Tian P. S. Oei

Pathological Gambling : A Comprehensive Review

Due to recent changes of gambling laws, accessibility to gambling has become more widespread and thus, there has also been an increase in the prevalence of pathological gambling (PG). The wide range of social, economic, and psychological problems associated with PG are well known. There is a need for better understanding of PG and this review attempts to do so. Literature searches using the Medline and PsycINFO databases were used. Critical examining of the literature showed that familial/genetic, sociological, and individual factors (e.g., an individuals personality, biochemistry, psychological states, and cognitions) are implicated in the development and maintenance of PG, yet at present, the evidences are not solid. Similarly, there have been a lot of theories for PG but again, none of them are solid enough to provide a clear understanding of PG. Recent psychological-based theories seem to provide some solid ground for further research. We highlight four areas for future consideration for research. (1) Most studies have generalized findings from one form of gambling to another. It is suggested that it is now not tenable to consider gambling as a single phenomenon that can explain all forms of gambling. (2) Almost all of the studies in the gambling literature are Western-based and the results are often generalized to other ethnic and cultural groups. There is now an urgent need to close this gap. (3) Future studies need to address methodological problems in the current gambling/PG literature. (4) Almost all of the gambling literature has focused on the issue of why people start gambling. It is suggested that looking at variables as to why people stop gambling in a single episode may be a more fruitful area of research then why people start gambling. This is because what motivates one to continue gambling, despite losses in a session and across sessions, is a characteristic that distinguishes nonproblem gamblers from problem gamblers and pathological gamblers (PGs).

A cognitive model of binge drinking: the influence of alcohol expectancies and drinking refusal self-efficacy.

While binge drinking-episodic or irregular consumption of excessive amounts of alcohol-is recognised as a serious problem affecting our youth, to date there has been a lack of psychological theory and thus theoretically driven research into this problem. The current paper develops a cognitive model using the key constructs of alcohol expectancies (AEs) and drinking refusal self-efficacy (DRSE) to explain the acquisition and maintenance of binge drinking. It is suggested that the four combinations of the AE and DRSE can explain the four drinking styles. These are normal/social drinkers, binge drinkers, regular heavy drinkers, and problem drinkers or alcoholics. Since AE and DRSE are cognitive constructs and therefore modifiable, the cognitive model can thus facilitate the design of intervention and prevention strategies for binge drinking.

Gambling among the Chinese: A comprehensive review

Despite being a significant issue, there has been a lack of systematic reviews on gambling and problem gambling (PG) among the Chinese. Thus, this paper attempts to fill this theoretical gap. A literature search of social sciences databases (from 1840 to now) yielded 25 articles with a total sample of 12,848 Chinese community participants and 3397 clinical participants. The major findings were: (1) Social gambling is widespread among Chinese communities as it is a preferred form of entertainment. (2) Prevalence estimates for PG have increased over the years and currently ranged from 2.5% to 4.0%. (3) Chinese problem gamblers consistently have difficulty admitting their issue and seeking professional help for fear of losing respect. (4) Theories, assessments, and interventions developed in the West are currently used to explain and treat PG among the Chinese. There is an urgent need for theory-based interventions specifically tailored for Chinese problem gamblers. (5) Cultural differences exist in patterns of gambling when compared with Western samples; however, evidence is inconsistent. Methodological considerations in this area of research are highlighted and suggestions for further investigation are also included. (6) Much of gambling research has focused on identifying risk factors and at-risk individuals. It is essential to balance this knowledge with a focus on fundamental character strengths, which act as protective factors and motivate one to refrain from gambling.

Differential causal roles of Dysfunctional Attitudes and Automatic Thoughts in depression

This research tested an integrated model derived form Becks cognitive theory of depression. The integrated model postulated dysfunctional attitudes as a cognitive moderator and automatic thoughts as a cognitive mediator in the relationship between negative life events and depressive symptoms. In Study 1, 355 undergraduates completed the Life Experiences Survey, the Dysfunctional Attitude Scale, the Automatic Thoughts Questionnaire, and the Beck Depression Inventory. In general, the structural equation analyses confirmed not only the integrated model but also the symptom model, one of the competing models, where negative cognitions are a consequence of depression. Study 2 reexamined the two models with two-wave panel data of 200 undergraduates who completed the four scales twice, with 3 months between testing sessions. The structural equation analyses on these data also confirmed both of the two models. These results were discussed in relation to the possibility of a model with a vicious circle between negative cognitions and depression.

Is Alcohol a Cofactor of HIV and AIDS? Evidence From Immunological and Behavioral Studies

The authors aim to critically examine empirical research on the effects of alcohol on HIV and AIDS from the immunological and behavioral fields. In vitro immunological studies demonstrate that social drinking increases the susceptibility of human cells to HIV infection. Animal studies show that acute and chronic alcohol ingestion increases rate of progression from retrovirus to clinical illness. In humans with HIV, no experimental evidence shows that alcohol is a cofactor of AIDS. Findings from behavioral studies show that a link between social drinking and risk of HIV is weak. No experimental evidence demonstrates that chronic drinking influences rate and course of disease progression to AIDS in humans who are HIV+. It is premature to promote the role of alcohol as a cofactor in HIV and AIDS.

To drink or not to drink: The differential role of alcohol expectancies and drinking refusal self-efficacy in quantity and frequency of alcohol consumption

Structural equation modeling was used to examine the relationships between alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE) beliefs on the one hand, and quantity and frequency aspects of alcohol consumption on the other, in a sample of 118 undergraduate students. Specific expectancies that alcohol increases assertiveness and that the subject would have poor control over drinking were directly related to the consumption of larger quantities of alcohol per drinking occasion. Drinking refusal self-efficacy was related inversely to frequency of drinking: Subjects with high opportunistic DRSE and high social pressure DRSE drank less frequently. Females drank less per drinking occasion, drank less frequently, had a lower expectancy that alcohol increases assertiveness, expected to have greater control over their drinking, and had higher opportunistic DRSE than did males. The findings indicate that AE and DRSE play different roles in influencing the frequency and quantity of alcohol consumption. The implication of these findings for future research is discussed.

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

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

Development of a drinking self-efficacy questionnaire

Self-efficacy has been postulated as a construct of central importance in the acquisition, maintenance, and treatment of addictive behavior. To date research has largely examined the role of outcome expectancies but literature on the relationship of self-efficacy and drinking is still unclear. This paper describes the development and psychometric properties of a Drinking Self-Efficacy Questionnaire (DSEQ). In Study I, 251 students were used to test the factor structure of the DSEQ. Factor analysis of the DSEQ showed three clear factors accounting for 60% of the common variance. These factors can be summarized as self-efficacy in situations characterized by social pressure, opportunistic drinking, and emotional relief. Study II used 138 people from a general community sample and discriminant analyses showed that the DSEQ has good discriminant validity. The findings suggest that the DSEQ has potential for use in research examining the role of drinking self-efficacy in problem drinkers.

Is Group More Cost Effective than Individual Cognitive Behaviour Therapy? The Evidence is not Solid Yet

This paper critically evaluates the empirical evidence of 36 studies regarding the comparative cost-effectiveness of group and individual cognitive behaviour therapy (CBT) as a whole, and also for specific mental disorders (e.g. depression, anxiety, substance abuse) or populations (e.g. children). Methods of calculating costs, as well as methods of comparing treatment outcomes were appraised and criticized. Overall, the evidence that group CBT is more cost-effective than individual CBT is mixed, with group CBT appearing to be more cost effective in treating depression and children, but less cost effective in treating drugs and alcohol dependence, anxiety and social phobias. In addition, methodological weaknesses in the studies assessed are noted. There is a need to improve cost calculation methodology, as well as more solid and a greater number of empirical cost-effectiveness studies before a firm conclusion can be reached that group CBT is more cost effective then individual CBT.

The relationship of positive and negative alcohol expectancies to patterns of consumption of alcohol in social drinkers.

Negative alcohol expectancies have recently come to occupy a more important position in the expectancy literature, but recent claims that positive expectancies are unimportant in the consumption of alcohol when compared with negative expectancies are based on potentially flawed methodology. This study investigated the relative contribution of positive and negative expectancies to the consumption of alcohol using an instrument designed to measure both positive and negative expectancies. One hundred ninety-three men and women from the general community participated in the study. Findings showed while negative expectancies accounted for the greater proportion of variance of frequency of consumption, positive expectancies remained an important predictor of consumption, accounting for the greater proportion of variance of quantity consumed per session. The interesting but sometimes counterintuitive directions of these relationships can be explained in terms of social learning principles. The relatively neglected concept of negative expectancies is worthy of further use and investigation.