Is There a Continuum of Behavioural Dependence in Problem Gambling? Evidence from 15 Years of Australian Prevalence Research

A common assumption in many public frameworks is that the harms and behavioural risk factors associated with gambling disorder lie on a continuum. At one end is lower risk or recreational gambling, and at the other, problem or disordered gambling. Movements along this continuum are associated with gradual increases or decreases in the level of behaviour and associated harm. This perspective is often advanced in opposition to more clinical or categorical frameworks that view problem gambling as a distinct clinical category from the other groups. In this paper, we investigate these competing perspectives with reference to 15 years of Australian prevalence studies. We examine the relationship between PGSI severity classifications and the endorsement of the principal criteria of the DSM-5 (e.g. tolerance, chasing, impaired control). The results showed that while elements of behavioural dependence increase across the PGSI categories (low to moderate to problem), problem gamblers have disproportionately greater endorsement. The PGSI severity and behavioural dependence relationship corresponds more strongly to a J-curve than a linear or r-curve and therefore lends greater support of a more categorical conceptualisation of the disorder.