Commentary on Petry et al. (2013): Actus Reus-Why it matters to pathological gambling treatment

Abstract

Comments on an article by Nancy M. Petry et al. (see record 2013-05963-023). Petry et al.'s paper addresses the issue of threshold for diagnosis, outlining one of the DSM-5 workgroup's proposed changes as being the reduction in number of criteria needed for the diagnosis down to a cut-off of four, as opposed to five. Petry et al.'s results indicated that the process of identifying pathological gamblers is marginally more accurate using a cut-off of four criteria out of nine questions by removing the illegal acts item. Part of the drive towards the workgroup's interest in eliminating the illegal acts criteria comes from literature in the field stating that illegal acts tend to be committed by severe pathological gamblers, people who are therefore a long way past having reached threshold for identification. The majority of these illegal acts are never discovered and such behavior is indeed a sign of severity, of a compulsion triggering an individual into actions that are ego-dystonic and repulsive to the perpetrator because of their unlikely occurrence without the coexisting pathological gambling present. By removing such an important assessment component from the battery of questions we are unlikely to lose out on the identification of pathological gamblers and I agree with Petry et al. that prevalence rates will not change significantly. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

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