Pathological Gambling : A Comprehensive Review

Due to recent changes of gambling laws, accessibility to gambling has become more widespread and thus, there has also been an increase in the prevalence of pathological gambling (PG). The wide range of social, economic, and psychological problems associated with PG are well known. There is a need for better understanding of PG and this review attempts to do so. Literature searches using the Medline and PsycINFO databases were used. Critical examining of the literature showed that familial/genetic, sociological, and individual factors (e.g., an individual's personality, biochemistry, psychological states, and cognitions) are implicated in the development and maintenance of PG, yet at present, the evidences are not solid. Similarly, there have been a lot of theories for PG but again, none of them are solid enough to provide a clear understanding of PG. Recent psychological-based theories seem to provide some solid ground for further research. We highlight four areas for future consideration for research. (1) Most studies have generalized findings from one form of gambling to another. It is suggested that it is now not tenable to consider gambling as a single phenomenon that can explain all forms of gambling. (2) Almost all of the studies in the gambling literature are Western-based and the results are often generalized to other ethnic and cultural groups. There is now an urgent need to close this gap. (3) Future studies need to address methodological problems in the current gambling/PG literature. (4) Almost all of the gambling literature has focused on the issue of why people start gambling. It is suggested that looking at variables as to why people stop gambling in a single episode may be a more fruitful area of research then why people start gambling. This is because what motivates one to continue gambling, despite losses in a session and across sessions, is a characteristic that distinguishes nonproblem gamblers from problem gamblers and pathological gamblers (PGs)

Changes to automatic thoughts and dysfunctional attitudes in group CBT for depression

The present study sought to clarify the role of cognitive change in Cognitive Behavioural Therapy (CBT) by examining the relationship between depression outcome and changes to automatic thoughts and dysfunctional attitudes at different points of therapy. Thirty patients suffering from Major Depression (MDD) or Dysthymia attended the 12 sessions of a group CBT program. Multiple regressions found total scores on the Automatic Thoughts Questionnaire (ATQ) and cumulative change scores on the Dysfunctional Attitudes Scale (DAS) to predict scores on the Beck Depression Inventory (BDI) at later stages of therapy, though neither form of cognition was predictive from earlier stages of therapy. Only scores on the ATQ were significantly related to both cognitive and somatic subscales of the BDI, indicating that automatic thoughts are more directly related to cognitive change than dysfunctional attitudes. Overall findings suggest that significant reductions in both automatic thoughts and dysfunctional attitudes are related to non-clinical levels of depressive symptoms at the end of the treatment

A review on assessment and treatment for depression in Malaysia.

This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT) was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation

Psychometric validation of the Dysexecutive Questionnaire (DEX)

This study reported on the validation of the psychometric properties, the factorability, validity, and sensitivity of the Dysexecutive Questionnaire (DEX) in 3 clinical and nonclinical samples. A mixed sample of 997 participants-community (n = 663), psychiatric (depressed [n = 92] and anxious [n = 122]), and neurologically impaired (n = 120)-completed self-report questionnaires assessing executive dysfunction, depression, anxiety, stress, general self-efficacy, and satisfaction with life. Before analyses the data were randomly split into 2 subsets (A and B). Exploratory factor analysis performed on Subset A produced a 3-factor model (Factor 1: Inhibition, Factor 2: Volition, and Factor 3: Social Regulation) in which 15 of the original 20 items provided a revised factor structure that was superior to all other structures. A series of confirmatory factor analyses performed on Subset B confirmed that this revised factor structure was valid and reliable. The revised structure, labeled the DEX-R, was found to be a reliable and valid tool for assessing behavioral symptoms of dysexecutive functioning in mixed community, psychiatric, and neurological samples

The Relationship of Positive and Negative Alcohol Expectancies to Patterns of Consumption of Alcohol in Social Drinkers

Negative alcohol expectancies have recently come to occupy a more important position in the expectancy literature, but recent claims that positive expectancies are unimportant in the consumption of alcohol when compared with negative expectancies are based on potentially flawed methodology. This study investigated the relative contribution of positive and negative expectancies to the consumption of alcohol using an instrument designed to measure both positive and negative expectancies. One hundred ninety-three men and women from the general community participated in the study. Findings showed while negative expectancies accounted for the greater proportion of variance of frequency of consumption, positive expectancies remained an important predictor of consumption, accounting for the greater proportion of variance of quantity consumed per session. The interesting but sometimes counterintuitive directions of these relationships can be explained in terms of social learning principles. The relatively neglected concept of negative expectancies is worthy of further use and investigation

Dysfunctional Attitude and Occupational Stress Process: a Test of the Organisational Stress Model

The relationship between occupational stress, dysfunctional attitudes and the cognitive phenomenological theory of stress and coping (CPS theory) was examined in the paper. Specifically, two tests, with a total of 244 subjects, were conducted on: 1) The relevance of dysfunctional attitudes to the aetiology or occupational stress, and 2), The validity of CPS theory on occupational stress. The different magnitudes of stress were also taken into consideration, this led to the collection of 2 sets of data. They were data from perceived high and perceived low occupational stress events. Results from structural equation modeling indicated that the CPS theory could not adequately represent data from both high and low occupational stresses. However, other statistical results indicated significant relationships between variables in the CPS theory. This suggested that the aetiological process of occupational stress was more complex than that depicted in the CPS theory. Dysfunctional attitude was found to be relevant to the aetiology of high occupational stress but not in low occupational stress. It appeared that dysfunctional attitude was triggered only when the occupational stress level reached a certain threshhold. Hence, two structurally different aetiological models were developed for high and low occupational stresses. Implications of the above findings were also discussed in this paper

Expectancy Theory: A Two-Process Model Of Alcohol Use And Abuse

In recent years, cognitive-behavioral approaches to drinking behaviour have postulated the importance of alcohol expectancy and drinking refusal self-efficacy in the development and maintenance of problem drinking. However, despite a growing number of publications, the structure and role of these constructs have not been clearly explicated in theoretical terms to date. This article proposes a two-process theory of alcohol use and abuse. It is suggested that the acquisition and maintenance phases of drinking behavior are governed by different principles and involve different decision-making processes. The acquisition phase is thought to be a time of instrumental learning, in which decision making involves controlled processing by means of a kind of 'mental algebra'. The maintenance phase is described as subject to the principles of classical conditioning, with automatic processing playing a major role in the making of decisions. Integral to both phases, though differing in structure and function from the first, is the concept of alcohol expectancies. Another cognitive construct, drinking refusal self-efficacy, is also hypothesized to play a role in decisions to drink or not to drink. It is suggested that the development of drinking behavior is best explained in terms of associative models of learning and memory. Implications for prevention and treatment of problem drinking are discussed

The Relationship Between Irrational Beliefs and Depressed Mood in Clinically Depressed Outpatients

Studies into the relationship between irrational beliefs and severity of depression have yielded variable results. Furthermore, there is a lack of information on the nature of this relationship within clinically depressed patients. The paper explores the relationship between BDI scores and individual irrational beliefs as measured by the Irrational Beliefs Test (IBT) in a clinical outpatient group (N=63) with major and minor depressive disorders diagnosed according to Research Diagnostic Criteria and in a comparison group of university students (N=43). The results of MANOVA analyses showed that the two groups differed significantly in overall level of irrational beliefs and in their endorsement of 7 out of 10 irrational belief scales. They also differed as to which irrational belief scale scores were predictive of BDI score. Findings suggested that several rational emotive therapy constructs lack explanatory and predictive power with respect to depressive relationships

A randomised controlled trial to examine the effectiveness of group cognitive behavioural therapy for the treatment of unipolar depression in Malaysia

Malaysia has been experiencing a dearth in mental health resources. Group Cognitive Behavioural Therapy (GCBT) has been an established form of treatment for unipolar depression. The objectives of the current study were to examine the effectiveness of using GCBT for the treatment of depression in Malaysia. A total of 174 participants suffering from unipolar depression were recruited and randomly allocated to one of GCBT+Treatment as Usual (TAU), Relaxation training+TAU, or TAU only treatment groups. The participants were between 18-60 years of age. The participants in the GCBT+TAU group received eight Group CBT sessions of over a span of two months. The participants receiving Relaxation+TAU treatment received eight relaxation training sessions over a span of two months. The participants in the TAU only treatment group received treatment as usual from their psychiatrists. The BDI-M, ATQ-M, ATQP-M and DAS-M were administered at pre-treatment, mid-treatment (week 4) and post-treatment. Repeated Measures MANOVA showed a significant interaction effect between treatment group and time for BDI-M, ATQ-M, ATQP-M and DAS-M. Results showed that GCBT+TAU was able to significantly reduce depressive symptoms, negative cognitions and beliefs. Moderate effect sizes for the BDI-M scores, as well as significantly reliable and clinical change, were also found. The current study was limited by geographical boundaries, where only hospitals in and around the greater Klang Valley area were sampled. Results from the current study suggest that GCBT is effective in reducing the symptoms of depression in a Malaysian setting

Feeling connected again: interventions that increase social identification reduce depression symptoms in community and clinical settings

Background: Clinical depression is often preceded by social withdrawal, however, limited research has examined whether depressive symptoms are alleviated by interventions that increase social contact. In particular, no research has investigated whether social identification (the sense of being part of a group) moderates the impact of social interventions