A new report published by GambleAware found that while the Problem Gambling Severity Index (PGSI) works, tweaks to its use could make identifying and helping those experiencing gambling harms easier and, potentially, more effective.
As a result, GambleAware has urged clinicians, politicians, and treatment services to incorporate the study’s recommendations to ensure people dealing with gambling harms are more accurately identified and effectively helped.
The study, undertaken by Ipsos UK, used advanced statistical methods on a dataset of over 21,000 people from 2020 and 2021 to explore the PGSI.
Notably, the findings show that PGSI is effective for estimating the potential risk of gambling harms. However, the review also identified several limitations and offered suggestions to improve outcomes.
In a release accompanying the report, Ipsos UK’s research director, Steven Ginnis, said:
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, the 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.
Study Offers Recos for Future PGSI Interpretation
The PGSI, the report establishes, is a validated screening tool developed in Canada and used widely around the world to estimate the occurrence of gambling problems.
Users employ the tool retrospectively to consider policies’ impact and proactively to inform guidelines, service policies, and targeted interventions.
Alongside other data, the PGSI also informs understanding of demographic behaviors, intervention outcomes, co-curring disorders and behaviors, and harms of individual gambling activities.
Users commonly lean on the index to monitor prevalence, inform policy and regulation, and evaluate service delivery.
In GambleAware’s case, the leading independent gambling harm charity in the UK uses the PGSI to develop prevention campaigns and measure the effectiveness of available treatment and support.
However, the report indicates that the PGSI was not developed as a clinical tool. Because of this, debate exists around how best to use it to identify and measure the risk of gambling harms.
With this report, GambleAware offers recommendations for the PGSI’s “future interpretation and use” by those seeking to understand and reduce incidences of gambling harm.
Despite Limitations, PGSI Effectively Estimates Risk
As noted above, the analysis found a “strong, consistent link” between higher PGSI scores and greater rates of mental distress. Additionally, results indicated that the scale is helpful when considering combining mental health interventions for those with a high PGSI score.
So, despite its limitations, the PGSI should continue as a general instrument for estimating the potential risk of “problem gambling” in larger groups.
However, the study raised concerns about the validity and application of the tool in some settings.
For instance, the research found some questions are more likely to indicate a severe risk of harm than others.
For example, the PGSI questions around borrowing money to fund gambling, experiencing related financial problems, or feeling the need to gamble more to feel the same thrill may indicate a greater level of harm.
Conversely, questions about feeling guilty or chasing losses appeared to indicate less harm.
Therefore, the study argues for weighting PGSI independently, suggesting they contribute differently to possible risk.
Researchers also recommend the full PGSI questionnaire — all nine questions — be used over the short-form three-question quiz whenever possible.
The shorter inquiry, the study suggests, should only be a last resort as it tends to miss cases of gambling harm. Relying on it too heavily could understate problem gambling prevalence compared to the results of the full questionnaire.
GambleAware to Clinicians, Policymakers: Take Note
Notably, GambleAware’s Ipsos report shared several additional considerations that could boost the power of the PGSI.
Researchers suggest there is merit in revisiting the existing PGSI classifications. However, they stress weighing benefits against “pragmatic considerations to identify, target, and track groups over time.”
The study also identifies the possibility that the PGSI underreports individuals at risk of problem gambling harm. Where possible, researchers assert, users should explore additional survey measures.
Finally, researchers suggest giving “careful consideration” to the PGSI harm threshold (1+) when results imply lumping people together is inappropriate.
The study cautions that changes to the PGSI will “disrupt ongoing statistical series and comparability with other countries using the same scale and groupings.”
Consideration of how to limit the negative impact of any changes is vital.
Still, Haroon Chowdry, GambleAware’s director of evidence and insights, is hopeful the report’s recommendations will make a difference to those who need it most.
The PGSI scale has long been an important tool for understanding the scale of gambling harms at both individual and population level. 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 analyzed 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.
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