Measurement and Validity Issues in Pathological Gambling (GAPP) 

Principal Investigator: Renee Cunningham-Williams
Funder:  National Institute on Drug Abuse (NIDA)
Timeframe: 09/03-04/07
Affiliation: Center of Mental Health Services Research (CMHSR)

Project Staff:  Renee Cunningham-Williams, PhD, PI                      
                        Edward L. Spitznagel, Jr., PhD,

                        Peter Dore, MA, Director of Data Management

                        Peichang Shi, MS, Statistical Analyst

                        Paul Sacco, MSW, NIDA pre-doctoral Trainee

Project Contact:   Renee Cunningham-Williams, PhD

                              Phone: (314) 935-4563

                              Email: williamsr@wustl.edu
                             
                                         
Project Update as of 09/28/2007:
Stage: Completed

Description:

This new-investigator initiated (R01) resubmission, "Validity and Measurement Issues in Pathological Gambling", responds to a call for much needed attention to measurement and design challenges in mental health research. This is especially essential in pathological gambling (PG) research. National research efforts have recognized the need for consensus in the validity and assessment of PG across diverse populations (e.g., those with comorbid mental health and substance abuse conditions; NRC Report 1999). Critical to making these inroads is the development of rigorously tested tools for diagnosing the disorder, such as our research team's development of the computerized Gambling Assessment Module (C-GAM). The C-GAM addresses the criticisms of currently available assessments of PG. The currently proposed study adds a new dimension of validity to the Pl's NIDA (K01) Award design. The order of the clinical interview session will be randomly assigned to occur either one week before or one week after the two lab administered interviews. The clinical interview session includes administration of the semi-structured CGAM and a comprehensive personality assessment. Thus, the major aim of the proposed study is to establish diagnostic concordance of the structured, lay administered C-GAM interview to the semi structured, clinician administered C-GAM interview for the overall sample (n=150) and for several subgroups of gamblers varying by socio-demographics and psychiatric and substance abuse comorbidity. We will also evaluate the sensitivity and specificity of the C-GAM and explore the dimensionality of PG. As a methodology to further understand answers given in multiple interviews, we will evaluate discrepancies between the clinical and lay interviews, reasons for those discrepancies, and level of respondent understanding of these items. The proposed methodology is innovative in PG research and can potentially increase our understanding of PG disorder, thus aiding in future research and clinical efforts in refining diagnoses, establishing prevalence estimates, and identifying risk and protective factors associated with the development of comorbid mental health and substance use problems.

Publications:

Cunningham-Williams RM., Hong S. (In press) [expected by Sept. 2007]. A Latent Class Analysis (LCA) of Problem Gambling Among a Sample of Community-Recruited Gamblers. Journal of Nervous and Mental Disease

Cunningham-Williams RM, Ostmann EL, Spitznagel EL, Books SJ. (2007). Racial/Ethnic variation in the reliability of pathological gambling disorder.  Journal of Nervous and Mental Disease 195 (7), 551-559

Sacco P, Cunningham-Williams RM, Ostmann E., Spitznagel EL.  Personality Disorder Comorbidity and Pathological Gambling. Society for Social Work and Research (SSWR), San Francisco, CA., January 14, 2007. (Oral)

Cunningham-Williams RM.  Are Gamblers With Substance Use Disorders Reliable Reporters of Their Gambling Behaviors?  Midwest Conference on Problem Gambling and Substance Abuse, Kansas City, Missouri, August 16-18, 2006. (oral)

Cunningham-Williams RM, Krygiel J, Books SJ.  Racial/Ethnic Differences in the Reliability of DSM-IV Pathological Gambling Disorder (PGD) Society for Social Work Research (SSWR), San Antonio, Texas, January 12-15, 2006. (oral)

Cunningham-Williams RM, Ostmann, E.L.  DSM-IV PGD Diagnoses: Concordance Between Non-Clinician and Clinician Interview Reports.  National Council on Problem Gambling, St. Paul, MN, June 22, 2006, Poster.

Stiffman, A.R., Pescosolido, B., Cabassa, L.J. (2004).  Building a Model to Understand Youth Service Access: The Gateway Provider Model.  Mental Health Services Research, 6, 189-198.

Striley, C.W., Stiffman, A.R., Spitznagel, E.L. (2003).  Functioning Mediates Between Symptoms and Provider Assessment. Mental Health Services Research, 5, 155-171.

Stiffman, A.R., Striley, C., Horvath, V.E., Hadley-Ives, E., Polgar, M., Elze, D., Pescarino, R. (2001).  Organizational Context and Provider Perception as Determinants of Mental Health Service Use.  Journal of Behavioral Health Services & Research, 28, 188-204.

Johnson, S.D., Stiffman, A.R., Hadley-Ives, E., Elze, D. (2001).  An Analysis of Stressors and Co-Morbid Mental Health Problems That Contribute to Youths’ Paths to Substances-Specific Services.  Journal of Behavioral Health Services & Research, 28, 412-426.

Stiffman, A.R., Howitz, S.M., Hoagwood, K., Compton, W., Cottler, L., Bean, D.L., Narrow, W.E., Weisz, J.R.  (2000). The Service Assessment for Children and Adolescents (SACA): Adult and child reports. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 1032-1039.

Hoagwood, K., Horwitz, S., Stiffman, A.R., Weisz, J., Bean D., Rae, D., Compton, W., Cottler, L., Bickman, L. & Leaf, P. (2000).  Concordance Between Parent Reports of Children’s Mental Health Services and Service Records: The Service Assessment for Children and Adolescents (SACA).  Journal of Child & Family Studies, 9, 315-331.

Stiffman, A.R., Hadley-Ives, E., Dore, P., Polgar, M., Horvath, V.E., Striley, C., Elze, D. (2000).  Youths’ access to mental health services: The role of providers’ training, resource connectivity and assessment of need.  Mental Health Services Research, 2, 141-154.

Hadley-Ives, E., Stiffman, A.R., Elze, D., Johnson, S.D., Dore, P.  (2000).  Measuring neighborhood and school environments: Perceptual and aggregate approaches.  Journal of Human Behavior in the Social Environment, 3, 1-28.

Elze, D.E., Stiffman, A.R., Dore, P.  (1999).  The association between types of violence exposure and youths’ mental health problems. International Journal of Adolescent Medicine and Health, 11, 221-255.

Stiffman, A.R., Elze, D., Hadley-Ives, E., Johnson, S. (1999).  Youth and provider perspectives on social service providers’ roles in mental health services.  Journal of Social Service Research, 25, 83-97.

Stiffman, A.R., Hadley-Ives, E. (1999).  Impact of environment on adolescent mental health and behavior: Structural equation modeling.  American Journal of Orthopsychiatry, 69, 73-86.

Stiffman, A.R., Chen, Y.W., Elze, D., Dore, P., Cheng, L.C.  (1997). Adolescents’ and privders’ perspectives on the need for and use of mental health services. Journal of Adolescent Health, 21, 335-342.