Association between burnout and post-traumatic stress disorder among frontline nurse during COVID-19 pandemic: A moderated mediation analysis.

AIMS AND OBJECTIVES: The aim of this study was to investigate the relationship between burnout and post-traumatic stress disorder (PTSD) among frontline nurses who went to assist the epidemic situation in Wuhan, China, during the outbreak in 2020. The study also explored the mediating role of depression and the moderating role of age in the main relationship. BACKGROUND: The relationship between burnout and PTSD in nurse has rarely been investigated in the context of the COVID-19 pandemic. Understand the relationship between these variables can provide empirical evidence for developing interventions and protocols that improve the health of nurses in future public health emergencies. DESIGN: An online cross-sectional survey of targeted local 327 nurses who went to assist the COVID-19 epidemic situation in Wuhan during the initial outbreak. METHODS: This study was conducted in August 2020, the burnout scale, the PTSD scale and the depression scale were used to survey participants. The moderated mediation model was used to test research hypotheses. RESULTS: Burnout could affect the PTSD symptoms in nursing staffs and depression could mediate this relationship. Age moderated the relationship between burnout/depression and PTSD, and the effects was strong and significant among younger participants in the relationship between burnout and PTSD. CONCLUSIONS: Burnout was identified as a core risk factor of PTSD in nurses. Depression and age played significant roles in the relationship between burnout and PTSD. RELEVANCE TO CLINICAL PRACTICE: PTSD, as a symptom that manifests after experiencing a stressful event, should be a key concern among frontline healthcare professionals. This study suggests that PTSD in nurses can be further reduced by reducing burnout. Attention should also be paid to the PTSD status of nurses of different age groups. PATIENT OR PUBLIC CONTRIBUTION: Patients and the public were not involved in the design and implementation of this study. Frontline nurses completed an online questionnaire for this study.

How does psychosocial safety climate cross-level influence work engagement and job burnout: the roles of organization-based self-esteem and psychological detachment.

BACKGROUND: Existing researches on nurses' work engagement and job burnout have mostly stayed at the individual level, and limited researches test the cross-level effects of psychosocial safety climate (PSC). The study aimed to explore the cross-level mediating effect of organization-based self-esteem (OBSE) and the moderating effect of psychological detachment between the relationship of PSC and work engagement and job burnout in nurses. METHODS: The cross-sectional study was conducted during November to December 2022 at a tertiary hospital in a northeastern province of China. Data was collected from 1832 nurses through an online questionnaire. Correlation analyses and hierarchical linear modeling were used to test study hypotheses. RESULTS: The results showed that PSC was positively associated with work engagement, and negatively associated with job burnout. OBSE mediated the effect of PSC on work engagement, as well as job burnout. Additionally, psychological detachment played a moderating role between PSC and work engagement, but no moderating effect was found between PSC and job burnout. CONCLUSIONS: PSC at the organizational level increases work engagement and reduces job burnout by stimulating nurses' high levels of OBSE. Psychological detachment, as a situational factor, enhances the positive influence of PSC on work engagement. The implementation of measures to improve the PSC levels of the organization, and the levels of OBSE and psychological detachment among nurses could help to promote their good work performance.

The influence of subjective well-being on mental health in nursing students: the role of student cynicism.

Previous studies have reported high rates of poor mental health among nursing students, but few studies focused on the internal pathway of mental health. This cross-sectional study was conducted at a vocational medical school and investigated 384 nursing students. Symptom Check List-90, Index of Well-Being Scale and Cynical Attitudes Toward College Scale were used to test mental health, subjective well-being (SWB) and cynicism of nursing students, respectively. Academic cynicism, social cynicism and institutional cynicism were negatively related to mental health. SWB not only directly had positive effect on mental health, but had an indirect effect on mental health through academic cynicism, social cynicism and institutional cynicism.

[Application of Precision Nursing Based on Multidisciplinary Collaboration Model in Older Patients Undergoing Thoracoscopic Surgery for Lung Cancer].

Objective: To examine the application effect of precision nursing strategies based on multidisciplinary collaboration model in older patients undergoing thoracoscopic surgery for lung cancer. Methods: A total of 100 patients who were admitted to our hospital for thoracoscopic surgery for lung cancer between July 2022 and March 2023 were prospectively enrolled for the study. They were assigned, with a random number table, to two groups, a control group receiving routine nursing care and an experimental group receiving nursing care based on multidisciplinary collaborative precision nursing strategies. Their lung function, anxiety and depression scores, and quality of life were assessed at three points of time, including upon admission, one week after surgery, and one month after surgery, and comparison was made between the two groups. Results: There were significant differences in forced expiratory volume in one second (FEV1) at the three time points ( F=156.787, P<0.001) and the ratio of FEV1 to forced vital capacity (FVC) (FEV1/FVC%) at the three time points ( F=25.587, P<0.001) between two groups. There were significant difference between the findings for FEV1, FEV1/FVC%, FVC, and maximum voluntary ventilation (MVV) indexes at 1 week and those at 1 month after surgery in the experimental group ( P<0.05). After the surgery, the pulmonary function of the experimental group was better than that of the control group. The anxiety and depression scores of the experimental group were lower than those of the control group, with the difference being statistically significant ( P<0.05), which suggested that the experimental group showed improvement in anxiety and depression in comparison with the control group. Regarding the quality of life, there were significant differences between the two groups in the scores for the functional dimension ( F=109.798, P<0.001), the symptom dimension ( F=106.936, P<0.001), other items ( F=78.798, P<0.001), and overall health dimensions ( F=174.307, P<0.001). At 1 week and 1 month after surgery, the experimental group had higher scores for the functional dimension and lower scores for the symptom dimension than the control group did, with the differences being statistically significant ( P<0.05). The overall health status of the experimental group was better than that of the control group. Conclusion: Precision nursing strategies based on multidisciplinary collaboration model can effectively help improve the lung function, the mood, and the quality of life of patients in the short term, showing considerable promise for wide clinical application.

Latent profile analysis of mental health among Chinese healthcare staff during the COVID-19 pandemic.

The mental health of individuals has become increasingly important during the novel coronavirus-2019 (COVID-19) pandemic. Given the number of healthcare staff that are helping to treat the victims of COVID-19 all over the world, there is a lack of research concerning the mental health of healthcare staff, and of the prior studies carried out, the research has been relatively descriptive and has not used more sophisticated types of analyses (e.g. latent profile analysis [LPA]). The aim of the present study was to investigate profiles of mental health among Chinese healthcare staff during the COVID-19 pandemic. The sample comprised of 456 healthcare staff, and participants completed an online survey including individual information and their working status during the COVID-19 pandemic. The survey included the Chinese Mental Health Scale (MHS-C), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). Utilizing the LPA, two profiles of mental health (good mental health and poor mental health) were identified for Chinese healthcare staff during the COVID-19 pandemic. Compared to those with a good mental health profile, those with poor mental health profile had significantly higher scores on SAS and SDS. Female healthcare staff had higher mental health disturbances than males. Taking care and protecting the mental health of healthcare staff is very important in the fight against COVID-19. The need for employers to implement positive and effective measures among mental healthcare staff is likely to help them to cope better with mental health issues and improve mental health, as well as enhance resilience. Healthcare staff with good mental health can dedicate themselves to better nursing practice and nursing education during the COVID-19 epidemic.

Psychological capital of petrochemical corporate employees during COVID-19 social isolation: a longitudinal analysis.

The COVID-19 pandemic is a major public health emergency and a significant stressor to most people. The objective of this study was to examine the mental health status and social support level of participants from 2019 to 2020. The study aimed to investigate the changes in people's psychological capital state due to the COVID-19 pandemic. A longitudinal study was performed to study the psychosocial predictors of mental health among a sample of 2,999 Chinese employees in 2019, and the follow-up survey was conducted one year later. Regression coefficients were visualized in a heatmap. Path analysis was performed base on the structural equation model (SEM) to measure the associations between study variables. The status of mental health, resilience, and optimism changed significantly during the pandemic (P < 0.05). The level of employee's social support in 2019 could significantly and positively predicted the level of employee's psychological capital in 2020, and the level of employee mental health in 2019 significantly and negatively predicted the level of employee psychological capital in 2020. The mental health of employees played an intermediary role between social support and psychological capital. These results highlight that the COVID-19 pandemic has a strong impact on the psychological capital of company employees. While demanding performance, corporations should ensure timely intervention in the mental health of their employees.

Psychological distress and internet addiction following the COVID-19 outbreak: Fear of missing out and boredom proneness as mediators.

COVID-19 has caused major changes in people's mental health and behavior. This study aimed to investigate whether boredom proneness and fear of missing out acted as mediators between psychological distress and Internet addiction (IA). A cross-sectional survey was conducted in 2020, including 552 youths aged 17-28 years. The recruited participants were asked to complete a series of self-reported questionnaires regarding psychological distress, fear of missing out, boredom proneness and IA. The results indicate that during the COVID-19 pandemic, the reporting rate of IA in young adults was 28.1%, and fear of missing out and boredom proneness played multiple mediation roles in the relationship between psychological distress and IA. Governments and education departments should focus on young people with psychological deficits to prevent them from succumbing to IA.

Effect of Psychological Intervention on Perceived Stress and Positive Psychological Traits Among Nursing Students: Findings During the COVID-19 Pandemic.

High levels of perceived stress and deterioration of positive psychological traits concomitant with the coronavirus disease 2019 pandemic have endangered the health and academic achievement of nursing students. Effective intervention research in this area should be performed as soon as possible. In the current study, a 15-month trial involving nursing students recruited from a medical university was conducted, in which an experimental group (n = 126) received the Three Good Things exercise based on social network groups. Two follow ups were performed. There was no intervention in the control group. During the intervention period, there were significant differences in perceived stress, self-efficacy, resilience, and optimism between the two groups (p < 0.05). Perceived stress in the experimental group was significantly reduced throughout the follow-up period (p < 0.001). Postintervention analysis of optimism showed maintenance of the improvement trend over a 3-month period (p < 0.01). There was no significant difference in hope between groups. The Three Good Things exercise had a short-term effect on decreasing perceived stress and increasing optimism among nursing students. [Journal of Psychosocial Nursing and Mental Health Services, 60(10), 39-48.].

The relationship between bullying victimization and depression in adolescents: multiple mediating effects of internet addiction and sleep quality.

Various studies have found that bullying victimization is an important factor affecting depression. However, few studies have explored the underlying mechanism of this effect.  The purpose of this study was to examine the effects of bullying victimization on depression, as well as the mediating roles of internet addiction and sleep quality. The participants were 2022 Chinese junior high school students who completed questionnaires regarding bullying victimization, internet addiction, sleep quality and depression. Correlation analysis indicated that bullying victimization, poor sleep quality, internet addiction, and depression have significant, positive correlations with each other. Hayes' PROCESS macro revealed that internet addiction and sleep quality played multiple mediation roles in the relationship between bullying victimization and depression. These results suggested that effective strategies focusing on improving problematic internet use along with sleep quality may contribute to reducing the negative effect of bullying victimization on depressive symptoms.

Does Social Support Moderate Wound Pain and Health-Related Quality of Life in Patients With Chronic Wounds? A Multicenter Descriptive Cross-sectional Study.

PURPOSE: We sought to explore the relationships among social support, health-related quality of life (HRQOL), and wound pain, and to examine whether social support would moderate the relationship between wound pain and HRQOL. DESIGN: A multicenter descriptive cross-sectional study. SUBJECTS AND SETTINGS: Individuals with chronic wounds attending wound clinics affiliated with 3 public hospitals in Beijing, China. METHODS: Sociodemographic and wound characteristics of 162 participants were retrieved from medical records. Participants completed questionnaires for wound-related pain intensity (Numerical Rating Scale), social support (Social Support Rating Scale), and HRQOL (Medical Outcome Study Short Form-36). The moderating effect analysis was examined using the PROCESS analytic tool developed by Hayes, based on the bias-corrected bootstrapping method. RESULTS: Results revealed that higher pain intensity was significantly related to lower HRQOL (P < .01), and higher social support was associated with better HRQOL (P < .01). However, there was no significant correlation between social support and wound pain (P = .55). Importantly, the moderating effect of social support on the relationship between wound pain and HRQOL was statistically significant (P = .008). CONCLUSIONS: We found that social support moderated the impact of wound pain on HRQOL in patients with chronic wounds. This finding suggests that support obtained from social networks may be a beneficial intervention to improve the HRQOL of patients with chronic wounds, especially those suffering from high-intensity wound pain.

Relationships among economic stress, social support, age and quality of life in patients with chronic wounds: A moderated mediation model.

AIMS: The aims of this study were as follows: (a) to determine if social support mediates the relationship between economic stress and quality of life; and (b) to explore whether participants' ages would moderate the indirect relationship between economic stress and quality of life through social support. DESIGN: A questionnaire-based, cross-sectional study. METHODS: From January 2015-June 2016, a total of 300 patients with chronic wounds were recruited from three hospitals. Data regarding economic stress, social support and quality of life were collected through survey questionnaires. The moderated mediation analysis was examined using the Hayes' PROCESS macro modelling tool, based on the bias-corrected bootstrapping method. RESULTS: Economic stress was negatively correlated with quality of life and social support. The indirect effect of economic stress on quality of life through social support was negative. Furthermore, age moderated the relationship between economic stress and quality of life, as well as the relationship between economic stress and social support. CONCLUSION: Reducing economic stress and improving social support are important strategies for improving quality of life in patients with chronic wounds, especially for younger patients. IMPACT: Patients with chronic wounds experience considerable economic stress and severely impaired quality of life; however, little is known about the inner mechanisms of this relationship. This study emphasized the importance of providing social support in coping with the damage that economic stress causes to health. Clinical nurses should strengthen the comprehensive assessment of the socioeconomic status of patients and adjust nursing plans timely, to reduce the economic burden of patients based on the rational use of wound care materials. Moreover, when nursing for patients with chronic wounds, especially the elders, caregivers should strengthen the evaluation of social support and develop interventions to improve social support.

The Effect of COVID-19 on Youth Mental Health.

The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97-38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09-5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03-1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00-1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.

Fear of Missing Out (FoMO) and Gaming Disorder among Chinese University Students: Impulsivity and Game Time as Mediators.

BACKGROUND AND AIMS: Research into the fear of missing out (FoMO) has greatly increased in recent years. Given the negative consequences of gaming disorder (GD) among a small minority of individuals, there is an increasing need for research examining the impact of FoMO on GD. However, little is known about the roles of impulsivity and gaming time as mediators in the relationship between FoMO and GD. The present study examined whether impulsivity and gaming time mediated the relationship between FoMO (trait-FoMO and state-FoMO) and GD among Chinese university students, as well as the prevalence of GD. METHODS: A total of 1127 university students completed an online survey including the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOS-C), the Barratt Impulsiveness Scale-Brief (BIS-Brief), gaming time survey, and the Chinese Gaming Disorder Scale (CGDS). RESULTS: The prevalence of GD was 6.4% among Chinese university students. Trait-FoMO was found to indirectly impact GD via impulsivity and gamine time, whereas the direct effect of trait-FoMO on GD and the mediation effects of gaming time were not confirmed. State-FoMO impacted on GD both directly, and indirectly via the mediation effects of impulsivity as well as impulsivity and gaming time. CONCLUSION: Trait-FoMO on GD was fully mediated via impulsivity and gaming time, whereas state-FoMO on GD was partly mediated via impulsivity and gaming time. Individuals with high levels of FoMO were more likely to show impulsivity and spend a longer time gaming, and these factors were associated with GD. These findings provide insights to incorporate into health prevention programs to help regulate emotion, control impulsivity, and decrease GD.

Sleep duration and self-rated health in Chinese university students.

PURPOSE: Little is known about the association between sleep duration and health status in Chinese university students. This study examined the association between sleep duration and self-rated health in university students in China. METHODS: Altogether, 2312 subjects (928 in Macao, 446 in Hong Kong, and 938 in mainland China) were recruited. Standardized measures of sleep and self-reported health were administered. Sleep duration was categorized in the following way: < 6 h/day, 6 to < 7 h/day, 7-9 h/day, and > 9 h/day. RESULTS: Overall, 71% of university students reported poor health, 53% slept 7-9 h/day, 14% slept less than 6 h/day, 32% slept 6 to < 7 h/day, and 1% slept > 9 h/day. Univariate analysis revealed that compared to students with medium sleep duration (7-9 h/day), those with short sleep duration (< 6 h/day and 6 to < 7 h/day) were more likely to report poor health. Multivariate logistic regression analysis found that after controlling for age, gender, body mass index, university location, being a single child, religious beliefs, interest in academic major, academic pressure, nursing major, pessimism about the future, and depression, sleep duration of less than 6 h/day (odds ratio (OR) 1.98, 95% confidence interval (CI) 1.34-2.92, p < 0.01) was independently and significantly associated with poor self-reported health. CONCLUSIONS: Poor health status is common in Chinese university students, which appears to be closely associated with short sleep duration. Further longitudinal studies are warranted to gain a better understanding of the interaction between sleep patterns and health status in university students.

The relationship between college students' alexithymia and mobile phone addiction: Testing mediation and moderation effects.

BACKGROUND: To explore the relationship between college students' alexithymia and mobile phone addiction as well as the mediating effects of mental health and the moderating role of being a single child or not. METHODS: A total of 1034 college students from Changchun were assessed with the Toronto Alexithymia Scale (TAS-20), General Health Questionnaire (GHQ) and Mobile Phone Addiction Index (MPAI). RESULTS: Alexithymia was positively correlated with mental health and mobile phone addiction. Alexithymia had not only a direct impact on mobile phone addiction but also an indirect impact via mental health. For college students who were not only children, higher levels of alexithymia led to an increase in mobile phone addiction, whereas the influence of alexithymia on mobile phone addiction was much weaker among only children. CONCLUSION: Mental health has a partial mediating effect on the relationship between alexithymia and mobile phone addiction, and the relationship was significantly moderated by whether students were only children or not.

Prevalence and Correlates of Suicidal Behaviors among College Students in Northeastern China: a Cross-Sectional Study.

The present study aimed to investigate the prevalence and correlates of suicidal behaviors among college students in Jilin Province, China. A cross-sectional survey was conducted in 2016, using a self-reported questionnaire. Convenience sampling method was used to select college students as participants. The analysis was based on a sample of 730 college students. We use multivariate logistic model to determine the risk factors of suicidal behaviors.The prevalence of suicidal ideation, suicidal plan, suicidal attempts were respectively 13.2%, 3.3% and 3.4%. After controlling for the potential confounding factors, history of family psychiatric illness, depression and quality of life were significantly associated with suicidal ideation. Besides, suicidal plan was predicted significantly by not living together with university roommates and depression. In terms of suicidal attempts, not living together with university roommates and history of family psychiatric illness were its risk factors. Comprehensive interventions regarding aims at risk factors may be critical as effective strategies to protect college students from suicide.

The influence of resilience on mental health: The role of general well-being.

BACKGROUND: Nurses are suffering from increasing stress, and nursing is recognized as one of the most stressful job. Their mental health problems are serious and worthy of attention. AIM: The purpose of this study was to explore the relationship between resilience and mental health and general well-being among nurses. METHODS: A cross-sectional survey was conducted in 2014, using a self-reported questionnaire. Participants were asked to complete the measure of resilience, mental health, and general well-being. The method of randomly cluster sampling was used to select nurses as participants. A survey of 365 nurses was conducted to test the hypothesized model. RESULTS: This study showed that resilience, mental health, and general well-being correlated with each other. General well-being was an effective predictor of resilience and mental health, whereas it both can moderate and mediate the relationship. CONCLUSIONS: Strategies to increase nurses' general well-being could enhance their resilience and reduce mental health problems. It is important to improve the mental health of nurses and maintain the professional values that ensure career sustainability.

[Association between autism spectrum disorder and epilepsy in children].

OBJECTIVE: To examine the association between autism spectrum disorder (ASD) and epilepsy in children. METHODS: A total of 190 children with ASD were enrolled. A self-designed questionnaire, Childhood Autism Rating Scale, and Autism Behavior Checklist were used to determine the association between ASD and epilepsy. RESULTS: Among the 190 children with ASD, 20 (10.5%) had epileptic seizures and 12 (6.3%) were diagnosed with epilepsy. The rates of abnormal physical development and hearing disorders before the age of one year were significantly higher in ASD children with epileptic seizures than in those without epileptic seizures (P<0.05). The ASD children diagnosed with epilepsy and those receiving epilepsy treatment had a significantly increased rate of abnormal physical development before the age of one year (P<0.05). The ASD children with epileptic seizures had poorer sensory responses and behavioral competencies than those without epileptic seizures (P<0.05). Epilepsy treatment have a positive effect on behavioral competencies in ASD children (P<0.05). CONCLUSIONS: There is a significant association between ASD and epilepsy in children. The possibility of the comorbidity between ASD and epilepsy may be assessed according to the status of growth and development before the age of one year, sensory responses and behavioral competencies, and the presence or absence of epileptic seizures.

Effects of lifestyle intervention using patient-centered cognitive behavioral therapy among patients with cardio-metabolic syndrome: a randomized, controlled trial.

BACKGROUND: Cardio-metabolic syndrome (CMS) is a highly prevalent condition. There is an urgent need to identify effective and integrated multi-disciplinary approaches that can reduce risk factors for CMS. METHODS: Sixty-two patients with a history of CMS were randomized 1:1 into two groups: a standard information -only group (control), or a self-regulated lifestyle waist circumference (patient-centered cognitive behavioral therapy) intervention group. A pretest and posttest, controlled, experimental design was used. Outcomes were measured at the baseline (week 0) and at the end of intervention (week 12). Comparisons were drawn between groups and over time. RESULTS: The mean (standard deviation) age of the subjects was 48.6 (5.8) years ranging from 32 to 63, and 56.9% of the participants were female. Both groups showed no significant differences in Demographic variables and the metabolic syndrome indicators at baseline. While the control group only showed modest improvement after 12 weeks, compared to baseline, the intervention group demonstrated significant improvement from baseline. This study controlled for patients' demographics and baseline characteristics when assessing the effects of intervention. After adjusting for age, education and baseline level, the experimental group and the control group were statistically significant different in the following post-treatment outcomes: WC (F = 35.96, P < 0.001), TG (F = 18.93, P < 0.001), RSBP (F = 33.89, P < 0.001) and SF-36(F = 157.93, P < 0.001). The results showed patients' age and education were not strong predictors of patients' outcome (including WC, TG, RSBP and SF-36). CONCLUSIONS: Lifestyle intervention on patient-centered cognitive behavioral therapy can improve the physical and mental health conditions among individuals reporting a history of cardio-metabolic syndrome, and possibly provided preliminary benefits for the treatment of CMS. TRIAL REGISTRATION: Chinese Clinical Trial Register #, ChiCTR15006148 .

At-Risk/Problematic Shopping and Gambling in Adolescence.

Elevated levels of both pathological gambling (PG) and problem shopping (PS) have been reported among adolescents, and each is associated with a range of other negative health/functioning measures. However, relationships between PS and PG, particularly during adolescence, are not well understood. In this study, we explored the relationship between different levels of problem-gambling severity and health/functioning characteristics, gambling-related social experiences, gambling behaviors and motivations among adolescents with and without at-risk/problematic shopping (ARPS). Survey data from Connecticut high school students (n = 2,100) were analyzed using bivariate analyses and logistic regression modeling. Although at-risk/problematic gambling (ARPG) was not increased among adolescents with ARPS, adolescents with ARPG (vs non-gamblers) were more likely to report having experienced a growing tension or anxiety that could only be relieved by shopping and missing other obligations due to shopping. In comparison to the non-ARPS group, a smaller proportion of respondents in the ARPS group reported paid part-time employment, whereas a greater proportion of respondents reported excessive gambling by peers and feeling concerned over the gambling of a close family member. In general, similar associations between problem-gambling severity and measures of health/functioning and gambling-related behaviors and motivations were observed across ARPS and non-ARPS adolescents. However, associations were weaker among ARPS adolescents for several variables: engagement in extracurricular activities, alcohol and caffeine use and gambling for financial reasons. These findings suggest a complex relationship between problem-gambling severity and ARPS. They highlight the importance of considering co-occurring risk behaviors such as ARPS when treating adolescents with at-risk/problem gambling.