Himelhoch Seth S, Miles-McLean Haley, Medoff Deborah R, Kreyenbuhl Julie, Rugle Loreen, Bailey-Kloch Marie, Potts Wendy, Welsh Christopher, Brownley Julie
University of Maryland, School of Medicine, Department of Psychiatry, Division of Psychiatric Services Research, Baltimore, Maryland.
University of Maryland, School of Medicine, Department of Psychiatry, Maryland Gambling Center of Excellence, Baltimore, Maryland.
Am J Addict. 2015 Aug;24(5):460-6. doi: 10.1111/ajad.12241. Epub 2015 May 12.
The goal of this study was to determine the diagnostic accuracy of brief screens for Gambling Disorder within a sample of people receiving outpatient treatment for substance use disorders.
Individuals (n = 300) recruited from intensive outpatient substance use treatment (23.67%) or methadone maintenance programs (76.34%) participated in the study. Four brief screens for Gambling Disorder were administered and compared to DSM-5 criteria. Receiver operator curves were created and an Area Under the Curve (AUC) analysis (an overall summary of the utility of the scale to correctly identify Gambling Disorder) was assessed for each.
On average participants were aged 46.4 years (SD = 10.2), African American/Black (70.7%), with an income less than $20,000/year (89.5%). Half the participants were female. Approximately 40% of participants (40.5%; n = 121) met DSM-5 criteria for Gambling Disorder. Accuracy of the brief screens as measured by hit rate were .88 for the BBGS, .77 for the Lie/Bet, .75 for NODS-PERC, and .73 for the NODS-CLiP. AUC analysis revealed that the NODS-PERC (AUC: .93 (95% CI: .91-.96)) and NODS-CLiP (AUC: .90 (95% CI: .86-.93)) had excellent accuracy.
The NODS-PERC and NODS-CLiP had excellent accuracy at all cut-off points. However, the BBGS appeared to have the best accuracy at its specified cut-off point.
Commonly used brief screens for Gambling Disorder appear to be associated with good diagnostic accuracy when used in substance use treatment settings. The choice of which brief screen to use may best be decided by the needs of the clinical setting.
本研究的目的是确定在接受物质使用障碍门诊治疗的人群样本中,赌博障碍简短筛查的诊断准确性。
从强化门诊物质使用治疗(23.67%)或美沙酮维持治疗项目(76.34%)招募的个体(n = 300)参与了本研究。对四种赌博障碍简短筛查工具进行了应用,并与《精神疾病诊断与统计手册》第五版(DSM - 5)标准进行比较。绘制了受试者工作特征曲线,并对每个工具进行了曲线下面积(AUC)分析(对该量表正确识别赌博障碍效用的总体总结)。
参与者平均年龄为46.4岁(标准差 = 10.2),非裔美国人/黑人(70.7%),年收入低于20,000美元(89.5%)。一半参与者为女性。约40%的参与者(40.5%;n = 121)符合DSM - 5赌博障碍标准。以命中率衡量的简短筛查工具准确性,BBGS为0.88,Lie/Bet为0.77,NODS - PERC为0.75,NODS - CLiP为0.73。AUC分析显示,NODS - PERC(AUC:0.93(95%置信区间:0.91 - 0.96))和NODS - CLiP(AUC:0.90(95%置信区间:0.86 - 0.93))具有出色的准确性。
NODS - PERC和NODS - CLiP在所有临界点均具有出色的准确性。然而,BBGS在其指定临界点似乎具有最佳准确性。
在物质使用治疗环境中使用时,常用的赌博障碍简短筛查工具似乎具有良好的诊断准确性。使用哪种简短筛查工具最好由临床环境的需求决定。