标题：Gamblers’ (mis-)interpretations of Problem Gambling Severity Index items: Ambiguities in qualitative accounts from the Swedish Longitudinal Gambling Study
摘要：The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify
risk and problem gambling. Even though the PGSI has good psychometric properties, it still produces
a large proportion of misclassifications. Aims: To explore possible reasons for misclassifications
in problem gambling level by analysing previously classified moderate-risk gamblers’
answers to the PGSI items, in relation to their own current and past gambling behaviours.
Methods: Semi-structured telephone interviews were conducted with 19 participants reporting
no negative consequences from gambling. They were asked the PGSI questions within an eight-year
time frame (2008 to 2016). Ambiguous answers to PGSI items were subject to content analysis.
Results: Several answers to the PGSI items contained ambiguities and misinterpretations, making
it difficult to assess to what extent their answers actually indicated any problematic gambling over
time. The item about feelings of guilt generated accounts rather reflecting self-recrimination over wasting money or regretting gambling as a meaningless or immoral activity. The item concerning
critique involved mild interpretations such as being ridiculed for buying lottery tickets or getting
comments for being boring. Similar accounts were given by the participants irrespective of initial
endorsement of the items. Other possible reasons for misclassifications were related to recall bias,
language difficulties, selective memory, and a tendency to answer one part of the question without
taking the whole question into account. Conclusions: Answers to the PGSI can contain a variety
of meanings based on the respondents’ subjective interpretations. Reports of lower levels of harm
in the population should thus be interpreted with caution. In clinical settings it is important to
combine use of screening instruments with interviews, to be able to better understand gamblers’
perceptions of the gambling behaviour and its negative consequences.
