Predictors of Treatment Outcome Among Asian Pathological Gamblers (PGs): Clinical, Behavioural, Demographic, and Treatment Process Factors
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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.
KeywordsPathological gambling Predictors Demographics Treatment
Conflict of interest
The authors declare that they have no conflict of interest.
- Department of Statistics Singapore. (2010). Census of population 2010 statistical release 1: Demographic characteristics, education, language and religion. Retrieved April 2, 2012, from http://www.singstat.gov.sg/pubn/popn/c2010sr1.html.
- Foo, K. H., Merrick, P. L., & Kazantzis, N. (2006). Counseling/psychotherapy with Chinese Singaporean clients. Asian Journal of Counselling, 13(2), 271–293.Google Scholar
- Jackson, A., Thomas, S., & Blaszczynski, A. (2003). Best practice in problem gambling services. Melbourne: Gambling Research Panel.Google Scholar
- Jackson, A., Thomas, S., Thomason, N., & Ho, W. (2000). Longitudinal evaluation of the effectiveness of problem gambling counselling services, community education strategies and information products—vol 2: Evaluation of the effectiveness of the counselling interventions at breakeven problem gambling counselling services. Melbourne: Victorian Department of Human Services. Retrieved April 2, 2012, from http://www.edfac.unimelb.edu.au/problemgambling/docs/Publications/pg_volume2.pdf.
- 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.Google Scholar
- 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.PubMedCrossRefGoogle Scholar
- National Council of Problem Gambling. (2012). Report of survey on participation in gambling activities among Singapore residents. Retrieved April 2, 2012, from http://www.knowtheline.sg/pdf/2011_NCPG_Gambling_Participation_Survey_23_Feb_2012.pdf.
- 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.Google Scholar
- 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.Google Scholar
- 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.Google Scholar