Question 1:  Are you preoccupied with gambling (e.g., preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble)?

-Here the word "preoccupied" does not mean the same as "all the time."  This term really is best to be thought of as "inappropriate"; for example, thinking about gambling, planning gambling experiences, tracking outcomes, or getting money to gamble or pay off gambling debts while at work, at meals with family/friends, during daily life.

2. Do you need to gamble with increasing amounts of money in order to achieve the desired excitement?

-Some people seem to get over focused on the term "desired excitement" because they are not gambling for excitement.  Consideration of the following questions can clarify this one a bit further: Are you gambling with more money than a few years ago? When you win does your wager size tend to increase?  Would small bets become boring to you?

3. Have you made repeated unsuccessful efforts to control, cut back, or stop gambling?

-This question is confusing for people that have not ever tried to stop in the past, if this is your situation then you might want to honestly contemplate what it might be like if you did try to stop gambling for an extended period of time, like 6 months or a year, or forever?????

4. Are you restless or irritable when attempting to cut down or stop gambling?

-See number 3, also this might not apply is someone knew that they were only stopping for a short time.

5. Do you gamble as a way of escaping from problems or of relieving feelings of helplessness, guilt, anxiety, or depression?

-Does gambling make you less concerned about the damage it is causing to family, yourself, or finances. 

6. After losing money gambling, do you often return another day to get even? Chasing losses is a sign of problem gambling as the disorder develops this is replaced with a feeling that "I can not ever get even so why even try."

7. Do you lie to family members, therapists, or to others to conceal the extent of involvement with gambling?

-This includes ANY behavior that is minimizes the time spent, the dollar amount, or any aspect of the behavior, this also would include attempt to hide the behavior in any manner.

8. Have you committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling?

-This would include check fraud, such as bouncing checks or writing checks that can not be covered if immediately deposited (while the latter is not technically theft if one has overdraft protection, it might be pushing the limits of acceptable banking practices.

2013 item 8 is being deleted

9. Have you jeopardized or lost a significant relationship, job or educational or career opportunity because of gambling?

-This can be very difficult to see at first, I have had many clients find new and better jobs after a year or more of not gambling, when they refocus on their lives.

10. Do you rely on others to provide money to relieve a desperate financial situation caused by gambling? 

-Essentially this would be any loan from anyone, it could include lending institutions as well.

 
SCORING KEY:

Scoring the DSM -IV is controversial to some extent , it is published that a person would need 5 or more symptoms to be likely to have a diagnosis of Impulse Control Disorder, however I have spoken with one of the original researchers who developed this and he stated that the research showed that 4 symptoms were more than adequate to differentiate between those who have Pathological Gambling and those who do not, but because this list is controlled by the American Psychiatric Association they insisted on a more strict number (one that would result in fewer false positives  (i.e., saying someone has it when they don't). However, my view is that if the person does not have very many symptoms one has to factor in two things:

Is the person affluent?

and

Have they ever tried to stop before

Because these two questions alone will eliminate as much as 40% of the possible symptoms.  Also, some symptoms are so severe that if a person just has one of them I think they likely have Pathological gambling disorder e.g. questions 8, 9, and 10 for sure and probably #3 and 5 for problem gambling. Which brings up another major limitation of this, it does not detect problem gambling only pathological if the 5 yes responses is used, and finally there is no indication of degree. I use the following scale in my office after a full interview:

none, mild, moderate, severe, extreme

 2013

In the current edition (DSM-IV), gambling disorder is classified as part of “Impulse-Control Disorders Not Elsewhere Classified,” which also includes disorders like kleptomania. In the new edition, gambling disorder will join substance-related addictions in a renamed group called “Addiction and Related Disorders.”

Reasons and Implications

According to Nigel, "Impulse Control Disorder" is not a very useful label because it has never been clearly defined, and it is often used as a place to dump conditions that defy normal classification. What’s more, all psychiatric problems are essentially issues of impulse control, so this classification does little to clarify the nature of the disorder.

More significantly, classifying gambling disorder separately from other addictions drives an artificial wedge between substance addictions and behavioral addictions, even though there are many commonalities between them and they are treated using similar methods. In general, then, classifying problem gambling with other addictions is more informative.

Finally, another implication of this change is that it de-emphasizes the substance per se and focuses more on the experience of the person. It also works towards an understanding of factors that make some people more vulnerable not just to a specific drug, but to any addictive behavior.

2) The lowering of the pathological gambling threshold to 4 symptoms

To be diagnosed with a gambling disorder, a certain set of behaviors must be present over a 12-month period—such as needing to bet with increased amounts of money, being preoccupied with gambling, or tending to chase losses. Currently, gamblers need to exhibit 5 of these behaviors to be diagnosed with a gambling disorder. In the DSM-5, the threshold will be lowered to 4.

Reasons and Implications

According to Nigel, this change is perhaps more controversial. His research shows that a cut off of 5 does result in substantially lower rates of problem gambling compared to other measures. Other researchers have argued that the cut off point of 5 may be too high for problem gambling.

This change does not address the important issue of sub-clinical forms of the disorder. Many gamblers who score below the threshold—meaning they only exhibit 2 or 3 behaviors on the list—do suffer some gambling-related problems. But, according to the DSM-5, they do not have a gambling disorder. Understanding this, researchers and prevention experts use terms like “at-risk gambling” or “moderate problems” to identify this group—creating inconsistency in terminology and definitions. Most importantly, recognizing the existence of gambling problems that do not meet the official criteria promotes early intervention, which is an important part of any effort to reduce the incidence of problem gambling.

3) The removal of the ‘‘illegal acts’’ criterion for the disorder

Another change is that, where in the DSM-IV there are 10 behaviors listed, in the DSM-5 there will only be 9. Whether or not a gambler has committed an illegal act (like theft or fraud) to finance gambling will no longer be considered a sign of pathological gambling.