Psychometric Evaluation of the Bilingual Russian-Kazakh Problem Gambling Severity Index: Item-Level Response Patterns and Behavioral Factors Associated with Gambling-Related Harm.

Population-level evidence on gambling-related risk remains limited in Central Asia, and no validated bilingual screening instrument has been available in Kazakhstan. This study evaluated the psychometric performance of the bilingual Kazakh-Russian Problem Gambling Severity Index (PGSI) and examined the distribution and correlates of PGSI-defined gambling severity in a multi-regional sample. A total of 1015 adults aged 18-60 years were recruited across all 17 regions and three cities of republican significance. Among the 474 respondents who directly completed all nine PGSI items, internal consistency was good (Cronbach's α = 0.846), and the first principal component accounted for 45.9% of the variance. Of these respondents, 275 (58.0%) met the conventional PGSI ≥ 8 screening threshold. The same 275 respondents constituted 27.1% of the overall survey sample (N = 1015). These percentages reflect different analytic denominators and are interpreted as sample-specific rather than as estimates of national prevalence. Item-level patterns indicated that elevated scores predominantly reflected cumulative moderate-frequency endorsements across multiple domains. In adjusted analyses, gambling expenditure and frequency showed the strongest associations with PGSI ≥ 8 status. Continuous-score analyses yielded a broadly consistent pattern, indicating that the principal behavioral associations were not solely attributable to dichotomization at the screening threshold. These findings provide initial psychometric evidence for the bilingual PGSI in Kazakhstan and support continued psychometric investigation before its use in epidemiological research or population-level screening.