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Erschienen in: Journal of Gambling Studies 1/2014

01.03.2014 | Original Paper

Predictors of Treatment Outcome Among Asian Pathological Gamblers (PGs): Clinical, Behavioural, Demographic, and Treatment Process Factors

verfasst von: Song Guo, Victoria Manning, Kyaw Kyaw Wai Thane, Andrew Ng, Edimansyah Abdin, Kim Eng Wong

Erschienen in: Journal of Gambling Studies | Ausgabe 1/2014

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Abstract

Research on predictors of treatment outcome among pathological gamblers (PGs) is inconclusive and dominated by studies from Western countries. Using a prospective longitudinal design, the current study examined demographic, clinical, behavioural and treatment programme predictors of gambling frequency at 3, 6 and 12-months, among PGs treated at an addiction clinic in Singapore. Measures included the Hospital anxiety and depression scale, gambling symptom assessment scale (GSAS), personal well-being index (PWI), treatment perception questionnaire and gambling readiness to change scale. Treatment response in relation to changes in symptom severity, personal wellbeing and abstinence were also assessed. Abstinence rates were 38.6, 46.0 and 44.4 % at 3, 6 and 12-months respectively. Significant reductions in gambling frequency, GSAS, and improvement in PWI were reported between baseline and subsequent outcome assessments, with the greatest change occurring in the initial three months. No demographic, clinical, behavioural or treatment programme variable consistently predicted outcome at all three assessments, though treatment satisfaction was the most frequent significant predictor. However, being unemployed, having larger than average debts, poor treatment satisfaction and attending fewer sessions at the later stages of treatment were associated with significantly poorer outcomes, up to 1-year after initiating treatment. These findings show promise for the effectiveness of a CBT-based treatment approach for the treatment of predominantly Chinese PGs. Clinical implications and suggestions for future research are discussed. Taken together, the findings suggest early treatment satisfaction is paramount in improving short-term outcomes, with baseline gambling behaviour and treatment intensity playing a more significant role in the longer term.
Literatur
Zurück zum Zitat Alegría, A. A., Petry, N. M., Hasin, D. S., Liu, S. M., Grant, B. F., & Blanco, C. (2009). Disordered gambling among racial and ethnic groups in the US: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. CNS Spectrums, 14(3), 132–142.PubMedCentralPubMed Alegría, A. A., Petry, N. M., Hasin, D. S., Liu, S. M., Grant, B. F., & Blanco, C. (2009). Disordered gambling among racial and ethnic groups in the US: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. CNS Spectrums, 14(3), 132–142.PubMedCentralPubMed
Zurück zum Zitat Battersby, M., Tolchard, B., Scurrah, M., & Thomas, L. (2006). Suicide ideation and behaviour in people with pathological gambling attending a treatment service. International Journal of Mental Health and Addiction, 4(3), 233–246.CrossRef Battersby, M., Tolchard, B., Scurrah, M., & Thomas, L. (2006). Suicide ideation and behaviour in people with pathological gambling attending a treatment service. International Journal of Mental Health and Addiction, 4(3), 233–246.CrossRef
Zurück zum Zitat Blaszczynski, A., Huynh, S., Dumlao, V. J., & Farrell, E. (1998). Problem gambling within a Chinese speaking community. Journal of Gambling Studies, 14(4), 359–380.PubMedCrossRef Blaszczynski, A., Huynh, S., Dumlao, V. J., & Farrell, E. (1998). Problem gambling within a Chinese speaking community. Journal of Gambling Studies, 14(4), 359–380.PubMedCrossRef
Zurück zum Zitat Crisp, B. R., Thomas, S. A., Jackson, A. C., & Thomason, N. (2001). The influence of demographic, behavioural and treatment characteristics on problem gambling counselling outcomes. Australian Journal of Primary Health, 7(2), 32–36.CrossRef Crisp, B. R., Thomas, S. A., Jackson, A. C., & Thomason, N. (2001). The influence of demographic, behavioural and treatment characteristics on problem gambling counselling outcomes. Australian Journal of Primary Health, 7(2), 32–36.CrossRef
Zurück zum Zitat Cummins, R. A., Eckersley, R., Pallant, J., Van Vugt, J., & Misajon, R. (2003). Developing a national index of subjective wellbeing: The Australian Unity Wellbeing Index. Social Indicators Research, 64, 159–190.CrossRef Cummins, R. A., Eckersley, R., Pallant, J., Van Vugt, J., & Misajon, R. (2003). Developing a national index of subjective wellbeing: The Australian Unity Wellbeing Index. Social Indicators Research, 64, 159–190.CrossRef
Zurück zum Zitat Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2), 205–219.CrossRef Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2), 205–219.CrossRef
Zurück zum Zitat Dowling, N., & Cosic, S. (2011). Client engagement characteristics associated with problem gambling treatment outcomes. International Journal of Mental Health and Addiction, 9(6), 656–671.CrossRef Dowling, N., & Cosic, S. (2011). Client engagement characteristics associated with problem gambling treatment outcomes. International Journal of Mental Health and Addiction, 9(6), 656–671.CrossRef
Zurück zum Zitat Echeburúa, E., Fernández-Montalvo, J., & Báez, C. (2001). Predictors of therapeutic failure in slot-machine pathological gamblers following behavioural treatment. Behavioural and Cognitive Psychotherapy, 29(3), 379–383.CrossRef Echeburúa, E., Fernández-Montalvo, J., & Báez, C. (2001). Predictors of therapeutic failure in slot-machine pathological gamblers following behavioural treatment. Behavioural and Cognitive Psychotherapy, 29(3), 379–383.CrossRef
Zurück zum Zitat Foo, K. H., Merrick, P. L., & Kazantzis, N. (2006). Counseling/psychotherapy with Chinese Singaporean clients. Asian Journal of Counselling, 13(2), 271–293. Foo, K. H., Merrick, P. L., & Kazantzis, N. (2006). Counseling/psychotherapy with Chinese Singaporean clients. Asian Journal of Counselling, 13(2), 271–293.
Zurück zum Zitat Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., et al. (1995). The severity of dependence scale (SDS): Psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90(5), 607–614.PubMedCrossRef Gossop, M., Darke, S., Griffiths, P., Hando, J., Powis, B., Hall, W., et al. (1995). The severity of dependence scale (SDS): Psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction, 90(5), 607–614.PubMedCrossRef
Zurück zum Zitat Grant, J. E., Kim, S. W., & Kuskowski, M. (2004). Retrospective review of treatment retention in pathological gambling. Comprehensive Psychiatry, 45(2), 83–87.PubMedCrossRef Grant, J. E., Kim, S. W., & Kuskowski, M. (2004). Retrospective review of treatment retention in pathological gambling. Comprehensive Psychiatry, 45(2), 83–87.PubMedCrossRef
Zurück zum Zitat Higgins, L. T., Davey, G., Gao, X., & Ni, Z. J. (2008). Counselling in China: Past, present and future. Psychology and Developing Societies, 20(1), 99–109.CrossRef Higgins, L. T., Davey, G., Gao, X., & Ni, Z. J. (2008). Counselling in China: Past, present and future. Psychology and Developing Societies, 20(1), 99–109.CrossRef
Zurück zum Zitat Hodgins, D. C., Stea, J. N., & Grant, J. E. (2011). Gambling disorders. The Lancet, 378(9806), 1874–1884.CrossRef Hodgins, D. C., Stea, J. N., & Grant, J. E. (2011). Gambling disorders. The Lancet, 378(9806), 1874–1884.CrossRef
Zurück zum Zitat Hounslow, V., Smith, D., Battersby, M., & Morefield, K. (2011). Predictors of problem gambling severity in treatment seeking gamblers. International Journal of Mental Health and Addiction, 9(6), 682–695.CrossRef Hounslow, V., Smith, D., Battersby, M., & Morefield, K. (2011). Predictors of problem gambling severity in treatment seeking gamblers. International Journal of Mental Health and Addiction, 9(6), 682–695.CrossRef
Zurück zum Zitat Jackson, A., Thomas, S., & Blaszczynski, A. (2003). Best practice in problem gambling services. Melbourne: Gambling Research Panel. Jackson, A., Thomas, S., & Blaszczynski, A. (2003). Best practice in problem gambling services. Melbourne: Gambling Research Panel.
Zurück zum Zitat Kee, C. H. Y. (2004). Cultural features as advantageous to therapy: A Singaporean perspective. Journal of Systemic Therapies, 23(4), 67–79.CrossRef Kee, C. H. Y. (2004). Cultural features as advantageous to therapy: A Singaporean perspective. Journal of Systemic Therapies, 23(4), 67–79.CrossRef
Zurück zum Zitat Kim, S. W., Grant, J. E., Potenza, M. N., Blanco, C., & Hollander, E. (2009). The gambling symptom assessment scale (G-SAS): A reliability and validity study. Psychiatry Research, 166(1), 76–84.PubMedCentralPubMedCrossRef Kim, S. W., Grant, J. E., Potenza, M. N., Blanco, C., & Hollander, E. (2009). The gambling symptom assessment scale (G-SAS): A reliability and validity study. Psychiatry Research, 166(1), 76–84.PubMedCentralPubMedCrossRef
Zurück zum Zitat Lau, A. L. D., Cummins, R. A., & McPherson, W. (2005). An investigation into the cross-cultural equivalence of the Personal Wellbeing Index. Social Indicators Research, 72, 403–430.CrossRef Lau, A. L. D., Cummins, R. A., & McPherson, W. (2005). An investigation into the cross-cultural equivalence of the Personal Wellbeing Index. Social Indicators Research, 72, 403–430.CrossRef
Zurück zum Zitat LeBlond, J., Ladouceur, R., & Blaszczynski, A. (2003). Which pathological gamblers will complete treatment? British Journal of Clinical Psychology, 42(2), 205–209.PubMedCrossRef LeBlond, J., Ladouceur, R., & Blaszczynski, A. (2003). Which pathological gamblers will complete treatment? British Journal of Clinical Psychology, 42(2), 205–209.PubMedCrossRef
Zurück zum Zitat Lee, K. M. T., Guo, S., Manning, V., Thane, K., & Wong, K. E. (2011a). Are the demographic and clinical features of pathological gamblers seeking treatment in Singapore changing? Singapore Medical Journal, 52(6), 428–431.PubMed Lee, K. M. T., Guo, S., Manning, V., Thane, K., & Wong, K. E. (2011a). Are the demographic and clinical features of pathological gamblers seeking treatment in Singapore changing? Singapore Medical Journal, 52(6), 428–431.PubMed
Zurück zum Zitat Lee, K. M. T., Manning, V., Teoh, H. C., Winslow, M., Lee, A., Subramaniam, M., et al. (2011b). Stress-coping morbidity among family members of addiction patients in Singapore. Drug and Alcohol Review, 30(4), 441–447.PubMedCrossRef Lee, K. M. T., Manning, V., Teoh, H. C., Winslow, M., Lee, A., Subramaniam, M., et al. (2011b). Stress-coping morbidity among family members of addiction patients in Singapore. Drug and Alcohol Review, 30(4), 441–447.PubMedCrossRef
Zurück zum Zitat Leung, C., & Tsang, S. (2011). The profiles of gamblers seeking counseling services: Evidence from Chinese gamblers in Hong Kong. Asia Pacific Journal of Social Work and Development, 21(2), 62–76.CrossRef Leung, C., & Tsang, S. (2011). The profiles of gamblers seeking counseling services: Evidence from Chinese gamblers in Hong Kong. Asia Pacific Journal of Social Work and Development, 21(2), 62–76.CrossRef
Zurück zum Zitat Loo, J. M. Y., Raylu, N., & Oei, T. P. S. (2008). Gambling among the Chinese: A comprehensive review. Clinical Psychology Review, 28(7), 1152–1166.PubMedCrossRef Loo, J. M. Y., Raylu, N., & Oei, T. P. S. (2008). Gambling among the Chinese: A comprehensive review. Clinical Psychology Review, 28(7), 1152–1166.PubMedCrossRef
Zurück zum Zitat Marsden, J., Bacchus, L., Stewart, D., Griffiths, P., Clarke, K., Gossop, M., et al. (1998). The treatment perceptions questionnaire (TPQ): A brief questionnaire for assessing service satisfaction (unpublished manuscript). London: National Addiction Centre. Marsden, J., Bacchus, L., Stewart, D., Griffiths, P., Clarke, K., Gossop, M., et al. (1998). The treatment perceptions questionnaire (TPQ): A brief questionnaire for assessing service satisfaction (unpublished manuscript). London: National Addiction Centre.
Zurück zum Zitat Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18(2), 207–229.PubMedCrossRef Milton, S., Crino, R., Hunt, C., & Prosser, E. (2002). The effect of compliance-improving interventions on the cognitive-behavioural treatment of pathological gambling. Journal of Gambling Studies, 18(2), 207–229.PubMedCrossRef
Zurück zum Zitat Morasco, B. J., Pietrzak, R. H., Blanco, C., Grant, B. F., Hasin, D., & Petry, N. M. (2006). Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosomatic Medicine, 68(6), 976–984.PubMedCrossRef Morasco, B. J., Pietrzak, R. H., Blanco, C., Grant, B. F., Hasin, D., & Petry, N. M. (2006). Health problems and medical utilization associated with gambling disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosomatic Medicine, 68(6), 976–984.PubMedCrossRef
Zurück zum Zitat Neighbors, C., Lostutter, T. W., Larimer, M. E., & Takushi, R. Y. (2002). Measuring gambling outcomes among college students. Journal of Gambling Studies, 18(4), 339–360.PubMedCentralPubMedCrossRef Neighbors, C., Lostutter, T. W., Larimer, M. E., & Takushi, R. Y. (2002). Measuring gambling outcomes among college students. Journal of Gambling Studies, 18(4), 339–360.PubMedCentralPubMedCrossRef
Zurück zum Zitat Oei, T. P. S., & Raylu, N. (2010). Gambling behaviours and motivations: A cross-cultural study of Chinese and Caucasians in Australia. International Journal of Social Psychiatry, 56(1), 23–34.PubMedCrossRef Oei, T. P. S., & Raylu, N. (2010). Gambling behaviours and motivations: A cross-cultural study of Chinese and Caucasians in Australia. International Journal of Social Psychiatry, 56(1), 23–34.PubMedCrossRef
Zurück zum Zitat Petry, N. M. (2005). Stages of change in treatment-seeking pathological gamblers. Journal of Consulting and Clinical Psychology, 73(2), 312–322.PubMedCrossRef Petry, N. M. (2005). Stages of change in treatment-seeking pathological gamblers. Journal of Consulting and Clinical Psychology, 73(2), 312–322.PubMedCrossRef
Zurück zum Zitat Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66(5), 564–574.PubMedCrossRef Petry, N. M., Stinson, F. S., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66(5), 564–574.PubMedCrossRef
Zurück zum Zitat Raylu, N., & Oei, T. (2007). Factors that predict treatment outcomes in a community treatment agency for problem gamblers. International Journal of Mental Health and Addiction, 5(2), 165–176.CrossRef Raylu, N., & Oei, T. (2007). Factors that predict treatment outcomes in a community treatment agency for problem gamblers. International Journal of Mental Health and Addiction, 5(2), 165–176.CrossRef
Zurück zum Zitat Shek, D. T. L., Chan, E. M. L., & Wong, R. H. Y. (2012). Associations between pathological gambling and psychiatric comorbidity among help-seeking populations in Hong Kong. The Scientific World Journal, 2012, 1–15. Shek, D. T. L., Chan, E. M. L., & Wong, R. H. Y. (2012). Associations between pathological gambling and psychiatric comorbidity among help-seeking populations in Hong Kong. The Scientific World Journal, 2012, 1–15.
Zurück zum Zitat Slutske, W. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two US national surveys. American Journal of Psychiatry, 163, 297–302.PubMedCrossRef Slutske, W. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two US national surveys. American Journal of Psychiatry, 163, 297–302.PubMedCrossRef
Zurück zum Zitat Smith, S., Thomas, S., & Jackson, A. (2004). An exploration of the therapeutic relationship and counselling outcomes in a problem gambling counselling service. Journal of Social Work Practice, 18(1), 99–112.CrossRef Smith, S., Thomas, S., & Jackson, A. (2004). An exploration of the therapeutic relationship and counselling outcomes in a problem gambling counselling service. Journal of Social Work Practice, 18(1), 99–112.CrossRef
Zurück zum Zitat Stinchfield, R., Kushner, M. G., & Winters, K. C. (2005). Alcohol use and prior substance abuse treatment in relation to gambling problem severity and gambling treatment outcome. Journal of Gambling Studies, 21(3), 273–297.PubMedCrossRef Stinchfield, R., Kushner, M. G., & Winters, K. C. (2005). Alcohol use and prior substance abuse treatment in relation to gambling problem severity and gambling treatment outcome. Journal of Gambling Studies, 21(3), 273–297.PubMedCrossRef
Zurück zum Zitat Tang, C. S., Wu, A. M. S., & Tang, J. Y. C. (2007). Gender differences in characteristics of Chinese treatment-seeking problem gamblers. Journal of Gambling Studies, 23(2), 145–156.PubMedCrossRef Tang, C. S., Wu, A. M. S., & Tang, J. Y. C. (2007). Gender differences in characteristics of Chinese treatment-seeking problem gamblers. Journal of Gambling Studies, 23(2), 145–156.PubMedCrossRef
Zurück zum Zitat Toneatto, T., Skinner, W., & Dragonetti, R. (2002). Patterns of substance use in treatment-seeking problem gamblers: Impact on treatment outcomes. Journal of Clinical Psychology, 58(7), 853–859.PubMedCrossRef Toneatto, T., Skinner, W., & Dragonetti, R. (2002). Patterns of substance use in treatment-seeking problem gamblers: Impact on treatment outcomes. Journal of Clinical Psychology, 58(7), 853–859.PubMedCrossRef
Zurück zum Zitat Vong, F. (2007). The psychology of risk-taking in gambling among Chinese visitors to Macau. International Gambling Studies, 7(1), 29–42.CrossRef Vong, F. (2007). The psychology of risk-taking in gambling among Chinese visitors to Macau. International Gambling Studies, 7(1), 29–42.CrossRef
Zurück zum Zitat Walker, M., Toneatto, T., Potenza, M. N., Petry, N., Ladouceur, R., Hodgins, D. C., et al. (2006). A framework for reporting outcomes in problem gambling treatment research: The Banff Alberta Consensus. Addiction, 101(4), 504–511.PubMedCrossRef Walker, M., Toneatto, T., Potenza, M. N., Petry, N., Ladouceur, R., Hodgins, D. C., et al. (2006). A framework for reporting outcomes in problem gambling treatment research: The Banff Alberta Consensus. Addiction, 101(4), 504–511.PubMedCrossRef
Zurück zum Zitat Welte, J., Barnes, G., Wieczorek, W., Tidwell, M. C., & Parker, J. (2001). Alcohol and gambling pathology among US adults: Prevalence, demographic patterns and comorbidity. Journal of Studies on Alcohol, 62(5), 706–712.PubMed Welte, J., Barnes, G., Wieczorek, W., Tidwell, M. C., & Parker, J. (2001). Alcohol and gambling pathology among US adults: Prevalence, demographic patterns and comorbidity. Journal of Studies on Alcohol, 62(5), 706–712.PubMed
Zurück zum Zitat Winslow, M., Subramaniam, M., Qiu, S., & Lee, A. (2010). Socio-demographic profile and psychiatric comorbidity of subjects with pathological gambling. Annals of the Academy of Medicine, 39(2), 122–128. Winslow, M., Subramaniam, M., Qiu, S., & Lee, A. (2010). Socio-demographic profile and psychiatric comorbidity of subjects with pathological gambling. Annals of the Academy of Medicine, 39(2), 122–128.
Zurück zum Zitat Winters, K. C., & Kushner, M. G. (2003). Treatment issues pertaining to pathological gamblers with a comorbid disorder. Journal of Gambling Studies, 19(3), 261–277.PubMedCrossRef Winters, K. C., & Kushner, M. G. (2003). Treatment issues pertaining to pathological gamblers with a comorbid disorder. Journal of Gambling Studies, 19(3), 261–277.PubMedCrossRef
Zurück zum Zitat Yeo, C. (2004). Mind your mind: A preventive programme for the control of major mental disorders in Singapore. In S. Saxena & P. J. Garrison (Eds.), Mental health promotion: Case studies from countries (pp. 73–75). Geneva, Switzerland: World Health Organization. Yeo, C. (2004). Mind your mind: A preventive programme for the control of major mental disorders in Singapore. In S. Saxena & P. J. Garrison (Eds.), Mental health promotion: Case studies from countries (pp. 73–75). Geneva, Switzerland: World Health Organization.
Zurück zum Zitat Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.PubMedCrossRef Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.PubMedCrossRef
Metadaten
Titel
Predictors of Treatment Outcome Among Asian Pathological Gamblers (PGs): Clinical, Behavioural, Demographic, and Treatment Process Factors
verfasst von
Song Guo
Victoria Manning
Kyaw Kyaw Wai Thane
Andrew Ng
Edimansyah Abdin
Kim Eng Wong
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Journal of Gambling Studies / Ausgabe 1/2014
Elektronische ISSN: 1573-3602
DOI
https://doi.org/10.1007/s10899-012-9328-7

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