The Nine Questions on the PGSI: What the PGSI Gambling Screening Questions Measure
The Problem Gambling Severity Index (PGSI) is a widely-used screening tool comprising 9 items, each scored from 0 to 3, to capture a total score between 0 and 27. A score of 8 or higher is considered a red…
How the nine questions work
The PGSI questionnaire asks you to rate various statements about your gambling behavior and its impact on your life. The nine items cover a range of experiences:
| | Item | 0 Points | 1 Point | 2 Points | 3 Points | | --- | --- | --- | --- | --- | --- | | 1 | In the past 12 months, How often have you bet more than you could really afford to lose? | Never | | Most of the time | Almost always | | 2 | In the past 12 months, when you gambled, how often did you bet with money you needed for things like food, shelter, or medical needs? | Never | | Most of the time | Almost always | | 3 | In the last 12 months, How often have you needed to gamble with larger amounts of money to get the same excitement you used to get? | Never | | Most of the time | Almost always | | 4 | In the past 12 months, how often have you gone back another day to win back money you lost? | Never | | Most of the time | Almost always | | 5 | In the past 12 months, how often have you borrowed money or sold anything to get money to gamble? | Never | | Most of the time | Almost always | | 6 | In the past 12 months, has anyone criticized your betting or told you that you had a gambling problem (regardless of whether or not you thought it was true)? | Never | | Most of the time | Almost always | | 7 | In the past 12 months, did you ever feel guilty about the way you gamble or what gambling has made you do? | | Sometimes | | | | 8 | How often have you felt that you might have a problem with gambling? | | Sometimes | | | | 9 | Has your gambling caused any financial problems for you or your household, such as trouble paying rent or mortgage, other bills, or debt? | | Sometimes | | |
These items look at how gambling is affecting your money, your relationships, and your health. It's rare for problems to be evenly distributed, so even if multiple were rarely a problem, being "most of the time" serious even just for one could potentially flag the behaviour of concern.
How scoring turns answers into a band
Each PGSI item is rated on a 0–3 scale. You score 0 points for every "never", 1 point for every "sometimes", 2 points for "most of the time", and 3 points for "almost always".
The possible total score is the sum of the individual item scores ranging from 0 to 27. The Gambling Commission groups the total score in four bands to interpret a person's current gambling severity. They are "0", "1-2", "3-7", and "8+".
The 8+ band indicates high levels of risk, but the below information should caution against taking it to be a diagnosis.
What the screen is measuring
The PGSI quests hit on the most common problems that mark unhealthy or at-risk gambling. From chasing losses by borrowing or selling things, to not being sure if you believe you might have a gambling problem, recognising if there have been medical or social consequences of this behaviour.
These questions supposedly map to several traditionally named categories, such as 'betting to get money for things you really need, chasing losses, emotional response, personal impacts, family, financial'.
What the result means
The PGSI is a screening tool, not a diagnostic instrument. If your score falls in the 1-2 or 3-7 bands, it might be time to reduce your exposure to gambling over time to see if the coping strategies for dealing with it improve. Only being classified in the 8+ band is considered problematic, and even then it is only intended as a prompt that an individual might be especially vulnerable to gambling. The gold-standard is still a clinical interview, and even then only a small minority have a gambling disorder,.
Screens do not tell the whole story, but they do allow a much larger population to be queried, and intervene for at-risk responses rather than only focusing on small number of patients who are more accessible to a medical community. The PGSI is used in ongoing national surveys of gambling and is part of the Canadian Problem Gambling Index among other widely referenced scales.
Where the cutoff comes from
A public screening manual used in problem gambling practice presents a PGSI score of 8 or more as representing an individual experiencing gambling problems. This is the threshold recommended by the developers.
Why readers should not overread the number
For all of the obvious gains of being able to instantly apply a single score, nobody should take this to represent anything more than 1 possible data point against which further more rigorous assessment criteria might be applied.
People who screen positive can still have disagreements if these approaches are suitable, they may have other better alternative explanations for why they flag this screen. Being called at risk is not the same as being a diagnostic decision, either. Further information should be urgently gathered.
Find out what the person actually does, not assumptions about how risky such behaviours might be. Like screening for other disorders, getting a high score can represent poorer health or comorbid conditions that could be treated to help.
Don't act on a PGSI score alone. Seek help if you are concerned about your results.