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

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.

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.

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.

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.

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.