1
|
Brouzos A, Papadopoulou A, Baourda VC. Effectiveness of a web-based group intervention for internet addiction in university students. Psychiatry Res 2024; 336:115883. [PMID: 38598947 DOI: 10.1016/j.psychres.2024.115883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/29/2024] [Accepted: 03/27/2024] [Indexed: 04/12/2024]
Abstract
The phenomenon of Internet addiction has been systematically addressed with numerous studies highlighting its association with deficits in self-regulation. Despite the extensive literature elucidating the adverse effects of Internet addiction on university students, the availability of relevant interventions has remained constrained. The current study aimed at evaluating a web-based, group intervention, which aimed to prevent Internet addiction and enhance self-regulation. The sample consisted of 47 undergraduate and postgraduate university students (Ν = 47, Mage=21, SD = 3), who were divided into an intervention (n = 24) and a control group (n = 23). The participants were asked to complete a) the Internet Addiction Test (Young, 1998), and b) the Self-Regulation Questionnaire (Brown et al., 1999), prior to the commencement of the intervention, after its conclusion, and one and a half months after the intervention. The web-based intervention consisted of 6 sessions, over a two-week period. Results indicated an improvement of self-regulation and Internet addiction levels for the intervention group, compared to the control group. These results were maintained at the one and a half months follow-up. Implications for designing and implementing web-based group interventions for Internet addiction are discussed.
Collapse
Affiliation(s)
- Andreas Brouzos
- Laboratory of Educational Psychology, Counselling and Research, Department of Primary Education, University of Ioannina, 451 10 Ioannina, Greece
| | - Aikaterini Papadopoulou
- Laboratory of Educational Psychology, Counselling and Research, Department of Primary Education, University of Ioannina, 451 10 Ioannina, Greece
| | - Vasiliki C Baourda
- Laboratory of Educational Psychology, Counselling and Research, Department of Primary Education, University of Ioannina, 451 10 Ioannina, Greece.
| |
Collapse
|
2
|
Johannessen DA, Overå S, Arnevik EA. The role of contextual factors in avenues to recover from gambling disorder: a scoping review. Front Psychol 2024; 15:1247152. [PMID: 38410405 PMCID: PMC10894926 DOI: 10.3389/fpsyg.2024.1247152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/17/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Recovery from complex conditions such as gambling disorders (GD) often entail considerable change and require a range of adaptable interventions in the health care system. Outcomes from such avenues to change are influenced by multifarious contextual factors, which are less frequently considered in treatment outcome studies. Accordingly, this scoping review aims to map the level of evidence and explore how contextual factors influence the provision and outcomes of GD interventions. Methods A systematic search in selected health and social science research databases yielded a total of 2.464 unique references. The results were screened in three selection steps-titles (n = 2.464), abstracts (n = 284) and full-text (n = 104). The scoping approach was applied to provide a narrative account of the final included references (n = 34). Results and discussion Findings suggest that the research on GD treatment is in the early stages of development. Additionally, studies on GD interventions are characterized by cultural biases (Region and ethnicity and Gender perspectives), while three key elements are described as successful avenues to recover from GD (Competence, Perception and Utilization). In line with these findings, proposals for future research and treatment designs are made.
Collapse
Affiliation(s)
- Dagny Adriaenssen Johannessen
- Department of Social Work, Child Welfare and Social Policy, OsloMet—Oslo Metropolitan University, Oslo, Norway
- Blue Cross East, Oslo, Norway
| | - Stian Overå
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - Espen Ajo Arnevik
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
3
|
Dieris-Hirche J, Bottel L, Basten J, Pape M, Timmesfeld N, te Wildt BT, Geisler BL, Wölfling K, Henningsen P, Beutel M, Neumann A, Niemann A, Beckers R, Herpertz S. Efficacy of a short-term webcam-based telemedicine treatment of internet use disorders (OMPRIS): a multicentre, prospective, single-blind, randomised, clinical trial. EClinicalMedicine 2023; 64:102216. [PMID: 37745023 PMCID: PMC10514435 DOI: 10.1016/j.eclinm.2023.102216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023] Open
Abstract
Background Evidence-based treatments for internet use disorders (IUDs) are limited, and online therapy approaches are poorly studied. We investigated the efficacy of a manualised therapist-guided online intervention (OMPRIS) to reduce IUD symptoms and improve psychological well-being. Methods In this multicentre, two-arm, single-blinded trial, individuals ≥16 years suffering from IUD symptoms were recruited in Germany from August 16, 2020, to March 11, 2022, through media advertisements and healthcare providers. Participants were randomly allocated by sequential balancing randomisation (1:1) to either the manualised webcam-based OMPRIS intervention or a waitlist control (WLC) group. OMPRIS provided strategies from motivational interviewing, behavioural therapy, and social counselling. The primary outcome at the end of treatment was a reduction in IUD symptoms as measured by the Assessment of Internet and Computer Scale (AICA-S). Follow-up assessments were conducted at 6 weeks and 6 months. Analyses were performed in the intention-to-treat population. This trial was registered (German Clinical Trial Register, DRKS00019925) and has been completed. Findings A total of 180 individuals were randomly assigned to the OMPRIS intervention (n = 89) or WLC (n = 91) arm. After treatment, 81 (91.0%) participants in the OMPRIS intervention group and 88 (96.7%) in the WLC group completed the outcome assessment. The ANCOVA model showed that OMPRIS participants had a significantly greater reduction in AICA-S scores from baseline (mean score 12.1 [SD 4.6]) to post-treatment (6.8 [5.2]) than those in the WLC group (from 12.6 [5.1] to 11.0 [5.4]; estimated mean difference -3.9; [95% CI -5.2 to -2.6]; p < 0.0001; d = 0.92). No adverse events were reported to the trial team. Interpretation Webcam-based OMPRIS therapy was effective and superior to waiting list conditions in reducing IUD symptoms. Webcam-based, specialised online therapy thus increases IUD treatment options. Funding German Innovation Fund of Germany's Federal Joint Committee (G-BA), grant number 01VSF18043.
Collapse
Affiliation(s)
- Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Jale Basten
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Universitätsstraße 105, 44789, Bochum, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| | - Nina Timmesfeld
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Universitätsstraße 105, 44789, Bochum, Germany
| | - Bert Theodor te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
- Psychosomatic Hospital Diessen Monastery, Klosterhof 20, 86911, Diessen, Germany
| | - Birte Linny Geisler
- Psychosomatic Hospital Diessen Monastery, Klosterhof 20, 86911, Diessen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Manfred Beutel
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Anja Niemann
- Institute for Health Care Management and Research, University Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Rainer Beckers
- Competence Centre of Healthcare Telematics, Haus Harkorten 8, 58135, Hagen, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany
| |
Collapse
|
4
|
Lupo R, Vitale E, Carriero MC, Calabrò A, Imperiale C, Ercolani M, Filippini A, Santoro P, Carvello M, Rizzo E, Artioli G, Conte L, Muratori PF. Gambling and internet addiction: a pilot study among a Population of Italian Healthcare : Gambling and Internet Addition in a Healthcare Group. J Gambl Stud 2023; 39:1337-1354. [PMID: 35908025 PMCID: PMC9362545 DOI: 10.1007/s10899-022-10150-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/19/2022] [Accepted: 06/26/2022] [Indexed: 12/24/2022]
Abstract
AIM Measuring the phenomenon of gambling and Internet addiction, with analysis of attitudes and psychophysical consequences among nurses working in different care settings. METHODS An observational, cross sectional, multicenter study was conducted from April to September 2020. Participants' socio-demographic information, the "Internet Addiction Test" (IAT) scale, and the "South Oaks Gambling Screen" (SOGS) were collected in order to assess the overuse of and whether an individual has a problematic relationship with gambling, respectively. RESULTS 502 nurses were enrolled in the study. Significant correlations were found (p < .001) between the IAT score and gender, number of years of work experience, job role, educational qualification; and between the SOGS and gender, number of years of work experience, job role and regions of Italy. CONCLUSIONS The study highlighted an emerging social problem, and the results may be just the tip of the iceberg. Given the lack of knowledge of these phenomena and a high percentage of people who suffer from them but are afraid to admit it and get help, this study could also be useful in expanding knowledge and allow more professionals to get help and learn about possible treatments and cures for the resolution of these addictions.
Collapse
Affiliation(s)
- Roberto Lupo
- "San Giuseppe da Copertino" Hospital, Lecce, Italy
| | - Elsa Vitale
- Department of Mental Health, Local Health Authority Bari, Bari, Italy
| | | | - Antonino Calabrò
- Nuovo Ospedale degli Infermi Hospital, ASL (Local Health Authority), Biella, Italy
| | | | | | - Aurelio Filippini
- Centre for Research in Clinical Ethics (CREC), University of Insubria, Varese, Italy
| | | | - Maicol Carvello
- Brisighella Community Hospital, ASL (Local Health Authority) of Romagna, Romagna, Italy
| | - Emanuele Rizzo
- Laboratory of Hygiene and Molecular Epidemiology, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, LE, Italy
| | | | - Luana Conte
- Laboratory of Interdisciplinary Research Applied to Medicine (DReAM), University of Salento and ASL (Local Health Authority) Lecce (LE), Lecce, Italy.
- Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics "E. De Giorgi", University of Salento, 73100, Lecce, LE, Italy.
| | | |
Collapse
|
5
|
Gueta K, Harel-Fisch Y, Walsh SD. Cultural accommodation of internet-based interventions for substance use and related disorders: a proposed comprehensive framework based on a pilot study and a literature review. Front Psychol 2023; 14:1063200. [PMID: 37416542 PMCID: PMC10321598 DOI: 10.3389/fpsyg.2023.1063200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 05/17/2023] [Indexed: 07/08/2023] Open
Abstract
Despite the low utilization rates of substance use and related disorders services, and the ability of internet-based interventions for substance use and related disorders (IBIS) to address challenges related to service engagement, limited attention has been placed on the processes for the accommodation of these interventions to diverse cultural settings. This study aimed to develop a framework for the cultural accommodation of IBIS across populations based on a pilot study and a literature review. A pilot study of cultural accommodation of an existing internet intervention for alcohol use was carried out in Israel, which involved focus groups and daily online surveys of prospective consumers (N = 24) as well as interviews with experts (N = 7) in the substance abuse treatment field. Thematic analysis revealed a range of themes that relate to the general Israeli culture and the specific Israeli drinking subculture, identified as needing to be addressed in the process of intervention accommodation. A comprehensive framework for cultural accommodation of IBIS is suggested, consisting of five stages: Technical and cultural feasibility; Engagement of target group; Identification of accommodation variables, Accommodation, and evaluation of the accommodated intervention. In addition, the framework consists of four dimensions of accommodation: Barriers and facilitators; Audio-visual materials and language; Mechanisms of change; Intersectional factors. We suggest that the proposed framework may serve as a guide for the cultural accommodation of existing internet-based interventions for substance use and related disorders across a range of cultural and geographical settings, thus augmenting the ecological validity of internet-based interventions for substance use and related disorders, expanding cross-cultural intervention research, and reducing health disparities worldwide.
Collapse
Affiliation(s)
- Keren Gueta
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Yossi Harel-Fisch
- The International Research Program on Adolescent Well-Being and Health, School of Education, Bar-Ilan University, Ramat Gan, Israel
| | - Sophie D. Walsh
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| |
Collapse
|
6
|
Kukafka R, Bottel L, Herpertz S, Timmesfeld N, Te Wildt BT, Wölfling K, Henningsen P, Neumann A, Beckers R, Pape M. Internet-Based Self-Assessment for Symptoms of Internet Use Disorder-Impact of Gender, Social Aspects, and Symptom Severity: German Cross-sectional Study. J Med Internet Res 2023; 25:e40121. [PMID: 36633897 PMCID: PMC9880811 DOI: 10.2196/40121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/23/2022] [Accepted: 10/24/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Internet use disorder (IUD) is a new type of behavioral addiction in the digital age. At the same time, internet applications and eHealth can also provide useful support in medical treatment. OBJECTIVE The purpose of this study is to examine if an internet-based eHealth service can reach individuals with IUD. In particular, it should be investigated whether both male and female individuals with more severe IUDs can be reached. METHODS Data were retrieved from the OMPRIS (online-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and internet use disorder) project (DRKS00019925), an internet-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and IUD. During the recruitment process (August 2020-March 2022), a total of 3007 individuals filled out the standardized scale for the assessment of internet and computer game addiction (AICA-S). The assessment was accessible via the project homepage. There was no preselection of participants at this stage of the study; however, the offer was addressed to people with hazardous internet use and IUDs. The web-based assessment was free and could be found via search engines, but attention was also drawn to the service via newspaper articles, radio reports, and podcasts. RESULTS Out of 3007 who participated in the web-based self-assessment, 1033 (34.4%) are female, 1740 (57.9%) are male, 67 (2.2%) are diverse individuals, and 167 (5.5%) did not disclose their gender. The IUD symptom severity score showed a wide range between the AICA-S extreme values of 0 and 27 points. On average, the total sample (mean 8.19, SD 5.47) was in the range of hazardous IUD behavior (AICA-S cutoff>7.0). Furthermore, 561 individuals (18.7% of the total sample; mean 17.42, SD 3.38) presented severe IUD (AICA-S cutoff>13.5). Focusing on female and male participants, 20.9% (363/1740) of the men and 14.9% (151/1033) of the women scored above 13.5 points, which can be considered pathological IUD behavior (χ22,2773=16.73, P<.001, effect size: Cramér V=0.078). Unemployment, being in vocational training or studying at a university, and being male were significantly associated with high IUD symptoms. CONCLUSIONS Using a large sample, the study showed that both mildly and severely IUD-affected individuals can be reached via the internet. An internet-based eHealth offer can thus be a good way to reach patients with IUD where they are addicted-on the internet. In addition, eHealth services increase the likelihood of reaching female patients, who hardly ever come to specialized outpatient clinics and hospitals. Since social problems, especially unemployment, have a strong association with disease severity, the integration of social counseling into treatment seems advisable in terms of a multidisciplinary approach. TRIAL REGISTRATION German Clinical Trials Register (DRKS) DRKS00019925; https://drks.de/search/de/trial/DRKS00019925.
Collapse
Affiliation(s)
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Nina Timmesfeld
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, Germany
| | - Bert Theodor Te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany.,Psychosomatic Hospital Diessen Monastery, Diessen, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Munich, Germany
| | - Anja Neumann
- Institute for Health Care Management and Research, University Duisburg-Essen, Essen, Germany
| | - Rainer Beckers
- Competence Centre of Healthcare Telematics, Hagen, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
7
|
Bottel L, te Wildt BT, Brand M, Pape M, Herpertz S, Dieris-Hirche J. Telemedicine as bridge to the offline world for person affected with problematic internet use or internet use disorder and concerned significant others. Digit Health 2023; 9:20552076221144185. [PMID: 36636726 PMCID: PMC9829884 DOI: 10.1177/20552076221144185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/21/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction Internet use disorder is a disorder of the digital age and presents a growing problem worldwide. It appears that due to structural and personal barriers, many persons affected (PA) and Concerned Significant Others (CSO) do not reach the health care system so far and thus a chronification of the pathology can proceed. Methods A telemedicine counseling service for PA and CSO of PA unwilling to enter treatment with two webcam-based sessions of 60 minutes for each group was created with the aim of reaching out to PA and CSO to provide a low-threshold support and refer the participants to the local health care system. Motivational interviewing for PA and CRAFT (Community Reinforcement and Family Training) for CSO were used as methods. Participants answered questions about their Internet use and sociodemographic data and six months after participation, participants were asked via email if they entered the local health care system. CSO answered the questions for themselves and in a third-party rating for PA unwilling to enter treatment. Results 107 PA (34 years (SD = 13.64), 86% male) and 38 CSO (53 years (SD = 6.11), 28.9% male) participated in the two telemedicine sessions. After participation, 43.9% of the PA and 42.1% of the CSO reached the health care system. When there was consistency between the location of telemedicine consultation and treatment locally, over 90% of participants arrived (PA: 92.3%, CSO: 100%). Conclusion The results from this study reveal that telemedicine services could be a promising approach to address PA and CSO and build a bridge to the local health care system. Future studies should verify if these results can be replicated in randomized controlled trials.
Collapse
Affiliation(s)
- Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany,Laura Bottel, Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Alexandrinenstr. 1-3, Bochum 44791, Germany.
| | - Bert Theodor te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany,Psychosomatic Hospital Diessen Monastery, Diessen am Ammersee, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| | - Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| |
Collapse
|
8
|
Kiburi SK, Ngarachu E, Tomita A, Paruk S, Chiliza B. Digital interventions for opioid use disorder treatment: A systematic review of randomized controlled trials. J Subst Abuse Treat 2023; 144:108926. [PMID: 36356329 DOI: 10.1016/j.jsat.2022.108926] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 09/05/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Opioid use disorders are associated with a high burden of disease and treatment gap. Digital interventions can be used to provide psycho-social treatment for opioid use disorders, as an alternative to or together with face-to-face interventions. This review aimed to assess the application and effectiveness of digital interventions to treat opioid use disorder globally. METHODS The study team searched four electronic databases (PubMed, Psych INFO, Web of Science and Cochrane Central register of controlled trials). The inclusion criteria were: randomized controlled trials, assessment for opioid use before and at least once following intervention, and use of digital interventions. The primary outcomes were opioid use and/or retention in treatment, with data being summarized in tables and a narrative review presented. RESULTS The initial database search yielded 3542 articles, of which this review includes 20. Nineteen were conducted among adults in the United States. The digital interventions used included web-based, computer-based, telephone calls, video conferencing, automated self-management system, mobile applications and text messaging. They were based on therapeutic education systems, community reinforcement approaches, cognitive behavior therapy, relapse prevention, brief interventions, supportive counselling and motivational interviewing. The studies had mixed findings; of the 20 studies, 10 had statistically significant differences between the treatment groups for opioid abstinence, and four had significant differences for treatment retention. Comparisons were difficult due to varying methodologies. Participants rated the interventions as acceptable and reported high rates of satisfaction. CONCLUSION The use of digital interventions for opioid use disorder treatment was acceptable, with varying levels of effectiveness for improving outcomes, which is influenced by participant and intervention delivery factors. Further studies in different parts of the world should compare these findings, specifically in low- and middle-income countries.
Collapse
Affiliation(s)
- Sarah Kanana Kiburi
- Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; Department of Psychiatry, Mbagathi Hospital, Nairobi, Postal address P.O. Box 20725-00202, Nairobi, Kenya.
| | - Elizabeth Ngarachu
- Department of Psychiatry, Mathari Teaching and Referral Hospital, Nairobi, Kenya
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa; KwaZulu-Natal Research Innovation and Sequencing Platform, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
| | - Saeeda Paruk
- Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Bonginkosi Chiliza
- Discipline of Psychiatry, Nelson Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa.
| |
Collapse
|
9
|
Pape M, Geisler BL, Cornelsen L, Bottel L, Te Wildt BT, Dreier M, Herpertz S, Dieris-Hirche J. A short-term manual for webcam-based telemedicine treatment of Internet use disorders. Front Psychiatry 2023; 14:1053930. [PMID: 36911137 PMCID: PMC9995520 DOI: 10.3389/fpsyt.2023.1053930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
In recent decades, the number of people who experience their Internet use behavior as problematic has risen dramatically. In Germany, a representative study from 2013 estimated the prevalence of Internet use disorder (IUD) to be about 1.0%, with higher rates among younger people. A 2020 meta-analysis shows a global weighted average prevalence of 7.02%. This indicates that developing effective IUD treatment programs is more critical than ever. Studies show that motivational interviewing (MI) techniques are widely used and effective in treating substance abuse and IUDs. In addition, an increasing number of online-based health interventions are being developed to provide a low-threshold treatment option. This article presents a short-term online-based treatment manual for IUDs that combines MI techniques with therapy tools from cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). The manual includes 12 webcam-based therapy sessions, each lasting 50 min. Each session is framed by a standardized beginning, conclusion, outlook, and flexible session content. In addition, the manual contains example sessions to illustrate the therapeutic intervention. Finally, we discuss the advantages and disadvantages of online-based therapy compared to analog treatment settings and provide recommendations for dealing with these challenges. By combining established therapeutic approaches with an online-based therapeutic setting based on flexibility and motivation, we aim to provide a low-threshold solution for treating IUDs.
Collapse
Affiliation(s)
- Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | | | - Lorraine Cornelsen
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | | | - Michael Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
10
|
Telehealth interventions for substance use disorders in low- and- middle income countries: A scoping review. PLOS DIGITAL HEALTH 2022; 1:e0000125. [PMID: 36812539 PMCID: PMC9931245 DOI: 10.1371/journal.pdig.0000125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/09/2022] [Indexed: 02/24/2023]
Abstract
The increasing prevalence and magnitude of harmful effects of substance use disorders (SUDs) in low- and middle-income countries (LMICs) make it imperative to embrace interventions which are acceptable, feasible, and effective in reducing this burden. Globally, the use of telehealth interventions is increasingly being explored as possible effective approaches in the management of SUDs. Using a scoping review of literature, this article summarizes and evaluates evidence for the acceptability, feasibility, and effectiveness of telehealth interventions for SUDs in LMICs. Searches were conducted in five bibliographic databases: PubMed, Psych INFO, Web of Science, Cumulative Index of Nursing and Allied Professionals and the Cochrane database of systematic review. Studies from LMICs which described a telehealth modality, identified at least one psychoactive substance use among participants, and methods that either compared outcomes using pre- and post-intervention data, treatment versus comparison groups, post-intervention data, behavioral or health outcome, and outcome of either acceptability, feasibility, and/or effectiveness were included. Data is presented in a narrative summary using charts, graphs, and tables. The search produced 39 articles across 14 countries which fulfilled our eligibility criteria over a period of 10 years (2010 to 2020). Research on this topic increased remarkably in the latter five years with the highest number of studies in 2019. The identified studies were heterogeneous in their methods and various telecommunication modalities were used to evaluate substance use disorder, with cigarette smoking as the most assessed. Most studies used quantitative methods. The highest number of included studies were from China and Brazil, and only two studies from Africa assessed telehealth interventions for SUDs. There has been an increasingly significant body of literature which evaluates telehealth interventions for SUDs in LMICs. Overall, telehealth interventions showed promising acceptability, feasibility, and effectiveness for SUDs. This article identifies gaps and strengths and suggests directions for future research.
Collapse
|
11
|
Augner C, Vlasak T, Aichhorn W, Barth A. Psychological online interventions for problem gambling and gambling disorder - A meta-analytic approach. J Psychiatr Res 2022; 151:86-94. [PMID: 35472684 DOI: 10.1016/j.jpsychires.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/24/2022] [Accepted: 04/06/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The Covid-19 pandemic has reignited discussions about the prevalence of and treatment options for problem gambling and gambling disorder (PGGD). Since affected persons seldom seek professional help, online interventions can improve accessibility. Thus, this study aimed to investigate the effectiveness of psychological online interventions on PGGD. METHODS We conducted a systematic review and meta-analysis and searched in PubMed, PsycINFO, and Google Scholar for peer-reviewed experimental and quasi-experimental research published between 2010 and 2021. We calculated two meta-anlyses, one for treatment control comparisons (TCC), and one for pre-post-comparisons (PCC). RESULTS We included six studies (ten TCC and n = 2076) in meta-analysis 1 and five studies (six PCC and n = 781) in meta-analysis 2. Online interventions turned out to be effective in both analyses with Hedges g = 0.41, 95% confidence interval = [0.22 to 0.60], p < .001, for meta-anaylsis 1 and Hegdes g = 1.28, 95% confidence interval = [0.85 to 1.71], p < .001, for meta-analysis 2. CONCLUSIONS We identified significant effects of online interventions on PGGD in both analyses, indicating the potential of online applications. We discuss methodological aspects and further research directions.
Collapse
Affiliation(s)
- Christoph Augner
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, University Clinics of the Paracelsus Medical University, Salzburg, Austria; Institute for Human Resources Research in Health Care, University Clinics of the Paracelsus Medical University, Salzburg, Austria.
| | - Thomas Vlasak
- Institute for Psychology, Sigmund Freud University Linz, Austria
| | - Wolfgang Aichhorn
- Department of Psychiatry, Psychotherapy & Psychosomatics, Christian-Doppler Medical Centre, University Clinics of the Paracelsus Medical University, Salzburg, Austria
| | - Alfred Barth
- Institute for Psychology, Sigmund Freud University Linz, Austria
| |
Collapse
|
12
|
Linskiy IV, Yi J, Korostiy VI, Grinevich EG, Lin Z. Modern lifestyle risks associated with alcohol consumption and cigarette smoking in Ukraine. JOURNAL OF SUBSTANCE USE 2022; 27:440-445. [PMID: 35836495 PMCID: PMC9275117 DOI: 10.1080/14659891.2022.2054475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background Substance uses confer huge risks for public health in modern society. This study aimed to evaluate current factors related to alcohol drinking and tobacco smoking in the republic of Ukraine. Methods We distributed a questionnaire to healthy volunteers in four Ukrainian regions and collected 929 responses regarding demographic information, reasons for starting substance use, substance use family history, environmental factors, use pattern (internet, drinking or smoking), consequences of drinking, and insomnia. Linear regression and logistic regression analyses were performed to identify factors related to alcohol drinking and cigarette smoking. Results Aging appeared to attenuate either drinking or smoking. To reduce school- or job-related stress, staying awake, peer pressure, friend-related issues, or to increase sexual desire and single parenting all would trigger drinking; male gender, family divorce, unhealthy diet and lack of awareness about harmful consequences were the main factors leading to smoking. Logistic regression suggested that education background, sleep problems, celebration events and lengthy internet work all could contribute to drinking. Conclusions Various real-world factors related to substance uses were identified for the public of Ukraine. A validated instrument would help to identify risk factors in patients with substance use disorders.
Collapse
Affiliation(s)
- Igor V. Linskiy
- Institute of Neurology, Psychiatry and Narcology of National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
| | - Jinyao Yi
- Medical Psychological Center, the Second Xiangya Hospital, Central South University; National Clinical Research Center for Mental Disorders, Changsha, China
| | - Volodymyr I. Korostiy
- University Clinic of Kharkiv National Medical University, Kharkiv, Ukraine
- Department of Psychiatry, Narcology, Medical Psychology and Social Work of Kharkiv National Medical University, Kharkiv, Ukraine
| | - Eugenia G. Grinevich
- Common, Childhood, Forensic Psychiatry & Drug Abuse Department of Shupyk National Healthcare University of Ukraine of the Ministry of Public Health of Ukraine, Kyiv, Ukraine
- National Military-Medical Clinical Center ”Main Military Clinical Hospital” of the Ministry of Defense of Ukraine, Kyiv, Ukraine
| | - Zhicheng Lin
- Department of Psychiatry, Harvard Medical School, Laboratory of Psychiatric Neurogenomics, McLean Hospital, Belmont, MA, USA
| |
Collapse
|
13
|
Brezing CA, Levin FR. Applications of technology in the assessment and treatment of cannabis use disorder. Front Psychiatry 2022; 13:1035345. [PMID: 36339845 PMCID: PMC9626500 DOI: 10.3389/fpsyt.2022.1035345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 11/30/2022] Open
Abstract
Cannabis use and Cannabis Use Disorder (CUD) have been increasing. There are no FDA approved medications and evidence-based psychotherapy is limited by insufficient providers, serving very few patients effectively. The lack of resources for prevention and treatment of CUD has resulted in a significant gap between the need for services and access to treatment. The creation of a scalable system to prevent, screen, refer and provide treatment for a chronic, relapsing diagnosis like CUD could be achieved through the application of technology. Many studies have utilized ecological momentary assessments (EMA) in treatment seeking and non-treatment seeking cannabis users. EMA allows for repeated, intensive, longitudinal data collection in vivo. EMA has been studied in cannabis use and its association with affect, craving, withdrawal, other substances, impulsivity, and interpersonal behaviors. EMA has the potential to serve as a valuable monitoring tool in prevention, screening, and treatment for CUD. Research has also focused on the development of internet and application-based treatments for CUD, including a currently available prescription digital therapeutic. Treatment options have expanded to more broadly incorporate telehealth as an option for CUD treatment with broad acceptance and change in regulation following the COVID-19 pandemic. While technology has limitations, including cost, privacy concerns, and issues with engagement, it will be a necessary medium to meet societal health needs as a consequence of an ever-changing cannabis regulatory landscape. Future work should focus on improving existing platforms while ethically incorporating other functions (e.g., sensors) to optimize a public and clinical health approach to CUD.
Collapse
Affiliation(s)
- Christina A Brezing
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Frances R Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| |
Collapse
|
14
|
Bottel L, Brand M, Dieris-Hirche J, Herpertz S, Timmesfeld N, te Wildt BT. Efficacy of short-term telemedicine motivation-based intervention for individuals with Internet Use Disorder - A pilot-study. J Behav Addict 2021; 10:1005-1014. [PMID: 34797218 PMCID: PMC8987429 DOI: 10.1556/2006.2021.00071] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/24/2021] [Accepted: 10/04/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Internet Use Disorders (IUD) cover a range of online-related behavioral addictions, which are acknowledged and strengthened by the inclusion of (online) gaming disorder in the ICD-11 by the World Health Organization. Internet-based telemedicine interventions offer the possibility to reach out for individuals with IUD where the disorder emerges, in order to enhance their motivation to change their Internet use behavior. METHODS In the course of the short-term telemedicine motivation-based intervention, adult participants took part in two webcam-based counselling sessions based on Motivational Interviewing techniques. Two weeks after the first webcam-based counselling session the second took place. Participants completed questionnaires regarding the motivation to change their Internet use behavior (iSOCRATES) and symptoms of IUD (s-IAT) at three times of measurement: t0 (pre-intervention), t1 (mid-intervention) and t2 (post-intervention). RESULTS 73 affected individuals (83.6% male, average age 35 years (SD = 12.49) took part in the whole intervention including the questionnaire-based post intervention survey (t2). Over the course of the telemedicine intervention, a significant increase in the motivation to change with regard to the own Internet use behavior as well as a significant reduction in the symptom severity of an IUD and duration of Internet use (reduction of 2 hrs/d) were shown. CONCLUSION The telemedicine pilot study shows that online-based consultation can be effective and helpful for individuals with IUD. Therefore, such a telemedicine intervention may be a suitable extension to the already existing analogous care system.
Collapse
Affiliation(s)
- Laura Bottel
- Ruhr University Bochum, LWL-University Hospital, Department of Psychosomatic Medicine and Psychotherapy, Bochum, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Jan Dieris-Hirche
- Ruhr University Bochum, LWL-University Hospital, Department of Psychosomatic Medicine and Psychotherapy, Bochum, Germany
| | - Stephan Herpertz
- Ruhr University Bochum, LWL-University Hospital, Department of Psychosomatic Medicine and Psychotherapy, Bochum, Germany
| | - Nina Timmesfeld
- Ruhr University Bochum, Department of Medical Informatics, Biometry and Epidemiology, Bochum, Germany
| | - Bert Theodor te Wildt
- Ruhr University Bochum, LWL-University Hospital, Department of Psychosomatic Medicine and Psychotherapy, Bochum, Germany
- Psychosomatic Hospital Diessen Monastery, Diessen am Ammersee, Germany
| |
Collapse
|
15
|
Sagoe D, Griffiths MD, Erevik EK, Høyland T, Leino T, Lande IA, Sigurdsson ME, Pallesen S. Internet-based treatment of gambling problems: A systematic review and meta-analysis of randomized controlled trials. J Behav Addict 2021; 10:546-565. [PMID: 34546971 PMCID: PMC8997228 DOI: 10.1556/2006.2021.00062] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/18/2020] [Accepted: 08/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS The effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects. METHODS A systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran's Q and the I 2 statistics. Publication bias was investigated using trim and fill. RESULTS Thirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43-1.03), gambling frequency (g = 0.29; 95% CI = 0.14-0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11-0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79-1.61), g = 0.36 (95% CI = 0.12-0.60), and g = 0.20 (95% CI = 0.12-0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems. DISCUSSION AND CONCLUSIONS Internet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.
Collapse
Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway,Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
| | - Mark. D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Eilin Kristine Erevik
- Department of Psychosocial Science, University of Bergen, Bergen, Norway,Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
| | - Turid Høyland
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Tony Leino
- Department of Psychosocial Science, University of Bergen, Bergen, Norway,Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway
| | - Ida Alette Lande
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | | | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway,Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, Norway,Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South-Africa,Corresponding author. E-mail:
| |
Collapse
|
16
|
Dieris-Hirche J, Bottel L, Pape M, Te Wildt BT, Wölfling K, Henningsen P, Timmesfeld N, Neumann A, Neusser S, Beckers R, Herpertz S. Effects of an online-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and internet use disorder (OMPRIS): study protocol for a randomised controlled trial. BMJ Open 2021; 11:e045840. [PMID: 34344675 PMCID: PMC8338317 DOI: 10.1136/bmjopen-2020-045840] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION In May 2019, the WHO classified internet gaming disorder (IGD) as a mental disorder in the upcoming International Classification of Diseases 11th Revision. However, individuals affected by IGD or internet use disorders (IUDs) are often not provided with adequate therapy due to a lack of motivation or absence of adequate local treatment options. To close the gap between individuals with IUDs and the care system, we conduct an online-based motivational intervention to reduce problematic internet use and promote treatment motivation in internet gaming disorder and internet use disorder (OMPRIS). METHODS AND ANALYSIS Within the randomised controlled trial, a total of n=162 participants will be allocated by sequential balancing randomisation to the OMPRIS intervention or a waitlist control group. The study includes an extensive diagnostic, followed by a 4-week psychological intervention based on motivational interviewing, (internet-related) addiction therapy, behavioural therapy techniques and additional social counselling. The primary outcome is the reduction of problematic internet use measured by the Assessment of Internet and Computer Game Addiction Scale. Secondary outcomes include time spent on the internet, motivation for change (Stages of Change Readiness and Treatment Eagerness Scale for Internet Use Disorder), comorbid mental symptoms (Patient Health Questionnaire-9, Generalized Anxiety Disorder Screener-7), quality of life (EuroQoL Standardised Measure of Health-related Quality of Life-5 Dimensions, General Life Satisfaction-1), self-efficacy (General Self-Efficacy Scale), personality traits (Big Five Inventory-10), therapeutic alliance (Helping Alliance Questionnaire) and health economic costs. The diagnosis of (comorbid) mental disorders is carried out with standardised clinical interviews. The measurement will be assessed before (T0), at midpoint (T1) and after the OMPRIS intervention (T2), representing the primary endpoint. Two follow-up assessments will be conducted after 6 weeks (T3) and 6 months (T4) after the intervention. The outcomes will be analysed primarily via analysis of covariance. Both intention-to-treat and per-protocol analyses will be conducted. ETHICS AND DISSEMINATION Participants will provide written informed consent. The trial has been approved by the Ethics Committee of the Faculty of Medicine, Ruhr University Bochum (approval number 19-6779). Findings will be disseminated through presentations, peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER DRKS00019925.
Collapse
Affiliation(s)
- Jan Dieris-Hirche
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Laura Bottel
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Magdalena Pape
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Bert Theodor Te Wildt
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
- Psychosomatic Hospital Diessen Monastery, Diessen am Ammersee, Germany
| | - Klaus Wölfling
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, Technical University Munich, Munich, Germany
| | - Nina Timmesfeld
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr University Bochum, Bochum, Germany
| | - Anja Neumann
- Institute for Medicine Management, University of Duisburg-Essen, Duisburg, Germany
| | - Silke Neusser
- Institute for Medicine Management, University of Duisburg-Essen, Duisburg, Germany
| | - Rainer Beckers
- Competence Centre of Healthcare Telematics, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
17
|
|
18
|
Pharmacological and Psychosocial Treatment of Adults With Gambling Disorder: A Meta-Review. J Addict Med 2021; 14:e15-e23. [PMID: 31651561 DOI: 10.1097/adm.0000000000000574] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Gambling disorder (GD) leads to impaired socioeconomical functioning and increased social costs. Although the research on GD has been rising over the years, approved treatment guidelines are currently not available. The aim of this study was to systematically review the literature on the pharmacological and psychosocial treatment of adults with GD, and to identify possible agreed-upon standards of care. METHODS MEDLINE, PubMed, Cochrane, Web of Science, Embase, and CINAHL electronic databases were searched up to April 2019 for systematic reviews on pharmacological, psychosocial, and combined treatment of adults with GD. Twenty-six studies were eventually included in this meta-review. RESULTS Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in subjects with comorbid bipolar disorders. Cognitive behavioral therapy (CBT) was the most commonly used psychological intervention and reduced global severity, gambling frequency, and financial loss. Motivational interviewing (MI) seemed to improve several GD domains, alone or in combination with CBT. Self-help interventions (SHIs) showed some efficacy in promoting treatment-seeking, and in combination with other treatments. CONCLUSIONS We found moderate evidence of effect for CBT, but weaker evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the short but not in the long term. It is likely that certain interventions might be more effective than others on specific features of GD. Further studies are needed to compare the efficacy and acceptability of individual and combined psychosocial and pharmacological interventions, to deliver patient-tailored treatments.
Collapse
|
19
|
Gold N, Yau A, Rigby B, Dyke C, Remfry EA, Chadborn T. Effectiveness of Digital Interventions for Reducing Behavioral Risks of Cardiovascular Disease in Nonclinical Adult Populations: Systematic Review of Reviews. J Med Internet Res 2021; 23:e19688. [PMID: 33988126 PMCID: PMC8164125 DOI: 10.2196/19688] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/05/2020] [Accepted: 02/03/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Digital health interventions are increasingly being used as a supplement or replacement for face-to-face services as a part of predictive prevention. They may be offered to those who are at high risk of cardiovascular disease and need to improve their diet, increase physical activity, stop smoking, or reduce alcohol consumption. Despite the popularity of these interventions, there is no overall summary and comparison of the effectiveness of different modes of delivery of a digital intervention to inform policy. OBJECTIVE This review aims to summarize the effectiveness of digital interventions in improving behavioral and health outcomes related to physical activity, smoking, alcohol consumption, or diet in nonclinical adult populations and to identify the effectiveness of different modes of delivery of digital interventions. METHODS We reviewed articles published in the English language between January 1, 2009, and February 25, 2019, that presented a systematic review with a narrative synthesis or meta-analysis of any study design examining digital intervention effectiveness; data related to adults (≥18 years) in high-income countries; and data on behavioral or health outcomes related to diet, physical activity, smoking, or alcohol, alone or in any combination. Any time frame or comparator was considered eligible. We searched MEDLINE, Embase, PsycINFO, Cochrane Reviews, and gray literature. The AMSTAR-2 tool was used to assess review confidence ratings. RESULTS We found 92 reviews from the academic literature (47 with meta-analyses) and 2 gray literature items (1 with a meta-analysis). Digital interventions were typically more effective than no intervention, but the effect sizes were small. Evidence on the effectiveness of digital interventions compared with face-to-face interventions was mixed. Most trials reported that intent-to-treat analysis and attrition rates were often high. Studies with long follow-up periods were scarce. However, we found that digital interventions may be effective for up to 6 months after the end of the intervention but that the effects dissipated by 12 months. There were small positive effects of digital interventions on smoking cessation and alcohol reduction; possible effectiveness in combined diet and physical activity interventions; no effectiveness for interventions targeting physical activity alone, except for when interventions were delivered by mobile phone, which had medium-sized effects; and no effectiveness observed for interventions targeting diet alone. Mobile interventions were particularly effective. Internet-based interventions were generally effective. CONCLUSIONS Digital interventions have small positive effects on smoking, alcohol consumption, and in interventions that target a combination of diet and physical activity. Small effects may have been due to the low efficacy of treatment or due to nonadherence. In addition, our ability to make inferences from the literature we reviewed was limited as those interventions were heterogeneous, many reviews had critically low AMSTAR-2 ratings, analysis was typically intent-to-treat, and follow-up times were relatively short. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42019126074; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=126074.
Collapse
Affiliation(s)
- Natalie Gold
- Public Health England, London, United Kingdom.,Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, London, United Kingdom
| | - Amy Yau
- Public Health England, London, United Kingdom.,Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Benjamin Rigby
- Public Health England, London, United Kingdom.,Department of Sociology, University of Durham, Durham, United Kingdom
| | - Chris Dyke
- Public Health England, London, United Kingdom.,Department of Social Science, Institute of Education, University College London, London, United Kingdom
| | - Elizabeth Alice Remfry
- Public Health England, London, United Kingdom.,Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | |
Collapse
|
20
|
Rauschenberg C, Schick A, Hirjak D, Seidler A, Paetzold I, Apfelbacher C, Riedel-Heller SG, Reininghaus U. Evidence Synthesis of Digital Interventions to Mitigate the Negative Impact of the COVID-19 Pandemic on Public Mental Health: Rapid Meta-review. J Med Internet Res 2021; 23:e23365. [PMID: 33606657 PMCID: PMC7951054 DOI: 10.2196/23365] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 12/18/2022] Open
Abstract
Background Accumulating evidence suggests the COVID-19 pandemic has negative effects on public mental health. Digital interventions that have been developed and evaluated in recent years may be used to mitigate the negative consequences of the pandemic. However, evidence-based recommendations on the use of existing telemedicine and internet-based (eHealth) and app-based mobile health (mHealth) interventions are lacking. Objective The aim of this study was to investigate the theoretical and empirical base, user perspective, safety, effectiveness, and cost-effectiveness of digital interventions related to public mental health provision (ie, mental health promotion, prevention, and treatment of mental disorders) that may help to reduce the consequences of the COVID-19 pandemic. Methods A rapid meta-review was conducted. The MEDLINE, PsycINFO, and CENTRAL databases were searched on May 11, 2020. Study inclusion criteria were broad and considered systematic reviews and meta-analyses that investigated digital tools for health promotion, prevention, or treatment of mental health conditions and determinants likely affected by the COVID-19 pandemic. Results Overall, 815 peer-reviewed systematic reviews and meta-analyses were identified, of which 83 met the inclusion criteria. Our findings suggest that there is good evidence on the usability, safety, acceptance/satisfaction, and effectiveness of eHealth interventions. Evidence on mHealth apps is promising, especially if social components (eg, blended care) and strategies to promote adherence are incorporated. Although most digital interventions focus on the prevention or treatment of mental disorders, there is some evidence on mental health promotion. However, evidence on process quality, cost-effectiveness, and long-term effects is very limited. Conclusions There is evidence that digital interventions are particularly suited to mitigating psychosocial consequences at the population level. In times of physical distancing, quarantine, and restrictions on social contacts, decision makers should develop digital strategies for continued mental health care and invest time and efforts in the development and implementation of mental health promotion and prevention programs.
Collapse
Affiliation(s)
- Christian Rauschenberg
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Isabell Paetzold
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,ESRC Centre for Society and Mental Health, King´s College London, London, United Kingdom
| |
Collapse
|
21
|
Blank L, Baxter S, Woods HB, Goyder E. Interventions to reduce the public health burden of gambling-related harms: a mapping review. LANCET PUBLIC HEALTH 2021; 6:e50-e63. [PMID: 33417847 DOI: 10.1016/s2468-2667(20)30230-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/09/2020] [Accepted: 09/22/2020] [Indexed: 12/11/2022]
Abstract
Recognition is growing that gambling, although highly profitable for corporations and governments, is a source of serious and unevenly distributed harm. This recognition has led to demands for public health strategies at the local, national, and international levels. We aimed to identify review-level evidence for interventions to address or prevent gambling-related harms and explore policy implications, using stakeholder consultation to assess the evidence base, identify gaps, and suggest key research questions. We opted for a systematic mapping review and narrative synthesis for all forms of gambling in any setting. We included participants from the whole population, identified gamblers including self-defined, and specific populations at risk (eg, children and young people). We included all outcome measures relating to prevention or treatment of gambling-related harms that were reported by review authors. After duplication, the searches generated 1080 records. Of 43 potential papers, 13 were excluded at the full paper stage and 30 papers were included in the Review. We identified whole-population preventive interventions, such as demand reduction (n=3) and supply reduction (n=4) interventions, and targeted treatment interventions for individuals addicted to gambling, such as therapeutic (n=12), pharmacological (n=5), and self-help or mutual support (n=4) interventions. We also reviewed studies (n=2) comparing these approaches. Interventions to screen, identify, and support individuals at risk of gambling-related harms and interventions to support ongoing recovery and prevent relapse for individuals with a gambling addiction were not represented in the review-level evidence. A public health approach suggests that there are opportunities to reduce gambling-related harms by intervening across the whole gambling pathway, from regulation of access to gambling to screening for individuals at risk and services for individuals with an identified gambling problem. The dearth of evidence for some interventions means that implementation must be accompanied by robust evaluation.
Collapse
Affiliation(s)
- Lindsay Blank
- School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Susan Baxter
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Helen Buckley Woods
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| |
Collapse
|
22
|
Chen J, Ho E, Jiang Y, Whittaker R, Yang T, Bullen C. Mobile Social Network-Based Smoking Cessation Intervention for Chinese Male Smokers: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e17522. [PMID: 33095184 PMCID: PMC7647814 DOI: 10.2196/17522] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/04/2020] [Accepted: 07/07/2020] [Indexed: 01/19/2023] Open
Abstract
Background Around 2 million Chinese people, mostly men, die annually from tobacco-related diseases; yet, fewer than 8% of Chinese smokers ever receive any smoking cessation support. Objective This study aimed to test the preliminary effectiveness and feasibility for a mobile social network (WeChat)–based smoking cessation intervention (SCAMPI program) among Chinese male smokers. Methods Chinese male smokers aged 25-44 years were recruited online from WeChat, the most widely used social media platform in China. Individuals using other smoking cessation interventions or who lacked capacity to provide online informed consent were excluded. Participants were randomly assigned (1:1) to intervention or control groups. Neither participants nor researchers were masked to assignment. The trial was fully online. All data were collected via WeChat. The intervention group received access to the full-version SCAMPI program, a Chinese-language smoking cessation program based on the Behaviour Change Wheel framework and relevant cessation guidelines. Specific intervention functions used in the program include: planning to help users make quitting plans, calculator to record quitting benefits, calendar to record progress, gamification to facilitate quitting, information about smoking harms, motivational messages to help users overcome urges, standardized tests for users to assess their levels of nicotine dependence and lung health, as well as a social platform to encourage social support between users. The control group had access to a static WeChat page of contacts for standard smoking cessation care. Both groups received incentive credit payments for participating. The primary outcome was 30-day biochemically verified smoking abstinence at 6 weeks after randomization, with missing data treated as not quitting. Secondary outcomes were other smoking status measures, reduction of cigarette consumption, study feasibility (recruitment and retention rate), and acceptability of and satisfaction with the program. Results The program recorded 5736 visitors over a 13-day recruitment period. We recruited 80 participants who were randomly allocated to two arms (n=40 per arm). At 6 weeks, 36 of 40 (90%) intervention participants and 35 of 40 (88%) control participants provided complete self-reported data on their daily smoking status via WeChat. Biochemically verified smoking abstinence at 6 weeks was determined for 10 of 40 (25%) intervention participants and 2 of 40 (5%) control participants (RR=5, 95% CI 1.2-21.4, P=.03). In the intervention group, the calculator function, motivational messages, and health tests were underused (less than once per week per users). Participants rated their satisfaction with the intervention program as 4.56 out of 5.00. Conclusions Our program is a novel, accessible, and acceptable smoking cessation intervention for Chinese male smokers. A future trial with a greater sample size and longer follow-up will identify if it is as effective as these preliminary data suggest. Trial Registration ANZCTR registry, ACTRN12618001089224; https://tinyurl.com/y536n7sx International Registered Report Identifier (IRRID) RR2-18071
Collapse
Affiliation(s)
- Jinsong Chen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Elsie Ho
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Yannan Jiang
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Tingzhong Yang
- Centre for Tobacco Control Research, Zhejiang University, Hangzhou, China
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| |
Collapse
|
23
|
Hilbrecht M, Baxter D, Abbott M, Binde P, Clark L, Hodgins DC, Manitowabi D, Quilty L, SpÅngberg J, Volberg R, Walker D, Williams RJ. The Conceptual Framework of Harmful Gambling: A revised framework for understanding gambling harm. J Behav Addict 2020; 9:190-205. [PMID: 32554839 PMCID: PMC8939413 DOI: 10.1556/2006.2020.00024] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/05/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS The Conceptual Framework of Harmful Gambling moves beyond a symptoms-based view of harm and addresses a broad set of factors related to the risks and effects of gambling harmfully at the individual, family, and community levels. Coauthored by international research experts and informed by multiple stakeholders, Gambling Research Exchange (GREO) facilitated the framework development in 2013 and retains responsibility for regular updates and mobilization. This review article presents information about the revised version of the Conceptual Framework of Harmful Gambling completed in late 2018. METHODS We describe eight interrelated factors depicted in the framework that represent major themes in gambling ranging from the specific (gambling environment, exposure, gambling types, and treatment resources) to the general (cultural, social, psychological, and biological influences). After outlining the framework development and collaborative process, we highlight new topics for the recent update that reflect changes in the gambling landscape and prominent discourses in the scientific community. Some of these topics include social and economic impacts of gambling, and a new model of understanding gambling related harm. DISCUSSION AND CONCLUSIONS We address the relevance of the CFHG to the gambling and behavioral addictions research community. Harm-based frameworks have been undertaken in other areas of addiction that can both inform and be informed by a model dedicated to harmful gambling. Further, the framework brings a multi-disciplinary perspective to bear on antecedents and factors that co-occur with harmful gambling.
Collapse
Affiliation(s)
- Margo Hilbrecht
- Gambling Research Exchange, Guelph, ON, Canada,Deptartment of Recreation & Leisure Studies, University of Waterloo, Waterloo, ON, Canada,Corresponding author. Gambling Research Exchange, 55 Wyndham St. N., Suite 204A, Guelph, ON, N1H 7T8, Canada E-mail: . Tel.: +1 519 763 8049, x101
| | | | - Max Abbott
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Per Binde
- School of Global Studies, University of Gothenburg, Gothenburg, Sweden
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Darrel Manitowabi
- School of Northern and Community Studies, Laurentian University, Sudbury, ON, Canada
| | - Lena Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Rachel Volberg
- School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Douglas Walker
- Department of Economics, College of Charleston, Charleston, SC, USA
| | - Robert J. Williams
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| |
Collapse
|
24
|
Wen S, Larsen H, Boffo M, Grasman RPPP, Pronk T, van Wijngaarden JBG, Wiers RW. Combining Web-Based Attentional Bias Modification and Approach Bias Modification as a Self-Help Smoking Intervention for Adult Smokers Seeking Online Help: Double-Blind Randomized Controlled Trial. JMIR Ment Health 2020; 7:e16342. [PMID: 32383682 PMCID: PMC7244992 DOI: 10.2196/16342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/25/2019] [Accepted: 01/26/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Automatically activated cognitive motivational processes such as the tendency to attend to or approach smoking-related stimuli (ie, attentional and approach bias) have been related to smoking behaviors. Therefore, these cognitive biases are thought to play a role in maintaining smoking behaviors. Cognitive biases can be modified with cognitive bias modification (CBM), which holds promise as an easy-access and low-cost online intervention. However, little is known about the effectiveness of online interventions combining two varieties of CBM. Targeting multiple cognitive biases may improve treatment outcomes because these biases have been shown to be relatively independent. OBJECTIVE This study aimed to test the individual and combined effects of two web-based CBM varieties-attentional bias modification (AtBM) and approach bias modification (ApBM)-in a double-blind randomized controlled trial (RCT) with a 2 (AtBM: active versus sham) × 2 (ApBM: active versus sham) factorial design. METHODS A total of 504 adult smokers seeking online help to quit smoking were randomly assigned to 1 of 4 experimental conditions to receive 11 fully automated CBM training sessions. To increase participants' intrinsic motivation to change their smoking behaviors, all participants first received brief, automated, tailored feedback. The primary outcome was point prevalence abstinence during the study period. Secondary outcomes included daily cigarette use and attentional and approach bias. All outcomes were repeatedly self-assessed online from baseline to the 3-month follow-up. For the examination of training effects on outcome changes, an intention-to-treat analysis with a multilevel modeling (MLM) approach was adopted. RESULTS Only 10.7% (54/504) of the participants completed all 11 training sessions, and 8.3% (42/504) of the participants reached the 3-month follow-up assessment. MLM showed that over time, neither AtBM or ApBM nor a combination of both differed from their respective sham training in point prevalence abstinence rates (P=.17, P=.56, and P=.14, respectively), and in changes in daily cigarette use (P=.26, P=.08, and P=.13, respectively), attentional bias (P=.07, P=.81, and P=.15, respectively), and approach bias (P=.57, P=.22, and P=.40, respectively), while daily cigarette use decreased over time across conditions for all participants (P<.001). CONCLUSIONS This RCT provides no support for the effectiveness of combining AtBM and ApBM in a self-help web-based smoking cessation intervention. However, this study had a very high dropout rate and a very low frequency of training usage, indicating an overall low acceptability of the intervention, which precludes any definite conclusion on its efficacy. We discuss how this study can inform future designs and settings of online CBM interventions. TRIAL REGISTRATION Netherlands Trial Register NTR4678; https://www.trialregister.nl/trial/4678.
Collapse
Affiliation(s)
- Si Wen
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Helle Larsen
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Marilisa Boffo
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | | | - Thomas Pronk
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | | | - Reinout W Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
25
|
Effect of a web-based relapse prevention program on abstinence among Japanese drug users: A pilot randomized controlled trial. J Subst Abuse Treat 2020; 111:37-46. [DOI: 10.1016/j.jsat.2019.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 12/22/2022]
|
26
|
Abstract
Gambling disorder is characterized by a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The prevalence of gambling disorder has been estimated at 0.5% of the adult population in the United States, with comparable or slightly higher estimates in other countries. The aetiology of gambling disorder is complex, with implicated genetic and environmental factors. Neurobiological studies have implicated cortico-striato-limbic structures and circuits in the pathophysiology of this disorder. Individuals with gambling disorder often go unrecognized and untreated, including within clinical settings. Gambling disorder frequently co-occurs with other conditions, particularly other psychiatric disorders. Behavioural interventions, particularly cognitive-behavioural therapy but also motivational interviewing and Gamblers Anonymous, are supported in the treatment of gambling disorder. No pharmacological therapy has a formal indication for the treatment of gambling disorder, although placebo-controlled trials suggest that some medications, such as opioid-receptor antagonists, may be helpful. Given the associations with poor quality of life and suicide, improved identification, prevention, policy and treatment efforts are needed to help people with gambling disorder.
Collapse
|
27
|
Wittekind CE, Bierbrodt J, Lüdecke D, Feist A, Hand I, Moritz S. Cognitive bias modification in problem and pathological gambling using a web-based approach-avoidance task: A pilot trial. Psychiatry Res 2019; 272:171-181. [PMID: 30583260 DOI: 10.1016/j.psychres.2018.12.075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 02/06/2023]
Abstract
There is evidence that training addicted participants to implicitly avoid disorder-related stimuli by using a training version of the Approach-Avoidance Task (AAT) results in reduced substance consumption (i.e., Approach Bias Modification [AppBM]). The aim of the present web-based study was to investigate the feasibility and effectiveness of AppBM in reducing gambling-related symptoms. A self-selected sample of participants with problem/pathological slot-machine gambling completed an online survey and received either AppBM or Sham training (final N = 131). Attrition during study participation was high (66%). In both conditions slot-machine related and neutral pictures were presented. Within the AppBM condition all slot-machine related pictures had to be pushed and all neutral pictures had to be pulled, whereas in the Sham condition the contingency was 50:50. Eight weeks after baseline, participants were re-assessed. Both groups showed a similar reduction in gambling-related symptoms. Findings are at odds with the hypothesis claiming that only contingency trainings yield beneficial effects. However, it cannot be ruled out that effects result from other factors unrelated to training such as expectancy effects. We think this study holds valuable information how to conduct larger trials in the future and may prove helpful to improve training and its delivery.
Collapse
Affiliation(s)
- Charlotte E Wittekind
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg 20246, Germany.
| | - Julia Bierbrodt
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg 20246, Germany
| | - Daniel Lüdecke
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Institute of Medical Sociology, Martinistraße 52, Hamburg 20246, Germany
| | - Ansgar Feist
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg 20246, Germany
| | - Iver Hand
- MVZ Falkenried, Falkenried 7, Hamburg 20251, Germany
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, Hamburg 20246, Germany
| |
Collapse
|
28
|
van der Maas M, Shi J, Elton-Marshall T, Hodgins DC, Sanchez S, Lobo DS, Hagopian S, Turner NE. Internet-Based Interventions for Problem Gambling: Scoping Review. JMIR Ment Health 2019; 6:e65. [PMID: 30617046 PMCID: PMC6329421 DOI: 10.2196/mental.9419] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 07/31/2018] [Accepted: 10/23/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This study seeks to give an overview of academic research on internet-based interventions that are used to address problem gambling. The rate of treatment seeking has been demonstrated to be low across several research environments. This is in part because of the systemic barriers that treatment seekers face to accessing traditional face-to-face treatment. Making treatment resources for problem gambling available through the internet is one way to reduce the impact of those systemic barriers. The use of internet-based resources to address problem gambling has been growing, and a field of research evaluating it has developed as well. However, little has been done to summarize this collection of research. OBJECTIVE This study aimed to provide a scoping review of the use of internet-based interventions for problem gambling treatment and prevention to provide an understanding of the current state of the field. METHODS A scoping review was performed for 6 peer-reviewed research databases (Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Social Science Abstracts, and Scopus) and 3 gray literature databases (MedEdPortal, Proquest: Dissertations, and OpenGrey). Article inclusion criteria were as follows: published over the 10-year period of 2007 to 2017, including an intervention for problem gambling, and involving the use of internet to deliver that intervention. RESULTS A total of 27 articles were found that met the review criteria. Studies were found from several different areas, with particularly strong representation for Australia, New Zealand, and Scandinavia. Cognitive behavioral therapy was the most common form of internet-based intervention. Internet-based interventions were generally shown to be effective in reducing problem gambling scores and gambling behaviors. A wide range of interventions that made use of internet resources included text-based interactions with counselors and peers, automated personalized and normative feedback on gambling behaviors, and interactive cognitive behavioral therapies. A lack of diversity in samples, little comparison with face-to-face interventions, and issues of changes in the treatment dynamic are identified as areas that require further investigation. CONCLUSIONS Internet-based interventions are a promising direction for treatment and prevention of problem gambling, particularly in reducing barriers to accessing professional help. The state of the current literature is sparse, and more research is needed for directly comparing internet-based interventions and their traditional counterparts.
Collapse
Affiliation(s)
- Mark van der Maas
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jing Shi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Tara Elton-Marshall
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, ON, Canada
| | - Sherald Sanchez
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Daniela Ss Lobo
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sylvia Hagopian
- Problem Gambling Institute of Ontario, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nigel E Turner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
29
|
Nahum-Shani I, Dziak JJ, Collins LM. Multilevel factorial designs with experiment-induced clustering. Psychol Methods 2018; 23:458-479. [PMID: 28383950 PMCID: PMC5630520 DOI: 10.1037/met0000128] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Factorial experimental designs have many applications in the behavioral sciences. In the context of intervention development, factorial experiments play a critical role in building and optimizing high-quality, multicomponent behavioral interventions. One challenge in implementing factorial experiments in the behavioral sciences is that individuals are often clustered in social or administrative units and may be more similar to each other than to individuals in other clusters. This means that data are dependent within clusters. Power planning resources are available for factorial experiments in which the multilevel structure of the data is due to individuals' membership in groups that existed before experimentation. However, in many cases clusters are generated in the course of the study itself. Such experiment-induced clustering (EIC) requires different data analysis models and power planning resources from those available for multilevel experimental designs in which clusters exist prior to experimentation. Despite the common occurrence of both experimental designs with EIC and factorial designs, a bridge has yet to be built between EIC and factorial designs. Therefore, resources are limited or nonexistent for planning factorial experiments that involve EIC. This article seeks to bridge this gap by extending prior models for EIC, developed for single-factor experiments, to factorial experiments involving various types of EIC. We also offer power formulas to help investigators decide whether a particular experimental design involving EIC is feasible. We demonstrate that factorial experiments can be powerful and feasible even with EIC. We discuss design considerations and directions for future research. (PsycINFO Database Record
Collapse
Affiliation(s)
- Inbal Nahum-Shani
- Institute for Social Research, 426 Thompson Street, Suite 2204, Ann Arbor, MI 48104-2321, University of Michigan
| | - John J. Dziak
- The Methodology Center, 404 Health and Human Development Building, Penn State, University Park, PA 16802, Pennsylvania State University
| | - Linda M. Collins
- Department of Human Development & Family Studies and The Methodology Center, 404 Health and Human Development Building, Penn State, University Park, PA 16802, Pennsylvania State University
| |
Collapse
|
30
|
Bücker L, Bierbrodt J, Hand I, Wittekind C, Moritz S. Effects of a depression-focused internet intervention in slot machine gamblers: A randomized controlled trial. PLoS One 2018; 13:e0198859. [PMID: 29883479 PMCID: PMC5993308 DOI: 10.1371/journal.pone.0198859] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/18/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Problematic and pathological gambling have been linked to depression. Despite a high demand for treatment and negative financial consequences, only a small fraction of problematic and pathological gamblers seek professional help. The existing treatment gap could be narrowed by providing low-threshold, anonymous internet-based interventions. The aim of the present study was to examine the acceptance and efficacy of an online-intervention for depression ("Deprexis") in a sample of problematic and pathological slot-machine gamblers. We hypothesized that the intervention group would show a greater reduction in both depressive and gambling-related symptoms compared to a wait-list control group. METHOD A total of 140 individuals with self-reported gambling and mood problems were randomly allocated either to the intervention group or to a wait-list control group. After 8 weeks, all participants were invited for re-assessment. The Patient Health Questionnaire - 9 (PHQ-9) served as the primary outcome assessment. Problematic gambling was measured with the Pathological Gambling Adaptation of Yale-Brown Obsessive Compulsive Scale (PG-YBOCS) and the South Oaks Gambling Screen (SOGS). The trial is registered with the German Registry for Clinical Studies (DRKS00013888). RESULTS ITT analyses showed that the intervention led to a significant reduction in depressive symptoms as well as gambling-related symptoms compared to the control group, with moderate to strong effect sizes. PP analyses failed to yield significant results due to high rates of non-completion and limited statistical power. Moderator analyses indicated that Deprexis was particularly beneficial in reducing problematic gambling for those scoring high on baseline gambling-related symptoms and for those who gamble due to loneliness. DISCUSSION Results of the present study suggest that Deprexis might be a useful adjunct to traditional interventions for the treatment of problematic gambling. The potential of internet-based interventions that are more targeted at issues specific to gambling should be evaluated in future studies. TRIAL REGISTRATION German Registry for Clinical Studies DRKS00013888.
Collapse
Affiliation(s)
- Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Bierbrodt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Iver Hand
- Ambulatory Healthcare Center Falkenried, Hamburg, Germany
| | - Charlotte Wittekind
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
31
|
Menchon JM, Mestre-Bach G, Steward T, Fernández-Aranda F, Jiménez-Murcia S. An overview of gambling disorder: from treatment approaches to risk factors. F1000Res 2018; 7:434. [PMID: 30090625 PMCID: PMC5893944 DOI: 10.12688/f1000research.12784.1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 12/26/2022] Open
Abstract
Gambling disorder (GD) has been reclassified recently into the "Substance-Related and Addictive Disorders" category of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a landmark occurrence for a behavioral addiction. GD is characterized by recurrent, maladaptive gambling behavior that results in clinically significant distress. Although the number of randomized controlled trials assessing the effectiveness of pharmacological treatments is limited, some pharmacological treatments, notably opiate antagonists, have been employed in the treatment of GD. Patients with GD often present cognitive distortions and specific personality traits, making treatment more difficult. Cognitive behavioral therapy has become the most common psychological intervention for treating gambling problems, and it is effective in reducing gambling behavior. In this brief overview, we provide a report on the state of pharmacological and psychological treatments for gambling disorder. Risk factors and potential future lines of research are addressed.
Collapse
Affiliation(s)
- José M Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona , Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain
| | - Gemma Mestre-Bach
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona , Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Departament of Clinical Sciences, School of Medicine, University of Barcelona , Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| |
Collapse
|
32
|
Rodda SN, Dowling NA, Knaebe B, Lubman DI. Does SMS improve gambling outcomes over and above access to other e-mental health supports? A feasibility study. INTERNATIONAL GAMBLING STUDIES 2017. [DOI: 10.1080/14459795.2017.1388831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S. N. Rodda
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland , Auckland, New Zealand
- Turning Point, Eastern Health , Fitzroy, Australia
- School of Psychology, Deakin University , Geelong, Australia
| | - N. A. Dowling
- School of Psychology, Deakin University , Geelong, Australia
- Melbourne Graduate School of Education , Melbourne, Australia
| | - B. Knaebe
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland , Auckland, New Zealand
| | - D. I. Lubman
- Turning Point, Eastern Health , Fitzroy, Australia
- Eastern Health Clinical School, Monash University , Melbourne, Australia
| |
Collapse
|