DSM-IV Pathological Gambling Diagnostic Form: Getting Help: Indiana Problem Gambling Awareness Program: Indiana University Bloomington

1. Have you often found yourself thinking about gambling [e.g., reliving past gambling experiences, planning the next time you will play or thinking of ways to get money to gamble]?

Yes
No

2. Have you needed to gamble with more and more money to get the amount of excitement you are looking for?

Yes
No

3. Have you become restless or irritable when trying to cut down or stop gambling?

Yes
No

4. Have you gambled to escape from problems or when you are feeling depressed, anxious or bad about yourself?

Yes
No

5. After losing money gambling, have you returned another day in order to get even?

Yes
No

6. Have you lied to your family or others to hide the extent of your gambling?

Yes
No

7. Have you made repeated unsuccessful attempts to control, cut back or stop gambling?

Yes
No

8. Have you been forced to go beyond what is strictly legal in order to finance gambling or to pay gambling debts?

Yes
No

9. Have you risked or lost a significant relationship, job, educational or career opportunity because of gambling?

Yes
No

10. Have you sought help from others to provide the money to relieve a desperate financial situation caused by gambling?

Yes
No