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GambleAware published a report on the Problem Gambling Severity Index (PGSI) scale, for those who wish to identify, understand and reduce gambling harms. The PGSI is set of nine questions about gambling behaviour which has been widely used to identify the extent and scale of gambling problems. However, it has not been developed as a…
4 comments
Gordon Moody uses the PGSI as part of a battery of measures to assess gambling harm. Our service users present with average PGSI scores of 20.6, alongside high scores on measures of psychological distress, depression and anxiety. This mirrors the “strong, consistent link” between higher PGSI scores and rates of psychological distress. On leaving treatment, services users present with significantly lower PGSI scores (average of 3.5, which is maintained 12 months later).
We support GambleAware’s statement that the scale could be further improved, with particular regard to the issue of no defined thresholds between the score of 8 and the maximum score of 27; the PGSI tool only indicates that any score >=8 reflects a “likelihood of problem gambling”. This is a wide scoring range which should call for a more stratified approach of tier-level support recommendations. For example, we know that 50% of women who attend our services with a PGSI score greater than 21 have attempted to end their life, whilst none of the women with a score lower than 15 have attempted to end their life.
Alongside the issues of item weighting and lack of clinical significance, the PGSI tool also fails to capture a number of important dimensions of harm, including those experienced by others than gamblers themselves (affected others), meaning this scale used in isolation may underestimate the scale of the problem. PGSI scores of above 8 should be integrated in a wider assessment framework in order to understand people’s individual holistic support and treatment needs as well as the effectiveness of treatment interventions.
We welcome more research into the validity and reliability in using the PGSI tool as both an initial assessment tool and an effectiveness indicator in treatment services
Would you have any recommendations on worthwhile increments post 8+? And how should they be referred to? Likelihood of Severe Problem Gambling for example. Then Extremely Severe?
Makes sense. It’s just that you identified the 21+ as someone being in danger and wondered if you’d observed any other obvious thresholds
This would be due to the fact that on application our clients have an average score PGSI score of 20.6. In the context of a “problem gambler” at PGSI 8+, this gives an indication of severity of the population we treat.
This has ramifications in terms of the NICE guidelines on Harmful Gambling: Identification, Assessment and Management that we are in the process of responding to which indicate that all scores of PGSI 8+ should be treated by the NHS.
As you can see, a very important topic at the moment along with the White Paper Consultations on who is best placed to treat problem gamblers.