Problems with the Problem Gambling Severity Index (PGSI): Is it fit for public health monitoring of gambling harms? An analysis with Rasch Measurement Theory.

Authors

James Close, Ryan Statton

Published in

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors. Oct 29, 2026. Epub Oct 29, 2026.

Abstract

The Problem Gambling Severity Index (PGSI) is a widely used tool for measuring gambling-related issues, playing a central role in service delivery and national monitoring, especially in the British context. However, it was developed a quarter of a century ago under clinical paradigms of "problem gambling," raising questions about alignment with contemporary public health approaches. This study evaluates the suitability of PGSI for clinical and population-level monitoring, using Rasch Measurement Theory.
Rasch Measurement Theory analysis was conducted on PGSI data from national data sets: Health Survey for United Kingdom, Scottish Health Survey, National Survey for Wales, and Gambling Survey for Great Britain (complete n = 15,716). Metrics assessed included person and item reliability and separation, rating-scale functionality, dimensionality, and relationship between raw and Rasch Measurement Theory scores.
As a clinical screen tool for problem gambling, the PGSI is broadly fit for purpose, exhibiting acceptable binary discrimination and high precision at the clinical threshold. However, person reliability (0.19-0.58) was suboptimal for discriminating between low-, medium-, and high-risk categories. For general population samples, the targeting (mean person measure = -3.18 to -2.69 logits) indicated items were too difficult. Dimensionality suggested two constructs: behaviors and impacts. Most items demonstrate item parameter drift in difficulty levels. Response categories "Most of the time" and "Almost always" exhibited redundancy.
While the PGSI functions well for its designed purpose (a clinical screen), limitations in targeting, reliability, and dimensionality undermine effectiveness for public health/national monitoring. Alternative tools are required, aligned with contemporary public health strategies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:
42956199
Bibliographic data and abstract were imported from PubMed on 30 Oct 2026.

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