Gambling disorder and problem gambling in Brazil: The development of a brief screening scale

AI Summary

Developed "3-Cs screener", a three-item on-site tool (control, coping, chasing) achieving 96.5% sensitivity for detecting problematic gambling.
A four-item variant attained high specificity for Gambling Disorder, 96.2%, supporting diagnostic accuracy for identifying disorder cases.
Large multistage sample of 5,407 lottery players at 494 kiosks; exhaustive combinatorial testing outperformed NODS-CLiP, though further validation is required.

Braz J Psychiatry. 2026 Jul 7. doi: 10.47626/1516-4446-2025-4662. Online ahead of print.

ABSTRACT

BACKGROUND: Brief, accurate, and context-sensitive screening tools are essential for detecting gambling-related problems, but most existing instruments are not validated for on-site gambling.

OBJECTIVES: This study aimed to estimate the prevalence and patterns of Gambling Disorder (GD) and problem gambling among Brazilian lottery players and to develop and test a concise screening tool optimized for this on-site context.

METHODS: A multistage, stratified sampling design recruited 5,407 adult gamblers at 494 lottery kiosks. Participants completed a version of the NODS adapted to DSM-5 criteria. Using an exhaustive combinatorial approach, all 2-4-item subsets from the NODS were tested for sensitivity and specificity.

RESULTS: Three combinations emerged as optimal. A three-item version (control, coping, chasing) showed the best balance for detecting problematic gambling (sensitivity = 96.5%), while a four-item version reached high specificity for GD (96.2%). All combinations outperformed the widely used NODS-CLiP.

CONCLUSIONS: The study introduces the “3-Cs screener,” a novel, ultra-brief tool for on-site lottery players. Its high diagnostic accuracy makes it a promising candidate for prevention and intervention strategies, though further validation in clinical and digital settings is warranted.

PMID:42413042 | DOI:10.47626/1516-4446-2025-4662

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