A School-Based Program for Problematic Internet Use for Adolescents in Japan

Despite the serious influence of problematic Internet use on mental health among Japanese adolescents, no randomized clinical trials have investigated universal school-based interventions for this potential health challenge. Therefore, this study aimed to assess the efficacy of a school-based educational program. This two-armed, parallel, cluster-based randomized clinical trial included 5312 students from 13 high schools situated in a mid-sized Japanese city. The students in the intervention arm received 10 weekly standardized sessions, including a combination of information provision and interactive sessions by schoolteachers. The students in the control group followed a standard school curriculum. A generalized estimating equation model was applied to assess the primary (Korean Scale for Internet Addiction [K-scale] score) and secondary (behavioral change status according to changes in the transtheoretical model smartphone addiction score and Internet usage time) outcomes two months after intervention completion. The intention-to-treat analysis included 2597 (97.2%) and 2504 (94.9%) students in the intervention and control groups, respectively. Nevertheless, a significant discrepancy emerged regarding the behavioral change status. Therefore, this school-based program did not improve the Internet or smartphone addiction scores among Japanese adolescents. Further studies are needed to develop appropriate interventions for adolescents.

Short-Term Effectiveness of the Youth Gambling Prevention Program "Who Really Wins?"-Results from the First National Implementation

As a response to significant adolescent gambling involvement, a Croatian team of researchers and practitioners developed a universal, comprehensive, evidence-based youth gambling prevention program called "Who Really Wins?". This study presents the results on its short-term effectiveness following the first national implementation in 18 Croatian cities, with a total of 629 high school students (66.5% male) who completed the program. A design with two measurement sessions (pre-test and post-test) was used to explore the short-term effects of the program on gambling-related knowledge and cognition, frequency of gambling, and various socio-emotional skills. The results showed significant effects when it comes to knowledge, cognitive distortions, and the frequency of sports betting and playing lottery games. Furthermore, the program had no harmful effects on any of the measured variables. The results are interpreted in terms of methodological challenges in measuring effects, possible improvements of the program, and implications for future evaluation research.

Adolescent Problem Gambling in Rural Ghana: Prevalence and Gender Differentiation

Problem gambling among young people is now a public health challenge in sub-Saharan Africa. However, the behaviour remains understudied, particularly, among rural-dwelling young people in countries within the subregion. We aimed to estimate the 12 months prevalence of problem gambling and to describe the overall and gender differences and commonalities in personal factors and social adversities associated with problem gambling among adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana; we used the DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) questionnaire to assess problem gambling during the previous 12 months. Personal lifestyle and psychosocial variables were assessed using adopted items from the 2012 WHO–Global School-based Student Health Survey. Overall, three in 10 adolescents (3 in 10 females; 4 in 10 males) in rural Ghana reported problem gambling in the previous 12 months. Female adolescents who experienced problem gambling were more likely to report family-related social adversities, while adolescent male problem gambling was associated with school-related factors and interpersonal factors outside the family context. Regardless of gender, sexual abuse victimisation was associated with three times increase in the odds of experiencing problem gambling. Relative to the prevalence of gambling among adolescents in urban contexts in other countries within sub-Saharan Africa, the estimates of problem gambling among in-school rural adolescents in Ghana are higher. Although further studies are needed to understand the nuances of the behaviour, the evidence of this study underscores the need for general and targeted health promotion, intervention and prevention efforts to mitigate the family, school, and interpersonal social adversities associated with adolescent problem gambling in rural Ghana.

The Effects of Perceived Gambling Availability on Problem Gambling Severity

The aim of this study was to determine the moderating effects of sociodemographic characteristics, substance use, and psychosocial problems on the relationship between perceived gambling availability and problem gambling severity. Bivariate and multivariate regression analyses of the 2008 and 2009 Social and Economic Impacts of Gambling in Alberta surveys found problem gambling severity was 1.25-1.39 times higher for those reporting gambling opportunities were 'too widely available'. Factors such as age, gender, place of residence, and psychosocial problems had significant moderating effects. Our findings indicate that the perception of gambling availability has a statistically significant impact on problem gambling severity.

School-based Prevention for Adolescent Internet Addiction: Prevention is the Key. A Systematic Literature Review

Adolescents' media use represents a normative need for information, communication, recreation and functionality, yet problematic Internet use has increased. Given the arguably alarming prevalence rates worldwide and the increasingly problematic use of gaming and social media, the need for an integration of prevention efforts appears to be timely. The aim of this systematic literature review is (i) to identify school-based prevention programmes or protocols for Internet Addiction targeting adolescents within the school context and to examine the programmes' effectiveness, and (ii) to highlight strengths, limitations, and best practices to inform the design of new initiatives, by capitalizing on these studies' recommendations. The findings of the reviewed studies to date presented mixed outcomes and are in need of further empirical evidence. The current review identified the following needs to be addressed in future designs to: (i) define the clinical status of Internet Addiction (IA) more precisely, (ii) use more current psychometrically robust assessment tools for the measurement of effectiveness (based on the most recent empirical developments), (iii) reconsider the main outcome of Internet time reduction as it appears to be problematic, (iv) build methodologically sound evidence-based prevention programmes, (v) focus on skill enhancement and the use of protective and harm-reducing factors, and (vi) include IA as one of the risk behaviours in multi-risk behaviour interventions. These appear to be crucial factors in addressing future research designs and the formulation of new prevention initiatives. Validated findings could then inform promising strategies for IA and gaming prevention in public policy and education.

Who Really Wins? Efficacy of a Croatian Youth Gambling Prevention Program

This paper reports on the development and pilot evaluation of a Croatian school-based youth gambling prevention program "Who really wins?". The program is aimed at minimizing risk and enhancing protective factors related to youth gambling. A short-term evaluation of the program was conducted with a sample of 190 first and second year high-school students (67.6% boys, aged 14-17 years; average age 15.61). An experimental design with two groups (Training vs. No Training) and two measurement sessions (pre-test and post-test sessions) was used to evaluate change in problem gambling awareness, cognitive distortions, knowledge of the nature of random events as well as in social skills. Results showed significant changes in the post-test sessions, which can be attributed to changes in the Training group. We observed a decrease in risk factors, namely better knowledge about gambling and less gambling related cognitive distortions. Immediate effects on protective factors such as problem solving skills, refusal skills, and general self-efficacy were not observed. Findings also show program effects to be the same for both boys and girls, students from different types of schools, for those with different learning aptitudes, as well as for those at different risk levels with regard to their gambling, which speaks in favour of the program's universality. The program had no iatrogenic effects on behaviour change and shows promise as an effective tool for youth gambling prevention. Future research and a long-term evaluation are needed to determine whether the observed changes are also linked to behavioural change.

Macau parents' perceptions of underage children's gambling involvement

Objectives

The study examined Macau parents’ perceptions of underage children’s gambling involvement, and parents’ attitudes towards help seeking if their children had a gambling problem. The parents’ gambling behavior in the past year was also investigated.

Methods

This is a parent survey using a self-administered questionnaire. A convenience sample of 311 Macau parents (106 fathers and 205 mothers) with underage children aged 3–17 years was recruited. The response rate is 77.8%. The participants were asked if they had ever approved or taught their underage children to gamble, and how did they award their children when they won in gambling games. The parents were also asked if they had gambled in the previous 12 months, and their gambling behavior was assessed by the Chinese Problem Gambling Severity Index (CPGSI).

Results

Half of the parents surveyed (52%) did not approve underage gambling but 81% taught their underage children to play different gambling games. Children were awarded with money (55%), praises (17.5%), toys (15%) and food (12.5%) when they won in games. One-fifth (20.6%) were distressed with their children’s gambling problem. Many (68.8%) were willing to seek help to cope with children’s gambling problems. Only 21.2% (n = 66) of the parents reported gambling in the past year. Using the CPGSI, 4.5% of these gamblers could be identified as problem gamblers, and 16.7% were moderate-risk gamblers.

Conclusion

The study results indicate parent education should be included in prevention of underage gambling.

Teacher Awareness and Attitudes Regarding Adolescent Risk Behaviours: a Sample of Finnish Middle and High School Teachers

Empirical evidence has shown that youth gamble on both regulated and unregulated games, despite legislative prohibitions. This study assesses middle and high school teachers' awareness and attitudes regarding adolescent gambling and other potentially high-risk behaviours in Finland. A convenience sample of teachers (N = 157) from 13 provinces participated in the survey. The results suggest that teachers in Finland were more knowledgeable of the age limits of other adolescent high-risk behaviours than the legal age for gambling. Teachers were somewhat familiar with the behaviours and consequences associated with adolescent gambling. All other risk behaviours were perceived as being more important than gambling. Teachers' awareness about gambling prevention material in Finnish schools was limited. Results suggest that initiatives are required to enhance teachers' knowledge of adolescent problem gambling and its harmful short- and long-term consequences. School policies and guidelines including gambling behavior should be implemented in middle and high schools globally.

Equipping School Psychologists to Address Another Risky Behavior

School psychologists are assuming an increasingly important role in ensuring youth have the mental and emotional health to succeed academically. Although considerable attention has been paid to a number of adolescent high-risk behaviors including drug and alcohol use, cigarette smoking, and sexually transmitted diseases, little attention has been paid to youth gambling behaviors. Youth problem gambling has been largely overlooked as a mental and public health issue although it can result in serious mental heath consequences and impede students’ academic success. The current state of knowledge regarding adolescent gambling is presented. Prevention and intervention initiatives that are accessible to school psychologists are outlined, and the challenges to school psychologists in implementing youth problem gambling prevention programs are discussed.

Personal gambling expectancies among Asian American and White American college students

Many college students are involved in gambling behavior as a recreational activity. Their involvement could potentially develop into problem gambling, an issue of increasing concern to student health. At the same time, evidence suggests that Asian Americans are overrepresented amongst problem gamblers in this age period. Research on factors related to initiation and development of problem gambling in college students is necessary to inform the development of effective and culturally-sensitive prevention efforts against gambling. The relationships between personal gambling expectancies at two levels of specificity (two general and six specific types of expectancies) and college student gambling at two levels of behavior (initiation and problems) were examined in a sample of 813 Asian American and White American college students. The study aimed to address (a) whether expectancies explained ethnic differences in gambling, (b) ethnic similarities and differences in the pattern of relationships between expectancies and gambling, and (c) whether expectancies that emerged in both ethnic groups have a greater risk or protective effect for one group than another. Results showed that Asian American students reported more problem gambling than White American students, but expectancies did not account for this group difference. Risk and protective factors for initiation were relatively similar between groups, but different patterns of risk emerged for each group for problem gambling. Implications for college primary prevention and harm reduction programs are discussed.

Examination of proposed DSM-5 changes to pathological gambling in a helpline sample

OBJECTIVES

To examine the effect of proposed the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) changes to pathological gambling relative to DSM-IV criteria in a large gambling helpline sample (N = 2,750). Changes in prevalence rates, the diagnostic utility of the illegal acts criterion, and severity of alternative diagnostic formulation thresholds were examined.

METHOD

Callers to the helpline completed a semistructured interview and DSM-IV criteria were assessed.

RESULTS

Without lowering the diagnostic threshold, removal of the illegal acts criterion resulted in loss of diagnostic status in less than 2% of helpline callers. The DSM-IV prevalence rate in this sample was 81.2%, and DSM-5 formulations with lowered thresholds of 4, 3, and 2 symptoms increased prevalence rates by 9% to 17%. However, item-level symptom endorsement suggested that subclinical gamblers experience significant adverse consequences.

CONCLUSIONS

Lowered thresholds may lead to earlier provision of treatment to gamblers and prevent escalation of the disorder, while being more consistent with diagnostic thresholds of other addiction disorders.

Parents' Perceptions of Adolescent Gambling: A Canadian National Study

Previous unsubstantiated reports by children and adolescents suggest tacit parental acceptance of their gambling behaviour. A Canadian national survey of parents with teens between the ages of 13 and 18 revealed that in general parents view adolescent gambling as a relatively unimportant issue compared to other potentially risky behaviours. Parental attitudes toward youth gambling, their knowledge and awareness of youth gambling prevention programs, and their gambling behaviours with their children suggest that gambling has become normalized, with few parents being aware of the potential seriousness of youth gambling. The results are interpreted with the aim of improving harm minimization and prevention initiatives.

Adolescent gambling: a review of an emerging field of research

PURPOSE

The purpose of this review was to summarize the research on adolescent gambling with implications for research and prevention or intervention.

METHOD

The methodology involved a comprehensive and systematic search of "adolescent or youth gambling" in three diverse electronic databases (MedlineAdvanced, PsycINFO, and Sociological Abstracts) and three peer-reviewed journals (International Journal of Gambling Studies, International Journal of Mental Health and Addiction, and Journal of Gambling Issues).

RESULTS

The search resulted in 137 articles (1985-2010) focusing on gambling among youth aged between 9 and 21 years: 103 quantitative, 8 qualitative, and 26 non-empirical. The study of adolescent gambling can be summarized as follows: (a) it is conducted by a relatively small group of researchers in Britain, Canada, and the United States; (b) it is primarily prevalence-focused, quantitative, descriptive, school-based, and atheoretical; (c) it has most often been published in the Journal of Gambling Studies; (d) it is most often examined in relation to alcohol use; (e) it has relatively few valid and reliable screening instruments that are developmentally appropriate for adolescents, and (f) it lacks racially diverse samples.

CONCLUSION

Four recommendations are presented for both research and prevention or intervention which are as follows: (1) to provide greater attention to the development and validation of survey instruments or diagnostic criteria to assess adolescent problem gambling; (2) to begin to develop and test more gambling prevention or intervention strategies; (3) to not only examine the co-morbidity of gambling and alcohol abuse, but also include other behaviors such as sexual activity; and (4) to pay greater attention to racial and ethnic differences in the study of adolescent gambling.

The Interplay of Appraisals, Specific Coping Styles, and Depressive Symptoms Among Young Male and Female Gamblers

The present study assessed gambling appraisals and specific coping styles among 400 young male (n = 230) and female (n = 170) gamblers. Of particular interest was to determine whether gender variations in stress-related responses are associated with the degree of gambling pathology, depressive symptoms, and attitude to seeking treatment. Results showed that greater appraisals of threat, illusions of control, and negative outcome expectancies were associated with higher levels of gambling pathology, particularly among males. Further, among women, gambling propensity was associated with reduced social support seeking, whereas for men gambling pathology was primarily accounted for by increased use of wishful thinking. These coping strategies, combined with other internally oriented emotion-focused strategies, mediated the relation between gambling and depressive symptoms. Not surprisingly, more positive attitudes to treatment seeking were reported by those with a greater propensity to use problem-solving and support seeking coping efforts. The utility of assessing specific components that comprise a gambler’s stress-response is discussed.

Environmental correlates of gambling behavior in urban adolescents

The present study considered the relation between adolescent gambling behavior and the perceived environment, the component of Jessor and Jessor's (1977) Problem Behavior Theory that assesses the ways that adolescents perceive the attitudes and behaviors of parents and peers. The predominantly African-American sample included 188 sophomores from two urban public high schools. Using the South Oaks Gambling Screen-Revised for Adolescents to assess gambling risk, rates of both at-risk (20.7%) and problem (12.8%) gambling were found to be high. Boys displayed more gambling problems than did girls. The perceived environment accounted for significant variance in gambling problems and frequency, with proximal components displaying stronger relationships than distal components. Perceiving parent gambling and friend models for problem behavior were positively correlated with gambling problems, and friend models were positively related to gambling frequency. Among girls, family support was positively related to gambling problems. Among boys, this relation was negative.

Promoting reduced and discontinued substance use among adolescent substance users: effectiveness of a universal prevention program

Efforts to address youth substance use have focused on prevention among non-users and treatment among severe users with less attention given to youth occupying the middle ground who have used substances but not yet progressed to serious abuse or addiction. Using a sample from 35 middle schools of 1,364 youth who reported using substances, this study examined the effectiveness of a universal youth substance use prevention program, the SAMHSA Model Program keepin' it REAL, in promoting reduced or recently discontinued alcohol, cigarette, and marijuana use. Discrete-time event history methods modeled the rates of reduced and recently discontinued use across four waves of data. Each substance (alcohol, cigarettes, and marijuana) was modeled separately. Beginning at the second wave, participants who reported use at wave 1 were considered at risk of reducing or discontinuing use. Since the data sampled students in schools, multi-level models accounted for the nesting of data at the school level. Results indicated that prevention program participation influenced the rates of reduced and recently discontinued use only for alcohol, controlling for baseline use severity, age, grades, socioeconomic status, ethnicity and gender. Among youth who reported use of alcohol in wave 1 (N=1,028), the rate of reducing use for program participants was 72% higher than the rate for control students. The rate of discontinuing use was 66% higher than the rate for control students. Among youth who reported use of one or more of the three substances in wave 1 (N=1,364), the rate of discontinuing all use was 61% higher for program participants than for control students. Limitations and implications of these findings and plans for further research are discussed.

Psychosocial variables associated with adolescent gambling

The authors empirically examined the relations between several psychosocial variables associated with adolescent problem gambling. Participants were 2,336 students in Grades 7-13, and all completed a questionnaire regarding gambling activities, gambling severity, perceived social support, drug and alcohol dependence, and various social, emotional, and behavioral problems. With respect to gambling severity, 4.9% of adolescents met the criteria for pathological gambling, and 8.0% were found to be at risk. Psychosocial difficulties associated with problem gambling include poor perceived familial and peer social support, substance use problems, conduct problems, family problems, and parental involvement in gambling and substance use. A set of predictor variables that may lead to problem gambling includes having family problems, having conduct problems, being addicted to drugs or alcohol, and being male.