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)

Problem gambling, gambling correlates and health seeking attitudes in a Chinese sample: An empirical evaluation.

There is an increasing consensus that problem gambling (PG) is a serious social issue among the Chinese, but little is known of the factors associated with PG among the Chinese using validated and improved PG measure-ments. This study examined the patterns of PG and the PG predictive ability of variables such as gam-bling-related cognitions, gambling urge, depression, anxiety, stress, and help-seeking attitudes among Chinese individuals living in Taiwan. The participants consisted of 801 Taiwanese Chinese student and community indi-viduals (Mean age = 25.36 years). The prevalence of PG (Problem Gambling Severity Index; PGSI) and patho-logical gambling (South Oaks Gambling Screen; SOGS) are higher in this Taiwanese Chinese sample as com-pared with past prevalence research. Significant differences were found between PGSI groups (i.e., non-PG, low-risk, moderate-risk, and PG) in socio-demographic variables. Erroneous gambling-related cognitions and overall negative psychological states significantly predicted PG. In addition, interaction effects of gender, mediation effects, and the predictive ability of help-seeking attitudes were discussed. The findings of this study have important implications in the understanding of PG among the Chinese. Gambling-related cognitions and negative psychological states are important factors that should be addressed in intervention programs

The relationship between cultural variables and gambling behavior among Chinese residing in Australia

Cultural variables (e.g., cultural values, acculturation and attitudes towards seeking professional assistance) have been found to play important roles in the initiation and maintenance of numerous mental health and substance related problems. However, there is a significant lack of empirical studies investigating the relationships between these cultural variables and gambling behavior. Thus, this study assessed whether these cultural variables could predict gambling behavior among 233 Chinese residing in Australia. Several questionnaires were used in the study including the South Oaks Gambling Screen (SOGS), the Asian Values Scale (AVS), Attitudes towards Seeking Psychological Help Scale (ATSPHS) and the modified version of the Cultural Life Style Inventory (CLSI). Results showed that although adherence to Asian values could not predict gambling behavior, acculturation (i.e., cultural shift and cultural incorporation) could negatively predict gambling behavior. Furthermore, the interpersonal openness subscale of ATSPHS could predict gambling behavior. Implications of these findings are discussed

Role of culture in gambling and problem gambling

There has been a significant gap in the gambling literature regarding the role of culture in gambling and problem gambling (PG). This paper aims to reduce this gap by presenting a systematic review of the cultural variations in gambling and PG as well as a discussion of the role cultural variables can play in the initiation and maintenance of gambling in order to stimulate further research. The review shows that although studies investigating prevalence rates of gambling and PG among different cultures are not plentiful, evidence does suggest certain cultural groups are more vulnerable to begin gambling and to develop PG. Significant factors including familial/genetic, sociological, and individual factors have been found in the Western gambling literature as playing important roles in the development and maintenance of PG. These factors need to be examined now in other cultural groups so we can better understand the etiological processes involved in PG and design culturally sensitive treatments. In addition, variables, such as cultural values and beliefs, the process of acculturation, and the influence of culturally determined help-seeking behaviors need to be also examined in relation to the role they could play in the initiation of and maintenance of gambling. Understanding the contribution of cultural variables will allow us to devise better prevention and treatment options for PG. Methodological problems in this area of research are highlighted, and suggestions for future research are included. (C) 2004 Elsevier Ltd. All rights reserved

A cognitive behavioural therapy programme for problem gambling: Therapist manual

The journey of this book started more than 10 years ago. At this time, the efficacy of cognitive behaviour therapy (CBT) in treating anxiety and mood disorders was well established. However, the efficacy of CBT in treating problem gambling was still unclear. In addition, due to changes in government policies and social factors gambling, in particular casino and electronic machine gambling were legalized and thus, widely accessible to the public in general. Thus, problem gambling and in particular the treatment of problem gambling became an important issue. Professor Oei is one of the earlier researchers examining the efficacy of CBT for the treatment of addictive behaviours, in particular alcohol addiction (Jackson & Oei, 1978; Oei & Jackson, 1980; 1982; 1984). When Dr. Raylu arrived at the University of Queensland in 1999, the journey of this book began. We decided to collaborate. Since both of us were using CBT for addictive behaviours, it was natural for us to find an efficient CBT program for problem gambling

The gambling urge scale: Development, confirmatory factor validation, and psychometric properties

The urge to gamble is a physiological, psychological, or emotional motivational state, often associated with continued gambling. The authors developed and validated the 6-item Gambling Urge Questionnaire (GUS), which was based on the 8-item Alcohol Urge Questionnaire (M. J. Bohn, D. D. Krahn, & B. A. Staehler, 1995), using 968 community-based participants. Exploratory factor analysis using half of the sample indicated a 1-factor solution that accounted for 55.18% of the total variance. This was confirmed using confirmatory factor analysis with the other half of the sample. The GUS had a Cronbach's alpha coefficient of .81. Concurrent, predictive, and criterion-related validity of the GUS were good, suggesting that the GUS is a valid and reliable instrument for assessing gambling urges among nonclinical gamblers

Cognitive and psychosocial variables predicting gambling behavior in a clinical sample

Previous studies have mostly examined cognitive and psychosocial variables that are critical to the cognitive behavioral conceptualization of Problem Gambling (PG) in community samples. This study aimed to assess whether cognitive and psychosocial variables (gambling refusal self-efficacy, gambling cognitions, gambling urges, comorbid negative psychological states, comorbid substance use/misuse, life satisfaction and quality of life) can predict gambling behaviour in a clinical sample. One hundred and thirty-nine volunteers for a PG self-help cognitive behaviour treatment program participated. Results showed that only perceived gambling refusal self-efficacy, cognitions of inability to stop gambling, hazardous drinking behaviors, and poor quality of life related to one's environment, significantly predicted SOGS and/or CPGI scores. Significant interactions between gender and a number of variables including gambling cognitions (especially gambling expectancies), gambling refusal self-efficacy as well as quality of life related to physical or environmental health predicted gambling behaviour in this clinical sample

Treatment planning for problem gamblers

Treatment dropout and relapse among problem gamblers (PGs) are high. Due to the heterogeneity of PGs, one form of treatment (i.e., mono-therapy) may not be sufficient in maintaining PGs in treatment or leading to successful outcomes. This paper aims to provide an overview of the status of the current problem gambling (PG) treatments before discussing tailoring interventions to address this heterogeneity. Although a number of effective pharmacological and psychological interventions exist for treating PG, currently there is no one treatment specifically recommended. Thus, treatment programs need to be tailored to individual needs. This requires good assessment of the problem behaviour and associated factors (e.g., risk and protective factors, gambling consequences, and comorbid psychological problems). Pictorial case formulations showing causal and maintenance factors would aid in choosing relevant techniques to address these factors. Treatment goals, controlled gambling versus abstinence, need to be decided with clients prior to commencing treatment. Given the high dropout rate among PGs, and depending on clients' willingness to make changes, what is initially covered in treatment is vital. Different combinations of interventions need to be chosen depending on clients' presenting problems. Treatment suggestions for different types of PGs are discussed. Finally, good measures (assessing symptoms, cognitions and behaviours) are required to track progress and evaluate outcomes

The current status and future direction of self-help treatments for problem gamblers

The self-help treatment (SHT) studies for other psychological problems significantly outweigh those for problem gambling. Currently, very little is published about the application and efficacy of various forms of SHTs for problem gambling. Thus, this paper reviews the self-help literature (using the PsycINFO database — all years up to April 2008) to stimulate further research in this area for problem gambling. The findings show that SHTs in problem gambling are still in their infancy. Although the problem gambling literature has mainly reported on two forms of SHTs with problem gamblers (i.e. use of self-help manuals and audiotapes), the review discuss utilizing a wide range of SHTs with problem gamblers. These include written materials (e.g. self-help books and treatment manuals), audiotapes, videotapes, computer-based SHTs implemented on palmtop computers, desktop computers, via telephone (Interactive Voice Response systems — IVR) or via the Internet and virtual reality applications. These SHTs would suit those problem gamblers who are not accessing professional treatment due to shame, guilt, fear of stigma, privacy concerns or financial difficulties, as well as those living in rural areas or with less severe gambling problems. The review also suggest future protocols for conducting further research in this area with problem gamblers, highlighting a need for a cohesive theory to guide research