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Black N, Chung S, Tisdale C, Fialho LS, Aramrattana A, Assanangkornchai S, Blaszczynski A, Bowden-Jones H, van den Brink W, Brown A, Brown QL, Cottler LB, Elsasser M, Ferri M, Florence M, Gueorguieva R, Hampton R, Hudson S, Kelly PJ, Lintzeris N, Murphy L, Nadkarni A, Neale J, Rosen D, Rumpf HJ, Rush B, Segal G, Shorter GW, Torrens M, Wait C, Young K, Farrell M. An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders. J Clin Med 2024; 13:2154. [PMID: 38610919 PMCID: PMC11012938 DOI: 10.3390/jcm13072154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.
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Affiliation(s)
- Nicola Black
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
| | - Sophie Chung
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Calvert Tisdale
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
| | - Luz Sousa Fialho
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Apinun Aramrattana
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sawitri Assanangkornchai
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Alex Blaszczynski
- School of Psychology, Brain and Mind Centre, Faculty of Science, University of Sydney, Sydney 2006, Australia;
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University College London, London NW1 2AE, UK
- Department of Psychiatry, Cambridge University, Cambridge CB2 1QW, UK
| | - Wim van den Brink
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Adrian Brown
- Northwick Park Hospital, Central and North West London Trust, London HA1 3UJ, UK
| | - Qiana L. Brown
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Medicine & Public Health and Health Professions, University of Florida, Homestead, FL 33031, USA
| | | | - Marica Ferri
- Department of Psychology, Faculty of Community and Health, European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal;
| | - Maria Florence
- Department of Biostatistics, School of Public Health, University of the Western Cape, Cape Town 7535, South Africa;
| | - Ralitza Gueorguieva
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT 06511, USA
| | | | - Suzie Hudson
- Network of Alcohol and Other Drugs Agencies, Sydney 2751, Australia;
| | - Peter J. Kelly
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, Australia;
| | - Nicholas Lintzeris
- Discipline of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia;
| | | | - Abhijit Nadkarni
- Addictions and Related Research Group, Sangath, Bardez 403501, Goa, India
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Joanne Neale
- Addictions Department, King’s College London, London SE1 9NH, UK
| | - Daniel Rosen
- School of Social Work, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Hans-Jürgen Rumpf
- Translational Psychiatry Unit, Universität zu Lübeck, 23562 Lübeck, Germany
| | - Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Gabriel Segal
- Department of Philosophy, King’s College London, London SE1 9NH, UK;
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast BT9 5AJ, UK
- Institute of Mental Health Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Marta Torrens
- Addiction Service, Hospital del Mar, 08003 Barcelona, Spain
| | | | - Katherine Young
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
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Warrier V, Chamberlain SR, Thomas SA, Bowden-Jones H. Genetics of gambling disorder and related phenotypes: The potential uses of polygenic and multifactorial risk models to enable early detection and improve clinical outcomes. J Behav Addict 2024; 13:16-20. [PMID: 38224367 PMCID: PMC10988411 DOI: 10.1556/2006.2023.00075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024] Open
Abstract
Gambling Disorder (GD) is an impactful behavioural addiction for which there appear to be underpinning genetic contributors. Twin studies show significant GD heritability results and intergenerational transmission show high rates of transmission. Recent developments in polygenic and multifactorial risk prediction modelling provide promising opportunities to enable early identification and intervention for at risk individuals. People with GD often have significant delays in diagnosis and subsequent help-seeking that can compromise their recovery. In this paper we advocate for more research into the utility of polygenic and multifactorial risk modelling in GD research and treatment programs and rigorous evaluation of its costs and benefits.
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Affiliation(s)
- Varun Warrier
- Department of Psychiatry, University of Cambridge, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southern Health NHS Foundation Trust, Southampton, UK
| | - Shane A. Thomas
- Vice Chancellor's Office and Institute of Health and Wellbeing, Federation University, Australia
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University of Cambridge, UK
- National Problem Gambling Clinic & National Centre for Gaming Disorders, London, UK
- Department of Brain Sciences, University College London, London, UK
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Dymond S, Dighton G, Hoon AE, Roderique-Davies G, John B, Bowden-Jones H. The ongoing need for NHS gambling harms services in Wales: time to put words into action. Front Psychiatry 2023; 14:1277435. [PMID: 37953940 PMCID: PMC10634300 DOI: 10.3389/fpsyt.2023.1277435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Affiliation(s)
- Simon Dymond
- School of Psychology, Swansea University, Swansea, United Kingdom
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
| | - Glen Dighton
- School of Psychology, Swansea University, Swansea, United Kingdom
| | - Alice E. Hoon
- Swansea University Medical School, Swansea, United Kingdom
| | - Gareth Roderique-Davies
- Faculty of Life Sciences and Education, University of South Wales, Treforest, United Kingdom
| | - Bev John
- Faculty of Life Sciences and Education, University of South Wales, Treforest, United Kingdom
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic and National Centre for Gaming Disorders, London, United Kingdom
- Department of Psychiatry, University of Cambridge; Cambridgeshire and Peterborough NHS Foundation Trust, London, United Kingdom
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Thomas SA, Browning CJ, Charchar FJ, Klein B, Ory MG, Bowden-Jones H, Chamberlain SR. Transforming global approaches to chronic disease prevention and management across the lifespan: integrating genomics, behavior change, and digital health solutions. Front Public Health 2023; 11:1248254. [PMID: 37905238 PMCID: PMC10613497 DOI: 10.3389/fpubh.2023.1248254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
Chronic illnesses are a major threat to global population health through the lifespan into older age. Despite world-wide public health goals, there has been a steady increase in chronic and non-communicable diseases (e.g., cancer, cardiovascular and metabolic disorders) and strong growth in mental health disorders. In 2010, 67% of deaths worldwide were due to chronic diseases and this increased to 74% in 2019, with accelerated growth in the COVID-19 era and its aftermath. Aging and wellbeing across the lifespan are positively impacted by the presence of effective prevention and management of chronic illness that can enhance population health. This paper provides a short overview of the journey to this current situation followed by discussion of how we may better address what the World Health Organization has termed the "tsunami of chronic diseases." In this paper we advocate for the development, validation, and subsequent deployment of integrated: 1. Polygenic and multifactorial risk prediction tools to screen for those at future risk of chronic disease and those with undiagnosed chronic disease. 2. Advanced preventive, behavior change and chronic disease management to maximize population health and wellbeing. 3. Digital health systems to support greater efficiencies in population-scale health prevention and intervention programs. It is argued that each of these actions individually has an emerging evidence base. However, there has been limited research to date concerning the combined population-level health effects of their integration. We outline the conceptual framework within which we are planning and currently conducting studies to investigate the effects of their integration.
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Affiliation(s)
- Shane A Thomas
- Vice Chancellor’s Office, Federation University, Ballarat, VIC, Australia
| | - Colette J Browning
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC, Australia
- Health Innovation and Transformation Centre (HITC), Federation University, Ballarat, VIC, Australia
| | - Fadi J Charchar
- Health Innovation and Transformation Centre (HITC), Federation University, Ballarat, VIC, Australia
| | - Britt Klein
- Health Innovation and Transformation Centre (HITC), Federation University, Ballarat, VIC, Australia
| | - Marcia G. Ory
- Center for Community Health and Aging, Texas A&M University, School of Public Health, College Station, TX, United States
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Southern Gambling Service, and Southern Health NHS Foundation Trust, Southampton, United Kingdom
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5
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Chamberlain SR, Ioannidis K, Bowden-Jones H. The UK Gambling White Paper: comments on implementation and timing. Compr Psychiatry 2023; 126:152410. [PMID: 37619283 DOI: 10.1016/j.comppsych.2023.152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Affiliation(s)
- Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, UK; NHS Southern Gambling Service, Southern Health NHS Foundation Trust, Southampton, UK.
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Southampton, UK; NHS Southern Gambling Service, Southern Health NHS Foundation Trust, Southampton, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic & National Centre for Gaming Disorders, London, UK; Department of Psychiatry, University of Cambridge, UK
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Di Carlo F, Verrastro V, Alessi MC, Sociali A, Altomare AI, Di Natale C, Stigliano G, Miuli A, Lalli A, Di Petta G, Chiappini S, Pettorruso M, Bowden-Jones H, Griffiths MD, Martinotti G. High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults. Eur Addict Res 2023; 29:241-252. [PMID: 37276845 DOI: 10.1159/000529544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 12/19/2022] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming. METHODS Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R). RESULTS High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives. DISCUSSION AND CONCLUSION The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.
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Affiliation(s)
- Francesco Di Carlo
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Maria Chiara Alessi
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Antonella Sociali
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Arianna Ida Altomare
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Chiara Di Natale
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Andrea Miuli
- Department of Mental Health, ASL2 Abruzzo, Chieti, Italy
| | - Aliseo Lalli
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Faculty of Brain Sciences, University College London, London, UK
| | - Mark D Griffiths
- Psychology Department, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
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7
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Fineberg NA, Menchón JM, Hall N, Dell'Osso B, Brand M, Potenza MN, Chamberlain SR, Cirnigliaro G, Lochner C, Billieux J, Demetrovics Z, Rumpf HJ, Müller A, Castro-Calvo J, Hollander E, Burkauskas J, Grünblatt E, Walitza S, Corazza O, King DL, Stein DJ, Grant JE, Pallanti S, Bowden-Jones H, Ameringen MV, Ioannidis K, Carmi L, Goudriaan AE, Martinotti G, Sales CMD, Jones J, Gjoneska B, Király O, Benatti B, Vismara M, Pellegrini L, Conti D, Cataldo I, Riva GM, Yücel M, Flayelle M, Hall T, Griffiths M, Zohar J. Advances in problematic usage of the internet research - A narrative review by experts from the European network for problematic usage of the internet. Compr Psychiatry 2022; 118:152346. [PMID: 36029549 DOI: 10.1016/j.comppsych.2022.152346] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 01/05/2023] Open
Abstract
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.
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Affiliation(s)
- Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Natalie Hall
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche", University of Milan, Milan, Italy
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Marc N Potenza
- Departments of Psychiatry, Neuroscience and Child Study, Yale University School of Medicine, and Wu Tsai Institute, Yale University, New Haven, USA, New Haven, USA; Connecticut Council on Problem Gambling, Wethersfield, USA; Connecticut Mental Health Center, New Haven, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
| | - Giovanna Cirnigliaro
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, South Africa
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Hans Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, Research Group S:TEP (Substance use and related disorders: Treatment, Epidemiology and Prevention) University of Lübeck, Lübeck, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - Eric Hollander
- Autism and Obsessive Compulsive Spectrum Program, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, 00135 Palanga, Lithuania
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Ornella Corazza
- Department of Clinical Pharmacological and Biological Science, University of Hertfordshire
| | - Daniel L King
- College of Education, Psychology, & Social Work, Flinders University, Adelaide, Australia
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town
| | - Jon E Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago
| | - Stefano Pallanti
- Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA; INS Istituto di Neuroscienze, Florence, Italy
| | | | - Michael Van Ameringen
- Deptartment of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Konstantinos Ioannidis
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Lior Carmi
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel; Reichman University, The Data Science Institution, Herzliya, Israel
| | - Anna E Goudriaan
- Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Institute for Addiction Research & Arkin, the Netherlands
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Célia M D Sales
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal; Center for Psychology at University of Porto (CPUP), University of Porto, Porto, Portugal
| | - Julia Jones
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | | | - Orsolya Király
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Beatrice Benatti
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Matteo Vismara
- Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy; "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Dario Conti
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK; Luigi Sacco University Hospital, Psychiatry 2 Unit, University of Milan, Milan, Italy
| | - Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Gianluigi M Riva
- School of Information and Communication Studies, University College Dublin
| | - Murat Yücel
- Brain Park, Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Monash Biomedical Imaging Facility, Monash University, Melbourne, Victoria, Australia
| | - Maèva Flayelle
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | | | | | - Joseph Zohar
- Post-Trauma Center, Sheba Medical Center, Tel Aviv University, Israel
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8
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Dowling N, Merkouris S, Lubman D, Thomas S, Bowden-Jones H, Cowlishaw S. Pharmacological interventions for the treatment of disordered and problem gambling. Cochrane Database Syst Rev 2022; 9:CD008936. [PMID: 36130734 PMCID: PMC9492444 DOI: 10.1002/14651858.cd008936.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Pharmacological interventions for disordered and problem gambling have been employed in clinical practice. Despite the availability of several reviews of the efficacy of pharmacological interventions for disordered or problem gambling, few have employed systematic search strategies or compared different categories of pharmacological interventions. Systematic reviews of high-quality evidence are therefore essential to provide guidance regarding the efficacy of different pharmacological interventions for disordered or problem gambling. OBJECTIVES The primary aims of the review were to: (1) examine the efficacy of major categories of pharmacological-only interventions (antidepressants, opioid antagonists, mood stabilisers, atypical antipsychotics) for disordered or problem gambling, relative to placebo control conditions; and (2) examine the efficacy of these major categories relative to each other. SEARCH METHODS: We searched the Cochrane Common Mental Disorders Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Embase, and PsycINFO (all years to 11 January 2022). SELECTION CRITERIA We included randomised trials evaluating a pharmacological intervention for the treatment of disordered or problem gambling. Eligible control conditions included placebo control groups or comparisons with another category of pharmacological intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures, including systematic extraction of included study characteristics and results and risk of bias assessment. Our primary outcome was reduction in gambling symptom severity. Our secondary outcomes were reduction in gambling expenditure, gambling frequency, time spent gambling, depressive symptoms, anxiety symptoms, and functional impairment; and responder status. We evaluated treatment effects for continuous and dichotomous outcomes using standardised mean difference (SMD) and risk ratios (RR), respectively, employing random-effects meta-analyses. A minimum of two independent treatment effects were required for a meta-analysis to be conducted (with only meta-analytic findings reported in this abstract). MAIN RESULTS We included 17 studies in the review (n = 1193 randomised) that reported outcome data scheduled for end of treatment. Length of treatment ranged from 7 to 96 weeks. Antidepressants: Six studies (n = 268) evaluated antidepressants, with very low to low certainty evidence suggesting that antidepressants were no more effective than placebo at post-treatment: gambling symptom severity (SMD -0.32, 95% CI -0.74 to 0.09, n = 225), gambling expenditure (SMD -0.27, 95% CI -0.60 to 0.06, n = 144), depressive symptoms (SMD -0.19, 95% CI -0.60 to 0.23, n = 90), functional impairment (SMD -0.15, 95% CI -0.53 to 0.22, n = 110), and responder status (RR 1.24, 95% CI 0.93 to 1.66, n = 268). Opioid antagonists: Four studies (n = 562) evaluated opioid antagonists, with very low to low certainty evidence showing a medium beneficial effect of treatment on gambling symptom severity relative to placebo at post-treatment (SMD -0.46, 95% CI -0.74 to -0.19, n = 259), but no difference between groups in responder status (RR 1.65, 95% CI 0.86 to 3.14, n = 562). Mood stabilisers: Two studies (n = 71) evaluated mood stabilisers (including anticonvulsants), with very low certainty evidence suggesting that mood stabilisers were no more effective than placebo at post-treatment: gambling symptom severity (SMD -0.92, 95% CI -2.24 to 0.39, n = 71), depressive symptoms (SMD -0.15, 95% CI -1.14 to 0.83, n = 71), and anxiety symptoms (SMD -0.17, 95% CI -0.64 to 0.30, n = 71). Atypical antipsychotics:Two studies (n = 63) evaluated the atypical antipsychotic olanzapine, with very low certainty evidence showing a medium beneficial effect of treatment on gambling symptom severity relative to placebo at post-treatment (SMD -0.59, 95% CI -1.10 to -0.08, n = 63). Comparative effectiveness: Two studies (n = 62) compared antidepressants with opioid antagonists, with very low certainty evidence indicating that antidepressants were no more effective than opioid antagonists on depressive symptoms (SMD 0.22, 95% CI -0.29 to 0.72, n = 62) or anxiety symptoms (SMD 0.21, 95% CI -0.29 to 0.72, n = 62) at post-treatment. Two studies (n = 58) compared antidepressants with mood stabilisers (including anticonvulsants), with very low certainty evidence indicating that antidepressants were no more effective than mood stabilisers on depressive symptoms (SMD 0.02, 95% CI -0.53 to 0.56, n = 58) or anxiety symptoms (SMD 0.16, 95% CI -0.39 to 0.70, n = 58) at post-treatment. Tolerability and adverse events: Several common adverse effects were reported by participants receiving antidepressants (e.g. headaches, nausea, diarrhoea/gastrointestinal issues) and opioid antagonists (e.g. nausea, dry mouth, constipation). There was little consistency in the types of adverse effects experienced by participants receiving mood stabilisers (e.g. tiredness, headaches, concentration difficulties) or atypical antipsychotics (e.g. pneumonia, sedation, increased hypomania). Discontinuation of treatment due to these adverse events was highest for opioid antagonists (10% to 32%), followed by antidepressants (4% to 31%), atypical antipsychotics (14%), and mood stabilisers (13%). AUTHORS' CONCLUSIONS This review provides preliminary support for the use of opioid antagonists (naltrexone, nalmefene) and atypical antipsychotics (olanzapine) to produce short-term improvements in gambling symptom severity, although a lack of available evidence precludes a conclusion regarding the degree to which these pharmacological agents can improve other gambling or psychological functioning indices. In contrast, the findings are inconclusive with regard to the effects of mood stabilisers (including anticonvulsants) in the treatment of disordered or problem gambling, and there is limited evidence to support the efficacy of antidepressants. However, these conclusions are based on very low to low certainty evidence characterised by a small number of included studies, high risk of bias, modest pooled sample sizes, imprecise estimates, moderate between-study heterogeneity, and exclusion of participants with psychiatric comorbidities. Moreover, there were insufficient studies to conduct meta-analyses on many outcome measures; to compare efficacy across and within major categories of interventions; to explore dosage effects; or to examine effects beyond post-treatment. These limitations suggest that, despite recommendations related to the administration of opioid antagonists in the treatment of disordered or problem gambling, pharmacological interventions should be administered with caution and with careful consideration of patient needs. A larger and more methodologically rigorous evidence base with longer-term evaluation periods is required before definitive conclusions can be drawn about the effectiveness and durability of pharmacological treatments for disordered or problem gambling.
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Affiliation(s)
- Nicki Dowling
- School of Psychology, Deakin University, Geelong, Australia
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | | | - Dan Lubman
- Turning Point, Eastern Health, Melbourne, Australia
- Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Shane Thomas
- School of Health, Federation University, Melbourne, Australia
- Research School of Population Health, Australian National University, Melbourne, Australia
- Peking University, Beijing, China
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic UK, Faculty of Brain Sciences, UCL, London, UK
- Department of Psychiatry, Cambridge University, Cambridge, UK
| | - Sean Cowlishaw
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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9
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Burkauskas J, Fineberg NA, Ioannidis K, Chamberlain SR, Bowden-Jones H, Griskova-Bulanova I, Pranckeviciene A, Dores AR, Carvalho IP, Barbosa F, Simonato P, De Luca I, Mooney R, Gómez-Martínez MÁ, Demetrovics Z, Ábel KE, Szabo A, Fujiwara H, Shibata M, Melero-Ventola AR, Arroyo-Anlló EM, Santos-Labrador RM, Kobayashi K, Di Carlo F, Monteiro C, Martinotti G, Corazza O. Online Behaviours during the COVID-19 Pandemic and Their Associations with Psychological Factors: An International Exploratory Study. IJERPH 2022; 19:ijerph19148823. [PMID: 35886679 PMCID: PMC9323465 DOI: 10.3390/ijerph19148823] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 12/24/2022]
Abstract
This cross-sectional study aimed to explore specific online behaviours and their association with a range of underlying psychological and other behavioural factors during the COVID-19 pandemic. Eight countries (Italy, Spain, the United Kingdom, Lithuania, Portugal, Japan, Hungary, and Brazil) participated in an international investigation involving 2223 participants (M = 33 years old; SD = 11), 70% of whom were females. Participants were surveyed for specific type of Internet use severity, appearance anxiety, self-compassion, and image and use of performance-enhancing drugs (IPEDs). Results were compared cross-culturally. The mean time spent online was 5 h (SD = ±3) of daily browsing during the pandemic. The most commonly performed activities included social networking, streaming, and general surfing. A strong association between these online behaviours and appearance anxiety, self-compassion, and IPEDs use was found after adjustment for possible confounders, with higher scores being associated with specific online activities. Significant cross-cultural differences also emerged in terms of the amount of time spent online during the initial stages of the COVID-19 pandemic.
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Affiliation(s)
- Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 00135 Palanga, Lithuania;
- Correspondence: ; Tel.: +370-612-04885
| | - Naomi A. Fineberg
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK; (N.A.F.); (P.S.); (I.D.L.); (G.M.); (O.C.)
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK; (K.I.); (H.B.-J.)
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
- Southern Health NHS Foundation Trust, Southampton SO40 2RZ, UK
| | - Samuel R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton SO17 1BJ, UK
- Southern Health NHS Foundation Trust, Southampton SO40 2RZ, UK
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University of Cambridge, Cambridge CB2 1TN, UK; (K.I.); (H.B.-J.)
| | - Inga Griskova-Bulanova
- Department of Neurobiology and Biophysics, Institute of Biosciences, Vilnius University, 03225 Vilnius, Lithuania;
| | - Aiste Pranckeviciene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, 00135 Palanga, Lithuania;
| | - Artemisa R. Dores
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal;
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal;
| | - Irene P. Carvalho
- Clinical Neurosciences and Mental Health Department, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal;
- CINTESIS@RISE, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal;
| | - Pierluigi Simonato
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK; (N.A.F.); (P.S.); (I.D.L.); (G.M.); (O.C.)
| | - Ilaria De Luca
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK; (N.A.F.); (P.S.); (I.D.L.); (G.M.); (O.C.)
| | - Rosin Mooney
- Medical Sciences Division, Department of Psychiatry, University of Oxford, Oxford OX1 3TG, UK;
| | | | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar GX11 1AA, Gibraltar;
- Institute of Psychology, ELTE Eötvös Loránd University, 1117 Budapest, Hungary; (K.E.Á.); (A.S.)
| | - Krisztina Edina Ábel
- Institute of Psychology, ELTE Eötvös Loránd University, 1117 Budapest, Hungary; (K.E.Á.); (A.S.)
| | - Attila Szabo
- Institute of Psychology, ELTE Eötvös Loránd University, 1117 Budapest, Hungary; (K.E.Á.); (A.S.)
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, 1117 Budapest, Hungary
| | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto 606-8501, Japan; (H.F.); (M.S.); (K.K.)
- Artificial Intelligence Ethics and Society Team, RIKEN Center for Advanced Intelligence Project, Saitama 103-0027, Japan
- General Research Division, Research Center on Ethical, Legal and Social Issues, Osaka University, Suita, Osaka 565-0871, Japan
| | - Mami Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto 606-8501, Japan; (H.F.); (M.S.); (K.K.)
| | - Alejandra R. Melero-Ventola
- Department of Psychology, Pontifical University of Salamanca, 37002 Salamanca, Spain; (M.Á.G.-M.); (A.R.M.-V.)
| | - Eva M. Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, 37002 Salamanca, Spain;
| | - Ricardo M. Santos-Labrador
- Department of Physical Education, University Teacher’s College ‘Fray Luis de León’, 47010 Valladolid, Spain;
| | - Kei Kobayashi
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto 606-8501, Japan; (H.F.); (M.S.); (K.K.)
| | - Francesco Di Carlo
- Department of Neuroscience, Imaging and Clinical Science “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Cristina Monteiro
- Department of Psychometrics, Institute of Psychology, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil;
| | - Giovanni Martinotti
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK; (N.A.F.); (P.S.); (I.D.L.); (G.M.); (O.C.)
- Department of Neuroscience, Imaging and Clinical Science “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9EU, UK; (N.A.F.); (P.S.); (I.D.L.); (G.M.); (O.C.)
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10
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Roberts A, Sharman S, Bowden-Jones H. The ability of the UK population surveys to capture the true nature of the extent of gambling-related harm. Addiction 2022; 117:2122-2123. [PMID: 35257425 DOI: 10.1111/add.15864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/16/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Amanda Roberts
- School of Psychology, University of Lincoln, Lincoln, UK
| | - Steve Sharman
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, UK.,Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Cambridge, UK
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11
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Carragher N, Billieux J, Bowden-Jones H, Achab S, Potenza MN, Rumpf HJ, Long J, Demetrovics Z, Gentile D, Hodgins D, Aricak OT, Baigent M, Gandin C, Rahimi-Movaghar A, Scafato E, Assanangkornchai S, Siste K, Hao W, King DL, Saunders J, Higuchi S, Poznyak V. Brief overview of the WHO Collaborative Project on the Development of New International Screening and Diagnostic Instruments for Gaming Disorder and Gambling Disorder. Addiction 2022; 117:2119-2121. [PMID: 34882889 DOI: 10.1111/add.15780] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/06/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Natacha Carragher
- Alcohol, Drugs and Addictive Behaviours Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland.,Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic; National Centre for Gaming Disorders, UK.,Faculty of Brain Sciences, University College London, London, UK
| | - Sophia Achab
- WHO Collaborating Centre in Research and Training in Mental Health, Faculty of Medicine, University of Geneva, Geneva, 1202, Switzerland.,Treatment Facility for Addictive Behaviors, Department of Psychiatry, University Hospitals of Geneva, Switzerland
| | - Marc N Potenza
- Department of Psychiatry and Neuroscience, Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Jiang Long
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, China.,Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar.,Addiction Research Group, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Douglas Gentile
- Department of Psychology, Iowa State University, Ames, IA, USA
| | - David Hodgins
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Osman Tolga Aricak
- Hasan Kalyoncu University, Gaziantep, Turkey.,Turkish Green Crescent Society, Istanbul, Turkey
| | - Michael Baigent
- Department of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, Australia.,Statewide Gambling Therapy Service, Flinders Medical Centre, Bedford Park, Australia
| | - Claudia Gandin
- National Observatory on Alcohol, National Institute of Health, Rome, Italy
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Emanuele Scafato
- National Observatory on Alcohol, National Institute of Health, Rome, Italy
| | - Sawitri Assanangkornchai
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Kristiana Siste
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia, dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, China.,Consortium on Clinical bigdata and Biobank for Addiction Research (3CBAR), Changsha, Hunan, China
| | - Daniel L King
- College of Education, Psychology, and Social Work, Flinders University, Australia
| | - John Saunders
- Department of Public Health Sciences, University of Connecticut School of Medicine, University of Queensland, Australia
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Japan
| | - Vladimir Poznyak
- Alcohol, Drugs and Addictive Behaviours Unit, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
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12
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King DL, Achab S, Higuchi S, Bowden-Jones H, Müller KW, Billieux J, Starcevic V, Saunders JB, Tam P, Delfabbro PH. Gaming disorder and the COVID-19 pandemic: Treatment demand and service delivery challenges. J Behav Addict 2022; 11:243-248. [PMID: 35413005 PMCID: PMC9295227 DOI: 10.1556/2006.2022.00011] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/18/2022] [Accepted: 03/13/2022] [Indexed: 02/02/2023] Open
Abstract
Gaming activities have conferred numerous benefits during the COVID-19 pandemic. However, some individuals may be at greater risk of problem gaming due to disruption to adaptive routines, increased anxiety and/or depression, and social isolation. This paper presents a summary of 2019-2021 service data from specialist addiction centers in Germany, Switzerland, Japan, and the United Kingdom. Treatment demand for gaming disorder has exceeded service capacity during the pandemic, with significant service access issues. These data highlight the need for adaptability of gaming disorder services and greater resources and funding to respond effectively in future public health crises.
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Affiliation(s)
- Daniel L. King
- College of Education, Psychology and Social Work, Flinders University, Australia
| | - Sophia Achab
- Outpatient Centre for Behavioral Addictions ReConnecte, Addiction Division, Department of Psychiatry, University Hospitals of Geneva, Switzerland
- Clinical and Sociological Research Unit, Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Japan
| | - Henrietta Bowden-Jones
- National Centre for Gaming Disorders, United Kingdom
- Faculty of Brain Sciences, University College London, United Kingdom
- Department of Psychiatry, Cambridge University, United Kingdom
| | - Kai W. Müller
- Outpatient Clinic for Behavioral Addictions, Department of Psychosomatic Medicine and Psychotherapy at the University Medical Center, Mainz, Germany
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Vladan Starcevic
- University of Sydney, Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, Sydney, Australia
| | - John B. Saunders
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Philip Tam
- The Psych Matters Clinic, Concord, Sydney, Australia
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13
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Sharman S, Roberts A, Harris B, Lockwood R, Bowden-Jones H. The National Centre for Gaming Disorders (UK) - Who is accessing this service? J Behav Addict 2022; 11:147-149. [PMID: 35385396 PMCID: PMC9295212 DOI: 10.1556/2006.2022.00010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/01/2022] [Accepted: 03/13/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Steve Sharman
- National Addiction Centre, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, 4 Windsor Walk, Camberwell, SE5 8AF, UK
| | - Amanda Roberts
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, UK
| | - Becky Harris
- National Centre for Gaming Disorders, 69 Warwick Road, Earls Court, London, SW5 9HB, UK
| | - Rebecca Lockwood
- National Centre for Gaming Disorders, 69 Warwick Road, Earls Court, London, SW5 9HB, UK
| | - Henrietta Bowden-Jones
- National Centre for Gaming Disorders, 69 Warwick Road, Earls Court, London, SW5 9HB, UK
- Division of Psychology and Language Sciences, UCL, 26 Bedford Way, Bloomsbury, London, WC1H 0AP, UK
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
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14
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Bowden-Jones H, Hook RW, Grant JE, Ioannidis K, Corazza O, Fineberg NA, Singer BF, Roberts A, Bethlehem R, Dymond S, Romero-Garcia R, Robbins TW, Cortese S, Thomas SA, Sahakian BJ, Dowling NA, Chamberlain SR. Gambling disorder in the UK: key research priorities and the urgent need for independent research funding. Lancet Psychiatry 2022; 9:321-329. [PMID: 35180386 PMCID: PMC7612512 DOI: 10.1016/s2215-0366(21)00356-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/31/2021] [Accepted: 08/10/2021] [Indexed: 12/24/2022]
Abstract
Gambling in the modern era is pervasive owing to the variety of gambling opportunities available, including those that use technology (eg, online applications on smartphones). Although many people gamble recreationally without undue negative effects, a sizeable subset of individuals develop disordered gambling, which is associated with marked functional impairment including other mental health problems, relationship problems, bankruptcy, suicidality, and criminality. The National UK Research Network for Behavioural Addictions (NUK-BA) was established to promote understanding of, research into, and treatments for behavioural addictions including gambling disorder, which is the only formally recognised behavioural addiction. In this Health Policy paper, we outline the status of research and treatment for disordered gambling in the UK (including funding issues) and key research that should be conducted to establish the magnitude of the problem, vulnerability and resilience factors, the underlying neurobiology, long-term consequences, and treatment opportunities. In particular, we emphasise the need to: (1) conduct independent longitudinal research into the prevalence of disordered gambling (including gambling disorder and at-risk gambling), and gambling harms, including in vulnerable and minoritised groups; (2) select and refine the most suitable pragmatic measurement tools; (3) identify predictors (eg, vulnerability and resilience markers) of disordered gambling in people who gamble recreationally, including in vulnerable and minoritised groups; (4) conduct randomised controlled trials on psychological interventions and pharmacotherapy for gambling disorder; (5) improve understanding of the neurobiological basis of gambling disorder, including impulsivity and compulsivity, genetics, and biomarkers; and (6) develop clinical guidelines based on the best contemporary research evidence to guide effective clinical interventions. We also highlight the need to consider what can be learnt from approaches towards mitigating gambling-related harm in other countries.
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Affiliation(s)
- Henrietta Bowden-Jones
- National Problem Gambling Clinic & National Centre for Gaming Disorders, London, UK; Department of Psychiatry, University of Cambridge, Cambridge, UK; Faculty of Brain Sciences, University of Sussex, Brighton, UK
| | - Roxanne W Hook
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, IL, USA
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of International Health, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Ornella Corazza
- Department of Clinical, Pharmacological and Biological Sciences, University of Hertfordshire, Hatfield, UK
| | - Naomi A Fineberg
- Department of Psychiatry, University of Cambridge, Cambridge, UK; School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertforshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
| | - Bryan F Singer
- School of Psychology, University of Sussex, Brighton, UK; Sussex Addiction Research and Intervention Centre, University of Sussex, Brighton, UK; Sussex Neuroscience, University of Sussex, Brighton, UK
| | - Amanda Roberts
- School of Psychology, College of Social Science, University of Lincoln, Lincoln, UK
| | | | - Simon Dymond
- Department of Psychology, Swansea University, Swansea, UK; Department of Psychology, Reykjavík University, Reykjavík, Iceland
| | - Rafa Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Departamento de Fisiología Médica y Biofísica, Instituto de Biomedicina de Sevilla, Universidad de Sevilla, Seville, Spain
| | - Trevor W Robbins
- Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Shane A Thomas
- School of Health, Federation University, Ballarat, VIC Australia
| | | | - Nicki A Dowling
- School of Psychology, Deakin University, Geelong, VIC, Australia; Melbourne Graduate School of Education, University of Melbourne, VIC, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK.
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15
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Cataldo I, Burkauskas J, Dores AR, Carvalho IP, Simonato P, De Luca I, Gómez-Martínez MÁ, Melero Ventola AR, Demetrovics Z, Szabo A, Ábel KE, Shibata M, Kobayashi K, Fujiwara H, Arroyo-Anlló EM, Martinotti G, Barbosa F, Griskova-Bulanova I, Pranckeviciene A, Bowden-Jones H, Esposito G, Corazza O. An international cross-sectional investigation on social media, fitspiration content exposure, and related risks during the COVID-19 self-isolation period. J Psychiatr Res 2022; 148:34-44. [PMID: 35093805 PMCID: PMC8782623 DOI: 10.1016/j.jpsychires.2022.01.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/19/2021] [Accepted: 01/13/2022] [Indexed: 01/16/2023]
Abstract
With the global COVID-19 pandemic, governments from many countries in the world implemented various restrictions to prevent the SARS-Cov-2 virus's spread, including social distancing measures, quarantine, in-home lockdown, and the closure of services and public spaces. This led to an in-creased use of social media platforms to make people feel more connected, but also to maintain physical activity while self-isolating. Concerns about physical appearance and the desire to keep or reach a muscular and toned ideal body, might have further reinforced the engagement in fitness-related social media activities, like sharing progresses in training achievements or following more fitness contents on popular profiles. To better understand the underlying relation among these factors, the present study investigates 729 responses to the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), the Self-Compassion Scale (SCS) and their association to social media usage and compares the results cross-culturally in five countries (Spain, Lithuania, United Kingdom, Japan, and Hungary). Findings highlight significant differences between males and females, espe-cially in regard to the time spent online (U = 477.5, p = 0.036). Greater levels of appearance anxiety were associated with the exposure to fitness-related contents on social media. These results strongly confirm the previously highlighted association between fitspiration media and body image anxiety predominantly in females. Clinical implications and future considerations in terms of prevention and treatment in a situation of global emergency are also discussed.
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Affiliation(s)
- Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy.
| | - Julius Burkauskas
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Artemisa R. Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal,School of Health, Polytechnic of Porto, Porto, Portugal
| | - Irene P. Carvalho
- Clinical Neurosciences and Mental Health Department and CINTESIS, School of Medicine, Porto, Portugal
| | - Pierluigi Simonato
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | - Ilaria De Luca
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
| | | | | | - Zsolt Demetrovics
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Attila Szabo
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | - Mami Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto, Japan
| | - Kei Kobayashi
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto, Japan
| | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, University of Kyoto, Kyoto, Japan,Artificial Intelligence Ethics and Society Team, RIKEN Center for Advanced Intelligence Project, Saitama, Japan
| | - Eva Maria Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, Salamanca, Spain
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, and Clinical Science “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Inga Griskova-Bulanova
- Department of Neurobiology and Biophysics, Institute of Biosciences, Vilnius University, Vilnius, Lithuania
| | - Aiste Pranckeviciene
- Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy,Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Ornella Corazza
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, AL10 9AB, UK
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Sallie SN, Ritou VJ, Bowden-Jones H, Voon V. Assessing online gaming and pornography consumption patterns during COVID-19 isolation using an online survey: Highlighting distinct avenues of problematic internet behavior. Addict Behav 2021; 123:107044. [PMID: 34311186 PMCID: PMC8434429 DOI: 10.1016/j.addbeh.2021.107044] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/29/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022]
Abstract
Background and aim The Coronavirus (COVID-19) pandemic has required drastic safety precautions to contain virus spread, involving a protracted self-isolation period. Those with greater perceived or actual life stress are vulnerable to develop problematic internet behaviors. Thus, we assessed how COVID-19 social isolation affected online gaming (OG) and pornography viewing (PV) in the general population. Methods We developed an online cross-sectional survey, Habit Tracker (HabiT), completed by 1,344 adults (≥18 years). HabiT was released internationally with individuals from 80 countries participating; a majority residing in the United States and United Kingdom. We measured changes in OG (IGDS9-SF) and PV (CYPAT) behaviors before and during the COVID-19 quarantine period. We also assessed psychiatric factors such as anxiety, depression (HADS), and impulsivity (SUPPS-P). The primary outcome measures were change in amount of, and current OG and PV severity during quarantine. These measures were related to ten COVID-19-related stress factors. Results Overall, we observed a large increase in OG and a minor increase in PV. Those who increased OG (63%) and PV (43%) during quarantine were younger individuals, males, those who left the quarantine household infrequently, those who reported low frequency or poor quality social interactions, and those with higher depression, anxiety, and urgency impulsivity. Discussion Our findings highlight similarities between forms of problematic internet behaviors driven by stress, depression, anxiety; while highlighting distinct avenues which these behaviors can manifest. Conclusion We emphasize the relevance of identifying those in need of emotional regulation interventions, to mitigate problematic internet behaviors in the context of COVID-19 isolation.
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Sallie SN, Ritou VJE, Bowden-Jones H, Voon V. #3123 Assessing international alcohol and internet use patterns during COVID-19 isolation using an online survey: highlighting distinct stressors conferring risk to compulsive behaviours. J Neurol Neurosurg Psychiatry 2021. [DOI: 10.1136/jnnp-2021-bnpa.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives and AimsThe Coronavirus (COVID-19) pandemic has required drastic safety measures to contain virus spread, including an extended self-isolation period. Those with greater perceived or actual life stress are vulnerable to develop or reinstate problematic behaviours characterised by addiction and compulsive mechanisms. Thus, we assessed how the COVID-19 pandemic and isolation measures affected alcohol consumption and internet use in the general population.MethodsWe developed an online international survey, entitled Habit Tracker (HabiT), completed by 1,346 adults (≥18 years), which measured changes in amount and severity of alcohol consumption (Alcohol Use Disorders Identification Test; AUDIT),online gaming (Internet Gaming Disorder Scale-Short Form; IGDS9-SF), and pornography viewing (Cyber Pornography Addiction Test; CYPAT) before (post-hoc recall)and during the COVID-19 pandemic and consequent lockdown. These measures were related to ten COVID-19-specific stress factors. Lastly, we assessed psychiatric factors widely recognized to be associated with problematic alcohol and internet use such as anxiety, depression (Hospital Anxiety and Depression Scale; HADS), and impulsivity (Short Impulsive-Behavior Scale; SUPPS-P).ResultsOf the sample, we observed an overall increase in online gaming and a decrease alcohol consumption and pornography viewing. Those who increased their amount and severity of alcohol use (36%) during lockdown reported stress associated with the pandemic itself, such as being an essential worker directly caring for those with or having a loved one become severely ill from COVID-19. Further, those residing in the United Kingdom- as opposed the United States or Canada- increased their weekly amount of alcohol consumption. Alternatively, those who increased online gaming (64%) and pornography viewing (43%)reported low frequency or poor quality social interactions resultant of lockdown measures. All three groups displayed higher levels of depression, anxiety, and urgency impulsivity.ConclusionsOur findings underscore the theoretical mechanism of negative emotionality underlying forms of compulsive behaviour driven by stress, depression, and anxiety; while highlighting distinct avenues by which these behaviours can manifest. Limitations include subjects being within varying phases of lockdown during the time of testing and a large degree of study dropout (n=1,515). We emphasise the relevance of identifying those in need of greater support services to mitigate negative health outcomes associated with problematic alcohol consumption and internet usage in the context of COVID-19 isolation.
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Dell’Osso B, Di Bernardo I, Vismara M, Piccoli E, Giorgetti F, Molteni L, Fineberg NA, Virzì C, Bowden-Jones H, Truzoli R, Viganò C. Managing Problematic Usage of the Internet and Related Disorders in an Era of Diagnostic Transition: An Updated Review. Clin Pract Epidemiol Ment Health 2021; 17:61-74. [PMID: 34497661 PMCID: PMC8386084 DOI: 10.2174/1745017902117010061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Problematic Usage of the Internet (PUI) refers to a broad and likely heterogeneous group of Internet-related conditions associated with behavioural disturbances and functional impairment. METHODS Within PUI several conditions have been reported, including Gaming Disorder, Shopping Addiction, Cyberchondria, Gambling Disorder, Cyberpornography Addiction and Cyberbullying. While increasing reports in the field try to define the epidemiologic and clinical boundaries of these conditions, the rapid and continuous evolution of Internet related behaviours as well as their problematic/pathological expressions are often difficult to diagnose, assess, approach with treatment interventions and follow-up. RESULTS In addition, some of the PUI-related conditions show characteristics of addiction to the Internet as a preferential tool to engage in specific behaviours, while some others exclusively manifest on the Internet, making it necessary to find distinct assessment and treatment pathways. CONCLUSION The inclusion of Internet Gaming Disorder in Section III by the DSM-5 and the recognition of Gaming Disorder by the ICD-11 opened the way for a systematic clinical investigation of this and other PUI-related conditions, particularly in terms of preventive and therapeutic strategies. The present article is aimed at offering an updated clinical overview on the main expressions of PUI, focussing on the latest acquisitions in this evolving field.
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Affiliation(s)
- Bernardo Dell’Osso
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Psychiatry, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, Stanford, CA, USA
- Aldo Ravelli” Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy
| | - Ilaria Di Bernardo
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Matteo Vismara
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Eleonora Piccoli
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Federica Giorgetti
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Laura Molteni
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL8 6HG, UK
- Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Calogero Virzì
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust, Division of Brain Science, Imperial College London, London, UK
| | - Roberto Truzoli
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Caterina Viganò
- Department of Psychiatry, University of Milan, Department of Biomedical and Clinical Sciences “Luigi Sacco”, ASST Fatebenefratelli-Sacco, Milan, Italy
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Bowden-Jones H, Crossley A. Gambling adverts: should they stay or should they go? BMJ 2021; 374:n1708. [PMID: 34233912 DOI: 10.1136/bmj.n1708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Adrian Crossley
- Addiction and Criminal Justice Policy Unit, Centre for Social Justice, London, UK
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Abstract
In response to the COVID-19 pandemic, the UK Government placed society on ‘lockdown’, altering the gambling landscape. This study sought to capture the immediate lockdown-enforced changes in gambling behaviour. UK adults (n = 1028) were recruited online. Gambling behaviour (frequency and weekly expenditure, perceived increase/decrease) was measured using a survey-specific questionnaire. Analyses compared gambling behaviour as a function of pre-lockdown gambling status, measured by the Brief Problem Gambling Scale. In the whole sample, gambling participation decreased between pre- and during-lockdown. Both gambling frequency and weekly expenditure decreased during the first month of lockdown overall, but, the most engaged gamblers did not show a change in gambling behaviour, despite the decrease in opportunity and availability. Individuals whose financial circumstances were negatively affected by lockdown were more likely to perceive an increase in gambling than those whose financial circumstances were not negatively affected. Findings reflect short-term behaviour change; it will be crucial to examine, at future release of lockdown, if behaviour returns to pre-lockdown patterns, or whether new behavioural patterns persist.
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Affiliation(s)
- Steve Sharman
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Camberwell, London, SE5 8AF UK.,School of Psychology, University of East London, Water Lane E15 4LZ, Stratford, UK
| | - Amanda Roberts
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS UK
| | - Henrietta Bowden-Jones
- Division of Psychology and Language Sciences, UCL, 26 Bedford Way, Bloomsbury, WC1H 0AP, London, UK.,Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ UK.,National Problem Gambling Clinic, 69 Warwick Road, London, SW5 9BH UK
| | - John Strang
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Camberwell, London, SE5 8AF UK
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Sharman S, Roberts A, Bowden-Jones H, Strang J. Gambling in COVID-19 Lockdown in the UK: Depression, Stress, and Anxiety. Front Psychiatry 2021; 12:621497. [PMID: 33569018 PMCID: PMC7868396 DOI: 10.3389/fpsyt.2021.621497] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/04/2021] [Indexed: 11/23/2022] Open
Abstract
To combat the spread of COVID-19, the UK Government implemented a range of "lockdown" measures. Lockdown has necessarily changed the gambling habits of gamblers in the UK, and the impact of these measures on the mental health of gamblers is unknown. To understand the impact of lockdown on gamblers, in April 2020, after ~6 weeks of lockdown, participants (N = 1,028, 72% female) completed an online questionnaire. Gambling engagement data was collected for pre-lockdown via the Brief Problem Gambling Screen (BPGS) allowing participants to be classified as Non-Gamblers (NG), Non-Problem Gamblers (NPG) or Potential Problem Gamblers (PPG). The Depression, Stress, and Anxiety Scale (DASS21) was used to measure depression, stress, and anxiety scores both pre- and during-lockdown. Results indicate that depression, stress and anxiety has increased across the whole sample. Participants classified in the PPG group reported higher scores on each sub scale at both baseline and during lockdown. Increases were observed on each DASS21 subscale, for each gambler group, however despite variable significance and effect sizes, the magnitude of increases did not differ between groups. Lockdown has had a significant impact on mental health of participants; whilst depression stress and anxiety remain highest in potential problem gamblers, pre-lockdown gambler status did not affect changes in DASS21 scores.
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Affiliation(s)
- Steve Sharman
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom.,School of Psychology, University of East London, London, United Kingdom
| | - Amanda Roberts
- School of Psychology, University of Lincoln, Lincoln, United Kingdom
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, United Kingdom.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Faculty of Brain Sciences, University College London, London, United Kingdom
| | - John Strang
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
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22
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Sallie SN, Ritou V, Bowden-Jones H, Voon V. Assessing international alcohol consumption patterns during isolation from the COVID-19 pandemic using an online survey: highlighting negative emotionality mechanisms. BMJ Open 2020; 10:e044276. [PMID: 33243820 PMCID: PMC7692002 DOI: 10.1136/bmjopen-2020-044276] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has required drastic safety measures to control virus spread, including an extended self-isolation period. Stressful situations increase alcohol craving and consumption in alcohol use disorder (AUD) and non-AUD drinkers. Thus, we assessed how COVID-19 related stress may have affected drinking behaviours in the general population. DESIGN We developed an online cross-sectional survey, Habit Tracker (HabiT), which measured changes in drinking behaviours before and during COVID-19 quarantine. We also assessed psychiatric factors such as anxiety, depression (Hospital Anxiety and Depression Scale) and impulsivity (Short-Impulsive Behavior Scale). Lastly, we related drinking behaviours to COVID-19 specific stress factors. SETTING HabiT was released internationally, with individuals from 83 countries participating. PARTICIPANTS Participants were included if they were 18 years of age or older and confirmed they were proficient in English. The survey was completed by 2873 adults with 1346 usable data (46.9% accurately completed). PRIMARY OUTCOME MEASURES Primary outcome measures were change in amount and severity of drinking behaviours before and during quarantine, and current drinking severity during quarantine. RESULTS Although drinking behaviours decreased overall during quarantine, 36% reported an increase in alcohol use. Those who increased alcohol use during quarantine were older individuals (95% CI 0.04 to 0.1, p<0.0001), essential workers (95% CI -0.58 to -0.1, p=0.01), individuals with children (95% CI -12.46 to 0.0, p=0.003), those with a personal relationship with someone severely ill from COVID-19 (95% CI -2 to -0.38, p=0.01) and those with higher depression (95% CI 0.67 to 1.45, p<0.0001), anxiety (95% CI 0.61 to 1.5, p=0.0002), and positive urgency impulsivity (95% CI 0.16 to 0.72, p=0.009). Furthermore, country-level subsample analyses indicated that drinking amount (95% CI 9.36 to 13.13, p=0.003) increased in the UK during quarantine. CONCLUSIONS Our findings highlight a role for identifying those vulnerable for alcohol misuse during periods of self-isolation and underscore the theoretical mechanism of negative emotionality underlying drinking behaviours driven by stress. Limitations include a large degree of study dropout (n=1515). Future studies should assess the long-term effects of isolation on drinking behaviours.
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Affiliation(s)
| | - Valentin Ritou
- Faculty of Basic and Biomedical Sciences, University of Paris, Paris, France
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Faculty of Brain Sciences, University College London, London, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
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Dymond S, Owen WE, Hoon AE, Roderique-Davies G, John B, Bowden-Jones H. The need for gambling disorder clinics in Wales. Lancet 2020; 396:e80. [PMID: 33125931 DOI: 10.1016/s0140-6736(20)32237-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 09/07/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Simon Dymond
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK; Department of Psychology, Reykjavík University, Reykjavík, Iceland.
| | | | | | | | - Bev John
- School of Psychology & Therapeutic Studies, University of South Wales, Pontypridd, UK
| | - Henrietta Bowden-Jones
- National Centre for Behavioural Addictions, London, UK; Division of Psychology and Language Sciences, University College London, London, UK; Department of Psychiatry, Cambridge University, Cambridge, UK
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Devos MG, Clark L, Bowden-Jones H, Grall-Bronnec M, Challet-Bouju G, Khazaal Y, Maurage P, Billieux J. The joint role of impulsivity and distorted cognitions in recreational and problem gambling: A cluster analytic approach. J Affect Disord 2020; 260:473-482. [PMID: 31539682 DOI: 10.1016/j.jad.2019.08.096] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 06/27/2019] [Accepted: 08/31/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS The Pathways Model (Blaszczynski & Nower, 2002) posits that problem gambling is a heterogeneous disorder with distinct subgroups (behaviorally conditioned gamblers, emotionally vulnerable gamblers, and antisocial-impulsivist gamblers). Impulsivity traits and gambling-related cognitions are recognized as two key psychological factors in the onset and maintenance of problem gambling. To date, these constructs have been explored separately, and their joint role in determining problem gambling subtypes has received little attention. The goal of our study was to identify subgroups of gamblers based on impulsivity traits and gambling-related cognitions, and to determine whether this approach is consistent with the Pathways model. METHODS Gamblers from the community (N = 709) and treatment-seeking pathological gamblers (N = 122) completed questionnaires measuring gambling habits, disordered gambling symptoms, gambling-related cognitions, and impulsivity traits. RESULTS Cluster analyses revealed that three clusters globally aligned with the pathways proposed by Blaszczynski & Nower (2002). Two other clusters emerged: (1) impulsive gamblers without cognitive-related cognitions; and (2) gamblers without impulsivity or gambling-related cognitions. Gamblers with both heightened impulsive traits and gambling-related cognitions had more severe problem gambling symptoms. CONCLUSION We successfully identified, based on an a priori theoretical framework, different subtypes of gamblers that varied in terms of problem gambling symptoms and clinical status. The diversity of the cluster profiles supports the development of personalized prevention strategies and psychological interventions.
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Affiliation(s)
- Mr Gaëtan Devos
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium; Service Universitaire d'Addictologie de Lyon (SUAL), CH Le Vinatier, F-69500, Bron, France; Scientific Research and Publication Cell (CRPS), Le Beau Vallon, Namur, Belgium.
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, Canada
| | | | - Marie Grall-Bronnec
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France; Université de Nantes, Université de Tours, UMR INSERM 1246 SHERE, Nantes, France
| | - Gaëlle Challet-Bouju
- CHU Nantes, Addictology and Psychiatry Department, Nantes, France; Université de Nantes, Université de Tours, UMR INSERM 1246 SHERE, Nantes, France
| | - Yasser Khazaal
- Addiction Division, Mental Health and Psychiatry Department, Geneva University Hospitals, Geneva, Switzerland; Addiction medicine, Department of Psychiatry, Lausanne University Hospital and Lausanne University, Switzerland
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Centre for Excessive Gambling, Lausanne University Hospitals (CHUV), Lausanne, Switzerland.
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25
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26
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Sharman S, Clark L, Roberts A, Michalczuk R, Cocks R, Bowden-Jones H. Heterogeneity in Disordered Gambling: Decision-Making and Impulsivity in Gamblers Grouped by Preferred Form. Front Psychiatry 2019; 10:588. [PMID: 31481905 PMCID: PMC6709538 DOI: 10.3389/fpsyt.2019.00588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Previous research has indicated that disordered gamblers display deficits in impulsivity and risky decision-making, compared to healthy control groups. However, disordered gamblers are not a homogenous group, and differences in performance on neurocognitive tasks may be related to the form of gambling in which an individual chooses to engage. The present study used neurocognitive tasks and questionnaire measures to ascertain group differences in gamblers grouped by preferred form of gambling. Method: Treatment-seeking pathological gamblers from the National Problem Gambling Clinic, London (n = 101), completed a neurocognitive assessment comprising the Cambridge gamble task (CGT), the stop-signal task (SST), a probabilistic reversal learning task (PRL), and the Kirby Monetary Choice Questionnaire, as well as questionnaire measures of gambling severity, impulsivity, depression, and anxiety. Analyses compared gamblers who favored fixed-odds betting terminals (FOBTs) (the modal form) to gamblers who preferred other forms of gambling (non-FOBT). Results: The FOBT group showed impaired decision-making under risk on the CGT compared to the non-FOBT group, choosing the likely option less on more uncertain decisions. The FOBT group made fewer perseverative errors on the PRL task, had lower depression and anxiety scores, and were less likely to have a family history of problem gambling than the non-FOBT group. Discussion: Decision-making and cognitive flexibility differences between gamblers grouped by gambling type supports preferred form as an important source of heterogeneity in gambling disorder. Decision-making strategies and risk attitudes should be considered when approaching cognition-focused treatment strategies, allowing interventions to be targeted at specific cognitive deficits.
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Affiliation(s)
- Steve Sharman
- School of Psychology, College of Applied Health and Communities, University of East London, London, United Kingdom.,Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Luke Clark
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom.,Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Amanda Roberts
- School of Psychology, College of Social Science, University of Lincoln, Lincoln, United Kingdom
| | - Rosanna Michalczuk
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom.,South London and Maudsley Trust, Bethlem Royal Hospital, London, United Kingdom
| | - Rachel Cocks
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom.,Royal Holloway, University of London, London, United Kingdom
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, United Kingdom.,Faculty of Medicine, Faculty of Medicine Centre, Imperial College London, London, United Kingdom
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27
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Verdejo-Garcia A, Lorenzetti V, Manning V, Piercy H, Bruno R, Hester R, Pennington D, Tolomeo S, Arunogiri S, Bates ME, Bowden-Jones H, Campanella S, Daughters SB, Kouimtsidis C, Lubman DI, Meyerhoff DJ, Ralph A, Rezapour T, Tavakoli H, Zare-Bidoky M, Zilverstand A, Steele D, Moeller SJ, Paulus M, Baldacchino A, Ekhtiari H. A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine. Front Psychiatry 2019; 10:877. [PMID: 31920740 PMCID: PMC6935942 DOI: 10.3389/fpsyt.2019.00877] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/06/2019] [Indexed: 01/01/2023] Open
Abstract
Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of constructs that predict meaningful clinical outcomes. Other requirements are the development of measures that are easily-administered, reliable, and ecologically-valid. Translation of neuroimaging techniques requires the development of diagnostic and prognostic biomarkers and testing the cost-effectiveness of these biomarkers in individualized prediction algorithms for relapse prevention and treatment selection. Integration of cognitive assessments with neuroimaging can provide multilevel targets including neural, cognitive, and behavioral outcomes for neuroscience-informed interventions. Application of neuroscience-informed interventions including cognitive training/remediation and neuromodulation requires clear pathways to design treatments based on multilevel targets, additional evidence from randomized trials and subsequent clinical implementation, including evaluation of cost-effectiveness. We propose to address these challenges by promoting international collaboration between researchers and clinicians, developing harmonized protocols and data management systems, and prioritizing multi-site research that focuses on improving clinical outcomes.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Valentina Lorenzetti
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Canberra, ACT, Australia
| | - Victoria Manning
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Hugh Piercy
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Raimondo Bruno
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Rob Hester
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - David Pennington
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Serenella Tolomeo
- School of Medicine, University of St Andrews, Medical and Biological Science Building, North Haugh, St Andrews, United Kingdom.,Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Shalini Arunogiri
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Marsha E Bates
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | | | - Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Christos Kouimtsidis
- Department of Psychiatry, Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, United Kingdom
| | - Dan I Lubman
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Dieter J Meyerhoff
- DVA Medical Center and Department of Radiology and Biomedical Imaging, University of California San Francisco, School of Medicine, San Francisco, CA, United States
| | - Annaketurah Ralph
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Hosna Tavakoli
- Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran.,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Anna Zilverstand
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Douglas Steele
- Medical School, University of Dundee, Ninewells Hospital, Scotland, United Kingdom
| | - Scott J Moeller
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Martin Paulus
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States
| | - Alex Baldacchino
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States
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28
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Lutri V, Soldini E, Ronzitti S, Smith N, Clerici M, Blaszczynski A, Bowden-Jones H. Impulsivity and Gambling Type Among Treatment-Seeking Disordered Gamblers: An Explorative Study. J Gambl Stud 2018; 34:1341-1354. [PMID: 29502327 DOI: 10.1007/s10899-018-9764-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Several studies have found that certain traits of impulsivity are associated with gambling disorder, and influence its severity. Furthermore, it has been suggested that some forms of gambling, particularly electronic gambling machines, are particularly widespread among pathological gamblers. In the present, exploratory study, we aim to clarify the role played by impulsivity in influencing the choice of specific gambling activities, by examining the relation between individual dimensions of impulsivity, and the choice of specific gambling activities in a clinical population. 100 consecutively admitted pathological gamblers at the National Problem Gambling Clinic in London (UK) in 2014 were administered the UPPS-P and BIS-11 impulsivity questionnaires, the Problem Gambling Severity Index, and underwent a structured interview concerning their gambling activities in the month and year prior to assessment. The correlation between individual gambling activities and impulsivity dimensions was analyzed both at a bivariate level, and using logistic regression. We found a significant correlation between Negative Urgency, Motor impulsivity and low-stakes machine gambling on multivariate analysis. Negative urgency (i.e. the tendency to act impulsively in response to negative affect), and Motor impulsivity (a tendency to rash action and restlessness) might be mediating factors in the choice of electronic gambling machines, particularly among patients whose gambling is escape-oriented. Structural and situational characteristics of gambling machines, particularly the widespread availability of low-stakes-rather than high-stakes-gaming machines, might concur to the choice of this form of gambling among individuals who present higher negative urgency and restlessness.
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Affiliation(s)
- Vittorio Lutri
- Department of Medicine and Surgery, Università degli Studi di Milano - Bicocca, Milan, Italy.
| | - Emiliano Soldini
- Methodology and Statistics Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Silvia Ronzitti
- Department of Medicine and Surgery, Università degli Studi di Milano - Bicocca, Milan, Italy
| | - Neil Smith
- National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
| | - Massimo Clerici
- Department of Medicine and Surgery, Università degli Studi di Milano - Bicocca, Milan, Italy
| | - Alex Blaszczynski
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
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29
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Breedvelt JJF, Rowe S, Bowden-Jones H, Shridhar S, Lovett K, Bockting C, Lingford-Hughes A, Strathdee G, Tracy DK. Unleashing talent in mental health sciences: gender equality at the top. Br J Psychiatry 2018; 213:679-681. [PMID: 30475195 DOI: 10.1192/bjp.2018.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Society is undergoing a shift in gender politics. Science and medicine are part of this conversation, not least as women's representation and pay continue to drop as one progresses through more senior academic and clinical levels. Naming and redressing these inequalities needs to be a priority for us all.Declaration of interestNone.
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Affiliation(s)
- Josefien J F Breedvelt
- Research Lead,The Mental Health Foundation,London,UKandPhD Candidate,Amsterdam UMC,Department of Psychiatry,University of Amsterdam,Department of Psychiatry,the Netherlands
| | - Sarah Rowe
- Lecturer,Division of Psychiatry,University College London,UK
| | - Henrietta Bowden-Jones
- Consultant Psychiatrist,CNWL Foundation Trust,London and Honorary Clinical Senior Lecturer,Imperial College London and President,Medical Women's Federation,UK
| | | | - Kate Lovett
- Consultant Psychiatrist,Devon Partnership Trust and Dean,Royal College of Psychiatrists,UK
| | - Claudi Bockting
- Professor,Amsterdam UMC,Department of Psychiatry,University of Amsterdam,the Netherlands
| | - Anne Lingford-Hughes
- Consultant Psychiatrist,CNWL Foundation Trust,London and Professor of Addiction Biology,Imperial College London and Head of the Centre for Psychiatry,Imperial College London,UK
| | | | - Derek K Tracy
- Consultant Psychiatrist,Clinical Director,Oxleas NHS Foundation Trust London and Senior Lecturer,King's College London,UK
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30
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Abstract
BACKGROUND AND AIMS To investigate the potential indications and adverse effects of using the opioid antagonist naltrexone to treat problem gamblers. CASE PRESENTATION The files of the 1,192 patients who were referred to the National Problem Gambling Clinic between January 2015 and June 2016 were audited. Seventeen patients were considered appropriate for treatment with naltrexone, having attended and failed to respond to psychological therapies at the clinic. Fourteen patients were placed on a regimen of 50 mg/day naltrexone. DISCUSSION Of the 14 patients who were treated with naltrexone, there were 10 for whom sufficient follow-up existed to analyze the treatment efficacy and side effects of naltrexone. Patients showed significant decreases in their craving to gamble and the majority (60%) were able to abstain completely from gambling in the treatment period, with a further 20% reducing their gambling to almost nothing. The reported side effects from the naltrexone included: loss of appetite, gastrointestinal pain, headaches, sedation, dizziness, and vivid dreams. Two patients with concurrent alcohol-use disorder relapsed during the treatment. One patient relapsed after the treatment period. CONCLUSIONS The study showed significant outcomes in reducing gambling cravings for the sample set. Given the design of the study as a case series, there was no control group, and a number of patients were on other psychotropic medications. We recommend care when prescribing to those suffering from concurrent alcohol-use disorder.
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Affiliation(s)
- Sophie Ward
- National Problem Gambling Clinic, Central and North West London NHS Foundation Trust, London, UK,Institute of Medical and Biomedical Education, St. George’s University of London, London, UK,Corresponding author: Sophie Ward; National Problem Gambling Clinic, Central and North West London NHS Foundation Trust, Cranmer Terrace, London SW17 0RE, UK; E-mail:
| | - Neil Smith
- National Problem Gambling Clinic, Central and North West London NHS Foundation Trust, London, UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, Central and North West London NHS Foundation Trust, London, UK,Faculty of Medicine, Imperial College London, London, UK
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31
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Rumpf HJ, Achab S, Billieux J, Bowden-Jones H, Carragher N, Demetrovics Z, Higuchi S, King DL, Mann K, Potenza M, Saunders JB, Abbott M, Ambekar A, Aricak OT, Assanangkornchai S, Bahar N, Borges G, Brand M, Chan EML, Chung T, Derevensky J, Kashef AE, Farrell M, Fineberg NA, Gandin C, Gentile DA, Griffiths MD, Goudriaan AE, Grall-Bronnec M, Hao W, Hodgins DC, Ip P, Király O, Lee HK, Kuss D, Lemmens JS, Long J, Lopez-Fernandez O, Mihara S, Petry NM, Pontes HM, Rahimi-Movaghar A, Rehbein F, Rehm J, Scafato E, Sharma M, Spritzer D, Stein DJ, Tam P, Weinstein A, Wittchen HU, Wölfling K, Zullino D, Poznyak V. Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective. J Behav Addict 2018; 7:556-561. [PMID: 30010410 PMCID: PMC6426367 DOI: 10.1556/2006.7.2018.59] [Citation(s) in RCA: 164] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.
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Affiliation(s)
- Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany,Corresponding author: PD Dr. Hans-Jürgen Rumpf; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Phone: +49 451 5009 8751; Fax: +49 451 5009 8754; E-mail:
| | - Sophia Achab
- Department of Mental Health and Psychiatry, Service of Addictology, Geneva University Hospitals, Geneva, Switzerland,Geneva WHO Collaborating Center for Training and Research, University of Geneva, Geneva, Switzerland
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust, Division of Brain Science, Imperial College London, London, UK
| | - Natacha Carragher
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Karl Mann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Marc Potenza
- Department of Psychiatry and Neuroscience, Child Study Center, The National Center on Addiction and Substance Abuse, Connecticut Mental Health Center, Yale University School of Medicine, New Haven, CT, USA
| | - John B. Saunders
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Max Abbott
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Atul Ambekar
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sawitri Assanangkornchai
- Epidemiology Unit and Centre for Alcohol Studies, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Norharlina Bahar
- Department of Psychiatry and Mental Health, Hospital Selayang, Selangor, Malaysia
| | | | - Matthias Brand
- General Psychology: Cognition Center for Behavioral Addiction Research, University Duisburg-Essen, Duisburg, Germany,Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany
| | - Elda Mei-Lo Chan
- Integrated Centre on Addiction Prevention and Treatment, Tung Wah Group of Hospitals, Hong Kong SAR, China
| | | | - Jeff Derevensky
- Applied Child Psychology and Department of Psychiatry, McGill University, Montreal, Canada
| | - Ahmad El Kashef
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Naomi A. Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, UK,Department of Postgraduate Medicine, University of Hertfordshire, Hertfordshire, UK
| | - Claudia Gandin
- National Centre on Addiction and Doping, National Observatory on Alcohol, Italian National Institute of Health, Rome, Italy
| | | | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Anna E. Goudriaan
- Department of Psychiatry, Academic Medical Center, Mental Health Care, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - David C. Hodgins
- Department of Psychology, The University of Calgary, Calgary, Alberta, Canada
| | - Patrick Ip
- Li Ka Shing Faculty of Medicine, Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Orsolya Király
- Institute of Psychology, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Daria Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Jeroen S. Lemmens
- Center for Research on Children, Adolescents, and the Media, Amsterdam School of Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Jiang Long
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Olatz Lopez-Fernandez
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Satoko Mihara
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Nancy M. Petry
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Halley M. Pontes
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Florian Rehbein
- Criminological Research Institute Lower Saxony, Hannover, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addictions and Mental Health, Toronto, Canada,Department of Psychiatry, Faculty of Medicine, Institute of Medical Science, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada,Epidemiological Research Unit, Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Emanuele Scafato
- National Observatory on Alcohol, National Institute of Health, Rome, Italy
| | - Manoi Sharma
- National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Daniel Spritzer
- Study Group on Technological Addictions, Porto Alegre, Brazil
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, SA MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Philip Tam
- Network for Internet Investigation and Research in Australia, The Delta Clinic, Sydney, NSW, Australia
| | - Aviv Weinstein
- Department of Behavioral Science, University of Ariel, Ariel, Israel
| | - Hans-Ulrich Wittchen
- Epidemiological Research Unit, Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Klaus Wölfling
- Outpatient Clinic for Behavioral Addiction, Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Daniele Zullino
- Department of Mental Health and Psychiatry, Service of Addictology, Geneva University Hospitals, Geneva, Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
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32
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Abstract
The DSM-5 includes provisions for episodic forms of gambling disorder, with such changes aligned with earlier accounts of potential binge gambling behaviours. However, there is little research that indicates the utility of these classifications of episodic or binge gambling, and this study considered their characteristics in a clinical sample. It involved administration of a new binge gambling screening tool, along with routine measures, to n = 214 patients entering a specialist treatment clinic for gambling problems. Results indicated that episodic gambling was common in this clinical context, with 28 and 32% of patients reporting gambling episodes that were (a) regular and alternating, and (b) irregular and intermittent, respectively. These patterns were distinguished by factors including associations with covariates that indicated differences from continuous gamblers. For example, the irregular episodic gamblers, but not the regular pattern, demonstrated lower levels of problem gambling severity and comorbidity. Rates of potential binge gambling, which was defined in terms of additional criteria, were around 4% and numbers were insufficient for comparable analyses. The findings support inclusion of episodic forms of gambling disorder in the DSM-5, but highlight the need for improved recognition and research on heterogeneous forms of episodic gambling.
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Affiliation(s)
- S Cowlishaw
- School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK.
| | - E Nespoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - J K Jebadurai
- University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK.,National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
| | - N Smith
- National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
| | - H Bowden-Jones
- National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK.,Department of Medicine, Imperial College London, London, UK
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33
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Abstract
There is a paucity of research in the UK which examines problem gambling and that which does exist is mainly quantitative, focuses on male samples and fails to look at treatment seeking populations or obstacles preventing problem gamblers from seeking treatment. This paper presents findings from part of a larger qualitative study that explored the experience of treatment for female problem gamblers. Data were collected using semi-structured interviews with eight women who had received individual cognitive-behavioural therapy in the National Health Service for their gambling problem. An interpretative phenomenological analysis approach was applied in the research process, identifying three main themes, of which the subtheme 'Barriers to Treatment' is examined here. Internal and external barriers to treatment organically emerged in all female participants' accounts and appear to have an impact on service utilisation. Input directly from gamblers can be combined with findings from other studies to devise better ways of reaching female problem gamblers. A better understanding of barriers to treatment can also provide valuable direction for future research and suggest applications in clinical service provision and treatment planning.
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Affiliation(s)
- Anna Kaufman
- Department of Psychology, City University London, Northampton Square, London, EC1V 0HB, UK.
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34
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Ronzitti S, Soldini E, Smith N, Clerici M, Bowden-Jones H. Gambling Disorder: Exploring Pre-treatment and In-treatment Dropout Predictors. A UK Study. J Gambl Stud 2018; 33:1277-1292. [PMID: 28332064 DOI: 10.1007/s10899-017-9686-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The aim of this study was to identify predictors of treatment dropout in a sample of gamblers attending a specialist clinic for gambling disorder. We analysed data on 846 treatment-seeking pathological gamblers. Firstly, we investigated differences in socio-demographic and clinical variables between treatment completers and pre-treatment dropouts, as well as between treatment completers and during-treatment dropouts. Subsequently, variables were entered into a multinomial logistic regression model to identify significant predictors of pre-treatment and in-treatment dropout. Overall, 44.8% of clients did not complete the treatment: 27.4% dropped out before starting it, while 17.4% dropped out during the treatment. Younger age and use of drugs were associated with pre-treatment dropout, while family history of gambling disorder, a lower PGSI score, and being a smoker were related with in-treatment dropout. Our findings suggest that pre-treatment dropouts differ from in-treatment dropouts, and, thus, further research will benefit from considering these groups separately. In addition, this newly gained knowledge will also be helpful in increasing treatment retention in specific subgroups of problem gamblers.
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Affiliation(s)
- Silvia Ronzitti
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK. .,Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. .,Yale University, 300 George Street, New Haven, CT, USA.
| | - Emiliano Soldini
- Methodology and Statistics Laboratory (LABStat), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Neil Smith
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Department of Mental Health, San Gerardo Hospital, Monza, Italy
| | - Henrietta Bowden-Jones
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, UK.,Department of Medicine, Imperial College London, London, UK
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35
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Ronzitti S, Soldini E, Smith N, Bayston A, Clerici M, Bowden-Jones H. Are Treatment Outcomes Determined by Type of Gambling? A UK Study. J Gambl Stud 2018; 34:987-997. [DOI: 10.1007/s10899-018-9752-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Jaisoorya TS, Beena KV, Beena M, Ellangovan K, Thennarassu K, Bowden-Jones H, Benegal V, George S. Do High School Students in India Gamble? A Study of Problem Gambling and Its Correlates. J Gambl Stud 2017; 33:449-460. [PMID: 27807640 DOI: 10.1007/s10899-016-9651-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Studies from the West suggest that significant numbers of high school students gamble, despite it being illegal in this age group. To date, there have been no studies on the prevalence of gambling among senior high school and higher secondary school students in India. This study reports point prevalence of gambling and its psychosocial correlates among high school students in the State of Kerala, India. 5043 high school students in the age group 15-19 years, from 73 schools, were selected by cluster random sampling from the district of Ernakulam, Kerala, South India. They completed questionnaires that assessed gambling, substance use, psychological distress, suicidality, and symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Of a total of 4989 completed questionnaires, 1400 (27.9 %) high school students reported to have ever gambled and 353 (7.1 %) were problem gamblers. Of those who had ever gambled, 25.2 % were problem gamblers. Sports betting (betting on cricket and football) was the most popular form of gambling followed by the lottery. Problem gamblers when compared with non-problem gamblers and non-gamblers were significantly more likely to be male, have academic failures, have higher rates of lifetime alcohol and tobacco use, psychological distress, suicidality, history of sexual abuse and higher ADHD symptom scores. Gambling among adolescents in India deserves greater attention, as one in four students who ever gambled was a problem gambler and because of its association with a range of psychosocial variables.
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Affiliation(s)
- T S Jaisoorya
- National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
| | - K V Beena
- National Rural Health Mission, Ernakulam, Kerala, India
| | - M Beena
- National Rural Health Mission, Ernakulam, Kerala, India
| | - K Ellangovan
- Department of Health and Family Welfare, Trivandrum, Kerala, India
| | - K Thennarassu
- National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India
| | | | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
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Mick I, Ramos AC, Myers J, Stokes PR, Chandrasekera S, Erritzoe D, Mendez MA, Gunn RN, Rabiner EA, Searle GE, Galduróz JCF, Waldman AD, Bowden-Jones H, Clark L, Nutt DJ, Lingford-Hughes AR. Evidence for GABA-A receptor dysregulation in gambling disorder: correlation with impulsivity. Addict Biol 2017; 22:1601-1609. [PMID: 27739164 PMCID: PMC5697606 DOI: 10.1111/adb.12457] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/14/2016] [Accepted: 08/30/2016] [Indexed: 12/11/2022]
Abstract
As a behavioural addiction, gambling disorder (GD) provides an opportunity to characterize addictive processes without the potentially confounding effects of chronic excessive drug and alcohol exposure. Impulsivity is an established precursor to such addictive behaviours, and GD is associated with greater impulsivity. There is also evidence of GABAergic dysregulation in substance addiction and in impulsivity. This study therefore investigated GABAA receptor availability in 15 individuals with GD and 19 healthy volunteers (HV) using [11C]Ro15‐4513, a relatively selective α5 benzodiazepine receptor PET tracer and its relationship with impulsivity. We found significantly higher [11C]Ro15‐4513 total distribution volume (VT) in the right hippocampus in the GD group compared with HV. We found higher levels of the ‘Negative Urgency’ construct of impulsivity in GD, and these were positively associated with higher [11C]Ro15‐4513 VT in the amygdala in the GD group; no such significant correlations were evident in the HV group. These results contrast with reduced binding of GABAergic PET ligands described previously in alcohol and opiate addiction and add to growing evidence for distinctions in the neuropharmacology between substance and behavioural addictions. These results provide the first characterization of GABAA receptors in GD with [11C]Ro15‐4513 PET and show greater α5 receptor availability and positive correlations with trait impulsivity. This GABAergic dysregulation is potential target for treatment.
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Affiliation(s)
- Inge Mick
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
| | - Anna C. Ramos
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
- Department of Psychobiology; Universidade Federal de São Paulo; Brazil
| | - Jim Myers
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
| | - Paul R. Stokes
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
- Centre for Affective Disorders, Department of Psychological Medicine; Institute of Psychiatry, Psychology and Neuroscience, King's College London; UK
| | - Samantha Chandrasekera
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
| | - David Erritzoe
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
| | - Maria A. Mendez
- Forensic and Neurodevelopmental Sciences; Institute of Psychiatry, King's College; UK
| | - Roger N. Gunn
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
- Imanova Ltd.; Centre for Imaging Sciences; UK
| | - Eugenii A. Rabiner
- Imanova Ltd.; Centre for Imaging Sciences; UK
- Department of Neuroimaging; Institute of Psychiatry, King's College; UK
| | | | | | - Adam D. Waldman
- Department of Imaging, Division of Experimental Medicine, Department of Medicine; Imperial College; UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, CNWL NHS Foundation Trust; Imperial College London; UK
| | - Luke Clark
- Centre for Gambling Research at UBC, Department of Psychology; University of British Columbia; Canada
| | - David J. Nutt
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
| | - Anne R. Lingford-Hughes
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine; Imperial College London; UK
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38
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Saunders JB, Hao W, Long J, King DL, Mann K, Fauth-Bühler M, Rumpf HJ, Bowden-Jones H, Rahimi-Movaghar A, Chung T, Chan E, Bahar N, Achab S, Lee HK, Potenza M, Petry N, Spritzer D, Ambekar A, Derevensky J, Griffiths MD, Pontes HM, Kuss D, Higuchi S, Mihara S, Assangangkornchai S, Sharma M, Kashef AE, Ip P, Farrell M, Scafato E, Carragher N, Poznyak V. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention. J Behav Addict 2017; 6:271-279. [PMID: 28816494 PMCID: PMC5700714 DOI: 10.1556/2006.6.2017.039] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Online gaming has greatly increased in popularity in recent years, and with this has come a multiplicity of problems due to excessive involvement in gaming. Gaming disorder, both online and offline, has been defined for the first time in the draft of 11th revision of the International Classification of Diseases (ICD-11). National surveys have shown prevalence rates of gaming disorder/addiction of 10%-15% among young people in several Asian countries and of 1%-10% in their counterparts in some Western countries. Several diseases related to excessive gaming are now recognized, and clinics are being established to respond to individual, family, and community concerns, but many cases remain hidden. Gaming disorder shares many features with addictions due to psychoactive substances and with gambling disorder, and functional neuroimaging shows that similar areas of the brain are activated. Governments and health agencies worldwide are seeking for the effects of online gaming to be addressed, and for preventive approaches to be developed. Central to this effort is a need to delineate the nature of the problem, which is the purpose of the definitions in the draft of ICD-11.
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Affiliation(s)
- John B. Saunders
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia,Corresponding author: John B. Saunders; Centre for Youth Substance Abuse Research, The University of Queensland, 1 Macquarie Street, Sydney, NSW 2000, Australia; Phone: +61 2 9252 0959; E-mail:
| | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jiang Long
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Karl Mann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Mira Fauth-Bühler
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Henrietta Bowden-Jones
- Central North West London NHS Trust and Division of Brain Science, Imperial College London, London, UK
| | - Afarin Rahimi-Movaghar
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Elda Chan
- Integrated Centre on Addiction Prevention and Treatment, Tung Wah Group of Hospitals, Hong Kong SAR, China
| | - Norharlina Bahar
- Department of Psychiatry and Mental Health, Hospital Selayang, Selangor, Malaysia
| | - Sophia Achab
- Mental Health and Psychiatry Department, University Hospitals of Geneva, Geneva, Switzerland
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Marc Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, and The National Center on Addiction and Substance Abuse, Yale University School of Medicine, and Connecticut Mental Health Center, New Haven, CT, USA
| | - Nancy Petry
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Daniel Spritzer
- Study Group on Technological Addictions, Porto Alegre, Brazil
| | - Atul Ambekar
- Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Jeffrey Derevensky
- Applied Child Psychology and Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Halley M. Pontes
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Daria Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Satoko Mihara
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Sawitri Assangangkornchai
- Epidemiology Unit and Centre for Alcohol Studies, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Manoj Sharma
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ahmad El Kashef
- National Rehabilitation Center, Abu Dhabi, United Arab Emirates
| | - Patrick Ip
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, Australia
| | - Emanuele Scafato
- National Observatory on Alcohol, National Institute of Health, Rome, Italy
| | - Natacha Carragher
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
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39
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Billieux J, King DL, Higuchi S, Achab S, Bowden-Jones H, Hao W, Long J, Lee HK, Potenza MN, Saunders JB, Poznyak V. Functional impairment matters in the screening and diagnosis of gaming disorder. J Behav Addict 2017; 6:285-289. [PMID: 28816514 PMCID: PMC5700712 DOI: 10.1556/2006.6.2017.036] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 04/18/2017] [Accepted: 04/18/2017] [Indexed: 11/19/2022] Open
Abstract
This commentary responds to Aarseth et al.'s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in "moral panics around the harm of video gaming" and "the treatment of abundant false-positive cases." The ICD-11 Gaming Disorder avoids potential "overpathologizing" with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.
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Affiliation(s)
- Joël Billieux
- Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development (INSIDE), University of Luxembourg, Esch-sur-Alzette, Luxembourg
- Internet and Gambling Disorders Clinic, Department of Adult Psychiatry, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Daniel L. King
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Center, Yokosuka, Kanagawa, Japan
| | - Sophia Achab
- Specialized Program in Behavioural Addictions, Addiction Division, Department of Mental Health and Psychiatry, University Hospitals of Geneva, Geneva, Switzerland
- Research Unit Addictive Disorders, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, and Faculty of Medicine, Imperial College London, London, UK
| | - Wei Hao
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Jiang Long
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience, Child Study Center, and The National Center on Addiction and Substance Abuse, Yale University School of Medicine and Connecticut Mental Health Center, New Haven, CT, USA
| | - John B. Saunders
- Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, QLD, Australia
| | - Vladimir Poznyak
- Department of Mental Health and Substance Abuse, WHO Headquarters, Geneva, Switzerland
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40
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Orford J, Cousins J, Smith N, Bowden-Jones H. Stress, strain, coping and social support for affected family members attending the National Problem Gambling Clinic, London. International Gambling Studies 2017. [DOI: 10.1080/14459795.2017.1331251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jim Orford
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Jenny Cousins
- Formerly at the National Problem Gambling Clinic, London, UK
| | - Neil Smith
- National Problem Gambling Clinic, London, UK
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, UK
- Department of Medicine, Imperial College London, London, UK
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41
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42
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Canale N, Vieno A, Bowden-Jones H, Billieux J. The benefits of using the UPPS model of impulsivity rather than the Big Five when assessing the relationship between personality and problem gambling. Addiction 2017; 112:372-373. [PMID: 27873374 DOI: 10.1111/add.13641] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 09/26/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Natale Canale
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | | | - Joël Billieux
- Laboratory for Experimental Psychopathology, Psychological Science Research Institute, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
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43
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Limbrick-Oldfield EH, Mick I, Cocks RE, McGonigle J, Sharman SP, Goldstone AP, Stokes PRA, Waldman A, Erritzoe D, Bowden-Jones H, Nutt D, Lingford-Hughes A, Clark L. Neural substrates of cue reactivity and craving in gambling disorder. Transl Psychiatry 2017; 7:e992. [PMID: 28045460 PMCID: PMC5545724 DOI: 10.1038/tp.2016.256] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 09/12/2016] [Accepted: 10/15/2016] [Indexed: 12/12/2022] Open
Abstract
Cue reactivity is an established procedure in addictions research for examining the subjective experience and neural basis of craving. This experiment sought to quantify cue-related brain responses in gambling disorder using personally tailored cues in conjunction with subjective craving, as well as a comparison with appetitive non-gambling stimuli. Participants with gambling disorder (n=19) attending treatment and 19 controls viewed personally tailored blocks of gambling-related cues, as well as neutral cues and highly appetitive (food) images during a functional magnetic resonance imaging (fMRI) scan performed ~2-3 h after a usual meal. fMRI analysis examined cue-related brain activity, cue-related changes in connectivity and associations with block-by-block craving ratings. Craving ratings in the participants with gambling disorder increased following gambling cues compared with non-gambling cues. fMRI analysis revealed group differences in left insula and anterior cingulate cortex, with the gambling disorder group showing greater reactivity to the gambling cues, but no differences to the food cues. In participants with gambling disorder, craving to gamble correlated positively with gambling cue-related activity in the bilateral insula and ventral striatum, and negatively with functional connectivity between the ventral striatum and the medial prefrontal cortex. Gambling cues, but not food cues, elicit increased brain responses in reward-related circuitry in individuals with gambling disorder (compared with controls), providing support for the incentive sensitization theory of addiction. Activity in the insula co-varied with craving intensity, and may be a target for interventions.
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Affiliation(s)
- E H Limbrick-Oldfield
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada,Department of Psychology, University of Cambridge, Cambridge, UK,Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, 2136 West Mall Vancouver, Vancouver, BC V6T 1Z4, Canada. E-mail:
| | - I Mick
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - R E Cocks
- Department of Psychology, University of Cambridge, Cambridge, UK,Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - J McGonigle
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - S P Sharman
- Department of Psychology, University of Cambridge, Cambridge, UK,School of Psychology, College of Social Science, University of Lincoln, Lincoln, UK
| | - A P Goldstone
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK,Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, UK
| | - P R A Stokes
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King’s College London, London, UK
| | - A Waldman
- Division of Experimental Medicine, Department of Imaging, Imperial College London, London, UK
| | - D Erritzoe
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - H Bowden-Jones
- National Problem Gambling Clinic, CNWL NHS Foundation Trust, Imperial College London, London, UK
| | - D Nutt
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - A Lingford-Hughes
- Centre for Neuropsychopharmacology, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK,Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, UK,National Problem Gambling Clinic, CNWL NHS Foundation Trust, Imperial College London, London, UK
| | - L Clark
- Centre for Gambling Research at UBC, Department of Psychology, University of British Columbia, Vancouver, BC, Canada,Department of Psychology, University of Cambridge, Cambridge, UK
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44
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Roberts KJ, Smith N, Bowden-Jones H, Cheeta S. Gambling disorder and suicidality within the UK: an analysis investigating mental health and gambling severity as risk factors to suicidality. International Gambling Studies 2016. [DOI: 10.1080/14459795.2016.1257648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kathryn J. Roberts
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
- University College London, London, UK
| | - Neil Smith
- National Problem Gambling Clinic, London, UK
| | | | - Survjit Cheeta
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
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45
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Roberts A, Coid J, King R, Murphy R, Turner J, Bowden-Jones H, Du Preez KP, Landon J. Gambling and violence in a nationally representative sample of UK men. Addiction 2016; 111:2196-2207. [PMID: 27393746 DOI: 10.1111/add.13522] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/05/2016] [Accepted: 07/05/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The relationship between violence and problem gambling in general population samples is under-researched and requires further attention to inform treatment and prevention efforts. We investigated the relationship between gambling problems and violence among men and sought to determine if the link can be accounted for by mental disorders, alcohol and drug dependence and impulsivity. DESIGN A cross-sectional survey. SETTING A UK representative general population survey conducted in 2009. PARTICIPANTS A total of 3025 UK men aged 18-64 years. MEASUREMENTS Binary logistic regression was used to examine relationships. Outcome measures included gambling behaviour and self-reports of violence. Covariates included alcohol and drug dependence, mental illness, impulsivity and socio-demography. FINDINGS Problem gambling and probable pathological gambling were associated with increased odds of the perpetration of violence [adjusted odd ratios (AOR) = 3.09, confidence interval (CI) = 1.90-5.00 and 4.09, CI = 2.76-6.30, respectively] and a range of other behaviours, such as using a weapon (AORs = 4.93, CI = 2.52-9.63 and 6.33, CI = 3.52-11.38) and the perpetration of intimate partner violence (AOR = 9.80, CI =2.45-39.04). The results were attenuated when adjusted for comorbid mental illness and impulsivity, but remained statistically significant. Alcohol and drug dependence had the most impact; relationships were most attenuated when they added into the models, with the latter having the largest effect. CONCLUSIONS Among men in the United Kingdom, self-reports of problem/pathological gambling remain predictive of a range of measures of violent behaviour after adjusting for alcohol and drug dependence, comorbid mental disorder and impulsivity; of the covariates, alcohol and drug dependence have the greatest effect in attenuating the gambling-violence association.
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Affiliation(s)
- Amanda Roberts
- School of Psychology, College of Social Science, University of Lincoln, Lincoln, UK
| | - Jeremy Coid
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, East London NHS Foundation Trust and Queen Mary University of London, St Bartholomew's Hospital, London, UK
| | - Robert King
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Raegan Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - John Turner
- School of Psychology, University of East London, London, UK
| | | | - Katie Palmer Du Preez
- Gambling and Addictions Research Centre Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Jason Landon
- Department of Psychology, Gambling and Addictions Research Centre Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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46
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Ronzitti S, Soldini E, Lutri V, Smith N, Clerici M, Bowden-Jones H. Types of gambling and levels of harm: A UK study to assess severity of presentation in a treatment-seeking population. J Behav Addict 2016; 5:439-47. [PMID: 27677350 PMCID: PMC5264411 DOI: 10.1556/2006.5.2016.068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background and aim Previous international research emphasized that some forms of gambling are more "addictive" than others. More recently, research has shown that we should shift our attention from the type of gambling activity to the level of involvement in a number of different gambling activities. The aim of our study was to verify whether a higher Problem Gambling Severity Index (PGSI) score was associated with particular gambling activities and evaluate the impact of involvement on gambling behavior. Methods A total of 736 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. First, the independent two-sample t-test and the Mann-Whitney test were used to verify if the PGSI score changed significantly according to the gambling activity at a bivariate level. Second, we conducted a cluster analysis and finally, we fitted a linear regression model in order to verify if some variables are useful to predict gambling addiction severity. Results The PGSI score was significantly higher for lower stakes gaming machine gamblers (1% significance level) and for fixed-odds betting terminal (FOBT) gamblers (5% significance level) at a bivariate level. Moreover, such finding was confirmed by cluster and linear regression analyses. Conclusions The results of this study indicated that gambling addiction severity was related to gambling involvement and, for a given level of gambling involvement, gambling addiction severity may vary according to gambling type, with a particularly significant increase for FOBT and gaming machine gambling.
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Affiliation(s)
- Silvia Ronzitti
- National Problem Gambling Clinic (NPGC), Central and North West London NHS Foundation Trust, London, UK,Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy,Department of Mental Health, San Gerardo Hospital, Monza, Italy,Corresponding author: Silvia Ronzitti; Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Phone: +1 203 606 4710; Fax: +1 203 937 4926; E-mail:
| | - Emiliano Soldini
- Methodology and Statistics Laboratory (LABStat), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Vittorio Lutri
- National Problem Gambling Clinic (NPGC), Central and North West London NHS Foundation Trust, London, UK,Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Neil Smith
- National Problem Gambling Clinic (NPGC), Central and North West London NHS Foundation Trust, London, UK
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy,Department of Mental Health, San Gerardo Hospital, Monza, Italy
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic (NPGC), Central and North West London NHS Foundation Trust, London, UK,Department of Medicine, Imperial College London, London, UK
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47
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Abstract
Treatment provision for individuals with gambling problems in Britain is at best inadequate. Here we call for gambling treatment provision to be integrated into mainstream drug and alcohol services, and for its commissioning responsibilities to fall under local public health departments.
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Affiliation(s)
- Sanju George
- Birmingham and Solihull Mental Health NHS Foundation Trust
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48
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Abstract
Background and aim Gambling is a widespread recreational activity in the UK. A significant percentage of gamblers develop subclinical or clinically relevant problem gambling issues, but only a low percentage of them seek treatment. Although characteristics of pathological gamblers from treatment-seeking population have been examined in some research, only a few studies have explored the differences between females and males. This study aimed to examine the gender-related differences in demographics, gambling measures, and clinical variables in an outpatient sample of pathological gamblers seeking treatment. Methods A total of 1,178 treatment-seeking individuals with gambling disorder were assessed at the National Problem Gambling Clinic in London. Sociodemographic characteristics, clinical variables, and gambling behavior habits were obtained during the assessment evaluation. Of the total sample, 92.5% were males and 7.5% were females. Results Males were more likely to be younger, white, and employed than females. In addition, compared to women, men showed a lower PGSI score, an earlier age of onset of gambling behavior, a higher gambling involvement, and preferred specific forms gambling. Female gamblers were more anxious and depressed, while men were more likely to use alcohol and illicit drugs. Conclusions Our findings support the importance of gender differences in a treatment-seeking population of pathological gamblers both in sociodemographic characteristics, gambling behavior variables, and clinical variables. Males and females might benefit from group-specific treatment.
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Affiliation(s)
- Silvia Ronzitti
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, United Kingdom,Department of Surgery and Translational Medicine, University of Milano-Bicocca, Monza, Italy,Department of Mental Health, San Gerardo Hospital, Monza, Italy,Corresponding author: Silvia Ronzitti; Department of Surgery and Translational Medicine, University of Milano-Bicocca, Via Cadore 48, 20900 Monza (MB), Italy; Phone: +39 346 0045094; E-mail:
| | - Vittorio Lutri
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, United Kingdom,Department of Surgery and Translational Medicine, University of Milano-Bicocca, Monza, Italy
| | - Neil Smith
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, United Kingdom
| | - Massimo Clerici
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, United Kingdom,Department of Mental Health, San Gerardo Hospital, Monza, Italy
| | - Henrietta Bowden-Jones
- NPGC, National Problem Gambling Clinic, Central North West London NHS Foundation Trust, London, United Kingdom,Department of Medicine, Imperial College London, London, United Kingdom
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49
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Abstract
Backgrounds and aims Problem gambling occurs at higher levels in the homeless than the general population. Past work has not established the extent to which problem gambling is a cause or consequence of homelessness. This study sought to replicate recent observations of elevated rates of problem gambling in a British homeless sample, and extend that finding by characterizing (a) the temporal sequencing of the effect, (b) relationships with drug and alcohol misuse, and (c) awareness and access of treatment services for gambling by the homeless. Methods We recruited 72 participants from homeless centers in Westminster, London, and used the Problem Gambling Severity Index to assess gambling involvement, as well as DSM-IV criteria for substance and alcohol use disorders. A life-events scale was administered to establish the temporal ordering of problem gambling and homelessness. Results Problem gambling was evident in 23.6% of the sample. In participants who endorsed any gambling symptomatology, the majority were categorized as problem gamblers. Within those problem gamblers, 82.4% indicated that gambling preceded their homelessness. Participants displayed high rates of substance (31.9%) and alcohol dependence (23.6%); these were not correlated with PGSI scores. Awareness of treatment for gambling was significantly lower than for substance and alcohol use disorders, and actual access of gambling support was minimal. Discussion and conclusions Problem gambling is an under-recognized health issue in the homeless. Our observation that gambling typically precedes homelessness strengthens its role as a causal factor. Despite the elevated prevalence rates, awareness and utilization of gambling support opportunities were low compared with services for substance use disorders.
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Affiliation(s)
- Steve Sharman
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom,School of Psychology, University of Lincoln, Lincoln, United Kingdom,Corresponding author: Steve Sharman; School of Psychology, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, United Kingdom; Phone: +44 (0)1522 886849; Fax: +44 (0)1522 886680; E-mail:
| | - Jenny Dreyer
- Connection at St Martins, London, United Kingdom
| | - Luke Clark
- University of British Columbia, Vancouver, Canada
| | - Henrietta Bowden-Jones
- National Problem Gambling Clinic, London, United Kingdom,Imperial College, London, United Kingdom
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50
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Abstract
Homelessness and problem gambling are two public health concerns in the UK that are rarely considered concurrently, and little is known about the extent of gambling involvement and problematic gambling in the homeless. We recruited 456 individuals attending homelessness services in London, U.K. All participants completed a screen for gambling involvement, and where gambling involvement was endorsed, the Problem Gambling Severity Index (PGSI) was administered. The PGSI risk categories were compared against data from the 2010 British Gambling Prevalence Survey (BGPS). PGSI problem gambling was indicated in 11.6% of the homeless population, compared to 0.7% in the BGPS. Of participants endorsing any PGSI symptoms, a higher proportion of homeless participants were problem gamblers relative to the low and moderate risk groups, compared to the BGPS data. These results confirm that the homeless constitute a vulnerable population for problem gambling, and that diagnostic tools for gambling involvement should be integrated into homelessness services in the U.K.
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Affiliation(s)
- Steve Sharman
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK,
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