Problem gambling and family violence: family member reports of prevalence, family impacts and family coping

This article reports on the Australian arm of a large-scale study of the patterns and prevalence of co-occurrence of family violence and problem gambling in Australia, New Zealand and Hong Kong.AbstractThere exists only a small number of empirical studies investigating the patterns of family violence in problem gambling populations, although some evidence exists that intimate partner violence and child abuse are among the most severe interpersonal correlates of problem gambling. The current article reports on the Australian arm of a large-scale study of the patterns and prevalence of co-occurrence of family violence and problem gambling in Australia, New Zealand and Hong Kong. The current study screened 120 help-seeking family members of problem gamblers in a range of clinical services for both family violence and problem gambling. The main results showed that 52.5% reported some form of family violence in the past 12 months: 20.0% reported only victimisation, 10.8% reported only perpetration and 21.6% reported both victimisation and perpetration of family violence. Parents, current and ex-partners were most likely to be both perpetrators and victims of family violence. There were no gender differences in reciprocal violence but females were more likely to be only victims and less likely to report no violence in comparison to males. Most of the 32 participants interviewed in depth, reported that gambling generally preceded family violence. The findings suggest that perpetration of family violence was more likely to occur as a reaction to deeply-rooted and accumulated anger and mistrust whereas victimisation was an outcome of gambler’s anger brought on by immediate gambling losses and frustration. While multiple and intertwined negative family impacts were likely to occur in the presence of family violence, gambling-related coping strategies were not associated with the presence or absence of family violence. The implications of the findings for service providers are discussed.Authored by Aino Suomi, Alun C Jackson, Nicki A Dowling, Tiffany Lavis, Janet Patford, Shane A Thomas, Peter Harvey, Max Abbott, Maria E Bellringer, Jane Koziol-McLain and Sue Cockman

Couple and family therapies for post-traumatic stress disorder (PTSD)

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objectives of this review will be to: assess the efficacy of couple and family therapies for adult PTSD, relative to 'no treatment' conditions, 'standard care', and structured or non‐specific individual psychological therapies; examine the clinical characteristics of studies that influence the relative efficacy of these therapies; and critically evaluate methodological features of studies that bias research findings

Implications of gambling problems for family and interpersonal adjustment:Results from the Quinte Longitudinal Study

AIMS: To evaluate (1) whether gambling problems predict overall trajectories of change in family or interpersonal adjustment and (2) whether annual measures of gambling problems predict time-specific decreases in family or interpersonal adjustment, concurrently and prospectively. DESIGN: The Quinte Longitudinal Study (QLS) involved random-digit dialling of telephone numbers around the city of Belleville, Canada to recruit 'general population' and 'at-risk' groups (the latter oversampling people likely to develop problems). Five waves of assessment were conducted (2006-10). Latent Trajectory Modelling (LTM) estimated overall trajectories of family and interpersonal adjustment, which were predicted by gambling problems, and also estimated how time-specific problems predicted deviations from these trajectories. SETTING: Southeast Ontario, Canada. PARTICIPANTS: Community sample of Canadian adults (n = 4121). MEASUREMENTS: The Problem Gambling Severity Index (PGSI) defined at-risk gambling (ARG: PGSI 1-2) and moderate-risk/problem gambling (MR/PG: PGSI 3+). Outcomes included: (1) family functioning, assessed using a seven-point rating of overall functioning; (2) social support, assessed using items from the Non-support subscale of the Personality Assessment Inventory; and (3) relationship satisfaction, measured by the Kansas Marital Satisfaction Scale. FINDINGS: Baseline measures of ARG and MR/PG did not predict rates of change in trajectories of family or interpersonal adjustment. Rather, the annual measures of MR/PG predicted time-specific decreases in family functioning (estimate: -0.11, P < 0.01), social support (estimate: -0.28, P < 0.01) and relationship satisfaction (estimate: -0.53, P < 0.01). ARG predicted concurrent levels of family functioning (estimate: -0.07, P < 0.01). There were time-lagged effects of MR/PG on subsequent levels of family functioning (estimate: -0.12, P < 0.01) and social support (estimate: -0.24, P < 0.01). CONCLUSIONS: In a longitudinal study of Canadian adults, moderate-risk/problem gambling did not predict overall trajectories of family or interpersonal adjustment. Rather, the annual measures of moderate-risk/problem gambling predicted time-specific and concurrent decreases in all outcomes, and lower family functioning and social support across adjacent waves

Is unemployment benefit stigma related to poverty, payment receipt, or lack of employment? A vignette experiment about Australian views

The present study sought to better understand the extent to which negative perceptions of people who receive unemployment benefits is due to their poverty status, their unemployment, and/or their receipt of income support payments. We sought to differentiate these three factors in a vignette-based experiment drawing on a large Australian general population sample (N = 778). Participants rated the personality and capability of two fictional characters. The key experimental manipulation of employment status and benefit receipt was embedded in description of other characteristics. Participants rated vignette characters who received unemployment benefits less favorably on personality (conscientiousness, emotional stability, agreeableness), competence, and warmth than characters described as having a job, as being poor, or as not having a job but without mention of receiving benefits. There was a gradient in the strength of negative assessments across these conditions, but only warmth, conscientiousness and employability distinguished between individuals receiving unemployment benefits and individuals without a job but no reference to benefit receipt. This study provides new insights showing that receiving benefits due to unemployment contributes to negative perceptions over and above the effects of poverty or being unemployed

Couple and family therapies for post-traumatic stress disorder (PTSD)

Background Post-traumatic stress disorder (PTSD) refers to an anxiety or trauma- and stressor-related disorder that is linked to personal or vicarious exposure to traumatic events. PTSD is associated with a range of adverse individual outcomes (e.g. poor health, suicidality) and significant interpersonal problems which include diGiculties in intimate and family relationships. A range of couple- and family-based treatments have been suggested as appropriate interventions for families impacted by PTSD. Objectives The objectives of this review were to: (1) assess the eGects of couple and family therapies for adult PTSD, relative to 'no treatment' conditions, 'standard care', and structured or non-specific individual or group psychological therapies; (2) examine the clinical characteristics of studies that influence the relative eGects of these therapies; and (3) critically evaluate methodological characteristics of studies that may bias the research findings. Search methods We searchedMEDLINE (1950-), Embase (1980-) andPsycINFO(1967-) via theCochraneCommonMentalDisordersControlledTrialsRegister (CCMDCTR) to 2014, then directly via Ovid aIer this date. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library. We conducted supplementary searches of PTSDPubs (all available years) (this database is formerly known as PILOTS (Published International Literature on Traumatic Stress)). We manually searched the early editions of key journals and screened the reference lists and bibliographies of included studies to identify other relevant research. We also contacted the authors of included trials for unpublished information. Studies have been incorporated from searches to 3 March 2018. Selection criteria Eligible studies were randomised controlled trials (RCTs) of couple or family therapies for PTSD in adult samples. The review considered any type of therapy that was intended to treat intact couples or families where at least one adult family member met criteria for PTSD. It was required that participants were diagnosed with PTSD according to recognised classification systems. Data collection and analysis We used the standard methodological procedures prescribed by Cochrane. Three review authors screened all titles and abstracts and two authors independently extracted data from each study deemed eligible and assessed the risk of bias for each study. We used odds ratios (OR) to summarise the eGects of interventions for dichotomous outcomes, and standardised mean diGerences (SMD) to summarise posttreatment between-group diGerences on continuous measures. Main results We included four trials in the review. Two studies examined the eGects of cognitive behavioural conjoint/couple's therapy (CBCT) relative to a wait list control condition, although one of these studies only reported outcomes in relation to relationship satisfaction. One study examined the eGects of structural approach therapy (SAT) relative to a PTSD family education (PFE) programme; and one examined the eGects of adjunct behavioural family therapy (BFT) but failed to report any outcome variables in suGicient detail — we did not include it in the meta-analysis. One trial with 40 couples (80 participants) showed that CBCT was more eGective than wait list control in reducing PTSD severity (SMD −1.12, 95% CI −1.79 to −0.45; low-quality evidence), anxiety (SMD −0.93, 95% CI −1.58 to −0.27; very low-quality evidence) and depression (SMD −0.66, 95% CI −1.30 to −0.02; very low-quality evidence) at post-treatment for the primary patient with PTSD. Data from two studies indicated that treatment and control groups did not diGer significantly according to relationship satisfaction (SMD 1.07, 95% CI −0.17 to 2.31; very low-quality evidence); and one study showed no significant diGerences regarding depression (SMD 0.28, 95% CI −0.35 to 0.90; very low-quality evidence) or anxiety symptoms (SMD 0.15, 95% CI −0.47 to 0.77; very low-quality evidence) for the partner of the patient with PTSD. One trial with 57 couples (114 participants) showed that SAT was more eGective than PFE in reducing PTSD severity for the primary patient (SMD −1.32, 95% CI −1.90 to −0.74; low-quality evidence) at post-treatment. There was no evidence of diGerences on the other outcomes, including relationship satisfaction (SMD 0.01, 95% CI −0.51 to 0.53; very low-quality evidence), depression (SMD 0.21, 95% CI −0.31 to 0.73; very low-quality evidence) and anxiety (SMD −0.16, 95% CI −0.68 to 0.36; very low-quality evidence) for intimate partners; and depression (SMD −0.28, 95% CI −0.81 to 0.24; very low-quality evidence) or anxiety (SMD −0.34, 95% CI −0.87 to 0.18; very low-quality evidence) for the primary patient. Two studies reported on adverse events and dropout rates, and no significant diGerences between groups were observed. Two studies were classified as having a 'low' or 'unclear' risk of bias in most domains, except for performance bias that was rated ‘high’. Two studies had significant amounts of missing information resulting in 'unclear'risk of bias. There were too few studies available to conduct subgroup analyses. Authors' conclusions There are few trials of couple-based therapies for PTSD and evidence is insuGicient to determine whether these oGer substantive benefits when delivered alone or in addition to psychological interventions. Preliminary RCTs suggest, however, that couple-based therapies for PTSD may be potentially beneficial for reducing PTSD symptoms, and there is a need for additional trials of both adjunctive and standalone interventions with couples orfamilies which targetreduced PTSD symptoms, mental health problems of family members and dyadic measures of relationship quality

Problem gambling and intimate partner violence : a systematic review and meta-analysis

This study provides a systematic review of the empirical evidence related to the association between problem gambling and intimate partner violence (IPV). We identified 14 available studies in the systematic search (8 for victimisation only, 4 for perpetration only and 2 for both victimisation and perpetration). Although there were some equivocal findings, we found that most of the available research suggests that there is a significant relationship between problem gambling and being a victim of IPV. There was more consistent evidence that there is a significant relationship between problem gambling and perpetration of IPV. Meta-analyses revealed that over one third of problem gamblers report being victims of physical IPV (38.1%) or perpetrators of physical IPV (36.5%) and that the prevalence of problem gambling in IPV perpetrators is 11.3%. Although the exact nature of the relationships between problem gambling and IPV is yet to be determined, the findings suggest that less than full employment and clinical anger problems are implicated in the relationship between problem gambling and IPV victimization and that younger age, less than full employment, clinical anger problems, impulsivity, and alcohol and substance use are implicated in the relationship between problem gambling and IPV perpetration. The findings highlight the need for treatment services to undertake routine screening and assessment of problem gambling, IPV, alcohol and substance use problems, and mental health issues and provide interventions designed to manage this cluster of comorbid conditions. Further research is also required to investigate the relationship between problem gambling and violence that extends into the family beyond intimate partners. © 2014, The Author(s) 2014. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record*

Problem Gambling and Intimate Partner Violence A Systematic Review and Meta-Analysis

Author version made available in accordance with the publisher's policyThis study provides a systematic review of the empirical evidence related to the association between problem gambling and intimate partner violence (IPV). We identified 14 available studies in the systematic search (six for IPV victimisation and ten for IPV perpetration). Although there were some equivocal findings, we found that most of the available research suggests that there is a significant relationship between problem gambling and being a victim of IPV. There was more consistent evidence that there is a significant relationship between problem gambling and perpetration of IPV. Meta-analyses revealed that over one-third of problem gamblers report being victims of physical IPV (38.1%) or perpetrators of physical IPV (36.5%) and that the prevalence of problem gambling in IPV perpetrators is 11.3%. Although the exact nature of the relationships between problem gambling and IPV is yet to be determined, the findings suggest that less than full employment and clinical anger problems are implicated in the relationship between problem gambling and IPV victimisation and that younger age, less than full employment, clinical anger problems, impulsivity, and alcohol and substance use are implicated in the relationship between problem gambling and IPV perpetration. The findings highlight the need for treatment services to undertake routine screening and assessment of problem gambling, IPV, alcohol and substance use problems, and mental health issues, and provide interventions designed to manage this cluster of comorbid conditions. Further research is also required to investigate the relationship between problem gambling and violence that extends into the family beyond intimate partners

Compressive stress-mediated p38 activation required for ER alpha plus phenotype in breast cancer

Breast cancer is now globally the most frequent cancer and leading cause of women's death. Two thirds of breast cancers express the luminal estrogen receptor-positive (ER alpha + ) phenotype that is initially responsive to antihormonal therapies, but drug resistance emerges. A major barrier to the understanding of the ER alpha-pathway biology and therapeutic discoveries is the restricted repertoire of luminal ER alpha + breast cancer models. The ER alpha + phenotype is not stable in cultured cells for reasons not fully understood. We examine 400 patient-derived breast epithelial and breast cancer explant cultures (PDECs) grown in various three-dimensional matrix scaffolds, finding that ER alpha is primarily regulated by the matrix stiffness. Matrix stiffness upregulates the ER alpha signaling via stress-mediated p38 activation and H3K27me3-mediated epigenetic regulation. The finding that the matrix stiffness is a central cue to the ER alpha phenotype reveals a mechanobiological component in breast tissue hormonal signaling and enables the development of novel therapeutic interventions. Subject terms: ER-positive (ER + ), breast cancer, ex vivo model, preclinical model, PDEC, stiffness, p38 SAPK. Reliable luminal estrogen receptor (ER alpha+) breast cancer models are limited. Here, the authors use patient derived breast epithelial and breast cancer explant cultures grown in several extracellular matrix scaffolds and show that ER alpha expression is regulated by matrix stiffness via stress-mediated p38 activation and H3K27me3-mediated epigenetic regulation.Peer reviewe

Compressive stress-mediated p38 activation required for ERα + phenotype in breast cancer

Breast cancer is now globally the most frequent cancer and leading cause of women's death. Two thirds of breast cancers express the luminal estrogen receptor-positive (ER alpha + ) phenotype that is initially responsive to antihormonal therapies, but drug resistance emerges. A major barrier to the understanding of the ER alpha-pathway biology and therapeutic discoveries is the restricted repertoire of luminal ER alpha + breast cancer models. The ER alpha + phenotype is not stable in cultured cells for reasons not fully understood. We examine 400 patient-derived breast epithelial and breast cancer explant cultures (PDECs) grown in various three-dimensional matrix scaffolds, finding that ER alpha is primarily regulated by the matrix stiffness. Matrix stiffness upregulates the ER alpha signaling via stress-mediated p38 activation and H3K27me3-mediated epigenetic regulation. The finding that the matrix stiffness is a central cue to the ER alpha phenotype reveals a mechanobiological component in breast tissue hormonal signaling and enables the development of novel therapeutic interventions. Subject terms: ER-positive (ER + ), breast cancer, ex vivo model, preclinical model, PDEC, stiffness, p38 SAPK.Reliable luminal estrogen receptor (ER alpha+) breast cancer models are limited. Here, the authors use patient derived breast epithelial and breast cancer explant cultures grown in several extracellular matrix scaffolds and show that ER alpha expression is regulated by matrix stiffness via stress-mediated p38 activation and H3K27me3-mediated epigenetic regulation.</p