Acculturation and the Help-Seeking
Behaviour of Asian-Canadian
Gamblers
David Liang
August 13th, 2007
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
Acculturation

-
Two perspectives to the construct
Unidirectional (assimilation model)
Low Acculturated
(Low dominant, high heritage)
-
High Acculturated
(High dominant, low heritage)
Bidirectional (integration model)
Low dominant
Low heritage
High dominant
High heritage
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
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?
Methodology
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
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
Recruitment

Internet recruitment (snowballing method)
- 166 participants

Psychology participant pool
- 4 participants
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)
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 helpseeking 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)
Results
Correlational analyses
 Pearson
product moment correlations
 Between outcome variables (ATSPPHPG and ATSIH-PG) and key predictor
variables
 Between outcome variables and
demographic variables
Correlation Table Key Variables
1
1 ATSPPH-PG
2
3
4
5
-
2 ATSIH-PG
.273**
-
3 ATSIH #1
.211*
.302**
-
4 VIA-M
.186*
.214**
.161*
-
5 VIA-H
-.019
.075
.166*
.125
-
6 CPGI
-.335*
-.160*
-.061
-.050
.104
**p < .01, *p < .05
6
-
Correlations Between Demographic
and Outcome Variables
ATSPPH-PG
ATSIH-PG
Age
.167*
-.024
Gender
-.180*
-.066
Years of Education
.211**
.083
SES Composite
.095
.135
Generation status
.041
.164*
.204**
.155*
Previous therapy experience
.131
-.064
Country of birth
-.011
.099
Immigration status
.031
.149
Years in Canada
.105
.146
Number of Siblings
.023
-.014
English Proficiency
**p < .01, *p < .05
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 helpseeking attitudes)
Regression 2: ATSIH-PG (informal help-seeking
attitudes)
Hierarchical Regression –
ATSPPH-PG
Variable
B
SE B
β
Step 1
ΔR²
.147***
Age
.022
.010
.194*
Years of
Education
.049
.026
.156
English
Proficiency
.230
.069
.255**
Gender
-.199
.069
-.219**
Step 2
CPGI
R²
-.385
.109
.062**
.218***
.009
-.261**
Step 3
VIA-M
.039
.031
.104
VIA-H
.003
.026
.008
***p < .001, **p < .01, *p < .05
.209***
Hypothesis 1a/1b- Hierarchical
MRA – ATSPPH-PG
Age
Sex
English Fluency
Years of education
CPGI
VIA-M
VIA-H
B
Beta
Sig.
.019
-.150
.158
.038
-.381
.039
.003
.170
-.165
.175
.121
-.258
.104
.008
.052
.031
.039
.150
.001
.911
.203
Hierarchical Regression –
ATSIH-PG
Variable
B
SE B
β
Step 1
.132
.077
.143
English Proficiency
.083
.066
.106
Step 2
-.217
.100
.071**
.027*
.089*
.018
-.169*
Step 3
VIA-M
.043
.029
.132
VIA-H
.017
.024
.055
**p < .01, *p < .05
ΔR²
.043*
Generation status
CPGI
R²
Hypothesis 2a/2b- Hierarchical
MRA – ATSIH-PG
Generation Status
English Fluency
CPGI
VIA-M
VIA-H
B
Beta
Sig.
.126
.028
-.217
.043
.017
.136
.036
-.169
.029
.024
.116
.681
.032
.136
.478
Discussion
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
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
Shared Variance Between Cultural
Predictors of ATSPPH-PG
ATSPPH-PG
.186*
.202**
Mainstream
Acculturation
English
Proficiency
.427**
Shared Variance Between Cultural
Predictors of ATSIH-PG
ATSIH-PG
.162*
.184*
.214**
Mainstream
Acculturation
.375**
.427**
Generation Status
.390***
English Proficiency
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
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
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
Gambling Severity and Attitudes
Toward Help-Seeking
2
1.8
ATSPPH-PG
ATSIH-PG
1.6
1.4
1.2
0
1
2
3
4
CPGI SCORE
5
6
7+
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 helpseeking
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
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
English fluency and Attitudes
Toward Help-Seeking
2
1.9
1.8
1.7
ATSPPH-PG
ATSIH-PG
1.6
1.5
1.4
1.3
Very fluent Fairly fluent Somewhat
fluent
English Fluency
Not very
fluent
English Fluency: Interpretation

Current findings consistent with previous
research
 English fluency not a predictor for ATSIHPG because in informal support network 
similar language, similar ethno-cultural
background
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
Gender and Attitudes Toward HelpSeeking
1.95
1.9
1.85
ATSPPH-PG
ATSIH-PG
1.8
1.75
1.7
Female
Male
Limitations

Characteristics of the sample
- General population
- Gambling severity
- English proficiency
- Acculturation
 Snowballing recruitment method
 Use of Web-based questionnaires
Clinical Implications

Insight to why professional treatment for
gambling is so underutilized
 Incorporation of transtheoretical model into
treatment protocols
 Gender
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
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 wellunderstood
 Findings contributed some answers to the
research literature, but also valuable questions
to be addressed in future investigations