Reliability, validity, and cut scores of the south oaks gambling screen (SOGS) for Chinese

Impulsivity, Gambling-Related Cognitions, Cognitive Reappraisal and Gambling Behaviour in a Malaysian Sample

The relationships between cognitive reappraisal and problem gambling have been widely studied in different contexts. However, previous research findings remain inconsistent. This discrepancy might be attributed to the effects of interactions between cognitive reappraisal and other risk factors for problem gambling. Using moderation models, this study examined the association between impulsivity, gambling-related cognitive distortions, cognitive reappraisal and problem gambling in a sample of Malaysian gamblers. A total of 149 community gamblers (103 males, 46 females; mean age = 32.18) completed an online questionnaire. Problem gambling was measured with the South Oaks Gambling Screen (SOGS); cognitive reappraisal was measured using the Emotion Regulation Questionnaire-Cognitive Reappraisal Subscale (ERQ-CR); impulsivity was measured with the Short-UPPS-P Impulsive Behaviour Scale (SUPPS-P); and gambling-related cognitive distortions were measured using the Gambling Related Cognitions Scale (GRCS). The results revealed impulsivity and gambling-related cognitive distortions as significant predictors of problem gambling. At high levels, impulsivity and cognitive distortions are significant moderator variables that strengthen the association between cognitive reappraisal and problem gambling. These findings demonstrate that reappraisal skills could exacerbate problem gambling severity amongst impulsive or self-deceptive gamblers. Future research with larger and more representative samples is needed to validate and generalise these findings.

Gambling and internet addiction: a pilot study among a Population of Italian Healthcare : Gambling and Internet Addition in a Healthcare Group

AIM

Measuring the phenomenon of gambling and Internet addiction, with analysis of attitudes and psychophysical consequences among nurses working in different care settings.

METHODS

An observational, cross sectional, multicenter study was conducted from April to September 2020. Participants' socio-demographic information, the "Internet Addiction Test" (IAT) scale, and the "South Oaks Gambling Screen" (SOGS) were collected in order to assess the overuse of and whether an individual has a problematic relationship with gambling, respectively.

RESULTS

502 nurses were enrolled in the study. Significant correlations were found (p < .001) between the IAT score and gender, number of years of work experience, job role, educational qualification; and between the SOGS and gender, number of years of work experience, job role and regions of Italy.

CONCLUSIONS

The study highlighted an emerging social problem, and the results may be just the tip of the iceberg. Given the lack of knowledge of these phenomena and a high percentage of people who suffer from them but are afraid to admit it and get help, this study could also be useful in expanding knowledge and allow more professionals to get help and learn about possible treatments and cures for the resolution of these addictions.

Prevalence and Possible Predictors of Gambling Disorder in a Sample of Students in the Healthcare Professions

The Italian version of the South Oaks Gambling Screen questionnaire (SOGS) and a socio-demographic questionnaire were administered to a sample of 275 healthcare professions students aged 19 to 58 years (mean age = 22.17; females = 81.1%) to address the research objectives: to examine the prevalence and correlates of problem gambling in a population of university healthcare professions students in Italy. Among the sample, 8.7% (n = 24) of participants showed problem gambling and 1.5% (n = 4) pathologic gambling. Lottery and scratch cards were the most frequent type of gambling in the sample, followed by cards and bingo. Compared to females, males tend to be more involved in problem gambling and pathological gambling. Males tend to be more involved than females in different types of gambling (such as cards, sports bets, gambling at the casino). Pathological gambling is positively associated with gender, being students lagging behind the regular schedule of exams and parents' level of education. These findings have important implications in terms of prevention and intervention on gambling and pathological gambling. Universities should make available educational programs and counselling services to address this issue.

Psychometric Properties of the South Oaks Gambling Screen Revised for Adolescents in Chinese Adolescent Gamblers

Objectives: Adolescent gambling is a public health concern of increasing importance. The lack of comprehensive evaluations on adolescent gambling disorder (GD) assessment tools hinders the timely detection of Chinese adolescents with gambling problems. This study aimed to evaluate the psychometric properties of South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) and determine its optimal screening cutoff score among Chinese adolescent gamblers to address this gap.

Methods: We surveyed 1407 Chinese secondary school students aged 11–19 years in Macao, China, among which 258 past-year gamblers’ data was used for assessing SOGS-RA’s performance in detecting risk for adolescent GD.

Results: SOGS-RA displayed satisfactory reliability and validity for assessing probable GD among Chinese adolescent gamblers. Under the DSM-5 GD framework, we proposed ≥4 as SOGS-RA’s optimal cutoff score of screening for probable GD and further identified 5.8% of past-year gamblers prone to probable GD in the present study.

Conclusion: SOGS-RA can provide a reliable and valid assessment of adolescent’ GD risk in the Chinese context, facilitate early identification of probable GD cases, and alleviate the public health concern for Chinese adolescents.

Harm as reported by affected others: A population-based cross-sectional Finnish Gambling 2019 study

This study investigates the prevalence of being an affected other (AO) of a person with problem gambling; and the associations between being an AO and socio-demographics, gambling behaviour, health-related correlates and the amount and type of gambling-related harm (GRH) for the AOs. Furthermore, perspectives of the affected family members (AFMs) and close friends (ACFs) were acknowledged. Cross-sectional, random sample Finnish Gambling population-based survey data (n = 3,994) were collected in 2019. AOs were identified using a question with seven options. Information on GRH was sought using structured questions. One-fifth (21.2 %) of all respondents were AOs, men being typically ACFs and women being more often AFMs. Being an AO was associated with younger age, gambling participation, having a gambling problem of their own and health barriers such as psychological distress. AFMs experienced GRH more often and the amount of different GRHs was greater among the AFMs. The most common harm category experienced by the AOs was emotional harm. Both health-related issues and the amount of GRHs was largest among the AFMs. A substantial amount of GRH was also experienced by ACFs. The study suggests that support could be tailored for AFMs and ACFs, based on their AO status and individual needs. A public health approach for effective harm prevention in primary, secondary and tertiary levels are discussed.

The Association between the Five-factor Model of Personality and Problem Gambling: a Meta-analysis

This meta-analysis examined the associations between five-factor personality model traits and problem gambling. To be eligible for inclusion in the meta-analysis, studies had to provide effect size data that quantified the magnitude of the association between all five personality traits and problem gambling. Studies also had to use psychometrically sound measures. The meta-analysis included 20 separate samples from 19 studies and 32,222 total participants. The results showed that problem gambling was significantly correlated with the five-factor model of personality. The strongest personality correlate of problem gambling was neuroticism r = .31, p = < 0.001, 95% CI [0.17, 0.44], followed by conscientiousness r = − .28, p = < 0.001, 95% CI [-0.38,-0.17] ), agreeableness r = − .22, p = < 0.001, 95% CI [-0.34, − 0.10], openness r = − .17, p = < 0.001, 95% CI [-0.22,-0.12], and extraversion r = − .11, p = .024, 95% CI [-0.20,-0.01]. These results suggest problem gamblers tend to share a common personality profile – one that could provide clues as to the most effective ways to prevent and to treat problem gambling.

Gambling problems among Lebanese adults: Arabic-Language version of the South Oaks Gambling Screen (SOGS) scale validation and correlates

BACKGROUND

In the DSM-5, gambling disorder is recognized as the only behavioral addiction. The number of people with mental health disorders is increasing in Lebanon, especially since the economic crisis and the COVID-19 pandemic. The South Oaks Gambling Screen (SOGS), the most used tool in the world in terms of pathological gambling, has never been translated to Arabic, culturally adapted in a way that suits the Lebanese population and validated. This study's objectives were to validate an Arabic-language version of the SOGS and assess factors associated with probable pathological gambling among Lebanese adults.

METHODS

This study was carried out between February and April 2021, during the lockdown period imposed by the Lebanese government. A total of 601 individuals participated in this study by filling the online questionnaire.

RESULTS

A factor analysis, using the principal component analysis, was performed on the SOGS scale items. The SOGS items were able to explain 73.35% of the variance, with an internal reliability of KR20 = 0.947 for the total scale. The results of the confirmatory factor analysis confirmed the results of the factor analysis. More problematic alcohol use (aOR = 1.17), and more depression (aOR = 1.13) were significantly associated with higher odds of probable pathological gambling, whereas females (aOR = 0.27) had significantly lower odds of probable pathological gambling compared to males.

CONCLUSION

Our study validated an Arabic-language version of the South Oaks Gambling Screen (SOGS) for use in Lebanon, and showed some factors associated with probable pathological gambling (male gender, alcohol use disorder and depression). This reliable and valid version will hopefully contribute towards better screening for gambling disorder in Lebanon.

Concurrent Disorders and Decision-Making in Electronic Gaming Machine Gamblers

This study aimed to investigate the self-reported measures of concurrent disorders (stress, social anxiety, anxiety, depression and alcohol use) among electronic gaming machine (EGM) gamblers with varying levels of gambling severity and to examine its relationship to decision-making. This cross-sectional study in New Zealand involved an online survey that utilised validated questionnaires to assess self-reported measures of concurrent disorders and the Iowa gambling task (IGT) to analyse decision-making. The study comprised of active EGM gamblers (n = 153) who were divided into two groups: non-problem gambling (NPG, n = 71) and problem gambling (PG, n = 82) based on the cut-off point of the South Oaks Gambling Screen (SOGS). Multiple logistic regression models were performed to analyse co-occurring disorders separately and simultaneously, and a log-linear model was developed to define the associations between significant variables. The first model showed a strong correlation between gambling severity and measures for depression (p < 0.01), anxiety (p < 0.05), stress (p < 0.05) and alcohol use (p < 0.01), however only depression (p < 0.05) and alcohol use (p < 0.01) remained significant in the second model. Further, no association between social anxiety scores and problem gambling was found in this sample of EGM gamblers in both models. On the IGT, EGM gamblers in the PG group performed significantly worse. Further, the presence of poor decision-making was more pronounced with higher depression scores (p < 0.01) across both NPG and PG groups and higher alcohol use scores (p < 0.05) scores in the PG group. The presence of high levels of co-occurring disorders and its link to poor decision-making are important considerations in the treatment paradigm of EGM problem gamblers.

Online Relationships and Social Media Interaction in Youth Problem Gambling: A Four-Country Study

The objective of this study was to examine if belonging to online communities and social media identity bubbles predict youth problem gambling. An online survey was administered to 15–25-year-old participants in the United States (N = 1212), South Korea (N = 1192), Spain (N = 1212), and Finland (N = 1200). The survey measured two dimensions of online behavior: perceived sense of belonging to an online community and involvement in social media identity bubbles. Belonging to an online community was examined with a single item and involvement in social media identity bubbles was measured with the six-item Identity Bubble Reinforcement Scale. The South Oaks Gambling Screen was used to assess problem gambling. Statistical analyses utilized linear regression modeling. According to the analyses, strong sense of belonging to an online community was associated with higher problem gambling, but the association was observed mainly among those young individuals who were also involved in social media identity bubbles. For those youths who did not indicate identity bubble involvement, online relationships appeared to function as those offline. Some differences across the four countries were observed but overall, the results indicate that social media identity bubbles could partly explain the harmful influence that some online relations have on youth behavior.

Craving for Gambling Predicts Income-Generating Offenses: A Pathways Model of a Japanese Prison Population

The links between gambling and criminal offenses have been frequently reported, but the pathways from gambling to a particular offense have not. Our study applied a pathways model to predict participants' income-generating, drug-related, and violent offenses stemming from their craving for gambling. The participants were 332 male inmates in a Japanese local prison. They answered questionnaires on gambling behavior, alcohol addiction, Internet addiction, impulsivity, and psychopathy. Their official records with information on their current offense, sentence length, number of imprisonments, and length of education were also analyzed. The results show that 38.55% (n = 128) of the participants had a probable gambling disorder, a rate of problem gambling at least four times higher than that among the general Japanese population. Furthermore, their craving for gambling predicted their income-generating offenses, but not their drug-related and violent offenses. Their craving for gambling can thus be linked to their financial issues, rather than their emotional and impulsive issues. The pathways model explained the path not only from addiction/psychopathy to gambling, but also from gambling to committing an income-generating offense.

Segmenting Chinese Gamblers Based on Gambling Forms: A Latent Class Analysis

Segmentation of gamblers is useful for understanding their distinctive characteristics and enforcing customized measures in harm minimization work. Previous research has commonly adopted gambling motivation and involvement as segmentation criteria. However, these criteria are less identifiable through observation. Gambling forms, used in recent gambling segmentation research, are more observable, facilitating the prevention and treatment work of governments and practitioners, as the identified segments have distinctive gambling disorder symptoms. As gambling is widespread in the Chinese population and little is known about this ethnic group in terms of gambling form segments, latent class analysis was used to classify 855 Chinese gamblers in Macau based on their participation in 11 gambling forms in the previous 12 months. The analysis identified three distinct segments: casino gamblers, lottery gamblers, and sociable gamblers. Socio-demographic differences between the three segments were revealed. Casino gamblers, compared with their counterparts, were more likely to have DSM-V symptoms, particularly escape and bailouts. Lottery gamblers and sociable gamblers only differed in one symptom, the latter having a higher probability of chasing their losses. Based on these results, Macau policymakers are advised to prioritize their harm minimization measures such as requiring casinos to provide training to workers to help to identify gambling disorder symptoms and that workers should intervene when the symptoms of escape and bailouts were identified from the gamblers. Special attention should be given to Macau casino gamblers who are male, unemployed, or with highest education of high school diploma.

Emotional dysregulation features and problem gambling in university students: a pilot study

Undergraduate students typically cope with various changes in their lives and experience many stressors associated with academic issues. Distress can make them more vulnerable to particular behavioral patterns in order to cope with negative affect. The association of problematic gambling with particular emotion regulation characteristics-some of which are developmentally dependent-becomes a recent focus of research with clinical and preventive implications. We carried out a pilot study enrolling voluntarily young adults of a public university in the Lisbon area, and 117 Portuguese-speaking individuals were interviewed. Participants, mainly female (M = 20.6; SD = 3.9), were investigated taking into consideration their gambling practices, characteristics of impulsivity and alexithymia, along with the symptoms of depression and anxiety. Portuguese versions of the South Oaks Gambling Scale (SOGS) and Short-Version of Impulsive Behavior Scale (S-UPPSP) were prepared (i.e., translation and back-translation of the original versions were performed). The prevalence of gambling problems in this sample is modest, although they were associated with negative urgency and sensation-seeking, as well as with depression symptoms. Multiple correspondence analysis, a particular multivariate model associating gambling problems with socio-demographic and psychological variables, allowed identifying different profiles of individuals. Trace and state emotional dysregulation features are selectively associated with distinctive gambling patterns, according to some previous findings in studies with other groups. Results may address new findings in terms of morbidity, risk factors and the design of future preventive strategies among such individuals.

Presence of problematic and disordered gambling in older age and validation of the South Oaks Gambling Scale

The use of instruments originally developed for measuring gambling activity in younger populations may not be appropriate in older age individuals. The aim of this study was to examine the presence of problematic and disordered gambling in seniors aged 50 or over, and study the reliability and validity properties of the SOGS (a screening measure to identify gambling related problems). Two independent samples were recruited: a clinical group of n = 47 patients seeking treatment at a Pathological Gambling Outpatient Unit, and a population-based group of n = 361 participants recruited from the same geographical area. Confirmatory factor analysis verified the bifactor structure for the SOGS with two correlated underlying dimensions [measuring the impact of gambling on the self primarily (Cronbach's alpha α = 0.87) or on both the self and others also (α = 0.82)], and a global dimension of gambling severity (also with excellent internal consistency, α = 0.90). The SOG obtained excellent accuracy/validity for identifying gambling severity based on the DSM-5 criteria (area under the ROC curve AUC = 0.97 for discriminating disordered gambling and AUC = 0.91 for discriminating problem gambling), and good convergent validity with external measures of gambling (Pearson's correlation R = 0.91 with the total number of DSM-5 criteria for gambling disorder, and R = 0.55 with the debts accumulated due to gambling) and psychopathology (R = 0.50, 0.43 and 0.44 with the SCL-90R depression, anxiety and GSI scales). The optimal cutoff point for identifying gambling disorder was 4 (sensitivity Se = 92.3% and specificity Sp = 98.6%) and 2 for identifying problem gambling (Se = 78.8% and Sp = 96.7%). This study provides empirical support for the reliability and validity of the SOGS for assessing problem gambling in elders, and identifies two specific factors that could help both research and clinical decision-making, based on the severity and consequences of the gambling activity.

The Role of Perceived Loneliness in Youth Addictive Behaviors: Cross-National Survey Study

BACKGROUND

In the ever-growing and technologically advancing world, an increasing amount of social interaction takes place through the Web. With this change, loneliness is becoming an unprecedented societal issue, making youth more susceptible to various physical and mental health problems. This societal change also influences the dynamics of addiction.

OBJECTIVE

Employing the cognitive discrepancy loneliness model, this study aimed to provide a social psychological perspective on youth addictions.

METHODS

A comprehensive survey was used to collect data from American (N=1212; mean 20.05, SD 3.19; 608/1212, 50.17% women), South Korean (N=1192; mean 20.61, SD 3.24; 601/1192, 50.42% women), and Finnish (N=1200; mean 21.29, SD 2.85; 600/1200, 50.00% women) youths aged 15 to 25 years. Perceived loneliness was assessed with the 3-item Loneliness Scale. A total of 3 addictive behaviors were measured, including excessive alcohol use, compulsive internet use, and problem gambling. A total of 2 separate models using linear regression analyses were estimated for each country to examine the association between perceived loneliness and addiction.

RESULTS

Loneliness was significantly related to only compulsive internet use among the youth in all 3 countries (P<.001 in the United States, South Korea, and Finland). In the South Korean sample, the association remained significant with excessive alcohol use (P<.001) and problem gambling (P<.001), even after controlling for potentially confounding psychological variables.

CONCLUSIONS

The findings reveal existing differences between youths who spend excessive amounts of time online and those who engage in other types of addictive behaviors. Experiencing loneliness is consistently linked to compulsive internet use across countries, although different underlying factors may explain other forms of addiction. These findings provide a deeper understanding in the mechanisms of youth addiction and can help improve prevention and intervention work, especially in terms of compulsive internet use.

Negative Mood States or Dysfunctional Cognitions: Their Independent and Interactional Effects in Influencing Severity of Gambling Among Chinese Problem Gamblers in Hong Kong

Gambling-related cognitions and negative psychological states have been proposed as major factors in the initiation and maintenance of problem gambling (PG). While there are a substantial number of studies supporting the role of cognitive dysfunctions in the initiation and maintenance of PG, very few empirical studies have explored the specific role of negative psychological states in influencing PG behaviours. In addition, very few studies have examined the interaction effects of cognitive dysfunctions and negative psychological states in exerting influence on PG behaviours. Therefore, the present study aims to examine the main and interaction effects of gambling-related cognitions and psychological states on the gambling severity among a group of problem gamblers in Hong Kong. A cross-sectional research design was adopted. A purposive sample of 177 problem gamblers who sought treatment from a social service organization in Hong Kong completed a battery of standardised questionnaires. While gambling-related cognitions were found to exert significant effects on gambling severity, negative psychological states (i.e. stress) significantly moderated the relationship between gambling cognitions and gambling severity. In essence, those participants who reported a higher level of stress had more stable and serious gambling problems than those who reported a lower level of stress irrespective of the level of gambling-related cognitions. The findings of the moderating role of negative emotions in the relationship between cognitive distortions and severity of gambling provide insight towards developing an integrated intervention model which includes both cognitive-behavioural and emotion regulation strategies in helping people with PG.

Evaluating the Effectiveness of an Integrated Cognitive-Behavioural Intervention (CBI) Model for Male Problem Gamblers in Hong Kong: A Matched-Pair Comparison Design

Very few clinical cognitive-behavioural intervention (CBI) studies were conducted with the Chinese gamblers. There is a lack of attention paid to intervening in negative emotions that may also adversely affect PGs in current CBI treatment modality. This study is the first attempt to systematically and rigorously evaluate both the short-term and longer-term effects of a culturally-attuned CBI group treatment with an emotion regulation component for a group of Chinese PGs in Hong Kong. A quasi-experimental matched-pairs design was adopted and 84 participants were allocated to the CBI (N = 42) and social activity groups (N = 42). There are 3 assessment points in the study: baseline at recruitment, post-intervention at the end of CBI and social activity groups, and at 6-month follow-up. When compared to the social activity group and after controlling for general group effects, there were significantly greater decreases in the severity of gambling, gambling-related cognitions (i.e. interpretive bias), negative psychological states (i.e. stress) and money spent on gambling in the past month in the CBI group between pre- and post-intervention and between pre-intervention and 6-month follow-up. Results also indicated that both reduction in gambling-related cognitions and negative psychological states could mediate the treatment effect of the CBI on the reduction of problematic gambling behaviours. The culturally attuned integrated CBI group treatment with an emotional regulation component appeared to be effective in treating Chinese problem gamblers in Hong Kong and the effects could be sustained at 6-month follow-up.

Test Performance Variation Between Settings and Populations

The present paper is the third in a series on the evaluation of new tests designed to detect the disordered gambler. The present paper has two objectives. First, the observed variation in test performance between settings and populations is described in general terms and an explanation of the observed variation is presented in terms of what is referred to as spectrum effects. Second the expected variation in test performance between settings and populations is illustrated with several examples and the implications emphasized for the purpose of test evaluation.

The Berlin Inventory of Gambling behavior - Screening (BIG-S): Validation using a clinical sample

BACKGROUND

Published diagnostic questionnaires for gambling disorder in German are either based on DSM-III criteria or focus on aspects other than life time prevalence. This study was designed to assess the usability of the DSM-IV criteria based Berlin Inventory of Gambling Behavior Screening tool in a clinical sample and adapt it to DSM-5 criteria.

METHODS

In a sample of 432 patients presenting for behavioral addiction assessment at the University Medical Center Mainz, we checked the screening tool's results against clinical diagnosis and compared a subsample of n=300 clinically diagnosed gambling disorder patients with a comparison group of n=132.

RESULTS

The BIG-S produced a sensitivity of 99.7% and a specificity of 96.2%. The instrument's unidimensionality and the diagnostic improvements of DSM-5 criteria were verified by exploratory and confirmatory factor analysis as well as receiver operating characteristic analysis.

CONCLUSIONS

The BIG-S is a reliable and valid screening tool for gambling disorder and demonstrated its concise and comprehensible operationalization of current DSM-5 criteria in a clinical setting.

Dimensions of the South Oaks Gambling Screen in Finland: A cross-sectional population study

The underlying structure of problematic gambling behaviors, such as those assessed by the South Oaks Gambling Screen (SOGS), remain unknown: Can problem gambling be assessed unidimensionally or should multiple qualitatively different dimensions be taken into account, and if so, what do these qualitative dimensions indicate? How significant are the deviations from unidimensionality in practice? A cross-sectional random sample of Finns aged 15-74 (n = 4,484) was drawn from the Population Information Registry and surveyed in 2011-2012. Analyses were conducted using descriptive statistics, Confirmatory factor analysis (CFA) and multidimensional item response theory (MIRT) models. Altogether, 14.9% of the population endorsed at least one of the 20 SOGS items, but nine items had low endorsement rates (≤ 0.2%). CFA and MIRT techniques suggested that individuals differed from each other in two positively correlated (r = 0.70) underlying dimensions: "impact on self primarily" and "impact on others also". This two-factor correlated-factors model can be reinterpreted as a bifactor model with one general gambling-problem factor and two specific factors with similar interpretation as in the correlated-factors model but with non-overlapping items. The two specific factors may provide clinically useful information without extra costs of assessment.

Understanding the Mechanisms Underlying Gambling Behaviour and Sleep

Problem gambling and sleep difficulty threaten health. Using the basis of self-regulatory theory, potential mechanisms for these problems were investigated. Fifty-nine treatment-seeking gamblers completed the Pittsburgh Sleep Quality Index (sleep difficulty), the Sleep Hygiene Index (negative sleep habits), the Problem Gambling Severity Index and measures of self-regulatory capacity and arousability with data entered into regression analyses. Results supported the relationship between problem gambling and greater sleep difficulty (β = .18, t = 3.22, p < .01). Self-regulatory capacity mediated the relationship between problem gambling and sleep difficulty (R (2) change = .15, F(2, 57) = 12.14, β = -.45, t = -3.45, p < .001) as well as between problem gambling and negative sleep habits; R (2) change = .17, F(2, 57) = 13.57, β = -.28, t = -3.76, p < .001. Arousability predicted sleep difficulty (β = .15, t = 3.07, p < .01) and negative sleep habits (β = .40, t = 5.40, p < .01) but showed no relationship with problem gambling (r = .09, ns). Self-regulatory capacity represents an important mediator of the relationship between problem gambling and sleep-related behaviour and if targeted could reduce behavioural threats to health.

Gambling problems and comorbidity with alcohol use disorders in Chinese-, Korean-, and White-American college students

BACKGROUND AND OBJECTIVES

This study examined gambling behaviors and the relationship between gambling problems and alcohol use disorders (AUDs) among Chinese-, Korean-, and White-American college students.

METHODS

Participants were 678 (179 Chinese, 194 Korean, and 305 White; 50% female) 21-26 year-old (M = 22.0 ± 1.36) students attending one university in California. The South Oaks Gambling Screen was administered to assess gambling behavior and the Semi-Structured Assessment for the Genetics of Alcoholism was administered to diagnose lifetime AUDs. Chi-squares and multinomial logistic regressions were conducted to test our hypotheses.

RESULTS

Rates of lifetime ever gambling and weekly gambling were similar across the three ethnic groups, but participation in five types of gambling behavior differed. Chinese had the highest rates of gambling problems followed by Koreans and then Whites. Univariate odds ratios determined being Chinese or Korean, being male, and having an AUD were risk factors for gambling problems. When stratified by gender and ethnicity, having an AUD was not related to gambling problems in women, but was strongly associated with gambling problems in Chinese and White men and modestly associated in Korean men. This was true despite low rates of AUDs in Chinese men.

DISCUSSION AND CONCLUSIONS

Gambling problems were strongly comorbid with AUDs in Chinese- and White-American men, and moderately comorbid in Korean-American men. No relationship of AUD with gambling problems was found in women.

SCIENTIFIC SIGNIFICANCE

The results highlight the importance of assessing disaggregated Asian-American subgroups with respect to addictive behaviors and their comorbidity.

A Preliminary Study of an Integrated and Culturally Attuned Cognitive Behavioral Group Treatment for Chinese Problem Gamblers in Hong Kong

Chinese people may have a higher rate of gambling problems than other cultural groups. However, there are very few clinical outcome studies that have demonstrated the effectiveness of clinical interventions for helping Chinese gamblers. Cognitive behavioural therapy (CBT) has been found to be effective for helping problem gamblers to significantly reduce their gambling problems in western countries. Very few CBT clinical trials have been conducted with the Chinese populations, and the results were masked by methodological limitations. This preliminary study attempted to test the effectiveness of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. This study adopted a randomized control design and 38 participants were allocated randomly to the experimental condition (n = 18) and control condition (n = 20). The experimental group received 10 weekly CBT group sessions and individual counseling services while control group only received the individual counseling services. Significant decreases in gambling severity and frequencies of gambling were found in the experimental group. The findings also showed that a change in gambling cognitions predicted the changes in gambling severity and gambling urge while a change in gambling severity was also linked to a change in depression. Preliminary evidence highlights the potential benefits of an integrated and culturally attuned CBT group treatment for Chinese problem gamblers in Hong Kong. However, a more vigorous research design with a larger sample is needed to provide solid evidence of the effectiveness of the model for Chinese problem gamblers.

Demographic Risk Factors and Gambling Preference May Not Explain the High Prevalence of Gambling Problems Among the Population with Migration Background: Results from a German Nationwide Survey

There are high proportions of problem gamblers among individuals who themselves or whose parents immigrated to Germany. This study aimed to examine whether demographic risk factors and gambling preference may explain the higher prevalence of gambling problems among those with migration background (MB). Data was obtained from a nationwide telephone survey which was part of the project "Pathological Gambling and Epidemiology" (PAGE). The sample comprised 15,023 study participants aged 14-64 years living in Germany. Participants who had reported gambling within their lifetime (n = 6,406) were defined as gamblers and categorized according to their MB (n = 1,209 with MB), additional demographic characteristics (sex, age, marital status, household size, education, occupation), preferred types of gambling (21 categories covering the gambling types available in Germany), and the count of lifetime gambling problem symptoms (0-10 criteria of the fourth Diagnostic and Statistical Manual of Mental Disorders). Estimates from a negative binomial regression revealed that there is a 146.2% increase in the expected count of gambling problem symptoms for gamblers with MB compared to those without MB. The percentage decreased to 102.5 and 97.6% after adjustment for demographic characteristics and further adjustment for preferred types of gambling, respectively. Demographic risk factors and gambling preference may partially mediate but not completely explain the higher prevalence of gambling problems among the population with MB. Having an MB may be considered as an independent risk factor for gambling problems, which indicates a need for culturally sensitive prevention and treatment measures.

Suicidal ideation and familicidal-suicidal ideation among individuals presenting to problem gambling services: a retrospective data analysis

BACKGROUND

Studies have consistently reported high rates of suicidal ideation (SI) among individuals with disordered gambling. None have explored gambling-related familicidal-suicidal ideation (FSI).

AIMS

This study examined the (1) prevalence of SI and FSI among treatment-seeking gamblers in Hong Kong, (2) characteristic profile of factors associated with SI and FSI, and (3) factors that predict SI and FSI.

METHOD

This is a retrospective analysis of data collected at initial clinical assessments from a specialized gambling counseling centre in Hong Kong. Participants were gamblers (N = 3,686) who sought treatment at the centre between 2003 and 2012. Information about socio-gambling demographics, physical and mental health status, current presenting problems, self-rated South Oaks Gambling Screen (SOGS, Chinese version), and occurrence of SI or FSI were examined. Descriptive analysis and ordinal regression analysis were used to investigate the characteristics of the gamblers and the association of variables.

RESULTS

In our sample, 720 (20.0%) individuals reported SI, and 22 (0.6%) individuals reported FSI at the initial assessment. Individuals with SI and FSI differed from the nonsuicidal individuals in terms of their demographics, gambling experiences and severity, mental and physical wellbeing, and types of gambling-related problems. The adjusted ordinal regression model shows that participating in table games in casinos and having familial and financial problems seem to enhance the likelihood of having SI and FSI.

CONCLUSION

While mental health issues are significantly related to SI and FSI among gambling treatment seekers, the impacts of physical, family, and financial strains should not be underestimated.

Comorbid physical and mental illnesses among pathological gamblers: Results from a population based study in Singapore

The aim of the current study was to examine the comorbidity of pathological gambling with other mental and physical disorders as well as to examine health related quality of life perceived by those with pathological gambling using data from a community survey in Singapore. All respondents were administered the South Oaks Gambling Screen to screen for pathological gambling. The diagnosis of mental disorders was established using the Composite International Diagnostic Interview; while chronic physical conditions were established using a checklist. The weighted lifetime prevalence of pathological gambling was 2.7%. After multiple logistic regression, age 18-34 years (OR=5.3, 95% CI=1.6-17.4), male gender (OR=7.8, CI=3.8-16.2), widowhood (OR=4.2, 95% CI=1.02-17.5), and those with pre-primary (OR=17.1, CI=4.9-59.1), primary (OR=5.3, CI=1.7-16.6), and secondary education (OR=6, CI=2.5-14.7) had significantly higher odds of having pathological gambling. Those of Malay (OR=0.1, 95% CI=0.07-0.2) and Indian ethnicity (OR=0.2, 95% CI=0.1-0.3) had significantly lower odds of having pathological gambling compared to those of Chinese ethnicity. Pathological gamblers had significantly higher odds of having comorbid mental and physical disorders than non-gamblers/non-problem gamblers. The significant association of comorbid mental and physical disorders among those with pathological gambling indicates a need to screen for these disorders and for their subsequent treatment.

The Role of Cultural Factors in Differentiating Pathological Gamblers

It is recognised that cultural factors play a role in the onset and continuation of several mental health problems. However, there is a significant lack of empirical studies investigating the relationships between cultural factors and gambling behavior. This study assessed whether the subjective cultures through which subjects interpret and enact their experience of the social environment play a major role in increasing (or decreasing) the probability of pathological gambling. Participants, recruited in three different contexts (public health services for the treatment of addiction, casino, undergraduate course) were subjected to the South Oaks Gambling Screen (SOGS) (Lesieur and Blume in Am J Psychiatry 144(9):1184-1188, 1987), in order to identify a group of pathological gamblers-and with the Questionnaire on the Interpretation of the Social Environment (QUISE) (Mossi and Salvatore in Eur J Educ Psychol 4(2):153-169, 2011)-in order to detect their subjective cultures. The study compares pathological group (scoring >5 on SOGS, n = 34) and a healthy control group (scoring <1 on SOGS, n = 35). One-way analysis of variance (ANOVA) was used to compare groups on QUISE scores of subjective culture. Moreover, a logistic regression was applied in order to esteem the capability of the QUISE scores to differentiate between pathological gamblers and control. The results are consistent with the hypothesis that pathological group expresses different subjective cultures compared with no gambler subjects. The theoretical and clinical implications of the results are discussed.

Gratitude, hope, mindfulness and personal-growth initiative: buffers or risk factors for problem gambling?

The majority of prevention and intervention research in problem gambling (PG) has focused on identifying negative risk factors. However, not all at-risk individuals go on to develop anticipated disorders and many thrive in spite of them. In healthcare settings, PG and other disorders are typically conceptualized from the biomedical perspective that frame disorders as something negative residing within the individual and reduction in negativity is seen as success. Indeed, this problem-focused conceptualization may be adequate in many cases as reducing PG behaviour is undoubtedly an important outcome, but the focus on negativity alone is too narrow to capture the complexity of human behaviour. Hence, this study attempts to bridge the gap in literature by providing an evaluation of the predictive ability of the positive dispositions on problem gambling severity, gambling-related cognitions, and gambling urges. The positive psychological dispositions examined were curiosity, gratitude, hope, personal growth initiative, and mindfulness. Participants consisted of 801 Taiwanese Chinese students and community individuals (Mean age = 25.36 years). Higher levels of gratitude and hope have been found to predict lower PG, gambling-related cognitions, or gambling urges. Meanwhile, higher mindfulness predicted lower PG, but only among Chinese males. However, lower personal growth initiative predicted lower PG, gambling-related cognitions, and gambling urges. These analyses have small to medium effect sizes with significant predictions. Findings of this study have essential implications in understanding and treating Chinese problem gamblers. These positive dispositions should be addressed by mental health professionals in preventative and treatment programs among Chinese individuals. Further implications and suggestions for future research are discussed.

The General Relationship Between Universal Human Values and Adolescents' Problem/Pathological Gambling in Macao: A Parsimonious, Quantitative Model

This study modeled the general relationship between individual Macao adolescents' universal human values, measured by the Schwartz Values Inventory, and their problem/pathological gambling, indicated by the South Oaks Gambling Screen, using parsimonious, quantitative structural equation modeling. Data were collected through 471 questionnaires (261 females and 210 males) in 2010. Of the 10 value types in the Schwartz Values Inventory and derived value subtypes, only the human value subtype "nonfaith tradition" was found to be (negatively) related to problem/pathological gambling in the model. The corresponding factor loading was -0.07 (p = .015). This study was supported by the Education and Youth Affairs Bureau, the Government of Macao.

Problem gambling of Chinese college students: application of the theory of planned behavior

The present study, using the theory of planned behavior (TPB), investigated psychological correlates of intention to gamble and problem gambling among Chinese college students. Nine hundred and thirty two Chinese college students (aged from 18 to 25 years) in Hong Kong and Macao were surveyed. The findings generally support the efficacy of the TPB in explaining gambling intention and problems among Chinese college students. Specifically, the results of the path analysis indicate gambling intention and perceived control over gambling as the most proximal predictors of problem gambling, whereas attitudes, subjective norms, and perceived control, which are TPB components, influence gambling intention. Thus, these three TPB components should make up the core contents of the prevention and intervention efforts against problem gambling for Chinese college students.

The relationship between universal human values and adolescent problem and pathological gambling

This article derives statistical models relating adolescents' universal human values with their problem and pathological gambling. An adolescent's values are measured by the priority accorded to each value using the Schwartz Values Inventory, whereas problem or pathological gambling, if any, is indicated by his or her answers to the South Oaks Gambling Screen. Among other complex results, statistical analysis suggests that the value subtypes of "non-faith tradition," "faith tradition," and "macro-universalism" and the value type "stimulation" are associated with less problem and pathological gambling. Among other uses, such findings help identify high-risk adolescents.

The Singapore Mental Health Study: an overview of the methodology

The Singapore Mental Health Study (SMHS) is a population-based, cross-sectional, epidemiological study on the Singapore multi-ethnic adult population. This article provides an overview of the research design and methods used which took into consideration the unique characteristics of the country and its multi-ethnic population. A face-to-face household survey of Singapore residents aged 18 years and above was undertaken from 2009 to 2010. The nationally representative probability sample was derived using a disproportionate stratified sampling method. In order to increase precision for subgroup estimations the design was stratified with over-sampling of Malays, Indians and those aged 65 years and above. Respondents were assessed using the English, Chinese (computerized) and Malay (paper and pencil based) version of the Composite International Diagnostic Interview (CIDI) 3.0 to establish lifetime and 12-month prevalence of mental disorders, the current use of mental health services (both Western and traditional services), the treatment gaps and loss of role functioning.

Validation of the Chinese version of the gambling motivation scale (C-GMS)

The French items of the Gambling Motivation Scale (GMS) were first developed and validated by Chantal and colleagues in 1994. The scale then became one of the most widely used motivational scales in the gambling literature of the West. The present study recruited 932 Chinese university students in order to validate the Chinese version of the Gambling Motivation Scale (C-GMS). The results of a confirmatory factor analysis of the Chinese data supported the 7-factor model as proposed by Chantal et al. (Soc Leis 17:189-212, 1994). This study also found a second-order model with three major factors, which corresponded to three types of gambling motivation including self-determined motivation (for knowledge, for accomplishment, for stimulation, and due to identified regulation), non self-determined motivation (due to introjected regulation and external regulation), and amotivation. All subscales demonstrated satisfactory internal consistency, and showed significant correlations with gambling correlates such as problem gambling symptoms and gambling intention. In sum, the C-GMS showed adequate psychometric properties and can be extended for use with Chinese populations.

Psychometric evaluation of the Problem Gambling Severity Index-Chinese version (PGSI-C)

The purpose of this study was to examine the psychometric properties of the Chinese 9-item Problem Gambling Severity Index (PGSI) derived from the 31-item Canadian Problem Gambling Index (CPGI) originally developed by Ferris and Wynne (2001). Exploratory factor analysis (EFA; n = 386; Group A data) and confirmatory factor analysis (CFA; n = 387; Group B data) on the Chinese student and community data (Mean age = 25.36 years) showed that a unifactorial model fitted the data with good reliability score (Cronbach's alpha = 0.77). The concurrent validity of the PGSI-C was good in terms of the Chinese data matching the expected correlation between PGSI-C and other variables or scales such as SOGS, gambling frequency, gambling urge, gambling cognitions, depression, anxiety, and stress. The scale also reported good discriminant and predictive validity. In sum, the PGSI-C has good psychometric properties and can be used among Chinese communities to identify at-risk problem gamblers. Implications and suggestions for future research are discussed.

Impulsivity and pathological gambling: Is it a state or a trait problem?

Background

This study tested 37 Chinese male pathological gamblers and 40 controls to understand the relationship between pathological gambling and impulsivity as a long-term trait or a short-term state in the cognitive and affective domain.

Results

Trait impulsivity was measured by the Barratt Impulsiveness Scale-11. State impulsivity in the cognitive and affective domains were measured by the Stroop Color Word Test and the Emotional Conflict Task, respectively. The pathological gamblers scored significantly higher than the controls on the Barratt Impulsiveness Scale-11. However, there were no significant group differences in performance on the Stroop Color Word Test or the Emotional Conflict Task.

Conclusions

Findings clearly show that pathological gambling is associated with trait but not state impulsivity. In other words, pathological gambling is associated with an impulsivity stemming from enduring personality characteristics that lead gamblers to focus on short-term gains (trait impulsivity) rather than momentary cognitive or affective disinhibition (state impulsivity). Interventions should aim to change pathological gamblers' habitual functioning style by cultivating healthy reflection habits and focusing on long-term rewards.