A Comment: Positive Play is a Subset of Responsible Gambling.

Confronted with criticisms focused on the nature of Responsible Gambling (RG), this article suggests that Positive Play (PP) is a conceptual subset of Responsible Gambling and not a fully developed and independent harm prevention or reduction framework. To advance public health initiatives and focus public policy. This article reviews and clarifies some of the confusing and subtle difference between Responsible Gambling and Positive Play. The discussion defines the notion of responsibility, Responsible Gambling, and Positive Play. We recognize that well-developed RG activities permit and encourage the underpinnings of PP. However, when viewed as a dependent measure, PP does not intend to reduce the prevalence of gambling-related harms or prevent the incidence of gambling-related harms. These objectives are the two basic and fundamental requirements to classify any activity as a RG program.

Moving Away from Individual Responsibility: A Comment.

In this comment, we suggest there has been a crusade among some gambling stakeholders to move the field away from personal responsibility influences and toward social setting effects. This perspective disproportionally attributes gambling-related negative consequences to the social setting rather than the gambler. We argue that personal responsibility is a pivotal issue during the emotional maturation of healthy adults and remains essential to understanding intemperate gambling. This comment explores this movement away from personal responsibility and briefly discusses some of the iatrogenic consequences that this position might create in a clinical setting.

A Scoping Review of "Responsible Drinking" Interventions.

Public health groups, researchers, the beverage alcohol industry, and other stakeholders have promoted and applied the concept of "responsible drinking" for the past 50 years. However, little is known about the state of the existing responsible drinking evaluation research and its application to policy and practice. This project provides a scoping review of studies evaluating responsible drinking interventions. Two primary research questions guided this investigation: (1) To what extent have authors attempted to define the concept of responsible drinking while evaluating responsible drinking interventions? and (2) What is the state of the responsible drinking intervention evaluation literature? We retrieved 49 peer-reviewed articles that evaluated interventions designed to promote "responsible drinking." Four articles provided, or attempted to provide, an explicit definition of responsible drinking; these four definitions lacked consensus. The existing responsible drinking interventions varied considerably in terms of the messages they attempted to convey (e.g., avoid binge drinking, use protective behavioral strategies, stick to relatively safe drinking limits), again suggesting lack of consensus. We observed greater consensus concerning the approach to evaluating responsible drinking interventions: studies typically recruited college students to complete brief, well-controlled experiments and measured potential predictors of drinking behavior (e.g., attitudes, expectancies, intentions) rather than actual drinking behavior. We discuss limitations of this methodological approach and the need for greater consensus regarding the concept of responsible drinking.

PTSD / substance use disorder comorbidity: Treatment options and public health needs.

Purpose of Review: Posttraumatic stress disorder (PTSD) commonly co-occurs with substance use disorder (SUD) and is challenging to treat. We review all behavioral therapy models with at least one randomized controlled trial in a current PTSD/SUD population. We identify factors in selecting a model for clinical use, emphasizing a public health framework that balances the need for evidence with the need for feasibility in frontline settings. Recent Findings: Seven published models and 6 unpublished models are reviewed. Public health considerations for choosing a model include: whether it's been studied across a broad range of SUDs and in complex SUD patients; whether it can be conducted in group modality; its appeal to patients and providers; its cost; workforce requirements; and its ability to reduce substance use in addition to PTSD. Summary: There are two broad types of models: those that originated in the PTSD field versus the SUD field. Overall, the latter are stronger on public health factors and more feasible in SUD settings. Published models in this category include Relapse Prevention, BRENDA, and Seeking Safety. PTSD/SUD research is at an early stage and there is a need for methodology that quantifies "level of burden" (patients' socioeconomic disadvantages) across trials.

Correction to: Gambling Research and Funding Biases.

Unfortunately, the original publication contains errors. The authors would like to correct the errors.

Gambling Research and Industry Funding.

This paper discusses the relationship between investigative credibility and the sources of funding associated with gambling research. Some researchers argue against accepting funding from gambling industry sources; similarly, they decline to participate in activities directly or indirectly sponsored by gambling industry sources. In contrast, these anti-industry investigators evidence less resistance toward accepting funds from sources other than industry, for example, governments, because they believe that they have greater independence, reliability, and validity, and less undue influence and/or interference. We organize this article, around six primary issues: (1) researchers making a priori judgments that restrict positions towards industry associated research; (2) the potential negative impacts of holding such a position; (3) a description of the different sources of funding available to support gambling-related research; (4) an examination of the extant empirical support associated with the sources of funding and whether such support evidences bias; (5) a description of six cases illustrating how refusing to participate in any project funded by the industry can adversely influence the advancement of science and, at times, be itself unethical; and finally, (6) we suggest some remedies to advance solutions to this problem by stimulating the participation of reluctant researchers to work towards a greater harmony, keeping in mind that the pivotal goal of our work is to increase our knowledge in different area of science and to harness it to public goods.

Gambling Research and Funding Biases.

A recent systematic review of the responsible gambling research suggests that there are no significant differences between gambling industry and non-industry funded research with regard to research design and outcomes. This study empirically synthesizes the outcomes of a larger sample of the scientific gambling literature to determine the generalizability of these original results. Our goal was to determine the extent to which funding sources might differentially influence characteristics of research design and outcomes. We conducted a comprehensive review of 18 research databases and examined studies published between January 2008 and August 2018. For four gambling-related journals, we reviewed all of the available studies. For 14 addiction-related journals, we examined only studies that examined gambling-related outcomes. To be included in this study, publications had to be quantitative and include a clear gambling-related hypothesis. After retrieving 1731 gambling studies, we applied the inclusion criteria and retained 720 studies for our final analytic sample. We used hypothesis confirmation and funding source information to determine the presence or absence of funding bias. Gambling industry funded studies were no more likely than studies not funded by the gambling industry to report either confirmed, partially confirmed, or rejected hypotheses. Nonetheless, studies funded by the gambling industry were more likely than other types of funding sources to include a conflict of interest statement. Studies with disclosed funding sources were more likely than those with undisclosed funding sources to include a conflict of interest statement. These findings highlight the importance of transparency and disclosure during research dissemination.

Psychiatric comorbidity among first-time and repeat DUI offenders.

Driving under the influence of alcohol or other substances is a serious public health concern. Previous research has shown that psychiatric comorbidity is more prevalent for repeat offenders than the general population, and that first-time offenders exhibit elevated rates of psychiatric comorbidity, but few studies have directly compared first-time and repeat DUI offenders. The current study compares psychiatric comorbidity among repeat and first-time DUI offenders. First-time and repeat DUI offenders completed the screener module of the Computerized Assessment and Referral System (CARS), adapted from the Composite International Diagnostic Interview (CIDI: Kessler & Ustun, 2004), to measure potential psychiatric comorbidity. For 16 of 19 psychiatric disorders, repeat DUI offenders were more likely to screen positive during their lifetime compared with first-time DUI offenders. Similarly, repeat DUI offenders were more likely to screen positive during the past year for 11 of 16 assessed psychiatric disorders. Overall, repeat DUI offenders screened positive for an average of 6.3 disorders during their lifetime, compared to first-time offenders who screened positive for an average of 3.7 disorders. Repeat DUI offenders also screened positive for more past-year disorders (M = 3.3) than first-time offenders (M = 1.9). Compared to first-time offenders, repeat DUI offenders evidence more severe and pervasive psychiatric comorbidity. Further research is necessary to determine whether psychiatric comorbidity among first-time offenders directly predicts re-offense. If so, screening for mental health issues among first-offenders could provide valuable information about how best to allocate resources for these offenders.

Patterns of Daily Fantasy Sport Play: Tackling the Issues.

Daily fantasy sports (DFS), a rapidly growing industry, allows players to create fantasy teams of real-life players and potentially win cash prizes, derived from entry fees. Some stakeholders have expressed concern that DFS's accelerated nature and other features might promote excessive play and related harm. We conducted the first descriptive summary of actual DFS play using records from a cohort of subscribers to a dominant operator, DraftKings. Participants (N = 10,385) initially entered paid National Football League (NFL) contests. Across all participants, players entered a median of two contests per entry day and typically submitted a single entry for each contest they entered. Players paid a median of $87 in entry fees throughout the 2014 NFL season and experienced an overall median net loss of $30.7. However, we identified heavily involved sub-groups of players based on number of contests entered, total entry fees, and net loss. These top 1% groups were less likely to restrict themselves to NFL games, exhibited greater time involvement, but also won a greater percentage of the contests they entered than typical players. Our observations of typical and heavily involved players tend to mirror those generated in previous Internet sports gambling research.

Responsible Gambling Research and Industry Funding Biases.

This brief report examines whether there are differences in aspects of different characteristics, including design/methodologies of responsible gambling (RG), between studies funded by industry as compared to other sources. To investigate this, the authors used those studies included in a recent meta-analysis focusing on the empirical basis of RG initiatives (Ladouceur et al. in Addict Res Theory 25:225-235, 2017). We examined eight associations between funding sources, and different design/methodological characteristics of these studies; type of strategy, inclusion of comparison groups, measurement scales and repeated measures, publication source, number of inclusion criteria met, secondary sources of funding, publication year. The results revealed no statistically significant difference between the funding source, and the index study characteristics. These results do not support claims that funding exerts influence on the design or methodologies of RG studies. However, the absence of statistically significant findings should not be used to assert the absence of a funding effect because there are many reasons for failing to find differences, or interpretation of findings. Unexpectedly, a third of the papers included in this study failed to disclose their funding sources. This finding highlights the need for more open and transparent disclosures.

Externalizing and self-medicating: Heterogeneity among repeat DUI offenders.

AIM: Despite significant reductions in Driving Under the Influence (DUI) in the United States during recent decades, DUI continues to be a major public health threat. The current study investigated the intersection of two domains known to influence DUI: criminal history and psychiatric comorbidity. METHODS: DUI recidivists (N = 743) attending a court-mandated two-week inpatient DUI program completed a computerized mental health assessment as part of their intake to that program. Participants' criminal records were obtained 4-5 years after program attendance. FINDINGS: This study identified three primary repeat DUI offender subtypes with distinct patterns of criminal behavior and psychiatric comorbidity: (Type I) those whose DUI emerges from a pattern of drinking to cope with mood and anxiety problems, (Type II) those whose DUI emerges as part of a larger pattern of externalizing and criminal behavior, and (Type III) those whose DUI offenses reflect more acute triggers and isolated episodes of excessive drinking. CONCLUSION: These findings suggest that current treatment models used in DUI programs are inadequate to address the heterogeneity in the population of DUI recidivists and that earlier and more comprehensive screening would allow for better targeting of resources to DUI offender subtypes.

Already at the Table: Patterns of Play and Gambling Involvement Prior to Gambling Expansion.

During 2011, the Governor of Massachusetts signed a bill to allow casino gambling in the state (Commonwealth of Massachusetts 2011). As a result, two resort casinos will begin operations during 2018 and 2019; a smaller slots parlor began operations during June 2015. Prior to this expansion, gambling was widely available in Massachusetts, through the state lottery, off-track betting, and gambling opportunities available in neighboring states. Within this context, it is important to understand the patterns of gambling involvement in the population prior to gambling expansion. The current study examined gambling involvement, patterns of play, and gambling-related problems prior to gambling expansion among a sample of 511 Massachusetts residents who were members of a statewide Internet panel. To measure patterns of play, we asked questions about past-year games played and frequency of play. To measure breadth of involvement, we assessed the number of different games played. To measure depth of involvement, we measured time spent gambling, amount wagered, and amount won or lost. Principal component analysis revealed four play pattern components accounting for more than 50% of the variance in game play frequency. Multiple regression analyses revealed that component scores composed of casino gambling and skill-based gambling (e.g., poker, sports) variables uniquely contributed to the prediction of gambling-related problems, even when depth of involvement was controlled. However, the addition of breadth of involvement to the model resulted in a model where no set of variables contributed significantly, suggesting a complex relationship among play patterns, depth, and breadth of involvement. The study established discrete and distinguishable gambling play patterns associated with gambling-related problems and identified groups of individuals potentially vulnerable to the effects of gambling expansion.

How do homeless adults change their lives after completing an intensive job-skills program? A prospective study.

Among people experiencing homelessness, difficulty securing housing is often compounded by concurrent challenges including unemployment, chronic illness, criminal justice involvement, and victimization. The Moving Ahead Program (MAP) is a vocational rehabilitation program that seeks to help adults facing these challenges to secure competitive employment. We prospectively studied how MAP graduates (N = 97) changed from the beginning of MAP to about six months after graduation. We observed a variety of positive outcomes not just in employment and housing but also in health, substance use, and criminal justice involvement. However, these gains were not universal; for instance, participants were less likely to report positive outcomes at follow-up if they started MAP with a serious mental illness, made relatively small gains in work skills, or did not seek mental health treatment during the six months after they completed MAP. These findings might encourage program staff to devote additional resources toward supporting at-risk students.

The relationship of problematic internet use with dissociation among South Korean internet users.

This study examined patterns of problematic internet use (PIU) among South Korean internet users to investigate the association between PIU and dissociative experiences. Five hundred and eight participants between 20 and 49 years old were recruited through an online panel survey. Using logistic regression analysis with PIU as the dependent variable, we observed that the participants with PIU were more likely to have alcohol-related behaviors or problems, higher levels of perceived stress, and dissociative experiences. Participants' scores on the Korean version of the Dissociative Experiences Scale were positively correlated with the severity of PIU. Individuals with PIU and dissociation had more severe PIU and more severe mental-health problems than those with PIU but without dissociation. These findings suggest that treatment programs for persons with PIU should focus on helping them tolerate negative affect and increase their level of awareness to prevent the occurrence of dissociative experiences.

Devil in the Details: A Critical Review of "Theoretical Loss".

In their review of Internet gambling studies, Auer and Griffiths (J Gambl Stud 30(4), 879-887, 2014) question the validity of using bet size as an indicator of gambling intensity. Instead, in that review and in a response (Auer and Griffiths, J Gambl Stud 31(3), 921-931, 2015) to a previous comment (Braverman et al., J Gambl Stud 31(2), 359-366, 2015), Auer and Griffiths suggested using "theoretical loss" as a preferable measure of gambling intensity. This comment extends and advances the discussion about measures of gambling intensity. In this paper, we describe previously identified problems that Auer and Griffiths need to address to sustain theoretical loss as a viable measure of gambling intensity and add details to the discussion that demonstrate difficulties associated with the use of theoretical loss with certain gambling games.

Changing Social Networks Among Homeless Individuals: A Prospective Evaluation of a Job- and Life-Skills Training Program.

Social networks play important roles in mental and physical health among the general population. Building healthier social networks might contribute to the development of self-sufficiency among people struggling to overcome homelessness and substance use disorders. In this study of homeless adults completing a job- and life-skills program (i.e., the Moving Ahead Program at St. Francis House, Boston), we prospectively examined changes in social network quality, size, and composition. Among the sample of participants (n = 150), we observed positive changes in social network quality over time. However, social network size and composition did not change among the full sample. The subset of participants who reported abstaining from alcohol during the months before starting the program reported healthy changes in their social networks; specifically, while completing the program, they re-structured their social networks such that fewer members of their network used alcohol to intoxication. We discuss practical implications of these findings.

Extending the RENO model: Clinical and ethical applications.

The RENO Model, first published during 2004, described a science-based framework of responsible gambling principles for a range of industry operators, health service providers, community and consumer groups, and governments. These strategic principles serve as a guide for the adoption and implementation of responsible gambling and harm-minimization initiatives. This article extends the RENO Model core principles by describing how to apply these strategies to clinical practice. This discussion examines the central tenets of the model and includes a review of (a) the ethical principles that should guide the development, implementation, and practice of RENO Model responsible gambling activities; (b) a brief consideration of the various perspectives that influence the treatment of gambling-related problems; and (c) a discussion of key applied elements of responsible gambling programs. This article advances the argument that, to maximize positive outcomes and to avoid unintended harms, clinicians should apply science-based principles to rigorously evaluate the efficacy and impact of their clinical practice activities. (PsycINFO Database Record

A Prospective Study of Psychiatric Comorbidity and Recidivism Among Repeat DUI Offenders.

Psychiatric comorbidity has emerged as a key element distinguishing DUI offenders from others, and, in some cases, distinguishing repeat offenders from first-time offenders. This paper utilizes a prospective design to determine whether the comorbid disorders identified among repeat DUI offenders can predict recidivism. Seven hundred forty-three repeat DUI offenders were recruited from a two-week inpatient treatment program at which they received a standardized mental health assessment and followed across five years post-treatment to track DUI offense, motor vehicle-related offenses, and general criminal offenses. Psychiatric comorbidity, though it did not predict DUI recidivism specifically, predicted criminal re-offense more generally. In addition, there was a specific relationship between lifetime attention deficit disorder and repeated motor vehicle-related offenses. These findings suggest that for many repeat offenders, DUI is one outlet in a constellation of criminal behavior, and that psychiatric comorbidity increases vulnerability for criminal re-offense.