The South Oaks Gambling Screen is a 20-item questionnaire based on DSM-III criteria for pathological gambling. It may be self-administered or administered by nonprofessional or professional interviewers. A total of 1,616 subjects were involved in its development: 867 patients with diagnoses of substance abuse and pathological gambling, 213 members of Gamblers Anonymous, 384 university students, and 152 hospital employees. Independent validation by family members and counselors was obtained for the calibration sample, and internal consistency and test-retest reliability were established. The instrument correlates well with the criteria of the revised version of DSM-III (DSM-III-R). It offers a convenient means to screen clinical populations of alcoholics and drug abusers, as well as general populations, for pathological gambling.

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This is a review of the literature on pathological gambling prepared for the work group on disorders of impulse control, not elsewhere classified of the American Psychiatric Association. It introduces the new DSM-IV criteria as well as outlines the phases of the career of the pathological gambler. Research discussed includes that on pathological gambling and psychiatric disorders, substance abuse, family issues, children, finances, and crime. Psychoanalytic, personality, behavioral, sociological, psychologically based addiction theories, and physiological research are also summarized. Finally, treatment outcome studies are outlined.

Seventy-two pathological gambling patients were followed-up after treatment in a combined alcohol, substance abuse and compulsive gambling treatment program. The Addiction Severity Index (modified for use with pathological gamblers) was used to evaluate the effectiveness of treatment. Patients reduced their intake of alcohol, other drugs and their gambling as well as improved in legal, family/social, and psychological functioning. There was a trend for improvement in medical condition and no net change in employment functioning. The study supports the idea that combined treatment is an effective way of dealing with patients whose gambling problems are discovered when they enter treatment for another addiction, as well as for patients whose initial complaints include pathological gambling, with or without additional problems.

Prior studies have reported an association between the presence of the 7 repeat allele of the 48 bp repeat polymorphism of the third cytoplasmic loop of the dopamine D4 receptor gene (DRD4) and novelty seeking behaviors, attention deficit hyperactivity disorder (ADHD), Tourette syndrome (TS), pathological gambling, and substance abuse. However, other studies have failed to replicate some of these observations. To determine whether we could replicate these associations we genotyped 737 individuals from four different groups of control subjects, and 707 index subjects from four different groups of impulsive, compulsive addictive behaviors including substance abuse, pathological gambling, TS, and ADHD. Chi-square analysis of those carrying the 7 allele versus non-7 allele carriers was not significant for any of the groups using a Bonferroni corrected alpha of.0125. However, chi-square analysis of those carrying any 5 to 8 allele versus noncarriers was significant for pathological gambling (p <.0001), ADHD (p

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Patients in an alcoholism and drug dependency treatment facility were questioned about their gambling behavior in order to find out what percentage of them were abusing alcohol and/or drugs and gambling. In order to do this, a pathological gambling signs index was constructed according to a modification of DSM III criteria and validated using independent procedures. Out of 458 patients interviewed, 40 (9%) were diagnosed as pathological gamblers and an additional 47 (10%) showed signs of problematic gambling. These patients showed clear signs of emotional, financial, family and occupational disruption, and illegal behavior in connection with their gambling which compound the disruption induced by alcohol and/or drugs. Five per cent of the patients abusing only alcohol, 12% of those with alcohol and another drug in combination, and 18% of those with other drug abuse problems without an alcohol component showed clear signs of pathological gambling; 11 1/2% of males and 2% of females were classified as pathological gamblers. The index was also significantly associated with parental gambling (38% of the children of pathological gamblers were pathological gamblers themselves). Gambling by siblings, alcoholism in the father (but not in the mother), gambling prior to age 20, greater amounts of gambling for more money, and "chasing losses in order to get even" were also positively correlated with the index. The implications for study and treatment of these individuals are discussed in terms of the study of addictions.