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Richardson T, Egglishaw A, Sood M. Does Childhood Trauma Predict Impulsive Spending in Later Life? An Analysis of the Mediating Roles of Impulsivity and Emotion Regulation. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:275-281. [PMID: 38938974 PMCID: PMC11199441 DOI: 10.1007/s40653-023-00600-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 06/29/2024]
Abstract
We sought to investigate whether adverse childhood experiences increase impulsive spending in later life, and whether emotion dysregulation and impulsivity mediate this association. Limited research has examined associations between these factors, and examining the mechanisms involved may inform interventions for impulsive spending. This study used a cross-sectional, correlational design including 189 adult participants who completed an online survey assessing childhood trauma, adverse childhood experiences, impulsive spending, impulsivity, and emotion dysregulation. Greater adverse childhood experiences and childhood trauma were positively correlated with impulsive spending, as well as general impulsivity and emotion dysregulation. Mediation analyses indicated that emotion dysregulation and greater impulsivity accounted for the positive relationship between childhood trauma and impulse spending. Adverse childhood experiences and childhood trauma are associated with increased risk of impulse spending in adulthood via elevated general impulsivity and emotion dysregulation.
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Affiliation(s)
- Thomas Richardson
- School of Psychology, University of Southampton, Building 44, Highfield Campus, University Road, Southampton, SO17 1BJ England, UK
| | - Annelise Egglishaw
- School of Psychology, University of Southampton, Building 44, Highfield Campus, University Road, Southampton, SO17 1BJ England, UK
| | - Monica Sood
- School of Psychology, University of Southampton, Building 44, Highfield Campus, University Road, Southampton, SO17 1BJ England, UK
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Najavits LM, Ledgerwood DM, Afifi TO. A Randomized Controlled Trial for Gambling Disorder and PTSD: Seeking Safety and CBT. J Gambl Stud 2023; 39:1865-1884. [PMID: 37306874 PMCID: PMC10258785 DOI: 10.1007/s10899-023-10224-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/13/2023]
Abstract
Studies show a compelling association between gambling disorder and posttraumatic stress disorder. However, there have been no randomized controlled trials for this co-morbidity. The aim of the current study was to compare two evidence-based models, one that addresses both disorders and another that addresses gambling alone. Sixty-five men and women with gambling disorder and posttraumatic stress disorder were randomized to one of two treatment conditions delivered via telehealth, Seeking Safety (integrated treatment for gambling and posttraumatic stress disorder) or Cognitive-Behavioral Therapy for Pathological Gambling (for gambling alone), in a randomized controlled non-inferiority trial. Primary outcomes were net gambling losses and number of sessions gambling. Secondary outcomes were posttraumatic stress disorder symptoms, coping skills, general psychiatric symptoms, global functioning, and gambling cognitions. Assessment occurred at baseline, 6-weeks, 3 months (end of treatment) and 1-year. On most measures, including primary outcomes, participants improved significantly over time with no difference between treatment conditions. Seeking Safety patients had significantly higher session attendance. Effect sizes were large for gambling, posttraumatic stress disorder and coping. All other measures except one showed medium effect sizes. Therapeutic alliance, treatment satisfaction, and the telehealth format were all rated positively. This was the first randomized trial of Seeking Safety in a gambling disorder population. Seeking Safety showed comparable efficacy to an established gambling disorder intervention; and significantly higher Seeking Safety attendance indicates especially strong engagement. Our finding of overall comparable results between the two treatments is consistent with the comorbidity treatment literature.Trial registration: ClinicalTrials.gov NCT02800096; Registration date: June 14, 2016.
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Affiliation(s)
- Lisa M. Najavits
- Treatment Innovations, Newton Centre, MA USA
- Department of Psychiatry, UMass Chan Medical School, Worcester, MA USA
| | - David M. Ledgerwood
- Department of Psychology, University of Windsor, Windsor, ON Canada
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI USA
| | - Tracie O. Afifi
- Department of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Canada
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Bonny-Noach H. Differences Between Illegal and Legal Gamblers in Israel: Gambling Behavior, Motivation, and Substance Use. J Gambl Stud 2023; 39:1239-1252. [PMID: 35780477 DOI: 10.1007/s10899-022-10142-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 10/17/2022]
Abstract
Little is known about people who gamble in illegal settings, and the extent of differences in gambling behavior between legal and illegal gamblers is unclear. The present study examined the characteristics of illegal gamblers and whether they engage in more frequent and severe gambling behaviors, and demonstrate greater motivation for gambling and substance use than legal gamblers. A cross-sectional online survey recruited 1251 people who gambled in the preceding year, of whom 13% (N = 161) participated in illegal gambling. Significant differences were found in gambling behaviors between illegal and legal gamblers in all outcomes examined. People who participated in illegal gambling reported more frequent participation in almost all types of legal gambling, more types of "multi-bets," more severe and high-risk gambling behaviors, higher motivations to gamble, and higher frequencies of substance use than those who engaged in legal gambling. Logistic regressions revealed that the stronger associations with illegal gambling were among problem gamblers (OR = 17.80; CI 9.21-34.4; p < 0.000), among the age group of 29-41 years (OR = 6.16; CI 3.15-12.3; p < 0.000), among moderate-risk gamblers (OR = 5.54; CI 3.42-3.42; p < 0.000) and among secular individuals (OR = 4.11; CI 1.73-9.77; p ≤ 0.001). A comprehensive gambling policy is needed in Israel to address illegal gambling. The policy should attend to harm reduction, treatment, prevention, and enforcement. Additionally, more studies are needed to examine gambling behavior and other risk behaviors of illegal gamblers.
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Affiliation(s)
- Hagit Bonny-Noach
- Department of Criminology, Faculty of Social Sciences and Humanities, Ariel University, Ariel, Israel.
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The Impact of Adverse Childhood Experiences on Problem Gambling in New Mexico. JOURNAL OF PREVENTION (2022) 2023; 44:309-324. [PMID: 36759431 DOI: 10.1007/s10935-023-00725-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Abstract
The study of Adverse Childhood Experiences (ACEs) has consistently demonstrated a strong relationship with poor behavioral health outcomes. Further research is needed to understand if a specific ACE, or subcategorizations of ACEs, matter more for behavioral health outcomes. A study of the association between ACEs and problem gambling involving a racially mixed sample (13,217 participants) in New Mexico is presented to illustrate how certain ACEs may have a larger impact on behavioral health outcomes. The researchers examined: 1.) the impact that each individual ACE have on participant's reported problem gambling; 2) which group (abuse or household challenges) had a greater odds ratio and marginal impact on participant's self-reported gambling; and 3) which BRFSS subcategories (emotional abuse, physical abuse, sexual abuse, IPV, substance abuse, mental illness, parental separation or divorce, and incarcerated household member) had a greater odds ratio and marginal impact on participant's self-reported gambling. The results of this study indicate ACEs had a significant influence on problem gambling, and data suggests that when BRFSS data is examined in groups or subcategories there is a difference in the influence that ACEs have on problem gambling. In particular, we found that odds ratio to be significant when participants reported mental health problems in the home (OR = 1.34, 95% CI [1.02, 1.76], p < 0.04), living with incarcerated household members (OR = 1.75, 95% CI [1.28, 2.41], p < 0.001), how often adults hit each other (OR = 1.29, 95% CI [1.10, 1.52], p < 0.001), and how often anyone at least 5 years older than them forced them to have sex (OR = 1.42, 95% CI [1.10, 1.82], p < 0.01) In relation to types of abuse, There was a significant difference in self-reported problem gambling for individuals who reported sexual abuse (OR = 1.64, 95% CI [1.10, 2.46], p < 0.016), as well as participants reporting living with an incarcerated household member (OR = 2.08, 95% CI [1.34, 3.22], p < 0.001); approaching significant results also included individuals who witnessed their parents act violent towards one another (OR = 1.52, 95% CI [.99, 2.33], p < 0.055), and having parents who were separated or divorced (OR = 0.68, 95% CI [0.46, 1.00], p < 0.053). Finally, there was a significant difference in self-reported problem gambling for individuals who reported abuse (OR = 1.36, 95% CI [1.11, 1.66], p < 0.003), while participants reporting household challenges did not quite reach statistical significance (OR = 1.49, 95% CI [0.99, 1.33], p < 0.062. These findings show us that the way we ask questions about the precedence and outcomes of risky behavior matter and warrant further attention.
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Wang X, Heath RD, Majewski D, Blake C. Adverse childhood experiences and child behavioral health trajectory from early childhood to adolescence: A latent class analysis. CHILD ABUSE & NEGLECT 2022; 134:105879. [PMID: 36115324 DOI: 10.1016/j.chiabu.2022.105879] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) profoundly influence child development. Different patterns of ACEs among boys and girls may be associated with different developmental trajectories. OBJECTIVE This study aimed to identify patterns of ACEs at age three and tested the associations of these patterns with child behavioral health problems from age three to age fifteen. PARTICIPANTS AND SETTING This study used data (N = 4898) from the Fragile Families Child Wellbeing Study. METHODS First, this study conducted latent class analysis (LCA) across ten indicators of ACEs at age 3. LCA was conducted separately for boys and girls. Second, class membership was tested for associations with child internalizing symptoms and externalizing behaviors (ages three, five, nine, and fifteen years). RESULTS LCA identified five classes of ACEs for girls: low ACEs, parental separation, financial difficulty, chaotic home, and child maltreatment. LCA for boys, however, identified a six-class solution, in which there was a physical abuse-only class, while also a sixth high ACEs class that included both physical and emotional abuse. Classes with the most ACEs often had the highest symptomology (internalizing symptoms ranging from 0.24 to 0.56; externalizing ranging from 0.36 to 1.00; ps < .05). However, differences in behavioral health were detected depending on the patterns of ACES. At ages nine and fifteen, the financial difficulty group also had high symptomatology (internalizing symptoms ranging from 0.23 to 0.43; externalizing from 0.23 to 0.46; ps < .05). CONCLUSIONS Findings provide implications including the need to examine ACEs heterogeneity and address financial difficulty as a substantial ACE.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
| | - Ryan D Heath
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Daniel Majewski
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Corinne Blake
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
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The intergenerational transmission of gambling and other addictive behaviors: Implications of the mediating effects of cross-addiction frequency and problems. Addict Behav 2022; 135:107460. [PMID: 35995016 DOI: 10.1016/j.addbeh.2022.107460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/19/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study examined the degree to which perceptions of familial and household participation in gambling and other addictive behaviors in youth was associated with frequency and problem severity of gambling, alcohol and/or drug use in participants as adults. METHOD The study measured perceived frequency of gambling, alcohol use, drug use and other potentially addictive behaviors in family/household members and the frequency and problem severity of gambling, alcohol, and drugs in an epidemiological sample of adults 18 and older (N = 3,499; m = 48.26 %, f = 51.74 %). RESULTS About 23.45 % of participants reported their father gambled when they were a child or adolescent, followed by mother (13.56 %), grandfather (9.73 %), or grandmother (7.83 %). A pathway model demonstrated cross-addiction inter- and intra-generational influences. Gambling by a father, mother or brother; substance use by a sister; and/or engagement in other behaviors by a brother, sister, grandmother or other household member was related to higher frequency of participant gambling (ps < 0.05), and, in turn, to higher levels of gambling, alcohol, and drug use problem severity (ps < 0.05). DISCUSSION Findings demonstrate the complex contributions of specific family and household members in the transmission of addictive behaviors. Frequency of gambling, alcohol use, and drug use mediated the relationship of perceived family behavior with and across addictions. In addition, perceptions regarding use of alcohol and/or other drugs, or engagement in other behaviors by family or household members was related not only to participants' alcohol and drug use but also to problem gambling frequency and severity.
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Bonnaire C, Billieux J. A process-based analysis of the pathways model of problem gambling through clinical case formulations. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2102203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Céline Bonnaire
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France
- Centre Pierre Nicole, “Consultation Jeunes Consommateurs”, Croix-Rouge Française, Paris, France
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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Lacey RE, Howe LD, Kelly-Irving M, Bartley M, Kelly Y. The Clustering of Adverse Childhood Experiences in the Avon Longitudinal Study of Parents and Children: Are Gender and Poverty Important? JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:2218-2241. [PMID: 32639853 PMCID: PMC8918866 DOI: 10.1177/0886260520935096] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Previous research has demonstrated a graded relationship between the number of Adverse Childhood Experiences reported (an ACE score) and child outcomes. However, ACE scores lack specificity and ignore the patterning of adversities, which are informative for interventions. The aim of the present study was to explore the clustering of ACEs and whether this clustering differs by gender or is predicted by poverty. Data on 8,572 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC) were used. ALSPAC is a regionally representative prenatal cohort of children born between 1991 and 1992 in the Avon region of South-West England. ACEs included parental divorce, death of a close family member, interparental violence, parental mental health problems, parental alcohol misuse, parental drug use, parental convictions, and sexual, emotional, and physical abuse, between birth and 19 years. Latent class analysis was used to derive ACE clusters and associations between poverty, gender, and the derived classes tested using multinomial logistic regression. Five latent classes were identified: "Low ACEs" (55%), "Parental separation and mother's mental health problems" (18%), "Parental mental health problems, convictions and separation" (15%), "Abuse and mental health problems" (6%), and "Poly adversity" (6%). Death of a close family member and sexual abuse did not cluster with other adversities. The clustering did not differ by gender. Poverty was strongly related to both individual ACEs and clusters. These findings demonstrate that ACEs cluster in specific patterns and that poverty is strongly related to this. Therefore, reducing child poverty might be one strategy for reducing ACEs.
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Affiliation(s)
- Rebecca E. Lacey
- University College London, UK
- Rebecca E. Lacey, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1A 6BT, UK.
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Bristow LA, Afifi TO, Salmon S, Katz LY. Risky Gambling Behaviors: Associations with Mental Health and a History of Adverse Childhood Experiences (ACEs). J Gambl Stud 2021; 38:699-716. [PMID: 34164766 PMCID: PMC9411081 DOI: 10.1007/s10899-021-10040-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 11/24/2022]
Abstract
Problem gambling and adverse childhood experiences (ACEs) are highly co-morbid and lead to numerous adverse health outcomes. Research demonstrates that greater levels of well-being protect individuals from experiencing ACE-related harms after a history of childhood adversity; however, this relationship has not been examined in the gambling literature. We hypothesized that individuals who experienced ACEs would engage in more problem gambling behaviors. We also hypothesized that individuals who experienced ACEs and reported flourishing mental health would have lower rates of problem gambling than individuals who experienced ACEs but did not report flourishing mental health. We conducted a secondary data analysis of the adult sample in the Well-Being and Experiences (WE) Study. Examining a parent population, parents and caregivers (N = 1000; Mage = 45.2 years; 86.5% female) of adolescents were interviewed on a variety of measures, including their history of ACEs, their gambling behaviors within the past year, and their mental health and well-being. We used multinomial logistic regression analysis to examine the relationship between 15 ACEs and gambling type (i.e., non-gambler, non-problem gambler, at-risk/problem gambler). We used interaction terms between each ACE and mental health to examine the moderating role of flourishing mental health and well-being. ACEs were associated with at-risk/problem gambling supporting hypothesis 1. Contrary to hypothesis 2, overall, flourishing mental health did not moderate the relationship between ACEs and gambling severity except for one ACE. In this study, we were able to gain a better understanding of how different ACEs each contribute to varying levels of gambling severity.
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Affiliation(s)
- Lindsay A. Bristow
- Max Rady College of Medicine, University of Manitoba, 727 McDermot Ave, Winnipeg, MB R3E 3P5 Canada
| | - Tracie O. Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, MB R3E 0W5 Canada
| | - Samantha Salmon
- Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Ave, Winnipeg, MB R3E 0W3 Canada
| | - Laurence Y. Katz
- Department of Psychiatry, University of Manitoba, PZ-162, 771 Bannatyne Ave, Winnipeg, MB R3E 3N4 Canada
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Forster M, Rogers C, Sussman SY, Yu S, Rahman T, Zeledon H, Benjamin SM. Adverse childhood experiences and problematic smartphone use among college students: Findings from a pilot study. Addict Behav 2021; 117:106869. [PMID: 33609812 DOI: 10.1016/j.addbeh.2021.106869] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND There has been a tremendous increase in the use of smartphones among college students and alongside the benefits there is growing concern over problematic/addictive smartphone use (PSU). Among the most robust predictors of behavioral and substance use disorders are a subset of adverse childhood experiences conceptualized as household dysfunction (HHD). Despite the high prevalence of HHD and risk of PSU among college students, research investigating the link between HHD and PSU among college populations is sparse, especially in the United States. METHODS Students (N = 351) from a diverse, southern California university responded to an online survey. Regression models assessed the association between HHD (e.g., parent alcohol and drug use, mental health, incarceration, suicide, intimate partner violence, separation/divorce, and homelessness; categorized into 0, 1-3, and 4 or more) and PSU using Smartphone Addiction Scale short version (SAS-SV) scale, adjusted for covariates. RESULTS Over 50% of students reported at least one type of household dysfunction and about 25% were at high risk for PSU. Compared to students who report no household stressors, students with 1-3 had twice the odds (AOR: 2.11, 95% CI: 1.13-3.83) and students with 4 or more had four times the odds (AOR: 4.01, 95% CI: 2.35-6.82) of PSU, after adjusting for covariates. There were no sex differences in this association. CONCLUSION Findings suggest that household dysfunction can increase the likelihood of developing behavioral disorders such as PSU. Implications for prevention efforts are discussed.
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Holmes Finch W. Performance of the Grade of Membership Model Under a Variety of Sample Sizes, Group Size Ratios, and Differential Group Response Probabilities for Dichotomous Indicators. EDUCATIONAL AND PSYCHOLOGICAL MEASUREMENT 2021; 81:523-548. [PMID: 33994562 PMCID: PMC8072947 DOI: 10.1177/0013164420957384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Social scientists are frequently interested in identifying latent subgroups within the population, based on a set of observed variables. One of the more common tools for this purpose is latent class analysis (LCA), which models a scenario involving k finite and mutually exclusive classes within the population. An alternative approach to this problem is presented by the grade of membership (GoM) model, in which individuals are assumed to have partial membership in multiple population subgroups. In this respect, it differs from the hard groupings associated with LCA. The current Monte Carlo simulation study extended on prior work on the GoM by investigating its ability to recover underlying subgroups in the population for a variety of sample sizes, latent group size ratios, and differing group response profiles. In addition, this study compared the performance of GoM with that of LCA. Results demonstrated that when the underlying process conforms to the GoM model form, the GoM approach yielded more accurate classification results than did LCA. In addition, it was found that the GoM modeling paradigm yielded accurate results for samples as small as 200, even when latent subgroups were very unequal in size. Implications for practice were discussed.
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12
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Moore LH, Grubbs JB. Gambling Disorder and comorbid PTSD: A systematic review of empirical research. Addict Behav 2021; 114:106713. [PMID: 33268184 DOI: 10.1016/j.addbeh.2020.106713] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/28/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Gambling Disorder (GD) and Posttraumatic Stress Disorder (PTSD) are frequently comorbid and often associated with a more severe clinical profile compared to those with either diagnosis alone. Despite recent growing interest in this comorbidity, there has been little effort to synthesize this domain of research and define areas of need for future research. DESIGN The present work details a systematic review of empirical studies examining the relationship between PTSD and GD-related factors. This review encompassed 74 studies each examining the overlap between GD and the following domains: PTSD, Trauma, Adverse Childhood Experiences, and Stressful Life Events. FINDINGS The included studies yielded 91 independent samples each providing associations between the above-mentioned constructs. The present work found that stress, trauma, and symptom severity of PTSD each influence the severity of both GD and subclinical levels of GD. The severity, type, and time at which trauma occurs in the lifespan all appear to influence the predictive strength of trauma on GD severity. However, PTSD symptoms appear to have a greater impact on GD severity compared to trauma alone. CONCLUSION PTSD symptoms result in increased severity of GD, and pathological dissociation plays a particularly important role in exacerbating this relationship. Clinical and etiological implications, as well as direction for future research from these findings, are revealed and discussed.
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Affiliation(s)
- Louis H Moore
- Bowling Green State University, Department of Psychology, United States.
| | - Joshua B Grubbs
- Bowling Green State University, Department of Psychology, United States.
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Adverse Childhood Experiences and Addictive Behaviors in Adolescence: the Moderating Effect of Internalizing and Externalizing Symptoms. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00288-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Lotzin A, Grundmann J, Hiller P, Pawils S, Schäfer I. Profiles of Childhood Trauma in Women With Substance Use Disorders and Comorbid Posttraumatic Stress Disorders. Front Psychiatry 2019; 10:674. [PMID: 31681026 PMCID: PMC6813657 DOI: 10.3389/fpsyt.2019.00674] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/20/2019] [Indexed: 12/25/2022] Open
Abstract
Background: It is increasingly becoming accepted that substance use disorders, including substance abuse and substance dependence, are closely related to childhood trauma and posttraumatic stress disorders. Among women with substance use disorders, the majority report sexual, physical or emotional abuse, or neglect. However, it is poorly understood which types of childhood trauma co-occur in women with substance use disorders and how combinations of different types and severities of childhood trauma are related to clinical characteristics. This information is important to inform treatment of substance use disorders. Aim: The first aim of this research was to investigate profiles of childhood trauma in female patients with substance use disorders and posttraumatic stress disorders. The second aim was to examine relationships between these childhood trauma profiles and addiction characteristics or current clinical symptoms. Methods: We includeda 343 treatment-seeking women with substance use disorders and comorbid posttraumatic stress disorders according to DSM-IV. Five types of childhood trauma (sexual abuse, physical abuse, emotional abuse) were measured using the Childhood Trauma Questionnaire. Addiction characteristics were assessed by using the Addiction Severity Index-lite. Current severity of clinical symptoms was determined by the Symptom-Checklist-27. Latent profile analysis was conducted to distinguish profiles of childhood trauma. Analysis of variance was applied to examine the relationship between childhood trauma profiles and addiction characteristics or severity of clinical symptoms. Results: Nine out of ten women reported at least one type of childhood abuse or neglect. Four different childhood trauma profiles could be distinguished that characterized different types and severities of childhood trauma: 'Low trauma'; 'Moderate sexual abuse and emotional abuse'; 'Severe sexual abuse and emotional abuse'; and 'Severe levels of all types of trauma'. Profiles with more severe levels of childhood trauma showed an earlier age at initiation and escalation of substance use. Furthermore, childhood trauma profiles were related to current severity of depressive symptoms, dysthymic symptoms, sociophobic symptoms, and distrust. Conclusion: In women with substance use disorders and posttraumatic stress disorders, childhood trauma profiles can inform about addiction characteristics and severity of a wide range of clinical symptoms. This information is essential to understand current treatment needs and should be systematically assessed in women with substance use disorders and trauma exposure.
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Affiliation(s)
- Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Johanna Grundmann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Philipp Hiller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
| | - Silke Pawils
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany
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