscription access article]

Oakes, J., Pols, R., Lawn, S. et al. (2018). International Journal of Mental Health and Addiction. doi:

Abstract: This paper reports a state of mind described by electronic gaming machine (EGM) problem gamblers (PGs) as the “zone”. Twenty-nine PGs engaged in focus groups and in-depth interviews. Participants described an altered state of awareness: the zone, which was highly desirable providing relief from negative emotions. PGs had difficulty recalling experiences whilst in the zone but described a constriction of attention, awareness and impairment of cognitive functions. During this time, the PG could not think critically, exercise self-observation, realistically appraise the use of money, see the consequences of their actions, exercise the will to cease gambling or learn from harms. Memory was impaired, as was decision-making and the capacity to make rational choices. Understanding the zone may provide insight into treatment where the capacity to learn may be reduced. Further research is needed to determine what proportions of EGM gamblers experience the zone and if this occurs with non-EGM gamblers. Article and access details

Prevention paradox logic and problem gambling: Does low-risk gambling impose a greater burden of harm than high-risk gambling? (Open access)

By Paul Delfabbro and Daniel King.

Background and aims: The aim of this paper is to examine the evidence and arguments in favor of prevention paradox (PP) logic in the context of problem gambling. Evidence from recent studies of gambling and the distribution of harm across lower and higher risk gamblers is reviewed to examine the contention that the absolute burden of harm is greater in low-risk (LR) gamblers than the problem gamblers.
Methods: The review examines a number of methodological and conceptual concerns about existing evidence in support of the PP.
Results: The principal problems identified include the misclassification of LR gamblers; the use of binary scoring method that understates the frequency of harms in high-risk populations; a tendency to confuse behavior and harm; and the use of potentially overly inclusive definitions of harm with low thresholds of severity.
Discussion and conclusions: This paper makes a number of recommendations for enhancement of this area of research, including the use of clear definitions of harm and LR behavior and a greater focus on harm with material impacts on people’s quality of life.