Skip to main content
Log in

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

  • Original Paper
  • Published:
Journal of Gambling Studies Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • 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.

    PubMed Central  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • Dowling, N. (2009). Client characteristics associated with treatment attrition and outcome in female pathological gambling. Addiction Research and Theory, 17(2), 205–219.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Grant, J. E., Kim, S. W., & Kuskowski, M. (2004). Retrospective review of treatment retention in pathological gambling. Comprehensive Psychiatry, 45(2), 83–87.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Hodgins, D. C., Stea, J. N., & Grant, J. E. (2011). Gambling disorders. The Lancet, 378(9806), 1874–1884.

    Article  Google Scholar 

  • 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.

    Article  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 productsvol 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.

  • Kee, C. H. Y. (2004). Cultural features as advantageous to therapy: A Singaporean perspective. Journal of Systemic Therapies, 23(4), 67–79.

    Article  Google Scholar 

  • 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.

    Article  PubMed Central  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • LeBlond, J., Ladouceur, R., & Blaszczynski, A. (2003). Which pathological gamblers will complete treatment? British Journal of Clinical Psychology, 42(2), 205–209.

    Article  PubMed  Google Scholar 

  • 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.

    CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  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.

    Article  PubMed  Google 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.

  • 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.

    Article  PubMed Central  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Petry, N. M. (2005). Stages of change in treatment-seeking pathological gamblers. Journal of Consulting and Clinical Psychology, 73(2), 312–322.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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 

  • Slutske, W. (2006). Natural recovery and treatment-seeking in pathological gambling: Results of two US national surveys. American Journal of Psychiatry, 163, 297–302.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Vong, F. (2007). The psychology of risk-taking in gambling among Chinese visitors to Macau. International Gambling Studies, 7(1), 29–42.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    CAS  PubMed  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 

  • 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.

    Article  PubMed  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 

  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Victoria Manning.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guo, S., Manning, V., Thane, K.K.W. et al. Predictors of Treatment Outcome Among Asian Pathological Gamblers (PGs): Clinical, Behavioural, Demographic, and Treatment Process Factors. J Gambl Stud 30, 89–103 (2014). https://doi.org/10.1007/s10899-012-9328-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10899-012-9328-7

Keywords

Navigation