NODS-CLiP Gambling Screen
NODS-CLiP Gambling Screen overview
Creator and Context
The NODS-CLiP is a three item rapid screen for problem and pathological gambling.
It was derived by Marianna Toce-Gerstein, Dean Gerstein and Rachel Volberg from the 17 item NORC Diagnostic Screen for Gambling Problems, and published in 2009. The name comes from the three criteria it covers: loss of Control, Lying, and Preoccupation.
Presenting Conditions
The three items map to three diagnostic criteria for pathological gambling:
Preoccupation: periods of at least two weeks spent thinking about gambling or planning future gambling
Loss of control: ever having tried to stop, cut down or control gambling
Lying: ever having lied to family, friends or others about how much you gamble or how much you lost
Administration
Three yes or no questions, self administered or asked by a clinician, taking about a minute. The items use a lifetime recall frame.
Desired Audience
Adults who gamble, in general population and addiction treatment settings. It is not validated for adolescents.
Gambling harm is almost never volunteered and almost never asked about. Three questions that take a minute remove every practical excuse for not asking, which is exactly why the NODS-CLiP exists.
Considerations
A screen, not a diagnosis. A positive result should lead to a fuller assessment.
It is effective at identifying moderate to severe gambling problems, but it is not recommended for detecting mild problems.
The loss of control item produces false positives in people who have deliberately moderated gambling that was never problematic.
It is based on DSM-IV criteria, predating the DSM-5 gambling disorder criteria.
How to score the NODS-CLiP Gambling Screen
Conducting the assessment
The person answers three yes or no questions. Each yes scores one point.
Interpretation
Scores range from 0 to 3.
The cut off is 1. A single yes to any of the three items is a positive screen and indicates that further assessment is warranted.
The items were derived from re analysis of eight US general adult field studies, and identify most people who would be classified as problem or pathological gamblers by the full NODS.
Clinical Considerations
A single yes is enough. Do not raise the threshold to reduce the workload, because that defeats the purpose of a rapid screen.
Follow a positive screen with a fuller assessment, not with a conclusion.
Screen routinely in substance use and mental health services. Gambling harm travels with both.
NODS-CLiP Gambling Screen use cases
Rapid screening for problem and pathological gambling
Routine screening in addiction and mental health services
Identifying who needs a full gambling assessment
Category
Gambling Addiction
Research Summary
Toce-Gerstein, M., Gerstein, D. R., & Volberg, R. A. (2009). The NODS-CLiP: A rapid screen for adult pathological and problem gambling. Journal of Gambling Studies, 25(4), 541 to 555.
Volberg, R. A., Munck, I. M., & Petry, N. M. (2011). A quick and simple screening method for pathological and problem gamblers in addiction programs and practices. American Journal on Addictions, 20(3), 220 to 227.
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