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Sinclair ESLL, Clark L, Wohl MJA, Keough MT, Kim HS. Cash outs during in-play sports betting: Who, why, and what it reveals. Addict Behav 2024; 154:108008. [PMID: 38479082 DOI: 10.1016/j.addbeh.2024.108008] [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] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 03/06/2024] [Indexed: 04/14/2024]
Abstract
Cashing out is a popular feature of modern 'in-play' sports betting that allows sports bettors to withdraw a bet before the sporting event on which the bet was placed is finalized. Previous studies have shown that use of the cash out feature is positively related to problem gambling symptomatology. However, little is known about demographic and psychological characteristics of in-play sports bettors who use the cash out feature, or their motivations for use. To fill this knowledge gap, we recruited 224 adults (18 + years) from Ontario who engaged in in-play sports betting in the past three months. Participants completed self-report measures of psychological and gambling-related variables. Participants also provided qualitative responses for their motivations for using the cash out feature. Approximately half (51.8 %) of the participants reported using the cash out feature. No statistically significant demographic differences were found between participants who used and did not use the cash out feature. Participants who used the feature (compared to those who did not) reported higher problematic alcohol and cannabis use, feelings of depression, anxiety, and stress, and were motivated to gamble to make money. The primary reasons for cashing out were to access money immediately, to cut losses, and because cashing out felt like a less risky option. The current findings shed light on underlying psychological vulnerabilities associated with individuals who use the cash out feature, which can inform initiatives to reduce the harms associated with this popular feature of sports betting.
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Affiliation(s)
- E S-L L Sinclair
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - L Clark
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - M J A Wohl
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - M T Keough
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - H S Kim
- Department of Psychology, University of Calgary, Alberta, Canada; University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada.
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Sapkota RP, Lozinski T, Wilhems A, Nugent M, Schaub MP, Keough MT, Sundström C, Hadjistavropoulos HD. Internet-delivered therapy for alcohol misuse: engagement, satisfaction, and outcomes when patients select their preference for therapist- or self-guided treatment. Addict Sci Clin Pract 2024; 19:30. [PMID: 38643242 PMCID: PMC11032586 DOI: 10.1186/s13722-024-00456-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/19/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Alcohol misuse is common and causes substantial harm. Internet-delivered cognitive behaviour therapy (ICBT) is effective in reducing alcohol misuse; however, the literature investigating how treatment outcomes are impacted by patients' preferences for therapist- versus self-guided ICBT for alcohol misuse is sparse. METHODS In this preference trial, 74 eligible patients (who reported ≥ 14 drinks in the previous week and obtained scores suggesting hazardous or harmful drinking) chose between enrolling in either therapist- or self-guided ICBT for alcohol misuse. We investigated whether those who chose therapist- versus self-guided ICBT differed in their (a) drinking outcomes-as measured by Timeline Follow-Back (TLFB) and heavy drinking days (HDD) at post-treatment and 3-month follow-up-and (b) post-treatment ICBT engagement and satisfaction. RESULTS The majority (81.1%) of eligible patients chose therapist-guided ICBT. These patients reported higher psychotropic medication use, drinking difficulties, and anxiety symptoms. For both the therapist- and self-guided patients, a modified intention-to-treat analysis revealed large within-group treatment effects for TLFB (β = - 2.64, SE 0.66; p < 0.001) and HDD (β = - 0.34, SE 0.07; p < 0.001), with large pre-to-post-treatment Cohen's effect sizes of d = 0.97 (95% CI [0.49, 1.45]) for TLFB and d = 1.19 (95% CI [0.69, 1.68]) for HDD. The interaction comparing the effects of therapist- to self-guided ICBT over time was not significant for TLFB (p = 0.34) or HDD (p = 0.06). With treatment, for both therapist- and self-guided patients, there was a significant improvement in drinking difficulties, cravings, and confidence with controlling cravings, as well as in anxiety, depression, and functional impairment. Further, the majority (75.7%) of patients completed five or more lessons, as well as reported overall satisfaction with the treatment (88.9%) and increased confidence in managing their symptoms (86.7%); these outcomes also did not differ between therapist- and self-guided patients. CONCLUSIONS The current study shows that ICBT for alcohol misuse is associated with reduced drinking and comorbid mental health difficulties over time, irrespective of whether patients chose to complete the course on their own or with therapist guidance. TRIAL REGISTRATION NUMBER NCT04611854 ( https://clinicaltrials.gov/ct2/show/NCT04611854 ).
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Affiliation(s)
- Ram P Sapkota
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Tristen Lozinski
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Andrew Wilhems
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Marcie Nugent
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, 8005, Zurich, Switzerland
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Christopher Sundström
- Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Norra Stationsgatan 69, 113 64, Stockholm, Sweden
| | - Heather D Hadjistavropoulos
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada.
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Bernusky HCR, Tibbo PG, Conrod PJ, Yunus FM, Keough MT, Thompson KD, Krank MD, Hadwin AF, Stewart SH. Do anxiety symptoms and coping motives serially mediate the association between psychotic-like experiences and cannabis-related problems in undergraduate recent cannabis users? Addict Behav 2024; 151:107937. [PMID: 38113687 DOI: 10.1016/j.addbeh.2023.107937] [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] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/01/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Many Canadian emerging adults (ages 18-25 years) use cannabis, with 60 % of past-three-month users experiencing one or more cannabis-related problems (i.e., adverse consequences of use). While psychotic-like experiences (PLEs) and cannabis problems overlap, little is known about the mechanisms explaining this link. One hypothesis is that PLEs are distressing and give rise to anxiety, with which emerging adults attempt to cope through increased cannabis use, in turn increasing their risk for cannabis-related problems. We tested a chained-mediational model to determine if anxiety and coping-with-anxiety motives for cannabis use sequentially mediated the link between PLEs and cannabis problems in emerging adult undergraduates; a conditional process model tested for moderation by sex. Emerging adult cannabis users (N = 413; mean [SD] age = 19.1 [1.5] years; 71.9 % female) from five Canadian universities provided cross-sectional, self-report survey data in fall 2021. Validated measures of PLEs, anxiety, cannabis coping-with-anxiety motives, and cannabis-related problems were administered. Path analyses supported the hypothesized chained mediational indirect effect (b = 0.027, 95 % bootstrap CI [0.012, 0.050]). No direct effect was found (p =.698), suggesting that the PLEs-to-cannabis problems association is fully explained by anxiety and cannabis coping-with-anxiety motives. Inconsistent with hypotheses, mediation did not depend on sex (95 % CIs crossed zero); therefore, anxiety and cannabis coping-with-anxiety motives explain the link between PLEs and cannabis problems in emerging adults regardless of their sex. Results highlight anxiety and cannabis coping-with-anxiety motives as potentially important intervention targets in cannabis-using emerging adults with PLEs, possibly preventing the development/worsening of cannabis-related problems.
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Affiliation(s)
- Haley C R Bernusky
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Patricia J Conrod
- Département de psychiatrie et d'addictologie, Université de Montréal, 2900, boulevard Édouard-Montpetit, bureau S-750, Pavillon Roger-Gaudry, Montréal, Québec H3T 1J4, Canada
| | - Fakir M Yunus
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, 225 Behavioural Science Building, North York, Ontario M3J 1P3, Canada
| | - Kara D Thompson
- Department of Psychology, St. Francis Xavier University, 2323 Notre Dame Avenue, 125 Annex, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Marvin D Krank
- Department of Psychology, University of British Columbia, 1147 Research Road, ART 334, Kelowna, British Columbia V1V 1V7, Canada
| | - Allyson F Hadwin
- Department of Educational Psychology and Leadership Studies, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada.
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Single A, Alcolado G, Keough MT, Mota N. Cannabis use and social anxiety disorder in emerging adulthood: Results from a nationally representative sample. J Anxiety Disord 2024; 101:102808. [PMID: 38061325 DOI: 10.1016/j.janxdis.2023.102808] [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: 05/12/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 01/17/2024]
Abstract
Cannabis use and social anxiety disorder (SAD) are prevalent during emerging adulthood. Previous work has demonstrated that SAD is related to cannabis use in adults; however, less is known about what correlates relate to this association in emerging adults. A subsample of individuals ages 18-25 years old from the NESARC-III (N = 5194) was used to (a) evaluate the association between cannabis use and SAD and (b) examine what correlates may be associated with cannabis use and SAD in emerging adulthood. Weighted cross-tabulations assessed sociodemographics and lifetime psychiatric disorder prevalence estimates among the emerging adult sample. Multinomial logistic regressions examined associations between sociodemographics and psychiatric disorders and four groups (i.e., no cannabis use or SAD; cannabis use only; SAD only; cannabis use + SAD). The prevalence of co-occurring cannabis use and SAD was 1.10%. Being White, a part-time student, or not a student were associated with increased odds of having co-occurring cannabis use + SAD (OR range: 2.26-3.09). Significant associations also emerged between major depressive disorder, bipolar I disorder, generalized anxiety disorder, specific phobia, agoraphobia, and panic disorder and co-occurring cannabis use + SAD (AOR range: 3.03-19.05). Results of this study may have implications for better identifying and screening emerging adults who are at risk of co-occurring cannabis use and SAD.
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Affiliation(s)
- Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Gillian Alcolado
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St., North York, Ontario M3J 1P3, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada
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Rapinda KK, Edgerton JD, Keough MT. Impulsivity Moderates the Association Between Anxiety and Problem Gambling Among Canadian Undergraduates. J Gambl Stud 2023; 39:1735-1750. [PMID: 37453956 DOI: 10.1007/s10899-023-10238-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Tension reduction theory suggests anxious people gamble to cope with negative affect. Literature demonstrates mixed associations between anxiety and gambling behaviours, hence, the important of examining moderators. This study examined how impulsivity moderated anxiety and problem gambling as well as gambling to cope. Given key gender differences, moderation was examined across genders. A sample of 484 undergraduate students who endorsed gambling behaviours completed anxiety, impulsivity, and problem gambling measures. Results showed men with higher levels of anxiety scored higher on problem gambling at both high (B = 0.706, SE = 0.073, p < 0.0001, f2 = 0.20) and low (B = 0.262, SE = 0.103, p = 0.01, f2 = 0.01) impulsivity, though the effect sizes were much larger for men with high impulsivity. This moderation effect was not found in women (B = 0.000, SE = 0.009, p = 0.959). Results showed men with higher levels of anxiety scored higher on coping motives for gambling at both high (B = 0.253, SE = 0.046, p < 0.0001, f2 = 0.06) and low B = 0.141, SE = 0.063, p = 0.026, f2 = 0.01) impulsivity, though the effect sizes were larger for men with high impulsivity. Again, this moderation effect was not found in women (B = - 0.101, SE = 0.006, p = 0.100). Findings from this may help inform impulsivity-focused interventions, such as strengthening impulse control and instilling more adaptive coping strategies to lower gambling risk among university men.
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Kim HS, Coelho SG, Vieira JL, Keough MT. Dispositional and contextual correlates of in-play sports betting and related harms: A 2-week ecological momentary assessment study. Psychol Addict Behav 2023; 37:1066-1079. [PMID: 37535553 DOI: 10.1037/adb0000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
OBJECTIVE In-play betting is a novel form of sports betting that allows players to make continuous bets during a game. The present study examined the dispositional and contextual correlates of in-play sports betting and related harms. METHOD Participants were 84 individuals (73.81% men, Mage = 41.02) who engaged in in-play betting. Participants first completed an online questionnaire including measures of problem gambling severity, childhood trauma, impulsivity, and emotion dysregulation. Participants then completed a 14-day ecological momentary assessment (EMA) study involving completing brief surveys twice per day. EMA surveys assessed in-play betting behaviors, motives, contexts, and harms. RESULTS A total of 1,365 EMA surveys were completed, of which 32.89% involved placing at least one in-play bet. A total of 77 (91.67%) participants placed at least one in-play bet during the study period. Participants reported greater in-play betting involvement (the number of bets placed, money spent) and an increased likelihood of experiencing in-play betting-related financial and relationship harms when using substances while betting and when motivated to place in-play bets by an interest in sports or to "be in the game." Participants, who used substances during a greater proportion of in-play betting occasions, who more frequently endorsed coping motives for in-play betting, and who exhibited elevated problem gambling severity, reported greater in-play betting involvement and the likelihood of experiencing in-play betting-related harms overall. CONCLUSIONS Responsible gambling initiatives targeting contextual risk factors, such as using alcohol and cannabis while in-play betting, may help to reduce the intensity of in-play betting and its associated harms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University
| | | | - Jenna L Vieira
- Department of Psychology, Toronto Metropolitan University
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Bernusky HCR, Tibbo PG, Conrod PJ, Yunus FM, Keough MT, Thompson KD, Krank MD, Hadwin AF, Stewart SH. Do Anxiety Symptoms Mediate the Association Between Cannabis Use Frequency and Psychotic-Like Experiences in Emerging Adult Undergraduates? Can J Psychiatry 2023; 68:860-869. [PMID: 37194263 PMCID: PMC10590089 DOI: 10.1177/07067437231176900] [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] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Cannabis is commonly used by Canadian emerging adults (ages 18-25 years), many of whom attend post-secondary institutions. Frequent cannabis use is linked with psychotic-like experiences (PLEs); however, the exact nature of this association remains unclear. Anxiety symptoms may mediate this association, as they are prevalent in emerging adults and have been independently linked with both cannabis use and PLEs. Past work found that anxiety mediated the association between cannabis use frequency and attenuated positive psychotic symptoms (further along the psychosis continuum than PLEs), however this research had yet to be validated in the Canadian population, and trait rather than state anxiety (frequency of anxiety symptoms) was studied. Thus, our primary objective was to examine if anxiety symptoms mediated the association between cannabis use frequency and PLEs in Canadian emerging adult undergraduates. Despite known sex differences in cannabis use, expression of anxiety, and PLEs, past work did not evaluate the potential impact of biological sex on the anxiety-mediated model, and thus is the secondary objective of the present study. METHODS 1,266 first-/second-year emerging adult undergraduates from five Canadian universities provided cross-sectional, self-report survey data in fall 2021 semester. Validated measures of cannabis use frequency, anxiety, and PLEs were administered. RESULTS Path analyses supported mediation from cannabis use to PLEs through anxiety (b = 0.07, P < 0.001, 95% bootstrap CI [0.03, 0.10]). No direct effect was found (P = 0.457), suggesting that the cannabis-to-PLEs association was mediated by anxiety. Mediation did not depend on biological sex (i.e., bootstrapped 95% CIs crossed zero). CONCLUSIONS Anxiety symptoms mediated the association between cannabis use and PLEs in emerging adults regardless of their biological sex. Assuming replication in prospective research, results highlight anxiety as an important intervention target in frequent cannabis-using emerging adults, to potentially prevent development/worsening of PLEs, and in turn psychotic illness.
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Affiliation(s)
| | - Philip G. Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Patricia J. Conrod
- Département de psychiatrie et d’addictologie, Université de Montréal, Montréal, Québec, Canada
| | - Fakir Md. Yunus
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Matthew T. Keough
- Department of Psychology, York University, North York, Ontario, Canada
| | - Kara D. Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Marvin D. Krank
- Department of Psychology, University of British Columbia, Kelowna, British Columbia, Canada
| | - Allyson F. Hadwin
- Department of Educational Psychology and Leadership Studies, University of Victoria, Victoria, British Columbia, Canada
| | - Sherry H. Stewart
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
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Boumparis N, Baumgartner C, Malischnig D, Wenger A, Achab S, Khazaal Y, Keough MT, Hodgins DC, Bilevicius E, Single A, Haug S, Schaub MP. Effectiveness of a web-based self-help tool to reduce problem gambling: A randomized controlled trial. J Behav Addict 2023; 12:744-757. [PMID: 37659086 PMCID: PMC10562826 DOI: 10.1556/2006.2023.00045] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/06/2023] [Accepted: 07/30/2023] [Indexed: 09/04/2023] Open
Abstract
Background and Aims Problem gambling constitutes a public health concern associated with psychopathological comorbidity, substance use, and financial difficulties. Most individuals with gambling problems avoid counseling services due to perceived stigma and their preference for self-reliance. Treatment accessibility could be improved through web-based interventions. Methods We recruited 360 individuals with gambling problems and randomized them to a web-based intervention (n = 185) or an active control group consisting of a self-help manual for problem gambling (n = 175). The primary outcome was the number of days of gambling in the last 30 days. Secondary outcomes included money spent in the last 30 days, time gambling in the last 7 days, gambling-related problems, consumption of alcohol and cigarettes, and psychopathological comorbidity measured at posttreatment and 6-month follow-up. Results The primary outcome decreased significantly for both groups, with no significant difference between the groups. There were significant group × time interactions according to the Gambling Symptom Assessment Scale (F = 8.83, p <0 .001), the Problem Gambling Severity Index (F = 3.54, p = 0.030), for cigarettes smoked in the last 7 days (F = 26.68, p < 0.001), the Patient Health Questionnaire-9 (F = 19.41, p <0 .001), and the Generalized Anxiety Disorder-7 (F = 41.09, p <0 .001) favoring the intervention group. We experienced an overall high dropout rate (76%). Conclusions Win Back Control seems to be an effective low-threshold treatment option for individuals with gambling problems that might otherwise be unapproachable for outpatient treatment services. Nevertheless, the high dropout rate should be considered when interpreting the study results, as they may have introduced a degree of variability.
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Affiliation(s)
- Nikolaos Boumparis
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Christian Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Doris Malischnig
- Institute for Addiction Prevention, Addiction and Drug Coordination Vienna, Austria
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Sophia Achab
- Department of Psychiatry, Faculty of Medicine, Clinical and Sociological Research Unit, University of Geneva, Switzerland
- Department of Psychiatry, Treatment Centre ReConnecte, Addiction Division, University Hospitals of Geneva, Switzerland
| | - Yasser Khazaal
- Addiction Medicine, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
- Department of Psychiatry and Addiction, Montreal University, Montreal, Canada
| | | | | | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alanna Single
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
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Reynolds A, Keough MT, Blacklock A, Tootoosis C, Whelan J, Bomfim E, Mushquash C, Wendt DC, O'Connor RM, Burack JA. The impact of cultural identity, parental communication, and peer influence on substance use among Indigenous youth in Canada. Transcult Psychiatry 2023:13634615231191999. [PMID: 37796930 DOI: 10.1177/13634615231191999] [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: 10/07/2023]
Abstract
Heavy drinking and smoking have been found to be among the leading causes of morbidity and mortality within Indigenous youth in North America. The focus of this study was to examine the relative roles of cultural identity, parent-child communication about the harms of substance use (SU), and perception about peers' opinions on heavy drinking and cigarette smoking among Indigenous youth. Strong Indigenous cultural identity, parent-child communication about SU, and affiliation with peers who do not use and/or who disapprove of substance use were all expected to reduce risk for heavy drinking and smoking. Substance use beliefs were hypothesized to mediate these effects. Youth (N = 117; Mage = 14.07; grades 6-11) from two Indigenous communities in Quebec completed self-reports. Consistent with the hypotheses, strong cultural identity predicted increased negative beliefs about substance use, which predicted reduced drinking and smoking. Similarly, affiliating with peers who did not use alcohol predicted decreased positive beliefs about alcohol use, which predicted reduced drinking. Affiliating with peers who did not smoke cigarettes predicted reduced cigarette smoking. Parental influences were not supported in this model. Intervention strategies may benefit from targeting cultural identity, peer groups, and substance use beliefs among Indigenous youth.
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Affiliation(s)
- Ashley Reynolds
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Matthew T Keough
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Adrienne Blacklock
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | | | - Joseph Whelan
- Central Québec School Board, Quebec City, Quebec, Canada
| | - Emiliana Bomfim
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Christopher Mushquash
- Department of Psychology, Lakehead University, and Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada
| | - Dennis C Wendt
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Roisin M O'Connor
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Jacob A Burack
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
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DeGrace S, Romero-Sanchiz P, Tibbo P, Barrett S, Arenella P, Cosman T, Atasoy P, Cousijn J, Wiers R, Keough MT, Yakovenko I, O'Connor R, Wardell J, Rudnick A, Nicholas Carleton R, Heber A, Stewart SH. Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories? Behav Res Ther 2023; 169:104387. [PMID: 37625353 DOI: 10.1016/j.brat.2023.104387] [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] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023]
Abstract
Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.
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Affiliation(s)
- S DeGrace
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada.
| | - P Romero-Sanchiz
- School of Psychology, University of Sussex Sussex House, Falmer, Brighton, BN1 9RH, United Kingdom
| | - P Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - S Barrett
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - P Arenella
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - T Cosman
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - P Atasoy
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - J Cousijn
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - R Wiers
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - M T Keough
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - I Yakovenko
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - R O'Connor
- Concordia University, Department of Psychology, 7141 Sherbrooke West PY-146, Montreal, QC, H4B 1R6, Canada
| | - J Wardell
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - A Rudnick
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - R Nicholas Carleton
- University of Regina, Department of Psychology, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - A Heber
- McMaster University, Department of Psychiatry and Behavioural Neurosciences, 100 West 5th Street, Hamilton, ON, Canada
| | - S H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
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Vieira JL, Coelho SG, Snaychuk LA, Parmar PK, Keough MT, Kim HS. Who makes in-play bets? Investigating the demographics, psychological characteristics, and gambling-related harms of in-play sports bettors. J Behav Addict 2023. [PMID: 37335776 DOI: 10.1556/2006.2023.00030] [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] [Received: 04/14/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/21/2023] Open
Abstract
Background and aims Sports betting has increased markedly in recent years, in part due to legislative changes and the introduction of novel forms of sports betting (e.g., in-play betting). Some evidence suggests that in-play betting is more harmful than other types of sports betting (i.e., traditional and single-event). However, existing research on in-play sports betting has been limited in scope. To address this gap, the present study examined the extent to which demographic, psychological, and gambling-related constructs (e.g., harms) are endorsed by in-play sports bettors relative to single-event and traditional sports bettors. Methods Sports bettors (N = 920) aged 18+ from Ontario, Canada completed an online survey containing self-report measures of demographic, psychological, and gambling-related variables. Participants were classified as either in-play (n = 223), single-event (n = 533), or traditional bettors (n = 164) based on their sports betting engagement. Results In-play sports bettors reported higher problem gambling severity, endorsed greater gambling-related harms across several domains, and reported greater mental health and substance use difficulties compared to single-event and traditional sports bettors. There were generally no differences between single-event and traditional sports bettors. Discussion Results provide empirical support for the potential harms associated with in-play sports betting and inform our understanding of who may be at risk for increased harms associated with in-play betting. Conclusions Findings may be important for the development of public health and responsible gambling initiatives to reduce the potential harms of in-play betting, particularly as many jurisdictions globally move towards legalization of sports betting.
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Affiliation(s)
- Jenna L Vieira
- 1Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Sophie G Coelho
- 2Department of Psychology, York University, Toronto, ON, Canada
| | - Lindsey A Snaychuk
- 1Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Puneet K Parmar
- 1Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | | | - Hyoun S Kim
- 1Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- 3University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, ON, Canada
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Morris V, Baptist-Mohseni N, Kronstein NB, Murphy CB, Yunus F, Thibault T, Livet A, Mahmoud A, Pétrin-Pomerleau P, Krank M, Thompson K, Conrod P, Stewart SH, Keough MT. Hazardous Drinking Mediates the Relation Between Externalizing Personality and Reduced Adherence to COVID-19 Public Health Guidelines in University Students. Emerg Adulthood 2023; 11:797-803. [PMID: 38603422 PMCID: PMC9676110 DOI: 10.1177/21676968221140449] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Using a multigroup path analysis, we examined if hazardous alcohol use mediated the relations between elevated externalizing personality traits (i.e., impulsivity or sensation seeking) and reduced adherence to COVID-19 public health guidelines. We hypothesized that those high in externalizing personality traits would demonstrate less adherence to public health guidelines and that hazardous alcohol use would mediate this relationship. First- and second-year undergraduates (N = 1232; ages 18-25) from five Canadian universities participated in a cross-sectional survey between January to April 2021. Individuals with higher levels of impulsive or sensation seeking personality traits demonstrated poorer adherence to COVID-19 public health guidelines and these relations were mediated by hazardous alcohol use. Results suggest that hazardous drinking is an important target for students high in impulsivity and sensation seeking to increase their adherence to public health guidelines and thereby help control viral spread.
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Affiliation(s)
- Vanessa Morris
- Department of Psychology, University of New Brunswick, Saint John, NB, Canada
| | | | | | - Clayton B. Murphy
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Fakir Yunus
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Tabatha Thibault
- Department of Psychology, St Francis Xavier University, Antigonish, NS, Canada
| | - Audrey Livet
- CHU Sainte-Justine Research Center, Montréal, QC, Canada
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
| | - Aram Mahmoud
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
| | | | - Marvin Krank
- Department of Psychology, The University of British Columbia, Okanagan
Campus, Kelowna, BC, Canada
| | - Kara Thompson
- Department of Psychology, St Francis Xavier University, Antigonish, NS, Canada
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Montréal, QC, Canada
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, QC, Canada
| | - Sherry H. Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
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Morris V, Keough MT, Stewart SH, O'Connor RM. Coping and Conformity Motives Mediate the Joint Effects of the Behavioral Inhibition and Approach Systems on Alcohol Problems in Young Adults. Subst Use Misuse 2023; 58:787-795. [PMID: 36943012 DOI: 10.1080/10826084.2023.2188460] [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: 03/23/2023]
Abstract
Background: Gray's original Reinforcement Sensitivity Theory (RST) posits that an oversensitive behavioral inhibition system (BIS) may increase risk for negative-reinforcement-motivated drinking, given its role in anxiety. However, existing data provides mixed support for the BIS-alcohol use association. The inconsistent evidence is not surprising, as the revised RST predicts that the behavioral approach system (BAS) should moderate the effect of the BIS on alcohol use. A strong BAS is thought to bring attention to the negatively reinforcing effects of alcohol, leading to problem drinking among those with a strong BIS. While emerging results support this interaction, we still have much to learn about the mechanisms underlying this effect on alcohol use. Accordingly, we examined motives for alcohol use as mediators of the joint associations of the BIS and the BAS on drinking behaviors. Specifically, our central hypothesis was that individuals with a strong BIS and a strong BAS would endorse increased negative reinforcement motives for drinking (coping and conformity motives), which in turn would predict heavy drinking and alcohol problems. Method: Participants (N=346; 195 women) completed study measures as part of the baseline assessment for a larger study. Results: Overall, results partially supported the hypotheses. Mediated moderation analyses showed that the indirect effect of the BIS on alcohol problems, through coping and conformity motives, was strongest at high levels of the BAS. This effect was not supported for alcohol use. Conclusions: Our findings suggest that clinical interventions should target coping and conformity reasons for drinking among anxious, reward responsive, young adults.
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Affiliation(s)
- Vanessa Morris
- Department of Psychology, University of New Brunswick Saint John, Saint John, Canada
| | | | - Sherry H Stewart
- Department of Psychiatry and Department of Psychology and Neuroscience, Dalhousie University, Nova Scotia, Canada
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Bui V, Baumgartner C, Bilevicius E, Single A, Vedelago L, Morris V, Kempe T, Schaub MP, Stewart SH, MacKillop J, Hodgins DC, Wardell JD, O'Connor R, Read J, Hadjistavropoulos HD, Sundström C, Dermody S, Kim AH, Keough MT. Efficacy of a novel online integrated treatment for problem gambling and tobacco smoking: Results of a randomized controlled trial. J Behav Addict 2023; 12:168-181. [PMID: 37000596 DOI: 10.1556/2006.2022.00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 04/28/2022] [Revised: 09/02/2022] [Accepted: 11/03/2022] [Indexed: 02/24/2023] Open
Abstract
AbstractBackground and aimsProblem gambling and tobacco use are highly comorbid among adults. However, there are few treatment frameworks that target both gambling and tobacco use simultaneously (i.e., an integrated approach), while also being accessible and evidence-based. The aim of this two-arm open label RCT was to examine the efficacy of an integrated online treatment for problem gambling and tobacco use.MethodsA sample of 209 participants (Mage = 37.66, SD = 13.81; 62.2% female) from North America were randomized into one of two treatment conditions (integrated [n = 91] or gambling only [n = 118]) that lasted for eight weeks and consisted of seven online modules. Participants completed assessments at baseline, after treatment completion, and at 24-week follow-up.ResultsWhile a priori planned generalized linear mixed models showed no condition differences on primary (gambling days, money spent, time spent) and secondary outcomes, both conditions did appear to significantly reduce problem gambling and smoking behaviours over time. Post hoc analyses showed that reductions in smoking and gambling craving were correlated with reductions in days spent gambling, as well as with gambling disorder symptoms. Relatively high (versus low) nicotine replacement therapy use was associated with greater reductions in gambling behaviours in the integrated treatment condition.Discussion and conclusionsWhile our open label RCT does not support a clear benefit of integrated treatment, findings suggest that changes in smoking and gambling were correlated over time, regardless of treatment condition, suggesting that more research on mechanisms of smoking outcomes in the context of gambling treatment may be relevant.
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Affiliation(s)
- Van Bui
- 1Department of Psychology, University of Manitoba, Canada
| | - Christian Baumgartner
- 2Swiss Research Institute for Public Health and Addiction, University of Zurich, Switzerland
| | | | - Alanna Single
- 1Department of Psychology, University of Manitoba, Canada
| | | | - Vanessa Morris
- 14Department of Psychology, University of New Brunswick, Canada
| | - Tyler Kempe
- 1Department of Psychology, University of Manitoba, Canada
| | - Michael P Schaub
- 2Swiss Research Institute for Public Health and Addiction, University of Zurich, Switzerland
| | - Sherry H Stewart
- 4Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Canada
| | - James MacKillop
- 5Peter Boris Centre for Addictions Research McMaster University/St. Joseph's Healthcare Hamilton, Canada
| | | | - Jeffrey D Wardell
- 3Department of Psychology, York University, Canada
- 12Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- 13Department of Psychiatry, University of Toronto, Canada
| | | | - Jennifer Read
- 8Department of Psychology, University of Buffalo, USA
| | | | | | - Sarah Dermody
- 11Department of Psychology, Ryerson University, Canada
| | - Andrew H Kim
- 11Department of Psychology, Ryerson University, Canada
| | - Matthew T Keough
- 1Department of Psychology, University of Manitoba, Canada
- 3Department of Psychology, York University, Canada
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Lambe LJ, Yunus FM, Moore M, Keough MT, Thompson K, Krank M, Conrod P, Stewart SH. Inhibited personality traits, internalizing symptoms, and drinking to cope during the COVID-19 pandemic among emerging adults. Cogn Behav Ther 2022; 52:198-212. [PMID: 36519887 DOI: 10.1080/16506073.2022.2152726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Emerging adults with high levels of inhibited personality traits may be at-risk for drinking to cope during the COVID-19 pandemic. The current research explored mediational pathways between two inhibited personality traits (anxiety sensitivity (AS) and hopelessness (HOP)), internalizing symptoms (anxiety, depression, and COVID-19 distress), and coping drinking motives (drinking to cope with anxiety and drinking to cope with depression) during the pandemic. Cross-sectional data were collected from 879 undergraduate drinkers (79% female, 83% White, 18-25 years old) at five Canadian universities from January-April 2021. Participants self-reported on their personality, anxiety (GAD-7), depressive symptoms (PHQ-9), COVID-19 distress, and coping drinking motives. Mediational path analyses provided evidence of both specific and non-specific pathways between personality and coping motives via internalizing symptoms. Depressive symptoms partially mediated the link between HOP and drinking to cope with depression motives. While anxiety symptoms did not significantly mediate links between AS and coping with anxiety motives in the full model, evidence of mediation was found in a post-hoc sensitivity analysis. COVID-19 distress served as a non-specific mediator. AS and HOP are critical transdiagnostic risk factors that increase vulnerability for internalizing psychopathology and, in turn, risky drinking motives, in the context of the COVID-19 pandemic.
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Affiliation(s)
- Laura J. Lambe
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Fakir Md Yunus
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mackenzie Moore
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Kara Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Marvin Krank
- Department of Psychology, University of British Columbia- Okanagan Campus, Kelowna, British Columbia, Canada
| | - Patricia Conrod
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
| | - Sherry H. Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
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Bambrah V, Wardell JD, Keough MT. Longitudinal co-trajectories of depression and alcohol problems in adults during the COVID-19 pandemic. Curr Psychol 2022:1-17. [PMID: 36531195 PMCID: PMC9748906 DOI: 10.1007/s12144-022-04109-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
We examined person-centered heterogeneity in the longitudinal co-development of depression and alcohol problems during the COVID-19 outbreak. We also investigated the risk factors (personality and coping) for being in "higher" relative to "lower" risk subgroups of combined depressive symptoms and alcohol problems. Canadian participants (N = 364, M age = 32.16, 54.67% male) completed questionnaires four times every three months, starting approximately 2 months after Canada announced its COVID-19 State-of-Emergency. Parallel-process latent class growth analysis found evidence for three latent subgroups: a "moderate increasing depression and alcohol problems" subgroup (Class 1); a "moderate stable depression, moderate decreasing alcohol problems" subgroup (Class 2); and a "low-risk normative" subgroup (with mild depression that was stable and mild alcohol problems that decreased; Class 3). Multinomial logistic regressions found that higher levels of hopelessness, impulsivity, and boredom proneness distinguished Class 1 from Class 3. Further, lower levels of general self-efficacy distinguished Class 1 from Classes 2 and 3. Linear mixed models found that Class 1 increasingly used maladaptive avoidant coping strategies (denial, drugs/alcohol, behavioural disengagement) as the pandemic progressed, whereas Class 2 increasingly used adaptive approach-oriented strategies (planning, seeking emotional support from others). We analyzed longitudinal data to detect classes of individuals with depressive and alcohol-related difficulties during COVID-19 and to characterize the vulnerability factors for increased difficulties. Highlighting the heterogeneity in the co-trajectory of depression and alcohol problems during COVID-19 and the personality and coping factors associated with combined increases in these mental health difficulties can inform treatment practices and bolster peoples' preparedness and resilience for future pandemics. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-04109-4.
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Affiliation(s)
- Veerpal Bambrah
- Department of Psychology, Faculty of Health, York University, Behavioural Sciences Building, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Jeffrey D. Wardell
- Department of Psychology, Faculty of Health, York University, Behavioural Sciences Building, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
| | - Matthew T. Keough
- Department of Psychology, Faculty of Health, York University, Behavioural Sciences Building, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
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Frohlich JR, Rapinda KK, Schaub MP, Wenger A, Baumgartner C, Johnson EA, Blankers M, Ebert DD, Hadjistavropoulos HD, Mackenzie CS, Wardell JD, Edgerton JD, Keough MT. Examining differential responses to the Take Care of Me trial: A latent class and moderation analysis. Addict Behav Rep 2022; 16:100437. [PMID: 35694108 PMCID: PMC9184289 DOI: 10.1016/j.abrep.2022.100437] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/01/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022] Open
Abstract
Take Care of Me participants fell into three classes varying in risk. The low-risk class had the lowest pre-treatment symptom severity. The high-risk group had the highest symptom severity and executive dysfunction. Moderate risk individuals experienced the greatest benefits of the program. Future interventions may be tailored based on risk to maximize efficacy.
Given prevalent alcohol misuse-emotional comorbidities among young adults, we developed an internet-based integrated treatment called Take Care of Me. Although the treatment had an impact on several secondary outcomes, effects were not observed for the primary outcome. Therefore, the goal of the current study was to examine heterogeneity in treatment responses. The initial RCT randomized participants to either a treatment or psychoeducational control condition. We conducted an exploratory latent class analysis to distinguish individuals based on pre-treatment risk and then used moderated regressions to examine differential treatment responses based on class membership. We found evidence for three distinct groups. Most participants fell in the “low severity” group (n = 123), followed by the “moderate severity” group (n = 57) who had a higher likelihood of endorsing a previous mental health diagnosis and treatment and higher symptom severity than the low group. The “high severity” group (n = 42) endorsed a family history of alcoholism, and the highest symptom severity and executive dysfunction. Moderated regressions revealed significant class differences in treatment responses. In the treatment condition, high severity (relative to low) participants reported higher alcohol consumption and hazardous drinking and lower quality of life at follow-up, whereas moderate severity (relative to low) individuals had lower alcohol consumption at follow-up, and lower hazardous drinking at end-of-treatment. No class differences were found for participants in the control group. Higher risk individuals in the treatment condition had poorer responses to the program. Tailoring interventions to severity may be important to examine in future research.
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Affiliation(s)
- Jona R. Frohlich
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Corresponding author at: Department of Psychology, University of Manitoba, 190 Dysart Rd., Winnipeg, Manitoba R3T 2N2, Canada.
| | - Karli K. Rapinda
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Christian Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Edward A. Johnson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Matthijs Blankers
- Arkin Mental Health Care, University of Amsterdam, Amsterdam, Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands
- Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - David D. Ebert
- Department of eMental Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Jeffrey D. Wardell
- Department of Psychology, York University, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason D. Edgerton
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, MB, Canada
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Sundström C, Peynenburg V, Chadwick C, Thiessen D, Wilhems A, Nugent M, Keough MT, Schaub MP, Hadjistavropoulos HD. Optimizing internet-delivered cognitive behaviour therapy for alcohol misuse—a randomized factorial trial examining effects of a pre-treatment assessment interview and guidance. Addict Sci Clin Pract 2022; 17:37. [PMID: 35871010 PMCID: PMC9308037 DOI: 10.1186/s13722-022-00319-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background Internet-delivered cognitive behavioral therapy (ICBT) for alcohol misuse has potential to radically improve access to evidence-based care, and there is a need to investigate ways to optimize its delivery in clinical settings. Guidance from a clinician has previously been shown to improve drinking outcomes in ICBT, and some studies suggest that pre-treatment assessments may contribute in initiating early change. The objective of this study was to investigate the added and combined effects of a pre-treatment assessment interview and guidance on the outcomes of ICBT for alcohol misuse delivered in an online therapy clinic. Methods A 2X2 factorial randomized controlled trial was conducted where participants received access to an 8-week ICBT program, and either a pre-treatment assessment interview (Factor 1), guidance (Factor 2), a combination of these, or neither of these. Participants were 270 individuals (66.8% female, mean age = 46.5) scoring 8 or more on the Alcohol Use Disorders Identification Test and consuming 14 standard drinks or more in the preceding week. Primary outcomes were number of drinks consumed and number of heavy drinking days during the preceding week, 3 months post-treatment. Results Large within-group effects were found in terms of alcohol reductions (dw ≥ 0.82, p < 0.001), but neither of the factors significantly improved drinking outcomes. Guidance was associated with greater adherence (i.e. completed modules). Conclusions Neither a pre-treatment assessment interview nor guidance from a clinician appears to improve drinking outcomes resulting from internet-delivered cognitive behaviour therapy for alcohol misuse when delivered in a routine online therapy clinic. Trial registration: NCT03984786. Registered 13 June 2019, https://clinicaltrials.gov/ct2/show/NCT03984786 Supplementary Information The online version contains supplementary material available at 10.1186/s13722-022-00319-0.
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Pilatti A, Klein ND, Mezquita L, Bravo AJ, Keough MT, Pautassi RM. Drinking Motives as Mediators of the Relationship of Cultural Orientation with Alcohol Use and Alcohol-Related Negative Consequences in College Students from Seven Countries. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Single A, Bilevicius E, Ho V, Theule J, Buckner JD, Mota N, Keough MT. Cannabis use and social anxiety in young adulthood: A meta-analysis. Addict Behav 2022; 129:107275. [PMID: 35184002 DOI: 10.1016/j.addbeh.2022.107275] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 01/16/2023]
Abstract
Young adulthood (ages 18 to 30 years old), a developmental age of exploration, is marked by new experiences and transitions. Cannabis use frequency is highest in young adulthood compared to other age periods. Social anxiety (characterized by fear, shyness, and inhibition in social situations where scrutiny and judgment is possible) is also prevalent during young adulthood. Social anxiety may be a complex predictor of cannabis use frequency and problems (e.g., any negative physical, emotional, or social outcome from use). Social anxiety may act as a risk factor as individuals may use cannabis frequently to manage their fear of negative evaluation and associated unpleasant affective states. The purpose of this meta-analysis was to quantify the magnitude of the associations between social anxiety and two cannabis variables (frequency of use and problems) in young adulthood. A comprehensive literature review was conducted to identify studies that included measures of social anxiety and at least one cannabis-related variable of interest among young adults. Eighteen studies were included in the meta-analysis. Results revealed a small, statistically significant positive association between social anxiety and cannabis problems (r = 0.197, k = 16, p = <0.001), and a nonsignificant association between social anxiety and cannabis use frequency (r = 0.002, k = 16, p = 0.929). The association between social anxiety and cannabis use frequency was moderated by the mean age such that samples with older mean ages exhibited a stronger correlation. Additionally, the association between social anxiety and cannabis problems was moderated by clinically significant levels of social anxiety, such that samples with fewer participants who met clinical levels of social anxiety exhibit a stronger correlation. This meta-analysis supports the idea that there is a complex relation between social anxiety and cannabis outcomes during young adulthood.
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Affiliation(s)
- Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Victoria Ho
- University of Manitoba Libraries, University of Manitoba, 25 Chancellors Circle, Winnipeg, Manitoba R3T 5V5, Canada.
| | - Jennifer Theule
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba R3T 2N2, Canada.
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge Louisiana 70803, United States.
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba R3E 3N4, Canada.
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, Ontario M3J 1P3, Canada.
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21
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Baptist Mohseni N, Morris V, Vedelago L, Kempe T, Rapinda K, Mesmer E, Bilevicius E, Wardell JD, MacKillop J, Keough MT. A longitudinal approach to understanding risk factors for problem alcohol use during the COVID-19 pandemic. Alcohol Clin Exp Res 2022; 46:434-446. [PMID: 35262939 PMCID: PMC9111299 DOI: 10.1111/acer.14774] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
Background We conducted a longitudinal study to examine person‐centered heterogeneity in problem drinking risk during the 2019 Coronavirus disease (COVID‐19) pandemic. We aimed to differentiate high‐ from low‐risk subgroups of drinkers during the pandemic, to report on the longitudinal follow‐up of the baseline sample reported in Wardell et al. (Alcohol Clin Exp Res, 44, 2020, 2073), and to examine how subgroups of drinkers differed on coping‐related and pre‐pandemic alcohol vulnerability factors. Methods Canadian alcohol users (N = 364) were recruited for the study. Participants completed surveys at four waves (spaced 3 months apart), with the first being 7 to 8 weeks after the COVID‐19 state of emergency began in Canada. The data were analyzed using a parallel process latent growth class analysis followed by general linear mixed models analysis. Results We found evidence for three latent classes: individuals who increased drinking (class 1; n = 23), low‐risk drinkers (class 2; n = 311), and individuals who decreased drinking (class 3; n = 30). Participants who increased (vs. those who decreased) problem drinking during the pandemic struggled with increasing levels of social disconnection and were also increasingly more likely to report drinking to cope with these issues. Those in the increasing class (relative to low‐risk drinkers) reported increasing levels of depression during the study. Relative to low‐risk drinkers, participants in the increasing class had higher pre‐pandemic AUDIT scores, greater frequency of solitary drinking, and higher alcohol demand. Interestingly, participants in the decreasing class had the highest pre‐pandemic AUDIT scores. Conclusions We examined longitudinal data to identify subgroups of drinkers during the pandemic and to identify factors that may have contributed to increased problem drinking. Findings suggest that while most of the sample did not change their alcohol use, a small portion of individuals escalated use, while a small portion decreased their drinking. Identifying the vulnerability factors associated with increased drinking could aid in the development of preventative strategies and intervention approaches.
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Affiliation(s)
| | - Vanessa Morris
- Department of Psychology, York University, North York, Ontario, Canada
| | - Lana Vedelago
- Department of Psychology, York University, North York, Ontario, Canada
| | - Tyler Kempe
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Karli Rapinda
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Emily Mesmer
- Department of Psychology, York University, North York, Ontario, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, North York, Ontario, Canada.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, McMaster University, Hamilton, Ontario, Canada.,Homewood Research Institute, Guelph, Ontario, Canada
| | - Matthew T Keough
- Department of Psychology, York University, North York, Ontario, Canada
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22
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Bernusky HCR, Rapinda KK, Single A, Bilevicius E, Foot M, Ellery M, Keough MT, Johnson EA. Examining Subtypes of Emerging Adult Situational Drinking: A Replication and Extension Study. Subst Use Misuse 2022; 57:96-104. [PMID: 34753393 DOI: 10.1080/10826084.2021.1990337] [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: 10/19/2022]
Abstract
Background: Emerging adulthood is associated with heavy drinking. Despite overall heavy use, studies show considerable heterogeneity in emerging adult drinking habits. Lau-Barraco and colleagues (2016 b) identified three subtypes (high, moderate, low) of emerging adult heavy drinkers based on patterns of use across common drinking situations. Heavy situational drinkers had more alcohol problems, mental health symptoms, and coping/conformity motives for alcohol use.Objective: Our goal was to replicate and extend the aforementioned study, expecting to find the same subgroups, then examining whether certain risk factors predicted subgroup membership.Methods/Results: Undergraduates (N = 497) completed online self-report measures and a latent profile analysis (LPA) found support for three similar subtypes; low, "moderate" (higher endorsement of pleasant emotion/social pressure situations, relative to the low group), and high. Univariate ANOVAs, followed by pairwise comparisons, found that heavy situational drinkers scored highest on measures of alcohol problems, problem gambling, drug use, depression, and anxiety compared to the other two groups, and consistent with previous findings.Conclusions: This study showed that emerging adults who drink heavily across various situations are likely to engage in other addictive behaviors and struggle with mental health symptoms. Identifying one's personal risk factors and their riskiest drinking situations is critical for developing targeted intervention programs and increasing the understanding of the heterogeneous nature of drinking behaviors in emerging adults in Canada.
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Affiliation(s)
| | - Karli K Rapinda
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alanna Single
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Melody Foot
- Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Michael Ellery
- Psychology, The University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Matthew T Keough
- Psychology, York University - Keele Campus, Toronto, Ontario, Canada
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23
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Taguba KK, Keough MT, Bravo AJ, Wardell JD. Measuring Impaired Control over Cannabis Use: Initial Evaluation of the Impaired Control Scale-Cannabis (ICS-C). Subst Use Misuse 2022; 57:1303-1312. [PMID: 35621317 DOI: 10.1080/10826084.2022.2079137] [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: 10/18/2022]
Abstract
Background: Impaired control is a central concept in addiction. Impaired control over alcohol has been associated with heavy drinking and alcohol-related problems in young adults, but there is less research on impaired control over cannabis. Currently, there is no validated self-report instrument that comprehensively assesses impaired control over cannabis use. This study examined the factor structure, reliability, and validity of a new measure, the Impaired Control Scale-Cannabis (ICS-C), which was adapted from the widely used Impaired Control Scale (ICS) for alcohol. Method: The sample consisted of students at two Canadian universities who reported past-month cannabis use (N = 362; 63% women; 66% White, mean age = 19.91). Participants completed an online survey including the ICS-C and ICS, along with measures of cannabis use, cannabis problems, alcohol use, impulsivity, and self-regulation. Results: After trimming problematic and redundant items, the final exploratory factor analysis of the ICS-C items yielded two factors: Attempted Control (attempts to control cannabis use) and Failed Control (unsuccessful attempts to limit cannabis use). High correlations between the ICS-C subscales and the Impaired Control subscale of the Marijuana Consequences Questionnaire provided evidence for convergent validity. Support for concurrent and discriminant validity was observed in the associations of the ICS-C subscales with cannabis use, cannabis problems, impulsivity, self-regulation, alcohol use, and the alcohol ICS. Conclusions: The ICS-C is a promising tool for assessing impaired control over cannabis in young adults. Future research should further validate the ICS-C and examine its potential clinical utility for identifying individuals at risk for cannabis use disorder.
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Affiliation(s)
| | - Matthew T Keough
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, USA
| | - Jeffrey D Wardell
- Department of Psychology, York University, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Bravo AJ, Prince MA, Pilatti A, Mezquita L, Keough MT, Hogarth L. Young adult concurrent use and simultaneous use of alcohol and marijuana: A cross-national examination among college students in seven countries. Addict Behav Rep 2021; 14:100373. [PMID: 34938834 PMCID: PMC8664774 DOI: 10.1016/j.abrep.2021.100373] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 06/14/2021] [Revised: 08/01/2021] [Accepted: 08/31/2021] [Indexed: 12/17/2022] Open
Abstract
Introduction Many young adults report frequent co-use of alcohol and marijuana, with some individuals engaging in simultaneous use (SAM; use of both substances within the same occasion resulting in an overlap of their effects) and others in concurrent use (CAM; use of both substances during a similar time period [e.g., past 30 days] but not within the same occasion). Emerging work demonstrates that SAM relative to CAM use places individuals at a greater risk for substance-related harms; however, these results primarily rely on U.S. samples. The goal of the present multi-country study was to examine prevalence rates of CAM and SAM use and examine differences in past 30-day SAM/CAM use on alcohol/marijuana substance-related outcomes among college students from seven countries. Methods A total of 9171 (70.5% women; Mean age = 20.28, SD = 3.96) college students participated in the cross-sectional online survey study. Results Among students who endorsed use of both alcohol and marijuana in the past 30-days (n = 2124), SAM use (75.8%) was far more prevalent than CAM use (24.2%). Moreover, ∼75% of students endorsed SAM use within each country subsample. Regression models showed that SAM vs. CAM use was associated with greater alcohol and marijuana use and negative consequences. Conclusions College students from around the world endorse high rates of SAM use, and this pattern of co-use is associated with greater frequency of use and substance-related harms. On college campuses, SAM use should be a target of clinical prevention/intervention efforts and the mechanisms underpinning the unique harms of SAM need to be clarified.
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Affiliation(s)
- Adrian J Bravo
- Department of Psychological Sciences, William & Mary, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, USA
| | - Angelina Pilatti
- Universidad Nacional de Córdoba, Facultad de Psicología, Instituto de Investigaciones Psicológicas, IIPsi, CONICET, Córdoba, Argentina
| | - Laura Mezquita
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Castellón, Spain.,Centre for Biomedical Research Network on Mental Health, Instituto de Salud Carlos III, Castelló de la Plana, Castellón, Spain
| | | | - Lee Hogarth
- School of Psychology, University of Exeter, United Kingdom
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25
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Frohlich JR, Rapinda KK, Schaub MP, Wenger A, Baumgartner C, Johnson EA, O'Connor RM, Vincent N, Blankers M, Ebert DD, Hadjistavropoulos HD, Mackenzie CS, Wardell JD, Augsburger M, Goldberg JO, Keough MT. Efficacy of a minimally guided internet treatment for alcohol misuse and emotional problems in young adults: Results of a randomized controlled trial. Addict Behav Rep 2021; 14:100390. [PMID: 34938848 PMCID: PMC8664864 DOI: 10.1016/j.abrep.2021.100390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/16/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Abstract
Cognitive-behavioural therapy (CBT) and motivational interviewing (MI) can be readily adapted for brief, minimally guided, online interventions. Minimally guided online treatment is beneficial for hazardous drinking, mood difficulties, and quality of life in the short-term among young adults. Strategies designed to increase treatment engagement will likely mitigate the risk of attrition in future programs. Future versions of the Take Care of Me program are still needed to determine long-term effects and differential responses to treatment.
Many young adults struggle with comorbid alcohol misuse and emotional problems (i.e., depression and anxiety). However, there is currently a paucity of evidence-based, integrated, accessible treatment options for individuals with these comorbidities. The main goal of this study was to examine efficacy of a novel online, minimally guided, integrated program for comorbid alcohol misuse and emotional problems in young adults. Method: The study was an open-label two-arm RCT. Participants (N = 222, Mage = 24.6, 67.6% female) were randomized to one of two conditions: the Take Care of Me program (an 8-week, online integrated treatment condition consisting of 12 modules), or an online psychoeducational control condition. Intervention modules incorporated content based on principles of cognitive behavioral therapy and motivational interviewing. Participants completed assessment data at baseline, at the end of treatment (i.e., 8 weeks), and at follow-up (i.e., 24 weeks). Data were analyzed using generalized linear mixed models. Results: We observed that participants in the treatment condition showed larger reductions in depression, hazardous drinking, as well as increases in psychological quality of life and confidence at the end of treatment. We did not find group differences on total alcohol use at follow-up, but participants in the treatment group reduced their hazardous drinking and improved their quality of life at 24-week follow-up. Conclusions: Our study provides promising initial evidence for the first iteration of the comorbid alcohol misuse and emotional problems online program.
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Affiliation(s)
- Jona R Frohlich
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Karli K Rapinda
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Christian Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Edward A Johnson
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Roisin M O'Connor
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Norah Vincent
- Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Matthijs Blankers
- Arkin Mental Health Care, University of Amsterdam, Amsterdam, Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.,Academic Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands
| | - David D Ebert
- Department of eMental Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Corey S Mackenzie
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, Toronto, ON, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mareike Augsburger
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Joel O Goldberg
- Department of Psychology, York University, Toronto, ON, Canada
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26
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Bilevicius E, Clark CC, Johnson EA, Keough MT. Corrigendum to: Ashamed and Alone-Risk Factors for Alcohol Craving Among Depressed Emerging Adults. Alcohol Alcohol 2021; 56:635-636. [PMID: 34332507 DOI: 10.1093/alcalc/agab058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Courtney C Clark
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Edward A Johnson
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, ON, M3J 1P3, Canada
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27
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Rapinda KK, Kempe T, Kruk RS, Edgerton JD, Wallbridge HR, Keough MT. Examining the temporal associations between depression and pathological gaming. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement 2021. [DOI: 10.1037/cbs0000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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28
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Baumgartner C, Schaub MP, Wenger A, Malischnig D, Augsburger M, Walter M, Berger T, Stark L, Ebert DD, Keough MT, Haug S. CANreduce 2.0 Adherence-Focused Guidance for Internet Self-Help Among Cannabis Users: Three-Arm Randomized Controlled Trial. J Med Internet Res 2021; 23:e27463. [PMID: 33929333 PMCID: PMC8122293 DOI: 10.2196/27463] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/18/2021] [Accepted: 04/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background Despite increasing demand for treatment among cannabis users in many countries, most users are not in treatment. Internet-based self-help offers an alternative for those hesitant to seek face-to-face therapy, though low effectiveness and adherence issues often arise. Objective Through adherence-focused guidance enhancement, we aimed to increase adherence to and the effectiveness of internet-based self-help among cannabis users. Methods From July 2016 to May 2019, cannabis users (n=775; male: 406/575, 70.6%, female: 169/575, 29.4%; age: mean 28.3 years) not in treatment were recruited from the general population and were randomly assigned to (1) an adherence-focused guidance enhancement internet-based self-help intervention with social presence, (2) a similar intervention with an impersonal service team, and (3) access to internet as usual. Controls who were placed on a waiting list for the full intervention after 3 months underwent an assessment and had access to internet as usual. The primary outcome measurement was cannabis-use days over the preceding 30 days. Secondary outcomes included cannabis-dependence severity, changes in common mental disorder symptoms, and intervention adherence. Differences between the study arms in primary and secondary continuous outcome variables at baseline, posttreatment, and follow-up were tested using pooled linear models. Results All groups exhibited reduced cannabis-use days after 3 months (social presence: –8.2 days; service team: –9.8 days; internet as usual: –4.2 days). The participants in the service team group (P=.01, d=.60) reported significantly fewer cannabis-use days than those in the internet as usual group; the reduction of cannabis use in the social presence group was not significant (P=.07, d=.40). There was no significant difference between the 2 intervention groups regarding cannabis-use reduction. The service team group also exhibited superior improvements in cannabis-use disorder, cannabis-dependence severity, and general anxiety symptoms after 3 months to those in the internet as usual group. Conclusions The adherence-focused guidance enhancement internet-based self-help intervention with an impersonal service team significantly reduced cannabis use, cannabis-use disorder, dependence severity, and general anxiety symptoms. Trial Registration ISRCTN Registry ISRCTN11086185; http://www.isrctn.com/ISRCTN11086185
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Affiliation(s)
- Christian Baumgartner
- Swiss Research Institute for Public Health and Addiciton, University of Zurich, Zürich, Switzerland
| | - Michael Patrick Schaub
- Swiss Research Institute for Public Health and Addiciton, University of Zurich, Zürich, Switzerland
| | - Andreas Wenger
- Swiss Research Institute for Public Health and Addiciton, University of Zurich, Zürich, Switzerland
| | - Doris Malischnig
- Institute for Addiction Prevention, Addiction and Drug Coordination Vienna, Vienna, Austria
| | - Mareike Augsburger
- Swiss Research Institute for Public Health and Addiciton, University of Zurich, Zürich, Switzerland
| | - Marc Walter
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lars Stark
- Arud Centre for Addiction Medicine, Zurich, Switzerland
| | - David Daniel Ebert
- Department for Sport and Health Sciences, Chair for Psychology and Digital Mental Health Care, Technical University Munich, Munich, Germany
| | | | - Severin Haug
- Swiss Research Institute for Public Health and Addiciton, University of Zurich, Zürich, Switzerland
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29
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DeGrace S, Baptist-Mohseni N, Single A, Keough MT, Wardell JD, Stewart SH. Sex differences in maladaptive emotional and behavioral responses to COVID-19: What is the role of personality? Pers Individ Dif 2021; 178:110834. [PMID: 33758454 PMCID: PMC7973079 DOI: 10.1016/j.paid.2021.110834] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 02/07/2023]
Abstract
Males are more non-adherent to public health measures for containing COVID-19 while females experience more COVID-19-related distress. Personality traits may influence both non-adherence and distress. We examined sensation seeking (SS), anxiety sensitivity (AS), impulsivity, and hopelessness as traits potentially associated with non-adherence and distress in response to COVID-19. Furthermore, we sought to understand if known sex differences in SS (male > female) and AS (female > male) may explain sex differences on these two COVID-19 outcomes. In the first month of the pandemic, 400 adults (mean age = 32.16 years; 45.3%F) completed the Substance Use Risk Profile Scale to assess personality. Degree of adherence to public health recommendations and COVID-19-related distress were also measured. Male sex was indirectly related to poorer adherence to stay-at-home advisories via SS, and female sex was indirectly related to higher COVID-19 distress via AS. Personality-targeted interventions may help reduce non-adherence and COVID-19 distress, potentially reducing sex differences.
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Affiliation(s)
- Sarah DeGrace
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax B3H 2E2, NS, Canada
| | | | - Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg R3T 2N2, MB, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, ON M3J 1P3, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, 4700 Keele St, North York, ON M3J 1P3, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto M5S 2S1, ON, Canada
- Department of Psychiatry, University of Toronto, 250 College St., Toronto M5T 1R8, ON, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax B3H 2E2, NS, Canada
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax B3H 4R2, NS, Canada
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30
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Biegun J, Edgerton JD, Keough MT. Are Some Subtypes of Video Gamer More at Risk for Gambling Issues? A Latent Class Analysis of a Canadian Sample of University Students. JGI 2021. [DOI: 10.4309/jgi.2021.46.11] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Recently there has been growing interest in identifying links between video game playing and problem gambling. As video games continue to take on more gambling-like elements such as loot boxes, there is rising concern that they represent a potential pathway towards problem gambling. In this study, we explored video gamer profiles in a sample of Canadian undergraduate university students (n = 687) to examine whether subgroups of gamers had different risk profiles for problem video gaming and/or problem gambling. Three predominant subgroups emerged: universal, free-to-play, and general gamer classes. Whereas the free-to-play class was associated with higher average amounts of time spent playing video games, the universal class was associated with higher average scores on measures of problem video gaming, problem gambling, and impulsivity. Although motivational differences were evident, there were no significant mental health differences among subgroups in this sample.RésuméOn s’intéresse de plus en plus depuis peu de temps à l’établissement de liens entre la pratique des jeux vidéo et le jeu compulsif. À mesure que les jeux vidéo comportent davantage d’éléments de jeux de hasard comme des coffres à butin, on s’inquiète davantage du fait qu’ils puissent mener au jeu compulsif. Cette étude a examiné le profil de joueurs de jeux vidéo parmi un échantillon d’étudiants canadiens de premier cycle (n = 687) afin de déterminer si les sous-groupes de joueurs présentaient un profil de risque différent pour le jeu vidéo compulsif et/ou le jeu compulsif. Trois sous-groupes prédominants sont ressortis : universel, gratuit et général. Le groupe des jeux gratuits était associé à une plus grande quantité de temps consacrée à jouer à des jeux vidéo, le groupe universel était associé pour sa part à un pointage moyen plus élevé au titre des paramètres de mesure du jeu vidéo compulsif, du jeu compulsif et de l’impulsivité. Les différences de motivation étaient évidentes, mais les sous-groupes de cet échantillon ne présentaient aucune différence importante sur le plan de la santé mentale.
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Bilevicius E, Van Landeghem C, Stewart SH, Sherry SB, Keough MT. Trait Impulsivity Impedes Maturing Out of Problem Drinking Among Socially Anxious Undergraduates. Alcohol Alcohol 2021; 56:101-108. [PMID: 33164042 DOI: 10.1093/alcalc/agaa109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/11/2020] [Accepted: 09/27/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS Alcohol use follows a developmental trajectory-steadily increasing and peaking in the early stages of emerging adulthood (e.g. first year of university) and declining thereafter. While most individuals 'mature out' of problem drinking as they move through emerging adulthood, some continue to drink heavily and experience serious problems. Tension reduction theory identifies social anxiety (SA) as a potential risk factor for problem drinking during emerging adulthood. However, mixed data suggest that the associations between SA and drinking behaviours are not straightforward. Cross-sectional studies demonstrate that socially anxious emerging adults are at risk for problem drinking, but only if they are also high in trait impulsivity. This study aimed to expand on previous work by examining trait impulsivity as moderator of the prospective associations between SA and maturing out of problem drinking in emerging adulthood. METHODS Undergraduates (N = 302) completed online self-reports at regular intervals (6-months) over an 18-month period, resulting in four waves of data. RESULTS Unconditional latent growth curve models indicated that alcohol problems (but not use) declined linearly over time. Next, conditional growth curve models revealed that SA was associated with impeded maturing out of alcohol problems, but this effect was only present in socially anxious participants with high levels of trait impulsivity. CONCLUSION Our study advances growing literature on the crucial moderating role that impulsivity plays in the SA pathway to problem drinking. Clinical interventions for problem drinking among socially anxious students should both assess for and target concurrent impulsivity.
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Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Rd., Winnipeg, Manitoba, Canada, R3T 2N2
| | - Chantal Van Landeghem
- Department of Psychology, University of Manitoba, 190 Dysart Rd., Winnipeg, Manitoba, Canada, R3T 2N2
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 8th floor, Abbie J. Lane Building, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia, Canada, B3H 2E2.,Department of Psychology and Neuroscience, Dalhousie University, 6299 South St., Halifax, Nova Scotia, Canada, B3H 3J5
| | - Simon B Sherry
- Department of Psychiatry, Dalhousie University, 8th floor, Abbie J. Lane Building, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia, Canada, B3H 2E2.,Department of Psychology and Neuroscience, Dalhousie University, 6299 South St., Halifax, Nova Scotia, Canada, B3H 3J5
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St., North York, Ontario, Canada, M3J 1P3
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Single A, Keough MT. Examining the Prospective Associations Between Mindfulness Facets and Substance Use in Emerging Adulthood. Alcohol Alcohol 2021; 56:64-73. [PMID: 33151271 DOI: 10.1093/alcalc/agaa112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Emerging adulthood (i.e. ages 18-25) is a developmental phase associated with frequent alcohol and cannabis use, placing this population at risk for substance use problems. Depression and anxiety (i.e. emotional psychopathology) are also prevalent during this phase, and some emerging adults use substances to cope with these negative emotions. Mindfulness-a multifaceted construct-involves being present in a nonjudgmental and nonreactive way. Certain mindfulness facets are particularly relevant in buffering against substance use. A recent longitudinal study [Single A, Bilevicius E, Johnson EA. et al. (2019) Specific facets of trait mindfulness reduce risk for alcohol and drug use among first-year undergraduate students. Mindfulness 10:1269-1279] showed that specific mindfulness facets (i.e. acting with awareness, nonjudging of inner experience and nonreactivity to inner experience) predicted decreased alcohol and drug use in undergraduates. These pathways were explained by low levels of emotional psychopathology. METHODS This study expanded this recent work by using a three time-point longitudinal design and by including measures of both alcohol and cannabis use and related problems. Using MTurk, participants (N = 299) completed online measures of trait mindfulness, depression, anxiety, alcohol and cannabis use and related problems at three time-points, each 2 weeks apart. Structural equation modeling was used to test the hypotheses. RESULTS The acting with awareness and nonjudging of inner experience facets predicted fewer alcohol problems, but not alcohol use, and this effect was mediated by low levels of emotional psychopathology. These results were not supported for cannabis use and problems. CONCLUSION This study demonstrates that there may be differences in the pathways from trait mindfulness to alcohol and cannabis use during emerging adulthood.
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Affiliation(s)
- Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Rd., Winnipeg, MB R3T 2N2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St., North York, Toronto, ON M3J 1P3, Canada
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Bilevicius E, Kempe T, Pankratz L, Wardell JD, Johnson EA, Keough MT. Shame's Associations with Depression and Problem Drinking: An Ecological Momentary Study. Subst Use Misuse 2021; 56:1715-1725. [PMID: 34253147 DOI: 10.1080/10826084.2021.1949616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Depression and problem drinking are comorbid in emerging adulthood, yet the processes that link them are not well understood. Research has argued that shame has a unique influence on the experience of problematic drinking, but this has rarely been assessed at the state level. Using ecological momentary assessments (EMAs), we assessed whether shame, and not guilt, mediated the association between baseline depression and alcohol use and problems. METHODS One hundred and eighty-four emerging adults (Mage= 19.27) completed a 12-day EMA study. Multilevel models were used to test hypotheses. RESULTS In a model with alcohol use as the outcome, there were no significant associations between shame or guilt and alcohol use at the within- or between-subjects level. In a model with alcohol problems as the outcome, guilt was positively associated with alcohol problems but only at the daily level. At the between-subjects level and after controlling for guilt, there was a significant association between depression, shame, and alcohol problems; average levels of shame mediated the association between depression and alcohol problems. In post-hoc reverse directionality models, average alcohol problems mediated the relationship between depression and shame and guilt at the between-person level. No mediation was present for alcohol use. CONCLUSION After controlling for guilt, shame is an emotion that helps explain risk for alcohol problems among depressed emerging adults, which has implications for targeted interventions. Reciprocal associations between shame, guilt, and alcohol problems emerged highlighting the need for more fulsome assessments of shame and guilt in future EMA research.
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Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tyler Kempe
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lily Pankratz
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, Toronto, Ontario, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Edward A Johnson
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Matthew T Keough
- Department of Psychology, York University, Toronto, Ontario, Canada
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Bilevicius E, Single A, Baumgartner C, Bui V, Kempe T, Schaub MP, Stewart SH, MacKillop J, Hodgins DC, Wardell JD, O'Connor R, Read J, Hadjistavropoulos H, Sundstrom C, Keough MT. Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial. Trials 2020; 21:937. [PMID: 33213506 PMCID: PMC7678080 DOI: 10.1186/s13063-020-04867-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 11/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e. targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. METHODS The aim of this two-arm open-label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an 8-week integrated or gambling only control condition. Both conditions will consist of seven online modules following cognitive behavioural therapy and motivational interviewing principles. Our three primary outcomes are (1) the number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e. 8 weeks from baseline), and at follow-up (i.e. 24 weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. DISCUSSION The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a cost-effective and accessible way to improve treatments for co-occurring problem gambling and tobacco use. TRIAL REGISTRATION ClinicalTrials.gov NCT03614884 . Registered on August 3, 2019.
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Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Alanna Single
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Chris Baumgartner
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, CH-8031, Zurich, Switzerland
| | - Van Bui
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Tyler Kempe
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Konradstrasse 32, CH-8031, Zurich, Switzerland
| | - Sherry H Stewart
- Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Abbie J Lane Building, 8th floor, 5909 Veteran's Memorial Lane, Halifax, NS, B3H 3A7, Canada
| | - James MacKillop
- Peter Boris Centre for Addictions Research McMaster University/St. Joseph's Healthcare Hamilton, 1280 Main St West, Hamilton, ON, L8S 4L8, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, 2500 University D NW, Calgary, AB, T2N 1N4, Canada
| | - Jeffrey D Wardell
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Roisin O'Connor
- Department of Psychology, Concordia University, 7141 Sherbrooke W., Montreal, Canada
| | - Jennifer Read
- Department of Psychology, University of Buffalo, 231 Park Hall, Buffalo, NY, 14260-4110, USA
| | | | - Christopher Sundstrom
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, ON, M3J 1P3, Canada.
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McPhee MD, Keough MT, Rundle S, Heath LM, Wardell JD, Hendershot CS. Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic. Front Psychiatry 2020; 11:574676. [PMID: 33192708 PMCID: PMC7661794 DOI: 10.3389/fpsyt.2020.574676] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [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: 06/20/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic. Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing ("pre-social-distancing"), and the 30 days after the start of state-mandated social distancing ("post-social-distancing"). Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.
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Affiliation(s)
- Matthew D. McPhee
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | | | - Samantha Rundle
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Laura M. Heath
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Jeffrey D. Wardell
- Department of Psychology, York University, Toronto, ON, Canada
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Christian S. Hendershot
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
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Wardell JD, Kempe T, Rapinda KK, Single A, Bilevicius E, Frohlich JR, Hendershot CS, Keough MT. Drinking to Cope During COVID-19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking, and Alcohol Problems. Alcohol Clin Exp Res 2020; 44:2073-2083. [PMID: 32870516 DOI: 10.1111/acer.14425] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/24/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic has resulted in massive disruptions to society, to the economy, and to daily life. Some people may turn to alcohol to cope with stress during the pandemic, which may put them at risk for heavy drinking and alcohol-related harms. Research is needed to identify factors that are relevant for coping-motivated drinking during these extraordinary circumstances to inform interventions. This study provides an empirical examination of coping motive pathways to alcohol problems during the early stages of the COVID-19 pandemic. METHODS Participants (N = 320; 54.7% male; mean age of 32 years) were Canadian adult drinkers who completed an online survey assessing work- and home-related factors, psychological factors, and alcohol-related outcomes over the past 30 days, covering a time period beginning within 1 month of the initiation of the COVID-19 emergency response. RESULTS The results of a theory-informed path model showed that having at least 1 child under the age of 18, greater depression, and lower social connectedness each predicted unique variance in past 30-day coping motives, which in turn predicted increased past 30-day alcohol use (controlling for pre-COVID-19 alcohol use reported retrospectively). Income loss was associated with increased alcohol use, and living alone was associated with increased solitary drinking (controlling for pre-COVID-19 levels), but these associations were not mediated by coping motives. Increased alcohol use, increased solitary drinking, and greater coping motives for drinking were all independently associated with past 30-day alcohol problems, and indirect paths to alcohol problems from having children at home, depression, social connectedness, income loss, and living alone were all supported. CONCLUSIONS Findings provide insight into coping-motivated drinking early in the COVID-19 pandemic and highlight the need for longitudinal research to establish longer term outcomes of drinking to cope during the pandemic.
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Affiliation(s)
- Jeffrey D Wardell
- From the Department of Psychology, York University, Toronto, ON, Canada.,Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Tyler Kempe
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Karli K Rapinda
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Alanna Single
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Jona R Frohlich
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Christian S Hendershot
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Matthew T Keough
- From the Department of Psychology, York University, Toronto, ON, Canada
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Marchica LA, Keough MT, Montreuil TC, Derevensky JL. Emotion regulation interacts with gambling motives to predict problem gambling among emerging adults. Addict Behav 2020; 106:106378. [PMID: 32203700 DOI: 10.1016/j.addbeh.2020.106378] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/17/2020] [Accepted: 02/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND It is presently estimated that as much as 10% of emerging adults are at risk for a gambling disorder. The consequences stemming from problematic gambling engagement include increased substance use, mental health disorders, suicidality, financial strain and legal issues. The present study explores whether deficits in specific dimensions of emotion regulation coupled with the motivation to escape negative emotions (i.e., coping motives) increases the likelihood of problem gambling severity, while controlling for variables such as gambling frequency, age, and sex. METHODS A sample of 919 emerging adult gamblers (Mage = 21.16 years-old, SD = 2.90, 48.1% female) completed an online survey including an assessment of problematic engagement in gambling over the past year, gambling motivations, and difficulties in emotion regulation. In total, 15.2% and 8.1% of this sample were at moderate or high risk for gambling disorder. RESULTS A series of six moderation analyses revealed that the total models accounted for approximately 37-38% of the variance in problem gambling and that coping motives interacted with less difficulties engaging in goal-directed behavior, increased lack of emotional clarity, and increased lack of emotional awareness to create a toxic mixture for problem gambling. CONCLUSIONS These findings reveal the importance of considering both psychological factors such as emotion regulation and motivational factors in understanding who is at greatest risk for gambling problems.
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Bilevicius E, Clark CC, Johnson EA, Keough MT. Ashamed and Alone—Risk Factors for Alcohol Craving Among Depressed Emerging Adults. Alcohol Alcohol 2020; 55:540-546. [DOI: 10.1093/alcalc/agaa056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/13/2020] [Accepted: 05/25/2020] [Indexed: 01/29/2023] Open
Abstract
Abstract
Aims
Comorbid alcohol use and depression have the highest prevalence among emerging adults and are associated with a number of consequences. Self-medication theory posits individuals with depression use alcohol to cope with their negative emotions. Preliminary work has investigated the social context of depression-related drinking and found that solitary drinking is a risky, atypical behaviour in emerging adulthood that is associated with alcohol misuse. However, it is unknown about what is unfolding in the moment that is driving depression-related drinking in solitary contexts. Accordingly, we used an experimental study to examine if shame mediated the association between depression and in-lab alcohol craving.
Methods
Emerging adults (N = 80) completed a shame induction followed by an alcohol cue exposure in either a solitary or social condition. We used moderated mediation to test hypotheses.
Results
Consistent with hypotheses, conditional indirect effects supported the mediation of depression and alcohol craving through shame among those in the solitary condition, but not in the social condition. There was no support for guilt as a mediator.
Conclusion
Our study demonstrates that shame is a specific emotional experience that contributes to solitary drinking among depressed emerging adults. It is important to use these results to inform interventions that directly target solitary contexts and shame.
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Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Courtney C Clark
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Edward A Johnson
- Department of Psychology, University of Manitoba, 190 Dysart Rd, Winnipeg, MB, R3T 2N2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele St, North York, ON, M3J 1P3, Canada
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Orui K, Frohlich JR, Stewart SH, Sherry SB, Keough MT. Examining Subgroups of Depression and Alcohol Misuse in Emerging Adults During University: a Replication and Extension Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00325-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Bilevicius E, Sommer JL, Keough MT, El-Gabalawy R. An Examination of Comorbid Generalized Anxiety Disorder and Chronic Pain on Substance Misuse in a Canadian Population-Based Survey. Can J Psychiatry 2020; 65:418-425. [PMID: 31896273 PMCID: PMC7265603 DOI: 10.1177/0706743719895340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Chronic pain and generalized anxiety disorder (GAD) are co-occurring, and both conditions are independently associated with substance misuse. However, limited research has examined the impact of comorbid GAD and chronic pain on substance misuse. The aim of this article was to examine the associations between comorbid GAD and chronic pain conditions compared to GAD only with nonmedical opioid use, drug abuse/dependence, and alcohol abuse/dependence in a Canadian, population-based sample. METHODS Data came from the 2012 Canadian Community Health Survey-Mental Health (N = 25,113). Multiple logistic regressions assessed the associations between comorbid GAD and chronic pain conditions (migraine, back pain, and arthritis) on substance misuse. RESULTS Comorbid GAD + back pain and GAD + migraine were associated with increased odds of nonmedical opioid use compared to GAD only. However, the relationship was no longer significant after controlling for additional chronic pain conditions. No significant relationship was found between GAD + chronic pain conditions with drug or alcohol abuse/dependence. CONCLUSIONS Comorbid GAD + back pain and GAD + migraine have a unique association with nonmedical opioid use in Canadians compared to GAD only, and chronic pain multimorbidity may be driving this relationship. Results emphasize the need for screening for substance misuse and prescription access in the context of GAD and comorbid chronic pain.
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Affiliation(s)
- Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jordana L Sommer
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Matthew T Keough
- Department of Psychology, York University, North York, Ontario, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
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Mills DJ, Marchica L, Keough MT, Derevensky JL. Exploring differences in substance use among emerging adults at-risk for problem gambling, and/or problem video gaming. International Gambling Studies 2020. [DOI: 10.1080/14459795.2020.1752768] [Citation(s) in RCA: 5] [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: 02/08/2023]
Affiliation(s)
- Devin J. Mills
- Department Of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, TX, USA
| | - Loredana Marchica
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | | | - Jeffrey L. Derevensky
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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Marchica LA, Mills DJ, Keough MT, Derevensky JL. Exploring Differences Among Video Gamers With and Without Depression: Contrasting Emotion Regulation and Mindfulness. Cyberpsychol Behav Soc Netw 2020; 23:119-125. [PMID: 31923362 DOI: 10.1089/cyber.2019.0451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Video games are a leisure activity with mass appeal for individuals of all ages. However, for some individuals, playing video games may become problematic and addictive, resulting in negative consequences affecting their physical, social, and psychological well-being. Internet gaming disorder (IGD) has estimated prevalence rates of around 3 percent and has been strongly associated with several psychopathologies, including depression. Given that emotion regulation (ER) and mindfulness are fluid constructs that can be enhanced, the potential for intervention and prevention is considerable. Thus, this study sought to, as a first step in determining clinical relevance, explore the differences in ER, mindfulness, and impulsivity among emerging adult gamers who met criteria for IGD, depression, or both IGD and depression (Dep + IGD). A sample of 1,536 gamers (45 percent male, Mage = 20.45 years old) completed an online survey, including an assessment for IGD, depression, difficulties with ER, impulsivity, and mindfulness. Relative to individuals below IGD and depression cutoffs (control), the clinical groups (IGD, depression, and Dep + IGD) reported greater ER difficulties, higher impulsivity, and lower mindfulness. Finally, relative to the IGD + depression group, the other two clinical groups had fewer difficulties with cognitive impulsivity, whereas the depression group reported more difficulties with strategy use. These results suggest that gamers should be considered a heterogeneous group and that comorbid disorders are important considerations when developing targeted treatments for individuals with IGD.
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Affiliation(s)
- Loredana A Marchica
- Department of Education and Counselling Psychology, McGill University, Montreal, Canada
| | - Devin J Mills
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Matthew T Keough
- Department of Psychology, Faculty of Health, York University, Toronto, Canada
| | - Jeffrey L Derevensky
- Department of Education and Counselling Psychology, McGill University, Montreal, Canada
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Affiliation(s)
- Damien A. Dowd
- Departments of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew T. Keough
- Departments of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, Faculty of Heath, York University, Toronto, ON, Canada
| | - Lorna S. Jakobson
- Departments of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - James M. Bolton
- Departments of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jason D. Edgerton
- Department of Sociology, University of Manitoba, Winnipeg, MB, Canada
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Hadjistavropoulos HD, Mehta S, Wilhelms A, Keough MT, Sundström C. A systematic review of internet-delivered cognitive behavior therapy for alcohol misuse: study characteristics, program content and outcomes. Cogn Behav Ther 2019; 49:327-346. [PMID: 31599198 DOI: 10.1080/16506073.2019.1663258] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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
Alcohol misuse is a common, disabling and costly issue worldwide. Internet-delivered cognitive behavior therapy (ICBT) has the potential to reduce the harms of alcohol misuse, particularly for individuals who are unable or unwilling to access face-to-face therapy. A systematic review was conducted using Medline, CINAHL, EMBASE and PsycINFO databases for all relevant articles published from 1980 to January 2019. Randomized controlled trials (RCTs) were included if (i) an ICBT intervention targeting alcohol misuse was delivered; (ii) participants were aged 18 years or older; and (iii) primary outcomes were quantity of drinking. A qualitative analysis was conducted on the content of the ICBT programs. Fourteen studies met inclusion criteria. Most studies included participants from the general population, while studies conducted within clinic settings with diagnosed individuals were rare. The programs were similar in terms of included modules. Small effects were seen in studies on self-guided ICBT, while therapist-guided ICBT rendered small to large effects. The current review indicates that ICBT has a significant effect in reducing alcohol consumption. Larger studies evaluating ICBT compared to active control groups especially within clinic settings are warranted.
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Affiliation(s)
| | - Swati Mehta
- Department of Physical Medicine and Rehabilitation, Western University , London, Ontario, Canada.,Parkwood Institute Research, Lawson Health Research Institute , London, Ontario, Canada
| | - Andrew Wilhelms
- Department of Psychology, University of Regina , Regina, Saskatchewan, Canada
| | - Matthew T Keough
- Department of Psychology, York University , Toronto, Ontario, Canada
| | - Christopher Sundström
- Department of Psychology, University of Regina , Regina, Saskatchewan, Canada.,Department of Clinical Neuroscience, Center for Psychiatric Research, Karolinska Institutet , Stockholm, Sweden
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Affiliation(s)
| | - Jason D. Edgerton
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, Manitoba, Canada
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Nogueira-Arjona R, Shannon T, Kehayes IL, Sherry SB, Keough MT, Stewart SH. Drinking to keep pace: A study of the moderating influence of extraversion on alcohol consumption similarity in drinking buddy dyads. Addict Behav 2019; 92:69-75. [PMID: 30597333 DOI: 10.1016/j.addbeh.2018.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 11/24/2022]
Abstract
Heavy drinking in college remains a concerning issue due to its association with both health and social risks. While modelling contributes to college students' alcohol use, little work has identified who might be most susceptible to modelling effects. Peterson, Morey, and Higgins (2005) found males high in extraversion were more susceptible than others to matching strangers' drinking levels in a lab-based social drinking context. We sought to replicate and extend these findings by examining the impact of extraversion on social matching of alcohol consumption levels of a drinking buddy in college students' real lives. First, a significant relationship between buddy and target drinking levels was predicted in dyadic drinking situations. Additionally, we hypothesized that target extraversion would positively moderate this buddy- target drinking levels relationship. Data from 149 college student targets (74% F) and their same-sex drinking buddy were collected through online questionnaires examining targets' extraversion levels, and the drinking levels and social drinking context of both dyad members through a 30-day Timeline Followback measure. Linear mixed-effects modelling confirmed the study's first social matching hypothesis, while also revealing that target extraversion positively moderated the relationship between buddy and target daily drinking levels in dyadic drinking contexts. Findings extend those of Peterson et al. (2005) to a real-world (vs. lab-based) context, modelling of a buddy's (vs. stranger's) drinking levels, and a sample including women (vs. all-male). Results provide novel information on extraversion's contributions to modelling of alcohol use that may guide useful modifications to personality-based interventions for reducing college student heavy drinking.
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Quilty LC, Wardell JD, Thiruchselvam T, Keough MT, Hendershot CS. Brief interventions for problem gambling: A meta-analysis. PLoS One 2019; 14:e0214502. [PMID: 30995229 PMCID: PMC6469774 DOI: 10.1371/journal.pone.0214502] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 03/14/2019] [Indexed: 01/18/2023] Open
Abstract
Background Brief interventions have been increasingly investigated to promote early intervention in gambling problems; an accurate estimate of the impact of these interventions is required to justify their widespread implementation. The goal of the current investigation was to evaluate the efficacy of in-person brief interventions for reducing gambling behaviour and/or problems, by quantifying the aggregate effect size associated with these interventions in the published literature to date. Methods Randomized controlled trials including the following design features were identified via systematic review: an adult sample experiencing problems associated with gambling; an in-person individual psychosocial intervention of brief duration (≤3 sessions); a control/comparison group; and an outcome related to gambling behaviour and/or problems. Results Five records compared brief interventions to assessment only control; using a random effect model, brief interventions were associated with a small but statistically significant reduction in gambling behaviour across short-term follow-up periods versus assessment only control (g = -.19, 95% CI [-.37, -.01]). Aggregate effect sizes for gambling problems and long-term follow-up periods were not statistically significant. Five records compared brief interventions to longer active interventions; there was no significant difference between brief interventions and longer active interventions. Conclusions Results supported the efficacy of brief interventions for problem gambling compared to inactive control in the reduction of gambling behaviour; no differences were found across brief versus longer interventions for both gambling behaviour and problems. While these findings must be interpreted in the context of the limited number of studies and small magnitude of the combined effect sizes, the current meta-analysis supports the further investigation of the public health impact of these cost-effective interventions.
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Affiliation(s)
- Lena C. Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- * E-mail:
| | - Jeffrey D. Wardell
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Thulasi Thiruchselvam
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Christian S. Hendershot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Bristow LA, Bilevicius E, Stewart SH, Goldstein AL, Keough MT. Solitary gambling mediates the risk pathway from anxiety sensitivity to excessive gambling: Evidence from a longitudinal ecological momentary assessment study. Psychol Addict Behav 2019; 32:689-696. [PMID: 30211589 DOI: 10.1037/adb0000395] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anxiety and gambling problems co-occur at high rates. Social learning theory (SLT) suggests that people high in anxiety engage in excessive gambling to reduce negative affect. Because anxiety sensitivity (AS) is a vulnerability factor associated with addictive behaviors, it is important to identify mediators in this high-risk pathway. Emerging research shows that social context mediates associations between anxiety vulnerability and addictive behaviors. This literature shows that anxiety-prone people are at increased risk for substance problems because they engage in frequent solitary substance use. Theory would predict a similar pathway to gambling problems, but this remains to be tested. Accordingly, this study aimed to examine solitary gambling as an explanatory variable in the anxiety pathway to gambling problems. We used a longitudinal ecological momentary assessment (EMA) design. After completing baseline measures, young adults (N = 108) were asked to report daily on their gambling behavior over a 30-day period. Bias corrected bootstrapped confidence intervals (CI) supported 1 hypothesized indirect effect from baseline AS (Time 1) to EMA time spent gambling (Time 2) via EMA solitary gambling (Time 2; B = 0.019, 95% CI [0.002, 0.045]). This suggests that emerging adults with high levels of AS at baseline engaged in frequent solitary gambling over the 30-day EMA sampling period, which in turn predicted more time spent gambling over this same time period. Our results show that solitary gambling mediates the relation between anxiety vulnerability and excessive gambling. Understanding how social context relates to excessive gambling can help create interventions to reduce solitary gambling among anxiety-prone individuals. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Abby L Goldstein
- Department of Applied Psychology and Human Development, University of Toronto
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Bilevicius E, Single A, Rapinda KK, Bristow LA, Keough MT. Frequent solitary drinking mediates the associations between negative affect and harmful drinking in emerging adults. Addict Behav 2018; 87:115-121. [PMID: 30005333 DOI: 10.1016/j.addbeh.2018.06.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/23/2018] [Accepted: 06/25/2018] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Depression and anxiety are highly comorbid conditions that are associated with harmful drinking. Social learning theory proposes that depressed or anxious individuals learn that drinking can reduce negative affect, which makes them susceptible to harmful drinking. Consistent with theory, evidence suggests that negative affect increases risk for harmful drinking. But, less is known about mediators of negative affect-pathways to harmful drinking. Research has demonstrated that solitary drinking is an underlying mechanism of harmful drinking among emerging adults with high levels of negative affect. However, much of this work is cross-sectional. We conducted a longitudinal study to examine solitary drinking as a key explanatory variable in the negative-affect pathway to harmful drinking. METHODS Emerging adults (N = 308) completed online self-reports of depression and anxiety at Time 1 (the beginning of their first semester in university), and drinking context and harmful drinking at Time 2 (the end of their first semester of university). RESULTS Structural equation modeling supported indirect effects from negative affect to harmful drinking via solitary drinking. Specifically, emerging adults with high levels of negative affect at the beginning of their first semester engaged in frequent solitary drinking over the rest of the semester, and subsequently experienced increased harmful drinking (controlling for Time 1 solitary/social drinking and harmful use). Social drinking was not a mediator of this effect. CONCLUSIONS The findings reveal that solitary drinking uniquely mediated the relation between negative affect and harmful drinking. Reducing solitary drinking might mitigate negative affect-related risk for harmful drinking in emerging adults.
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Hendershot CS, Wardell JD, Vandervoort J, McPhee MD, Keough MT, Quilty LC. Randomized trial of working memory training as an adjunct to inpatient substance use disorder treatment. Psychol Addict Behav 2018; 32:861-872. [PMID: 30475014 DOI: 10.1037/adb0000415] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite interest in computerized working memory training as a transdiagnostic intervention, little is known about its feasibility and efficacy in addiction treatment settings. This double-blind, randomized controlled trial examined the efficacy of working memory training for improving performance on standardized measures of executive function during inpatient substance use disorder treatment. Secondary outcomes included delay discounting, adherence to cognitive training, and posttreatment relapse. Adults (N = 110) entering inpatient alcohol or drug treatment were randomized to active (adaptive) or control (nonadaptive) training conditions, with up to 25 training sessions spanning inpatient and postdischarge phases. In generalized estimating equation (GEE) analyses, the experimental group showed relatively greater improvements on the primary outcome (digit span performance) based on Time × Treatment interactions in per-protocol (p < .05) and intent-to-treat (p = .07) models. Similar results were observed for one secondary outcome. Lower working memory performance at baseline predicted significantly greater delay discounting; however, no time or treatment effects on discounting were observed. Adherence to cognitive training was generally good during inpatient treatment, but suboptimal overall. These results suggest that implementing cognitive training is feasible in inpatient settings, and that adaptive working memory training can potentially lead to near-transfer effects for select cognitive outcomes. However, further work is necessary to establish training effects on clinical outcomes and to improve adherence in outpatient contexts. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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