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Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Fernández-Aranda F, Jiménez-Murcia S. Statistical predictors of the co-occurrence between gambling disorder and problematic pornography use. J Psychiatr Res 2024; 178:125-129. [PMID: 39137720 DOI: 10.1016/j.jpsychires.2024.07.033] [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: 12/28/2023] [Revised: 05/23/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024]
Abstract
Co-occurrence between gambling disorder (GD) and other mental disorders is common, but its association with problematic pornography use (PPU) remains unexplored. This study aimed to investigate relationships between sociodemographic variables, personality measures, psychopathology, emotional regulation, and impulsivity and the co-occurrence of GD and PPU using structural equation modeling (SEM). The sample consisted of 359 adults seeking treatment for GD. The short version of the Problematic Pornography Consumption Scale (PPCS-6) identified patients with GD + PPU. Psychopathology, impulsivity, emotional regulation, and personality were also assessed. Higher impulsivity levels statistically predicted co-occurrence between GD and PPU. Impulsivity mediated the relationship between younger age, maladaptive personality features, and emotional dysregulation and co-occurrence. Psychopathological distress did not directly associate with GD + PPU co-occurrence. Impulsivity relates importantly to the co-occurrence of GD and PPU. Younger age, maladaptive personality, and emotional dysregulation contribute to increased impulsivity levels and co-occurrence. The findings highlight the importance of addressing impulsivity in understanding and treating co-occurring GD and PPU.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Child Study Center, Yale University School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Departament de Psicobiologia i Metodologia de les Ciencies de la Salut, Universitat Autonoma de Barcelona, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Juan Carlos Uríszar
- Clinical Psychology Department, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Sub-Directorate General for the Regulation of Gambling, Directorate General for Taxation and Gambling, Secretariat of Finance, Ministry of the Economy and Finance, Generalitat de Catalunya, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Clinical Psychology Department, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Clinical Psychology Department, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Mestre-Bach G, Potenza MN, Granero R, Uríszar JC, Tarragón E, Chiclana Actis C, Testa G, Fernández-Aranda F, Jiménez-Murcia S. Understanding the Co-occurrence of Gambling Disorder and Problematic Pornography Use: Exploring Sociodemographic and Clinical Factors. J Gambl Stud 2024; 40:1295-1314. [PMID: 38151657 DOI: 10.1007/s10899-023-10274-3] [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: 11/25/2023] [Indexed: 12/29/2023]
Abstract
The co-occurrence between gambling disorder (GD) and problematic pornography use (PPU) has not yet been explored. Therefore, the present study compared (a) sociodemographic variables, (b) GD-related factors, (c) substance use, (d) psychopathology, (e) personality features, (f) impulsivity, and (g) emotion regulation between individuals with GD (GD group) and those with co-occurring GD and PPU (GD+PPU group). The sample consisted of 359 treatment-seeking individuals with GD: n = 332 individuals had GD only (GD group) and n = 37 individuals had GD and co-occurring PPU (GD+PPU group). GD severity, impulsivity, psychopathology, personality, emotion regulation, and other sociodemographic and clinical variables were assessed. No between-group differences in sociodemographic measures were observed. The GD+PPU group demonstrated greater GD severity and a higher likelihood of substance use compared to those without PPU. Furthermore, the presence of PPU was associated with worse psychopathology, higher impulsivity (except for lack of premeditation and positive urgency), more difficulties in emotion regulation (except for non-acceptance of emotions and limited access to emotions), and a personality profile characterized by lower levels of self-directedness and cooperativeness. The co-occurrence of GD and PPU seems associated with a more dysfunctional clinical profile.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Juan Carlos Uríszar
- Clinical Psychology Unit, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Sub-Directorate General for the Regulation of Gambling, Directorate General for Taxation and Gambling, Secretariat of Finance, Ministry of the Economy and Finance, Generalitat de Catalunya, Barcelona, Spain
| | | | - Carlos Chiclana Actis
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain
- Unidad de Sexología Clínica y Salud Sexual, Consulta Dr. Carlos Chiclana, Madrid, Spain
| | - Giulia Testa
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, Avenida de la Paz, 137, 26006, Logroño, La Rioja, Spain
| | - Fernando Fernández-Aranda
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
- Bellvitge University Hospital-IDIBELL and CIBERObn, c/Feixa Llarga s/n, 08907, Hospitalet de Llobregat, Barcelona, Spain.
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Seel CJ, Jones M, Christensen DR, May R, Hoon AE, Dymond S. Treatment of harmful gambling: a scoping review of United Kingdom-based intervention research. BMC Psychiatry 2024; 24:392. [PMID: 38783231 PMCID: PMC11112764 DOI: 10.1186/s12888-024-05843-8] [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: 08/18/2023] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Understanding and treating the harm caused by gambling is a growing international psychiatric and public health challenge. Treatment of gambling harm may involve psychological and pharmacological intervention, in conjunction with peer support. This scoping review was conducted to identify, for the first time, the characteristics and extent of United Kingdom (UK) based gambling treatment research. We reviewed studies conducted among people seeking treatment for disordered or harmful gambling in the UK, the settings, research designs, and outcome measures used, and to identify any treatment research gaps. METHODS Systematic searches of PsycInfo, PsycArticles, Scopus, PubMed, and Web of Science databases were carried out for gambling treatment research or evaluation studies conducted in the UK. Studies were included if they evaluated the effectiveness of an intervention or treatment designed to improve symptoms of harmful or problematic gambling, reported outcomes of interventions on treatment adherence, gambling symptoms, or behaviours using standardised measures, were conducted in the UK, and were published since 2000. RESULTS Eight studies met the inclusion criteria. Four were retrospective chart reviews, two were single-participant case reports, one described a retrospective case series, and one employed a cross-sectional design. None used an experimental design. CONCLUSION The limited number of studies included in this review highlights a relative paucity of gambling treatment research conducted in UK settings. Further work should seek to identify potential barriers and obstacles to conducting gambling treatment research in the UK.
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Affiliation(s)
- Christopher J Seel
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK
| | - Matthew Jones
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK
| | | | - Richard May
- School of Psychology and Therapeutic Studies, University of South Wales, Pontypridd, CF371DL, UK
| | - Alice E Hoon
- Swansea University Medical School, Singleton Campus, Swansea, SA2 8PP, UK
| | - Simon Dymond
- School of Psychology, Swansea University, Singleton Campus, Swansea, SA2 8PP, UK.
- Department of Psychology, Reykjavík University, Menntavegur 1, Nauthólsvík, 101 Reykjavík, Reykjavik, Iceland.
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Mestre-Bach G, Potenza MN. Pharmacological management of gambling disorder: an update of the literature. Expert Rev Neurother 2024; 24:391-407. [PMID: 38357896 DOI: 10.1080/14737175.2024.2316833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
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.
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Affiliation(s)
- Gemma Mestre-Bach
- Instituto de Investigación, Transferencia e Innovación, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council On Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
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Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review. Eur J Psychotraumatol 2023; 14:2178203. [PMID: 37052089 PMCID: PMC9970237 DOI: 10.1080/20008066.2023.2178203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
Background: PTSD and gambling disorder (GD) are frequently comorbid. Gambling may provide escape-based coping for the emotions experienced by PTSD sufferers. Military personnel may be at increased risk of PTSD and/or GD. Acceptance and Commitment Therapy (ACT) has been found to improve both PTSD and GD outcomes, yet research into the potential effectiveness of ACT for PTSD and/GD in veterans is scarce.Objective: This review aimed to systematically assess and describe the evidence relating to the use of ACT and acceptance-based therapy for military populations with PTSD and/or GD.Method: Six databases were searched. Selection criteria included studies that featured the armed forces/military, delivered ACT/acceptance-based therapy, and aimed to improve PTSD and/or GD outcomes. A narrative synthesis approach was adopted.Results: From 1,117 results, 39 studies were fully screened and 14 met inclusion criteria. All studies originated from the USA and 9 were associated with United States Department of Veterans Affairs. Therapy use within each study produced an improvement in PTSD and/or GD, yet only one study examined GD and no studies considered comorbid PTSD/GD. The broad range of study designs made it difficult to compare the findings or make generalisations from the collective results. It is unclear which method of ACT delivery is superior (app-based, telehealth, face-to-face, groups, one-to-one, manualised, or unstructured), or what the true effect size is of ACT for PTSD and/or GD.Conclusions: These preliminary findings are promising, yet more research is needed on the delivery format and content of ACT sessions, and whether findings generalise beyond USA-recruited military samples. The cost-effectiveness of remote-based ACT also warrants investigation.HIGHLIGHTS Among veterans, psychological interventions such as Acceptance and Commitment Therapy (ACT) may be effective for Post-Traumatic Stress Disorder (PTSD) and/or Gambling Disorder (GD).There is a paucity of evidence on ACT approaches for treating PTSD and GD in veterans.Further work is needed on context-specific delivery (in-person vs. group), method of ACT intervention (manualised vs unstructured, digital therapeutics) with non-US samples.
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Rossi R, Reda F, Federico I, Jannini TB, Socci V, D'Aurizio G, Pettorruso M, Pacitti F, Rossi A, Martinotti G, Di Lorenzo G. The association between traumatic experiences and substance and behavioral addictions in late adolescence: A role for PTSD and cPTSD as potential mediators. J Psychiatr Res 2023; 168:82-90. [PMID: 37897840 DOI: 10.1016/j.jpsychires.2023.10.023] [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: 05/03/2023] [Revised: 09/18/2023] [Accepted: 10/14/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND & AIM Traumatic experiences (TEs) are a risk factor for behavioral and substance addictions (SBAs). However, the role of post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD) deserves further elucidation. The present study assesses the association between different types of TEs on cannabis, alcohol, gambling, and problematic internet use in late adolescents. Furthermore, this study aims at evaluating the role of PTSD and cPTSD as potential mediators. METHODS An observational cross-sectional study was conducted on one thousand ten late adolescents (510 males, 498 females; age: mean = 18.7, SD = 0.65). Data regarding intentional (iTEs) and unintentional TEs (uTEs), cannabis, alcohol, gambling and problematic use of the internet (PIU), PTSD, and cPTSD were collected. Association between TEs, SBAs, and PTSD/cPTSD symptoms were explored by means of logistic regressions. Mediation was assessed using a path analysis. RESULTS uTEs were associated with cannabis use (OR = 1.34 [1.13,1.59]) and alcohol use (OR = 1.21 [1.10,1.35]), iTEs were associated with cannabis use (OR = 1.15 [1.06,1.25]), alcohol use (OR = 1.08 [1.02,1.13]), and PIU (OR = 1.17 [1.10,1.24]). PTSD was associated with alcohol use (OR = 1.59 [1.03,2.46]) and PIU (OR = 1.92 [1.18,3.13]). cPTSD was associated with cannabis use (OR = 3.54 [1.56,8.04]) and PIU (OR = 5.13 [2.71,9.70]). cPTSD mediated 58.75% of the total effect of iTEs on cannabis. Regarding PIU, PTSD mediated 68.18% of the effect of uTEs; the effect of iTEs on PIU was mediated by 65.5% via cPTSD and 34.45% via PTSD. CONCLUSION cPTSD and SBAs show a complex pattern of association. A thorough assessment of stress-related conditions, including cPTSD, is of pivotal importance in treating SBAs.
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Affiliation(s)
- Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Flaminia Reda
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Isabella Federico
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Tommaso B Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Giulia D'Aurizio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy.
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy; Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy.
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Stefanovics EA, Potenza MN, Tsai J, Pietrzak RH. Prevalence and Clinical Characteristics of Recreational and At-Risk/Problematic Gambling in a National Sample of U.S. Military Veterans. J Gambl Stud 2023; 39:1077-1097. [PMID: 36378356 DOI: 10.1007/s10899-022-10165-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
Gambling among U.S. military veterans is common, with more extensive involvement linked to gambling disorder and associated problems. This study examined associations between recreational gambling (RG) and at-risk/problem gambling (ARPG), and clinical measures (psychiatric disorders, substance use), behaviors (suicidality, homelessness, arrests) and functioning in a nationally representative sample of U.S. military veterans. Data were analyzed from 4069 veterans who participated in the National Health and Resilience in Veterans Study. Chi-square tests, analyses of variance (ANOVAs) and logistic regressions were conducted to examine unadjusted and adjusted associations between gambling group status and lifetime and current psychiatric diagnoses and behavioral and functioning measures. A significant minority of U.S. veterans reported gambling, with 27.3% (95% confidence interval [CI] 25.5-29.1%) exhibiting RG and 4.9% (95% CI 4.0-5.9%) screening positive for ARPG. The prevalence of ARPG was higher among younger, non-White, male veterans, while RG was more prevalent among retired veterans and those with higher household incomes relative to non-gambling (NG) individuals. ARPG was associated with greater trauma burden, lifetime and current psychiatric diagnoses, mental health treatment, alcohol and drug use disorders, suicidal ideation, homelessness, arrests, and poorer functioning relative to NG and RG, with stronger magnitude differences relative to NG. RG was associated with substance use disorders and arrest histories relative to NG. Results of the current study provide an up-to-date estimate of the current prevalence of RG and ARPG among U.S. veterans and underscore the importance of routine screening and monitoring of gambling problems, as well as interventions for ARPG in this population.
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Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- U.S. Department of Veterans Affairs New England Mental Illness Research and Education Clinical Center (MIRECC), VA Connecticut Healthcare System (116A-4), 950 Campbell Avenue, Building 36, West Haven, CT, 06516, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Jack Tsai
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA
- Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
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Hagen AEF, Nogueira-Arjona R, Sherry SB, Rodriguez LM, Yakovenko I, Stewart SH. What explains the link between romantic conflict with gambling problems? Testing a serial mediational model. Front Psychol 2023; 14:1018098. [PMID: 37502746 PMCID: PMC10370473 DOI: 10.3389/fpsyg.2023.1018098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/09/2023] [Indexed: 07/29/2023] Open
Abstract
Introduction While individuals have many motives to gamble, one particularly risky motive for gambling is to cope with negative affect. Conflict with one's romantic partner is a strong predictor of negative affect, which may elicit coping motives for gambling and, in turn, gambling-related problems. Support for this mediational model was demonstrated in relation to drinking-related problems. We extended this model to gambling. Method Using a cross-sectional design, we examined links between romantic conflict (Partner-Specific Rejecting Behaviors Scale), negative affect (Depression, Anxiety, and Stress Scales-21), coping gambling motives (Gambling Motives Questionnaire, coping subscale), and gambling-related problems [Problem Gambling Severity Index (PGSI)] in 206 regular gamblers (64% men; mean age = 44.7 years; mean PGSI = 8.7) who were in a romantic relationship and recruited through Qualtrics Panels in July 2021. Results Results supported our hypothesis that the association between romantic conflict and gambling-related problems would be sequentially mediated through negative affect and coping gambling motives, β = 0.38, 95% CI [0.27, 0.39], and also showed a strong single mediation pathway through negative affect alone, β = 0.27, 95% CI [0.17, 0.38]. Discussion Negative affect and coping gambling motives partially explain the link between romantic conflict and gambling-related problems. Interventions should target both negative affect and coping gambling motives in response to romantic conflict to reduce gambling-related problems in partnered gamblers.
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Affiliation(s)
- Amanda E. F. Hagen
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | | | - Simon B. Sherry
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Lindsey M. Rodriguez
- Department of Psychology, University of South Florida St. Petersburg Campus, Tampa, FL, United States
| | - Igor Yakovenko
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Sherry H. Stewart
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Stefanovics EA, Potenza MN, Szymkowiak D, Tsai J. Chronically homeless veterans with gambling disorder: Epidemiology, clinical correlates, and traumatic experiences. J Psychiatr Res 2023; 164:118-124. [PMID: 37339548 DOI: 10.1016/j.jpsychires.2023.05.062] [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: 10/18/2022] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Gambling disorder (GD) is often a concern for people living in poverty. Although GD has been correlated with homelessness, there has been no study of factors related to chronic homelessness among veterans with GD. METHOD This study used data from specialized homeless programs from the U.S. Department of Veterans Affairs Homeless Operations Management System to explore prevalence and correlates of chronic homelessness among veterans with GD in this program and to describe initial descriptive epidemiology. Chi-square tests, analyses of variance, and logistic regressions were conducted to examine differences in sociodemographic, military, clinical, and behavioral characteristics between veterans with versus without chronic homelessness. RESULT Of 6053 veterans with GD, 1733 (28.6%) had chronic homelessness. Veterans with versus without chronic homelessness were more likely to be older, male, unemployed, and of low educational attainment and report having spent fewer years in the military. Chronic homelessness was associated with elevated odds of mental health and medical diagnoses, traumatic experiences, incarceration, and suicidal thoughts. Veterans with versus without chronic homelessness more frequently reported needing substance use, medical and psychiatric treatments but expressed low interest in participation in psychiatric treatment. CONCLUSION Veterans with GD and chronic homelessness have more clinical and behavioral concerns and needs for treatment, but participate in treatment at lower rates. It may be important to address both chronic homelessness and GD concurrently in order to effectively support veterans facing these challenges.
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Affiliation(s)
- Elina A Stefanovics
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs New England, Mental Illness Research and Education Clinical Center (MIRECC), West Haven, CT, USA; National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Yale Child Study Center, Yale University, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Dorota Szymkowiak
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA
| | - Jack Tsai
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Tampa, FL, USA; Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
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Lee BK, Ofori Dei SM, Isik E. Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part II): Targeted areas and mechanisms of change. FAMILY PROCESS 2023; 62:534-556. [PMID: 36245316 DOI: 10.1111/famp.12816] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/08/2022] [Accepted: 07/20/2022] [Indexed: 06/08/2023]
Abstract
Study of change mechanisms is important to advance theory development and to reveal the active components that make a critical difference in treatment. Improved outcomes in a randomized controlled trial that favored Congruence Couple Therapy (CCT) vs individual-based Treatment-as-Usual (TAU) were correlated within each group. Partial correlations were used to test for mediation effects. The aggregate correlation coefficient of improved variables in addiction and mental health, couple adjustment, emotion regulation (ER) and life stress was moderate for CCT and weak for TAU. CCT showed greater number of mediating effects among improved variables than TAU. The prominence of the process mechanism of improved ER with its mediating effects for addiction and psychiatric symptoms evidenced in both groups is noteworthy, but ER improvement was significantly associated with improved couple adjustment only in CCT. Reduction in life stress in CCT was associated with a broader range of improvements in CCT compared to TAU. Correlation patterns were substantiated by CCT participants' endorsement of treatment targets emphasizing relationship, communication, emotion, problem solving, addiction and intergenerational issues of trauma. TAU participants reported significantly lower endorsements for these treatment targets. The correlation of ER and couple adjustment suggested as a key process mechanism should be further elucidated in future studies to differentiate relationship-based vs individual-based models and their respective outcomes for primary clients and partners. These findings are considered preliminary, requiring larger samples and advanced modelling among variables to provide a more profound mechanism analysis.
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Affiliation(s)
- Bonnie K Lee
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Samuel M Ofori Dei
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Erkan Isik
- Istanbul Aydin University, Istanbul, Turkey
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11
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Psychotraumatisme chez les étudiants : prévention et interventions à l’université. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2023. [DOI: 10.1016/j.amp.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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12
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Goudriaan AE, de Waal MM. Commentary on Nower et al: Patterns in pathways: underlying comorbidities and the importance of assessment. Addiction 2022; 117:2009-2010. [PMID: 35315144 PMCID: PMC9314676 DOI: 10.1111/add.15859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 02/24/2022] [Indexed: 12/18/2022]
Affiliation(s)
- Anna E. Goudriaan
- Arkin Mental Health Care, Jellinekand Amsterdam Institute for Addiction ResearchAmsterdamThe Netherlands,Amsterdam UMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
| | - Marleen M. de Waal
- Arkin Mental Health Care, Jellinekand Amsterdam Institute for Addiction ResearchAmsterdamThe Netherlands,Amsterdam UMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands,Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
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13
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Dighton G, Wood K, Armour C, Fossey M, Hogan L, Kitchiner N, Larcombe J, Rogers RD, Dymond S. Gambling problems among United Kingdom armed forces veterans: Associations with gambling motivation and posttraumatic stress disorder. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2063923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Glen Dighton
- School of Psychology, Swansea University, Swansea, UK
| | - Katie Wood
- School of Psychology, Swansea University, Swansea, UK
| | - Cherie Armour
- Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, Queen’s University Belfast, Northern Ireland, UK
| | - Matt Fossey
- Veterans and Families Institute for Military Social Research, Anglia Ruskin University, Chelmsford, UK
| | - Lee Hogan
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Neil Kitchiner
- Veterans NHS Wales, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | | | - Robert D. Rogers
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, UK
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
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14
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Sundqvist K, Wennberg P. Problem gambling and anxiety disorders in the general swedish population - a case control study. J Gambl Stud 2022; 38:1257-1268. [PMID: 35380396 DOI: 10.1007/s10899-022-10117-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 03/09/2022] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
Co-occurring psychiatric comorbidity is high among problem gamblers, and anxiety disorders has repeatedly been linked to problem gambling. Less conclusive, however, is the association between problem gambling and specific anxiety disorders. The aim of this study is to examine the association between problem gambling and specific anxiety disorders in subgroups of gender, age and socio-economic status (SES) in the general Swedish population. A case-control design was employed - nested in the Swedish longitudinal gambling study cohort. All anxiety disorders studied - Panic Disorder, Social Phobia, Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD), were significantly associated with problem gambling, however the pattern differed across subgroups. Social Phobia was the anxiety disorder most commonly associated with problem gambling across subgroups. The strongest associations between problem gambling and various anxiety disorders were found in participants under the age of 25, among females, and in the group with middle SES. In those groups three of the four anxiety disorders studied were significantly associated with problem gambling, with different patterns. Quite remarkably, participants under the age of 25 had three times higher risk of having had GAD compared to their controls. Efforts to prevent an escalation of either gambling or anxiety could target the presented vulnerable groups specifically.
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Affiliation(s)
| | - Peter Wennberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Department of Global Public Health, Karolinska Institutet, Solna, Sweden
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Bogolyubova O, Lovakov A. What Do We Know About EMDR Therapy Research? A Bibliometric Analysis. JOURNAL OF EMDR PRACTICE AND RESEARCH 2022. [DOI: 10.1891/emdr-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Bibliometric analysis is a quantitative method designed to analyze large volumes of scientific output data and to map the intellectual landscape of a specific area of knowledge by describing its scientometric indicators (e.g., number of publications and citations, etc.) and structural relationships (e.g., co-authorship patterns, keyword clustering, etc.) between its different components. In this article, methods of bibliometric analysis are applied to the corpus of publications on eye movement desensitization and reprocessing (EMDR) therapy research. A total of 1,150 papers found in the Web of Science database and published between 1994 and early 2021 were included in the analysis. Retrieved bibliometric data was analyzed and visualized using VOSViewer software. Temporal distribution of publications (number of publications per year); spatial distribution of publications (author affiliations); top journals; impact of EMDR research as assessed by highly cited publications; author co-citation as a measure of collaboration; literature co-citation as a measure of internal structure; and key terms were analyzed. The results of the study provide the readers with a broad, “one-stop overview” of the current state of research on EMDR therapy, with a focus on the quantitative characteristics of its output and on the key represented topics.
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