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Ten myths about work addiction

Author(s): Mark D. Griffiths,Zsolt Demetrovics,Paweł Atroszko / Language(s): English Issue: 4/2018

Research into work addiction has steadily grown over the past decade. However, the literature is far from unified and there has been much debate on many different issues. Aim and methods. This paper comprises a narrative review and focuses on 10 myths about work addiction that have permeated the psychological literature and beyond. The 10 myths examined are (a) work addiction is a new behavioral addiction, (b) work addiction is similar to other behavioral addictions, (c) there are only psychosocial consequences of work addiction, (d) work addiction and workaholism are the same thing, (e) work addiction exclusively occurs as a consequence of individual personality factors, (f) work addiction only occurs in adulthood, (g) some types of work addiction are positive, (h) work addiction is a transient behavioral pattern related to situational factors, (i) work addiction is a function of the time spent engaging in work, and (j) work addiction is an example of overpathogizing everyday behavior and it will never be classed as a mental disorder in the DSM. Results. Using the empirical literature to date, it is demonstrated that there is evidence to counter each of the 10 myths. Conclusion. It appears that the field is far from unified and that there are different theoretical constructs underpinning different strands of research.

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Myths about “The myths about work addiction” Commentary on: Ten myths about work addiction (Griffiths et al., 2018)

Author(s): Cecilie Schou Andreassen,Wilmar B. Schaufeli,Ståle Pallesen / Language(s): English Issue: 4/2018

The present paper encompasses a response to the debate paper by Griffiths et al. about work addiction myths. Generally, we found weak empirical basis for the statement that there exist major myths and controversies regarding work addiction. Although we agree with Griffiths et al. on several issues, we argue that: (a) although work addiction is not a new behavioral addiction, work addiction research is still in its infancy; (b) work addiction is largely similar to other behavioral addictions; (c) work addiction and workaholism are actually the same; and (d) there is no compelling evidence that work addiction occurs before adulthood.

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Ten myths and twenty years: What we know and what we still do not know about work addiction. Commentary on: Ten myths about work addiction (Griffiths et al., 2018)

Author(s): Bernadette Kun / Language(s): English Issue: 4/2018

This commentary addresses a recent article by Griffiths et al. (2018) about myths in work addiction. In response to the narrative review, I reflect on all the myths that the authors highlighted and the argument on how they tried to counter them. In comparison to an earlier overview by Robinson (1998), it is clear which myths about work addiction are persistent and represent the most important issues about this problem. Most of the myths were countered by the authors, but some of them need more evidence to be unequivocally defeated. The commentary focuses on the most important future research directions based on the myths discussed in this paper.

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Recommendations for increasing research on co-occurring serious mental illness and gambling problems. Commentary on: Disordered gambling and psychosis: Prevalence and clinical correlates (Cassetta et al., 2018)

Author(s): Rebecca E. Pullman,Marc N. Potenza,Shane W. Kraus / Language(s): English Issue: 4/2018

Psychiatric disorders frequently co-occur with gambling disorder. Although community and clinical samples show frequent co-occurrence between gambling and psychotic disorders, relatively little research has been conducted on this population. Here, we comment on a recent study conducted in Brazil on the clinical correlates of psychotic disorders in treatment-seeking individuals with gambling disorder, relate the findings to those from the northeastern region of the United States, and discuss implications with respect to promoting responsible gambling in the setting of the expansion of legalized gambling.

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Breaking the habit

Author(s): Kai W. Müller / Language(s): English Issue: 4/2018

Internet gaming disorder has been widely recognized as a new health issue. At present, we are experiencing a rapid growth of knowledge on different aspects of this disorder, such as, for instance, prevalence rates, underlying neurobiological mechanisms, and treatment strategies. In contrast, preventing individuals from developing Internet gaming disorder is a matter that has not yet progressed sufficiently. Although we can basically refer to measures and techniques known to be effective in preventing other addictive behaviors, the special demands of preventing Internet gaming disorder remain largely obscured or disregarded. The policy actions identified in the review by Király et al. (2018) demonstrate that first preventive approaches have been initiated but, on the other hand, it also points out that empirical research on their feasibility and effectiveness needs improvement.

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Who uses self-exclusion to regulate problem gambling? A systematic literature review

Author(s): Franziska Motka,Bettina Grüne,Pawel Sleczka,Barbara Braun,Jenny Cisneros Örnberg,Ludwig Kraus / Language(s): English Issue: 4/2018

Self-exclusion programs offer an intervention for individuals with problem gambling behavior. However, these programs are insufficiently used. This review describes sociodemographic features and gambling behavior of self-excluders as well as goals and motives for initiating self-exclusion from terrestrial and online gambling. In addition, use of further professional help and barriers to self-exclusion are examined. Methods. Based on systematic literature search and quality assessment, n = 16 original studies (13 quantitative, 2 qualitative, and 1 mixed method) published between 1997 and 2017 in English or German language were analyzed. Results are presented for online and terrestrial gambling separately. Results. Online self-excluders were on average 10 years younger than terrestrial self-excluders. Self-exclusion was mainly motivated by financial problems, followed by feelings of losing control and problems with significant others. Financial problems and significant others were less important for online than for terrestrial gamblers. Main barriers for self-exclusion were complicated enrollment processes, lack of complete exclusion from all venues, little support from venue staff, and lack of adequate information on self-exclusion programs. Both self-excluders from terrestrial and online gambling had negative attitudes toward the need of professional addiction care. Conclusion. To exploit the full potential of self-exclusion as a measure of gambler protection, its acceptance and its utilization need to be increased by target-group-specific information addressing financial issues and the role of significant others, simplifying the administrative processes, facilitating self-exclusion at an early stage of the gambling career, offering self-determined exclusion durations, and promoting additional use of professional addiction care.

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A mindful model of sexual health: A review and implications of the model for the treatment of individuals with compulsive sexual behavior disorder

Author(s): Gretchen R. Blycker,Marc N. Potenza / Language(s): English Issue: 4/2018

Mindfulness-based approaches, derived from centuries of eastern philosophy and practice, have been increasingly incorporated into western medicine. For example, data support the efficacy of mindfulness-based therapies to reduce stress and promote mental health. Methods. In this study, we briefly review models and approaches to sexual health in the context of considering compulsive sexual behavior disorder, describe mindfulness-based approaches to stress, addiction, and compulsive sexual behaviors, and present a Mindful Model of Sexual Health (MMSH) that incorporates elements of eastern and western philosophies. We further illustrate the clinical utility of the MMSH in a clinical case description. Results. We propose the MMSH as a holistic and integrative model that honors and acknowledges individual differences and provides mindfulness-based tools and practices to support individuals to proactively manage, balance, and promote sexual and mental health. The MMSH may be used as a framework to organize information regarding physical, mental, emotional, sexual, and relational health, as well as a conceptual map offering navigational skills to access information within one’s mind/body to make informed decisions to promote well-being regarding sexual satisfaction and health. In its organizational structure, the MMSH is divided into eight domains that are theoretically linked to biological functions and may be used to identify and overcome barriers to sexual health through mindful inquiries in clinical practice or educational settings. Discussion and conclusion. Given its focus on awareness of interoceptive processes through mind/body connectedness, the MMSH may resonate with a wide range of individuals, including those with compulsive sexual behavior disorder.

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A cohort study of patients seeking Internet gaming disorder treatment

Author(s): Doug Hyun Han,Minkyoung Yoo,Perry F. Renshaw,Nancy M. Petry / Language(s): English Issue: 4/2018

Although Internet gaming disorder (IGD) is included as a condition in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, little is known about its nature or treatment response. This study is a follow-up of 755 patients who received professional treatment for IGD over a 5-year period. Methods. The initial recommended treatment course lasted for 8 weeks, with additional care provided as needed. Treatment completion rates in the complete sample, as well as baseline predictors of treatment completion and long-term recovery among the 367 patients who completed the follow-up, are reported. Results. Nearly two thirds of patients who initiated treatment for IGD completed the 8-week psychotherapy. Of these, about two thirds who had not recovered completely by the end were offered additional care. Independent predictors of extended treatment were higher baseline scores on the Young Internet Addiction Scale, Beck Depression Inventory (BDI), and Korean-Attention Deficit Hyperactivity Disorder-Rating Scale (K-ADHD-RS). Between 1 and 5 years later, 33.5% of the complete sample was considered as recovered from IGD. Significant predictors of recovery from IGD were older age, earlier admission to the clinic, lower baseline scores on the BDI and K-ADHD-RS, and no offer of extended treatment. Discussion and conclusions. The majority of the patients seeking treatment for IGD continued experiencing difficulties and randomized controlled trials of interventions, which are needed to be conducted to improve outcomes. Age, family, social factors, and psychological symptoms should be considered, while designing and evaluating interventions, because they impact initial and sustained response to treatment for IGD.

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Treatment efficacy of a specialized psychotherapy program for Internet Gaming Disorder

Author(s): Alexandra Torres-Rodríguez,Mark D. Griffiths,Xavier Carbonell,Ursula Oberst / Language(s): English Issue: 4/2018

Internet Gaming Disorder (IGD) has become health concern around the world, and specialized health services for the treatment of IGD are emerging. Despite the increase in such services, few studies have examined the efficacy of psychological treatments for IGD. The primary aim of this study was to assess the efficacy of a specialized psychotherapy program for adolescents with IGD [i.e., the “Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la Información y la Comunicación” (PIPATIC) program]. Methods. The sample comprised 31 adolescents (aged 12–18 years) from two public mental health centers who were assigned to either the (a) PIPATIC intervention experimental group or (b) standard cognitive-behavioral therapy (CBT) control group. The interventions were assessed at pre-, middle-, and post-treatment phases, as well as a 3-month assessment was carried out after completing the interventions. Results. No significant differences between either group in the pre-treatment phase were found. Relating to the different interventions examined, significant differences were found at pre-test and post-test on the following variables: comorbid disorders, intrapersonal and interpersonal abilities, family relationships, and therapists’ measures. Both groups experienced a significant reduction of IGD symptoms, although the PIPATIC group experienced higher significant improvements in the remainder of the variables examined. Discussion and conclusions. The findings suggest that PIPATIC program is effective in the treatment of IGD and its comorbid disorders/symptoms, alongside the improvement of intra- and interpersonal abilities and family relationships. However, it should also be noted that standard CBT was also effective in the treatment of IGD. Changing the focus of treatment and applying an integrative focus (including the addiction, the comorbid symptoms, intra- and interpersonal abilities, and family psychotherapy) appear to be more effective in facilitating adolescent behavior change than CBT focusing only on the IGD itself.

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Association between problematic Internet use, sleep disturbance, and suicidal behavior in Chinese adolescents

Author(s): Lan Guo,Min Luo,Wan-Xin Wang,Yan Xu,Xue Gao,Ci-Yong Lu,Wei-Hong Zhang / Language(s): English Issue: 4/2018

This large-scale study aimed to test (a) associations of problematic Internet use (PIU) and sleep disturbance with suicidal ideation and suicide attempts among Chinese adolescents and (b) whether sleep disturbance mediates the association between PIU and suicidal behavior. Methods. Data were drawn from the 2017 National School-based Chinese Adolescents Health Survey. A total of 20,895 students’ questionnaires were qualified for analysis. The Young’s Internet Addiction Test was used to assess PIU, and level of sleep disturbance was measured by the Pittsburgh Sleep Quality Index. Multilevel logistic regression models and path models were utilized in analyses. Results. Of the total sample, 2,864 (13.7%) reported having suicidal ideation, and 537 (2.6%) reported having suicide attempts. After adjusting for control variables and sleep disturbance, PIU was associated with an increased risk of suicidal ideation (AOR = 1.04, 95% CI = 1.03−1.04) and suicide attempts (AOR = 1.03, 95% CI = 1.02−1.04). Findings of the path models showed that the standardized indirect effects of PIU on suicidal ideation (standardized β estimate = 0.092, 95% CI = 0.082−0.102) and on suicide attempts (standardized β estimate = 0.082, 95% CI = 0.068−0.096) through sleep disturbance were significant. Conversely, sleep disturbance significantly mediated the association of suicidal behavior on PIU. Discussion and conclusions. There may be a complex transactional association between PIU, sleep disturbance, and suicidal behavior. The estimates of the mediator role of sleep disturbance provide evidence for the current understanding of the mechanism of the association between PIU and suicidal behavior. Possible concomitant treatment services for PIU, sleep disturbance, and suicidal behavior were recommended.

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The role of self-esteem in Internet addiction within the context of comorbid mental disorders: Findings from a general population-based sample

Author(s): Katrin Sevelko,Gallus Bischof,Anja Bischof,Bettina Besser,Ulrich John,Christian Meyer,Hans-Jürgen Rumpf / Language(s): English Issue: 4/2018

Background and aims: Internet Addiction (IA) has consistently been related to comorbid psychiatric disorders and lowered self-esteem. However, most studies relied on self-report questionnaires using non-representative samples. This study aims to analyze the relative impact of self-esteem and comorbid psychopathology with lifetime IA in a population-based sample of excessive Internet users using clinical diagnoses assessed in a personal interview. Methods: The sample of this study is based on a general population survey. Using the Compulsive Internet Use Scale, all participants with elevated Internet use scores were selected and invited to a follow-up interview. Current DSM-5 criteria for Internet gaming disorder were rephrased to apply to all Internet activities. Out of 196 participants, 82 fulfilled the criteria for IA. Self-esteem was measured with the Rosenberg’s Self-Esteem Scale. Results: Self-esteem is significantly associated with IA. For every unit increase in self-esteem, the chance of having IA decreased by 11%. By comparison, comorbidities such as substance-use disorder (excluding tobacco), mood disorder, and eating disorder were significantly more likely among Internet-addicted than in the non-addicted group. This could not be reported for anxiety disorders. A logistic regression showed that by adding self-esteem and psychopathology into the same model, self-esteem maintains its strong influence on IA. Discussion and conclusions: Self-esteem was associated with IA, even after adjustment for substance-use disorders, mood disorder, and eating disorder. Self-esteem and psychopathology should be considered in prevention, intervention measures, as well as in the conception of etiological models.

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Associations between the dark triad of personality and unspecified/specific forms of Internet-use disorde

Author(s): Cornelia Sindermann,Rayna Sariyska,Bernd Lachmann,Matthias Brand,Christian Montag / Language(s): English Issue: 4/2018

Background and aims. Despite indications that the dark triad of personality might be associated with Internet-use disorder (IUD), research about these associations is lacking. Methods. Two studies were performed to grasp the links between these variables. In the first study, a sample consisting of N = 468 participants (n = 130 males) filled in the Short Dark Triad Questionnaire to assess scores in the dark triad of personality and the short Internet Addiction Test to assess tendencies toward unspecified IUD. In the second study, another independent sample of N = 472 participants (n = 143 males) filled in the same questionnaires plus items about specific forms of IUD. Results. Traits Machiavellianism and psychopathy were positively linked to tendencies toward unspecified IUD in both samples and males and females. Regarding the associations between tendencies toward specific IUDs and the dark triad of personality, no significant associations were found in males (at least not passing correction procedures for multiple testing). In females, trait Machiavellianism/psychopathy and tendencies toward Internet-shopping disorder, trait psychopathy, and tendencies toward Internet-pornography-use disorder as well as trait Machiavellianism and tendencies toward Internet-communication disorder were significantly positively correlated [at least one of the (sub)scales assessing the respective specific IUD was significantly associated with the respective dark triad trait even after correction procedures for multiple testing]. No robust pattern of associations between trait narcissism and unspecified/specific forms of IUD could be observed across (sub)samples. Discussion and conclusions. These results indicate positive associations of the traits Machiavellianism and psychopathy (on a subclinical level) with tendencies toward IUD, especially unspecified IUD. The associations with tendencies toward specific forms of IUD seem more complex with differential personality correlates for each specific IUD. These associations need to be replicated.

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Understanding and predicting profiles of compulsive sexual behavior among adolescents

Author(s): Yaniv Efrati,Mateusz Gola / Language(s): English Issue: 4/2018

This two-study research was designed to define and predict profiles of compulsive sexual behavior (CSB) among non-clinical population of adolescents, and aimed to fill gaps in the current research. Methods. In Study 1 (N = 1,182), we examined the profiles of CSB among adolescents using latent profile analysis. Results revealed the following three clusters: abstainers, sexual fantasizers, and individuals with CSB. In Study 2 (N = 618), we replicated this classification and examined differences between the clusters in Big Five personality traits, locus of control, attachment orientations, loneliness, age, gender, socioeconomic status (SES), residence quality, use of pornography, and sex-related online activities. Results. Adolescents classified into different clusters significantly differed in personality traits, loneliness, age, SES, use of pornography, and sex-related online activities. Specifically, individuals with CSB had external locus of control, anxious attachment, greater loneliness, higher frequency of pornography use, and more sex-related online activities than the other groups. Discussion. The current research expands the knowledge about CSB by providing a more individualized approach to understanding CSB among adolescence.

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The contribution of personality factors and gender to ratings of sex addiction among men and women who use the Internet for sex purpose

Author(s): Lee Shimoni,Moria Dayan,Koby Cohen,Aviv Weinstein / Language(s): English Issue: 4/2018

Sex addiction is characterized by excessive sexual activity on the Internet. We have investigated the contribution of the Big Five personality factors and sex differences to sex addiction. Methods. A total of 267 participants (186 males and 81 females) were recruited from Internet sites that are used for finding sexual partners. Participants’ mean age was 31 years (SD = 9.8). They filled in the Sexual Addiction Screening Test (SAST), the Big Five Index, and a demographic questionnaire. Results. Men have shown higher scores of sex addiction than women (Cohen’s d = 0.40), they were more open to experiences (Cohen’s d = 0.42), and they were less neurotic than women (Cohen’s d = 0.67). Personality factors contributed significantly to the variance of sex addiction [F(5, 261) = 6.91, p < .001, R2 = .11]. Openness to experience (β = 0.18) and neuroticism (β = 0.15) had positive correlations with SAST scores, whereas conscientiousness (β = −0.21) had a negative correlation with SAST scores, and personality traits explained 11.7% of the variance. A parallel moderation model of the effect of gender and personality traits on sex addiction explained 19.6% of the variance and it has indicated that conscientiousness had a negative correlation with SAST scores. Greater neuroticism was associated with higher scores of SAST in men but not in women. Discussion and conclusions. This study confirmed higher scores of sex addiction among males compared to females. Personality factors together with gender contributed to 19.6% of the variance of ratings of sex addiction. Among men, neuroticism was associated with greater propensity for sex addiction.

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Exploring relationships between problem gambling, scratch card gambling, and individual differences in thinking style

Author(s): Madison Stange,Alexander C. Walker,Derek J. Koehler,Jonathan A. Fugelsang,Mike J. Dixon / Language(s): English Issue: 4/2018

Scratch cards are a popular form of lottery gambling available in many jurisdictions. However, there is a paucity of research that examines associations between individual differences in thinking style, participation in scratch card gambling, and problem gambling severity. Methods. In three studies, we sought to examine the relationships among these variables in large, online samples of participants. Participants completed the Cognitive Reflection Test (CRT), the Problem Gambling Severity Index (PGSI), the Actively Open-Minded Thinking Scale, and self-reported their frequency of scratch card gambling. Results. Throughout all three studies, specific associations were reliably established. Specifically, negative associations were observed between participants’ CRT and PGSI scores, as well as between participants’ CRT scores and scratch card gambling frequency. In addition, we found a positive association between problem gambling severity and scratch card gambling frequency. Finally, problem gambling severity was shown to correlate positively with participants’ willingness to pay for irrelevant information in a scratch card gambling scenario. Discussion and conclusions. Overall, we observed that problem gambling severity is associated with an individuals’ thinking style and scratch card gambling behavior. This study adds to the existing literature examining problem gambling, and highlights the role of thinking style in understanding gambling behavior and problematic gambling.

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Gambling, motor cautiousness, and choice impulsivity: An experimental study

Author(s): Andrew Harris,Daria J. Kuss,Mark D. Griffiths / Language(s): English Issue: 4/2018

Impulsivity is currently more commonly regarded as multifaceted, comprising both motor and cognitive subdomains. However, it is less clear how distinct these subdomains are, and the extent to which they interact and draw upon the same psychological resources. Methods. The present experiment comprised 70 regular (non-problem) gamblers, and investigated the potential to induce impulsivity transfer effects within an electronic gambling context. Original and existing harm-minimization approaches were tested for their efficacy in inducing motor cautiousness during an electronic slot machine simulation. Participants were exposed to a forced discriminatory motor choice procedure, or pop-up responsible gambling messages that either contained emotive or non-emotive responsible gambling content. The subsequent impact these interventions had on delay discounting and reflection impulsivity was also measured using the 27-item Monetary Choice Questionnaire and Information Sampling Task, respectively. Results. Findings demonstrated that only original harm-minimization approaches, which force the gambler to engage in discriminatory motor choice procedures during gambling, were successful in inducing motor cautiousness. However, both the discriminatory choice procedure and emotive message harm-minimization approaches were successful in facilitating cognitive choice, even though the emotive message intervention was unsuccessful in facilitating motor response inhibition, suggesting both an indirect motor cautiousness route, and a more direct route to improved cognitive choice during gambling. Conclusion. This study demonstrated that decision-making during gambling can be improved by making simple structural changes to slot machine platforms, by encouraging active engagement in motor processes, which result in a transfer of cautiousness to wider cognitive domains.

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The impact of self-control cues on subsequent monetary risk-taking

Author(s): Damien Brevers,Jennifer Foucart,Ofir Turel,Anais Bertrand,Mikael Alaerts,Paul Verbanck,Charles Kornreich,Antoine Bechara / Language(s): English Issue: 4/2018

The “process-model” of self-control proposes that the ego-depletion effect is better explained by a switch between interest in “have-to” labor and cognitive “want-to” leisure, rather than being mainly due to a decrease in cognitive resources, as advanced by the “strength-model” of self-control. However, it is currently difficult to disentangle the “process-model” from the “strength-model” of self-control. Here, we employed a stepwise approach, featuring three studies, for testing the process model of self-control. Methods. In Study 1, we created a list of 30 self-control events for characterizing “have-to” conducts in the daily life. In Study 2, mental visualization of effortful self-control events (“have-to”) and monetary risk-taking (“want-to”) were employed for testing the strength-model of self-control. In Study 3, to test the process-model of self-control, participants were simply required to read self-control (or neutral) sentences. Results. Study 1 provided evidence regarding external validly for the list of self-control events. Study 2 showed that mental visualization of effortful self-control events increases subsequent monetary risk-taking. Study 3 highlighted that the brief apparition of a self-control-related sentence was sufficient for increasing risk-taking. These patterns were evidenced in the trial with the less advantageous gain/loss ratio. Discussion. Altogether these findings support the process-model of self-control in showing that triggering the semantic content of a “have-to” conduct, without its actual execution, is sufficient for modulating subsequent “want-to” activity. Conclusion. These findings could contribute to advancing current knowledge on how the high availability of ready-to-consume rewards in modern environments is redefining humans’ self-control ability.

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The effect of loss-limit reminders on gambling behavior: A real-world study of Norwegian gamblers

Author(s): Michael Auer,Niklas Hopfgartner,Mark D. Griffiths / Language(s): English Issue: 4/2018

Over the past two decades, problem gambling has become a public health issue and research from many countries indicates that a small but significant minority of individuals are problem gamblers. In Norway, the prevalence of problem gambling among adults is estimated to be just less than 1%. To help minimize the harm from gambling, the Norwegian government’s gambling operator (Norsk Tipping) has introduced several responsible gambling initiatives to help protect players from developing gambling problems (e.g., limit-setting tools, voluntary self-exclusion, personalized feedback, etc.). Aim. The aim of this study was to determine whether the receiving of personalized feedback exceeding 80% of a personally set monetary personal limit had an effect on subsequent playing behavior compared to those gamblers who did not receive personalized feedback. Methods. Out of 54,002 players, a total of 7,884 players (14.5%) received at least one piece of feedback that they had exceeded 80% of their personal global monthly loss limit between January and March 2017. Results. Using a matched-pairs design, results showed that those gamblers receiving personalized feedback in relation to limit-setting showed significant reductions in the amount of money gambled. Conclusion. The findings of this study will be of great value to many stakeholder groups including researchers in the gambling studies field, the gambling industry, regulators, and policymakers.

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Young people’s recall and perceptions of gambling advertising and intentions to gamble on sport

Author(s): Christian Nyemcsok,Samantha L. Thomas,Amy Bestman,Hannah Pitt,Mike Daube,Rebecca Cassidy / Language(s): English Issue: 4/2018

There has been an increased international policy focus on the factors that may contribute to, and prevent, the normalization of gambling for young people. However, there is still limited research, which investigates the role of advertising in shaping young people’s gambling attitudes and consumption intentions. Methods. Mixed methods study of 111 young people aged 11–16 years recruited from community basketball stadiums in Victoria, Australia, between May and July 2018. Interviewer-assisted surveys investigated recall and awareness of sports betting brands, perceptions of promotional strategies, intention to gamble, and reasons for betting on particular sports. Quantitative data were analyzed using descriptive statistics and χ2 tests. Thematic analyses were used to interpret qualitative responses. Results. Young people had high recall and awareness of advertising, with most able to name at least one betting brand (n = 90, 81.1%), and many demonstrating a high awareness of the distinct characteristics (such as colors and appeal strategies) of different brands. A fifth of young people (n = 25, 22.5%) expressed intentions to gamble at 18 years, with boys significantly more likely than girls to state they would gamble (χ2 = 10.90, p = .001). Young people perceived that advertising strategies associated with inducement promotions would be the most influential in encouraging individuals to gamble. While many young people took promotions at face value, there was evidence that some were able to critically engage with and challenge the messages within marketing. Discussion and conclusions. Current regulatory structures appear to be ineffective in limiting young people’s recall and awareness of gambling advertising. Lessons from tobacco control support the application of precautionary approaches as a more effective way to limit young people’s development of positive gambling attitudes and behaviors.

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Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study

Author(s): Anna Karlsson,Anders Hakansson / Language(s): English Issue: 4/2018

Gambling disorder (GD) appears to be an independent risk factor for suicide, and all-cause mortality has been sparsely studied in patients with GD. This study aims to explore mortality and suicide rates in individuals with GD compared to the general population as well as explore risk factors associated with all-cause mortality and suicide mortality. Methods. This is a nationwide register study on 2,099 individuals with a GD diagnosis in the Swedish inpatient and/or outpatient specialist health care system between the years of 2005–2016. Comorbid diagnoses from treatment episodes included in national registers were categorized into diagnostic groups according to the 10th revision of International Classification of Diseases, and prevalence rates (any occurrence during 2005–2016) were calculated for each diagnostic group. Multivariate Cox regression analyses on risk factors for death and suicide were performed, controlling for age, gender, and major categories of comorbidity. Standardized mortality ratios (SMRs) were calculated for men and women with regard to overall mortality and suicide compared to the general Swedish population. Results. The population consisted of 1,625 men and 474 women ranging from 18 to 83 years of age at first GD diagnosis (mean: 36.5 years). Sixty-seven individuals passed away, among whom 21 deaths were due to suicide. SMR calculations showed a 1.8-fold increase in mortality for individuals 20–74 years old with GD compared to the general population, and a 15-fold increase in suicide mortality. All-cause mortality was predicted by higher age and any treatment episode for cardiovascular disease, whereas suicide death was predicted by depression. Discussion and conclusions. Mortality and suicide rates are significantly elevated among individuals with GD. Although common mental health comorbidities did not predict overall mortality, depression predicted suicide death. Findings call for attention to long-term risk of death in GD patients and interventions against comorbid health problems.

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