The Gambling Commission released the findings from its Gambling Survey for Great Britain study on Thursday 25 July, noting that 2.5% of respondents had behaviours pointing to gambling harm.
However, rather than the amount of problem gamblers increasing fivefold since the last survey, it’s more likely that the previous rate was underreported, while this new 2.5% figure may be an overestimation.
The Commission has also been clear in stating that “direct comparisons between the GSGB and previous surveys should not be used to assess trends over time.”
The new methodology will be explained and analysed below.
PGSI vs DSM-IV
The respondents were rated on the Problem Gambling Severity Index (PGSI), which was developed specifically for use among the general population, rather than a clinical situation.
The 2.5% figure comes from respondents who scored an 8 or above on the PGSI, which indicated “adverse consequences from gambling and may have lost control of their behaviour.”
This is the same index that was used in the Health Survey for England, Scottish Health Survey and the Welsh Problem Gambling Survey.
However, all of these surveys also used the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV).
“As PSGI scores are higher for those with more gambling engagement, a lower response rate, potentially over-representing those who gamble, would serve to increase reported PGSI scores” – Gambling Commission
The DSM-IV tool was developed in 1994 to be used by clinicians to assist in the diagnosis and treatment of 410 disorders. However, there have been three major updates to the DSM system, with the latest DSM-5-TR published in 2022 and many believing the DSM-IV is too outdated by this point.
The PGSI asks the following questions, and respondents can answer on a four-point scale ranging from never, sometimes, most of the time or almost always:
Thinking about the last 12 months...
Have you bet more than you could really afford to lose?
Have you needed to gamble with larger amounts of money to get the same feeling of excitement?
When you gambled, did you go back another day to try to win back the money you lost?
Have you borrowed money or sold anything to get money to gamble?
Have you felt that you might have a problem with gambling?
Has gambling caused you any health problems, including stress or anxiety?
Have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
Has your gambling caused any financial problems for you or your household?
Have you felt guilty about the way you gamble or what happens when you gamble?
In comparison, the DSM-IV wording looked a little more like this:
Are preoccupied with gambling (for example preoccupied with reliving past gambling experiences, handicapping or planning the next venture, or thinking of ways to get money with which to gamble)?
Have committed illegal acts, such as forgery, fraud, theft, or embezzlement, in order to finance gambling?
“Both findings point to social desirability bias in the HSE as a reason for lower problem gambling estimates in this survey” – Patrick Sturgis
So, immediately, you can see that the wording in the PSGI is more friendly and approachable for the general public to understand. However, the Commission and Patrick Sturgis, Professor of Quantitative Social Science at the London School of Economics, both acknowledged that this may “substantially overstate the true level of gambling and gambling harm in the population.”
It is worth emphasising once again that the Commission has publicly addressed this and is not pretending it is not the case.
Collection mode
Traditionally, the Health Survey for England (HSE) would be conducted by an interviewer in a face-to-face encounter. The questions relating to gambling would be self-completed, but it’s important to acknowledge that these would be done with both the interviewer and other household members present.
This is something that Sturgis also brings up in his report: “It also found that HSE respondents reported lower PGSI scores when another household member was present during the interview.
“Both findings point to social desirability bias in the HSE as a reason for lower problem gambling estimates in this survey.”
When you consider the nature of the questions, many of them relating to causing issues to the household, interpersonal relationships and finances, it’s easy to see why some people might be misleading in their answers in this methodology.
However, the Gambling Survery for Great Britain is a self-completed online survey, meaning the user going through the survey has less eyes watching their answers. They can do it away from the people their actions could affect, and has the potential to see respondents answer more truthfully.
“People who gamble, and those who gamble more heavily, may be more likely to complete the GSGB than those who do not gamble” – Gambling Commission
Ages of respondents
The HSE could be completed by anyone over the age of 16, mainly due to the fact that the content of the questionnaire focused on the overall health of the individual. In comparison, the GSGB focuses on gambling and restricts the survey to being completed by those aged 18 and over.
This presents an immediate aspect of bias, addressed by the Commission: “People who gamble, and those who gamble more heavily, may be more likely to complete the GSGB than those who do not gamble.
“As PSGI scores are higher for those with more gambling engagement, a lower response rate, potentially over-representing those who gamble, would serve to increase reported PGSI scores.”
If somebody does not gamble, they may not see the point in responding to a gambling survey.
However, health affects everybody, so you’re more likely to get a range of responses to the gambling section from a broader audience.
Also, by excluding those under 18, you’re denying yourself the chance to see how problem gambling can affect those who are underage.
Geography and sample size
As the name may suggest, the Health Survey for England was typically completed by those in the titular country.
However, the GSGB is offered to people in England, Wales and Scotland, giving a much wider and representative look at the population.
The sample size was also 10,000 as opposed to 7,100 for the HSE, although the response rates were 19% and 36% respectively.
The availability of completing the survey online makes it easier to scale up, however, with the Commission planning on surveying 20,000 people in the second year of this study.
“This might have been a result of the use of an updated list of gambling activities on the 2023 survey but it might equally have been due to an increase in gambling harm in the population” – Patrick Sturgis
Conclusion
In his independent review of the study, Sturgis noted that: “This might have been a result of the use of an updated list of gambling activities on the 2023 survey but it might equally have been due to an increase in gambling harm in the population.
“In order to assess the impact of the updated gambling activity list, an experimental design is necessary.”
This is exactly the perspective we need to have when addressing the new 2.5% rate.
It may reflect a change in people's behaviour, but it’s unlikely that five times more people are gambling problematically than they were a few years ago.
While some were sceptical at how insistent the Commission was that these new figures couldn’t be used in comparison to earlier studies, once you explore all the changes in methodology this point becomes very clear.
There’s a mixture of more digestible questions, a private way to complete the survey and a risk that the focus on gambling will only attract those who partake in it over those who don’t; this mixture is likely the reason that the figure has quintupled, but there’s no way to tell for sure until further work is completed.
While we wait for more data to be collected and analysed, the Commission has stressed that while the new survey can be used to look at patterns between different groups and assess future trends, it should not be used as a measure of addiction or an overall rate of gambling-related harm in Great Britain.