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Authors: Young-Chul Shin, Sam-Wook Choi, Juwon Ha, Jung-Seok Choi and Dai-Jin Kim

Background and Aims

To date, few studies have examined the clinical manifestation of disordered gamblers in financial markets. This study examined the differences in the clinical and treatment-related features of gambling disorder between financial markets and horse races.

Methods

Subjects who met the DSM-IV criteria for pathological gambling (PG) and who sought treatment were assessed by retrospective chart review. One hundred forty-four subjects were included in this sample, which consisted of the following groups: financial markets (n = 45; 28.6%) and horse races (n = 99; 71.4%).

Results

Multiple similar manifestations were found between the groups, including severity of PG, age of PG onset, amounts of gambling debts, drinking days per week, depressive mood, duration of seeking treatment after the onset of PG, and treatment follow-up duration. However, disordered gamblers who invested in the financial market were significantly more likely to be educated (p = 0.003), live with their spouses (p = 0.007), have full-time jobs (p = 0.006), and they were more likely to participate in the first type of gambling than the horse races group (p<0.001). Furthermore, the financial markets group received the anti-craving medication less often than the horse races group (p = 0.04).

Discussion and Conclusions

These findings suggest that disordered gamblers in financial markets show different socio-demographic, clinical and treatment-related features compared with the horse race gamblers, despite a similar severity of gambling disorder. Understanding these differential manifestations may provide insight into prevention and treatment development for specific types of gambling.

Open access
Authors: Sam-Wook Choi, Young-Chul Shin, Jung Yeon Mok, Dai-Jin Kim, Jung-Seok Choi and Samuel Suk-Hyun Hwang

Background and aims

Gambling disorder (GD) shares many similarities with substance use disorders (SUDs) in clinical, neurobiological, and neurocognitive features, including decision-making. We evaluated the relationships among, GD, decision-making, and brain-derived neurotrophic factor (BDNF), as measured by serum BDNF levels.

Methods

Twenty-one male patients with GD and 21 healthy sex- and age-matched control subjects were evaluated for associations between serum BDNF levels and the Problem Gambling Severity Index (PGSI), as well as between serum BDNF levels and Iowa Gambling Task (IGT) indices.

Results

The mean serum BDNF levels were significantly increased in patients with GD compared to healthy controls. A significant correlation between serum BDNF levels and PGSI scores was found when controlling for age, depression, and duration of GD. A significant negative correlation was obtained between serum BDNF levels and IGT improvement scores.

Discussion

These findings support the hypothesis that serum BDNF levels constitute a dual biomarker for the neuroendocrine changes and the severity of GD in patients. Serum BDNF level may serve as an indicator of poor decision-making performance and learning processes in GD and help to identify the common physiological underpinnings between GD and SUDs.

Open access
Authors: Sam-Wook Choi, Hyun Kim, Ga-Young Kim, Yeongju Jeon, Su Park, Jun-Young Lee, Hee Jung, Bo Sohn, Jung-Seok Choi and Dai-Jin Kim

Open access
Authors: Sam-Wook Choi, Dai-Jin Kim, Jung-Seok Choi, Heejune Ahn, Eun-Jeung Choi, Won-Young Song, Seohee Kim and Hyunchul Youn

Background and Aims

Smartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. This study assessed the risk and protective factors associated with smartphone addiction in college students and compared these factors to those linked to Internet addiction.

Methods

College students (N = 448) in South Korea completed the Smartphone Addiction Scale, the Young’s Internet Addiction Test, the Alcohol Use Disorders Identification Test, the Beck Depression Inventory I, the State–Trait Anxiety Inventory (Trait Version), the Character Strengths Test, and the Connor–Davidson Resilience Scale. The data were analyzed using multiple linear regression analyses.

Results

The risk factors for smartphone addiction were female gender, Internet use, alcohol use, and anxiety, while the protective factors were depression and temperance. In contrast, the risk factors for Internet addiction were male gender, smartphone use, anxiety, and wisdom/knowledge, while the protective factor was courage.

Discussion

These differences may result from unique features of smartphones, such as high availability and primary use as a tool for interpersonal relationships.

Conclusions

Our findings will aid clinicians in distinguishing between predictive factors for smartphone and Internet addiction and can consequently be utilized in the prevention and treatment of smartphone addiction.

Open access
Authors: Daeyoung Roh, Soo-Young Bhang, Jung-Seok Choi, Yong Sil Kweon, Sang-Kyu Lee and Marc N. Potenza

Background

Potential concerns are increasing that smartphone and Internet addictions may have deleterious effects on the mental health. Despite the recognition of the important role that implicit associations may have over explicit processes in addiction, such implicit associations have not been comprehensively investigated with respect to Internet addiction. Therefore, we modified the Implicit Association Test (IAT) for smartphone and Internet addictions and investigated its validity in children and adolescents.

Methods

In this experimental study, 78 at-risk children and adolescents ranging in age from 7 to 17 years completed an IAT modified with pictures captured from the most popular Internet games among youth. Furthermore, measures of Internet and smartphone addictions, mental health and problem behaviors, impulsive tendencies, self-esteem, daily stress, and quality of life were assessed simultaneously.

Results

Significant correlations were found between IAT D2SD scores and standardized scales for Internet (r = .28, p < .05) and smartphone (r = .33, p < .01) addictions. There were no significant correlations between IAT parameters and other scales measuring the constructs that are less relevant to the features of addiction, such as daily stress levels, impulsivity, and quality of life. Multiple regression analysis revealed that the IAT D2SD was independently and positively associated with smartphone addiction (p = .03) after controlling for other clinical correlates.

Conclusions

This study demonstrated good convergent and discriminant validity of this IAT as a novel measurement relating to Internet and smartphone addictions. Further longitudinal and prospective studies are needed to evaluate its potential utility in clinical and community settings.

Open access

Background and aims

Internet gaming disorder (IGD) has gained recognition as a potential new diagnosis in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders, but genetic evidence supporting this disorder remains scarce.

Methods

In this study, targeted exome sequencing was conducted in 30 IGD patients and 30 control subjects with a focus on genes linked to various neurotransmitters associated with substance and non-substance addictions, depression, and attention deficit hyperactivity disorder.

Results

rs2229910 of neurotrophic tyrosine kinase receptor, type 3 (NTRK3) was the only single nucleotide polymorphism (SNP) that exhibited a significantly different minor allele frequency in IGD subjects compared to controls (p = .01932), suggesting that this SNP has a protective effect against IGD (odds ratio = 0.1541). The presence of this potentially protective allele was also associated with less time spent on Internet gaming and lower scores on the Young’s Internet Addiction Test and Korean Internet Addiction Proneness Scale for Adults.

Conclusions

The results of this first targeted exome sequencing study of IGD subjects indicate that rs2229910 of NTRK3 is a genetic variant that is significantly related to IGD. These findings may have significant implications for future research investigating the genetics of IGD and other behavioral addictions.

Open access
Authors: Ji Yoon Lee, Su Mi Park, Yeon Jin Kim, Dai Jin Kim, Sam-Wook Choi, Jun Soo Kwon and Jung-Seok Choi

Background and aims

Impulsivity is a core feature of gambling disorder (GD) and is related to the treatment response. Thus, it is of interest to determine objective neurobiological markers associated with impulsivity in GD. We explored resting-state electroencephalographic (EEG) activity in patients with GD according to the degree of impulsivity.

Methods

In total, 109 GD subjects were divided into three groups according to Barratt impulsiveness scale-11 (BIS-11) scores: high (HI; 25th percentile of BIS-11 scores, n = 29), middle (MI; 26th–74th percentile, n = 57), and low-impulsivity (LI) groups (75th percentile, n = 23). We used generalized estimating equations to analyze differences in EEG absolute power considering group (HI, MI, and LI), brain region (frontal, central, and posterior), and hemisphere (left, midline, and right) for each frequency band (delta, theta, alpha, beta, and gamma).

Results

The results indicated that GD patients in the HI group showed decreased theta absolute power, and decreased alpha and beta absolute power in the left, right, particularly midline frontocentral regions.

Discussion and conclusions

This study is a novel attempt to reveal impulsive features in GD by neurophysiological methods. The results suggest different EEG patterns among GD patients according to the degree of impulsivity, raising the possibility of neurophysiological objective features in GD and helping clinicians in treating GD patients with impulsive features.

Open access
Authors: Ji-Won Chun, Chang-Hyun Park, Jin-Young Kim, Jihye Choi, Hyun Cho, Dong Jin Jung, Kook-Jin Ahn, Jung-Seok Choi, Dai-Jin Kim and In Young Choi

Abstract

Background and aims

Although the Internet has provided convenience and efficiency in many areas of everyday life, problems stemming from Internet use have also been identified, such as Internet gaming disorder (IGD). Internet addiction, which includes IGD, can be viewed as a behavioral addiction or impulse control disorder. This study investigated the altered functional and effective connectivity of the core brain networks in individuals with IGD compared to healthy controls (HCs).

Methods

Forty-five adults with IGD and 45 HCs were included in this study. To examine the brain networks related to personality traits that influence problematic online gaming, the left and right central executive network (CEN) and the salience network (SN) were included in the analysis. Also, to examine changes in major brain network topographies, we analyzed the default mode network (DMN).

Results

IGD participants showed lower functional connectivity between the dorsal lateral prefrontal cortex (DLPFC) and other regions in the CEN than HC participants during resting state. Also, IGD participants revealed reduced functional connectivity between the dorsal anterior cingulate cortex and other regions in the SN and lower functional connectivity in the medial prefrontal cortex of the anterior DMN. Notably, in IGD individuals but not HC individuals, there was a positive correlation between IGD severity and effective connectivity and a positive correlation between reward sensitivity and effective connectivity within the ventral striatum of the SN.

Conclusions

Problematic online gaming was associated with neurofunctional alterations, impairing the capacity of core brain networks.

Open access
Authors: Yeon-Jin Kim, Jae A. Lim, Ji Yoon Lee, Sohee Oh, Sung Nyun Kim, Dai Jin Kim, Jong Eun Ha, Jun Soo Kwon and Jung-Seok Choi

Background and aims

Internet gaming disorder (IGD) is characterized by a loss of control and a preoccupation with Internet games leading to repetitive behavior. We aimed to compare the baseline neuropsychological profiles in IGD, alcohol use disorder (AUD), and obsessive–compulsive disorder (OCD) in the spectrum of impulsivity and compulsivity.

Methods

A total of 225 subjects (IGD, N = 86; AUD, N = 39; OCD, N = 23; healthy controls, N = 77) were administered traditional neuropsychological tests including Korean version of the Stroop Color–Word test and computerized neuropsychological tests, including the stop signal test (SST) and the intra–extra dimensional set shift test (IED).

Results

Within the domain of impulsivity, the IGD and OCD groups made significantly more direction errors in SST (p = .003, p = .001) and showed significantly delayed reaction times in the color–word reading condition of the Stroop test (p = .049, p = .001). The OCD group showed the slowest reading time in the color–word condition among the four groups. Within the domain of compulsivity, IGD patients showed the worst performance in IED total trials measuring attentional set shifting ability among the groups.

Conclusions

Both the IGD and OCD groups shared impairment in inhibitory control functions as well as cognitive inflexibility. Neurocognitive dysfunction in IGD is linked to feature of impulsivity and compulsivity of behavioral addiction rather than impulse dyscontrol by itself.

Open access
Authors: Yeong Seon Jo, Soo Young Bhang, Jung-Seok Choi, Hae Kook Lee, Seung Yup Lee and Yong-Sil Kweon

Abstract

Background and aim

Whereas many studies on Internet gaming disorder (IGD) have used self-report questionnaires, only a few have adopted clinical interviews and samples. The current study aimed at using data from face-to-face diagnostic interviews, based on the criteria for IGD in the DSM-5, to determine the Internet, gaming, and smartphone usage patterns of children and adolescents.

Methods

A latent class analysis was conducted using data collected through diagnostic interviews for Internet, gaming, and smartphone addiction with 190 participants (M = 13.14 years, SD = 2.46; 143 boys, 47 girls) who were part of a multicenter clinical cohort study.

Results

Participants were classified into four groups: pleasure-seeking (Class 1), internal-use (Class 2), problematic-use (Class 3), and pathological-use (Class 4). The pleasure-seeking group (8.11%) showed low tendencies in general and proper control. The internal-use group (17.63%) showed significant increases in “cognitive salience” and “craving,” with strong internal desires. The problematic-use group (37.28%) had no “interference with role performance”; however, they displayed “difficulty regulating use” and “persistent use despite negative consequences,” with a slight functional impairment. The pathological-use group (36.98%) scored the highest on all these items, revealing a severe functional impairment. Compared to the other groups, the pathological-use group had the highest depression and daily stress levels and displayed the lowest levels of happiness.

Conclusions

This study provides basic data to elucidate Internet, gaming, and smartphone overuse patterns among children and adolescents, which could be used to develop differentiated intervention strategies for each group.

Open access