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Acculturation and the Help-Seeking Behaviour of Asian-Canadian Gamblers

This study explores the impact of acculturation on the attitudes towards seeking professional and informal help among Asian-Canadian gamblers. The research aims to understand the cultural variables that contribute to underutilization of treatment services in this population.

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Acculturation and the Help-Seeking Behaviour of Asian-Canadian Gamblers

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  1. Acculturation and the Help-Seeking Behaviour of Asian-Canadian Gamblers David Liang August 13th, 2007

  2. Rationale for Study • Rise of legalized gambling • Underutilization of gambling treatment services • Asian Canadians – cultural susceptibility to pathological gambling • Cultural variables to underutilization of treatment services • Bidirectional measure of acculturation • Measurement of informal help

  3. Acculturation • Two perspectives to the construct • Unidirectional (assimilation model) Low Acculturated High Acculturated (Low dominant, high heritage) (High dominant, low heritage) • Bidirectional (integration model) Low dominant High dominant Low heritage High heritage

  4. The Current Study • Bidirectional measure of acculturation • Measures of attitudes towards seeking professional psychological help, as well as attitudes towards seeking informal sources of help • Measure of gambling severity

  5. Research questions • How does bidirectional acculturation influence attitudes toward seeking professional help for gambling problems? • How does bidirectional acculturation influence attitudes toward seeking informal sources of help for gambling problems?

  6. Methodology

  7. Participants • 170 Asian-Canadian adults • Well-educated (average 15.8 years of education, 43% had over 4 years of post-secondary education) • Mostly middle-upper class • Fluent in English • 88% Canadian Citizens • 71% Chinese, 8% Korean, 7% Vietnamese, 7 other ethnicities at 3% or less • 57% female, 43% male • 82% with no previous therapy experience • On the CPGI • 35% no risk, 33% low risk, 28% moderate risk, 4% high risk

  8. Inclusion criteria • Inclusion criteria: • East Asian or Southeast Asian descent • Recruitment posters and online questionnaire clearly specified that participants must have engaged in gambling behaviour in the past 12 months

  9. Recruitment • Internet recruitment (snowballing method) - 166 participants • Psychology participant pool - 4 participants

  10. Measures • Demographics measure • Vancouver Index of Acculturation (VIA; Ryder, Alden, & Paulhus, 2000) • Attitudes Toward Seeking Professional Psychological Help Scale for Problem Gambling (ATSPPH-PG; Fischer & Farina, 1995; Hart & Frisch, 2006) • Attitudes Toward Seeking Informal Help Scale for Problem Gambling (ATSIH) • Canadian Problem Gambling Index (CPGI; Ferris & Wynne, 2001)

  11. Hypotheses • Hypothesis 1a: Acculturation to the Canadian culture (VIA mainstream scores) positively predicts help-seeking attitudes towards professional psychological services (ATSPPH-PG scores) (above and beyond demographic variables and gambling severity) • Hypothesis 1b: Acculturation to the mainstream Canadian culture (VIA mainstream scores) negatively predicts help-seeking attitudes towards informal help (ATSIH-PG scores) • Hypothesis 2a: Acculturation to the heritage Asian culture (VIA heritage scores) negatively predicts help-seeking attitudes towards professional psychological services (ATSPPH-PG scores) • Hypothesis 2b: Acculturation to the heritage Asian culture (VIA heritage scores) positively predicts help-seeking attitudes towards informal help (ATSIH-PG scores)

  12. Results

  13. Correlational analyses • Pearson product moment correlations • Between outcome variables (ATSPPH-PG and ATSIH-PG) and key predictor variables • Between outcome variables and demographic variables

  14. Correlation Table Key Variables **p < .01, *p < .05

  15. Correlations Between Demographic and Outcome Variables **p < .01, *p < .05

  16. Hierarchical Regression Procedure • Significant demographic variables entered in first step • CPGI scores (gambling severity) entered in second step • VIA-M and VIA-H (Canadian and Asian acculturation) entered in final step • Outcome variables • Regression 1: ATSPPH-PG (professional help-seeking attitudes) • Regression 2: ATSIH-PG (informal help-seeking attitudes)

  17. Hierarchical Regression – ATSPPH-PG ***p < .001, **p < .01, *p < .05

  18. Hypothesis 1a/1b- Hierarchical MRA – ATSPPH-PG

  19. Hierarchical Regression – ATSIH-PG **p < .01, *p < .05

  20. Hypothesis 2a/2b- Hierarchical MRA – ATSIH-PG

  21. Discussion

  22. Hypothesis 1a/1b – Canadian Acculturation Hypothesis 1a: Acculturation to the Canadian culture (VIA mainstream scores) positively predicts help seeking attitudes towards professional psychological services (ATSPPH-PG scores) (above and beyond demographic variables and gambling severity) Hypothesis 1b: Acculturation to the mainstream Canadian culture (VIA mainstream scores) negatively predicts help seeking attitudes towards informal help (ATSIH-PG scores) (above and beyond demographic variables and gambling severity) • VIA-M not a significant predictor of ATSPPH-PG or ATSIH-PG – hypothesis 1a/1b NOT supported • VIA-M was significantly correlated with both ATSPPH-PG and ATSIH-PG

  23. Interpretation of findings – Hypothesis 1 • Findings are inconsistent with previous research on acculturation and professional help-seeking • No research on attitudes toward seeking help from informal sources • Lack of variability in acculturation • Significant shared variance between Canadian acculturation and other culture-related variables in regression

  24. Shared Variance Between Cultural Predictors of ATSPPH-PG ATSPPH-PG .186* .202** Mainstream Acculturation English Proficiency .427**

  25. Shared Variance Between Cultural Predictors of ATSIH-PG ATSIH-PG .162* .184* .214** Mainstream Acculturation Generation Status .375** .427** .390*** English Proficiency

  26. Hypothesis 2a/2b –Heritage (Asian) Acculturation Hypothesis 2a: Acculturation to the heritage Asian culture (VIA heritage scores) negatively predicts help seeking attitudes towards professional psychological services (ATSPPH-PG scores) Hypothesis 2b: Acculturation to the heritage Asian culture (VIA heritage scores) positively predicts help seeking attitudes towards informal help (ATSIH-PG scores) • VIA-H not a significant predictor of ATSPPH-PG or ATSIH-PG scores – Hypothesis 2a and 2b NOT supported • VIA-H not correlated with attitudes toward help-seeking

  27. Interpretation of Findings: Hypothesis 2 • Inconsistent with previous research, however, heritage acculturation is relatively understudied • Identification to Asian culture may not be significant factor influencing attitudes toward seeking help for gambling problems • Asian conceptualization of mental illness may differ from Westerners, but they may not differ in their conceptualization of the factors that motivate help-seeking for problem gambling • Asian cultural identification may not be as important as Canadian culture for present sample

  28. Gambling Severity and Attitudes Toward Help-Seeking • Gambling severity was strongest predictor for attitudes toward professional and informal help for problem gambling • Negative relationship – contrary to previous research

  29. Gambling Severity and Attitudes Toward Help-Seeking CPGI SCORE

  30. Possible explanations • Prochaska and DiClemente’s transtheoretical model • Individual progresses through 4 linear stages of increasing readiness to change a problematic behaviour • Early stages: Individual may actively deny problem exists, may feel benefits of continuing gambling behaviour outweighs cost of seeking help, not motivated to behavioural change • Later stages: Committed to behavioural change, takes direct action • Because present sample is from general community, vast majority of present sample has not sought help for their gambling problem  early stages of change • Denial of problem and defense towards treatment may explain negative relationship between gambling severity and attitudes toward help-seeking • Transtheoretical model predicts that individuals in later stages of change would have more positive attitudes toward help-seeking  needs to be validated by future research with gamblers in treatment programs

  31. Possible explanations • Cultural characteristics of Asians • May utilize coping strategy known as avoidance coping (Sheu & Sedlacek, 2004) • Differentiation between gambling severity and adverse consequences from problem gambling • Freyer et al. (2006) found adverse consequences due to alcohol abuse to be significant positive predictor of attitudes toward seeking help for alcohol dependence, while alcoholism severity was not a predictor

  32. English fluency and Attitudes Toward Help-Seeking English Fluency

  33. English Fluency: Interpretation • Current findings consistent with previous research • English fluency not a predictor for ATSIH-PG because in informal support network  similar language, similar ethno-cultural background

  34. Gender • Predictor of ATSPPH-PG • Women had more positive attitudes toward professional help than men • Consistent with previous research (Addis & Mahalik, 2003) • May be problematic for PG because PG predominantly affects men (NESARC, 2002) • Reluctance by men to seek professional help may be due to traditional masculine gender role • However, gender not a predictor of ATSIH-PG • Men may feel more comfortable discussing vulnerabilities with social support network rather than a professional, and may also feel less obliged to uphold traditional gender role

  35. Gender and Attitudes Toward Help-Seeking

  36. Limitations • Characteristics of the sample • General population • Gambling severity • English proficiency • Acculturation • Snowballing recruitment method • Use of Web-based questionnaires

  37. Clinical Implications • Insight to why professional treatment for gambling is so underutilized • Incorporation of transtheoretical model into treatment protocols • Gender

  38. Future Directions • Inclusion of alternate cultural variables into the help-seeking model • Utilization of subscales of ATSPPH-PG and ATSIH-PG • Incorporation of transtheoretical theory into help-seeking model • Development of adverse consequences of gambling scale

  39. Conclusion • Several findings are consistent with previous research, while other findings are not • The unexpected results indicate that influence of cultural variables and gambling severity on help-seeking attitudes are still not well-understood • Findings contributed some answers to the research literature, but also valuable questions to be addressed in future investigations

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