Pathological Gambling, Gambling Disorder, and Problem Gambling Among the Chinese Ethnic Population Living in Western Countries: Is Culture a Sufficient Explanation for the Reported Excess Rates?

A significant gap remains in the understanding of the psychosocial and cultural factors and processes in the development and maintenance of pathological gambling, gambling disorder, and problem gambling among the Chinese ethnic population living in the Western countries. This narrative reviews papers on gambling and pathological gambling among the Chinese ethnic group in Western countries to provide a deeper understanding of the cultural and psychosocial factors and processes that lead to the development and maintenance of pathological gambling, gambling disorder, and problem gambling. The factors leading to development of problem gambling, which also carry distinctive cultural differences, include acculturation process among Chinese migrants to western countries, their social learning patterns in gambling, the patterns and motivation seen in Chinese gamblers, their gambling-related cognitive bias and distortions as well as barriers to their help-seeking behaviours. The collectivistic oriental culture may explain for intrafamilial development of gambling behaviour and this strong male authority in the traditional Chinese family set-up also reinforces this influence. The Chinese culture is associated with increased risk-taking behaviour. Superstitious thinking is more prevalent in the Chinese culture and this can be manifested in individuals' perceptions of fate and luck. Future research projects studying pathological gambling and ethnic minorities in the UK should seek greater understanding and improved management of this condition in a small but highly relevant population.

Clinical Profile and Psychiatric Comorbidity of Treatment-Seeking Individuals with Pathological Gambling in South-Africa

Pathological gambling is a prevalent and disabling mental illness, which is frequently associated with mood, anxiety, and substance use disorders. However, there is relatively little data on comorbidity in individuals with pathological gambling from low and middle income countries such as South-Africa. The Mini-International Neuropsychiatric Interview was used to assess the frequency of DSM-IV-TR disorders among 100 male and 100 female treatment-seeking individuals with pathological gambling in South-Africa. The Sheehan Disability Scale was used to assess functional impairment. In a South-African sample of individuals with pathological gambling, the most frequent current comorbid psychiatric disorders were major depressive disorder (28%), anxiety disorders (25.5%) and substance use disorders (10.5 %). Almost half of the individuals had a lifetime diagnosis of major depressive disorder (46%). Female pathological gamblers were significantly more likely to be diagnosed with a comorbid major depressive disorder or generalised anxiety disorder than their male counterparts. Data from South-Africa are consistent with previously published data from high income countries. Psychiatric comorbidity is common among individuals with pathological gambling.

Pathological gambling: a review of the literature

Most national surveys into gambling have concluded that there are more gamblers than non-gamblers. Although most gamblers can control their gambling behaviour, a small minority can suffer from pathological gambling. The acquisition, development and maintenance of pathological gambling is an area that is continually disputed and was only recognized as a bona fide mental disorder in the third edition of the Diagnostic and Statistical Manual (DSM-III, American Psychiatric Association 1980). The exact causes and reasons for continuing gambling behaviour seem to be dependent upon the individual, but there does seem to be some general underlying factors and reoccurring themes. This paper reviews the prevalence and history of pathological gambling and traces the phases of the pathological gambler's career. It is concluded that explanations of gambling behaviour (and particularly excessive gambling) are best served by an integrated biopsychosocial model, which stresses the individuality and idiosyncratic nature of the development of gambling problems.

Personality and problem gambling

Matched groups of problem and social gamblers were compared in terms of their locus of control and their responses to the Myers Briggs Type Indicator. Contrary to previous studies no significant differences occurred on the locus of control measure. It was hypothesized that problem gamblers would be more extraverted and intuitive than social gamblers. However, none of the four scales on the Myers Briggs Type Indicator showed a significant difference between the groups. These findings and the results of earlier studies are compared and discussed. Earlier studies are difficult to interpret because of inappropriate or inconsistent controls. It is suggested that future personality studies of problem gamblers differentiate between different types of gambling and different types of problem gamblers.