Gambling problems, risk factors, community knowledge, and impact in a US Lao immigrant and refugee community sample.

OBJECTIVES: The objectives of this study were to examine gambling-related problems, risk factors, help-seeking attitudes, community perceptions, and correlates of problem gambling in a Lao sample of Southeast Asian refugees and immigrants and to discuss cultural implications for the treatment and prevention of gambling problems in Southeast Asian refugee and immigrant populations. STUDY DESIGN: This was a cross-sectional, community-based interview study. METHODS: Participants (N = 200, males = 51%, females = 49%) were recruited from a Lao community center in a major US metropolitan area (convenience sample; community center recruitment and peer nomination). Structured interviews on gambling and substance use were conducted by Lao center staff members in both English and Lao languages. RESULTS: Gambling-related problems were measured using the South Oaks Gambling Screen (SOGS), gambling frequency, and quantity measures. In a previous study, we reported a substantial number of participants from the sample endorsed gambling-related harms and problems (SOGS score of five or more = 24%) and common methods of play were slots, house betting, cards at a casino, and sports betting. Among those endorsing five or more gambling problems, reasons for gambling included making money (68%), social life (31.3%), entertainment (58.3%), and reducing boredom (35.4%). Less commonly endorsed reasons were depression or stress (14.6%) and escape (10.4%). Many participants reported a family history of gambling problems. Those with problem gambling had twice the level of sibling problem gambling histories relative to those without problem gambling (35.4% vs. 11.1%). There were substantially more participants in the problem gambling group who had started gambling before the age of 13 years than in non-problem gamblers (P < .05). Many recognized gambling as a significant issue in the community and reported knowing several individuals affected by gambling-related problems. CONCLUSIONS: Many participants recognized gambling as a significant issue in the Lao community. We include insights gleaned from a research partnership with a community organization. Although data cannot be generalized to the Lao community because of limitations in sampling methodology, participants viewed gambling as a culturally common social practice. Cultural norms affected where community members gamble, types of games, and betting practices. In this context, community members may view gambling-related harms as both a community-level and individual-level concern. These data suggest a significant need for rigorous research to inform policies and a culturally sensitive approach to public health prevention, intervention, and education. We discuss the challenges and cultural barriers to research and community engagement and offer suggestions for prevention and intervention ideas efforts.

Social Networking Addiction Among Hong Kong University Students: Its Health Consequences and Relationships With Parenting Behaviors.

The use of social networking sites (SNSs) has been growing at a staggering rate, especially among university students. The present study investigated the prevalence of social networking addiction (SNA), its health consequences, and its relationships with parents' Internet-specific parenting behaviors in a sample of Hong Kong university students (N = 390). Adopting the 9-item social media disorder scale, 21.5% of the participating students met the criteria for SNA. Students with SNA showed longer sleeping latency, more sleep disturbance, poorer academic performance, lower levels of life satisfaction, and higher levels of depression than did students without SNA. Parental reactive restriction and limiting online behaviors of the participants were associated with higher risk of SNA. The findings suggest the severity of SNA and its negative consequences among Hong Kong university students. While parental behaviors limiting children's use of SNSs were found to increase the occurrence rate of SNA among university students, longitudinal studies are needed to further examine this causal relationship.

Anti-racism and substance use treatment: Addiction does not discriminate, but do we?

Contemporary racism in the United States contributes to health, mental health, and substance use disorder (SUD) disparities among People of Color (POC) compared with White individuals. Despite entering into substance use treatment with a greater severity of SUD and related consequences, POC experience more barriers to treatment engagement, completion, and satisfaction than their White counterparts. As substance use treatment counselors are socialized within institutions of systemic racism, it is important to examine their positioning on racism in relation to their capacity for culturally competent care. This article articulates a need to implement an antiracist framework for substance use treatment.

Australia's Gambling Epidemic: The Role of Neighbourhood Ethnic Diversity.

Gambling is a popular leisure activity but also a significant public health issue in Australia. The severity of gambling in Australia is characterised by unprecedented gambling expenditures and losses representing the highest gambling rates in the world, which has led to renewed interests in understanding the factors influencing gambling behaviours. We contribute to the debate on the determinants of gambling by providing the first study that examines the impact of ethnic diversity on gambling. Using data from the Household, Income and Labour Dynamics in Australia survey, we find that ethnic diversity is positively associated with gambling. This result is robust to alternative estimation approaches, alternative ways of measuring ethnic diversity and irrespective of whether gambling is measured using the Problem Gambling Severity Index, gambling expenditures or number of gambling activities. Our results also suggest stronger effects of ethnic diversity for problem gamblers compared to gamblers in other risk categories. These results support the need for policies that promote social capital in diverse communities to reduce the risks of social isolation, which is an important motivator of gambling behaviour.

Does establishing local treatment institutions lead to different populations seeking treatment among Greenlandic Inuit?

Introduction: In 2016, a new addiction treatment service was established in Greenland to tackle the addiction problems with alcohol, cannabis and gambling among the population. The new service has established a treatment center in each of the five municipalities and works in partnership with a central private provider of treatment for those who reside in areas without a local treatment center.Methods: The national addiction database provided us with data from the Alcohol Use Disorder Identification Test, Alcohol Severity Index and questions on cannabis use and gambling behavior received at referral to, and at initiation of treatment. The data were analyzed for differences between the population in local or central treatment using SPSS version 25 (SPSS Inc., Chicago, IL).Results: Significant differences between the individuals in local and central treatment were revealed. Individuals in local treatment are more often women with minor children and a job, and their alcohol use is concentrated on weekends/holidays. Individuals in central treatment are more equal in both genders, few have minor children living at home, heavy drinking is more pronounced, and cannabis is used more frequently as well.Discussion: The findings support our expectations of local treatment being more attractive to individuals with obligations at home. The differences in the populations are worth considering when planning the treatment service, as the needs of the populations might differ. The findings are limited by many missing in the analyses, which we believe is caused by the establishing process of the new service.

Use of E-Cigarettes for Nicotine, Marijuana, and Just Flavoring Among U.S. Youth.

INTRODUCTION: E-cigarette use is gaining popularity among youth, but knowledge on patterns of youth vaping different substances is limited. This study examines risk factors associated with past-30-day self-reported vaping of nicotine, marijuana, and just flavoring among youth and the patterns (single, dual, and poly) of substances youth reported in their e-cigarettes. METHODS: The 2017 Monitoring the Future survey was analyzed. Weighted estimates of substances that youth vaped were calculated, and multivariable logistic regressions were performed to examine risk factors associated with youth vaping these substances. Analyses were conducted in 2019. RESULTS: Overall (n=14,560), 8.0% of participants reported currently vaping just flavoring, followed by 7.4% vaping nicotine and 3.6% vaping marijuana. Youth who were in 12th and 10th grade (versus 8th grade), male (versus female), current smokers (versus noncurrent smokers), and current marijuana users (versus noncurrent users) had increased risk of vaping nicotine, marijuana, and just flavoring. Black non-Hispanics were less likely than white non-Hispanics to report currently vaping. Among students who reported e-cigarette use in the last 30 days (n=1,685), only 24.9% reported vaping just flavoring only, and a majority (75.1%) reported vaping nicotine, marijuana, or multiple substances. Higher (versus lower) grade or increasing cigarette smoking intensity was associated with a higher proportion of students reporting vaping nicotine only and a lower proportion of students reporting vaping just flavoring only. CONCLUSIONS: Youth e-cigarette use reveals a complex pattern, and youth reported vaping substances potentially addictive beyond just flavoring. Strategies and interventions to reduce youth e-cigarette use are needed.

Hispanics, Addictions, and the Opioid Epidemic: Brief Report.

Opioid addiction is a public health concern. Opioid overdose death rates account for one third to a half of all global substance-related deaths. Opioid mortality rates increased nearly fivefold in the United States between 1999 and 2016. Recent research has found health care disparities in the United States among minority populations with opioid use disorder, particularly Hispanics. Current literature also suggests that a number of social and cultural factors, including the stigma linked to mental illness and treatment in the Hispanic culture, may further negatively contribute to the problem. This brief report pays close attention to the opioid epidemic in the United States and addresses issues related to the crisis among Hispanics. Recommendations for clinical practice, research, and health care policy are also discussed.

Racial-ethnic differences in impulsivity and compulsivity in recreational gambling.

BACKGROUND: Prior data indicate high rates of problematic gambling in some racial-ethnic minority groups, yet research into mechanisms contributing to these associations is scant. The aim of the present study was to examine whether impulsivity and compulsivity differ across racial-ethnic groups in recreational gamblers. METHODS: Young adult non-treatment seeking recreational gamblers were recruited from the general community. Presence of mental health diagnoses (including gambling disorder) was exclusionary. Participants completed clinical interviews, questionnaires, and cognitive tasks germane to impulsivity and compulsivity. RESULTS: 202 recreational gamblers (63.5% males) had mean (standard deviation) age 23.8 (2.7) years and identified using the following racial-ethnic identities: Caucasian (N = 145), African-American (N = 41), and Asian (N = 16). Groups did not differ on age, gender, education, or impulsivity measures. Compared to the Caucasian group, the African-American group reported significantly higher endorsement of sub-syndromal disordered gambling, higher compulsivity scores, and exhibited decision-making decrements on the Gambling Task. The Asian and Caucasian groups did not differ on any measure. CONCLUSIONS: This study suggests that young adult African-American recreational gamblers may experience greater levels of subsyndromal gambling compared to other racial-ethnic groups, and this appears linked with aspects of compulsivity. Future work should evaluate gambling longitudinally to better understand nuanced presentations across different groups, including in other age groups.

Further Evidence for the Psychometric Properties of Young's Internet Addiction Test (IAT): A Study on a Sample of Israeli-Arab Male Adolescents.

Objectives: In this study, we assessed the psychometric properties of the Hebrew version of the 20-item Internet Addiction Test (IAT). Methods: We had 180 Israeli-Arab male adolescents ranging in age from 12 to 16 (M = 13.92, SD = 1.42) complete the IAT and report their pornography viewing habits, their physical activity rate, and their grades at school. Results: We used exploratory and confirmatory factor analyses to determine the tool's structure, resulting with one-factor and 2-factor solutions both accounting for at least 50% of the variance explained by the models (using EFA). Upon dropping item 12 and items 12 and 15 from the one-factor model and the 2-factor model, respectively, the models demonstrated adequate psychometric properties (.73 ≤ α ≤ .94) and fitted fairly with the data (using CFA). The IAT scores correlated significantly with concurrent reports of the participants' pornography viewing, grades at school, and physical activity rate, reinforcing the tool's construct validity. Conclusions: Our findings suggest that the IAT is a valid and reliable instrument for measuring Internet addiction among literate Israeli-Arab male adolescents for whom Hebrew is their second language and, presumably, other Israeli adolescents for whom Hebrew is the native language.

Mental health services in the Northwest Territories: a scoping review.

The impacts of colonization have had significant impacts on the mental health and community wellness Indigenous peoples in the Northwest Territories (NWT). It is important that all communities in the NWT have access to key services in a culturally relevant way in achieving mental and community wellness. A scoping review was conducted to identify mental health services available in the NWT. To guide the understanding of the landscape of mental health services in the NWT, the information on health services gathered was organized using the First Nations Mental Wellness Continuum (FNMWC) Model's Continuum of Essential Services. Documents accessed included grey literature, consisting of government documents, practice guidelines, education materials, community wellness reports, internet searches and expert consult interviews to collect data on mental health and wellness services in the NWT. 68 mental health services were included in this review, from 23 different sources. Results were summarized and described the Continuum of Essential Services from the FNMWC Model. This guided approach was found to be useful for mapping mental health services for communities in the NWT. The findings highlight and catagorize existing mental health services and gaps in relation to a First Nation's perspective using the FNMWC Model. Specific areas examined included the Continuum of Essential Services, Key Partners, Culture as a Foundation, and Indigenous Social Determinants of Health. Findings can guide communities and health authorities in planning, implementing and coordinating a full range of optimized mental health services in the NWT.

Intensive online videogame involvement: A new global idiom of wellness and distress.

Extending classic anthropological "idioms of distress" research, we argue that intensive online videogame involvement is better conceptualized as a new global idiom, not only of distress but also of wellness, especially for emerging adults (late teens through the 20s). Drawing on cognitive anthropological cultural domain interviews conducted with a small sample of U.S. gamers (N = 26 free-list and 34 pile-sort respondents) (Study 1) and a large sample of survey data on gaming experience (N = 3629) (Study 2), we discuss the cultural meaning and social context of this new cultural idiom of wellness and distress. Our analysis suggests that the "addiction" frame provides a means for gamers to communicate their passion and commitment to online play, even furthering their enthusiasm for the hobby and community in the process, but also a way for players to express and even resolve life distress such as depression and loneliness. The American Psychiatric Association (APA) has recently included "Internet gaming disorder" (IGD) as a possible behavioral addiction, akin to gambling, warranting further consideration for eventual formal inclusion in the next iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Our study leads us to suggest that clinicians only sparingly use IGD as a clinical category, given that medical and gamer understandings of "addictive" play differ so markedly. This includes better distinguishing positive online gaming involvement-also sometimes framed by gamers as "addictive"-from other play patterns more clearly entailing distress and dysfunction.

Cultural Correlates of Internet Addiction.

Increasing problems connected with excessive Internet use can be observed all over the world. Internet addiction is defined as excessive involvement in the Internet with negative consequences. The main aim of the study was to investigate economic indicators as correlates of Internet addiction. The study was conducted in nine countries. The number of participants amounted to a total of 3,279 Internet users (54% were female), with a mean age of M = 25.14 (SD = 10.03). The authors used Young's Internet Addiction Test. In addition, some social and economic indicators characterizing the countries were taken into consideration. We found that Internet addiction was positively related to economic well-being, social progress, and human development as well as negatively related to human well-being, health, safety, and security. The results of the study contribute to the international debate on Internet addiction.

Korean Validation of the Internet Gaming Disorder-20 Test.

Since "Internet gaming disorder (IGD)" was included as a tentative disorder in Section III of the Diagnostic and Statistical Manual of Mental Disorders-fifth edition (DSM-5), more efforts have been undertaken to provide standardized assessment tools. Among the recently proposed measures of IGD, the IGD-20 (IGD-20) Test was designed to encompass the nine IGD criteria of the DSM-5, and it was subsequently validated into other languages. The present study aimed to validate the Korean version of the IGD-20 Test. In total, 1,403 Korean online game users were recruited for a self-report survey comprising the Korean IGD-20 (K-IGD-20) Test and other measures, including demographics and playing variables. The K-IGD-20 Test had good reliability, and a confirmatory factor analysis revealed six factors, consistent with the original scale. Moreover, the K-IGD-20 Test demonstrated appropriate concurrent and convergent validity with other measures of Internet (game) addiction and psychological problems. Overall, the present results indicate that the K-IGD-20 Test could be used as a reliable and valid tool in IGD research on Korean-speaking populations. Furthermore, this adds empirical evidence to continue the cross-cultural validation of the IGD-20 Test, which could contribute to a more unified, integrative approach in IGD research worldwide.

Additive Effect of Physical Activity and Sedentary Time on Depressive Symptoms in Rural Japanese Adults: A Cross-Sectional Study.

BACKGROUND: Previous studies have reported an additive effect of moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) on depressive symptoms. However, no studies have been conducted in rural community settings. This cross-sectional study investigated whether the additive effect of MVPA and ST was associated with depressive symptoms in rural Japanese adults. METHODS: We identified 2,814 participants from health examinations conducted in Shimane, rural Japan, in 2012 and analyzed data from 1,958 participants. We assessed depressive symptoms using the Zung Self-Rating Depression Scale and measured the total time spent on MVPA and ST using a Japanese short version of the International Physical Activity Questionnaire. Poisson regression analysis examined the prevalence ratios (PR) of depressive symptoms in nine category combinations of MVPA level (no, insufficient, or sufficient MVPA) and ST level (high, moderate, or low ST). RESULTS: A total of 117 (6.0%) participants had depressive symptoms. Compared with the reference category (no MVPA/high ST), multivariate analysis showed that the likelihood of depressive symptoms was significantly lower in the sufficient MVPA/low ST category (PR 0.23; 95% confidence intervals [CI], 0.08-0.66), insufficient MVPA/low ST category (PR 0.37; 95% CI, 0.16-0.86), and insufficient MVPA/moderate ST category (PR 0.39; 95% CI, 0.17-0.90). CONCLUSION: Analysis of the additive effect of MVPA and ST showed that the combinational category of sufficient MVPA and low ST had the lowest prevalence of depressive symptoms in rural Japanese adults. Moderate ST and low ST showed significantly lower likelihoods of depressive symptoms, regardless of insufficient MVPA.

Distinguishing Core from Peripheral Psychiatric Symptoms: Addictive and Problematic Internet Gaming in North America, Europe, and China.

We explore the problem of distinguishing the relatively constant versus culturally variable dimensions of mental suffering and disorder in the context of a cross-cultural study of Internet gaming-related distress. We extend the conceptual contrast of "core" and "peripheral" symptoms drawn from game studies and use a framework that synthesizes cultural and neurobiological understandings of emotional distress. In our framework, "core" symptoms are relatively constant across cultures and therefore presumed to be more closely tied to a neurobiological base. By contrast, we treat as "peripheral" symptoms those that are more culturally variable, and thus less directly tied to the neurobiology of addiction. We develop and illustrate this approach with a factor analysis of cross-cultural survey data, resting on previous ethnographic work, through which we compare online gaming distress experienced in North America (n = 2025), Europe (n = 1198), and China (n = 841). We identify the same four-factor structure across the three regions, with Addiction always the first and most important factor, though with variability in regional factors' exact item composition. The study aims to advance an integrative biocultural approach to distinguishing universal as opposed to culturally contingent dimensions of human suffering, and to help resolve debates about whether problem gaming represents a form of addiction.

Internet addiction in Tibetan and Han Chinese middle school students: prevalence, demographics and quality of life.

Internet addiction (IA) is common amongst young people, but no data on IA are available in Tibetan middle school students in China. This study compared the prevalence of IA between Tibetan and Han Chinese middle school students, and examined its association with quality of life. The study was conducted in two middle schools in the Tibetan area of Qinghai province and two Han Chinese middle schools in Anhui province, China. Internet addiction, depressive symptoms and quality of life were measured using standardized instruments. Totally, 1,385 students completed the assessments. The overall prevalence of IA was 14.1%; 15.9% in Tibetan students and 12.0% in Han students. After controlling for the covariates, the prevalence of IA was significantly higher in Tibetan students than in Han students (OR = 3.5, p < 0.001). More severe depressive symptoms, religious beliefs and male gender were positively associated with IA, while good family relationship was negatively associated with IA. Internet addiction was also associated with significantly lower QOL in physical, psychological and environmental domains. Internet addiction appears to be common in Chinese middle school students, particularly amongst Tibetan Chinese students. Considering its negative impact on quality of life, appropriate educational programs and preventive measures for IA should be urgently developed.

Measurement Invariance of the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) between the United States of America, India and the United Kingdom.

The Internet Gaming Disorder Scale-Short-Form (IGDS9-SF) has been extensively used worldwide to assess Internet Gaming Disorder (IGD) behaviors. Therefore, investigating cultural limitations and implications in its applicability is necessary. The cross-cultural feasibility of a test can be psychometrically evaluated with measurement invariance analyses. Thus, the present study used Multigroup Confirmatory Factor Analysis (MGCFA) to examine the IGDS9-SF measurement invariance across gamers from the United States of America (USA), India, and the United Kingdom (UK). A total of 1013 gamers from the USA (n = 405), India (n = 336), and the UK (n = 272) were recruited. Although the one-factor structure of the IGD construct was supported, cross-country variations were demonstrated considering the way that this was reflected on items assessing preoccupation/salience, tolerance, deception, gaming escapism/mood modification, as well as daily activities' impairment related to gaming. Furthermore, the same scores on items assessing withdrawal symptoms, tolerance, lack of control over gaming engagement, escapism/mood modification and daily activities impairment associated to gaming, have been found to reflect various levels of IGD severity across the three groups. The implications of these results are further discussed in the context of existing evidence regarding the assessment of IGD.

Human identity versus gender identity: The perception of sexual addiction among Iranian women.

This qualitative study was conducted to explore the images of personal identity from the perspective of women with sexual addiction. The data required for the study were collected through 31 in-depth interviews. Sensing a threat to personal identity, dissatisfaction with gender identity, dissociation with the continuum of identity, and identity reconstruction in response to threat were four of the experiences that were common among women with sexual addiction. Painful emotional experiences appear to have created a sense of gender and sexual conflict or weakness in these women and thus threatened their personal identity and led to their sexual addiction.

Cross-cultural adaptation and psychometric properties of the Korean Scale for Internet Addiction (K-Scale) in Japanese high school students.

The Korean Scale for Internet Addiction (K-Scale) was developed in Korea for assessing addictive internet behaviors. This study aims to adopt K-Scale and examine its psychometric properties in Japanese adolescents. In 2014, 589 (36.0% boys) high school students (Grade 10-12) from Japan completed a survey, including items of Japanese versions of K-Scale and Smartphone Scale for Smartphone Addiction (S-Scale). Model fit indices of the original four-factor structure, three-factor structure obtained from exploratory factor analysis, and improved two-factor structure of K-Scale were computed using confirmatory factor analysis, with internal reliability of included items reported. The convergent validity of K-Scale was tested against self-rated internet addiction, and S-Scale using multiple regression models. The results showed that a second-order two-factor 13-item structure was the most parsimonious model (NFI=0.919, NNFI=0.935, CFI=0.949, and RMSEA=0.05) with good internal reliability (Cronbach's alpha=0.87). The two factors revealed were "Disturbance of Adaptation and Life Orientation" and "Withdrawal and Tolerance". Moreover, the correlation between internet user classifications defined by K-Scale and self-rating was significant. K-Scale total score was significantly and positively associated with S-Scale total (adjusted R2=0.440) and subscale scores (adjusted R2=0.439). In conclusion, K-Scale is a valid and reliable assessment scale of internet addiction for Japanese high school students after modifications.