ABSTRACT
Objectives
Gambling Disorder (GD) frequently co-occurs with other mental disorders, a clinical condition termed Gambling Dual Disorder (GDD) that is often overlooked. We aimed to develop and validate a brief multidomain questionnaire to assess GDD severity within a dimensional, transdiagnostic framework.
Methods
A 55-item questionnaire was developed and tested across three phases (feasibility, reliability, validity) in 30, 57, and 223 treatment-seeking adults with DSM-5-TR GD. We assessed internal consistency, test–retest reliability, convergent validity against reference instruments (STAI, BDI-II, ISI, BIS, CAARS, SPIN, MULTICAGE-CAD-4, TCI-R, SDI), ROC-derived cutoffs, and the latent dimensional structure via exploratory and confirmatory factor analyses, mapped onto the NIMH Research Domain Criteria (RDoC).
Results
Internal consistency was excellent (α = 0.93); test–retest reliability was moderate (ICC = 0.29–0.62). Convergent validity was strong (r ≈ 0.51–0.72). ROC-based cutoffs prioritized sensitivity, with negative predictive values generally above 0.80. A global severity threshold near 1.44 enabled clinical stratification. A four-factor structure emerged: emotional distress and gambling impairment, impulsivity and behavioral activation, social anxiety and interpersonal suspiciousness, and executive dysfunction with negative self-perception.
Conclusion
The instrument is a reliable, valid, RDoC-aligned tool for stratifying GDD severity and tailoring integrated interventions.