Concurrent Gaming Disorder/Internet Gaming Disorder and Electronic Nicotine Delivery Systems Dependency in Emerging Adults [pre-print]

A growing proportion of young adults report regularly playing video games and using electronic nicotine delivery systems (ENDS). Although video gaming is often normative and adaptive, excessive gaming is associated with adverse health outcomes and dependency, as seen in gaming disorder/internet gaming disorder (GD/IGD). Possible additive detrimental effects of ENDS use on the physical outcomes of GD/IGD lend particular concern to these concurrent behaviors. The present study explored group differences in concurrent ENDS and GD/IGD dependency by demographic factors, including age, sex, gender, sexual orientation, racial identity, relationship status, and year in school. The interaction effect of symptoms of attention-deficit hyperactivity disorder (ADHD) on the association between ENDS dependency and GD/IGD was also examined. Lastly, group differences in ADHD symptoms for individuals who endorse (1) neither GD/IGD nor ENDS dependency, (2) either GD/IGD or ENDS dependency, or (3) both GD/IGD and ENDS dependency were explored. Data were collected in a large, multi-university sample of college students (N = 1,054). Higher symptoms of GD/IGD were positively associated with greater symptoms of ENDS dependency. Men and individuals with significant symptoms of ADHD were at an increased risk of concurrent GD/IGD and ENDS dependency. These results may be used to identify demographic and psychological associations linked to these comorbidities, ultimately informing future prevention strategies

Predicting Psychotherapy Session Attendance among Individuals Experiencing Gambling-Related Harms

Almost 2 in 5 individuals experiencing gambling-related harms will initiate treatment and then prematurely discontinue. However, studies have proven unsuccessful in identifying a consistent set of variables that predict discontinuation. The absence of consistent findings may be attributed to 1) disparate definitions of discontinuation and 2) the focus on demographic variables rather than personal history variables that might impact the receipt of treatment. The present study intends to improve upon existing research by focusing on treatment participation (i.e., number of sessions attended) rather than discontinuation and examining a broader set of variables that are specific to an individual’s gambling and financial status before deciding to enter treatment (i.e., pretreatment abstinence, bankruptcy, debt). Archival data from a sample of 128 patients receiving treatment for gambling-related harms at an outpatient treatment facility will be analyzed. On average, participants are 45 years old and predominantly men (55.8%) who represent diverse races (58% White and 37% Black). Participants completed a battery of self-report questions assessing for demographic information, pre-treatment financial status, and gambling history. Linear regressions and independent samples t-tests will be used. Implications: These results may elucidate a relation between previously unexplored variables and psychotherapy session attendance. We anticipate that this finding would enhance clinicians’ ability to identify patients at risk of low treatment engagement. It may also inform future research intending to mitigate the risk of low engagement through targeted interventions

Does Gambling-Focused Treatment Affect Mental Health and Quality of Life? A Systematic Review and Meta-Analysis

Abstract: Cognitive-behavioral (CB) techniques have received substantial empirical support for reducing gambling disorder symptoms and behavior. What has not been established is whether gambling-focused treatment reduces psychological problems and improves quality of life. Individuals experiencing gambling-related harms report that sustained recovery involves changing both gambling behaviors and psychological problems and building a meaningful life. The current systematic review and meta-analysis aimed to examine the effect of CB techniques targeting gambling harms on nontargeted outcomes such as psychological problems and quality of life. Following PRISMA guidelines, a systematic article search was conducted to locate published studies of randomized controlled trials of CB techniques targeting gambling harms and reporting nontargeted outcomes. Random effects meta-analysis was used to quantify the effect of CB techniques on nontargeted outcomes. Ten studies representing 797 participants were included. Eight studies reported the effect of CB techniques on anxiety, 8 on depression, 3 on substance use, and 7 on quality of life. CB techniques significantly reduced anxiety (g = -0.44), depression (g = -0.35), gambling frequency (g = -0.30), and gambling intensity (g = -0.36) at posttreatment, but not substance use. CB techniques also significantly improved quality of life (g = 0.39) at posttreatment. Implications: The targeted reduction of gambling harms may serve as a mechanism of change for reducing psychological problems and improving quality of life. Future studies should employ longitudinal designs to understand the associations between gambling reductions and changes in nontargeted recovery outcomes over time

Measurement Models Matter: How Retrospective Calendar Versus Global Reports Yield Different Estimates of Treatment Outcome

Abstract: Retrospective reports are less accurate than objective measures of behavior and must be interpreted with consideration of the amount of distortion and error introduced by this methodology. The Gambling-Timeline Followback (G-TLFB) method is the gold standard retrospective assessment tool that is designed to minimize such error by asking for a specific recall of precise gambling behavior day-by-day using recall aids as compared to a global summation over time (e.g., how many gambling days in last month, how much money gambled in the last month). It remains an empirical question whether this difference in measurement format, G-TLFB versus global reports, alters the estimates of gambling treatment efficacy. Eighteen studies were identified for inclusion in a meta-analysis to explore this question. A mixed-effects subgroup analysis indicated that the effect of treatment relative to nonactive control on gambling frequency at posttreatment was significantly lower for studies using the G-TLFB (g = -0.20) than studies using other assessments (g = -0.71). There was no significant difference in the effect of treatment relative to nonactive control on gambling intensity at posttreatment between studies using the G-TLFB (g = -0.22) and studies using other assessments (g = -0.38). Implications: The G-TLFB yields more conservative and likely more precise estimates of the effect of gambling treatment on gambling frequency but not intensity than other retrospective assessments. The use of global retrospective assessments to assess gambling frequency and intensity may overestimate effects of gambling treatment on gambling frequency

Gambling Warning Messages: The Impact of Winning and Losing on Message Reception across a Gambling Episode

Warning messages prevent and modify risk-taking behaviors. When controlling the outcome of each wager, studies suggest such messages can increase a player’s knowledge about gambling-specific risks, modify their gambling-related cognitive distortions, and even change play. The present study takes the next step by asking if the reception of the warning message is influenced by the player’s experience of winning or losing. In a laboratory study, participants were randomly assigned to a winning or losing gambling experience where they either viewed periodic warning messages or not. Using a mixed model analysis, the influence of the warning messages was related to players’ winning or losing over the course of the wagering session. Those in the warning message-win condition made the fewest number of spins, F(3,144) = 3.1, p \u3c .05, and did not increase their betting rate over the course of play compared to the losing or no message conditions. Those in the warning message-loss condition decreased the size of their bets over the course of play compared to those who received messages while winning, t(24671) = -7.9, p \u3c .05. Whether an individual is winning or losing may have significant consequences on the impact of a warning message. Whereas a message to change gambling behavior may be able to encourage a winning gambler to stop play, the same message for a losing player may lead to a small minimization in harm by helping them to decrease their bet size

Indicators of Clinically Significant Gambling Treatment Gains

Treatments should be tailored to the individual in order to improve their effectiveness and efficiency. An assessment of treatment gains is essential to this goal, particularly the ability to identify when clinically significant change is achieved. This paper will examine the sensitivity and specificity of two constructs that moderate change for gambling-focused treatments: self-efficacy to control gambling and strength of gambling-related cognitive distortions. Participants completed measures of gambling symptoms: the Gambling Self-Efficacy Questionnaire (GSEQ) to assess self-efficacy to control gambling, and the Gamblers’ Beliefs Questionnaire to assess cognitive distortions (GBQ). Included was a clinical sample of 312 treatment-seeking outpatient disordered gamblers. We conducted sensitivity/specificity analyses with the clinical sample and a community sample. For the GSEQ analyses, the community sample included 309 adults. For the GBQ analyses, we recruited 204 past-year gamblers from Mechanical Turk. The clinical sample’s pre-treatment GSEQ scores (M = 42.3) were significantly lower than post-treatment scores (M = 77.9, t(210) = -10.8, p M = 71.2) were significantly higher than post-treatment scores (M = 46.7, t(126) = 6.5, p \u3c .05) indicating a decrease in cognitive distortions. ROC analyses indicated that a score of 70 on the GSEQ provided high sensitivity (89%) and specificity (81%) with gambling disorder diagnosis. We found a linear relationship between gambling disorder and GBQ score. These results can be used to guide clinical decisions about the inclusion of treatment elements and the conclusion of therapy