Association of Sociodemographic, Psychopathological and Gambling-Related Factors with Treatment Utilization for Pathological Gambling

Background/Aims: Only a small percentage of pathological gamblers utilizes professional treatment for gambling problems. Little is known about which social and gambling-related factors are associated with treatment utilization. The aim of this study was to look for factors associated with treatment utilization for pathological gambling. Methods: The study followed a sampling design with 3 different recruitment channels, namely (1) a general population-based telephone sample, (2) a gambling location sample and (3) a project telephone hotline. Pathological gambling was diagnosed in a telephone interview. Participants with pathological gambling (n = 395) received an in-depth clinical interview concerning treatment utilization, comorbid psychiatric disorders and social characteristics. Results: Variables associated with treatment were higher age [odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.08], an increased number of DSM-IV criteria for pathological gambling (OR 1.34, 95% CI 1.06-1.70), more adverse consequences from gambling (OR 1.10, 95% CI 1.03-1.16) and more social pressure from significant others (OR 1.17, 95% CI 1.07-1.27). Affective disorders were associated with treatment utilization in the univariate analysis (OR 1.81, 95% CI 1.19-2.73), but multivariate analysis showed that comorbid psychiatric disorders were not independently associated. Conclusion: These results indicate that individuals with more severe gambling problems utilize treatment at an older age when more adverse consequences have occurred. Further research should focus on proactive early interventions

Assessment of Problematic Internet Use by the Compulsive Internet Use Scale and the Internet Addiction Test: A Sample of Problematic and Pathological Gamblers

This study aims to analyze psychometric properties and validity of the Compulsive Internet Use Scale (CIUS) and the Internet Addiction Test (IAT) and, second, to determine a threshold for the CIUS which matches the IAT cut-off for detecting problematic Internet use. A total of 292 subjects with problematic or pathological gambling (237 men, 55 women) aged 14-63 years and with private Internet use for at least 1 h per working or weekend day were recruited via different recruitment channels. Results include that both scales were internally consistent (Cronbach's α = 0.9) and had satisfactory convergent validity (r = 0.75; 95% CI 0.70-0.80). The correlation with duration of private Internet use per week was significantly higher for the CIUS (r = 0.54) compared to the IAT (r = 0.40). Among all participants, 25.3% were classified as problematic Internet users based on the IAT with a cut-off ≥40. The highest proportion of congruent classified cases results from a CIUS cut-off ≥18 (sensitivity 79.7%, specificity 79.4%). However, a higher cut-off (≥21) seems to be more appropriate for prevalence estimation of problematic Internet use

Soziale Determinanten von Suchterkrankungen am Beispiel der Prävalenz von Glücksspielstörungen und einer Intervention gegen Tabakrauch

Soziodemografische Merkmale, wie der Migrationshintergrund (MH), Bildung und Erwerbsstatus, sind vielfach mit der Verbreitung von Suchterkrankungen und der Inanspruchnahme von gesundheitsförderlichen Angeboten assoziiert. Ziel der Arbeit ist es, diese sozialen Determinanten von Suchterkrankungen am Beispiel der Prävalenz von Glücksspielstörungen und einer Intervention gegen Tabakrauch zu untersuchen und ihre Bedeutung für die gesundheitlichen Ungleichheiten in der Bevölkerung zu diskutieren. Die Prävalenz von Glücksspielstörungen in der Allgemeinbevölkerung wurde mittels eines deutschlandweiten Telefonsurveys von 15.023 Personen im Alter von 14 bis 64 Jahren geschätzt. Die Befragten wurden nach der Existenz eines MH und ihrer Herkunftsregionen sowie der Anzahl der Symptome von Glücksspielstörungen nach dem Diagnostischen und Statistischen Manual Psychischer Störungen (DSM) kategorisiert. Für die Interventionsstudie wurden alle 3.570 Haushalte mit wenigstens einem Kind im Alter von 3 Jahren oder jünger im Nordosten des Bundeslandes Mecklenburg-Vorpommern eingeladen, an einer Maßnahme zur Senkung der häuslichen Tabakrauchbelastung teilzunehmen. Die Erreichungsraten zur Kontaktherstellung und Auskunftsbereitschaft sowie Studienteilnahme der Familien wurden hinsichtlich Bildung und Erwerbsstatus verglichen. Im Vergleich zur Bevölkerung ohne MH zeigten die für weitere soziodemografische Merkmale adjustierten Zähldatenregressionsverfahren der Prävalenzstudien beim Vorliegen eines MH sowie der Herkunftsregionen Türkei und Jugoslawien, eine um 102,5 % sowie 70,3 % und 87,2 % erhöhte Anzahl der Symptome von Glücksspielstörungen. Insbesondere die Herkunft aus der Türkei geht mit einer höheren Chance auf Symptome von Glücksspielstörungen einher. Die Ergebnisse zur Interventionsstudie zeigten, dass 2.641 der 3.293 erfolgreich kontaktierten Familien Angaben zum Gesundheitsverhalten machten und 917 der 1.282 Familien mit wenigstens einem rauchenden Elternteil an der Intervention teilnahmen. Unter den kontaktierten, auskunftsbereiten Familien waren höhere Raten an besser Gebildeten und Erwerbstätigen als in der Allgemeinbevölkerung. Im Vergleich zu den besser gebildeten und erwerbstätigen Familien zeigte die für weitere soziodemografische Merkmale adjustierte logistische Regressionsanalyse, dass Familien mit zehn bzw. mehr als zehn Bildungsjahren eine höhere Chance (OR=1,5 bzw. OR=1,9) und nicht erwerbstätige Familien eine niedrigere Chance (OR=0,7) auf die Teilnahme an der Studie hatten. Die Effektstärke dieses Zusammenhangs war jedoch mit Cohens f2=.01 klein. Der MH und die Herkunftsregionen bzw. Bildung und Erwerbsstatus der Menschen in Deutschland leisten einen eigenständigen Beitrag für die Erklärung der Prävalenz von Glücksspielstörungen bzw. der Erreichbarkeit für Interventionen gegen Tabakrauch. Die bestehenden gesundheitlichen Ungleichheiten könnten sich dadurch verstärken.Socio-demographic characteristics, such as the migration background (MB), education and employment status, are often associated to the distribution of addictions and the utilization of health-promoting services. The aim of this study is to investigate these social determinants of addictions using the example of the prevalence of gambling disorders and an intervention against tobacco smoke and to discuss their implications for health disparities in the population. The prevalence of gambling disorders among the general population was estimated by a Germany-wide telephone survey of 15,023 people aged 14 to 64 years. Respondents were categorized by the existence of a MB and their regions of origin as well as the number of symptoms of gambling disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). For the intervention study all 3,570 households with at least one child aged 3 years or younger in the northeast of Mecklenburg-Western Pomerania were invited to participate in an intervention to reduce the environmental tobacco smoke exposure at home. The rates for making contact and to provide information as well as participation in the study among the families were compared in terms of education and employment status. Estimates from adjusted count data regression analyses revealed that there is a 102.5 % and 70.3 % and 87.2 % increase in the expected number of symptoms of gambling disorders for gamblers with MB and those from the regions of origin Turkey and Yugoslavia compared to those without MB. Especially the region of origin Turkey is associated with a higher chance of symptoms of gambling disorders. The results for the intervention study showed that 2,641 of the 3,293 successfully contacted families provided information on health behaviors and 917 of the 1,282 families with at least one smoking parent participated in the intervention. There were higher rates of better educated and employed persons among the contacted families that were willing to give information than in the general population. Compared to the better educated and employed families the adjusted logistic regression analysis revealed that families with ten or more than ten years of education have had a higher chance (OR = 1.5 and OR = 1.9) and non-working families a lower chance (OR = 0.7) for participation in the study. The effect size of this association, however, was small with Cohens f2 = .01. The MB and the regions of origin as well as education and employment status of the people in Germany make an independent contribution to explain the prevalence of gambling disorders and accessibility for interventions against tobacco smoke, respectively. Thus, the existing health inequalities could be increased

Predictors of indoor smoking at young children’s homes—a cross-sectional study

The aim of the study was to determine factors associated with indoor smoking in homes (ISIH) using a sample of households with at least one child aged 3 or younger and at least one smoking adult. In a defined German region, all households (n = 3,570) with a child aged 3 or younger were invited to participate in a study that tested the efficacy of an intervention for reducing exposure to environmental tobacco smoke. In 1,282 households, at least one parent reported daily smoking. Among these, 917 (71.5 %) participated in the study. ISIH was defined as smoking ‘in specific rooms only’ or ‘everywhere’. Cross-sectional data were analysed using regression analysis. Among the households, 37.5 % reported ISIH. ISIH was more likely if the youngest child had not visited a nursery (OR, 1.81; CI, 1.21–2.70) and if no private outdoor area was present (OR = 4.38, CI, 2.64–7.25). Lower household education level and partly unemployment in dual-parent households were associated with ISIH. Conclusion: Fostering nursery attendance and availability of a private outdoor area may protect young children living in household with smoking parents from environmental tobacco smoke