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Racial/Ethnic Variation in the Reliability of DSM-IV Pathological Gambling Disorder

Cunningham-Williams, Renee M. PhD, MPE*; Ostmann, Emily L. MPH*; Spitznagel, Edward L. PhD; Books, Samantha J. MPE*

The Journal of Nervous and Mental Disease: July 2007 - Volume 195 - Issue 7 - p 551-559
doi: 10.1097/NMD.0b013e318093ed13
Original Article

Racial/ethnic disparities in mental disorders, including pathological gambling disorder (PGD), may be either real or artifacts of how they are conceptualized and measured. We aimed to assess racial/ethnic variation in the reliability of self-reported lifetime PGD determined by meeting ≥5 criteria of the Diagnostic and Statistical Manual of Mental Disorders. Using community advertising, we recruited 15–85-year-old Caucasians (n = 225) and African (American/other minorities (n = 87), who had gambled more than 5 times lifetime), for 2 interviews, held 1 week apart, about gambling and associated behaviors. Results indicate substantial to almost-perfect DSM-IV PGD reliability for Caucasians (κ = 0.82) and African Americans/other minorities (κ = 0.68). Reliability for symptoms and for game-specific disorders was fair to almost perfect (κ = 0.37–0.90). After adjusting results for confounding variables and multiple comparisons, racial/ethnic variation in PGD and game-specific reliability failed to persist. Implications exist for increased attention to screening and prevention efforts critical to reducing racial/ethnic disparities in PGD prevalence.

*George Warren Brown School of Social Work, and †Department of Mathematics, Washington University, St. Louis, Missouri.

Supported by the National Institute on Drug Abuse of the National Institutes of Health Grant, GAMCO Project No. K01 DA 00430 (to R.M.C), and GAPP Project No. R01 DA 015032 (to R.M.C.).

This article was presented at the Society for Social Work and Research Conference, San Antonio, TX, January 14–16, 2006.

Send reprint requests to Renee M. Cunningham-Williams, PhD, MPE, LCSW, George Warren Brown School of Social Work, Washington University, One Brookings Drive, St. Louis, MO 63130. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.