Dsm Iv Diagnosis

The diagnostic criteria were modified in DSM III-R (American Psychiatric Association, 1987) and in DSM IV (American Psychiatric Association, 1994). The diagnostic criteria for pathological gambling in DSM IV are provided below.

A. Persistent and recurrent maladaptive gambling behavior as indicated by five (or more) of the following: 1. is preoccupied with gambling, e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble

2. needs to gamble with increasing amounts of money in order to achieve the desired excitement

3. has repeated unsuccessful efforts to control, cut back, or stop gambling

4. is restless or irritable when attempting to cut down or stop gambling

5. gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)

6. after losing money gambling, often returns another day to get even ("chasing" one's losses)

7. lies to family members, therapist, or others to conceal the extent of involvement with gambling

8. has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling

9. has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling

10. relies on others to provide money to relieve a desperate financial situation caused by gambling B. The gambling behavior is not better accounted for by a Manic Episode.

Key features in these criteria include: obsessive preoccupation (including craving); progressive inability to control all aspects of gambling; and continuation of gambling despite increasing negative consequences of gambling.

To assist certified clinicians who are not experts in pathological gambling in making a reliable diagnosis of pathological gambling, several DSM IV based structured interviews have been developed but no validation studies have been reported.

It would be clinically useful to include in the future revision of DSM the less severe category of gambling abuse to parallel the current substance abuse diagnostic categories in DSM IV.

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