Conduct problems and depressive symptoms in association with problem gambling and gaming: A systematic review

Gambling-specific metacognitions, depression, and responsible gambling in Macao, China

The Self-regulatory Executive Function model elucidates how metacognitions link to the development and maintenance of gambling disorder, however whether, and how, metacognitions explain responsible gambling remains unknown. This study is the first to address this knowledge gap by: (a) examining whether both generic and gambling-specific metacognitions explain variances in responsible gambling; and (b) testing the mediating role of depression between generic/gambling-specific metacognitions and responsible gambling. A two-stage cluster random sampling method was used to obtain a probability sample of 837 Chinese adult gamblers (48.5 % men, mean age = 41.11, SD = 14.31) in Macao, China. Hierarchical regression analysis indicated that gambling-specific metacognitions contributed to an additional 23 % variance explained in responsible gambling after considering generic metacognitions and demographics. Path analysis further showed that the direct paths from generic, positive and negative gambling-specific metacognitions to responsible gambling were all significant while the positive type showing a stronger effect. Moreover, depression partially mediated the effects of both generic and gambling-specific metacognitions on responsible gambling. Findings suggest that responsible gambling campaigns should consider improving the awareness of metacognitions and emotion regulation in depression among Chinese adult gamblers.

Depression, anxiety, and stress in young adult gamers and their relationship with addictive behaviors: A latent profile analysis

BACKGROUND

There is limited research examining latent profiles of gamers based on emotional variables, which has implications for prevention efforts. The study sought to identify young adult gamer profiles based on depression, anxiety, and stress, and to examine differences between the latent profiles in other addictive behaviors (i.e., tobacco, alcohol, cannabis, illegal substance use, gaming, and gambling).

METHODS

A total of 1209 young adults (Mage = 19.37, SD = 1.62; 55.3%males) reported past-year gaming. A latent profile analysis (LPA) was performed to identify distinct profiles, and a set of ANOVA and chi-square analyses characterized the profiles in terms of sociodemographic, addictive behaviors, and emotional variables.

RESULTS

LPA suggested a three-profile solution: profile 1 (n = 660, 'low emotional distress'), profile 2 (n = 377, 'moderate emotional distress'), and profile 3 (n = 172, 'high emotional distress'). Participants with 'moderate' and 'high emotional distress' were mostly women, showed greater gaming severity, higher prevalence of past-month substance use (i.e., tobacco and illegal drugs), and greater consequences of alcohol use.

LIMITATIONS

The cross-sectional nature of the study and sample being university students.

CONCLUSION

Findings revealed three distinct profiles of gamers, which differed in emotional, gaming, and substance use severity. Transdiagnostic prevention programs have the potential to provide significant benefits to college students by addressing the core processes (e.g., emotion regulation) that underlie substance use and gaming.

Problematic Gaming and Gambling: A Systematic Review of Task-Specific EEG Protocols

Even though gaming and gambling bear similar problematic behavioral aspects, there are no recognizable neurophysiological biomarkers or features characterizing and/or distinguishing these conditions. A systematic review of the literature with a focus on methods was performed in PubMed, Scopus, Web of Science (Web of Science Core Collection), EBSCOhost Research Databases (APA PsycINFO; APA PsycArticles; OpenDissertations; ERIC) databases. Following search terms were used to search the databases: ERP, "event related potential*", EP, "evoked potential*", SS, "steady state", EEG, electroencephal*; gam*. Data about the participants (total number, gender, age), main aim of the study and information about the experimental setup (experimental task description, stimuli used, ERPs measured (latency windows and placement of the electrodes), process evaluated) was extracted. A total of 24 studies were revised (problematic gaming - 16, pathological gambling - 8). The experimental protocols could be grouped into 3 main target domains (Cue-reactivity, General Information processing and Reward Processes & Risk Assessment). Sample-related limitations (small sample sizes, gender differences, differences between the groups regarding potential confounding variables) and heterogeneity regarding the experimental tasks, implementation and interpretation reviewed. Gambling-related research is highly focused on the investigation of the reward-related processes, whereas gaming-related research is mostly focused on the altered aspects of more general information processing. A vast heterogeneity regarding the ERP experimental paradigms being used and lack of clear guidelines and standardized procedures prevents identification of measures capable to reliably discriminate or characterize the population susceptible to addictive behavior or being able to diagnose and monitor these disorders.

Chasing among older-aged gamblers: the role of mentalizing and psychological distress

Background

Despite the increasing proportion of older-aged individuals suffering from problematic gambling, research on gambling among this specific age cohort is still in its infancy. Chasing is a pathognomonic feature of disordered gambling and is considered one of the key risk factors in the transition from recreational to disordered gambling. Despite the increased research on chasing over the past decade, no previous study has ever examined the psychological determinants of chasing behavior among old-aged gamblers. Given the importance of chasing in facilitating and maintaining problem gambling, and the paucity of research examining gambling among older individuals, the present study is the first to empirically investigate the joint role of chasing behavior, negative affectivity, and mentalizing among older-aged gamblers.

Methods

The sample comprised 116 older-aged gamblers who were administered the South Oaks Gambling Screen (SOGS), the Depression Anxiety Stress Scale (DASS-21) and the Reflective Functioning Questionnaire (RFQ-8) to assess gambling severity, psychological distress, and mentalizing, respectively. Participants also performed the ChasIT, a computerized task that assesses chasing behavior, in which participants were randomly assigned to three different experimental conditions: loss, control, and win.

Results

No effect of the experimental conditions of ChasIT on chasing behavior was observed. Regression analyses indicated that heightened levels of gambling severity and lower levels of certainty about mental states (i.e., hypermentalizing) predicted both the decision to chase and chasing frequency. Along with problem gambling and hypermentalizing, chasing frequency was also predicted by high levels of depression.

Conclusions

The present study demonstrated the association between disordered gambling, depression, and hypermentalizing in chasing behavior among older-aged gamblers. The findings make an important contribution to providing insight regarding variables that are associated with chasing among older-aged gamblers, one of the least represented populations of gamblers in the literature. The results suggest that specific training on mentalizing abilities could help gamblers to reflect on their own behaviors in terms of mental states, rather than following the impulse to gamble in order to ameliorate poor mood.

Internet gaming disorder and risky behaviours among Czech adolescents: A nationally representative study

Background and aims

The aim of the present study was to estimate the complex association between Internet Gaming Disorder (IGD), substance use, and other risky behaviours in Czech adolescents whilst providing prevalence estimates of IGD and psychometric information regarding the Czech Internet Gaming Disorder Scale-Short-Form (IGDS9-SF).

Methods

A representative sample of 3,950 Czech adolescents was recruited through stratified random sampling in the school setting.

Results

Disordered gamers showed frequent use of specific substances such as pharmaceuticals, methylenedioxymethamphetamine, and lysergic acid diethylamide. In contrast, non-gamers had higher prevalence of alcohol, cigarettes, sedatives and tranquillisers, and marijuana use. A logistic regression, utilising IGDS9-SF raw scores and average daily gaming time, revealed a U-shaped relationship between gaming and both alcohol and cigarette use. Additionally, conduct problems such as bullying, and risky in-game behaviours were more prevalent among disordered gamers, with the exception of forging parents' signatures. The overall prevalence of IGD was 3.62% (95% CI = [3.1%, 4.3%]), with higher rates in males (5.89%; 95% CI = [4.9%, 7.0%]) than in females (1.45%; 95% CI = [1.0%, 2.1%]).

Discussion and conclusions

The Czech IGDS9-SF used in the present study showed adequate psychometric properties. The association between gaming and substance use behaviours may be specific and multifaceted depending on the severity of the gaming-related problems. Furthermore, disordered gamers may become more vulnerable due to a higher incidence of conduct problems, bullying (victimisation), and in-game risky behaviours such as engagement with microtransactions mechanics (e.g., loot box) within video games.

Understanding the Emergence of Comorbidity between Problematic Online Gaming and Gambling: A Network Analysis Approach

BACKGROUND/OBJECTIVES

Problematic online gaming and gambling tend to co-occur. The exact mechanisms underlying this phenomenon and the potential effects of gender differences remain unknown. This study aimed to identify the early clustering patterns of problematic online gaming and gambling in a community sample of young adults without a lifetime history of psychiatric treatment.

METHODS

Data were collected through an online survey and analyzed using partial correlations and Bayesian networks.

RESULTS

Altogether, 1441 individuals (aged 18-40 years, 51.4% females) participated in the survey. Both problematic online behaviors were weakly interrelated, suggesting that they serve as distinct constructs. Men's networks appeared to be more complex and had significantly higher global connectivity. Moreover, men and women differed with respect to the specific nodes that bridged both constructs. In men, the bridge nodes were "being criticized because of betting or being told about gambling problems", "loss of previous interests due to gaming", "deceiving other people because of gaming", and "health consequences of gambling". Among women, the bridge nodes were "feeling guilty because of gambling", "loss of previous interests because of gaming", "social consequences of gaming", and "continued gaming problems with other people". In men, the strongest edge was found between "borrowing money/selling anything to gamble" and "financial problems because of gambling", while in women, the strongest edge appeared between "betting more than afforded to be lost" and "tolerance symptoms of gambling".

CONCLUSIONS

The findings indicate that problematic online gaming and gambling tend to emerge in different ways among men and women. Therapeutic interventions should be planned considering gender differences.

Commercial determinants of mental ill health: An umbrella review

Mental ill health has complex and interrelated underlying causes, with wider determinants of health often overlooked as risk factors. The 'commercial determinants of health' are gradually receiving more attention and recognition but there is a relative lack of awareness of the commercial determinants of mental health. This aim of this umbrella review was to synthesise systematic review level evidence for the association between commercial determinants and mental health outcomes. This umbrella review included evidence from high, middle, and low-income countries. We included terms related to broader commercial activities and terms focused on six key unhealthy commodities (tobacco, alcohol, ultra-processed foods, gambling, social media, fossil fuels) and the impacts of fossil fuel consumption (climate change, air pollution, wider pollution). We included 65 reviews and found evidence from high quality reviews for associations between alcohol, tobacco, gambling, social media, ultra-processed foods and air pollution and depression; alcohol, tobacco, gambling, social media, climate change and air pollution with suicide; climate change and air pollution with anxiety; and social media with self-harm. There was a lack of evidence examining wider practices of commercial industries. Our umbrella review demonstrates that by broadening the focus on commercial determinants, the influence of commercial products and activities on mental ill health can be better understood. The lack of research examining broader commercial practices on mental ill health is an area that should be addressed. Our review highlights the existing base of high-quality evidence for many of these unhealthy commodities' impacts on mental ill health and indicates that commercial determinants is a valuable framework for understanding the drivers of mental ill health.

The Dual Burden of Emerging Adulthood: Assessing Gambling Severity, Gambling-Related Harm, and Mental Health Challenges

Growing concerns over gambling problems across age groups have sparked research in public health and psychology. During emerging adulthood, individuals are more susceptible to mental health problems and more likely to develop gambling problems than in other age groups. This study explored the potential differences between emerging adults and adults aged 30+ in terms of problem gambling severity (PGS), gambling-related harm (GRH), depression and anxiety, and the mediating role of depression and anxiety in the association between age, PGS, and GRH. A representative online sample of 3244 Israelis aged 18 and over was divided into two groups: 740 emerging adults aged 18-29 and 2504 adults aged 30+. Gambling behaviors, the Problem Gambling Severity Index, the Short Gambling Harm Screen, and the Patient Health Questionnaire-4 assessing depression and anxiety were administered. Emerging adults had significantly higher levels of GRH, PGS, and depression-anxiety than their older counterparts, above and beyond gender and education. Depression-anxiety fully mediated the associations between age and gambling-related outcomes. These findings underscore the importance of considering psychological well-being in efforts to address problem gambling and gambling-related harms, especially in emerging adults.

A Study of the Psychometric Properties of the Persian Version of the Online Gambling Symptom Assessment Scale in the Iranian Population

Background

The primary objective of the current paper was to assess the psychometric attributes of the Persian version of the Online Gambling Symptom Assessment Scale (P-OGSAS) within the Iranian population.

Methods

The current study was conducted through a convenient sampling method between September and November 2021, involving 187 participants who had experienced online gambling at least once a month for the last 3 months. OGSAS was translated from English into Persian using the forward-backward translation method. Cronbach's alpha coefficient and principal component analysis (PCA) were employed to evaluate the reliability and validity of the scale, respectively. Participants were administered a battery of assessments, including P-OGSAS, Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Patient Health Questionnaire-9 Items (PHQ-9), and Generalized Anxiety Disorder Questionnaire (GADQ-7), to assess validity and reliability.

Findings

The results showed that the 3-factor model of this scale provides the highest level of predictability. The 3-factor model accounts for 54.8% of the square load. With a Cronbach's alpha coefficient of 0.807, P-OGSAS demonstrated satisfactory reliability. Finally, OGSAS has a significant correlation with other scales, and as a result, this scale has suitable convergent validity.

Conclusion

P-OGSAS can adequately assess the symptoms and severity of online gambling. Therefore, clinicians could use this scale to evaluate the problems related to online gambling in the Iranian population.

Trajectory Classes of Externalizing and Internalizing Symptoms to Adolescent Gambling Participation: An Exploratory Study

Engagement in underage gambling remains a public health concern. Risk factors for the development of gambling behaviours in adolescence include the presence of externalizing and/or internalizing problems. This study aims to better understand the role of co-occurrence between externalizing and internalizing symptoms from childhood to adolescence in adolescent gambling. Participants were drawn from an ongoing longitudinal study of children with and without early conduct problems. Externalizing and internalizing problems were measured annually using teacher and parent reports. Gambling behaviours were measured using self-report when participants were approximately 15 years old. Latent class growth trajectory analyses identified five mental health trajectory classes: (1) a co-occurring trajectory characterized by stable clinical levels of both externalizing and internalizing problems, (2) an externalizing trajectory characterized by stable high clinical levels of externalizing problems, (3) an internalizing trajectory characterized by stable at-risk levels of internalizing problems, (4) an at-risk externalizing trajectory characterized by decreasing levels of externalizing problems, and (5) a non-clinical trajectory. Invariance analyses suggested that this model remained valid in both boys and girls. Logistic regression analyses suggested that youth who belonged in the externalizing trajectory reported a greater likelihood of past-year gambling behaviours when compared to youth who belong in the comorbid trajectory. No other mental health trajectory was significantly associated with adolescent gambling. Stable high externalizing behaviours in development appear to increase one's risk of gambling behaviours in adolescence. Efforts to target these throughout development could help decrease one's future risk of engaging in these behaviours.

Looking at Sex Differences in Gambling Disorder: The Predictive Role of the Early Abandonment Schema, Gambling Motives and Alexithymia in Depression

A growing body of research indicates differences between men and women with gambling disorder. However, although alexithymia, gambling motives or abandonment have been associated with GD, women's clinical profile remains unexplored. This study aims, firstly, to explore mean differences in gambling motives (i.e. enhancement, coping and social [SOC]), the early maladaptive abandonment schema, alexithymia and depression in women and men with GD. Secondly, to analyse the correlation between the aforementioned variables as a function of sex. Thirdly, to examine the predictive role of gambling motives, early abandonment schema and alexithymia in depression as a function of sex. Lastly, to analyse the mediating role of COP between the early maladaptive abandonment schema and depression in women with GD, and the mediating role of ENH and the early maladaptive abandonment schema between alexithymia and depression in men with GD. The sample comprised 108 adults with GD diagnosis, of whom 60 were women and 48 were men. Regression and mediation analyses were carried out to explore possible sex differences in GD, through the SPSS programme. Results showed that depressive symptoms are predicted by alexithymia in men with GD and by the early maladaptive abandonment schema in women with GD. Regarding mediation analyses, the results suggest that COP mediated the relationship between early abandonment schema and depressive symptoms in females; and ENH and abandonment schema mediated the relationship between alexithymia and depressive symptoms in males. These results provide evidence of the relevance of considering sex differences when establishing therapeutic strategies in GD rehabilitation.

University Students' Gaming and Gambling Behaviors, Related Factors, and the Relationship Between Gaming and Gambling

The purpose of this study was to investigate university students' gaming and gambling behaviors, the factors that relate to these behaviors, and the connection between gaming and gambling behaviors. The study was designed as survey research, which is one of the quantitative research methods. The sample for the study consists of 232 students who are continuing their education at a state university in Turkey. The data of the research were collected through the Student Information Form, the Game Addiction Scale, and the South Oaks Gambling Screen. While the rate of students with problematic gambling behavior was 9.1% (n = 21), the rate of students with problematic gambling behavior was 14.2% (n = 33). Gaming behavior showed significant differences according to gender, age, the feeling of success, leisure time sufficiency, sleep proficiency, smoking, and alcohol use. Gambling behavior showed significant differences according to gender, family type, family income, the feeling of success, level of happiness, the experience of psychological distress, social relationship satisfaction, smoking, and alcohol use, and the presence of an addicted person in the social environment. Gender, perception of success, leisure proficiency, and alcohol use were variables associated with both gambling and gaming. There was a positive and significant relationship between gaming and gambling behavior (r = .264, p < .001). As a result, it is seen that the variables related to gaming and gambling behavior differ rather than partnership. Considering the weak relationship between gaming and gambling behavior, it is difficult to put forward sharp views on the relationship between gaming and gambling.

Relapse prevention therapy for internet gaming disorder in Swedish child and adolescent psychiatric clinics: a randomized controlled trial

Objectives

To evaluate the effectiveness of relapse prevention (RP) as a treatment for internet gaming disorder (IGD).

Design

Randomized controlled trial.

Setting

Three child and adolescent psychiatry (CAP) units in Region Skåne, Sweden.

Participants

Children aged 13-18 years, coming for their first visit to CAP during 2022, were screened for gaming behavior. Those who met the proposed DSM-5 criteria for IGD were offered participation in the trial, if they had the capacity to provide written informed consent and if they spoke Swedish. A total of 111 CAP patients agreed to participate. Out of those, 11 patients were excluded due to incorrect inclusion such as young age (n = 1), or due to the absence of responses to follow-up measures (n = 9). After exclusion, 102 participants remained (intervention = 47, control = 55).

Interventions

The intervention, RP, is based on cognitive behavioral treatment (CBT) and was provided individually, comprising of five to seven 45-min sessions over a period of 5 to 7 weeks versus treatment as usual.

Outcome measures

Participants were assessed with Game Addiction Scale for Adolescents pre-treatment (GASA) (baseline), post-treatment (treatment group only), and 3 months after baseline (follow-up).

Results

The repeated measures ANOVA showed a significant interaction effect between treatment and time. Both the control group and treatment group lowered their mean GASA score from baseline to follow-up significantly, but the improvement was greater in the treatment group (mean difference in control group -5.1, p < 0.001, 95% CI = - 3.390 to -6.755, mean difference in treatment group -9.9, p < 0.001, 95% CI = -11.746 to -8.105).

Conclusion

RP was found to be superior to treatment as usual in terms of reduction of IGD symptoms. Future research should address which aspects within a given treatment are effective, who benefits from treatment, in what aspects, and why.

Trial registration number

ClinicalTrials.gov, NCT05506384 https://clinicaltrials.gov/ct2/show/NCT05506384.

Adolescents' Perceptions of a Relapse Prevention Treatment for Problematic Gaming-A Qualitative Study

Given the increasing prevalence of problematic gaming, in 2013, the diagnosis "Internet gaming disorder (IGD)" was included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as a potential diagnosis. With a new diagnosis, it is important to determine treatment options. The importance of the parent-child relationship has been emphasised in problematic gaming and its treatment. This study aims to provide more knowledge about adolescents' perceptions of a treatment for problematic gaming and understand whether such treatment may have a bearing on the parent-child relationship. We conducted individual interviews with nine adolescents who completed a treatment for problematic gaming. The interviews were analysed using thematic analysis. The analysis revealed three themes. Theme 1: adolescents' experiences of the new treatment; Theme 2: adolescents' perceptions of the effect of the treatment on their gaming behaviour; and Theme 3: adolescents' perceptions of changes in their parent-child relationships. The adolescents viewed the treatment as a way of gaining control of their gaming, a process in which a therapist played an integral part. For the majority of the adolescents in our study, the main effects of treatment were gaining insight into how their gaming and gaming-related behaviours affected other parts of their lives. The participants felt that the treatment improved their relationship with their parents through reducing everyday conflicts. This new knowledge can be used for the development of future interventions involving children and adolescents.

What explains the link between romantic conflict with gambling problems? Testing a serial mediational model

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.

Five-Factor Model and DSM-5 Alternative Model of Personality Disorder Profile Construction: Associations with Cognitive Ability and Clinical Symptoms

Although numerous studies have explored latent profiles using the Five-Factor Model (FFM) of normative personality, no studies have investigated how broad personality traits (i.e., FFM) and pathological personality traits using the alternative model of personality disorder (AMPD) may combine for latent personality profiles. The present study recruited outpatients (N = 201) who completed the Big Five Aspects Scales (BFAS), Personality Inventory for DSM-5 (PID-5), Structured Clinical Interview for DSM-IV (SCID-I/P), gambling and alcohol use measures, and the Weschler Intelligence subtests. When FFM and AMPD measures were combined, latent profile analyses revealed four profiles, Internalizing-Thought disorder, Externalizing, Average-Detached, and Adaptive. Detachment and openness to experience were the most and least essential traits for profile distinction, respectively. No associations between group membership and cognitive ability measures were found. Internalizing-Thought disorder membership was linked with a current mood and anxiety disorder diagnosis. Externalizing profile membership was associated with younger age, problematic gambling, alcohol use, and a current substance use disorder diagnosis. The four FFM-AMPD profiles overlapped with the four FFM-only and three AMPD-only profiles. Overall, the FFM-AMPD profiles appeared to have better convergent and discriminant validity with DSM-relevant psychopathology.

Annual Research Review: Emergence of problem gambling from childhood to emerging adulthood: a systematic review

BACKGROUND

The risk for problematic gambling and associated high-risk behaviors is elevated during adolescence and emerging adulthood. Activities with gambling-like features and novel forms of gambling may place youth at an increased risk for problem gambling.

AIM AND METHOD

The aim of this review is to provide an overview of the association between both activities with gambling-like features and novel gambling activities and problem gambling among youth while examining the role of psychopathology and cognitive processes. Six databases (PsychINFO, MEDLINE, PubMed, Social Work Abstracts, Technology Collection, and Scopus) were searched in November 2021 for peer-reviewed articles investigating the association between the aforementioned variables among youth up to the age of 25 years. Risk of bias was assessed using the Observational Study Quality Evaluation.

FINDINGS

Forty-five articles were included in the review. Positive associations were observed between engagement in activities with gambling-like features (e.g., video games, social casino games, loot boxes) and problem gambling. Increased involvement with novel forms of gambling (e.g., online sports betting, fantasy sports, and esports betting) were also associated with a greater risk for problematic gambling. Males reported higher rates of engagement in these activities and a greater risk of problem gambling than females. Impulsivity, risk taking, cognitive distortions, and specific emotional vulnerabilities were associated with an increased risk of problem gambling.

CONCLUSIONS

Despite the need for additional longitudinal research controlling for relevant confounders, these findings underline how engagement in activities with gambling-like features are relevant in the developmental trajectory toward problem gambling.

Depression in mothers at childhood: Direct and indirect association with problematic gaming in late adolescence/young adulthood

OBJECTIVES

Little is known about the relationship between depression in mothers and problematic gaming in their children. Therefore, we aimed to investigate the potential role of mothers' depression in childhood as a risk factor for problematic gaming in their offspring in late adolescence/young adulthood.

METHODS

We assessed data from 1557 participants on three waves (T0 collected in 2010/2011, T1 in 2013/2014, and T2 in 2018/2019) of a large Brazilian school-based cohort. Mother's depression at T0 was tested as a predictor of problematic gaming at T2 in a logistic regression model. In mediation analyses, we individually assessed internalizing or externalizing disorders at T1 as mediators in this association, with participants' sex being tested as a moderator in both models. Inverse probability weights were used to account for sample attrition at T2. All models were adjusted for maternal and participant-related covariates.

RESULTS

Mother's depression at T0 was significantly associated with problematic gaming at T2 (OR = 2.09, p < 0.001) even after adjusting for multiple confounding factors. The presence of any internalizing disorder at T1 was a partial mediator of this relationship, accounting for 8.18% (p = 0.032) of the total effect, while the presence of any externalizing disorder at T1 was not a significant mediator. Participants' sex was not a significant moderator in mediation models.

CONCLUSIONS

These findings suggest mother's depression in childhood as a risk factor for problematic gaming in later developmental stages, which may be partially mediated by internalizing psychopathology.

Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet

Global concern about problematic usage of the internet (PUI), and its public health and societal costs, continues to grow, sharpened in focus under the privations of the COVID-19 pandemic. This narrative review reports the expert opinions of members of the largest international network of researchers on PUI in the framework of the European Cooperation in Science and Technology (COST) Action (CA 16207), on the scientific progress made and the critical knowledge gaps remaining to be filled as the term of the Action reaches its conclusion. A key advance has been achieving consensus on the clinical definition of various forms of PUI. Based on the overarching public health principles of protecting individuals and the public from harm and promoting the highest attainable standard of health, the World Health Organisation has introduced several new structured diagnoses into the ICD-11, including gambling disorder, gaming disorder, compulsive sexual behaviour disorder, and other unspecified or specified disorders due to addictive behaviours, alongside naming online activity as a diagnostic specifier. These definitions provide for the first time a sound platform for developing systematic networked research into various forms of PUI at global scale. Progress has also been made in areas such as refining and simplifying some of the available assessment instruments, clarifying the underpinning brain-based and social determinants, and building more empirically based etiological models, as a basis for therapeutic intervention, alongside public engagement initiatives. However, important gaps in our knowledge remain to be tackled. Principal among these include a better understanding of the course and evolution of the PUI-related problems, across different age groups, genders and other specific vulnerable groups, reliable methods for early identification of individuals at risk (before PUI becomes disordered), efficacious preventative and therapeutic interventions and ethical health and social policy changes that adequately safeguard human digital rights. The paper concludes with recommendations for achievable research goals, based on longitudinal analysis of a large multinational cohort co-designed with public stakeholders.

Gambling problems among Lebanese adults: Arabic-Language version of the South Oaks Gambling Screen (SOGS) scale validation and correlates

BACKGROUND

In the DSM-5, gambling disorder is recognized as the only behavioral addiction. The number of people with mental health disorders is increasing in Lebanon, especially since the economic crisis and the COVID-19 pandemic. The South Oaks Gambling Screen (SOGS), the most used tool in the world in terms of pathological gambling, has never been translated to Arabic, culturally adapted in a way that suits the Lebanese population and validated. This study's objectives were to validate an Arabic-language version of the SOGS and assess factors associated with probable pathological gambling among Lebanese adults.

METHODS

This study was carried out between February and April 2021, during the lockdown period imposed by the Lebanese government. A total of 601 individuals participated in this study by filling the online questionnaire.

RESULTS

A factor analysis, using the principal component analysis, was performed on the SOGS scale items. The SOGS items were able to explain 73.35% of the variance, with an internal reliability of KR20 = 0.947 for the total scale. The results of the confirmatory factor analysis confirmed the results of the factor analysis. More problematic alcohol use (aOR = 1.17), and more depression (aOR = 1.13) were significantly associated with higher odds of probable pathological gambling, whereas females (aOR = 0.27) had significantly lower odds of probable pathological gambling compared to males.

CONCLUSION

Our study validated an Arabic-language version of the South Oaks Gambling Screen (SOGS) for use in Lebanon, and showed some factors associated with probable pathological gambling (male gender, alcohol use disorder and depression). This reliable and valid version will hopefully contribute towards better screening for gambling disorder in Lebanon.

Diathesis stress or differential susceptibility? testing the relationship between stressful life events, neuroticism, and internet gaming disorder among Chinese adolescents

A previous study has documented that stressful life events is positively related to Internet gaming disorder (IGD) among adolescents. However, the mechanism underlying this relationship remains unclear. The current study examined whether the link between stressful life events and adolescent IGD was moderated by neuroticism and whether the interaction of stressful life events and neuroticism supported the diathesis stress model or differential susceptibility model. To this end, self-report questionnaires were distributed. Participants were 927 Chinese adolescents (meanage = 14.53 years, 51.02% male). After controlling for adolescent gender, age, family economic situation, and family socioeconomic status, the results revealed that stressful life events could be positively associated with adolescent IGD and that this link is moderated by neuroticism. Moreover, the results of interaction effects supported the "diathesis stress" model. The above findings contributed to a better understanding of how and when stressful life events increase the risk of IGD and provided new evidence for the diathesis stress hypothesis.

Prediction of problem gambling by demographics, gaming behavior and psychological correlates among gacha gamers: A cross-sectional online survey in Chinese young adults

OBJECTIVE

The objective of this study is to explore the association of problem gambling with demographics, psychological distress, and gaming behavior in young adult gacha gamers in Hong Kong.

MATERIALS AND METHODS

Cross-sectional data was collected in the first and fifth waves of COVID-19 pandemic in Hong Kong online. Participants who aged 18-25 years and had been playing gacha games over the past 12 months were recruited. Stepwise multiple regression was used to explore the association among risk of problem gambling, gaming behavior, participation in gaming activities and psychological distress. A two-sided p-value <0.05 was considered as statistical significance.

RESULTS

Three hundred and thirty-seven completed questionnaires were received with no missing data. 34.7% (n = 117) of the participants had non/low-risk of problem gambling. About 40% (n = 136) of them had moderate-risk and the remaining 25% (n = 84) were at high risk of problem gambling. A higher proportion of female participants (78.6%) were found in high-risk group as compared to 39.7% and 55.6% only in the non/low-risk and moderate-risk groups, respectively. The regression model (R ² = 0.513, F = 71.895, p < 0.001) showed that 51.3% of the variance of the total problem gambling score could be explained by stress, anxiety, monthly expenses on gacha purchases, number of motives for gacha purchase and number of gambling activities engaged.

CONCLUSION

The present study provides empirical evidence to support the association between problem gambling and microtransaction especially for gacha which is the most popular type of video game microtransaction in Asia. The established regression model suggests that gacha gamers with higher risk of problem gambling tend to have greater stress, higher anxiety level, spend more on gacha purchase, have more motives for gacha purchases and engage in more gambling activities. In contrast to the extant literature, higher proportion of female participants in high-risk group indicates that female gacha gamers are also at very high risk of becoming problem gamblers.

Factors related to the dual condition of gambling and gaming disorders: A path analysis model

BACKGROUND AND AIMS

Gaming disorder has experienced rapid growth in the last decade among youth and adult populations, in parallel to the expansion of the videogame industry. The objective of this study was to explore the underlying process to explain the dual diagnosis of gaming with gambling disorder.

METHODS

The sample included n = 117 patients who met clinical criteria for gaming disorder, recruited from a tertiary care unit specialized in the treatment of behavioral addictions. Path analysis (implemented through structural equation modeling) assessed the direct and mediational mechanisms between the dual condition of gaming + gambling disorder and sociodemographic variables and personality traits.

RESULTS

The comorbid gaming + gambling disorder was met for 14.5% of the participants (additionally, 6.0% of the sample also met criteria for problematic gambling). The dual diagnosis was directly related to an older age at onset of the addiction problems, a higher level of the novelty seeking trait and being in active work. Employment status also mediated the relationship between persistence levels and chronological age. Greater psychopathological distress was related to females, higher levels of harm avoidance and persistence and lower levels of self-directedness.

CONCLUSIONS

The results of this study provide empirical evidence for the specific factors that increase the likelihood of the dual gaming + gambling disorder. Clinical settings should consider these features to improve gaming diagnosis and treatment. Preventive programs should also be focused on the most vulnerable groups to prevent onset and progression of this comorbid condition.

Beyond internalizing and externalizing symptoms: The association between body disconnection and the symptoms of Internet gaming disorder

As the vast majority of online videogames imply the immersion into an alternative reality where a virtual body is also involved, the current cross-sectional study aims to investigate the contribution of low body awareness (i.e. low attention to sensory cues indicating bodily state) and body dissociation (i.e. low emotional connection with one's own body) in predicting Internet gaming disorder (IGD) symptoms, after controlling for internalizing (i.e., depression, anxiety, and stress) and externalizing symptoms (i.e., aggression). A total of 370 online-game players (73% men; mean age 29.63 ± 7.64 years) recruited in online player communities took part in the study and were given a survey that included gaming characteristics, the Depression, Anxiety and Stress Scale -21, the Aggression Questionnaire, the Body Disconnection Scale, and the Internet Gaming Disorder Scale- Short Form. A hierarchical regression analysis showed that low body awareness and high body dissociation predicted IGD scores after controlling for all the other factors. Moreover, we found an interaction effect between physical aggression and body dissociation in predicting IGD scores. On the one hand, these results provide support to previous studies that stressed the potential association between dissociative detachment (in terms of bodily disconnections) and problematic videogaming; on the other hand, the current study provides first evidence of the opportunity to focus on the integration of bodily experiences in clinical practice with people suffering from problematic gaming, as this factor might be incisively related to their aggressive and internalizing symptoms.

Subtyping treatment-seeking gaming disorder patients

BACKGROUND AND AIMS

Gaming Disorder (GD) is characterized by a pattern of persistent and uncontrolled gaming behavior that causes a marked impairment in important areas of functioning. The evolution of the worldwide incidence of this disorder warrants further studies focused on examining the existence of different subtypes within clinical samples, in order to tailor treatment. This study explored the existence of different profiles of patients seeking treatment for GD through a data-driven approach.

METHODS

The sample included n = 107 patients receiving treatment for GD (92% men and 8% women) ranging between 14 and 60 years old (mean age = 24.1, SD = 10). A two-step clustering analysis approach explored the existence of different underlying GD profiles based on a broad set of indicators, including sociodemographic features, clinical course of the condition (e.g., onset or evolution), psychopathological symptoms, and personality traits.

RESULTS

Two GD profiles emerged. The first cluster grouped together patients who presented with a lower psychological impact (n = 72, 66.1%), whereas the second cluster comprised patients with a higher psychological impact (n = 35, 32.7%). Cluster comparisons revealed that those patients presenting the higher impact were older, with a later onset of pathological gaming patterns, and more pronounced psychopathological symptoms and dysfunctional personality profiles.

CONCLUSIONS

GD severity is influenced by specific demographic, clinical, and psychopathological factors. The identification of two separate profiles provides empirical evidence that contributes to the conceptualization of this disorder, as well as to the development of reliable and valid screening tools and effective intervention plans focused on the precise characteristics of the treatment-seeking patients.

Burden and Help-Seeking Behaviors Linked to Problem Gambling and Gaming: Observational Quantitative and Qualitative Analysis

BACKGROUND

Models based on the uniqueness of addiction processes between behavioral addictions are highly contentious, and the inclusion of gaming disorder in the addiction nosography remains controversial. An exploratory approach could clarify a hypothesized common and subjectively identifiable process in addictive behaviors and the necessarily different expressions of the disorder due to behavior specificities, in particular the sociocultural characteristics and profiles of users.

OBJECTIVE

The aim of this study was to describe the nature of contacts to a help service by exploring commonality and specificities of burden and help-seeking for problem gambling or gaming.

METHODS

This was an observational quantitative-qualitative study. We included all contacts (ie, online questions and contacts by phone or chat when the helper completed a summary) to a helpline for gamers, gamblers, and relatives over a 7-year period. We constituted a text corpus with online questions and summaries of contacts by phone or chat. We collected basic sociodemographic data, including the device used to contact the service (phone or internet), contacting the service for oneself ("user") or being a relative of a user and type of relative, gambling (yes/no), gaming (yes/no), and age and sex of the gambler/gamer. We describe the corpus descriptively and report the computerized qualitative analysis of online questions, chat, and summary of phone calls. We performed a descendant hierarchical analysis on the data.

RESULTS

A total of 14,564 contacts were made to the helpline, including 10,017 users and 4547 relatives. The corpus was composed of six classes: (1) gaming specificities, (2) shared psychological distress and negative emotions, (3) the procedure for being banned from gambling, (4) the provided help, (5) gambling specificities, and (6) financial problems.

CONCLUSIONS

Negative emotions and shared distress linked to gambling and gaming support current scientific consensus that these behaviors can produce psychological distress in se; however, meaningful differences were observed in core symptoms of addiction between gamers and gamblers, beyond specificities related to the behavior itself: loss of control was elicited in the class corresponding to gambling specificities and not by gamers and their relatives.

Between two worlds: Exploring esports betting in relation to problem gambling, gaming, and mental health problems

BACKGROUND AND AIMS

Esports betting is an emerging gambling activity where individuals place bets on an organized video gaming competition. It represents only one of several gambling activities commonly endorsed by adolescents. To date, limited research has explored the relationship between esports betting and mental health among adolescents and its convergence with both problem gambling (PG) and problem video gaming (PVG). The present study examined the relation between esports betting, PG and PVG, and both externalizing and internalizing problems among adolescents while accounting for adolescents' video gaming intensity (i.e., how often they play 2 h or more in a day) and engagement in other gambling activities.

METHODS

Data was collected from 6,810 adolescents in Wood County, Ohio schools. A subset of 1,348 adolescents (M age = 14.67 years, SD = 1.73, 64% male) who had gambled and played video games during the past year were included in the analyses.

RESULTS

Approximately 20% (n = 263) of the included sample had bet on esports during the past year. Esports betting was positively correlated with other forms of gambling, both PG and PVG, and externalizing behaviors. Mediation analyses revealed esports betting was associated to both internalizing and externalizing problems through PVG and not PG.

CONCLUSIONS

Esports betting may be particularly appealing to adolescents who are enthusiastic video gamers. As such, regulators must be vigilant to ensure codes of best practices are applied to esports betting operators specifically for underaged individuals.

What game we are playing: the psychosocial context of problem gambling, problem gaming and poor well-being among Italian high school students

Gambling and gaming are not infrequent among adolescents and preventing low-risk youth from becoming at-risk appears to be a priority of public health strategies. Greater scrutiny of the risk and protective factors in the relationships and community of young people appears crucial in steering prevention initiatives adequately. This study aimed to explore the role of the qualities of relational networks (i.e. family functioning, perceived social and class support), family and peer approval and view of the social environment in predicting problem gambling, problem gaming and overall well-being among adolescents. High-school students aged 14-18 years (N: 595; female: 68,7%) completed a survey including the target variables. A multivariate multiple regression analysis was performed to examine the role of socio-demographic characteristics and psychosocial predictors on gaming, gambling, and well-being. Multivariate multiple regressions identify a common core underpinning problem gambling, gaming and poor well-being but also the distinct roles of psychosocial variables: being male, with low parental monitoring, and an anomic view of the social environment all predict problem gambling and gaming, which were also found to be associated. Low social support predicts problem gambling but not problem gaming; poor family functioning predicts problem gaming but not problem gambling. All the target psychosocial variables, except approval of gambling, predict poor well-being. On the whole the findings suggest the need to look more closely at the way adolescents, their system of activity and their culture participate in constructing the meaning of gambling and gaming activities and their impact on adolescents' well-being, so that future studies and strategies can more effectively examine the relational dynamics in which problem gambling and gaming develop.

Longitudinal predictors for incidence of internet gaming disorder among adolescents: The roles of time spent on gaming and depressive symptoms

INTRODUCTION

Internet gaming disorder (IGD) was popular among adolescents worldwide, but whether some associated factors could contribute to the development of IGD was unclear. This longitudinal study explored the temporal stability of IGD over one year and determined the predictors for IGD incidence.

METHODS

Participants were 1121 adolescents from six junior high schools in Shanghai, China (50.6% males; median age = 13.0 years). The baseline and follow-up questionnaire survey measured IGD, time spent on gaming, depressive symptoms, insomnia condition, substance use and background variables from 7th to 8th grade. Multivariate logistic regression analysis was conducted to test the associations between other factors and IGD incidence.

RESULTS

IGD incidence was 7.7% at one-year follow-up. Gender, family financial condition, parental educational level, time spent on gaming, insomnia condition and depressive symptoms were associated with IGD incidence in univariate analysis, whereas only gender, family financial condition, time spent on gaming and depressive symptoms were associated with IGD incidence in multivariate logistic regression.

CONCLUSIONS

IGD might persist for years during adolescence. After controlling for sociodemographic factors, time spent on gaming and depressive symptoms were independent predictors for IGD incidence.

Depression and anxiety symptoms associated with internet gaming disorder before and during the COVID-19 pandemic: A longitudinal study

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic has profoundly impacted aspects of human life globally. Playing videogames has been encouraged by several organizations to help individuals cope with the COVID-19 pandemic and associated restrictive measures. This longitudinal study was the first to examine gaming in the context of the pandemic and its association with depressive and anxiety symptoms.

METHODS

The sample comprised 1,778 children and adolescents (50.7% male) who were part of the Project of School Mental Health in Southwest China. Data were collected at two-time intervals: before the COVID-19 pandemic (October to November 2019 - [T1]) and during the COVID-19 pandemic (April to May 2020 - [T2]). Data were collected on perceived COVID-19 impacts, videogame use, Internet Gaming Disorder (IGD), and depressive and anxiety symptoms. Cross-lagged panel models were computed to examine longitudinal relationships.

RESULTS

The results indicated that both videogame use and IGD increased significantly for adolescents at T2. The cross-lagged panel model results suggested that depressive and anxiety symptoms at T1 positively predicted IGD and videogame use at T2 (especially for boys), but not inversely. Perceived COVID-19 impacts mediated the relationship between depressive and anxiety symptoms at T1 and IGD at T2.

CONCLUSION

Children and adolescents both increased videogame use at T2, but only adolescents significantly increased IGD severity at T2. The findings supported the compensatory hypothesis, and are consistent with the Interaction of Person-Affect-Cognition-Execution model as individual responses to COVID-19 may function as a mediator between personal predisposing variables and IGD.