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GambleAware reassured over independent PGSI scale study

| By Robert Fletcher
GambleAware says it is reassured by the findings of an independent study into the Problem Gambling Severity Index (PGSI) scale.
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The PGSI is a set of nine questions about gambling behaviour. GambleAware says it is used to estimate both the extent and scale of gambling problems.

However, as it has not been developed as a clinical tool, there is debate over how best to use it for identifying and measuring gambling harms. This led GambleAware to commission Ipsos UK to analyse the index in an independent study.

This used a dataset of over 21,000 people from the 2020 and 2021 Annual GB Treatment and Support Survey. The yearly report is commissioned and published by GambleAware.

The Ipsos UK-led study found the PGSI scale can continue to be used to estimate potential risk of gambling harm. 

Among the core findings was that there is a strong and consistent link between higher PGSI scores and higher rates of psychological distress. The study also says the scale can be used as a tool when considering integrating mental health interventions into treatment for people who score highly on the scale.   

Report flags possible limitations of PGSI scale 

However, the study picked out some limitations with PGSI. Researchers found some PGSI questions are more likely to indicate severe risk of harm than others. 

One example of this is when questions look at whether a person has borrowed money to fund gambling, if they are experiencing financial problems due to gambling, or if they feel the need to gamble more to experience the same thrill.

For questions like this, researchers say they may indicate a greater level of harm. However, questions on whether someone feels guilty about gambling or chases losses when gambling, appear to indicate less harm.

This, the report says, raises questions about whether each PGSI item should be weighted equally when using the PGSI as either a clinical or screening tool.

All nine PGSI questions should be used when possible

The other stand-out finding focuses on the use of questions. Researchers say the full PGSI questionnaire – all nine questions – should be used wherever possible.

The alternative PGSI, with three questions, should only be used if there is “extremely limited” opportunity to interact with people. This, researchers say, is because using the short-form PGSI has a tendency to fail to identify some cases of “problem gambling”. Therefore, this can understate the prevalence of problem gambling, compared to the full PGSI.

“The PGSI scale has long been an important tool for understanding the scale of gambling harms at both individual and population level,” GambleAware’s director of evidence and insights, Haroon Chowdry, said. 

“We commissioned this independent study because we wanted to take a closer look at the features of this index, how exactly it varies and how well it captures different kinds of harm, which has not been analysed before.

“We are reassured by the findings that the PGSI generally works well as an index and can identify different levels of harm. Although there are areas where the scale or how it is used may be able to be improved. 

“We hope treatment services, clinicians and policymakers will take note of the recommendations to ensure they are making the best use of this scale to help those experiencing gambling harms.”

Researchers: look beyond the broad classification groupings

Ipsos UK research director Steven Ginnis adds: “The results of this study increase the knowledge base on the PGSI scale and confirm that it should continue to be used to estimate the potential risk of ‘problem gambling’ among large groups. 

“However, findings suggest PGSI is unlikely to work as well on its own as a diagnostic instrument for individuals or for screening purposes. 

“We therefore recommend that PGSI users and practitioners also look beyond the broad classification groupings. Not all people within a PGSI classification are at the same potential risk of harm from gambling.”

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