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Harold J. Wynne, Ph.D.
Wynne Resources
Edmonton, Alberta
Canada
780-488-5566
hwynne@wynne.com
January 2003
INTRODUCING THE
CANADIAN PROBLEM
GAMBLING INDEX
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The Canadian Problem Gambling Index
INTRODUCING THE
CANADIAN PROBLEM GAMBLING INDEX
Harold J. Wynne, Ph.D.
May 2002
BACKGROUND
The development of the Canadian Problem Gambling Index (CPGI) was the result
of a collaborative, three-year research venture (1997-2000) managed by the Canadian
Centre on Substance Abuse (CCSA) and funded by the Canadian provinces. The goal
was to develop a new, more meaningful measure of problem gambling for use in general
population surveys in Canada, one that reflected a more holistic view of gambling within
a social and community context.
The CPGI was developed as part of a larger research project entitled Measuring
Problem Gambling in Canada. The Inter-Provincial Task Force on Problem Gambling
was formed to guide the three-year study, and this group was comprised of government
and agency representatives from across Canada (see Appendix 1 for a list of reps). The
CCSA research team members included Dr. Harold Wynne, Jackie Ferris, Dr. Eric
Single, and Dr. Nigel Turner and the following expert panel of Canadian and
international gambling researchers advised the team at various stages of the project:
Robert Ladouceur, Ph.D., Laval University, Quebec City
Jeff Derevensky, Ph.D., McGill University, Montreal
Rina Gupta, Ph.D., McGill University, Montreal
Ron Frisch, Ph.D., University of Windsor, Ontario
Sue Fisher, Ph.D., Cornwall, England
Henry Lesieur, Ph.D., Pawtucket, Rhode Island
Durand Jacobs, Ph.D., Loma Linda University, Redlands, California
Randy Stinchfield, Ph.D., University of Minnesota, Minneapolis
Ken Winters, Ph.D., University of Minnesota, Minneapolis
Robert Wildman, Ph.D., Reno, Nevada
Alex Blaszczynski, Ph.D. University of New South Wales, Sydney, Australia
Michael Walker, Ph.D., University of New South Wales, Sydney, Australia
The CPGI instrument resulted from (a) a review and synthesis of the most current
gambling research available, and (b) expert opinion from internationally renowned
gambling researchers, and it draws on the measures that have been used in the past for
many of its key items. Consequently, the CPGI is less a “new” instrument and more an
evolution of older measures, and it is based on the following operational definition of
problem gambling developed by the research team:
Problem gambling is gambling behaviour that creates negative
consequences for the gambler, others in his or her social network, or
for the community.
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The Canadian Problem Gambling Index
METHODOLOGY
The three-year Measuring Problem Gambling in Canada research project was
conducted in two phases--a development phase and a testing phase. The development
phase involved the clarification of the concept of problem gambling, the positing of an
operational definition, and the designing of an instrument for measuring problem
gambling in the general population. The second phase involved validity and reliability
testing of the new instrument in a Canada-wide gambling prevalence study.
The second phase of this project involved the fine-tuning, validity and reliability
testing of the instrument developed in Phase I. This was accomplished by (a) conducting
a pilot test of the face-valid instrument with 143 people; (b) following this pilot test with
a general population survey of 3,120 Canadian adults; (c) re-testing 417 respondents from
the general population survey, and (d) conducting clinical interviews with 148
respondents from the general population survey.
The pilot test was conducted with three separate groups of about 50 persons each,
intended to represent three potential sub-groups classified by the new instrument, namely:
(1) a random, general population sample unlikely to have gambling problems (non-
problem gamblers); (2) a group of regular gamblers who may be at risk because of higher
participation frequency and expenditure on gambling (at-risk gamblers); and (3) those
who felt that they have a gambling problem at the severe end of the continuum (problem
gamblers). This pilot test was used to determine if there were scored items from the face-
valid instrument that did not discriminate between groups, and so could be eliminated in
the next round of testing. Consequently, several items were deleted from the final survey
instrument, but the South Oaks Gambling Screen (SOGS) and DSM-IV items were
maintained in their entirety for comparative purposes.
The final survey questionnaire, named the Canadian Problem Gambling Index,
was administered to a random sample of 3,120 adults selected from the ten Canadian
provinces. This large, general population survey was conducted for three main reasons.
First, the large sample size allowed for fine-tuning the new instrument in terms of
selecting items to be included/discarded in future iterations. Second, the survey provided
a basis for comparison of the new instrument scored items with those from the DSM-IV
and SOGS measures. Finally, the survey provided gambling/problem gambling
prevalence information for the Nation and for individual Canadian provinces, and these
data can be used as a benchmark for subsequent national or provincial studies.
Although reliability can be assessed using a measure of internal consistency, and
so could be calculated based solely on the general population survey, it was determined
that a re-test of a small sub-sample from the general population survey would add to the
rigor and credibility of the validation process. Consequently, a random sample of 417
respondents was re-called, and asked to complete the survey for a second time.
Finally, to further test the validity of the new measure, clinical psychologists
conducted telephone interviews with a sub-sample of 148 respondents from the general
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The Canadian Problem Gambling Index
population survey. This was expected to provide confirmation of the classification
scoring accuracy of the new instrument.
CANADIAN PROBLEM GAMBLING INDEX
The new instrument has been named the Canadian Problem Gambling Index
(CPGI). The CPGI examines eighteen variables in four domains, and specific measurable
indicators and corresponding questionnaire items are identified in Appendix 2.
Domains of the CPGI
Gambling involvement. The first CPGI section explores gambling involvement,
with questions about (a) type of gambling activity, (b) the frequency of play, (c) duration
of play, and (d) expenditure. The “type of activity” question is adjusted to suit the
jurisdiction in which the CPGI is being used, and researchers are encouraged to identify
as many gambling activities as are appropriate. These questions take very little time to
administer, especially for those who participate in few gambling activities, which is the
majority of respondents in a general population survey.
Problem gambling assessment. The CPGI assesses two domains of problem
gambling, namely (a) problem gambling behaviour, and (b) consequences of that
behaviour for the individual or others. There are twelve items in these two domains, and
nine of these are scored to determine problem gambling severity. This nine-item index is
referred to as the Problem Gambling Severity Index (PGSI), and these items, along with
the scoring algorithm, are included in Appendix 3. Depending on how a respondent
scores on these nine PGSI items, he or she may be classified as being in one of four
gambler sub-types, namely: (a) non-problem gambler, (b) low risk gambler, (c) moderate
risk gambler, and (4) problem gambler (qualitative descriptions for each of these four
sub-types are included in Appendix 4). Scoring the nine-item PGSI is crucial to the
classification of gambler sub-types and, therefore, the PGSI items should not be removed
or altered in any way.
Correlates. The problem gambling correlates domain includes variables that
further develop the profiles of gambler sub-types. Findings from the latest research in the
field of gambling studies are reflected in these variables, and it is expected that new
correlates will continue to be added by researchers.
Reliability and Validity of the PGSI
The psychometric properties of the Canadian Problem Gambling Index, including
the nine-item Problem Gambling Severity Index, are described in detail in the Phase II
report available on the Canadian Centre on Substance Abuse web site (www.ccsa.ca). A
brief summary of the reliability and validity of the PGSI follows.
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The Canadian Problem Gambling Index
Reliability. Reliability is the ability of a measuring instrument to give consistent
results on repeated trials. The PGSI was subjected to two types of reliability testing;
namely, internal consistency and repeated measures methods.
First, the Cronbach alpha reliability coefficient was computed, which provided an
indication of the internal consistency of the PGSI measure. The alpha coefficient for the
PGSI (0.84) was stronger than that for either the SOGS (0.81) or DSM-IV (0.76). The
reliability of three sub-components of the PGSI was also examined (i.e., the two items
retained from the SOGS, the two from the DSM-IV, and the five “new” PGSI items).
The two SOGS items (0.71), two DSM-IV items (0.79), and five PGSI items (0.80)
correlated relatively highly with their parent measures, respectively, although they did
not perform reliably as two or five-item stand-alone measures.
The second method for examining reliability was to repeat the survey by re-
testing the same people on the same three measures. To establish re-test reliability, 417
of the original 3,120 respondents were re-surveyed, and the Pearson Product-Moment
correlation coefficient for the three measures included in the survey was calculated. In
terms of re-test reliability, the DSM-IV (0.91) was strongest over time, followed by the
PGSI (0.78) and SOGS (0.75).
From these tests, it is apparent that the nine-item PGSI is a reliable measure of
problem gambling.
Validity. The validity of the PGSI was addressed in terms of content (face)
validity, criterion-referenced validity, and construct validity. Content validity is the
degree to which a test measures an intended content area. In this vein, the original PGSI
went through several rounds of expert feedback, with twelve of the world’s foremost
gambling experts providing advice on the most appropriate “content” needed to
discriminate problem gambling (i.e., domains, variables, measurable indicators and
items). The expert consensus was that the five PGSI “problem gambling behaviour” and
four “adverse consequence” items appeared to measure both the construct and operational
definition of “problem gambling” very well. Subsequent statistical factor analysis of the
PGSI confirmed that the nine items in the index load on one factor, which the researchers
naturally labeled “problem gambling.” Consequently, it may be concluded that the PGSI
has very good content validity as a measure of problem gambling.
Criterion-referenced validity generally refers to validity that is found by
correlating a measure with an external criterion of the entity being assessed. There are
two types of criterion-referenced validity—concurrent validity and predictive validity.
Concurrent validity refers to validity assessed by correlating a measure with an
alternative measure of the same phenomenon taken at the same point in time.
Predictive validity refers to the ability of a measure to predict some attribute or
characteristic in the future.
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The Canadian Problem Gambling Index
In the Canadian national survey, the nine-item PGSI, the twenty-item SOGS, and
the ten-item DSM-IV measures were administered to each of the 3,120 adult respondents.
The PGSI was shown to have good concurrent validity because its scores correlated
highly with those from both the SOGS (0.83) and the DSM-IV (0.83). In terms of
predictive validity, the PGSI (0.48) also had a higher correlation with the clinical
assessment interview results than either of the other two measures, although the
correlation is only moderate. In view of these findings, it may be concluded that the
PGSI has strong concurrent validity with the SOGS and DSM-IV, and moderate
predictive validity with clinical interviews.
Finally, the validation study examined PGSI construct validity, which refers to the
degree to which the measurement agrees with the theoretical concept being investigated.
In terms of theory, one might expect that those in the problem gambling group would
spend more money on gambling, gamble more frequently, and be more likely to endorse
the problem gambling correlates. When trend analysis was conducted on the data,
differences were apparent by gambler sub-type on almost all of these indicators and
correlates. Those in the problem gambling group do spend more, gamble more often, and
endorse most of the correlates at higher rates than those in the at-risk or non-problem
groups. In view of this, it may be concluded that the PGSI is a valid measure of the
construct labeled “problem gambling.”
Classification Accuracy
In the context of screening, there are two other measures of validity that must be
considered, namely sensitivity and specificity. Sensitivity refers to the ability of the test
to identify correctly all screened individuals who actually have the condition. In contrast,
specificity refers to the ability of the test to identify only “non-diseased” individuals who
actually do not have the condition.
A main challenge in validating the PGSI was to set cut-points along the
continuum of scores (i.e., from 0 to 27 points) to maximize both the sensitivity and
specificity of the measure. It was important to ensure that those classified as “problem
gamblers” according to PGSI scores were “true positives” for this condition; moreover, it
was also important that the cut-point ideally captured everyone who was a problem
gambler (sensitivity). Similarly, cut-points needed to be set to ensure that individuals
who were not problem gamblers were identified as not having this condition (specificity).
Typically in setting cut-points, there is a trade-off between maximizing sensitivity versus
specificity, and this was the challenge in validating the PGSI. In the final analysis, the
cut-point set to discriminate the “problem gambling” sub-group (PGSI ≥ 8) had relatively
good sensitivity, as it successfully (a) identified seven out of nine (78%) individuals who
were classified in the clinical interviews as being problem gamblers, and (b) identified
83% of the individuals who scored on the DSM-IV diagnostic measure as being
pathological gamblers. Specificity was 100% for all measures, and this means that the
people identified by the DSM-IV and SOGS as having no gambling problem were also
categorized as having no problem by the PGSI.
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The Canadian Problem Gambling Index
In determining the cut-point that discriminates low-risk from moderate-risk
gambler sub-types (i.e., PGSI = 2 vs. 3), the distribution of DSM-IV and SOGS scores,
along with clinical assessment interviews that differentiated those deemed to be at “low”
versus “moderate” risk, were taken into account. Issues of specificity and sensitivity
have little meaning when applied to these at-risk sub-groups, as individuals therein do not
have the “problem gambling condition,” per se; rather, they are deemed to be at
greater/lesser risk for developing a gambling problem.
CONCLUDING COMMENT
A tenet of public health is that primary prevention of disease and socio-health
disorders such as problem gambling is the best approach. However, if these health
conditions cannot be prevented, then the next best strategy is early detection in
asymptomatic, apparently healthy individuals. To facilitate early detection, screening
measures are typically employed, and the nine-item PGSI was developed as such a
measure to detect individuals in the general population who have a gambling problem, or
who are at risk for developing a problem.
It should be noted that screening differs from diagnosis, which is the process of
confirming an actual case of a disease or health condition. As a result of diagnosis, a
treatment intervention may be initiated. Diagnostic tests are used to follow-up positive
screening test results, or to concurrently screen for and diagnose a health condition. In
screening for and diagnosing problem gambling, the “gold standard” measures have been
the South Oaks Gambling Screen and DSM-IV, respectively. Interestingly, the SOGS
has also been used in research and clinical interventions to “diagnose” problem gambling,
notwithstanding that it was developed as a screening instrument. Similarly, the DSM-IV
has been used in population surveys to “screen” individuals for a gambling problem,
despite its primary purpose being to diagnose the mental health disorder labeled as
pathological gambling.
The utility of both the SOGS and DSM-IV for screening and/or diagnosing
problem gambling has been debated at length in the gambling literature. Given that
severe problem gambling is a fairly robust health disorder, the SOGS, DSM-IV, and other
related measures have been generally successful in screening for the most seriously
disordered. However, these measures have had far less utility for classifying individuals
who have sub-clinical symptoms, or who may be at some level of risk for developing a
gambling problem.
Like these other measures, the nine-item PGSI successfully classifies those
problem gamblers who are most severely disordered. However, unlike other measures,
the PGSI has greater classification accuracy for successfully identifying individuals who
are at low or moderate risk for developing a gambling problem. Moreover, given that the
PGSI is part of the larger CPGI measure, there is much more information gathered about
the at-risk and problem gamblers’ experience. This wealth of CPGI gambling-related
information results in a much more detailed picture of the relationship between gambling
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The Canadian Problem Gambling Index
activities, problem gambling behaviour, adverse consequences, and other problem
gambling correlates.
Future CPGI-based research. Since the Canadian Problem Gambling Index
was published in 2001, it has been integral to a growing body of research in the gambling
studies field. This ever-increasing use of the CPGI bodes well for (a) the future
refinement of the instrument, including the PGSI sub-index, and (b) the development of a
growing statistical database that includes directly comparable research results. The
following are known instances where the CPGI has been utilized in recent gambling
research projects:
Canadian CPGI-based research
1. Doiron, J. & Nicki, R. (1999). The Prevalence of Problem Gambling in Prince
Edward Island. Prepared for the Prince Edward Island Department of Health and
Social Service. Prince Edward Island.
• This is the CPGI baseline study of the prevalence of problem gambling in
PEI. This research used an earlier, non-validated version of the CPGI
(N=809).
2. Ferris, J. and Wynne. H. (February 2001). The Canadian Problem Gambling
Index: Final Report. Report to the Canadian Inter-Provincial Advisory
Committee. Ottawa, ON: Canadian Centre on Substance Abuse.
• This report contains information on the Canadian national survey that
validated the newly developed CPGI (N=3,120).
3. Wiebe, J., Single, E, and Falkowski-Ham, A. (November 2001). Measuring
Gambling and Problem Gambling in Ontario. Report to the Ontario Problem
Gambling Research Centre. Submitted by the Canadian Centre on Substance
Abuse and the Responsible Gambling Council (Ontario).
• This is the CPGI baseline study of the prevalence of gambling and
problem gambling in Ontario (N=5,000).
4. Wynne, H. (January 2002). Gambling and Problem Gambling in Saskatchewan.
Report to Saskatchewan Health. Submitted by the Canadian Centre on Substance
Abuse.
• This is the CPGI baseline study of the prevalence of gambling and
problem gambling in Saskatchewan (N=1,848)
5. Smith, G. and Wynne, H. (February 2002). Measuring Gambling and Problem
Gambling in Alberta Using the Canadian Problem Gambling Index: Final Report.
Report to the Alberta Gambling Research Institute.
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The Canadian Problem Gambling Index
• This is the CPGI baseline study of the prevalence of gambling and
problem gambling in Alberta (N=1,804).
6. Patton, D., Brown, D., Dhaliwal, J., Pankratz, C., and Broszeit, B. (April 2002).
Gambling Involvement and Problem Gambling in Manitoba. Report to the
Addictions Foundation of Manitoba.
• This is an omnibus prevalence survey that examines gambling in various
populations in Manitoba, including adolescent, adult, senior, women, and
First Nation samples (n=3,119). The adult survey serves as a CPGI
baseline study for this population as this instrument, as well as the SOGS,
was utilized to discriminate gambler sub-types.
7. CPGI prevalence studies are presently being designed for the Canadian provinces
of Quebec, British Columbia, and Nova Scotia.
8. Statistics Canada is presently conducting a Canadian national mental health study,
and the survey instrument includes a module on problem gambling. A modified
version of the CPGI, which includes the full PGSI, is the instrument that is being
used in the survey’s problem gambling module (N=35,000).
9. Wiebe and Single are presently examining the OPGRC “problem gambling
framework” by plotting data from the Ontario CPGI study within the framework’s
four risk categories.
10. In an OPGRC-funded study of the separate and combined effects of cognitive
behavioral therapy and medication on pathological gambling, Ravindran and
Telner are measuring pre-post changes based on PGSI scores.
11. At the Royal Alexandra Hospital in Edmonton, Smith and Wynne are using the
PGSI in an opportunistic screening protocol for health conditions with all non-
urgent patients presenting in the emergency department.
CPGI-based research in other countries
12. Gambling Policy Directorate (2002). Queensland Household Gambling Survey
2001. Report to the Queensland Government Treasury.
• This gambling/problem gambling prevalence telephone survey was
conducted in September 2001 with a random sample of 13,082
Queensland, Australia residents over 18 years-of-age. The researchers
chose to use both the CPGI and SOGS to identify gambler sub-types, and
a comparative analysis concluded that, “the results show that all problem
gambling respondents who have been captured by the CPGI were also
captured by the SOGS.” Findings and conclusions were subsequently
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The Canadian Problem Gambling Index
reported based on the CPGI classifications. The researchers concluded,
“The CPGI provides important information about gambling groups in the
population. Research is warranted to identify the common characteristics
of the Low Risk, Moderate Risk and Problem Gambling groups which
might identify those at most risk of developing problem gambling.”
13. Gambling Policy Directorate (2002). Problem Gambling Prevalence Survey 2002.
Report to the Queensland Government Treasury.
• This report outlines the findings of research conducted into the incidence
of problem gambling within a random sample of 178 male and female
prisoners incarcerated in Queensland, Australia corrective services
facilities. The CPGI was used to classify gambler subtypes because,
according to the Gambling Policy Directorate, “the Canadian Problem
Gaming Index (CPGI) was utilised by Treasury in its Queensland
Household Gambling Survey 2001,” and “In addition, the CPGI’s
definition of problem gambling, as referred to in Section 1 of this report is
analogous to that which is currently utilised for policy purposes in
Queensland.”
14. Linnet is conducting a study in Denmark with pathological gamblers in treatment,
and a translated version of the PGSI is being used to discriminate gambler sub-
types.
15. McMillen is working with two Australian state governments that are
contemplating using the PGSI to screen problem gamblers for treatment.
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The Canadian Problem Gambling Index
APPENDIX 1
Inter-Provincial Task Force Members
And Key Informants
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The Canadian Problem Gambling Index
Name
Title/Affiliation/Location
Telephone
Contact Via:
New Brunswick:
Jean Guy Le Blanc Gambling Counselor 506-856-2333 Jgleb@nbnet.nb.ca
Carolyn Green Gambling Counselor 506-452-5558 FAX:506-452-5533
Bob Jones Treatment Consultant/Coordinator 506-453-2283 Bobjo@gov.nb.ca
Carol Harned Outpatient Counselor 506-674-4300 FAX: 506-674-4374
Dr. Alberto Barcelo Task Force Member Albertob@gov.nb.ca
Nova Scotia:
Jerome McCoyne Addiction Services 902-563-2590
Ann McLean Field administrator 902-485-4335
Joel Baltzer Researcher, Gaming Control
Commission 902-424-4744 Jbaltzeji@gov.ns.ca
Brian Wilbur Director, Drug Dependency
Services 902-424-7219
Carrie Chambers Researcher, Sterling Research 902-466-1091 Sterl2@istar.ca
Tracey Shranz Researcher, Focal Research 902-454-8856
John Laroque 902-424-7220
Ontario:
Carolyn Nutter
ARF, VP Community Health and
Education 416-595-6135 Cnutter@arf.org
Nigel Turner ARF, psychologist, psychometrist 416-595- Nturner@arf.org
Tony Toneatto ARF, psychologist, clinician 416-595-6828 Toneatto@arf.org
Nina Littman-Sharpe
Donwood, clinician, head of
gambling treatment program 416-599-1322 Nlittman@donwood.org
Geoff Noonan Gambling counselor, Donwood Gnoonan@donwood.org
Roger Horbay Gambling counselor, Donwood Rhorbay@donwood.org
Jane Scott Gambling counselor, CFCG
(Ontario) 416-499-9800 Cfcg@netcomca
Dr. Stanley Debow Gambling counselor 416-597-0196 MAIL
Colette Prevost Addiction Services of Nipissing 705-472-6515 PHONE
Patrick Au Counselor, Chinese Family Life
Services 416-979-8299 FAX:416-979-2743
Lynn Eaton Gambling counselor, Grey Bruce
Alcohol Assessment 519-436-2599 FAX:519-371-7751
Wilf Bowering* Homewood Health Centre, head of
gambling programs 519-824-1010
X291 FAX:519-824-1827
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The Canadian Problem Gambling Index
Manitoba:
Jamie Wiebe Researcher, AFM 204-944-6291 Vglatz@afm.mb.ca
Ron Norton Professor, University of Winnipeg 204-786-9757 norton-r@L-
H.Uwinnipeg.ca
Gerry Kolesar Supervisor, Gambling Programs
AFM 204-944-6205
Saskatchewan:
Bob Markosky Saskatchewan Health Bmarkosk@health.govsk
.ca
Steve Christensen Saskatchewan Health Schriste@health.gov.sk.c
a
Kevin Hanna Community Mental Health Services 306-778-5410
Jean Dunlop Saskatoon Health District,
Addictions 306-655-4103 FAX:306-655-4115
Don Osga Mental Health 306-766-7800
Jim Worrel Prince Albert Health District 306-953-5671 FAX: 306-953-5674
Maureen Boyko Addiction Services 306-778-5432 FAX: 306-778-5425
Alberta:
Art Dyer Manager, Service Monitoring &
Research, AADAC Art.Dyer@aadac.gov.ab.
ca
David Hodgins Director of Research Addiction
Centre, Foothills Hospital, Calgary 403-670-4785 Dhodgins@acs.ucalgary.
ca
Barry Andres* Counselling Supervisor, AADAC
Adult Services 403-415-0037 Barry.andres@aadac.gov.
ab.ca
British Columbia:
Jane Burke Consultant, women and problem
gambling, Peardonville House 604-856-3966
Kathie Neufeld Consultant, seniors and problem
gambling, ADEPT Services 604-538-2522
X307
Greg McQuarrie Specialist, aboriginals and problem
gambling, Northwest Alcohol and
Drug Services
250-638-8117
Nwadster@kermode.net
Thomas Chan Specialist, multi-cultural
populations and problem gambling,
Family Services of Greater
Vancouver
604-874-2938
Miki Hansen Director, Adult Addictions Services
Branch, BC 250-953-3113
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The Canadian Problem Gambling Index
APPENDIX 2
The Canadian Problem Gambling Index
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The Canadian Problem Gambling Index
Canadian Problem Gambling Index
For each of the items in the CPGI questionnaire, respondents are asked to respond
“in the past twelve (12) months.” This past-year time frame does not apply to the
following questions: 18, 19, 20, 21, 22, and 23. The response scales for each of the
questionnaire items are as follows:
Question 1 - yes; no
Question 2 - daily; 2-6 times/week; about once/week; 2-3 times/month; about
once/month; between 6-11 times/year; between 1-5 times/year;
never in the past year
Question 3 - record actual minutes and/or hours
Questions 4 & 5 - record actual dollar amount
Questions 5 to 17 - never; sometimes; most of the time; almost always
Questions 18 & 19 - strongly agree; agree; disagree; strongly disagree
Questions 20 to 33 - yes; no
DOMAIN VARIABLES INDICATORS
ITEMS AND QUESTION NUMBERS
Type Gambling
activities 1. Have you bet or spent money on (list of gambling activities)?
Frequency Frequency of
play 2. How often did you bet or spend money on (list activity: daily, weekly,
monthly, yearly)?
Duration Time at
play/type/session
3. When spending money on (list activity), how many minutes/hours do you
normally spend each time?
Gambling
Involvement
Expenditure Money wagered
monthly
Largest amount
wagered
4. How much money, not including winnings, did you spend on (list activity) in
a typical month?
5. What is the largest amount of money you ever spent on (list activity) in any
one day?
Loss of
control Bet more than
could afford 6. How often have you bet more than you could really afford to lose?
Bet or spent
more than
wanted to
7. How often have you bet or spent more money than you wanted to on
gambling?
Motivation Increase wagers 8. How often have you needed to gamble with larger amounts of money to get
the same feeling of excitement?
Chasing Returning to win
back losses 9. How often have you gone back another day to try to win back the money you
lost?
Borrowing Borrow money
or sold anything 10. How often have you borrowed money or sold anything to get money to
gamble?
Problem
Gambling
Behavior Lying Lied to family
members or
others
11. How often have you lied to family members or others to hide your
gambling?
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The Canadian Problem Gambling Index
DOMAIN VARIABLES INDICATORS
ITEMS AND QUESTION NUMBERS
Problem
recognition Felt problem 12. How often have you felt that you might have a problem with gambling?
Wanted to stop,
didn’t think
could
13. How often have you felt like you would like to stop betting money or
gambling, but you didn’t think you could?
Criticism 14. How often have people criticized your betting or told you that you had a
gambling problem, regardless of whether or not you thought it was true?
Feelings of guilt 15. How often have you felt guilty about the way you gamble or what happens
when you gamble?
Personal
Consequences
Negative health
effects 16. How often has gambling caused you any health problems, including stress or
anxiety?
Adverse
Consequences
Social
Consequences Financial
problems 17. How often has your gambling caused any financial problems for you or your
household?
Faulty
cognition Due for a win
after losses 18. After losing many times in a row, you are more likely to win.
Having a
winning system 19. You could win more if you use a certain system or strategy.
First
experiences Remember a big
win 20. Do you remember a big WIN when you first started gambling?
Remember big
loss 21. Do you remember a big LOSS when you first started gambling?
Family
problems Family gambling
problem 22. Has anyone in your family EVER had a gambling problem?
Family alcohol
or drug problem 23. Has anyone in your family EVER had an alcohol or drug problem?
Co-Morbidity Gamble, drugs,
alcohol 24. Have you used alcohol or drugs while gambling?
Gamble when
high 25. Have you gambled while drunk or high?
Problem
recognition Felt alcohol/drug
problem 26. Have you felt you might have an alcohol or drug problem?
Relieve pain Self-medication
(gambling) 27. If something painful happened in your life, did you have the urge to gamble?
Self-medication
(alcohol) 28. If something painful happened in your life, did you have the urge to have a
drink?
Self-medication
(drugs) 29. If something painful happened in your life did you have the urge to use
drugs or medication?
Stress Treated for
stress 30. Have you been under a Dr’s care because of physical or emotional problems
brought on by stress?
Depression Feelings of
depression 31. Was there ever a time when you felt depressed for two weeks or more in a
row?
Suicide Suicide ideation 32. Have you ever seriously thought about committing suicide as a result of your
gambling?
Problem
Gambling
Correlates
Suicide attempts 33. Have you ever attempted suicide as a result of your gambling?
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The Canadian Problem Gambling Index
APPENDIX 3
Problem Gambling Severity Index
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The Canadian Problem Gambling Index
PROBLEM GAMBLING SEVERITY INDEX
Scoring Algorithm and Questionnaire Items
1. PGSI Questionnaire Items Scored
• The 9 items (Q1-Q9) in the questionnaire below are scored.
• Score 1 for each response of “sometimes,” 2 for each “most of the time,” and 3
for each “almost always.” A score of between 0 and 27 points is possible.
2. Classification of Gambler Sub-Types
• There are four classification categories based on the following cut-points for
PGSI scores:
o 0 = non-problem gambler
o 1-2 = low risk gambler
o 3-7 = moderate risk gambler
o 8+ = problem gambler
• The non-problem gambler group is separated into gamblers and non-gamblers as
these sub-groups have quite different characteristics.
3. PGSI Scored Items by Category
Dimension Variables Indicators PGSI Scored Items
Loss of control Bet more than could afford 1. How often have you bet more than you could really afford to lose?
Motivation Increase wagers 2. How often have you needed to gamble with larger amounts of money
to get the same feeling of excitement?
Chasing Return to win back losses 3. How often have you gone back another day to try to win back the
money you lost?
Problem
Gambling
Behaviour
Borrowing Borrow money or sold anything 4. How often have you borrowed money or sold anything to get money to
gamble?
Problem
recognition Felt problem 5. How often have you felt that you might have a problem with gambling?
Criticism 6. How often have people criticized your betting or told you that you had
a gambling problem, regardless of whether or not you thought it was
true?
Feelings of guilt 7. How often have you felt guilty about the way you gamble or what
happens when you gamble?
Personal
consequences
Negative health effects 8. How often has your gambling caused you any health problems,
including stress or anxiety?
Adverse
Consequences
Social
consequences Financial problems 9. How often has your gambling caused any financial problems for you or
your household?
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The Canadian Problem Gambling Index
CANADIAN PROBLEM GAMBLING INDEX
Problem Gambling Severity Index
Questionnaire Items
Q1. Thinking about the past 12 months, how often have you bet more than you
could really afford to lose? Would you say:
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
Q2. Thinking about the past 12 months, how often have you needed to gamble
with larger amounts of money to get the same feeling of excitement?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
Q3. Thinking about the past 12 months, how often have you gone back another
day to try to win back the money you lost?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
Q4. Thinking about the past 12 months, how often have you borrowed money or
sold anything to get money to gamble?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
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The Canadian Problem Gambling Index
Q5. Thinking about the past 12 months, how often have you felt that you might
have a problem with gambling?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
Q6. Thinking about the past 12 months, how often have people criticized your
betting or told you that you had a gambling problem, regardless of whether or not
you thought it was true?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
Q7. Thinking about the past 12 months, how often have you felt guilty about the
way you gamble, or what happens when you gamble?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
Q8. Thinking about the past 12 months, how often has your gambling caused you
any health problems, including stress or anxiety?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
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The Canadian Problem Gambling Index
Q9. Thinking about the past 12 months, how often has your gambling caused any
financial problems for you or your household?
Never.......................................................................................................................................1
Sometimes..............................................................................................................................2
Most of the time ....................................................................................................................3
Almost always.......................................................................................................................4
(DO NOT READ) Don't Know..........................................................................................8
(DO NOT READ) Refused / No Response......................................................................9
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The Canadian Problem Gambling Index
APPENDIX 4
PGSI Gambler Sub-Types
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The Canadian Problem Gambling Index
Problem Gambling Severity Index
Gambler Sub-Types
Public health research relies on the science of epidemiology, which has as its first
main goal the identification of positive “cases” of a condition (e.g. tuberculosis, small
pox, AIDS) in a human population. In this vein, problem gambling prevalence studies
have all sought to identify true cases of problem gambling in human populations, and
various screening instruments and measurement strategies have been developed to
accomplish this. Moreover, researchers have chosen different labels for categories of
gambler cases (e.g. non-problem, at-risk, problem, pathological, Level 1,2,3). These
various approaches have caused some confusion, and it is often difficult to compare
studies because of differences in definition, labeling, and measurement.
In problem gambling research, it is incumbent on investigators to carefully
describe the measures they use, scoring algorithms, and labels that are assigned to
categories of cases. In view of this, the four PGSI gambler sub-types are described below.
In epidemiological research, correctly classifying and labeling positive cases of a
health condition is crucial for researchers and service providers to identify and treat
individuals. However, sometimes the label becomes a pejorative term that stigmatizes
the person with the condition. There are many examples of health condition labels that
have served to isolate and ostracize the afflicted within societies (e.g., leper, addict,
alcoholic, schizophrenic, AIDS victim, pedophile), thus adding to the individual’s
torment. While the PGSI utilizes convenient labels to categorize individuals who have
some severity of gambling problem (e.g., low risk, moderate risk, and problem gambler),
it must be stressed that the focus should be on the problem behaviour and consequences
of that behaviour, rather than on the individual, per se. This is a very important
distinction that will hopefully serve to focus public health discussion, communiqués, and
intervention strategies on the issue of problem gambling behaviour, thus mitigating the
potential harmful effect the problem gambling label may have for the individual.
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The Canadian Problem Gambling Index
PGSI Score Gambler Sub-Type Description
0 Non gambler Respondents in this group have not gambled at all in
the past 12 months, and will have been skipped through
the majority of the questionnaire, with the exception of
the correlates section. Non-gamblers may have some of
the correlates of problem gambling. This information is
important in the context of long-term tracking, in that
the correlates may predict those who were once or may
become gamblers or problem gamblers.
0 Non-problem gambler Respondents in this group will have responded “never”
to all of the indicators of behavioral problems, although
there may well be a frequent gambler with heavy
involvement in terms of time and money. The
“professional” gambler would fit into this category.
This group probably will not have experienced any
adverse consequences of gambling. Again, the
information on correlates here is important for
comparative purposes, and would be particularly useful
in long-term tracking.
1-2 Low risk gambler Respondents in this group will have responded “never”
to most of the indicators of behavioral problems, but
will have one or more sometimes or more often
responses. Gamblers may be at risk if they are heavily
involved in gambling and if they respond positively to
at least two of the correlates of problem gambling. This
group likely will not have experienced any adverse
consequences from gambling.
3-7 Moderate risk gambler Respondents in this group will have responded “never”
to most of the indicators of behavioral problems, but
will have one or more “most of the time” or “always”
responses. Gamblers may be at risk if they are heavily
involved in gambling and if they respond positively to
three or four of the correlates of problem gambling.
This group may or may not have experienced adverse
consequences from gambling.
8 and over Problem gambler Respondents in this group are those who have
experienced adverse consequences from their
gambling, and may have lost control of their behavior.
Involvement in gambling can be at any level, but is
likely to be heavy. The correlates may be useful here in
profiling capacity, as one would anticipate that this
group would respond positively to more of the
correlates than members of other groups, on average.
