Gamblers' use of measures to prevent gambling problems and reduce harm

In this study, the use of measures to control gambling were investigated. Data from gamblers (N = 5,878) participating in a cross-sectional survey in 2019 based on random sampling from the Norwegian Population Registry, were analysed. The survey included questions about use of eight measures, which comprised the dependent variables. Questions about sociodemographics, gambling behaviour, gambling problems, self-reported impact from gambling advertisement and beliefs in measures to control gambling comprised the predictor variables. Logistic regression analyses were employed to identify significant predictors. Use of measures varied, ranging from 0.8% (contacting help services) to 23.2% (pre-commitment to affordable loss limits). All predictors had at least one significant association with the actual use of measures. Being a moderate risk or problem gambler was the most consistent predictor and was associated with the use of all eight measures. Being born outside Norway in a western or non-western country was associated with use of seven of the eight measures, whereas gambled online and participated in low-risk game only (inversely) were associated with use of six measures. Gender, age, game spending and beliefs in the usefulness of measures were associated with use of four measures. Participation in random games only was inversely associated with use of three measures. Self-reported impact from gambling advertisement was only (inversely) associated with self-testing for gambling problems. Several mechanisms responsible for the associations between predictors and the dependent variables are suggested, e.g., younger gamblers and moderate risk or problem gamblers may use these measures as they may acknowledge personal susceptibilities for developing gambling problems, such as impaired impulse control. Online gambling on the other hand was associated with use of various measures as the latter more often are integrated in online than offline gambling. Notably, the beliefs in measures as helpful was a significant predictor of use of four of the measures, which illustrates that positive views on the use of measures are not consistently associated with actual use of all the measures. Characteristics of the gamblers (e.g., place of birth, moderate risk or problem gambler), the game itself and the online distribution seem to be the most consistent predictors

Workplace bullying and sleep - A systematic review and meta-analysis of the research literature

This systematic review and meta-analysis 1) clarifies and quantifies existing results on the association between exposure to workplace bullying and sleep, 2) evaluates the methodological quality of existing studies, 3) identifies theoretical frameworks used in research, 4) determines moderating and mediating variables, and 5) provides guidelines for future research. Searches for primary studies were conducted in Pubmed, Medline, Embase, PsycINFO and Web of Science. Of the 406 studies identified, 26 fulfilled the inclusion criteria for the qualitative synthesis whereas sixteen studies were included in the meta-analysis (cross sectional effect sizes: 15; N=69,199/prospective effect sizes: 6; N=26,164). Workplace bullying was significantly related to sleep problems in all studies. Across cross-sectional studies, targets of bullying had 2.31 higher odds of reporting sleep problems compared to non-bullied workers. The odds across the prospective studies was 1.62. The quality of evidence for the association between workplace bullying and sleep problems was low to moderate. Only eight studies had a predefined theoretical rationale for the association, and few studies examined mediating and moderating variables or bidirectional associations. The methodological quality of the studies was moderate. Further research is needed to establish the nature, directionality, mechanisms, and conditions of the association between bullying and sleep.publishedVersio

Insomnia – A Heterogenic Disorder Often Comorbid With Psychological and Somatic Disorders and Diseases: A Narrative Review With Focus on Diagnostic and Treatment Challenges

Patients with insomnia complain of problems with sleep onset or sleep maintenance or early morning awakenings, or a combination of these, despite adequate opportunity and circumstances for sleep. In addition, to fulfill the diagnostic criteria for insomnia the complaints need to be associated with negative daytime consequences. For chronic insomnia, the symptoms are required to be present at least 3 days per week for a duration of at least 3 months. Lastly, for insomnia to be defined as a disorder, the sleep complaints and daytime symptoms should not be better explained by another sleep disorder. This criterion represents a diagnostic challenge, since patients suffering from other sleep disorders often complain of insomnia symptoms. For instance, insomnia symptoms are common in e.g., obstructive sleep apnea and circadian rhythm sleep-wake disorders. It may sometimes be difficult to disentangle whether the patient suffers from insomnia disorder or whether the insomnia symptoms are purely due to another sleep disorder. Furthermore, insomnia disorder may be comorbid with other sleep disorders in some patients, e.g., comorbid insomnia and sleep apnea (COMISA). In addition, insomnia disorder is often comorbid with psychological or somatic disorders and diseases. Thus, a thorough assessment is necessary for correct diagnostics. For chronic insomnia disorder, treatment-of-choice is cognitive behavioral therapy, and such treatment is also effective when the insomnia disorder appears comorbid with other diagnoses. Furthermore, studies suggest that insomnia is a heterogenic disorder with many different phenotypes or subtypes. Different insomnia subtypes may respond differently to treatment, but more research on this issue is warranted. Also, the role of comorbidity on treatment outcome is understudied. This review is part of a Research Topic on insomnia launched by Frontiers and focuses on diagnostic and treatment challenges of the disorder. The review aims to stimulate to more research into the bidirectional associations and interactions between insomnia disorder and other sleep, psychological, and somatic disorders/diseases.publishedVersio

Gamblers' use of measures to prevent gambling problems and reduce harm

In this study, the use of measures to control gambling were investigated. Data from gamblers (N = 5,878) participating in a cross-sectional survey in 2019 based on random sampling from the Norwegian Population Registry, were analysed. The survey included questions about use of eight measures, which comprised the dependent variables. Questions about sociodemographics, gambling behaviour, gambling problems, self-reported impact from gambling advertisement and beliefs in measures to control gambling comprised the predictor variables. Logistic regression analyses were employed to identify significant predictors. Use of measures varied, ranging from 0.8% (contacting help services) to 23.2% (pre-commitment to affordable loss limits). All predictors had at least one significant association with the actual use of measures. Being a moderate risk or problem gambler was the most consistent predictor and was associated with the use of all eight measures. Being born outside Norway in a western or non-western country was associated with use of seven of the eight measures, whereas gambled online and participated in low-risk game only (inversely) were associated with use of six measures. Gender, age, game spending and beliefs in the usefulness of measures were associated with use of four measures. Participation in random games only was inversely associated with use of three measures. Self-reported impact from gambling advertisement was only (inversely) associated with self-testing for gambling problems. Several mechanisms responsible for the associations between predictors and the dependent variables are suggested, e.g., younger gamblers and moderate risk or problem gamblers may use these measures as they may acknowledge personal susceptibilities for developing gambling problems, such as impaired impulse control. Online gambling on the other hand was associated with use of various measures as the latter more often are integrated in online than offline gambling. Notably, the beliefs in measures as helpful was a significant predictor of use of four of the measures, which illustrates that positive views on the use of measures are not consistently associated with actual use of all the measures. Characteristics of the gamblers (e.g., place of birth, moderate risk or problem gambler), the game itself and the online distribution seem to be the most consistent predictors.publishedVersio

Immigration, acculturation, and preferred help-seeking sources for depression: comparison of five ethnic groups

Background Immigrants are more likely than the majority population to have unmet needs for public mental health services. This study aims to understand potential ethnic differences in preferred help-seeking sources for depression in Norway, and how such preferences relate to acculturation orientation. Methods A convenience sample of immigrants from Russia (n = 164), Poland (n = 127), Pakistan (n = 128), and Somalia (n = 114), and Norwegian students (n = 250) completed a survey. The sample was recruited from social media platforms, emails, and direct contact. The survey consisted of a vignette describing a moderately depressed person. Respondents were asked to provide advice to the person by completing a modified version of the General Help-Seeking Questionnaire. The immigrant sample also responded to questions about acculturation orientation using the Vancouver Index of Acculturation Scale. Results Significant differences were found in the endorsement of traditional (e.g., religious leader), informal (e.g., family), and semiformal (e.g., internet forum) help-sources between immigrant groups, and between immigrant groups and the Norwegian respondent group. Immigrants from Pakistan and Somalia endorsed traditional help sources to a greater extent than immigrants from Russia and Poland, and the Norwegian student sample. There were no ethnic differences in endorsement of formal mental help sources (e.g., a medical doctor). Maintenance of the culture of origin as the acculturation orientation was associated with preferences for traditional and informal help sources, while the adoption of mainstream culture was associated with semiformal and formal help-seeking sources. Conclusion Ethnic differences in help-seeking sources need to be considered when designing and implementing mental health services.publishedVersio

The prevalence of orthorexia in exercising populations: a systematic review and meta-analysis

Aim Orthorexia Nervosa (ON) describes a pathological obsession with proper and high-quality nutrition that is necessary to research further in order to elucidate its prevalence and correlates which may bear implications for prevention and treatment. The aim of this study was to review studies that report the prevalence of ON in people who exercise, calculate an overall prevalence through a random-effects meta-analysis approach and investigate the association of ON prevalence using a random-effects meta-regression. In addition, a sub-group-analysis based on ON-instruments and a sensitivity analysis excluding students samples, were conducted. Method Systematic searches were conducted in the following online databases: PubMed, Embase, Web of Science, PsychInfo, CINAHL, Google Scholar and OpenNet. The following search terms were used: Orthore* AND (prevalenc* OR incidenc* OR frequen* OR cut-off OR epidem*). A total of 613 unique hits were reviewed by two blinded authors, and 24 studies were coded and assessed for risk of bias (Holy et.al). The meta-regression included three independent variables (sex, type of sport, and sample size). Results The overall prevalence of ON in the exercising population was 55.3% (95% CI 43.2–66.8). Cochran’s Q was 11,436.38 (df = 23, p < 0.0000), and the I2 was 98.4%, indicating high heterogeneity across studies. The sensitivity showed an overall prevalence of 51.3% (95% CI 51.3–70.0). There was a significant difference in prevalence estimates based on the instruments used (Qbet = 33.6, df = 2, p < 0.01). Discussion The overall prevalence of ON in exercising populations was very high. The between-study disparity was large and was partly explained by the ON-instrument administered. One fourth of the studies had a moderate risk of bias. The majority of the studies did not specify relevant demographic information about the sample, and information about the type of sport was frequently missing.publishedVersio

Prevalence and stability of insomnia from preschool to early adolescence: a prospective cohort study in Norway

Background There is limited knowledge about the prevalence and stability of insomnia defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM). We therefore provide such estimates from preschool to early adolescence and explore potential sex differences. Methods We followed a representative community sample (n=1037) biennially from 4 to 14 years of age (2007–2017). Insomnia diagnoses and symptoms were captured by a semistructured clinical interview of parents and children (from age 8 years). Results At ages 4 and 6 years approximately 2.5% of children met the criteria for insomnia, whereas at ages 8, 10, 12 and 14 years the prevalence ranged from 7.5% to 12.3%. During the 10-year period examined nearly 1 in 5 children had insomnia at least once (18.7%). Sex differences were apparent with DSM-IV, but not DSM-5, criteria: boys (8.1%) had more insomnia than girls (4.5%) did at ages 4–10 years, whereas girls (11.4%) had more insomnia than boys (7.1%) did at ages 12 and 14 years. Insomnia proved stable, with 22.9%–40.1% of children retaining their diagnosis 2 years later. Having current insomnia produced medium to large ORs of between 5.1 (95% CI 2.6 to 9.8) and 15.3 (95% CI 4.4 to 52.9) for subsequent insomnia 2 years later compared with not having preceding insomnia. Conclusions Insomnia was less prevalent than previous research indicates, with nearly 1 in 5 participants having insomnia at least once between the ages of 4 and 14 years. Female preponderance emerged in early adolescence. Having insomnia at one time point was a considerable risk for subsequent insomnia, indicating that insomnia is persistent and warrants clinical attention.publishedVersio

Aggression and Anabolic-Androgenic Steroid Use Intent in Adolescents: A Longitudinal Study

Background: There is a dearth of longitudinal studies on risk factors for anabolic–androgenic steroid (AAS) use and intent. Objectives: We conducted a longitudinal investigation of factors associated with AAS use intent from age 18 to 19, examining particularly the role of physical and verbal aggression. A sample of Norwegians completed questionnaires containing demographic, AAS use and intent, other addictions, aggression, and health measures at ages 18 (N = 1333, females = 58.9%) and 19 (N = 1277, females = 61.7%). The data were analyzed using descriptive statistics, correlations, and hierarchical multiple regression. Results: Results show that AAS use prevalence increased from 1 person at age 18 to 4 persons at age 19. Intent to use AAS, being male, living alone, and AAS use (all at 18 years) were associated with higher AAS use intent at 19 years. We found no associations between physical or verbal aggression and AAS use intent from ages 18 to 19. Conclusions: Our findings indicate temporal stability in AAS use intent, as well as the influence of demographic and health factors on AAS use intent from ages 18 to 19. Implications of findings for practice and future research are discussed.acceptedVersio

Shift work and age in the offshore petroleum industry

Background. Shift work is associated with sleep and health problems. Tolerance to shift work is reported to decrease with age. Shift work tolerance should be considered in different shift work populations. The aim of the study was to examine the relationship between age, shift work exposure, shift type, and morningness and sleep/health problems in oil rig shift workers. Material and methods. A total of 199 workers participated. They worked either two weeks of 12-h day shifts (n = 96) or two weeks of swing shifts (n = 103) (one week of 12-h night shifts followed by one week of 12-h day shifts), followed by four weeks off work. The workers filled out questionnaires on demographics, work, sleep, and health. Results. We found no significant associations between age or years of shift work exposure and any of the sleep, sleepiness, or health parameters. There was a significant association between shift type and sleep duration, showing that swing shift workers had longer sleep duration than day shift workers. In addition, we found a significant association between the interaction age*, shift type, and sleep duration, where sleep duration was negatively associated with age for the swing shift workers and positively associated with age for the day shift workers. There were significant associations between morningness and sleep latency, sleep efficiency, and insomnia. Conclusions. Older workers may tolerate shift work well. Age, shift work exposure time, and shift type seemed not to affect shift work tolerance in this population. However, this may be due to a healthy worker effect and/or selection bias.publishedVersio

The Prevalence of Insomnia Subtypes in Relation to Demographic Characteristics, Anxiety, Depression, Alcohol Consumption and Use of Hypnotics

Objective: The aim of the present study was to examine the prevalence of insomnia subtypes in relation to several demographic characteristics, as well as to investigate the prevalence of possible anxiety and depression, alcohol consumption and use of hypnotics within the different insomnia subtypes. Methods: The present study was based on an extensive web-based survey made publicly available in 2012. The data was downloaded in January 2019, after 113 887 people had responded to parts of, or the entire questionnaire. The 64 503 participants who met the criteria for chronic insomnia disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) comprised the study population. The present study divided insomnia into seven subtypes based on type of sleep difficulty reported; sleep onset insomnia (SOL-insomnia), sleep maintenance insomnia (WASO-insomnia), early morning awakening insomnia (EMA-insomnia) and combinations of these. Data were analyzed with chi-square tests and logistic regression analyses adjusted for sex, age, level of education and marital status. Results: More than 60% of the study population met the criteria of either SOL-insomnia or a mixed insomnia subtype consisting of SOL-, WASO- and EMA-insomnia (SOL + WASO + EMA-insomnia). The percentage distribution of insomnia subtypes within the demographic characteristics showed that participants with female sex, high age, low level of education and who were divorced, separated or a widow/widower had a higher prevalence of SOL + WASO + EMA-insomnia compared to their respective demographic counterparts. The prevalence of possible anxiety, possible depression and use of hypnotics were higher among participants with SOL + WASO + EMA-insomnia compared to the other insomnia subtypes. The combination of WASO- and EMA-insomnia (WASO + EMA-insomnia) was associated with the most frequent alcohol consumption. Conclusion: Our findings suggest that there are major differences between the insomnia subtypes, both regarding demographics, but also in terms of how the complaints may affect daily life. Participants with combinations of SOL, WASO and EMA were more likely than participants with the other subtypes to have possible anxiety and possible depression, high alcohol consumption and to use hypnotics.publishedVersio