Journal of Behavioral Addictions最新文献

Background: Attention deficit hyperactivity disorder (ADHD) and behavioral addictions (BAs) are highly comorbid but little is known about the effect of anti-ADHD medications on behavioral addiction symptoms. Thus, the aim of this naturalistic prospective study was to investigate the long-term changes on BAs symptoms among methylphenidate-treated adults with a primary diagnosis of ADHD.

Methods: 37 consecutive adult ADHD outpatients completed a baseline and follow-up assessment of ADHD, mood and BAs symptoms (internet, shopping, food, sex addictions and gambling disorder) after one year of methylphenidate (flexible dose) treatment.

Results: Internet addiction test scores pre-treatment were significantly higher than post-treatment scores (p < 0.001). The same trend was seen for the shopping addiction (p = 0.022), food addiction scores (p = 0.039) and sex addiction scores (p = 0.047). Gambling disorder scores did not differ pre and post treatment since none of the included patients reported significant gambling symptoms at baseline. The rate of ADHD patients with at least one comorbid BA was reduced after methylphenidate treatment (51.4% vs 35.1%). The correlation analyses showed a moderate positive correlation between the changes in sluggish cognitive tempo symptoms, cognitive impulsivity, mood and anxiety symptoms and changes in internet addiction symptoms.

Conclusions: This is the first study showing that after one-year of treatment with methylphenidate, adult ADHD patients show a significant reduction on internet, food, shopping and sex addiction symptoms. Further controlled studies with larger samples should replicate these preliminary results and elucidate the role of methylphenidate and other moderator factors (such as concomitant psychological treatments or lifestyle habits changes) on BAs improvements.

Investigating the impacts of addiction policymaking following implementation is important. Effective policies should be considered for emulation elsewhere, whilst ineffective policies should be repealed. Zhou et al. (2024) reported how Mainland Chinese under-18s responded to the 2021 restrictions on their online videogame playtime, which were intended to curb online gaming addiction. However, Zhou et al. failed to mention that Mainland China had previously tried to achieve the same regulatory aim by imposing rules in 2019 that were more lenient than the 2021 rules but nonetheless restricted under-18s' gameplay time. These 2019 restrictions were neither acknowledged as crucial background in the introduction section nor accounted for by Zhou et al. when interpreting their results, thus giving readers the incorrect impression that the 2021 rules were the first ones introduced and that under-18s' gameplay time was not restricted at all prior to 2021. Importantly, Zhou et al.'s entire sample of young people therefore consisted not merely of 'heavy gamers' as they euphemistically described them as, but 'counterplayers' who actively contravened the 2019 rules. The misleading omission of this context is a major limitation and misrepresentation. The results should be interpreted accordingly and not overgeneralised.

Background and aims: Conflicting findings have been reported for the longitudinal course of behavioral addictions, especially for social media addiction (SMA) and work addiction (WA). Therefore, evaluating whether these constructs are more trait-like or state-like might be informative. The aim of the present study was to examine the proportion of variance of SMA and WA symptoms (as defined by the components model of addiction) explained by trait and occasion-specific factors in addition to exploring cross-lagged relationships between SMA and WA.

Methods: Young adults from a representative sample who continuously used social media and worked at least 40 hours a week during the first three waves of the Budapest Longitudinal Study were included (N = 1,551; Females: 50.6%; Age: M = 27.7 years [SD = 4.40]). The Bergen Social Media Addiction Scale and the Bergen Work Addiction Scale were administered in all three waves.

Results: A latent state-trait model with a general trait factor was considered for both SMA and WA. Symptomatic variability in SMA was explained approximately equally by trait and state-like factors, while WA-related symptom variability was mostly attributed to state-like factors. SMA negatively predicted WA over time, while WA showed a positive cross-lagged effect on SMA.

Discussion and conclusions: While the symptoms of WA were more state-like, the trait-like effects were stronger in SMA. Situational influences and previous symptom severities might have to be considered in the screening process.

Background and aims: Mobile phone bans in secondary schools are claimed to reduce student distraction and promote learning and face-to-face socializing. Currently, the evidence on phone bans is limited. The aim of this preregistered study was to evaluate the South Australian mobile phone ban's effects on students' problematic phone use, academic engagement, school belonging, and bullying. The study also sought to identify student variables that predict phone ban compliance.

Methods: As the ban was phased in over 2023, a 2 (phone ban: yes/no) × 2 (time: baseline, 1-month follow-up) repeated-measures design was employed. Students (n = 1,282 at baseline; n = 1,256 at follow-up) in Grades 7 to 12 were recruited from five public secondary schools. Surveys included measures drawn from the Longitudinal Study of Australian Children (LSAC) and the Programme for International Student Assessment (PISA).

Results: Problematic phone use was reported by 2.6% of the sample. Being older and a more frequent user of social media predicted lower phone ban compliance. Linear mixed models indicated that ban and no ban school groups did not differ significantly in terms of problematic phone use, academic engagement, and school belonging. There was slightly higher bullying in the ban group but bullying decreased significantly in both groups.

Discussion: Imposing access restrictions may not affect the underlying psychological mechanisms that drive problematic phone use. Although these results indicate limited to no short-term benefits of the ban, further evaluation with more sensitive methodologies is recommended.

Conclusions: Student-technology interactions in learning institutions should be continually monitored to determine the optimal balance to support student etiquette, learning, and wellbeing.

Background: Compulsive buying-shopping is recognised as a significant mental health concern, yet its aetiology is largely understudied. A known risk factor for compulsive buying-shopping is adverse childhood experiences (ACEs). ACEs are also associated with greater problems regulating emotions, as well as depression and anxiety. These factors are also known to be associated with compulsive buying-shopping problems. In this study, we aimed to test a serial mediation model in which ACEs were associated with compulsive buying-shopping problems via emotion dysregulation, and then emotional psychopathology (depression, anxiety).

Methods: We tested this model cross-sectionally in two large samples (N = 1,868 & 4,742) to evaluate the robustness of the model. Both samples completed self-report measures of ACEs, emotional dysregulation, compulsive buying, depression, and anxiety symptoms.

Results: We found support for indirect effects, and all results were consistent for both samples. ACEs predicted greater emotion dysregulation, which then predicted greater depression and anxiety. In turn, anxiety (but not depression) predicted compulsive buying symptoms.

Discussion and conclusions: Emotion dysregulation and anxiety consistently mediated the relationship between ACEs and compulsive buying symptoms. Both emotion dysregulation and anxiety represent malleable targets in clinical interventions for compulsive buying-shopping problems. Our findings also suggest that anxiety may be a stronger predictor of compulsive buying compared to depression, which may be an important avenue for future researchers to investigate.

Background and aims: Electronic gaming machines (EGMs) are a significant source of gambling spend due to their widespread use. Skill-based gambling machines (SGMs) represent an innovative adaptation, merging EGMs' chance-based rewards with video game-like skills. This study aimed to explore the appeal and behavioural consequences of playing SGMs in comparison to traditional reel-based EGMs, particularly focusing on illusions of control, betting behaviour, and the subjective experience of gamblers.

Methods: Participants (N = 1,260) were recruited online and engaged in an online task simulating either an SGM or a reel-based EGM, with outcomes represented to influence their survey compensation. The study examined the effect of SGMs relative to EGMs on bet size, persistence, enjoyment, illusions of control, game immersion, and the influence of demographic and gambling problem severity.

Results: SGMs particularly appealed to younger adults, regular EGM players, and people with more gambling problems. Despite identical payout structures, people assigned to play SGM showed greater illusions of control, believing in the influence of skill on game outcomes and that practice could improve results. However, there was no significant difference in overall betting intensity between SGM and EGM players, although specific demographic groups showed faster betting speeds in SGMs.

Discussion and conclusions: SGMs, despite not inherently encouraging higher betting intensity, attract vulnerable groups and create illusions of control, posing new regulatory challenges. The visual and interactive features of SGMs, while appealing, might contribute to these perceptions, indicating a need for careful regulation and further research on their long-term impacts on gambling behaviour and harm.

Background and aims: The South Oaks Gambling Screen (SOGS) is a commonly used tool for screening potential gambling problems. The SOGS score has been found to be correlated with the DSM-5 criteria for Gambling Disorder (GD). However, one of its main limitations is the high rate of false positives. The objective of this study was to establish more accurate cutoff points for the SOGS based on the DSM-5 criteria and severity levels, taking into account sex-specific samples. Additionally, we aimed to validate these cutoff points using external measures.

Methods: The study sample comprised 4.516 patients (398 women and 4,118 men) who sought treatment for GD. Of these patients, 4.203 met the DSM-5 criteria for GD, while 313 did not meet the threshold for GD diagnosis.

Results: The recommended cutoff value for the SOGS is eight for men (Sensitivity (Se): 82.9%, Specificity (Sp): 86.2%) and seven for women (Se: 85.6%, Sp: 77.4%). For moderate severity of GD, the cutoff points are nine for men (Se: 82.1%, Sp: 82.0%) and eight for women (Se: 86.3%, Sp: 73.3%), while for severe cases of GD, the cutoff point is ten for both sexes (Se: 83.0%, Sp: 56.7% for men; Se: 80.0%, Sp: 77.4% for women). These cutoff values are validated by evidence of worse psychopathological states, more dysfunctional personality traits, and risky behaviours commonly associated with GD.

Discussion and conclusions: These findings support adjusting the reference values for the SOGS to eight in males and seven in females to enhance the classification of individuals potentially experiencing GD. The use of higher cutoff values has significant implications for clinical and research purposes, enabling a more precise assessment of the diagnosis and severity of GD.

Craving is a central feature of substance use disorders and disorders due to addictive behaviors. Considerable research has investigated neural mechanisms involved in the development and processing of craving. Recently, connectome-based predictive modeling, a data-driven method, has been used in four studies aiming to predict craving related to substance use, addictive behaviors, and food. Studies differed in methods, samples, and conceptualizations of craving. Within the commentary we aim to compare, contrast and consolidate findings across studies by considering conceptual and methodological features of the studies. We derive a theoretical model on the functional connectivity-craving relationships across studies.

Background and aims: Gaming disorder (GD) is a prevalent and complex issue that has recently been recognized as a condition that impairs mental health, underscoring the urgent need for early prevention measures. This evaluation study examined the effectiveness of the Digital Netizen Alliance (D.N.A.) program, a new multicomponent positive psychology program for preventing GD and bolstering mental wellness among Chinese children.

Methods: Drawing on gamification and positive psychology principles, the program builds four key positive skills collectively referred to as the P-A-G-E framework: psychological resilience, active coping, growth mindset, and emotion regulation. A randomized controlled trial was conducted with 264 primary school pupils attending fourth, fifth, or sixth grade in Hong Kong (63% female; mean age = 10.83, SD = 1.18).

Results: The findings revealed that participation in the program effectively promoted active coping, a growth mindset, and emotion regulation. Moreover, program participation alleviated GD symptoms and reduced negative affect. These desirable changes were fully explained by the P-A-G-E framework.

Discussion and conclusions: The new D.N.A. program, which cultivates the positive psychology skills specified in the P-A-G-E framework, facilitates favorable psychological changes among children. These results emphasize the importance of using multicomponent frameworks for interventions targeting GD prevention.

Background and aims: Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD).

Methods: The study employed a case-control design, including all adult Norwegians receiving a GD diagnosis within specialist health services from January 2008 to December 2018 (n = 5,131). These individuals were compared with age- and sex-matched controls from the general population (n = 30,164), as well as controls with somatic and psychiatric diagnoses (n = 30,476).

Results: Logistic regressions showed that those in the highest quartile of unpaid unemployment days had more than double the odds (odds ratio [OR] 2.23 (95% CI [1.96, 2.52]) of developing GD compared to those with no unpaid unemployment days. Similarly, higher levels of paid unemployment were also found to increase the odds for GD, with those in the highest quartile having an OR of 1.86 (95% CI [1.50, 2.28]) compared to those with no paid unemployment days. Moreover, an interaction analysis indicated that the association between paid unemployment days and GD was significantly stronger among men compared to women.

Conclusions: The present study suggests that both paid and unpaid unemployment constitute risk factors for GD. Programs aiming at obtaining and sustaining work have been found to improve health and future studies should examine if the risk for GD can be similarly mitigated.