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Authors: Arundhuti Das, Luca Pagliaroli, Andrea Vereczkei, Eszter Kotyuk, Banrida Langstieh, Zsolt Demetrovics and Csaba Barta

Background and aims

Some form of gambling can be observed in nearly every society, as the gratification felt upon winning in uncertain conditions is universal. A culturally distinct form of gambling, associated with a traditional sporting event of archery known as “teer,” is innate to the province of Meghalaya, India. The objective of this study was to find genetic variants underlying this unique form of behavioral addiction. To better understand game-based gambling, we studied genetic variants related to dopaminergic pathways and other genes previously linked to various psychological disorders.

Methods

This study was carried out on a sample of 196 Indo-Aryan adults from Shillong, Meghalaya. Genotyping of glial cell line-derived neurotrophic factor (GDNF) polymorphisms was carried out using real-time PCR. We further investigated 32 single nucleotide polymorphisms located in the 3′ UTR of additional genes of interest using an OpenArray® real-time PCR platform.

Results

Case–control analysis revealed a significant association between GDNF variant rs2973033 (p = .00864, χ2 = 13.132, df = 2) and contactin-associated protein-like 2 (CNTNAP2) variant rs2530311 (p = .0448, χ2 = 13.132, df = 2) with gambling.

Discussion and conclusions

Association of the GDNF gene with gambling could be attributed to its involvement in the development and survival of dopaminergic neurons. Our result is in good agreement with previous data indicating the role of GDNF in certain substance addictions. Several rare variants in the CNTNAP2 gene were also implicated in alcohol addiction in a previous study. This pilot study provides further support for the role of GDNF and CNTNAP2 in addiction behaviors.

Open access
Authors: Ildikó Tombor, Borbála Paksi, Róbert Urbán, Bernadette Kun, Petra Arnold, Sándor Rózsa and Zsolt Demetrovics

Tanulmányunkban áttekintjük a magyar felnőtt lakosság körében készült, a dohányzás prevalenciáját becslő országos reprezentatív felméréseket. Célkitűzés: Az Országos lakossági adatfelvétel az addiktológiai problémákról (OLAAP) felmérés dohányzásra vonatkozó eredményeinek bemutatása, valamint ezek összevetése a korábbi vizsgálatok eredményeivel. Módszer: A kutatás célpopulációja a 18–64 éves magyarországi népesség. A nettó minta nagysága 2710 fő volt. Az adatfelvétel részben személyes kérdezéssel, részben önkitöltős módszerrel történt. Eredmények: A magyar felnőtt lakosság 36,1%-a dohányzik (29,9%-a napi rendszerességgel). A nemi arányokat tekintve a férfiak 40,6%-a, míg a nők 31,7%-a dohányos (a napi dohányosok aránya nemek szerint 34,6%, illetve 25,3%). A dohányzás szempontjából kockázati tényezőként azonosítható a férfi nem, az alacsonyabb életkor, az alacsonyabb iskolai végzettség, a kedvezőtlenebb szocioökonómiai státus, valamint a szülők dohányzása. Következtetések: Eredményeink a korábbi évek heterogén eredményei közül a magasabb dohányzási prevalenciákat támasztják alá, illetve enyhe mértékű növekedést feltételeznek, amiért a dohányzás nők körében történt emelkedése felelős. A férfiak esetében stagnálás figyelhető meg.

Restricted access
Authors: Eszter Kotyuk, Anna Magi, Andrea Eisinger, Orsolya Király, Andrea Vereczkei, Csaba Barta, Mark D. Griffiths, Anna Székely, Gyöngyi Kökönyei, Judit Farkas, Bernadette Kun, Rajendra D. Badgaiyan, Róbert Urbán, Kenneth Blum and Zsolt Demetrovics

Abstract

Background and aims

Changes in the nomenclature of addictions suggest a significant shift in the conceptualization of addictions, where non-substance related behaviors can also be classified as addictions. A large amount of data provides empirical evidence that there are overlaps of different types of addictive behaviors in etiology, phenomenology, and in the underlying psychological and biological mechanisms. Our aim was to investigate the co-occurrences of a wide range of substance use and behavioral addictions.

Methods

The present epidemiological analysis was carried out as part of the Psychological and Genetic Factors of the Addictive Behaviors (PGA) Study, where data were collected from 3,003 adolescents and young adults (42.6% males; mean age 21 years). Addictions to psychoactive substances and behaviors were rigorously assessed.

Results

Data is provided on lifetime occurrences of the assessed substance uses, their co-occurrences, the prevalence estimates of specific behavioral addictions, and co-occurrences of different substance use and potentially addictive behaviors. Associations were found between (i) smoking and problematic Internet use, exercising, eating disorders, and gambling (ii) alcohol consumption and problematic Internet use, problematic online gaming, gambling, and eating disorders, and (iii) cannabis use and problematic online gaming and gambling.

Conclusions

The results suggest a large overlap between the occurrence of these addictions and behaviors and underlies the importance of investigating the possible common psychological, genetic and neural pathways. These data further support concepts such as the Reward Deficiency Syndrome and the component model of addictions that propose a common phenomenological and etiological background of different addictive and related behaviors.

Open access
Authors: Máté Kapitány-Fövény, Róbert Urbán, Gábor Varga, Marc N. Potenza, Mark D. Griffiths, Anna Szekely, Borbála Paksi, Bernadette Kun, Judit Farkas, Gyöngyi Kökönyei and Zsolt Demetrovics

Abstract

Background and aims

Due to its important role in both healthy groups and those with physical, mental and behavioral disorders, impulsivity is a widely researched construct. Among various self-report questionnaires of impulsivity, the Barratt Impulsiveness Scale is arguably the most frequently used measure. Despite its international use, inconsistencies in the suggested factor structure of its latest version, the BIS-11, have been observed repeatedly in different samples. The goal of the present study was therefore to test the factor structure of the BIS-11 in several samples.

Methods

Exploratory and confirmatory factor analyses were conducted on two representative samples of Hungarian adults (N = 2,457; N = 2,040) and a college sample (N = 765).

Results

Analyses did not confirm the original model of the measure in any of the samples. Based on explorative factor analyses, an alternative three-factor model (cognitive impulsivity; behavioral impulsivity; and impatience/restlessness) of the Barratt Impulsiveness Scale is suggested. The pattern of the associations between the three factors and aggression, exercise, smoking, alcohol use, and psychological distress supports the construct validity of this new model.

Discussion

The new measurement model of impulsivity was confirmed in two independent samples. However, it requires further cross-cultural validation to clarify the content of self-reported impulsivity in both clinical and nonclinical samples.

Open access
Authors: Beáta Bőthe, Marc N. Potenza, Mark D. Griffiths, Shane W. Kraus, Verena Klein, Johannes Fuss and Zsolt Demetrovics

Abstract

Background

Compulsive Sexual Behavior Disorder (CSBD) is included in the eleventh edition of The International Classification of Diseases (ICD-11) as an impulse-control disorder.

Aims

The aim of the present work was to develop a scale (Compulsive Sexual Behavior Disorder Scale–CSBD-19) that can reliably and validly assess CSBD based on ICD-11 diagnostic guidelines.

Method

Four independent samples of 9,325 individuals completed self-reported measures from three countries (the United States, Hungary, and Germany). The psychometric properties of the CSBD-19 were examined in terms of factor structure, reliability, measurement invariance, and theoretically relevant correlates. A potential threshold was determined to identify individuals with an elevated risk of CSBD.

Results

The five-factor model of the CSBD-19 (i.e., control, salience, relapse, dissatisfaction, and negative consequences) had an excellent fit to the data and demonstrated appropriate associations with the correlates. Measurement invariance suggested that the CSBD-19 functions similarly across languages. Men had higher means than women. A score of 50 points was found as an optimal threshold to identify individuals at high-risk of CSBD.

Conclusions

The CSBD-19 is a short, valid, and reliable measure of potential CSBD based on ICD-11 diagnostic guidelines. Its use in large-scale, cross-cultural studies may promote the identification and understanding of individuals with a high risk of CSBD.

Open access
Authors: Bence András Lázár, Ildikó Katalin Pribék, Csenge Kovács, Ildikó Demeter, János Kálmán, János Szemelyácz, Gábor Kelemen, Zoltán Janka, Zsolt Demetrovics and Bálint Andó

Absztrakt:

Bevezetés és célkitűzés: Alkoholbetegek egészségügyi ellátása során az alkoholfogyasztás csökkentésével vagy annak elhagyásával alkohol okozta megvonási szindróma alakulhat ki. Jelenleg hazánkban nem áll rendelkezésre olyan standardizált mérőeszköz, amellyel az alkoholmegvonás tünetei mérhetők lennének. A nemzetközi szakirodalom, illetve irányelvek a megvonás tüneteinek monitorozására elsődlegesen a Clinical Institute Withdrawal Assessment of Alcohol, Revised mérőeszközt ajánlják, melynek hazai bevezetése hiánypótlónak tekinthető. A jelen vizsgálat célja a Clinical Institute Withdrawal Assessment of Alcohol, Revised hazai változata (Alkohol Megvonási Skála) pszichometriai mutatóinak feltárása, illetve a mérőeszköz alkalmazásának bemutatása. Módszer: A vizsgálat a Szegedi Tudományegyetem Pszichiátriai Klinikájára alkohol okozta megvonási szindróma iránydiagnózissal osztályra felvett páciensek (n = 30) körében történt, utánkövetéses elrendezésben. Kétnaponta, hat alkalommal került felvételre az Alkohol Megvonási Skála, illetve mellette a Klinikai Globális Összbenyomás – Súlyosság Skála. A felvételek során kapott átlagok összehasonlítása ismételt méréses varianciaanalízissel történt. Belső konzisztenciai mutatók (Cronbach-alfa, tétel-totál korreláció), konvergens és divergens validitási mutatók (Alkohol Megvonási Skála, illetve a Klinikai Globális Összbenyomás – Súlyosság Skála közötti Pearson korrelációs elemzés alapján) kerültek kiszámításra. Eredmények: Szignifikáns csökkenés volt megfigyelhető a 6 adatfelvételi időpontban az Alkohol Megvonási Skála (F = 202,46, p<0,001), illetve a Klinikai Globális Összbenyomás – Súlyosság Skála (F = 503,04, p<0,001) pontszámainak esetében. A Cronbach-alfa-értékek az első 3 mérési napon 0,7 felett voltak. Az egy időben felvett Alkohol Megvonási Skála és a Klinikai Globális Összbenyomás – Súlyosság Skála minden esetben 0,45 feletti korrelációt mutatott. Következtetés: Az Alkohol Megvonási Skála megbízható és érvényes mérőeszköz a megvonási tünetek részletes szimptomatológiai vizsgálatára. Így lehetővé teszi a hazai betegellátási gyakorlatban az alkoholmegvonás tüneteinek felismerését és súlyosságának meghatározását. Orv Hetil. 2019; 160(30): 1184–1192.

Open access
Authors: Orsolya Király, Mark D. Griffiths, Daniel L. King, Hae-Kook Lee, Seung-Yup Lee, Fanni Bányai, Ágnes Zsila, Zsofia K. Takacs and Zsolt Demetrovics

Background and aims

Empirical research into problematic video game playing suggests that overuse might cause functional and psychological impairments for a minority of gamers. Therefore, the need for regulation in the case of video games (whether governmental or self-imposed) has arisen but has only been implemented in a few countries around the world, and predominantly in Asia. This paper provides a systematic review of current and potential policies addressing problematic gaming.

Methods

After conducting a systematic search in the areas of prevention, treatment, and policy measures relating to problematic Internet and video game use, papers were selected that targeted problematic gaming policies (N = 12; six in English and six in Korean). These papers served as the basis of this review.

Results

Policies were classified into three major groups: (i) policy measures limiting availability of video games (e.g., shutdown policy, fatigue system, and parental controls), (ii) measures aiming to reduce risk and harm (e.g., warning messages), and (iii) measures taken to provide help services for gamers. Beyond the attempt to classify the current and potential policy measures, the authors also tried to evaluate their efficiency theoretically and (if data were available) empirically.

Discussion and conclusions

Overall, it appears that although several steps have been taken to address problematic video game playing, most of these steps were not as effective as expected, or had not been evaluated empirically for efficacy. The reason for this may lie in the fact that the policies outlined only addressed or influenced specific aspects of the problem instead of using a more integrative approach.

Open access
Authors: Olatz Lopez-Fernandez, Daria J. Kuss, Lucia Romo, Yannick Morvan, Laurence Kern, Pierluigi Graziani, Amélie Rousseau, Hans-Jürgen Rumpf, Anja Bischof, Ann-Kathrin Gässler, Adriano Schimmenti, Alessia Passanisi, Niko Männikkö, Maria Kääriänen, Zsolt Demetrovics, Orsolya Király, Mariano Chóliz, Juan José Zacarés, Emilia Serra, Mark D. Griffiths, Halley M. Pontes, Bernadeta Lelonek-Kuleta, Joanna Chwaszcz, Daniele Zullino, Lucien Rochat, Sophia Achab and Joël Billieux

Background and aims

Despite many positive benefits, mobile phone use can be associated with harmful and detrimental behaviors. The aim of this study was twofold: to examine (a) cross-cultural patterns of perceived dependence on mobile phones in ten European countries, first, grouped in four different regions (North: Finland and UK; South: Spain and Italy; East: Hungary and Poland; West: France, Belgium, Germany, and Switzerland), and second by country, and (b) how socio-demographics, geographic differences, mobile phone usage patterns, and associated activities predicted this perceived dependence.

Methods

A sample of 2,775 young adults (aged 18–29 years) were recruited in different European Universities who participated in an online survey. Measures included socio-demographic variables, patterns of mobile phone use, and the dependence subscale of a short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ; Billieux, Van der Linden, & Rochat, 2008).

Results

The young adults from the Northern and Southern regions reported the heaviest use of mobile phones, whereas perceived dependence was less prevalent in the Eastern region. However, the proportion of highly dependent mobile phone users was more elevated in Belgium, UK, and France. Regression analysis identified several risk factors for increased scores on the PMPUQ dependence subscale, namely using mobile phones daily, being female, engaging in social networking, playing video games, shopping and viewing TV shows through the Internet, chatting and messaging, and using mobile phones for downloading-related activities.

Discussion and conclusions

Self-reported dependence on mobile phone use is influenced by frequency and specific application usage.

Open access
Authors: Matthias Brand, Hans-JÜrgen Rumpf, Zsolt Demetrovics, Astrid MÜller, Rudolf Stark, Daniel L. King, Anna E. Goudriaan, Karl Mann, Patrick Trotzke, Naomi A. Fineberg, Samuel R. Chamberlain, Shane W. Kraus, Elisa Wegmann, JoËl Billieux and Marc N. Potenza

Abstract

Background

Gambling and gaming disorders have been included as “disorders due to addictive behaviors” in the International Classification of Diseases (ICD-11). Other problematic behaviors may be considered as “other specified disorders due to addictive behaviors (6C5Y).”

Methods

Narrative review, experts' opinions.

Results

We suggest the following meta-level criteria for considering potential addictive behaviors as fulfilling the category of “other specified disorders due to addictive behaviors”:

1. Clinical relevance: Empirical evidence from multiple scientific studies demonstrates that the specific potential addictive behavior is clinically relevant and individuals experience negative consequences and functional impairments in daily life due to the problematic and potentially addictive behavior.

2. Theoretical embedding: Current theories and theoretical models belonging to the field of research on addictive behaviors describe and explain most appropriately the candidate phenomenon of a potential addictive behavior.

3. Empirical evidence: Data based on self-reports, clinical interviews, surveys, behavioral experiments, and, if available, biological investigations (neural, physiological, genetic) suggest that psychological (and neurobiological) mechanisms involved in other addictive behaviors are also valid for the candidate phenomenon. Varying degrees of support for problematic forms of pornography use, buying and shopping, and use of social networks are available. These conditions may fit the category of “other specified disorders due to addictive behaviors”.

Conclusion

It is important not to over-pathologize everyday-life behavior while concurrently not trivializing conditions that are of clinical importance and that deserve public health considerations. The proposed meta-level-criteria may help guide both research efforts and clinical practice.

Open access

Including gaming disorder in the ICD-11: The need to do so from a clinical and public health perspective

Commentary on: A weak scientific basis for gaming disorder: Let us err on the side of caution (van Rooij et al., 2018)

Authors: Hans-Jürgen Rumpf, Sophia Achab, Joël Billieux, Henrietta Bowden-Jones, Natacha Carragher, Zsolt Demetrovics, Susumu Higuchi, Daniel L. King, Karl Mann, Marc Potenza, John B. Saunders, Max Abbott, Atul Ambekar, Osman Tolga Aricak, Sawitri Assanangkornchai, Norharlina Bahar, Guilherme Borges, Matthias Brand, Elda Mei-Lo Chan, Thomas Chung, Jeff Derevensky, Ahmad El Kashef, Michael Farrell, Naomi A. Fineberg, Claudia Gandin, Douglas A. Gentile, Mark D. Griffiths, Anna E. Goudriaan, Marie Grall-Bronnec, Wei Hao, David C. Hodgins, Patrick Ip, Orsolya Király, Hae Kook Lee, Daria Kuss, Jeroen S. Lemmens, Jiang Long, Olatz Lopez-Fernandez, Satoko Mihara, Nancy M. Petry, Halley M. Pontes, Afarin Rahimi-Movaghar, Florian Rehbein, Jürgen Rehm, Emanuele Scafato, Manoi Sharma, Daniel Spritzer, Dan J. Stein, Philip Tam, Aviv Weinstein, Hans-Ulrich Wittchen, Klaus Wölfling, Daniele Zullino and Vladimir Poznyak

The proposed introduction of gaming disorder (GD) in the 11th revision of the International Classification of Diseases (ICD-11) developed by the World Health Organization (WHO) has led to a lively debate over the past year. Besides the broad support for the decision in the academic press, a recent publication by van Rooij et al. (2018) repeated the criticism raised against the inclusion of GD in ICD-11 by Aarseth et al. (2017). We argue that this group of researchers fails to recognize the clinical and public health considerations, which support the WHO perspective. It is important to recognize a range of biases that may influence this debate; in particular, the gaming industry may wish to diminish its responsibility by claiming that GD is not a public health problem, a position which maybe supported by arguments from scholars based in media psychology, computer games research, communication science, and related disciplines. However, just as with any other disease or disorder in the ICD-11, the decision whether or not to include GD is based on clinical evidence and public health needs. Therefore, we reiterate our conclusion that including GD reflects the essence of the ICD and will facilitate treatment and prevention for those who need it.

Open access