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Expression of NMDA receptor subunits in human blood lymphocytes: A peripheral biomarker in online computer game addiction

Author(s): Mitra-Sadat Sadat-Shirazi,Nasim Vousooghi,Bertolhoda Alizadeh,Seyed Mohammad Makki,Seyed Zeinolabedin Zarei,Shahrzad Nazari,Mohammad Reza Zarrindast / Language(s): English Issue: 2/2018

Background and aims. Repeated performance of some behaviors such as playing computer games could result in addiction. The NMDA receptor is critically involved in the development of behavioral and drug addictions. It has been claimed that the expression level of neurotransmitter receptors in the brain may be reflected in peripheral blood lymphocytes (PBLs). Methods. Here, using a real-time PCR method, we have investigated the mRNA expression of GluN2A, GluN2D, GluN3A, and GluN3B subunits of the NMDA receptor in PBLs of male online computer game addicts (n = 25) in comparison with normal subjects (n = 26). Results. Expression levels of GluN2A, GluN2D, and GluN3B subunits were not statistically different between game addicts and the control group. However, the mRNA expression of the GluN3A subunit was downregulated in PBLs of game addicts. Discussion and conclusions. Transcriptional levels of GluN2A and GluN2D subunits in online computer game addicts are similar to our previously reported data of opioid addiction and are not different from the control group. However, unlike our earlier finding of drug addiction, the mRNA expression levels of GluN3A and GluN3B subunits in PBLs of game addicts are reduced and unchanged, respectively, compared with control subjects. It seems that the downregulated state of the GluN3A subunit of NMDA receptor in online computer game addicts is a finding that deserves more studies in the future to see whether it can serve as a peripheral biomarker in addiction studies, where the researcher wants to rule out the confusing effects of abused drugs.

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The impact of comorbid impulsive/compulsive disorders in problematic Internet use

Author(s): Samuel R. Chamberlain,Konstantinos Ioannidis,Jon E. Grant / Language(s): English Issue: 2/2018

Background and aims.Problematic Internet use (PIU) is commonplace but is not yet recognized as a formal mental disorder. Excessive Internet use could result from other conditions such as gambling disorder. The aim of the study was to assess the impact of impulsive–compulsive comorbidities on the presentation of PIU, defined using Young’s Diagnostic Questionnaire. Methods. A total of 123 adults aged 18–29 years were recruited using media advertisements, and attended the research center for a detailed psychiatric assessment, including interviews, completion of questionnaires, and neuropsychological testing. Participants were classified into three groups: PIU with no comorbid impulsive/compulsive disorders (n = 18), PIU with one or more comorbid impulsive/compulsive disorders (n = 37), and healthy controls who did not have any mental health diagnoses (n = 67). Differences between the three groups were characterized in terms of demographic, clinical, and cognitive variables. Effect sizes for overall effects of group were also reported. Results. The three groups did not significantly differ on age, gender, levels of education, nicotine consumption, or alcohol use (small effect sizes). Quality of life was significantly impaired in PIU irrespective of whether or not individuals had comorbid impulsive/compulsive disorders (large effect size). However, impaired response inhibition and decision-making were only identified in PIU with impulsive/compulsive comorbidities (medium effect sizes). Discussion and conclusions. Most people with PIU will have one or more other impulsive/compulsive disorders, but PIU can occur without such comorbidities and still present with impaired quality of life. Response inhibition and decision-making appear to be disproportionately impacted in the case of PIU comorbid with other impulsive/compulsive conditions, which may account for some of the inconsistencies in the existing literature. Large scale international collaborations are required to validate PIU and further assess its clinical, cognitive, and biological sequelae.

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Oppositional defiant disorder/conduct disorder co-occurrence increases the risk of Internet addiction in adolescents with attention-deficit hyperactivity disorder

Author(s): Hatice Gunes,Canan Tanidir,Hilal Adaletli,Ali Güven Kılıçoğlu,Caner Mutlu,Mustafa Kayhan Bahali,Melike Topal,Nurullah Bolat,Ozden Sukran Uneri / Language(s): English Issue: 2/2018

Objectives. The aims of this cross-sectional study were to assess the prevalence of Internet addiction (IA) in a clinical sample of adolescents with attention-deficit hyperactivity disorder (ADHD) and to detect the moderating effects of co-occurring oppositional defiant disorder/conduct disorder (ODD/CD) on the association between ADHD and IA. Methods. The study group comprised 119 adolescent subjects who were consecutively referred to our outpatient clinic with a diagnosis of ADHD. The Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was completed by parents, and subjects were asked to complete the Internet Addiction Scale (IAS). Results. The IAS results indicated that 63.9% of the participants (n = 76) fell into the IA group. Degree of IA was correlated with hyperactivity/impulsivity symptoms but not with inattention symptoms. As compared to the ADHD-only group (without comorbid ODD/CD), ADHD + ODD/CD subjects returned significantly higher scores on the IAS. Conclusions. As adolescents with ADHD are at high risk of developing IA, early IA detection and intervention is of great importance for this group. In addition, adolescents with ADHD + ODD/CD may be more vulnerable to IA than those in the ADHD-only group and may need to be more carefully assessed for IA.

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Positive outcome expectancy mediates the relationship between social influence and Internet addiction among senior high-school students

Author(s): Min-Pei Lin,Jo Yung-Wei Wu,Chao-Jui Chen,Jianing You / Language(s): English Issue: 2/2018

Background and aims. Based on the foundations of Bandura’s social cognitive theory and theory of triadic influence (TTI) theoretical framework, this study was designed to examine the mediating role of positive outcome expectancy of Internet use in the relationship between social influence and Internet addiction (IA) in a large representative sample of senior high-school students in Taiwan. Methods. Using a cross-sectional design, 1,922 participants were recruited from senior high schools throughout Taiwan using both stratified and cluster sampling, and a comprehensive survey was administered. Results.Structural equation modeling and bootstrap analyses results showed that IA severity was significantly and positively predicted by social influence, and fully mediated through positive outcome expectancy of Internet use. Discussion and conclusions. The results not only support Bandura’s social cognitive theory and TTI framework, but can also serve as a reference to help educational agencies and mental health organizations design programs and create policies that will help in the prevention of IA among adolescents.

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The personality, motivational, and need-based background of problematic Tinder use

Author(s): Gábor Orosz,Mária Benyó,Bernadett Berkes,Edina Nikoletti,Éva Gál,István Tóth-Király,Beáta Böthe / Language(s): English Issue: 2/2018

Background and aims. Tinder is a geo-located online dating application, which is present in almost 200 countries and has 10 million daily users. The aim of the present research was to investigate the motivational, personality, and basic psychological need-related background of problematic Tinder use. Methods. After qualitative pretest and item construction, in Study 1 (N = 414), confirmatory factor analysis was conducted to corroborate the different motivational factors behind Tinder use. In Study 2 (N = 346), the associations between Big Five traits, Tinder motivations, and problematic Tinder use were examined with structural equation modeling (SEM). In Study 3 (N = 298), the potential role of general self-esteem, relatedness need satisfaction, and frustration in relation to Tinder-use motivations and problematic Tinder use was examined with SEM. Results. In Study 1, a 16-item first-order factor structure was identified with four motivational factors, such as sex, love, self-esteem enhancement, and boredom. In Study 2, problematic Tinder use was mainly related to using Tinder for self-esteem enhancement. The Big Five personality factors were only weakly related to the four motivations and to problematic Tinder use. Counterintuitively, Study 3 showed that instead of global self-esteem, relatedness need frustration was the strongest predictor of self-esteem enhancement Tinder-use motivation which, in turn, was the strongest predictor of problematic Tinder use. Discussion. Four motivational factors were identified as predictors of problematic use with need frustration being a relevant background variable instead of general personality traits.

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Impulsivity traits and addiction-related behaviors in youth

Author(s): Kristine Rømer Thomsen,Mette Buhl Callesen,Morten Hesse,Timo Lehmann Kvamme,Michael Mulbjerg Pedersen,Mads Uffe Pedersen,Valerie Voon / Language(s): English Issue: 2/2018

Background and aims Impulsivity is a risk factor for addictive behaviors. The UPPS-P impulsivity model has been associated with substance addiction and gambling disorder, but its role in other non-substance addiction-related behaviors is less understood. We sought to examine associations between UPPS-P impulsivity traits and indicators of multiple substance and non-substance addiction-related behaviors in youth with varying involvement in these behaviors. Methods Participants (N = 109, aged 16–26 years, 69% males) were selected from a national survey based on their level of externalizing problems to achieve a broad distribution of involvement in addiction-related behaviors. Participants completed the UPPS-P Questionnaire and standardized questionnaires assessing problematic use of substances (alcohol, cannabis, and other drugs) and non-substances (Internet gaming, pornography, and food). Regression analyses were used to assess associations between impulsivity traits and indicators of addiction-related behaviors. Results The UPPS-P model was positively associated with indicators of all addiction-related behaviors except problematic Internet gaming. In the fully adjusted models, sensation seeking and lack of perseverance were associated with problematic use of alcohol, urgency was associated with problematic use of cannabis, and lack of perseverance was associated with problematic use of other drugs than cannabis. Furthermore, urgency and lack of perseverance were associated with binge eating and lack of perseverance was associated with problematic use of pornography. Discussion and conclusions We emphasize the role of trait impulsivity across multiple addiction-related behaviors. Our findings in at-risk youth highlight urgency and lack of perseverance as potential predictors for the development of addictions and as potential preventative therapeutic targets.

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Prevalence, risk factors, and psychosocial adjustment of problematic gambling in adolescents: Results from two representative German samples

Author(s): Sebastián Giralt,Kai W. Müller,Manfred E. Beutel,Michael Dreier,Eva Duven,Klaus Wölfling / Language(s): English Issue: 2/2018

Background and aims. Gambling disorder is a significant public health concern. Especially, male minors have been shown to gamble in a problematic way, despite legal prohibitions. Methods. We examined representative samples of students aged from 12 to 18 years (N = 9,309) in two German federal states to provide prevalence data and clinical description of risk factors for problematic gambling. Results. We found that about 40% of the adolescents reported engaging in gambling activities within the past 12 months and found prevalence rates of 1.7% and 2.2% for problematic gambling. Especially, use of online gambling and slot machines was found to be related to problematic gambling. Male adolescents with a migration background were of higher risk for problematic gambling and psychopathological symptoms were significantly elevated among that group. Discussion. The results indicate that participation in gambling activities is common among underaged adolescents and that prevalence of problematic gambling exceeds rates of adults. Similarly, problematic gambling is associated with increased psychopathological strain. Conclusion. Given that a high proportion of adult gamblers report having started gambling in adolescents, our data emphasize the need for prevention and early intervention strategies for problematic gambling.

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At-risk gambling in patients with severe mental illness: Prevalence and associated features

Author(s): Annalisa Bergamini,Cesare Turrina,Francesca Bettini,Anna Toccagni,Paolo Valsecchi,Emilio Sacchetti,Antonio Vita / Language(s): English Issue: 2/2018

Background and aims. The primary objective of this study was to investigate the prevalence of at-risk gambling in a large, unselected sample of outpatients attending two community mental health centers, to estimate rates according to the main diagnosis, and to evaluate risk factors for gambling. Methods. All patients attending the centers were evaluated with the Canadian Problem Gambling Index and the Mini International Neuropsychiatric Interview. Diagnoses were checked with the treating psychiatrists and after a chart review of the university hospital discharge diagnoses. Results. The rate of at-risk gambling in 900 patients was 5.3%. In those who gambled over the last year, 10.1% were at-risk gamblers. The rates in the main diagnostic groups were: 4.7% schizophrenia and related disorders, 4.9% bipolar disorder, 5.6% unipolar depression, and 6.6% cluster B personality disorder. In 52.1% of the cases, at-risk gambling preceded the onset of a major psychiatric disorder. In a linear regression analysis, a family history of gambling disorder, psychiatric comorbidities, drug abuse/dependence, and tobacco smoking were significantly associated with at-risk gambling. Discussion and conclusion. The results of this study evidenced a higher rate of at-risk gambling compared to community estimates and call for a careful screening for gambling in the general psychiatric population.

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Gambling problems and the impact of family in UK armed forces veterans

Author(s): Glen Dighton,Elystan Roberts,Alice E. Hoon,Simon Dymond / Language(s): English Issue: 2/2018

Background and aims. International evidence indicates elevated problem gambling rates in armed forces veterans compared with the general population. Gambling problems adversely impact one’s family, and family-related variables may increase vulnerability to gambling-related harm. Little is known, however, about gambling problems in the United Kingdom (UK) veterans or to what extent family variables, such as parenting history and experience of domestic violence, influence veterans’ gambling. Methods. We compared veterans (n = 257) and sex- and age-matched controls (n = 514) drawn from the 2007 Adult Psychiatric Morbidity Survey on gambling, financial management, domestic violence, childhood parental presence, and experience of stressful life events. Veterans who left the military before or after 4 years of service were compared. Results. Problem gambling was significantly more prevalent in veterans (1.4%) than non-veterans (0.2%), and the impact of gambling problems on the family was specific to male veterans, particularly those who had experienced a traumatic event after the age of 16, and those who were more likely to have been physically attacked by their partner. Overall, this study revealed that the UK armed forces veterans report a higher prevalence rate of problem gambling compared with non-veterans, with potential negative impact on family life

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Gambling disorder and obsessive–compulsive personality disorder: A frequent but understudied comorbidity

Author(s): Gustavo C. MEDEIROS,Jon E. Grant / Language(s): English Issue: 2/2018

Background and aims. Epidemiological data have suggested that the prevalence of co-occurring personality disorders is particularly high in people with gambling disorder (GD). Among the personality disorders, obsessive–compulsive personality disorder (OCPD) appears to be the most common problem. The objective of this study was to investigate the clinical presentation of GD with and without co-occurring OCPD. Methods. We studied 25 subjects with current GD and lifetime diagnosis of OCPD. They were matched for age and gender with 25 individuals with current GD but no lifetime diagnosis of any personality disorder. Results. Subjects with GD and OCPD demonstrated (a) lower severity of gambling symptoms, (b) slower progression from recreational gambling to full-blown GD, (c) preferred individual forms of betting, (d) identified more triggers to gambling (specially the availability of money and stress); and (e) reported less negative impact on relational problems due to GD. Conclusions. Our research provides further insight on GD co-occurring with OCPD, such as increasing social support and improvement of coping skills, especially to deal with financial difficulties and stress. Our findings may lead to more customized and effective therapeutic approaches to this frequent comorbidity.

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Correlates of frequent gambling and gambling-related chasing behaviors in individuals with schizophrenia-spectrum disorders

Author(s): Igor Yakovenko,Rebecca Fortgang,Jennifer Prentice,Rani A. Hoff,Marc N. Potenza / Language(s): English Issue: 2/2018

Background and aims. Published research on the relationship between disordered gambling and schizophrenia is limited. However, existing data suggest that individuals with schizophrenia/schizoaffective disorder may have a high prevalence of co-occurring disordered gambling. As such, effective strategies for screening and assessing gambling-related problems in individuals with psychosis are needed. The goal of this study was to explore the correlates of increased gambling frequency and chasing behavior, a hallmark feature of gambling disorder, in a sample of individuals with schizophrenia and schizoaffective disorders. Methods. Data from 336 participants who met DSM-IV criteria for schizophrenia or schizoaffective disorder were used to examine differences between non-gamblers, infrequent gamblers, frequent gamblers who do not report chasing, and frequent gamblers who report chasing on a variety of associated features and symptoms of schizophrenia and disordered gambling. Results and discussion. The results of the study support the conclusion that chasing behavior in individuals with schizophrenia/schizoaffective disorder lies on a continuum of severity, with more frequent gamblers endorsing greater chasing. Chasing was also associated with indicators of lower functioning across co-occurring disorders, such as greater problems with alcohol and drugs, greater gambling involvement, and a family history of gambling problems. The findings from the study suggest the utility of screening for chasing behavior as a brief and efficient strategy for assessing risk of gambling problems in individuals with psychotic-spectrum disorders.

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Explaining the relation between pathological gambling and depression: Rumination as an underlying common cause

Author(s): Kristian Krause,Anja Bischof,Silvia Lewin,Diana Guertler,Hans-Jürgen Rumpf,Ulrich John,Christian Meyer / Language(s): English Issue: 2/2018

Background and aims. Symptoms of pathological gambling (SPG) and depression often co-occur. The nature of this relationship remains unclear. Rumination, which is well known to be associated with depression, might act as a common underlying factor explaining the frequent co-occurrence of both conditions. The aim of this study is to analyze associations between the rumination subfactors brooding and reflection and SPG. Methods. Participants aged 14–64 years were recruited within an epidemiological study on pathological gambling in Germany. Cross-sectional data of 506 (80.4% male) individuals with a history of gambling problems were analyzed. The assessment included a standardized clinical interview. To examine the effects of rumination across different levels of problem gambling severity, sequential quantile regression was used to analyze the association between the rumination subfactors and SPG. Results. Brooding (p = .005) was positively associated with the severity of problem gambling after adjusting for reflection, depressive symptoms, and sociodemographic variables. Along the distribution of problem gambling severity, findings hold for all but the lowest severity level. Reflection (p = .347) was not associated with the severity of problem gambling at the median. Along the distribution of problem gambling severity, there was an inverse association at only one quantile. Discussion and conclusions. Brooding might be important in the development and maintenance of problem gambling. With its relations to depression and problem gambling, it might be crucial when it comes to explaining the high comorbidity rates between SPG and depression. The role of reflection in SPG remains inconclusive.

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Associations between the HEXACO model of personality and gambling involvement, motivations to gamble, and gambling severity in young adult gamblers

Author(s): Daniel S. McGrath,Tessa Neilson,Kibeom Lee,Christina L. Rash,Mandana Rad / Language(s): English Issue: 2/2018

Background and aims. Substantial research has examined the role of personality in disordered gambling. The predominant model in this work has been the five-factor model (FFM) of personality. In this study, we examined the personality correlates of gambling engagement and gambling severity using a six-dimensional framework known as the HEXACO model of personality, which incorporates FFM characteristics with the addition of honesty–humility. In addition, the potential mediating role of gambling motives in the personality and gambling severity relationship was explored. Methods. A sample of undergraduate gamblers (n = 183) and non-gamblers (n = 143) completed self-report measures of the Problem Gambling Severity Index (PGSI) and the Gambling Motives Questionnaire-Financial, as well as self- and observer report forms of the HEXACO-100. Results. Logistic regression results revealed that scores on honesty–humility were positively associated with non-gambling over gambling status. Furthermore, it was also found that honesty–humility, agreeableness, and conscientiousness were each uniquely associated with PGSI severity scores. The results of the mediational analyses suggest that each personality factor has different gambling motivational paths leading to PGSI gambling severity. Discussion and conclusions. The findings of this study contribute to the literature on behavioral addictions by providing an increased understanding of individual personality factors associated with likelihood of gambling, overall gambling severity, and gambling motives. Ultimately, these findings suggest that the honesty–humility dimension may be a target for the prevention efforts against problematic gambling outcomes.

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Placing your faith on the betting floor: Religiosity predicts disordered gambling via gambling fallacies

Author(s): Hyoun S. Kim,Alexandra Shifrin,Travis Sztainert,Michael J. A. Wohl / Language(s): English Issue: 2/2018

Background and aims. We examined the potential role religious beliefs may play in disordered gambling. Specifically, we tested the idea that religiosity primes people to place their faith in good fortune or a higher power. In the context of gambling, however, this may lead to gambling fallacies (e.g., erroneous beliefs that one has control over a random outcome). People who are high in religiosity may be more at risk of developing gambling fallacies, as they may believe that a higher power can influence a game of chance. Thus, this research investigated the relationship between religiosity and gambling problems and whether gambling fallacies mediated this relationship. Methods. In Study 1, we recruited an online sample from Amazon's Mechanical Turk to complete measures that assessed the central constructs (religiosity, disordered gambling, and gambling fallacies). In Study 2, we conducted a secondary analysis of a large data set of representative adults (N = 4,121) from a Canadian province, which contained measures that assessed the constructs of interest. Results. In Study 1, religiosity significantly predicted gambling problem. Conversely, there was no direct relationship between religiosity and gambling in Study 2. Importantly, a significant indirect effect of religiosity on disordered gambling severity through gambling fallacies was found in both studies, thus establishing mediation. The results remained the same when controlling for age, gender, ethnicity, and socioeconomic status for both studies. Discussion and conclusion. These findings suggest religiosity and its propensity to be associated with gambling fallacies, which should be considered in the progression (and possibly treatment) of gambling.

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Prevalence of gambling-related harm provides evidence for the prevention paradox

Author(s): Matthew Browne,Matthew J. Rockloff / Language(s): English Issue: 2/2018

Background. The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm. Aims. To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling. Methods. Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey (N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community. Results. The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers. Conclusion. Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.

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Internet pornography viewing preference as a risk factor for adolescent Internet addiction: The moderating role of classroom personality factors

Author(s): Kyriaki Alexandraki,VASILEIOS STAVROPOULOS,Tyrone L. Burleigh,Daniel L. King,Mark D. Griffiths / Language(s): English Issue: 2/2018

Background and aims. Adolescent Internet pornography viewing has been significantly increased in the last decade with research highlighting its association with Internet addiction (IA). However, there is little longitudinal data on this topic, particularly in relation to peer context effects. This study aimed to examine age- and context-related variations in the Internet pornography–IA association. Methods. A total of 648 adolescents, from 34 classrooms, were assessed at 16 years and then at 18 years to examine the effect of Internet pornography preference on IA in relation to the classroom context. IA was assessed using the Internet Addiction Test (Young, 1998), Internet pornography preference (over other Internet applications) was assessed with a binary (yes/no) question, and classroom introversion and openness to experience (OTE) with the synonymous subscales within the Five Factor Questionnaire (Asendorpf & Van Aken, 2003). Results. Three-level hierarchical linear models were calculated. Findings showed that viewing Internet pornography exacerbates the risk of IA over time, while classroom factors, such as the average level of OTE and introversion, differentially moderate this relationship. Discussion and conclusion. The study demonstrated that the contribution of Internet pornography preference (as an IA risk factor) might be increased in more extroverted classrooms and decreased in OTE classrooms.

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“Pornographic binges” as a key characteristic of males seeking treatment for compulsive sexual behaviors: Qualitative and quantitative 10-week-long diary assessment

Author(s): Małgorzata Wordecha,Mateusz Wilk,Ewelina Kowalewska,Maciej Skorko,Adam Łapiński,Mateusz Gola / Language(s): English Issue: 2/2018

Background and aims. Compulsive sexual behaviors (CSBs) are an important clinical and social issue. Despite the increasing number of studies, some of CSB’s aspects remain under-investigated. Here, we explore the nature of CSB, such as binge pornography use and masturbation (PuM), and verify the correspondence between self-perceived factors leading to such behavior with its measures obtained in a diary assessment. Methods. Semi-structuralized interviews with nine treatment-seeking males aged 22–37 years (M = 31.7, SD = 4.85) were followed by a questionnaire and a 10-week-long diary assessment, allowing us to acquire real-life daily patterns of CSB. Results. Six out of nine subjects experienced binge (multiple hours or times a day) PuM. All subjects presented a high level of anxiety and perceived PuM as a way to regulate mood and stress. Data collected in the diary assessment uncovered a high diversity in the patterns of sexual behaviors (such as frequency of regular and binge PuM) and its correlates. Binge PuM was related to decreased mood and/or increased stress or anxiety. The causal relation between these correlates remains undetermined. Discussion and conclusions. Binge PuM seems to be one of the most characteristic behavior among males who are seeking treatment for CSB and is related to the feeling of losing control over one’s sexual activity. CSB individuals indicate a variety of binge triggers. Also, diary assessment data indicate that specific correlates of binge PuM (decreased mood, increased stress, and anxiety) differ between subjects. It suggests the existence of significant individual differences in binge PuM behaviors, and a need to study these differences, as it may help guide personalized treatment.

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Compulsive sexual behavior: A twelve-step therapeutic approach

Author(s): Yaniv Efrati,Mateusz Gola / Language(s): English Issue: 2/2018

Background and aims. Sexuality is natural to human life and inseparable from it, yet some individuals develop compulsive sexual behavior (CSB). Many individuals with CSB seek treatment in free self-support groups based on the twelve-step program. This program was extensively studied in substance abuse disorders (e.g., Alcoholics Anonymous), but little is known about its efficiency in CSB. Methods. We “assesed” questionnaire data on sociodemographical-, psychological-, and recovery-related factors from 97 male participants of Sexaholics Anonymous (SA) programs in Israel. Results. Our results indicated that advancement in the SA program, measured as a current step of the program, is significantly related to lower levels of sexual-related overall sense of helplessness, avoidant help-seeking, self-control, overall CSB, and sexual suppression. It is also related to the higher well-being. Discussion. This is the first study to examine psychological factors of CSB recovery process in twelve-step groups, and future research is needed to replicate our results within a longitudinal study.

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Distinct patterns of Internet and smartphone-related problems among adolescents by gender: Latent class analysis

Author(s): Seung-Yup Lee,Donghwan Lee,Cho Rong Nam,Da Yea Kim,Sera Park,Jun-Gun Kwon,Yong Sil Kweon,Youngjo Lee,Dai-Jin Kim,Jung-Seok Choi / Language(s): English Issue: 2/2018

Background and objectives. The ubiquitous Internet connections by smartphones weakened the traditional boundaries between computers and mobile phones. We sought to explore whether smartphone-related problems differ from those of computer use according to gender using latent class analysis (LCA). Methods. After informed consents, 555 Korean middle-school students completed surveys on gaming, Internet use, and smartphone usage patterns. They also completed various psychosocial instruments. LCA was performed for the whole group and by gender. In addition to ANOVA and χ2 tests, post-hoc tests were conducted to examine differences among the LCA subgroups. Results. In the whole group (n = 555), four subtypes were identified: dual-problem users (49.5%), problematic Internet users (7.7%), problematic smartphone users (32.1%), and “healthy” users (10.6%). Dual-problem users scored highest for addictive behaviors and other psychopathologies. The gender-stratified LCA revealed three subtypes for each gender. With dual-problem and healthy subgroup as common, problematic Internet subgroup was classified in the males, whereas problematic smartphone subgroup was classified in the females in the gender-stratified LCA. Thus, distinct patterns were observed according to gender with higher proportion of dual-problem present in males. While gaming was associated with problematic Internet use in males, aggression and impulsivity demonstrated associations with problematic smartphone use in females. Conclusions. An increase in the number of digital media-related problems was associated with worse outcomes in various psychosocial scales. Gaming may play a crucial role in males solely displaying Internet-related problems. The heightened impulsivity and aggression seen in our female problematic smartphone users requires further research.

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Gaming under the influence: An exploratory study

Author(s): Kateřina Škařupová,Lukas Blinka,Adam Ťápal / Language(s): English Issue: 2/2018

Background and aims. Association between substance use and excessive play of online games exists both in theory and research. However, no study to date examined playing online games under the influence of licit and illicit drugs. Methods. We questioned a convenient online sample of 3,952 Czech online gamers on their experiences and motives of using caffeine, alcohol, tobacco, psychoactive pharmaceuticals, and illicit drugs while playing massive multiplayer online games (MMOGs). Results. The results showed low prevalence of illicit drug use while playing online games. Substance use was positively associated with intensity of gaming and both addiction and engagement; psychoactive substances with stimulating effect were linked to higher engagement and gaming intensity, whereas use of sedatives was associated with higher addiction score. Substance use varied slightly with the preference of game genre. Discussion. Drug use while playing appears as behavior, which is mostly not related to gaming – it concerns mostly caffeine, tobacco, alcohol, or cannabis. For some users, however, drug use was fueled by motivations toward improving their cognitive enhancement and gaming performance.

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