Deficits in emotion regulation strategies among problematic and pathological gamblers in a sample of vocational school students

Background and aims: Deficits in emotion regulation (ER) are associated with mental disorders. To date, there are hardly any studies focusing on the role of ER strategies in the context of gambling behavior. The aim of this study was to investigate the association between specific ER strategies and pathological as well as problematic gambling in a proactively recruited sample. Methods: A large and unselected sample (n = 4,928) has been screened proactively and systematically in vocational schools. We assessed the Affective Style Questionnaire to measure ER strategies and the Stinchfield questionnaire for assessing problematic and pathological gambling. Associations were investigated with linear and multinomial logistic regression analyses. Results: The analyses showed a significant negative correlation between the subscales “Adjusting” and “Tolerating” and the Stinchfield sum score. Lower scores on these subscales were associated with a higher number of endorsed Stinchfield items. A lower score on the ER strategies “Adjusting” [conditional odds ratio (COR) = 0.95, confidence interval (CI) = 0.91–0.99] and “Tolerating” [COR = 0.95, CI = 0.92–99] led to a higher chance of being classified as a pathological gambler. In problematic gambling, on a subthreshold level, only “Tolerating” turned out to be significant [COR = 0.96, CI = 0.93–0.99]. Discussion and conclusions: For the first time, deficits in specific ER strategies were identified as independent risk factors for problematic and pathological gambling in a large and proactively recruited sample. ER skills, especially acceptance-focused strategies, should be considered in prevention and psychotherapy

Motivational brief interventions for adolescents and young adults with Internet use disorders: A randomized-controlled trial

Background: Adolescents and young adults (AYA) have an increased risk for Internet use disorders (IUD) compared to older individuals that may lead to functional impairments in daily life. To date, evidence-based brief interventions are lacking. This study aimed to test the efficacy of a low-threshold counseling approach based on Motivational Interviewing (MI) in a vocational school setting. Methods: Of 8.230 vocational students (age M520.56, SD54.68; 51.85% female) being proactively screened for IUD, 937 with positive screenings took part in telephone-based diagnostic interviews. IUD were assessed in line with the criteria of the Internet Gaming Disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Readiness to change, self-efficacy, and impairments in daily life were additionally assessed with standardized screening instruments. Participants fulfilling at least two IUD criteria were randomized to the intervention group (n5240, up to three MI-based counseling sessions via telephone) or the control group (n5257, information brochure on responsible Internet use). Follow-up interviews were conducted after five and ten months. The primary outcome was the reduction of IUD criteria. Secondary outcomes were improvements of readiness/ self-efficacy to change and the reduction of daily impairments. Data were analyzed with Intention-to-Treat (ITT) and complier average causal effect (CACE) analyses. Results: Overall, 153 (63.75%) individuals assigned to the intervention group participated at least in one counseling session (5compliers). Both groups reduced the number of IUD criteria over time. In ITT analyses, however, we did not find intervention effects for primary and secondary outcomes. Bayes statistics were inconclusive. Based on low participation rates in the intervention group, explorative CACE analyses were conducted to compare compliers in the intervention group to potential compliers in the control group. Again, we did not find intervention effects apart from improvements in self-efficacy after five months. Discussion: Telephonebased counseling seems not appropriate to address AYA at risk for IUD. Low participation rates in the intervention group caused underpowered analyses. Besides, dealing with the own Internet use during intensive assessments and receiving an information brochure led to behavioral changes also in the control group. Since the efficacy of brief interventions under the condition of higher participation rates cannot be fully ruled out, further research is required by taking the implications of this study into account

Association of Increased Impulsiveness and Internet Use Disorder in Adolescents and Young Adults with Different Main Activities on the Internet

Objective: Increased impulsiveness is a risk factor for health-endangering behavior patterns. Little is known about whether increased impulsiveness is associated with Internet Use Disorder (IUD) and whether individuals with various main activities on the Internet differ in their levels of impulsiveness. Methods: In total, 8,230 vocational students were screened for problematic Internet use with the Compulsive Internet Use Scale (CIUS). Participants scoring at least 21 points in the CIUS took part in an in-depth diagnostic interview. IUD was assessed according to the criteria of Internet Gaming Disorder (IGD) as suggested in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Impulsiveness was assessed with the Barratt Impulsiveness Scale (BIS-15). The data was analyzed using binary logistic regression models and nonparametric tests. Results: Participants with IUD (n = 144) showed increased impulsiveness (p = .005) compared to those without IUD (n = 774). Participants with different main activities on the Internet did not differ in their levels of impulsiveness. Conclusions: Results indicate that impulsiveness is associated with IUD, independent of the main Internet activity. This highlights the necessity to consider patients' impulsiveness in prevention and therapeutic approaches. Because of the cross-sectional study design, further research with longitudinal study designs is needed