Psychometric properties of the transaddiction craving triggers questionnaire in alcohol use disorder.

We aimed to develop the transaddiction craving triggers questionnaire (TCTQ), which assesses the propensity of specific situations and contexts to trigger craving and to test its psychometric properties in alcohol use disorder (AUD). This study included a sample of 111 AUD outpatients. We performed exploratory factor analysis (EFA) and calculated item-dimension correlations. Internal consistency was measured with Cronbach's alpha coefficient. Construct validity was assessed through Spearman correlations with craving, emotional symptoms, impulsivity, mindfulness, and drinking characteristics. The EFA suggested a 3-factor solution: unpleasant affect, pleasant affect, and cues and related thoughts. Cronbach's coefficient alpha ranged from .80 to .95 for the three factors and the total score. Weak positive correlations were identified between the TCTQ and drinking outcomes, and moderate correlation were found between the TCTQ and craving strength, impulsivity, anxiety, depression, and impact of alcohol on quality of life. The 3-factor structure is congruent with the well-established propensity of emotions and cues to trigger craving. Construct validity is supported by close relations between the TCTQ and psychological well-being rather than between the TCTQ and drinking behaviors. Longitudinal validation is warranted to assess sensitivity to change of the TCTQ and to explore its psychometric properties in other addictive disorders

Giving room to subjectivity in understanding and assessing problem gambling: A patient-centered approach focused on quality of life

Background and aims: Problem gambling is characterized by high stigma and self-stigma, making relevant measurement of the burden of the disorder complex. The aim of our qualitative study was to describe health-related quality of life (HRQOL) impacted by problem gambling from the patients’ perspective. Methods: We conducted 6 focus groups with 25 current or lifetime at-risk problem gamblers to identify key domains of quality of life impacted by problem gambling. A content analysis from the focus groups data was conducted using Alceste© software, using descendant hierarchical classification analysis, to obtain stable classes and the significant presences of reduced forms. The class of interest, detailing the core of impacted quality of life, was described using a cluster analysis. Results: Thematic content analysis identified three stable classes. Class 1 contained the interviewers’ speech. Class 3 was composed of the vocabulary related to gambling practice, games and gambling venues (casino, horse betting, etc.). Class 2 described the core of impact of gambling on quality of life and corresponded to 43% of the analyzed elementary context units. This analysis revealed seven key domains of impact of problem gambling: loneliness, financial pressure, relationships deterioration, feeling of incomprehension, preoccupation with gambling, negative emotions, and avoidance of helping relationships. Conclusions: We identified, beyond objective damage, the subjective distress felt by problem gamblers over the course of the disorder and in the helping process, marked in particular by stigma and self-stigma. Four impacted HRQOL areas were new and gambling-specific: loneliness, feeling of incomprehension, avoidance of helping relationships, and preoccupation with gambling. These results support the relevance of developing, in a next step, a specific HRQOL scale in the context of gambling

Self-exclusion in online poker gamblers: effect on time and money as compared to matched controls

International audienceNo comparative data is available to report on the effect of online self-exclusion. The aim of this study was to assess the effect of self-exclusion in online poker gambling as compared to matched controls, after the end of the self-exclusion period. Methods: We included all gamblers who were first-time self-excluders over a 7-year period (n = 4887) on a poker website, and gamblers matched for gender, age and account duration (n = 4451). We report the effects over time of self-exclusion after it ended, on money (net losses) and time spent (session duration) using an analysis of variance procedure between mixed models with and without the interaction of time and self-exclusion. Analyzes were performed on the whole sample, on the sub-groups that were the most heavily involved in terms of time or money (higher quartiles) and among short-duration self-excluders (<3 months). Results: Significant effects of self-exclusion and short-duration self-exclusion were found for money and time spent over 12 months. Among the gamblers that were the most heavily involved financially, no significant effect on the amount spent was found. Among the gamblers who were the most heavily involved in terms of time, a significant effect was found on time spent. Short-duration self-exclusions showed no significant effect on the most heavily involved gamblers. Conclusions: Self-exclusion seems efficient in the long term. However, the effect on money spent of self-exclusions and of short-duration self-exclusions should be further explored among the most heavily involved gamblers

Mindfulness dans le traitement des addictions: Quelles perspectives pour la prise en charge du jeu pathologique

International audience[No abstract

Quantitative damage-benefit evaluation of drug effects: major discrepancies between the general population, users and experts

International audienceAims:This study sought to quantify the perceptions of damage and benefit, for users and society, associated with five addictive substances (alcohol, tobacco, cannabis, cocaine and heroin) and one addictive behavior (gambling), in a large sample representative of the French population. We compared with expert assessments and investigated the effects of substance consumption on these perceptions. Findings: The ranking of substances by the lay public is very divergent from that of experts. The public overestimates damage to users and to society and underestimates the benefit, in comparison with experts, for all substances. Alcohol is the only exception, with damage and benefit perceptions similar to those of experts. Heroin and cocaine are perceived as the two most dangerous substances. The damage of cannabis and alcohol are judged to be equivalent. The three legal substances are associated with the highest overall benefit, although cannabis has the highest perceived benefit for users. Substances with the highest perceived benefit tend to be associated with perception of lower levels of damage. Individuals with an history of substance use have a perception of the damage and the benefit for that substance which is more congruent with experts, including a similar ranking of substances. Conclusions: Prevention campaigns focused on perceptions of damage alone have reached their limits. The perception of benefit should be taken into account in early interventions with illegal substance users

Quality of life instruments used in problem gambling studies: A systematic review and a meta-analysis

International audienc

Qual Life Res

INTRODUCTION: The objective for this study was to combine drinking characteristics and two subjective measures, drinker identity and alcohol-related quality of life, i.e., negative impact of alcohol on quality of life, to determine relevant profiles for indicated prevention programs. In particular, we hypothesized that different profiles of students with high level of alcohol consumption exist when exploring subjectivity. METHODS: We performed an online survey among 16,930 students. We collected sociodemographics and environmental data, including alcohol-related quality of life, drinker identity, and drinking characteristics. We performed a hierarchical clustering on principal components. We described all variables in each cluster and explored between clusters differences by Kruskal-Wallis tests. RESULTS: We identified five clusters as regarding drinker identity, drinking characteristics, and alcohol-related quality of life. Among these five clusters, three clusters presented high drinking characteristics. A very vulnerable cluster showed high level of alcohol consumption, impact on quality of life and on academic results, and strong drinker identity. An egodystonic cluster showed high level of consumption, mild impact on quality of life and on academic results, but low drinker identity. A cluster seemed short-term super-adapted in heavy drinking environment, showing high level of alcohol consumption and drinker identity, but low impact on quality of life and on academic results (all between clusters p values < 0.001 with Kruskal-Wallis tests). CONCLUSION: The subjective experience of students from these clusters was significantly different (p value < 0.001), and could explain some inadequacy of certain prevention strategies, considering binge drinker student as a homogeneous group. Prospective studies are needed to explore changes over time of these clusters