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Journal of Behavioral Addictions
Authors: Dominic Sagoe, Mark. D. Griffiths, Eilin Kristine Erevik, Turid Høyland, Tony Leino, Ida Alette Lande, Mie Engen Sigurdsson, and Ståle Pallesen

Abstract

Background and aims

The effect of internet-based psychological treatment for gambling problems has not been previously investigated by meta-analysis. The present study is therefore a quantitative synthesis of studies on the effects of internet-based treatment for gambling problems. Given that effects may vary according to the presence of therapist support and control conditions, it was presumed that subgroup analyses would elucidate such effects.

Methods

A systematic search with no time constraints was conducted in PsycINFO, MEDLINE, Web of Science, and the Cochrane Library. Two authors independently extracted data using a predefined form, including study quality assessment based on the Cochrane risk of bias tool. Effect sizes were calculated using random-effects models. Heterogeneity was indexed by Cochran’s Q and the I 2 statistics. Publication bias was investigated using trim and fill.

Results

Thirteen studies were included in the analysis. Random effects models at post-treatment showed significant effects for general gambling symptoms (g = 0.73; 95% CI = 0.43–1.03), gambling frequency (g = 0.29; 95% CI = 0.14–0.45), and amount of money lost gambling (g = 0.19; 95% CI = 0.11–0.27). The corresponding findings at follow-up were g = 1.20 (95% CI = 0.79–1.61), g = 0.36 (95% CI = 0.12–0.60), and g = 0.20 (95% CI = 0.12–0.29) respectively. Subgroup analyses showed that for general gambling symptoms, studies with therapist support yield larger effects than studies without, both post-treatment and at follow-up. Additionally, on general gambling symptoms and gambling frequency, there were lower effect sizes for studies with a control group compared to studies without a control group at follow-up. Studies with higher baseline severity of gambling problems were associated with larger effect sizes at both posttreatment and follow-up than studies with more lenient inclusion criteria concerning gambling problems.

Discussion and conclusions

Internet-based treatment has the potential to reach a large proportion of persons with gambling problems. Results of the meta-analysis suggest that such treatments hold promise as an effective approach. Future studies are encouraged to examine moderators of treatment outcomes, validate treatment effects cross-culturally, and investigate the effects of novel developments such as ecological momentary interventions.

Open access

Abstract

Background and aims

Mobile phone addiction (MPA) has recently aroused much attention due to its high incidence and considerable health hazards. Although some existing studies have documented that physical activity is negatively associated with MPA, it is little known about the potential effects underlying this relation. The aim of this study was to investigate the relationship between physical activity and MPA among undergraduates in China, and to further examine the moderating effect of exercise type in the relation between them.

Methods

By the quota sampling, a total of 650 participants engaged in this survey and completed relevant measurements including physical activity rating scale-3 (PARS-3) and mobile phone addiction tendency scale (MPATS).

Results

Gender (β = 0.271, P < 0.05) and major (β = −0.169, P < 0.05) could significantly predict MPA, respectively, and physical activity was an imperative protective factor to decrease MPA (β = −0.266, P < 0.001). While the physical activity level enhanced from none exercise to medium exercise, an optimum dose-response relationship would emerge between physical activity and MPA (F (3,604) = 4.799, P < 0.01). Most important, the relation between physical activity and MPA can be moderated by exercise type. Especially in terms of aerobic endurance exercise, the higher level of physical activity the undergraduates performed, the lower degree of MPA would be suffered by them (β = −0.266, P < 0.001).

Discussion

These findings could be conducive to better understand the positive and potential effects of physical activity on the intervention in MPA, and served as a persuasive evidence that as for university students, actively engaging in aerobic endurance exercise with the medium activity level would be a practicable exercise strategy to deal with MPA in daily lifestyle behavior.

Open access

Abstract

Background

Gamblers engage in a range of “soft” financial options to limit access to money or cash for gambling (e.g., family looks after cash). Such barriers are easily overturned, resulting in a demand for financial systems and tools that offer “hard” restrictions on access to money and cash in a gambling context. The aim of this scoping review was to determine the attitudes and preferences of gamblers and their families on systems or tools to restrict access to money and cash, as well as the effectiveness of systems and tools that can be used to accomplish that goal.

Methods

A systematic search of articles related to financial restrictions and gambling was conducted. Eligibility criteria included samples of gamblers or affected others and interventions targeted at money or cash restrictions in a gambling context. Soft financial barriers such as family involvement were excluded, as were limit-setting systems which focused on gambling expenditure in gambling venues.

Results

Nine studies met the eligibility criteria, with three focused on financial systems (e.g., ban on credit betting) and six focused on removal of cash machines from gambling venues. The included literature was generally of low quality, with just two pre-post studies and seven cross-sectional or qualitative ones.

Conclusions

The included studies provided strong support for financial mechanisms to support gamblers and their families. Future studies need to involve multiple stakeholders to provide this type of support as well as to evaluate the holistic impact that such hard barriers can have on gambling and gambling-related harms.

Open access
Journal of Behavioral Addictions
Authors: Beáta Bőthe, Mónika Koós, Léna Nagy, Shane W. Kraus, Marc N. Potenza, and Zsolt Demetrovics

Abstract

Background and aims

Limitations of research into sexuality and compulsive sexual behavior disorder (CSBD) include the use of simplistic methodological designs and the absence of quality and unified measurements, empirically supported theoretical models, and large, collaborative studies between laboratories. We aim to fill these gaps with the International Sex Survey (ISS, http://internationalsexsurvey.org/).

Methods

The ISS is a large-scale, international, multi-lab, multi-language study using cross-sectional survey methods, involving more than 40 countries. Participants responding to advertisements complete a self-report, anonymous survey on a secure online platform. Collaborators from each country collect a community sample of adults with a minimum sample size of 2,000 participants with a gender ratio of approximately 50–50% men and women, including diverse individuals with respect to sexuality and gender. The ISS includes a wide range of sociodemographic questions and scales assessing a diverse set of sexual behaviors, pornography use, psychological characteristics, and potential comorbid disorders. Analyses are conducted within a structural equation modeling framework, including variable (e.g., measurement invariance tests) and person-centered approaches (e.g., latent profile analysis).

Discussion and conclusions

The ISS will provide well-validated, publicly available screening tools, helping to eliminate significant measurement issues in the field of sexuality research and health care. It will provide important insights to improve the theoretical understanding of CSBD as well as help to identify empirically supported treatment targets for prevention and intervention programs. Following open-science practices and making study materials open-access, the ISS may serve as a blueprint for future large-scale research in addiction and sexuality research.

Open access
Journal of Behavioral Addictions
Authors: Irene Montiel, Jéssica Ortega-Barón, Arantxa Basterra-González, Joaquín González-Cabrera, and Juan Manuel Machimbarrena

Abstract

Background and aims

Despite its illegality among adolescents, online gambling is a common practice, which puts their mental health and well-being at serious risk. This systematic review summarises international scientific literature from the last 20 years on problematic online gambling among adolescents (11–21 years old) to determine its prevalence and to analyse related measurement issues.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, IC: CRD42020162932). Five academic databases were consulted, which resulted in an initial sample of 658 papers.

Results

Sixteen studies met the inclusion criteria for this review. All studies were cross-sectional and targeted students from elementary school, secondary school or university. Most followed a convenience sampling procedure. The primary measurement instruments used were the DSM-IV-MR-J and SOGS-RA. Between 0.77% and 57.5% of adolescents present some degree of problematic online gambling (problem, pathological or disordered) depending on the instruments used, the study samples and the timeframe analysed. Between 0.89% and 1% of adolescents exhibited an online gambling disorder.

Discussion and conclusion

There is a great heterogeneity in the methodology of the reviewed studies (samples, measurement instruments, cut-off points and criteria applied). The limited number of studies and the limited generalizability of their results suggest the need for further research and for development of specific instruments to assess different levels of problematic online gambling in representative samples of adolescents based on clinical ‘gold standard’ criteria and more accurate cut-off points.

Open access
Journal of Behavioral Addictions
Authors: Daniela Röttinger, Gallus Bischof, Dominique Brandt, Anja Bischof, Svenja Orlowski, Bettina Besser, Elisa Wegmann, Matthias Brand, and Hans-Jürgen Rumpf

Abstract

Background and aims

An increasing number of people experience negative consequences from the excessive use of different Internet applications or sites (e.g., Instagram, League of Legends, YouTube). These consequences have been referred to as specific Internet Use Disorders (IUDs). The present study aims to examine the Fear of Missing Out (FoMO) on rewarding experiences with respect to specific Internet activities. FoMO has been found to mediate the link between psychopathology and symptoms of Internet Communication Disorder (ICD). However, the role of FoMO in other IUDs is controversial.

Methods

The current study (N = 7,990) consecutively screened in vocational schools) analyzed the associations between online-specific state-FoMO, general trait-FoMO, mental health, and IUD symptoms in a structural equation model. After testing the model for the entire sample of Internet users, it was analyzed separately for the two main user groups: Social Networking Site (SNS) users and gamers.

Results

The proposed model explained 42.0% of the variance in IUD symptoms in the total sample, 46.8% for SNS users, and 32.8% for gamers. Results suggest that impaired mental health and high trait-FoMO predict IUD symptoms. For both SNS users and gamers, trait-FoMO mediated the link between low mental health and IUD, whereas state-FoMO mediated the link between trait-FoMO and IUD in both user groups.

Discussion

Our results partly support the theoretical model of specific IUDs, highlighting trait-FoMO as a predisposing fear of disconnection related to general mental health. Online-specific FoMO appears to contribute to problematic Internet use mainly because of its link to the general fear of disconnection. Moreover, the described mechanism seems to be comparable for both females and males.

Conclusions

FoMO is a multidimensional construct underlying IUD symptoms related to the use of socially gratifying, but distinct Internet applications. FoMO and psychopathology should be targeted together in prevention and treatment plans of IUDs.

Open access

Abstract

Psychedelic-assisted psychotherapy is an emerging psychiatric treatment that is attracting significant scientific, medical, and public attention. Whilst preliminary results from empirical studies are promising, the medical use of these compounds is highly controversial. Surprisingly, and despite the current controversies caused by the re-medicalisation of psychedelics, bioethicists have remained mysteriously silent. This paper aims to stimulate further bioethical reflection regarding the re-medicalisation of psychedelics. The current paper aims to do this by applying a normative phenomenological lens of analysis. Namely, this paper applies Martin Heidegger's critique of modern technology, and Fredrik Svenaeus' extension of this critique, to the re-medicalisation of psychedelics. I argue that when this critique of modern technology is applied several normative issues become apparent. Specifically, it becomes apparent that the re-medicalisation of psychedelics risks turning the ecological sources, cultural contexts, and experiences induced by psychedelics into resources to be exploited for human goals; all of which risks endangering ecosystems, appropriating traditional knowledge, and reducing the therapeutic effects of psychedelic-assisted psychotherapy. Furthermore, I suggest that preserving non-reductionist, non-instrumentalising traditional ways of understanding psychedelic compounds is essential in mitigating these consequences. More discussion by bioethicists is necessary as these consequences represent important global challenges for the psychedelic renaissance that require immediate addressing.

Open access
Journal of Behavioral Addictions
Authors: I-Hua Chen, Chao-Ying Chen, Chieh-hsiu Liu, Daniel Kwasi Ahorsu, Mark D. Griffiths, Yu-Pin Chen, Yi-Jie Kuo, Chung-Ying Lin, Amir H. Pakpour, and Shu-Mei Wang

Abstract

Background and aims

The present longitudinal study examined the changes in problematic internet use (problematic smartphone use, problematic social media use, and problematic gaming) and changes in COVID-19-related psychological distress (fear of COVID-19 and worry concerning COVID-19) across three time-points (before the COVID-19 outbreak, during the initial stages of the COVID-19 outbreak, and during the COVID-19 outbreak recovery period).

Methods

A total of 504 Chinese schoolchildren completed measures concerning problematic internet use and psychological distress across three time-points. Latent class analysis (LCA) was used to classify participants into three groups of problematic internet use comprising Group 1 (lowest level), Group 2 (moderate level), and Group 3 (highest level).

Results

Statistical analyses showed that as problematic use of internet-related activities declined among Group 3 participants across the three time points, participants in Group 1 and Group 2 had increased problematic use of internet-related activities. Although there was no between-group difference in relation to worrying concerning COVID-19 infection, Groups 2 and 3 had significantly higher levels of fear of COVID-19 than Group 1 during the COVID-19 recovery period. Regression analysis showed that change in problematic internet use predicted fear of COVID-19 during the recovery period.

Conclusion

The varied levels of problematic internet use among schoolchildren reflect different changing trends of additive behaviors during COVID-19 outbreak and recovery periods.

Open access

Abstract

Background and aims

Cited in over 100 articles, the interactional model of exercise addiction (Egorov & Szabo, 2013) forms the theoretical foundation of many studies on the risk of exercise addiction. Still, the inclusion of previously omitted determinants could make it more useful. Therefore, this review presents the expanded version of the original model.

Method

We added ‘self-concept’ as another determinant in the ‘personal factors’ domain and ‘attractive alternatives’ to the ‘situational factors’ domain. Further, we doubled the reasons for exercise in the ‘incentives for exercise domain.’ Last, we added a new domain, the ‘exercise-related stressors,’ to illustrate that exercise itself might be a source of stress.

Results

The expanded model is more inclusive and accounts for a greater combination of interactions playing roles in exercise addiction. Overlooking the eventuality that stress resulting from exercise might also fuel the dysfunction was a significant omission from the original model, rectified in the current update. Finally, the new expansions make the model more applicable to competitive situations too

Conclusion

The expanded interactional model of exercise addiction is more comprehensive than its original version. It also accounts for the exercise or sport-related stress as possible fuel in addictive exercise behavior.

Open access

Abstract

The recently published Imperial College study of a Phase II, double-blind, randomized, controlled trial comparing psilocybin-assisted therapy to a six-week titration of escitalopram for Major Depressive Disorder (MDD) should raise concerns for this illness category as a target of early psychedelic research given a goal of FDA approval. There are three reasons why MDD is the wrong target at this stage of research development. Firstly, the psychiatric category of MDD is heterogeneous, vaguely-defined, and overdiagnosed in a way that will problematize finding a reliable signal with psychedelic interventions (or any intervention), particularly within non-severe cases. Secondly, current rating scales for MDD (QIDS used in the Imperial College trial, but also HAM-D) are limited in approximating the kinds of things we ultimately care most about with depressive states, namely functional status, quality of life, and well-being: measures that seem more salient for psychedelic interventions and which are not adequately captured by these rating scales used in a majority of clinical trials. And thirdly, there are inherent conflicts between psychiatric conceptualizations of MDD (and its symptom amelioration) and the kinds of perspectives on one’s suffering often occasioned by psychedelic experiences themselves: while these kinds of psychedelic-catalyzed openings may lead to a form of acceptance or equanimity with regards to one’s life circumstances this could be in many ways orthogonal to reductions in HAM-D scores. We argue that for these reasons MDD is a non-ideal target at this stage of the science and propose alternative directions.

Open access