Efficacy of a novel online integrated treatment for problem gambling and tobacco smoking: Results of a randomized controlled trial

Background and aimsProblem gambling and tobacco use are highly comorbid among adults. However, there are few treatment frameworks that target both gambling and tobacco use simultaneously (i.e., an integrated approach), while also being accessible and evidence-based. The aim of this two-arm open label RCT was to examine the efficacy of an integrated online treatment for problem gambling and tobacco use.MethodsA sample of 209 participants (M$_{age}$ = 37.66, SD = 13.81; 62.2% female) from North America were randomized into one of two treatment conditions (integrated [n = 91] or gambling only [n = 118]) that lasted for eight weeks and consisted of seven online modules. Participants completed assessments at baseline, after treatment completion, and at 24-week follow-up.ResultsWhile a priori planned generalized linear mixed models showed no condition differences on primary (gambling days, money spent, time spent) and secondary outcomes, both conditions did appear to significantly reduce problem gambling and smoking behaviours over time. Post hoc analyses showed that reductions in smoking and gambling craving were correlated with reductions in days spent gambling, as well as with gambling disorder symptoms. Relatively high (versus low) nicotine replacement therapy use was associated with greater reductions in gambling behaviours in the integrated treatment condition.Discussion and conclusionsWhile our open label RCT does not support a clear benefit of integrated treatment, findings suggest that changes in smoking and gambling were correlated over time, regardless of treatment condition, suggesting that more research on mechanisms of smoking outcomes in the context of gambling treatment may be relevant

Genetic and environmental aetiologies of associations between dispositional mindfulness and ADHD traits: a population-based twin study

© The Author(s) 2019. To get additional insight into the phenotype of attentional problems, we examined to what extent genetic and environmental factors explain covariation between lack of dispositional mindfulness and attention-deficit/hyperactivity disorder (ADHD) traits in youth, and explored the incremental validity of these constructs in predicting life satisfaction. We used data from a UK population-representative sample of adolescent twins (N = 1092 pairs) on lack of dispositional mindfulness [Mindful Attention Awareness Scale (MAAS)], ADHD traits [Conners’ Parent Rating Scale-Revised (CPRS-R): inattentive (INATT) and hyperactivity/impulsivity (HYP/IMP) symptom dimensions] and life satisfaction (Students’ Life Satisfaction Scale). Twin model fitting analyses were conducted. Phenotypic correlations (rp) between MAAS and CPRS-R (INATT: rp = 0.18, HYP/IMP: rp = 0.13) were small, but significant and largely explained by shared genes for INATT (% rp INATT–MAAS due to genes: 93%, genetic correlation rA = 0.37) and HYP/IMP (% rp HYP/IMP–MAAS due to genes: 81%; genetic correlation rA = 0.21) with no significant contribution of environmental factors. MAAS, INATT and HYP/IMP significantly and independently predicted life satisfaction. Lack of dispositional mindfulness, assessed as self-reported perceived lapses of attention (MAAS), taps into an aspect of attentional functioning that is phenotypically and genetically distinct from parent-rated ADHD traits. The clinically relevant incremental validity of both scales implicates that MAAS could be used to explore the underlying mechanisms of an aspect of attentional functioning that uniquely affects life satisfaction and is not captured by DSM-based ADHD scales. Further future research could identify if lack of dispositional mindfulness and high ADHD traits can be targeted by different therapeutic approaches resulting in different effects on life satisfactio

Trait Emotional Empathy and Resting State Functional Connectivity in Default Mode, Salience, and Central Executive Networks

Emotional empathy is the ability to experience and/or share another person’s emotional states and responses. Although some research has examined the neural correlates of emotional empathy, there has been little research investigating whether this component of empathy is related to the functional connectivity of resting state networks in the brain. In the current study, 32 participants answered a trait emotional empathy questionnaire in a session previous to their functional magnetic resonance imaging scan. Results indicate that emotional empathy scores were correlated with different patterns of functional connectivity in the default mode network (DMN), salience network (SN), and left and right central executive networks. For example, within the DMN, emotional empathy scores positively correlated with connectivity in the premotor cortex. Within the SN, empathy scores were positively correlated with the fusiform gyrus and cuneus. These findings demonstrate that emotional empathy is associated with unique patterns of functional connectivity in four of the brain’s resting state networks

Altered Neural Activity Associated with Mindfulness during Nociception: A Systematic Review of Functional MRI

Objective: To assess the neural activity associated with mindfulness-based alterations of pain perception. Methods: The Cochrane Central, EMBASE, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched on 2 February 2016. Titles, abstracts, and full-text articles were independently screened by two reviewers. Data were independently extracted from records that included topics of functional neuroimaging, pain, and mindfulness interventions. Results: The literature search produced 946 total records, of which five met the inclusion criteria. Records reported pain in terms of anticipation (n = 2), unpleasantness (n = 5), and intensity (n = 5), and how mindfulness conditions altered the neural activity during noxious stimulation accordingly. Conclusions: Although the studies were inconsistent in relating pain components to neural activity, in general, mindfulness was able to reduce pain anticipation and unpleasantness ratings, as well as alter the corresponding neural activity. The major neural underpinnings of mindfulness-based pain reduction consisted of altered activity in the anterior cingulate cortex, insula, and dorsolateral prefrontal cortex

Trait Emotional Empathy and Resting State Functional Connectivity in Default Mode, Salience, and Central Executive Networks

Emotional empathy is the ability to experience and/or share another person’s emotional states and responses. Although some research has examined the neural correlates of emotional empathy, there has been little research investigating whether this component of empathy is related to the functional connectivity of resting state networks in the brain. In the current study, 32 participants answered a trait emotional empathy questionnaire in a session previous to their functional magnetic resonance imaging scan. Results indicate that emotional empathy scores were correlated with different patterns of functional connectivity in the default mode network (DMN), salience network (SN), and left and right central executive networks. For example, within the DMN, emotional empathy scores positively correlated with connectivity in the premotor cortex. Within the SN, empathy scores were positively correlated with the fusiform gyrus and cuneus. These findings demonstrate that emotional empathy is associated with unique patterns of functional connectivity in four of the brain’s resting state networks

Shame’s Associations with Depression and Problem Drinking: An Ecological Momentary Study

Introduction: Depression and problem drinking are comorbid in emerging adulthood, yet the processes that link them are not well understood. Research has argued that shame has a unique influence on the experience of problematic drinking, but this has rarely been assessed at the state level. Using ecological momentary assessments (EMAs), we assessed whether shame, and not guilt, mediated the association between baseline depression and alcohol use and problems. Methods: One hundred and eighty-four emerging adults (Mage = 19.27) completed a 12-day EMA study. Multilevel models were used to test hypotheses. Results: In a model with alcohol use as the outcome, there were no significant associations between shame or guilt and alcohol use at the within- or between-subjects level. In a model with alcohol problems as the outcome, guilt was positively associated with alcohol problems but only at the daily level. At the between-subjects level and after controlling for guilt, there was a significant association between depression, shame, and alcohol problems; average levels of shame mediated the association between depression and alcohol problems. In post-hoc reverse directionality models, average alcohol problems mediated the relationship between depression and shame and guilt at the between-person level. No mediation was present for alcohol use. Conclusion: After controlling for guilt, shame is an emotion that helps explain risk for alcohol problems among depressed emerging adults, which has implications for targeted interventions. Reciprocal associations between shame, guilt, and alcohol problems emerged highlighting the need for more fulsome assessments of shame and guilt in future EMA research.This work was supported by a University of Manitoba startup grant and the Vanier Canada Graduate Scholarship from the Social Sciences and Humanities Research Council

Drinking to cope during COVID-19 pandemic: The role of external and internal factors in coping motive pathways to alcohol use, solitary drinking, and alcohol problems

Background: The COVID-19 pandemic has resulted in massive disruptions to society, to the economy, and to daily life. Some people may turn to alcohol to cope with stress during the pandemic, which may put them at risk for heavy drinking and alcohol-related harms. Research is needed to identify factors that are relevant for coping-motivated drinking during these extraordinary circumstances to inform interventions. This study provides an empirical examination of coping motive pathways to alcohol problems during the early stages of the COVID-19 pandemic. Methods: Participants (N = 320; 54.6% male; mean age 32 years old) were Canadian adult drinkers who completed an online survey assessing work- and home-related factors, psychological factors, and alcohol-related outcomes over the past 30 days, covering a time period beginning within one month of the initiation of the COVID-19 emergency response. Results: The results of a theory-informed path model showed that having at least one child under age 18, greater depression, and lower social connectedness each predicted unique variance in past 30-day coping motives, which in turn predicted increased past 30-day alcohol use (controlling for pre-COVID-19 alcohol use reported retrospectively). Income loss was associated with increased alcohol use, and living alone was associated with increased solitary drinking (controlling for pre-COVID-19 levels), but these associations were not mediated by coping motives. Increased alcohol use, increased solitary drinking, and greater coping motives for drinking were all independently associated with past 30-day alcohol problems, and indirect paths to alcohol problems from living with children, depression, social connectedness, income loss, and living alone were all supported. Conclusions: Findings provide insight into coping-motivated drinking early in the COVID-19 pandemic and highlight the need for longitudinal research to establish longer-term outcomes of drinking to cope during the pandemic.This research was supported by general operating funds provided by York University to Matthew T. Keoug

Efficacy of a web-based self-help tool to reduce problem gambling in Switzerland: study protocol of a two-armed randomised controlled trial

The past-year prevalence of problem gambling worldwide averages 2.3%. Switzerland exhibits a slightly lower past-year prevalence rate, of 1.1%, among adults. Only a minority of these adults attend outpatient treatment. Surveyed problem gamblers have explained that they wanted to handle the problem on their own. The option of a web-based self-help programme could potentially reach those users who hesitate to approach treatment centres and help them to reduce or stop their problem gambling. The effectiveness of such web-based interventions has been shown in other countries

Developing and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial

Background Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e. targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. Methods The aim of this two-arm open-label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an 8-week integrated or gambling only control condition. Both conditions will consist of seven online modules following cognitive behavioural therapy and motivational interviewing principles. Our three primary outcomes are (1) the number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e. 8 weeks from baseline), and at follow-up (i.e. 24 weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. Discussion The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a cost-effective and accessible way to improve treatments for co-occurring problem gambling and tobacco use