Cunningham-Williams Renee M, Ostmann Emily L, Spitznagel Edward L, Books Samantha J
George Warren Brown School of Social Work, Washington University, St. Louis, Missouri 63130, USA.
J Nerv Ment Dis. 2007 Jul;195(7):551-9. doi: 10.1097/NMD.0b013e318093ed13.
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 > or = 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 (kappa = 0.82) and African Americans/other minorities (kappa = 0.68). Reliability for symptoms and for game-specific disorders was fair to almost perfect (kappa = 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.
包括病态赌博障碍（PGD）在内的精神障碍中的种族/民族差异，可能是真实存在的，也可能是其概念化和测量方式所导致的人为现象。我们旨在评估根据满足《精神疾病诊断与统计手册》≥5条标准确定的自我报告终生PGD可靠性方面的种族/民族差异。通过社区宣传，我们招募了15至85岁的白人（n = 225）和非洲裔（美国人/其他少数族裔，n = 87，终生赌博超过5次），进行了两次间隔1周的访谈，内容涉及赌博及相关行为。结果表明，白人（kappa = 0.82）和非裔美国人/其他少数族裔（kappa = 0.68）的DSM-IV PGD可靠性从实质到几乎完美。症状及特定游戏障碍的可靠性为中等至几乎完美（kappa = 0.37 - 0.90）。在对混杂变量和多重比较的结果进行调整后，PGD及特定游戏可靠性方面的种族/民族差异不再存在。这意味着需要更加关注筛查和预防工作，这对于减少PGD患病率方面的种族/民族差异至关重要。
