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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

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
Journal of Behavioral Addictions
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
Journal of Behavioral Addictions
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
Journal of Behavioral Addictions
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

Abstract

Background and aims

Resting-state brain activity may be associated with the ability to perform tasks; however, a multimodal approach involving resting-state functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) has not been widely used to investigate addictive disorders.

Methods

We explored resting-state fMRI and auditory oddball ERP values from 26 with internet gaming disorder (IGD) patients and 27 age- and intelligence quotient-matched healthy controls (HCs). To assess the characteristics of resting-state fMRI, we calculated regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and fractional amplitude of low-frequency fluctuation (fALFF); we also calculated the P3 component of the ERPs.

Results

Compared with HCs, the individuals with IGD exhibited significant decreases in ReHo and fALFF values in the left inferior occipital gyrus, increased ReHo and ALFF values in the right precuneus, increased ALFF in the left superior frontal gyrus, and lower P3 amplitudes in the midline centro-parietal area during the auditory ERP task. Furthermore, the regional activity of resting-state fMRI in the right inferior temporal gyrus and the occipital regions were positively correlated with the P3 amplitudes in IGD patients, whereas ReHo values of the left hippocampus and the right amygdala were negatively correlated with P3.

Discussion and conclusions

Our results suggest that IGD patients have difficulty interacting effectively with cognitive function and sensory processing, although its interpretations need some cautions. The findings in this study will broaden the overall understanding of the neurobiological mechanisms that underlie IGD pathophysiology.

Open access
Journal of Behavioral Addictions
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

Abstract

Background

With the continued spread of smartphones and development of the internet, the potential negative effects arising from problematic smartphone use (PSU) in adolescents are being reported on an increasing basis. This study aimed to investigate whether altered resting-state functional connectivity (rsFC) is related to the psychological factors underlying PSU in adolescents.

Methods

Resting-state functional magnetic resonance images were acquired from 47 adolescents with PSU and 46 healthy control adolescents (the CON group). Seed-based functional connectivity analyses were then performed to compare the two groups with respect to rsFC in the right inferior frontal gyrus, associated with various forms of self-control, and rsFC in the left inferior frontal gyrus.

Results

Compared to the CON group, the PSU group exhibited a reduction in rsFC between the right inferior frontal gyrus and limbic areas, including the bilateral parahippocampal gyrus, the left amygdala, and the right hippocampus. In addition, a reduction in fronto-limbic rsFC was associated with the severity of PSU, the degree of self-control, and the amount of time the subjects used their smartphones.

Conclusion

Adolescents with PSU exhibited reduced levels of fronto-limbic functional connectivity; this mechanism is involved in salience attribution and self-control, attributes that are critical to the clinical manifestation of substance and behavioral addictions. Our data provide clear evidence for alterations in brain connectivity with respect to self-control in PSU.

Open access

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

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