Journal of Behavioral Addictions最新文献

Background: Non-face-to-face interventions offer promise, with cognitive training showing potential but inconsistent efficacy in problem gambling.

Methods: We conducted a non-face-to-face, parallel, randomized, controlled, single-blinded trial to evaluate training programs in adults with problem gambling (CPGI ≥5). Participants were randomized 1:1 to a web-based cognitive training program targeting inhibition unrelated to addiction cues or a control program on visuo-spatial functioning. Both programs benefited from weekly phone calls to support engagement and transferability to daily life. A mixed community and out-patient sample was recruited at the national-level. The primary outcome was change in CPGI at week 6. Secondary outcomes were change in impulsivity, gambling behavior and quality of life at 6 and 14 weeks.

Results: 187 participants were screened, with 185 randomized: 93 to intervention and 92 to control. No significant differences were found between groups for any outcome. Mean PGSI change at 6 weeks was -2.75, 95% CI [-12.95; 7.44] in the experimental arm versus -2.44, 95% CI [-13.52; 8.64] in controls, p = 0.76. 34% of participants were classed as no longer problem gamblers at week 14. Intervention acceptability was moderate, with 21 participants (22.58%) in the experimental group, and 32 (34.78%) controls never accessing the platform (p = 0.07).

Conclusions: Further research is needed to optimize cognitive interventions in problem gambling, to improve engagement and to demonstrate their added value beyond minimal intervention. For a number of problem gamblers, minimal telephone interventions appeared to be sufficient to reduce gambling. Objective account-based gambling data will provide valuable insights into long-term and objective effects.

Background and aims: The study of stigma contributes greatly to our understanding of individuals' experiences of mental disorders. Addictive disorders are often associated with public misconceptions of the disorder, which can contribute to shame, discrimination, and reticence to seek help. This review aimed to: (1) evaluate the nature, frequency, and prevalence of addiction stigma; (2) identify the correlates of addiction stigma; and (3) examine the psychometric qualities of addiction stigma measures.

Methods: A search of Web of Science, PubMed, Scopus, PsycINFO, and PsycNet, had 5,515 results which were screened for eligibility using Covidence. Eligible papers were quantitative, peer-reviewed studies, which reported an outcome variable of stigma related to an addiction.

Results: A total of 99 studies were included in the review, including 70 studies of substance-based addictions, 19 studies of behavioral addictions, and 10 studies which examined both. Thirteen of the 20 studies examining the impact of familiarity with addiction reported that greater familiarity was associated with lower public stigma. Studies comparing substance and behavioral addictions (n = 5) typically reported greater public stigma towards vignettes depicting substance-based addictions than for behavioral addictions. Between 22% and 40% of individuals with an addictive disorder identified stigma as a significant barrier to seeking help; however, the relative importance of stigma among other barriers was unclear.

Discussion and conclusions: Evidence for countermeasures to prevent and/or reduce stigma is currently limited. Further research on the nature and prevalence of addiction stigma is needed to inform the development of effective clinical and public health countermeasures.

Background and aims: Uncontrollable gaming behavior is a core symptom of Internet Gaming Disorder (IGD). Attentional bias towards game-related cues may contribute to the difficulty in regulating online gaming behavior. However, the context-specific attentional bias and its cognitive mechanisms in individuals with IGD have not been systematically investigated.

Methods: We compared individuals with IGD to healthy controls (HC) using a rapid serial visual presentation (RSVP) task to measure temporal attentional bias. By applying game-related and neutral stimuli as targets, we specifically assessed how attentional resources were allocated to game-related stimuli compared to neutral stimuli.

Results: The IGD group showed enhanced attentional blink effect when a game-related stimulus was the first target and a neutral target was the next, reflecting IGD's difficulty in disengaging from game-related stimuli. Both IGD and HC individuals exhibited decreased accuracy in identifying a neutral first target followed by a game-related second target at shorter lags, indicating increased attentional engagement with game-related stimuli in general.

Discussion: The results provide a cognitive basis for recurrent and uncontrollable gaming behaviors in individuals with IGD. Game cues have priority in the allocation of attentional resources in individuals with IGD. The results shed new light on the development of specific treatments for IGD.

Background and aims: Internet gaming disorder (IGD) is a highly engrossing activity with the individual spending up to 10 h per day gaming, this causes issues in accomplishing their tasks and personal goals. Also, to generate in them increased anxiety, impulsivity and lack of social skills, this impacts the good personal development and individual's quality of life. Therefore, it is vital to better understand, in terms of treatment, which factors are associated with therapeutic outcomes (largely to achieve control over the use of video games and the lack of relapses) following a standardized Cognitive Behavioral Therapy (CBT) protocol. This study aimed to explore sociodemographic and personality variables and their relation to treatment outcome in patients with IGD.

Method: The sample included n = 105 patients with IGD, considered between January 2005 and December 2022 and recruited from the Behavioral Addictions Unit at the University Hospital of Bellvitge. Data at baseline was registered (sociodemographic and clinical measures), as well as the therapy outcomes (compliance with the guidelines, presence of relapses and dropouts).

Results: Patients were mainly males (n = 95) with a mean age of 24.97 (SD = 12.03). All patients included in this sample had individual CBT treatment in relation to their problematic gaming behavior. In terms of patients who relapsed, they had higher interpersonal sensitivity, hostility and persistence with lower self-directedness. Patients who dropped out were males with an older age of IGD onset. When looking at treatment noncompliance, it was related to higher psychoticism and reward dependence, and lower cooperation. Patients with IGD show higher levels of treatment noncompliance.

Conclusion: These findings evidence a positive and promising effect of CBT on IGT. The factors identified as predictors of good and poor treatment outcomes should be considered for developing new evidence-based interventions focused on learning healthier key coping strategies to manage both cravings and triggers.

Background and aims: The inclusion of gaming disorder as a new diagnosis in the 11th revision of the International Statistical Classification of Diseases (ICD-11) has caused ongoing debate. This review aimed to summarise the potential neural mechanisms of gaming disorder and provide additional evidence for this debate.

Methods: We conducted a comprehensive literature review of gaming disorder, focusing on studies that investigated its clinical characteristics and neurobiological mechanisms. Based on this evidence, we further discuss gaming disorder as a psychiatric disorder.

Results: The present review demonstrated that the brain regions involved in gaming disorder are related to executive functioning (e.g., anterior cingulate cortex and dorsolateral prefrontal cortex), reward systems (e.g., striatum and orbitofrontal cortex), and emotional regulation (e.g., insula and amygdala). Despite the inclusion of gaming disorder in the ICD-11, the debate remains on the benefits and harms of classifying it as a mental health disorder. Opponents argue that the current manifestations that support gaming disorder as a psychiatric disorder remain inadequate, it could cause moral panic among healthy gamers, and that the label of gaming disorder is stigmatising.

Discussion: Evidence suggests that gaming disorder shares similar neurobiological alterations with other types of behavioural and substance-related addictions, which further supports gaming disorder as a behavioural addiction. Ongoing debates on whether gaming disorder is a psychiatric disorder push for further exploring the nature of gaming disorder and resolving this dilemma in the field.

Background: During the development of addictive behaviors, theoretical models assume a shift from experience of gratification being a driver in early stages to experience of compensation which dominates at later stages of addiction development. Initial studies show a trend in this direction; however, this shift has not yet been investigated in clinical samples. We assume experienced gratification to be highest in individuals with risky use (indicating the beginning of the addiction process), and compensation to be highest in individuals with pathological use.

Methods: Data from 834 participants from a multi-center study (FOR2974) investigating specific Internet-use disorders (IUDs) including gaming, buying-shopping, pornography use, and social-network use disorders were analyzed about Experience of Gratification (EGS) and Experience of Compensation (ECS), symptom severity, use expectancies, and usage motives. A diagnostic interview based on DSM-5 criteria for gaming disorder was used to classify individuals into either non-problematic, risky, or pathological use group.

Results: The groups (non-problematic, risky, pathological) differed significantly regarding EGS and ECS. Individuals with pathological use reported highest experiences of compensation but equally high experienced gratification as individuals with risky use. Effects vary with respect to the specific behavior. All measures correlated significantly. Symptom severity was most strongly associated with facets of compensation.

Conclusion: The experience of gratification and compensation appear to be crucial for addiction-like Internet use. Experienced gratification is already high in individuals experiencing first negative consequences and appear to be stable in individuals with pathological use indicating the relevance of both positive and negative reinforcement during the addiction processes.

Background and aims: Video games are a common form of entertainment in adolescents, which may result in gaming habits characterized by impairment to reward-related decision-making. The aim of the current study was to investigate the relationship between reward processing and symptoms of gaming addiction in adolescents.

Methods: Data from three consecutive follow-up years (years 2, 3 and 4) of the Adolescent Brain Cognitive Development (ABCD) Study were analyzed (n = 6,143, total observations = 12,745, mean age at year-2 = 12 years). Participants completed the Video Game Addiction Questionnaire (VGAQ) at each visit. Discrete stages of reward processing were measured at the year-2 visit using the Monetary Incentive Delay task while the participant completed a functional magnetic resonance imaging (fMRI) scan. Bayesian hierarchical linear models were employed to examine the longitudinal association between reward processing in regions of interest at year-2 and VGAQ scores over time.

Results: Lower activation in the bilateral caudate during the anticipation of a large reward (β = -0.87, 95% CI: -1.68, -0.07) was associated with greater VGAQ scores over time. This implies that for each one-unit increase in brain activity in the caudate, there was an associated 0.87-point decrease in symptoms of gaming addiction as measured by the VGAQ. No association was found between reward feedback and VGAQ scores.

Discussion and conclusions: The findings suggest that abnormal reward processing in the caudate nucleus is associated with symptoms of gaming addiction in adolescents. These results provide a clearer understanding of the brain mechanisms involved in gaming addiction, which could inform future preventive and therapeutic strategies.

Background: The lower risk gambling guidelines (LRGG) represent an evidence-based collaborative effort to provide clear advice to people on the limits of safe gambling consumption. The guidelines are as follows: 1) Gamble no more than 1% of household income per month; and 2) Gamble no more than 4 days per month; and 3) Avoid regularly gambling at more than 2 types of games.

Methods: In an online survey study (N = 778), we evaluated the feasibility and acceptability of the LRGG among different subpopulations in Finland.

Results: We found that the guidelines were generally evaluated positively as understandable, sensible, clear, and "just right" in terms of their content. There were some notable differences between subpopulations: Individuals who were at risk of gambling problems evaluated the LRGG more negatively than others, while professionals working in the field of gambling prevention were the most optimistic about the guidelines. Thus, increased level of potentially harmful gambling engagement was linked with a somewhat more pessimistic attitude towards the guidelines. On the other hand, those who had not gambled in the past year viewed the guidelines as too permissive compared with those who had gambled, or those working in gambling prevention.

Discussion: Overall, our results show clear differences of opinion between the various subpopulations, which appear to be associated with the individuals' level and nature of gambling experience. We conclude that the LRGG can likely be adopted into wider use in Finland.

Background and aims: The authors of the present study wanted to know whether the previously reported psychiatric comorbidities of internet gaming disorder (IGD) based on DSM-5 criteria were also more prevalent among gaming disorder (GD) or hazardous gaming (HG) based on ICD-11 criteria. Therefore, the present case-control study evaluated the psychiatric comorbidities and associative factors of GD and HG based on ICD-11 criteria.

Methods: A sample of 60 individuals with GD, 45 with HG, and 120 controls were assessed with an ICD-11 criteria-based diagnostic interview along with attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), depressive disorder, and social anxiety disorder (SAD). Participants also completed Conners' Continuous Performance Test (CCPT), Dickman's Impulsivity Inventory, the Emotion Regulation Questionnaire, and the Behavior Inhibition System and Behavior Approach System Scales.

Results: GD was associated with ADHD, depressive disorder, and GAD. ADHD was the most associative comorbidity of HG. Depressive disorder was associated with GD relative to HG. Moreover, individuals with lower reappraisal, higher aversion sensitivity, and impulsivity were more likely to be diagnosed with GD. Those with higher fun-seeking were more likely to be diagnosed with HG.

Conclusion: In the present study, ADHD was the psychiatric comorbidity most significantly associated with GD, followed by depressive disorder and GAD, as previously reported for IGD. ADHD was also associated with HG. Depressive disorder was more associated with GD compared to HG. Intervention for HG and GD should be tailored by the consideration of the clients' psychiatric comorbidity as well as their reappraisal skills, impulsivity, aversion sensitivity, and fun-seeking.