The Role of Attachment in Gambling Behaviors and Gambling Disorder: A Systematic Review

Pharmacological management of gambling disorder: an update of the literature

INTRODUCTION

Gambling disorder (GD) is a mental health condition characterized by persistent and problematic betting behavior. GD generates distress and impairment, and treatment options include psychological and pharmacological interventions.

AREAS COVERED

This narrative review explores existing pharmacological treatments for GD. The following classes of medications were considered: opioid-receptor antagonists (e.g. naltrexone and nalmefene), serotonin reuptake inhibitors (e.g. fluvoxamine, paroxetine, sertraline, escitalopram, and citalopram), glutamatergic agents (e.g. N-acetylcysteine (NAC), acamprosate, and memantine), mood stabilizers (e.g. topiramate, carbamazepine, lithium), and other medications (e.g. modafinil, nefazodone, olanzapine, haloperidol, tolcapone, and bupropion).

EXPERT OPINION

Due to the limitations of the studies reviewed, solid conclusions regarding the optimal choice of pharmacotherapy for individuals with GD are challenging to draw at this time. Despite some medications, such as naltrexone and nalmefene, showing promising results, efficacy has varied across studies. The review highlights current gaps/limitations, including small sample sizes, limited diversity in participant demographics, the need for exploring different gambling subtypes and treatment responses, high placebo response rates, lack of longer-term longitudinal information, limited investigation of neurobiological correlates and co-occurring disorders, and the importance of implementation research. Further research is needed to address these gaps and explore additional medications, as well as interventions like neuromodulation.

Effects of use motivations and alexithymia on smartphone addiction: mediating role of insecure attachment

Background and objectives

Concern exists regarding the potential negative consequences of smartphone addiction among adolescents. This study investigated the effect of use motivations and alexithymia on smartphone addiction among adolescents with two insecure attachment styles, namely, anxious and avoidant attachment. These attachment styles were regarded as mediating variables.

Methods

Self-report measures were used to assess use motivations, alexithymia, insecure attachment and smartphone addiction. Data were collected from 748 junior high school students (382 males and 366 females) in northeastern China. Structural equation modeling was used to test our hypothesis that use motivations and alexithymia are directly associated with smartphone addiction and also through the mediation of attachment insecurities.

Results

The structural equation modeling results showed a strong and positive correlation between use motivation and smartphone addiction, with avoidant attachment mediating such a relationship. Meanwhile, the two components of alexithymia, difficulty identifying feelings and externally oriented thinking, positively predicted smartphone addiction, with avoidant attachment serving as a mediator of this effect. In addition, the mediation analysis results demonstrated that attachment anxiety mediated the connection between escape drive, extrinsically focused thought, and smartphone addiction.

Conclusion

Findings describe how attachment insecurities, smartphone use motivations, and alexithymia can interact with one another to predict smartphone addiction. Smartphone use motivation types and alexithymia symptoms should be taken into consideration when designing targeted intervention programs for smartphone addiction to address the different attachment needs of adolescents, which would be helpful to reduce their smartphone addiction behaviors.

Problematic Media Use among Children up to the Age of 10: A Systematic Literature Review

INTRODUCTION

Digital screen media use has significantly grown in all age groups and at an increasingly young age, including toddlers, schoolers, and primary school children. Although there is evidence that excessive early childhood media exposure can lead to several negative developmental outcomes, no systematic review on Problematic Media Use (PMU) of children under 10 years old have been provided. The aim of the present systematic review was to identify (i) the main instruments used to measure children's PMU across different studies; (ii) the risk and protective factors which might increase or reduce children's PMU; and (iii) the negative outcomes associated with children's PMU.

METHODS

This study was conducted following the systematic review guidelines proposed in the PRISMA statement. A total of 35 studies published between 2012-2022 and with a mean sample age between 0 and 10 years old were ultimately included in this literature review.

RESULTS

Use of media for more than 2 h a day, male gender, and higher age increased the risk of developing PMU among children. PMU led to several negative consequences for children's development and well-being (e.g., more problematic behaviors, sleep problems, higher depressive symptoms, lower emotional intelligence, and lower academic achievements). Children who experienced negative psychological symptoms, a dysfunctional parent-child relationship, and difficulties in school context were more prone to develop PMU. However, an authoritative parenting style and restrictive parental mediation reduced the risk of developing PMU among children. Finally, self-report measures specifically designed to get the younger children's perspective are still few and not so widely used.

CONCLUSIONS

Overall, this research field is still in its infancy and needs further investigation. Likely, a dysfunctional family system can lead children to experience emotional distress and negative psychological symptoms, which they try to manage by escaping into the virtual world, thus increasing the risk of developing PMU. As the children's PMU is closely affected by the family environment, future prevention interventions should target both children and their parents to improve their self-regulatory and mentalizing capabilities, as well as parental mediation strategies and general parenting practices.