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Family resilience refers to the processes through which a family adapts to and bounces back from adversities. Pandemic burnout refers to feeling emotionally exhausted, cynical, and lack of accomplishment during the pandemic and/or toward various preventive polices and measures. This two-wave, region-wide, longitudinal study included 796 adult participants residing in mainland China. Participants completed online surveys at two time points during the COVID-19 pandemic. Time 1 (T1) survey was conducted when the number of new infected cases in China stabilized, while Time 2 (T2) was conducted 5 months later when there was a sudden surge of new infected cases. Results of a hierarchical regression analysis revealed that the interaction and main effects of pandemic burnout and family resilience at T2 showed significant incremental prediction of depression and anxiety at T2, after controlling for demographic as well as individual and family resilience at T1. These results supported the hypotheses that current family resilience functions as a protective factor, whereas pandemic burnout functions as a risk factor of mental health during successive waves of pandemic outbreaks. In particular, family resilience at T2 mitigated the negative impact of high pandemic burnout on anxiety and depression at T2.

Given that the perinatal period is a time of increased risk for pregnant women to manifest mental health problems, the identification of antenatal hypomanic symptoms is particularly important. However, data on antenatal hypomanic symptoms is lacking. The present study was aimed at filling this research gap by investigating the prevalence of hypomanic symptoms, including the "active-elated" and "irritable/risk-taking" sides of hypomanic symptoms at the first trimester, and examining their associations with anxiety and depressive symptoms at the following time points: the first trimester, the second trimester, and up to 6-week postpartum. A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 229 pregnant Chinese women in Hong Kong was assessed. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32). Of the sample, 43.6% had elevated levels of hypomanic symptoms in the first trimester. Multiple regression analysis showed that after adjusting for potential confounding factors, irritable/risk-taking symptoms were independently associated with higher anxiety symptoms in the first and second trimesters and in the 6-week postpartum period. Primary healthcare practitioners should be made aware of antenatal hypomanic symptoms in pregnant women to facilitate early identification and intervention for anxiety and depression to improve the well-being of both mothers and infants.

Objective Addiction-like eating (AE) is characterized by food cravings and loss of control over excessive food consumption. This study investigated the associations among emotional factors, personality traits, and AE symptoms in Asian young adults. Method This study included 6,823 Asian university students in South Korea, China, Singapore, Hong Kong/Macao, Japan, and Taiwan. Participants completed the modified Yale Food Addiction Scale (mYFAS) and scales on the Big-Five personality traits, impulsivity, anxiety, and depression. Results 6.2% of the participants met the mYFAS (DSM-IV-TR) food addiction diagnostic threshold. Participants from South Korea (7.9%) had the highest rate of food addiction, while participants from Japan (5.1%) and Taiwan (4.1%) reported the lowest rates. Emotional factors of anxiety and depression were the most robust correlates of AE symptoms, followed by country/region and personality factors of higher impulsivity, higher extraversion, and lower agreeableness. Personality correlates were region-specific. Higher impulsivity was a significant correlate for participants from South Korea and Taiwan, higher extraversion for participants from Singapore and Japan, and lower agreeableness for participants from China and Taiwan. Gender was also a significant correlate for participants from South Korea, Hong Kong/Macao, and Taiwan. Discussion Emotional and personality factors are important correlates of AE symptoms among Asian young adults.

This study examined the phenomenon of sibling violence in Singapore. The underlying mechanisms through which maternal authoritativeness and maladaptive coping influenced psychological adjustment following sibling violence were also investigated. Questionnaires were administered to 287 female and 128 male Singaporean college students between the ages of 18 to 27. Results showed that lifetime and past-year prevalence estimates of sibling violence in college students in Singapore were 89.9% and 62.0%, respectively. Lifetime psychological sibling violence involvement and past-year sibling violence involvement (both physical and psychological) were significantly related to maladaptive coping and overall psychological adjustment; lifetime sibling violence involvement was significantly related to maternal authoritativeness, anxiety, and depression only. Maladaptive coping was found to be a significant mediator between past-year physical and psychological sibling violence involvement and two measures of psychological adjustment, anxiety and depression. Maternal authoritativeness functioned as a moderator only for the relationship between past-year psychological sibling violence exposure and psychological adjustment. At low but not high levels of maternal authoritativeness, past-year psychological violence involvement was significantly related to higher levels of anxiety and depression, and lower levels of self-esteem. These findings show that sibling violence is a pervasive problem in Asian countries as well, such as in Singapore. There is a need to educate both the public and the relevant authorities so that steps can be taken to protect those who have experienced or are at risk of experiencing such violence. Through elucidating the role of maternal authoritativeness and maladaptive coping, the present study also suggests new avenues for interventions to reduce the adverse effects of sibling violence. Limitations and future directions are also discussed.

Background Pregnancy is a time of increasing vulnerability to the development of body dissatisfaction, anxiety, and depression. The present study aims to examine associations of body dissatisfaction with anxiety and depression at the following points: 6 months before pregnancy (retrospective report); in the first, second, and third trimesters of pregnancy; and up to 6 weeks postpartum. Methods A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,371 Chinese pregnant women in Hong Kong was assessed using standardized instruments at four time points. Results A mixed-effects model with repeated measures revealed that body dissatisfaction and depression symptoms changed across different stages of pregnancy. Hierarchical multiple regressions showed that, after adjusting for the identified risk factors, body dissatisfaction before and during pregnancy were positively associated with antenatal anxiety and depression symptoms. Concurrent body dissatisfaction was positively associated with postpartum depression symptoms. Limitations There was a high attrition rate in the follow-up assessments. Antenatal anxiety symptoms were assessed using the scale for general anxiety, which may not adequately capture the experience of anxiety among pregnant women. Conclusions Primary healthcare practitioners should be made aware of body dissatisfaction among pregnant women in order to facilitate early intervention for anxiety and depression, because untreated psychological disturbance during pregnancy may persist into the postpartum period.

Family resilience, which refers to the processes through which a family adapts to and thrives from adversities, has growing importance in recent years. In response to the need for further research on family resilience, the present research aims to abbreviate and validate Sixbey's Family Resilience Assessment Scale (FRAS) into a 16-item version Family Resilience Scale Short Form in the US (FRS16) and Chinese (FRS16_C) samples. The samples included 1,236 (Study 1) and 1,135 (Study 2) participants from the US and China, respectively. Results of confirmatory factor analysis (CFA) supported the proposed three-factor structure of FRS16: Family Communication and Connectedness, Positive Framing, and External Support across two samples. Overall, the reliability and validity of full and subscales of FRS16 and FRS16_C were satisfactory. Multi-group CFA revealed that both configural and metric invariance are supported, suggesting that participants in the US and Chinese samples assign comparable meaning to the latent factors of FRS16. Results suggested that FRS16 and FRS16_C are valid instruments for family resilience in the US and Chinese samples.

Objective: This study aims to evaluate the reliability and validity of the translated Chinese-Cantonese version of the Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R) in a sample of pregna...

Adverse Childhood Experiences (ACEs) increase developmental vulnerabilities for adult psychopathology, and behavioural addictions in particular. However, our understanding of the common psy...

Objectives This study aimed to determine the relative risks of addiction to the Internet, online gaming and online social networking of college students in six Asian countries/regions (Singapore, Hong Kong [HK]/Macau, China, South Korea, Taiwan and Japan) compared with students in the United States (US). It also explored the relative risks of depression and anxiety symptoms among students with Internet-related addictions from these countries/regions. Study design This is a cross-sectional survey. Methods A convenience sample of 8067 college students aged between 18 and 30 years was recruited from seven countries/regions. Students completed a survey about their use of the Internet, online gaming and online social networking as well as the presence of depression and anxiety symptoms. Results For all students, the overall prevalence rates were 8.9% for Internet use addiction, 19.0% for online gaming addiction and 33.1% for online social networking addiction. Compared with the US students, Asian students showed higher risks of online social networking addiction but displayed lower risks of online gaming addiction (with the exception of students from HK/Macau). Chinese and Japanese students also showed higher risks of Internet addiction compared with the US students. In general, addicted Asian students were at higher risks of depression than the addicted US students, especially among Asian students who were addicted to online gaming. Addicted Asian students were at lower risks of anxiety than the addicted US students, especially among Asian students who were addicted to online social networking, and addicted students from HK/Macau and Japan were more likely to have higher relative risks of depression. Conclusions There are country/regional differences in the risks of Internet-related addictions and psychiatric symptoms. It is suggested that country/region-specific health education programmes regarding Internet-related addictions are warranted to maximise the efficiency of prevention and intervention. These programmes should attempt to tackle not only problematic Internet-related behaviours but also mood disturbances among college students.

The effects of psychoeducation on thought–action fusion (TAF) beliefs are understudied. We tested whether adding mock electroencephalography (EEG)-based computer trials that induce cognitive dissonance about TAF beliefs, prior to TAF-specific psychoeducation, would enhance and maintain the reduction of TAF beliefs. An unselected sample of 140 Singaporean undergraduates (89 females, 51 males) was randomly assigned to a combined intervention, TAF-specific psychoeducation-only, or control group. Self-report measures of TAF beliefs and cognitive dissonance about TAF beliefs were administered 4 times in the initial session, and once at 1-month follow-up. Findings included the following: (a) greatest cognitive dissonance about TAF beliefs in the initial session with the combined intervention; (b) greater reduction in TAF beliefs in the initial session in both intervention groups, compared with the control group; and (c) incremental reduction in TAF beliefs in the initial session and maintenance at 1-month follow-up with the combined intervention. Cognitive dissonance should be investigated extensively in other aspects of cognitive behavioral therapy (CBT) procedures for TAF beliefs (e.g., behavioral experiments, exposure, and response prevention) to determine whether it contributes to therapeutic change with these techniques. Our combined intervention procedure should also be examined for relevant psychopathology (e.g., obsessive-compulsive symptoms).

Given that the perinatal period is a time of increased risk for pregnant women to manifest mental health problems, the identification of antenatal hypomanic symptoms is particularly important. However, data on antenatal hypomanic symptoms is lacking. The present study was aimed at filling this research gap by investigating the prevalence of hypomanic symptoms, including the "active-elated" and "irritable/risk-taking" sides of hypomanic symptoms at the first trimester, and examining their associations with anxiety and depressive symptoms at the following time points: the first trimester, the second trimester, and up to 6-week postpartum. A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 229 pregnant Chinese women in Hong Kong was assessed. Hypomanic symptoms were assessed with the Hypomania Checklist-32 (HCL-32). Of the sample, 43.6% had elevated levels of hypomanic symptoms in the first trimester. Multiple regression analysis showed that after adjusting for potential confounding factors, irritable/risk-taking symptoms were independently associated with higher anxiety symptoms in the first and second trimesters and in the 6-week postpartum period. Primary healthcare practitioners should be made aware of antenatal hypomanic symptoms in pregnant women to facilitate early identification and intervention for anxiety and depression to improve the well-being of both mothers and infants.

The current study investigated the rates of addictions to Internet use, online gaming, and online social networking as well as their associations with depressive symptoms among young adults in China, Singapore, and the United States. A total of 3267 undergraduate students were recruited. Psychological instruments were used to assess various Internet-related addictions and depressive symptoms. Male students were more addicted to Internet and online gaming whereas female students were more addicted to online social networking. Compared with students in the United States, Chinese and Singaporean students were more addicted to Internet use and online social networking but less to online gaming. The odds of depression among students with addiction to various Internet-related addictions were highest in China. Internet-related addiction is a new public health concern of young adults, especially in the Asia-Pacific regions. It is found to associate with depressive symptoms. Strategies should address this phenomenon with attention to specific needs of gender and region while managing mood disturbances.

Purpose of the research This study aimed to determine the prevalence of addiction to social networking sites/platforms (SNS) and its comorbidity with other behavioral addiction and affective disorder among college students in Singapore. 1110 college students (age: M = 21.46, SD = 1.80) in Singapore completed measures assessing online social networking, unhealthy food intake and shopping addiction as well as depression, anxiety and mania. Descriptive analyses were conducted to investigate the prevalence and comorbidity of behavioral addiction and affective disorder. Chi-square tests were used to examine gender differences. The principal results The prevalence rates of SNS, food and shopping addiction were 29.5%, 4.7% and 9.3% respectively for the total sample. SNS addiction was found to co-occur with food addiction (3%), shopping addiction (5%), and both food and shopping addiction (1%). The comorbidity rates of SNS addiction and affective disorder were 21% for depression, 27.7% for anxiety, and 26.1% for mania. Compared with the total sample, students with SNS addiction reported higher comorbidity rates with other behavioral addiction and affective disorder. In general, females as compared to males reported higher comorbidity rates of SNS addiction and affective disorder. Major conclusions SNS addiction has a high prevalence rate among college students in Singapore. Students with SNS addiction were vulnerable to experience other behavior addiction as well as affective disorder, especially among females.

This study aimed to examine psychological mechanisms underlying work stress and burnout that may increase the risk of problem gambling. A serial multiple mediation model is proposed to specify that work stress (high job demand-low job control) can deplete employee resources and lead to burnout. Employees who have emotion dysregulation may engage in gambling to escape or avoid burnout and negative emotions at work. Over time, these employees may become increasingly rely on gambling to cope with their burnout experience, leading to problem gambling. A total of 1233 full-time employees in the United States completed a web survey on work stress. Results supported the proposed serial multiple mediation model. The indirect effect of work stress on problem gambling first through burnout then through emotion dysregulation was significant. The direct effect of work stress on problem gambling was reduced to nonsignificance after controlling for the two mediators (burnout and emotion dysregulation). When the two mediators were considered together in the specified sequence, the indirect effects of work stress on problem gambling through individual mediators were also reduced to nonsignificance. Gender was a nonsignificant moderator, and pathways of the proposed serial multiple mediation model were similar for men and women. Supplementary analyses did not support an alternate sequence of mediators. The present findings suggest that prevention and treatment programs for work stress, burnout, and problem gambling should include the assessment and enhancement of emotion regulation skills.

Past research frequently reports significant relation between workaholism and job burnout, and some studies further indicate workaholism varies across countries. Surprisingly, there is no study that directly examines whether country moderates the workaholism-burnout association. To address this research question, we have collected independent work samples from two culturally diverse countries, namely the People’s Republic of China and the United States. A total of 2243 participants (1243 American respondents and 1000 Chinese respondents) were recruited. Preliminary group comparison suggested that there were statistical differences among participants from different industries on the key variables, including workaholism, job demands, autonomy and emotional exhaustion. Therefore, we have divided our participants into three subsamples [i.e., (1) natural resources, mining and construction industry, (2) manufacturing industry, and (3) service industry] and separate analyses were conducted. In the moderated regression analyses, workaholism significantly predicted two dimensions of job burnout, namely emotional exhaustion and depersonalization, even when job demand and job autonomy were controlled. Finally, although two significant moderating effects were found, there was a lack of consistent empirical support to the hypothesized moderating effect of country on workaholism-burnout association. Implications and limitations were discussed.

Background and aims The addictive nature of compulsive buying implies that mood disturbances, stress, and cognitive biases that underlie compulsive buying might operate in ways similar in both genders. In the current study, we aimed to test hypothetical pathways of mood compensation and irrational cognitions, which may explain compulsive buying tendencies. We also examined potential gender differences in these pathways. Methods Two-hundred and thirty-two male (age: M = 20.30, SD = 1.74) and 373 female Chinese college students (age: M = 19.97, SD = 1.74) in Hong Kong and Macau completed measures assessing compulsive buying, psychological distress, avoidance coping, materialism, and buying-related cognitions. Mediation analyses via a structural equation modeling approach explained by Cheung (2007, 2009) were conducted, with gender as a grouping variable. Results There was a gender difference in the mood compensation pathway; avoidance coping partially mediated the link between psychological distress and compulsive buying severity in females only. On the other hand, the irrational cognitive pathway, in which irrational buying-related cognitions fully mediated the link between materialism and compulsive buying severity, was supported for both genders. There was no gender difference in the extent of mediation within the irrational cognitive pathway, and the mediation effect within the irrational cognitive pathway was larger than that within the mood compensation pathway for both genders. Conclusions Mood compensation processes in compulsive buying might be female specific, and secondary to irrational cognitions, which were gender invariant. Gender-dependent mechanisms and irrational cognitions should be emphasized in compulsive buying treatment.

Quality of Life (QOL) is reported to be lower for patients with depression than the general population. This study aims to investigate the mediational effects of protective resource factors (PSFs), such as depressive symptom management ability, self-efficacy, social support and problem-focused coping act, in the relationship between dysfunctional attitudes and QOL. It is hypothesized that these PSFs have different mediating strengths. Self-report questionnaires which aimed to determine the influences of these PSFs through a multiple mediation framework were completed by 80 depressed adult outpatients from the National University Hospital of Singapore. PSFs have different influence on mental and physical QOL. Depressive symptom management ability is the most important PSF mediating both domains and better problem-focused coping abilities demonstrate improvement in the physical domain of QOL. Self-efficacy and social support are shown to be non-significant mediators. The results suggest for future effective interventions to focus primarily on improving depression patients' symptom management ability and problem-focused coping skills to raise their life quality. Furthermore, findings from this study have implications on the future investigation of QOL as a unitary construct.

OBJECTIVE Although eating disorders in pregnancy have been studied extensively, little research attention has been given to disordered eating. The objectives of the present study were to determine the prevalence and levels of disordered eating in the perinatal period, and to identify risk factors and adverse outcomes of disordered eating during pregnancy. METHOD A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,470 Chinese pregnant women from hospitals in Hong Kong was assessed using standardized instruments at five time points from the first trimester to 6 months postpartum. RESULTS The levels of disordered eating changed significantly across trimesters. Higher levels of disordered eating in pregnancy were significantly associated with higher levels of disordered eating at 6 weeks and 6 months postpartum, greater anxiety and depressive symptoms, lower 1-min Apgar scores, and abnormal birth weight. DISCUSSION The present study pointed to the need for more research and clinical attention to antenatal disordered eating given that it is associated with anxiety, depression, postpartum disordered eating and obstetric outcomes.

Background: This study extended the stress-vulnerability model in order to understand Internet addiction in Asian countries. A parallel mediation model was proposed to specify that emotional and personality vulnerabilities would mediate the influence of social anxiety on Internet addiction. Methods: A total of 1127 participants (430 males and 697 females) aged from 17 to 28 were recruited from universities in Singapore. Participants completed a paper-and-pencil questionnaire on standardized psychological scales that assessed social anxiety, depression, impulsivity, and Internet addiction. Results: About 9.4% of the participants met the cut-off score for Internet addiction. The bootstrapping procedure was conducted to test the hypothesized parallel mediation model. Results showed that social anxiety had a direct effect on Internet addiction, as well as indirect effects via depression and impulsivity. Depression was found to be a stronger mediator than impulsivity. In particular, high levels of social anxiety were related to high levels of impulsivity and depression, which were in turn related to high levels of Internet addiction. The pathways of the proposed parallel mediation model were similar for males and females. There were no gender differences on the levels of Internet addiction, social anxiety, and impulsivity; but females reported more depression symptoms than males. Conclusions: Internet addiction is common in university students. It is associated with impulsivity and high rates of depression and social anxiety. Prevention and intervention strategies should be designed to address this phenomenon. Assessment and management of social anxiety, depression, and impulsive personality should also be included in the programs that aim to reduce Internet addiction.

This chapter examines contemporary women’s lives in China, Hong Kong, and Taiwan by highlighting common issues related to gender roles and stereotypes, marriage and family, paid and unpaid labor, violence against women, and mental health. The central role of the family in traditional Chinese culture intersects with women’s role identity and social experience. Notwithstanding political divides in systems and socioeconomic changes, the culture of gender defines the experience of Chinese women across geographical regions. Entrenched in gender stereotypes and ideologies, new challenges for women arise despite advances in their socioeconomic development. A gender mainstreaming approach is regarded as a more comprehensive model for women’s advancement in which men would be engaged as equal partners to address women’s issues in a gender perspective.

The literature on positive psychology and resilience demonstrates that individuals utilize their personal strengths and environmental resources to facilitate positive adaptation. Using a qualitative approach, we investigated how these frameworks operated as self-protective strategies for female sex workers to maintain their psychological and physical well-being under stressful socioeconomic and work-related conditions. Twenty-three female sex workers in Hong Kong participated in in-depth interviews. We used the grounded theory approach for data analysis. The informants reported negative feelings in response to financial burden, clients’ demands, threats to physical health, and stigma. Some female sex workers showed their resilience by being able to rationalize their role, believe their ability to make a change in life, and stay optimistic. They adopted strategies including emotional regulation and acceptance of their responsibility and limits to cope with stressful life events. The results help us understand the role of positive psychology and resilience in this vulnerable population.

The shortage of organs for transplantation in Japan has alerted health professionals to the low organ donation rate among Japanese people. The unique cultural view of death and altruism has been su...

Objectives While patients with systemic lupus erythematosus (SLE) have poorer health-related quality of life (HRQoL) and are more depressed than healthy people, the impact of proinflammatory cytokines, particularly tumour necrosis factor-alpha (TNFα), on these unfavourable psychosocial parameters is unclear. We aim to explore potential relationships between lupus-related proinflammatory cytokines, HRQoL and depressive symptoms in patients with SLE. Methods Patients with SLE and age-matched healthy subjects were assessed for HRQoL and depressive and anxiety symptoms by the Short Form Health Survey-36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) respectively. Using multiplex immunoassay, a panel of serum proinflammatory cytokines including TNFα, interleukin (IL)-1β, IL-6, IL-17, IL-23 and IL-33 were determined and compared between both groups. Independent associations between SF-36, serum proinflammatory cytokine levels and HADS scores were studied by regression models. Results In total, 54 patients and 54 healthy controls were studied. Lupus patients had significantly poorer HRQoL ( p Conclusions Higher serum TNFα level is independently associated with poorer HRQoL and more severe depressive symptoms in SLE patients. These associations suggest a potential impact of inflammatory response on depressive symptoms and the quality of life in patients with SLE.

Background There remains a paucity of research on control attribution and depression within Asian populations. This study examines: (1) Success/Failure condition as a moderator between depression and negative affect or shame, and (2) differences in control attribution between patients with depression and healthy controls in Singapore. Methods Seventy one patients with depression and 71 healthy controls went through a digit-span memory task where they were randomized into either the Success or Failure condition. Participants in the Success condition had to memorize and recall 5-digit strings, while participants in the Failure condition did the same for 12-digit strings. They then completed self-report measures of negative affect, shame, and attribution of control. One-way ANCOVA was performed to examine task condition as a moderator of association between mental health status and post-task negative affect or shame. Test of simple effects was carried out on significant interactions. Sign test and Mann-Whitney U test were employed to investigate differences in attribution of control. Results Mental health status and Success/Failure condition had significant effects on reported negative affect and shame. Healthy controls reported less post-task negative affect and shame in the Success than in the Failure condition while patients with depression reported similar levels of post-task negative affect and shame in both conditions. However, these differences were not significant in the test of simple effects. In addition, healthy controls felt a stronger sense of personal control in success than in failure and were more likely to blame external factors in failure than in success. Conversely, patients with depression were more inclined to credit external factors in success than in failure and ascribed greater personal control in failure than in success. Conclusion The results suggest that successful conditions may not necessitate the reduction of negative affect in Asians with depression, indicating possible cultural variation in affective states as a result of control attribution and the importance of attending to these variations in designing psychological intervention for Asians. Further studies are required to gather more evidence on control attributions in different contexts and study other cognitive mechanisms related to depression in the Asian population.

Current HIV prevention interventions for female sex workers (FSWs) have tended to target the cognitive factors in changing their behaviors, yet little attention has been paid to the psychological factors that influence the behavior of women in sex work. This review aimed to explore the associations between the psychological health of FSWs and HIV risk. A total of eight studies published in English before July 2013 were identified and reviewed. FSWs had reported psychological issues, including depression, suicidal thoughts as well as lower quality of life, and the pooled prevalence of probable depression was as high as 62.4%. The majority of studies showed that higher scores in psychological health problems were associated with increased HIV risk behavior, in particular inconsistent condom use, or sexually transmitted infections. Among the five studies which measured symptoms of depression, four documented that higher depression scores were significantly associated with inconsistent condom use among FSWs with their clients and/or partners. Meta-analysis using a fixed-effects model was performed to examine the association between depression and inconsistent condom use and found that higher scores in depression were significantly associated with inconsistent condom use (odds ratio = 2.57, p

This study examined the role of impulsivity and its interplay with gambling correlates in influencing the severity of pathological gambling in Chinese societies. It also investigated the extent to which impulsivity would moderate and/or mediate the relationship between life stress and pathological gambling in 94 Chinese treatment-seeking gamblers. Results of a hierarchical regression analysis showed that years of gambling, life stress, and impulsivity were significant correlates of pathological gambling. Post-hoc analyses of a significant impulsivity x life stress 2-way interaction effect indicated that life stress was significantly associated with pathological gambling among participants with low impulsivity only, whereas pathological gambling remained high regardless of the stress level among participants with high impulsivity. Bootstrapping results also showed that impulsivity partially mediated the influence of life stress on pathological gambling. Findings have implications for gambling treatment programs.

This study investigated the extent to which gambling-related cognitive biases would associate with various levels of gambling pathology among 2,835 youths, 934 young adults, and 162 mature adults in Chinese societies. Results showed that gambling cognitive biases, especially biases in perceived inability to stop gambling and positive gambling expectancy, were salient correlates of pathological gambling across the three age cohorts. Analyses of variances on total cognitive biases also showed a gambling pathology main effect and an age cohort × gambling pathology 2-way interaction effect. It was noted that the probable pathological gambling group had greater cognitive biases than the probable problem gambling group, which in turn had greater cognitive biases than the non-problem gambling group. In the non-problem gambling group, mature adults had greater cognitive biases than youths and young adults, but this pattern was reversed in the probable problem gambling group. In the probable pathological gambling group, youths had greater cognitive biases than young and mature adults. Specific categories of cognitive biases also varied according to gender and gambling pathology. While men as compared to women in the non-problem and probable problem gambling groups reported a greater bias in their perceived inability to stop gambling, no significant gender difference in this bias was found in the probable pathological gambling group. Men generally had greater perceived gambling expectancy bias than women.