An Outcome Scale for Pathological Gambling

DESCRIPTION (provided by applicant): Pathological gambling (PG) is a serious public health problem affecting at least 1% of the adult population in the U.S. By extension, it impacts families, business; and communities. Publicly funded-mental health services for pathological gamblers (PGs) exist in some states, but not in others. As the dependence of state governments on gambling revenues increases, public funding for services to PGs should also increase. Instruments that measure the severity of PG have been limited in theoretical frame and content. They tend to assess PG by gambling behavior, debts, and other obvious, immediate consequences. This Phase II application intends to use the Rhode Island Gambling Outcome Rating Scale (RIGORS) in a state-funded, hospital- based gambling treatment program to: 1) Examine the utility of the RIGORS in identifying vulnerability to relapse in PGs during a12-month period. We expect that the RIGORS will provide incremental improvement in predictive validity of outcomes, including point-prevalence abstinence, frequency of gambling, and time to relapse when compared to other commonly used outcome measures; and 2) Establish that the RIGORS has strong, unbiased and stable psychometric properties in evaluating outcomes over time. We will compare the reliability, representativeness of items, levels of discrimination, and influence of gender bias on the RIGORS relative to other methods of assessing the severity of PG over time. 3) Commercially, the RIGORS will fill a niche for a brief, clinically useful, valid and reliable measure of a broad, latent continuum of PG severity. It can be used to monitor treatment effectiveness and cost efficiency, as well as for treatment planning and guidance. We hope to show that the RIGORS will be sensitive and unbiased at lower levels of severity in gamblers, and: thus may be used as a prophylactic tool to signal vulnerability to PG. The target market for the RIGORS will include mental health providers and state agencies that administer services for PG.