Associations between pathological gambling and psychiatric comorbidity among help-seeking populations in Hong Kong
Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. Hence, Shek, Chan & Wong conducted a study in Hong Kong (findings published in 2012) with the following objectives: (a) determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b) compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c) explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (𝑁 = 2 0 1) who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants (𝑁 = 128) had comorbid psychiatric disorders in their lifetime, whereas 44.8% of participants (𝑁 = 90) had at least one comorbid psychiatric disorder at the time of evaluation. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders. (Extract from the abstract of Shek, Chan & Wong (2012))
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, Article ID 571434, 15 pages. doi:10.1100/2012/571434 https://www.hindawi.com/journals/tswj/2012/571434/
Blaszczynski和Nower根據其多年對賭博失調者的研究，於2002年就賭博失調者的特質提出了一個概念理論模型 – 路徑模型 (the pathways model) 。路徑模型綜合了生物學、人格學、心理社會發展理論、認知學、學習理論以及賭博失調者的生態決定因素，是一個可被經驗測試的模式，在這模型下，賭博失調者可分為三個獨特的類別，即 （一）行為習慣化的賭博失調者(behaviourally conditioned problem gamblers)，（二）情緒脆弱的賭博失調者 (emotionally vulnerable problem gamblers)，以及（三）反社會及衝動的賭博失調者(antisocial impulsivist problem gamblers)。
Chan, C. C., & Ohtsuka, K. (2011). Pathways to development of problem gambling among Chinese gamblers in Hong Kong: Validation of the Blaszczynski and Nower (2002) Model.Asian Journal of Gambling Issues and Public Health, 2: 17–28.
Wong conducted an investigation on the prevalence of gambling involvement and pathological gambling among students aged 12 to 17 years in Hong Kong, and investigated the correlates of problem gambling. The findings were published in 2010. In this study, the DSM-IV-MR-J was completed by 1,001 students. The response rate was 89.3%. Sixty percent of the participants gambled in the previous year, 69% were infrequent players who bet less than 4 times a month, and 4.8% gambled at least once a day. Most (89.8%) wagered less than HK$100 a week, only 3.1% staked over HK$500, and 24% borrowed money to finance their gambling activities. The majority (78.6%) had started gambling before the age of 15 years. One-fifth (21.5%) transferred gambling payments at the betting venues, 44.7% were assisted by their parents and 19.7% were helped by peers. Using the DSM-IV criteria, 3.4% and 1.8% of the participants could be classified as pathological and problem gamblers, respectively. Significant gender (χ 2(1)=8.3, p < 0.01) and age differences (χ 2(7)=21, p < 0.01) were noted for such gambling addiction. Pathological and problem gambling were significantly correlated with age (r= 0.44, p < 0.01), gambling frequency (r= 0.41, p < 0.001), gender (r= 0.33, p < 0.01), early initiation (r= −0.31, p < 0.05), psychiatric disturbances (r= 0.25, p < 0.001), as well as parents (r= 0.21, p < 0.01) and peers (r= 0.18, p < 0.05) having gambling problems. The findings have implications for preventive initiatives. (Abstract extracted from Wong (2010))
Wong & So於2014年發表了一份就香港12至19歲青少年的互聯網賭博活動和病態賭博的研究報告。該項研究透過隨機抽班方法，徵得1,004名學生（597名男生，407名女生） 填寫 《青少年賭博行為量表》（DSM-IV-MR-J）（Fisher, 2000），回應率為86.6％。結果顯示，參與傳統 (非互聯網) 賭博的受訪者比參與互聯網賭博的受訪者更多（63.5％對3.5％），但網絡賭客成為危機賭徒及病態賭徒的風險比非網絡賭客更高(為1.5倍和3.2倍)。根據DSM-IV-MR-J標準，5.7％和22.9％的網絡賭客可分別被識別為危機賭徒和病態賭徒。受訪的網絡賭客大多數（94.3％）在家中網上下注 ，91.4％在18歲前首次網上下注，60％在12歲前首次網上下注，他們大多視互聯網賭博為潮流（71.4％）和安全（54.3％）的娛樂。結果顯示，有問題的互聯網賭博與性別(男性)、(較高)年級、網上賭博頻率、投注額以及家中賭博環境顯著相關。該調查結果對賭博研究和防賭計劃有所啟示。
Wong & So conducted an investigation on internet gambling involvement and pathological gambling among Hong Kong adolescents aged 12–19 years, which findings were published in 2014. In this study, the diagnostic and statistical manual (4th edition) multiple response format for juveniles (DSM-IV-MR-J) (Fisher in J Gambl Stud 16:253–273, 2000) was filled by 1,004 students (597 boys, 407 girls) recruited by random selection of classes. The response rate was 86.6 %. Results indicate that more respondents participated in land-based gambling than Internet gambling (63.5 vs. 3.5 %) but online gamblers are 1.5 and 3.2 times more likely to develop pathological and at-risk gambling than non-Internet gamblers. Using the DSM-IV-MR-J criteria, 5.7 and 22.9 % of the Internet gamblers could be classified as at-risk gamblers and pathological gamblers, respectively. Majority (94.3 %) wagered online at home, and 91.4 % made their first bet before 18 years. Many perceived Internet gambling as a trendy (71.4 %) and safe entertainment (54.3 %). Problematic Internet gambling was significantly associated with the male gender, school grades, online gambling frequency, amount wagered and a gambling family environment. Survey results have implications for gambling research and preventive programs. (Abstract extracted from Wong & So (2014))