'I Can Tell You It's a Bit of a Gamble': A Qualitative Analysis of How People Who Engage in Gaming and Gambling Understand a Link Between These Two Behaviours.

This article explores the attention given to potential motives and determinants of the transition process from video games to gambling. Forty individual interviews were conducted among active video game players (n = 20), and people diagnosed with a gambling disorder who had the experience of playing video games (n = 20). A qualitative thematic analysis was employed to explore the collected empirical data. The range of factors considered responsible for the transition from playing video games to gambling included experiencing similar emotional states, the presence of gambling in video games, advertising of gambling companies in video games, loot boxes. The awareness of factors associated with the development of gambling disorders among video game players has an important role in informing prevention policies in the rapidly changing video gaming and gambling market. Decision-makers should introduce effective regulation of the use of gambling components in video games to protect gamers against the gambling-related harm.

Psychometric properties of the Polish version of two screening tests for gambling disorders: the Problem Gambling Severity Index and Lie/Bet Questionnaire.

To date, no screening tests for gambling disorders have been adapted and validated in Central and Eastern Europe. The aim of this study is to adapt the Problem Gambling Severity Index (PGSI) and Lie/Bet questionnaire (Lie/Bet) and assess their psychometric properties once translated for use with the Polish population. A mixed sample (N = 300) was drawn from venues, social media, snowballing and treatment centers. PGSI had a higher coefficient of predictive power than Lie/Bet. However, differences between validated tests are not significant. Validation of screening tests of gambling disorders showed the necessity for verification of the scale of interpretation of results when conducting tests in Poland, changing cutoff values. The PGSI and Lie/Bet tests are short and easy to apply, they can be implemented in various types of institutions: for screening patients in primary health care facilities and for identifying comorbid gambling disorders in alcohol- and drug-dependence treatment facilities, and in social welfare centers.

Barriers in Access to the Treatment for People with Gambling Disorders. Are They Different from Those Experienced by People with Alcohol and/or Drug Dependence?

A prevalence of gambling disorders is diversified depending on the region of the world. Almost three quarters of pathological gamblers had never sought a professional treatment as well as an assistance in self-help groups. Reasons why they do not initiate a treatment are complex. The aim of the article is to compare barriers to the treatment for people with gambling disorders found in presented study and barriers to alcohol and drug treatment identified in the available literature. The semi structured interviews were applied and conducted with people with gambling disorders, social workers, therapists employed in the addiction treatment facilities, General Practitioners and psychiatrists. Selection of the respondents was based on purposive sampling. In total, 90 interviews were completed. Respondents identified individual barriers as well as structural ones. Individual barriers include internal resistance and a fear of the treatment. In turn structural barriers apply to the organization of the therapy, infrastructure, personnel, and the therapeutic program. A comparison of barriers experienced by people with gambling disorders and substance use disorders showed that they are largely similar, but people with gambling disorders also experience specific barriers. Empirical studies focused specifically on treatment needs of people experiencing gambling disorders may improve an offer of help for them. More adequate treatment options could contribute to the increasing in the number of people who start the treatment. It can result in improving their quality of life and may have positive impact on public health.

What influences changes in alcoholic beverage consumption over time? Poland in the light of the European Union Amphora study.

This paper is based on the Polish country-level final report of the European Union Amphora study: contextual determinants and alcohol polices. The authors present the results of a time series analysis model designed to explore and explain the influence of selected alcoholic beverage control policy measures and unplanned sociodemographical determinants on changes in alcoholic beverage consumption from 1960 to the 2000s in Poland. Complex historical and social changes are described, which occurred during the 50 years covered by the study. The study findings confirmed that sociodemographical determinants have an important influence on alcoholic beverage consumption. Study limitations are noted and future research is suggested.

A crisis of exhaustion in the game of escalation: a qualitative exploration of the consequences of occupational burnout among addiction therapists.

Purpose: Research shows that occupational burnout can affect health, the quality of personal relationships, and levels of job satisfaction and engagement. At the same time, the impact of individual burnout at the group and organisational levels has tended to be neglected. We aim to provide theoretical insights into the multidimensionality of burnout consequences at the individual, interpersonal and societal levels. Methods: A theory-driven, computer-assisted qualitative data analysis was conducted, comprising a thematic analysis of 40 semi- structured telephone interviews with therapists working in alcohol treatment facilities in Poland. Maximum variation sampling was used to ensure the representation of participants with different characteristics. Results: To theorise the implications of the collected data, the different viewpoints of addiction therapists on burnout and its consequences were interpreted through the lens of Rosa's resonance theory. Four interrelated sets of consequences were identified in the data: they related to (a) the therapists themselves, (b) their patients and the therapeutic process, and - in a broader sense - (c) the therapeutic team and (d) the treatment facility. Conclusions: Occupational burnout in individual therapists has serious implications for their patients and colleagues. It can also lead to a reduction in the quality and ultimately the effectiveness of the treatment of alcohol use disorders leading to a negative social image of the treatment facility and thus creating a further barrier to treatment for people with alcohol-related problems. Furthermore, the complexity of the individual experience of occupational burnout and a cause-and-effect chain forms a loop, deepening the severity of its consequences.

Adaptation and validation of the Columbia-Suicide Severity Rating Scale (C-SSRS) - screen version. / Polska adaptacja i walidacja wersji przesiewowej Skali Oceny Ryzyka Samobójstwa z Uniwersytetu Columbia (C-SSRS).

OBJECTIVES: To perform an adaptation and psychometric validation of the Polish version of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen version in a clinical sample of patients admitted to the psychiatric hospital. METHODS: This was a single-center, observational and cross-sectional study. A total of 318 consecutive patients completed a set of questionnaires upon their admission to acute psychiatric units. The set comprised C-SSRS screener and the reference measures: the Suicidal Behaviors Questionnaire - Revised (SBQ-R), the Suicidal Ideation Attributes Scale (SIDAS), the Center of Epidemiological Studies Depression Scale - Revised (CESD-R), the Scale of Psychache, the Purpose in Life scale (PIL), and alcohol misuse screen test (CAGE). RESULTS: Cronbach's α of the C-SSRS was 0.89. Two latent components were identified in the factor analysis: (1) suicidal thoughts, intentions and plans, and (2) history of suicidal attempts. There were differences in the mean scores of all the utilized questionnaires (namely, SBQ-R, the Psychache scale, CAGE, SIDAS, PIL and CESD-R) between the C-SSRS risk groups (p=0.01). The C-SSRS risk group was associated with the category of the primary psychiatric diagnosis (p<0.001). CONCLUSIONS: The Polish version of the Columbia-Suicide Severity Rating Scale screener is a questionnaire with good psychometric features to assess the suicidal risk among psychiatric in-patients. It can be used for the purposes of a routine assessment of suicidal risk among hospitalized patients.

Mobile application recovery support for patients with an alcohol use disorder. Acceptance, usability, and perceived helpfulness.

The aim of this study was to qualitatively explore the experiences of patients of abstinence-oriented treatment programs, who were using a mobile application (mWSPARCIE) after completing a 6-week inpatient treatment program, and to assess its role as a tool supporting the process of recovery initiated in the treatment facility.Telephone in-depth interviews were conducted after six months of application use among a convenience sample of former patients of the inpatient treatment (n = 33). Transcriptions of the interviews were analyzed and coded sentence-by-sentence. The coding procedure allowed researchers to establish the main analytical categories.Most respondents did not install the application or did not use it despite installing it, due to individual preferences and needs as well as to technical limitations. However, two thirds of the respondents who downloaded the application, used it on a regular basis, and four out of five considered it helpful in their recovery process. The application was used primarily for self-observation, allowing subjects to monitor their abstinence as well as the frequency and intensity of their alcohol craving.Acceptance of mHealth is low among patients of abstinence-oriented treatment programs. Therefore, this is clearly not a solution for all patients, because of individual preferences and needs as well as technical and financial barriers. However for those who use it, the tested application was an attractive source of additional support, a tool to maintain the motivation to change and to monitor abstinence and craving during the six months following their completion of treatment.

Motives for using new psychoactive substances in three groups of Polish users: nightlife, marginalised and active on the In. / Motywy uzywania nowych substancji psychoaktywnych w trzech grupach uzytkowników: rekreacyjnych, zmarginalizowanych i aktywnych w internecie.

OBJECTIVES: The aim of this article is to present the motives for using new psychoactive substances (NPS) among users in Poland and to evaluate the relationships between motives and consumption of different types of NPS. METHODS: The fieldwork was conducted in four locations: in Warsaw, Krakow, Poznan, and Tricity. The study involved a total of 596 users of new psychoactive substances. Among them were: nightlife users, using NPS recreationally (N = 172), socially marginalised users (N = 86) and users active on the internet (N = 338). The technique used in the study was a self-filled questionnaire. RESULTS: As assessed by all respondents, enhancement of mood was the most frequently indicated motive for using NPS. Among nightlife users, the NPS were most often used for the purpose of having more fun at parties. Among the marginalised users, the most common motive for using the new psychoactive substances was the desire to get intoxicated, which is a motive belonging to the group of motives related to enhancement. In the group of people active on the Internet, the most common motives for using these substances were those related to expansion. CONCLUSIONS: Identifying motives for using new psychoactive substances may contribute to reducing the use of NPS. The recreational and marginalised users have different motives for using substances. The same conclusion applies to the use of the individual NPS. The motives of using them vary. Thus, preventive, educational and therapeutic programs should be judiciously adapted to the needs of the users as well as to the kind of substances they use.

Contextual determinants of alcohol consumption changes and preventive alcohol policies: a 12-country European study in progress.

Beginning with France in the 1950s, alcohol consumption has decreased in Southern European countries with few or no preventive alcohol policy measures being implemented, while alcohol consumption has been increasing in Northern European countries where historically more restrictive alcohol control policies were in place, even though more recently they were loosened. At the same time, Central and Eastern Europe have shown an intermediate behavior. We propose that country-specific changes in alcohol consumption between 1960 and 2008 are explained by a combination of a number of factors: (1) preventive alcohol policies and (2) social, cultural, economic, and demographic determinants. This article describes the methodology of a research study designed to understand the complex interactions that have occurred throughout Europe over the past five decades. These include changes in alcohol consumption, drinking patterns and alcohol-related harm, and the actual determinants of such changes.

Patients' and professionals' beliefs about the impact of social stigmatization on treatment of gambling-related disorders. / Przekonania pacjentów i profesjonalistów o wplywie spolecznej stygmatyzacji na podejmowanie leczenia z powodu zaburzen zwiazanych z hazardem.

OBJECTIVES: Studies carried out so far have shown that negative stereotypes concerning people with gambling disorders and, in particular, the belief that these people bear personal responsibility for their illness, can significantly contribute to the stigmatization of these people. Shame and fear of stigmatization significantly hinder the decision to start treatment. This study investigates the beliefs of respondents about the impact of stigmatization of people with gambling disorders on the social perception of treatment of gambling disorders and the beliefs of respondents about the impact of stigmatization on undertaking treatment or seeking help. Furthermore, the study investigates whether treatment can help reduce stigma and whether professionals, in some way, take this problem into account in their practice. METHODS: In the first half of 2015, 90 semi structured individual interviews were conducted with people with gambling disorders, social workers, therapists employed in addiction treatment facilities, General Practitioners and psychiatrists. RESULTS: The public reaction to the fact of starting treatment depends on how gambling disorder is perceived: in terms of a medical problem or rather in moral terms. Positive reviews were mainly manifested by significant others who, according to Goffman's terminology, are 'wise'. Very often, treatment means having to reveal your problem and face stigmatization. Women in particular are stigmatized because of gambling disorders. This study showed that treatment allows to getr id of guilt by acquiring knowledge on the subject of gambling disorders. CONCLUSIONS: Addressing stigma during early stages of treatment may contribute to the continuity of treatment. Professionals should be aware of their prejudices, as their stigmatizing attitudes can influence treatment outcomes.

Risk perception and risk aversion among people who use New Psychoactive Substances.

INTRODUCTION: New Psychoactive Substances (NPS) are often considered to be harmful and less safe alternatives to traditional recreational drugs. Yet we have little knowledge of the ways in which risk aversion affects NPS risk perception and how risk judgements differ across types of NPS. In the analysis that follows, we investigate whether the perceived severity of risk is amplified or attenuated by users' experiences, risk avoidance strategies and modes of knowledge on risk. MATERIAL AND METHODS: The data were derived from a Polish cross-sectional study on patterns of NPS use and associated risks. A convenience sample of 605 users of NPS (Mean age = 22; range 15-49 years) completed a questionnaire. A principal component analyses and ordinal regression models were used to reveal the latent variables indicating modes of knowledge on NPS risk and risk avoidance strategies, and to determine the associations between risk aversion and perceived personal risk of NPS use. RESULTS: Several precautionary measures were employed by the majority of participants in the study. The perception of individual risk differed across NPS types. Principal component analysis yielded three components in both risk avoidance strategies ('avoiding mixes', 'precautionary measures', 'planning') and modes of knowledge on risk ('experience', 'technical knowledge', 'harm reduction'). However, ordinal regression models show that perceptions of risk are only partially affected by the modes of knowledge on NPS risk and by risk avoidance strategies. DISCUSSION: The results indicate that risk perception largely depends on NPS type. The perception of risk is driven by both modes of knowledge and risk avoidance strategies. However, they have different impacts on how individuals judge risk across various types of NPS. The perspective of risk perception should inform policy-makers and prevention experts to focus their efforts on honest and substantive risk communication. CONCLUSIONS: The present study shows that individuals tend to rely on various strategies of risk avoidance, which indicates the need to improve the substantive communication on NPS risks, with a particular focus on the types of NPS, which could help people using them make informed choices.

Negative consequences of novel psychoactive substances use among the Polish users. / Negatywne konsekwencje wynikajace z przyjmowania nowych substancji psychoaktywnych przez polskich uzytkowników.

OBJECTIVES: The use of the novel psychoactive substances (NPS) is a relatively new phenomenon on the Polish drug scene. At the same time, it is rapidly growing group of substances. The aim of the article is to present the negative consequences to physical, mental and social health due to novel psychoactive substances use. METHODS: Fieldwork was conducted in 2016 in four locations: Warsaw, Krakow, Poznan, and Tri-City. A total of 596 users of novel psychoactive substances participated in the study. Among them were: nightlife users (N = 172), marginalised users (N = 86) and users active on the internet (N = 338). A self-administered questionnaire was used. RESULTS: The substances from the stimulant/empathogen/nootropics group were the most commonly used among nightlife users, marginalised users and users active on the internet. The herbal blends were less popular, and the synthetic cannabinoids appeared on the third position. The acute side effects were most common consequences. Prevalence of medium- and long-termproblems withmentaland physicalhealth as well as social problems was at a similar level. All types of negative consequences were most prevalent among marginalised users. CONCLUSIONS: Novel psychoactive substances users experience several negative consequences. This poses a challenge to the treatment services that must answer with adequate form of help. This is not easy due to diagnostic difficulties as the effects of NPS use are often indistinguishable to the symptoms of the traditional drugs. Thus, there is a need for further research, which would allow to observe and closely monitor the problem.

Perceived social stigmatisation of gambling disorders and coping with stigma.

Aim: This study concerns perceived social stigmatisation of gambling disorder and its determinants, the self-perceptions of people with gambling disorder (self-stigma) and how they cope with stigma. Design: In total, 30 interviews with persons with gambling disorder and 60 with professionals were conducted. Selective sampling procedures were employed in the recruitment phase. In the case of professionals, the inclusion criteria were employment in facilities where treatment of gambling disorder is offered, and profession. For people with gambling disorder, the criterion was a diagnosis confirmed by a psychiatrist. Results: Elements revealed in past research on stigma-creation processes were reflected in respondents' statements. The type of gambling, the occurrence of negative consequences, the possibility of hiding, personal responsibility, social status and contact with stigmatised populations are perceived determinants of problem gamblers' stigmatisation. Gambling disorder sufferers experience anxiety associated with the possibility of rejection and a fear related to their condition being revealed to others. Various manifestations of cognitive distancing and hiding were coping mechanisms identified in the study. Conclusions: People with gambling disorder experience anxiety associated with the possibility of rejection, and they often conceal their disorder, which may hinder their treatment. Therefore the issue of stigma should be addressed in therapy.

Why do people use new psychoactive substances? Development of a new measurement tool in six European countries.

INTRODUCTION: New psychoactive substances (NPS) pose a public health threat. Many studies have tried to identify the reasons of NPS use; however, none of them have so far used any standardised measures. The aim of this study was (i) to develop and cross-culturally validate the New Psychoactive Substance Use Motives Measure (NPSMM) and (ii) to compare motives of NPS use across countries and user types. METHODS: Three subgroups (socially marginalised users, nightlife attendees and members of online communities) of NPS users (N = 3023) were recruited from six EU member countries. Demographics, motives and types of NPS used were assessed. NPS use motives were measured by adapting the extended six-factor version of the Marijuana Motives Measure. RESULTS: Exploratory and confirmatory factor analysis resulted in a similar five-factor solution across most of the countries: coping, enhancement, social, conformity and expansion motives. Marginalised users scored higher on coping and conformity motives, nightlife groups showed higher endorsement of social motive, whereas online community users showed higher scores on expansion motives. Various types of NPS were also associated with different motives. CONCLUSION: NPS use motives might be associated with both the groups of users and the specific types of NPS being consumed. Expansion (psychedelics) and enhancement (stimulants) motives seemed to be linked to the chosen NPS product type, while coping, social and conformity motives were rather associated with user groups. NPSMM was found to be a valid instrument to measure NPS motives.

Screening of problem gambling among a homeless population in Warsaw.

BACKGROUND: While homelessness and problem gambling are both recognised as social and public health concerns and the prevalence of addictive disorders among homeless populations tends to be high. These questions have been studied predominantly independently. AIM: The aim of the study was to explore the co-occurrence of the two phenomena among the homeless population using shelters and night shelters in Warsaw, and, more specifically, to provide information about the forms and frequency of gambling in this homeless population. METHOD: Homeless persons (N = 690) were interviewed in rehabilitation-shelters (n = 17) and night-shelters (n = 2) in Warsaw from November 2015 until January 2016. The core component of the questionnaire was a screening test (Problem Gambling Severity Index). In addition, data regarding the intensity of gambling and various types of games or settings were collected. RESULTS: The prevalence of problem gambling in this population of homeless people was 11.3%, whereas the prevalence of problem gambling in the general population in Poland is much lower (0.7%). Similarly to the general population, the most prevalent gambling games in the homeless population were lotteries; however, homeless people gambled in lotteries almost three times more often compared to the general population. CONCLUSIONS: This is the first study examining the prevalence of problem gambling in the homeless population in Poland. The findings of the study suggest that problem gambling among the homeless is a significant social and public health concern. High rates of problem gambling in the homeless population show the need to identify and monitor this problem in shelters and consequently to provide easier access to gambling treatment or prevention programmes.

What makes people with gambling disorder undergo treatment? Patient and professional perspectives.

AIMS: The aim of the article is to identify factors which bring people with gambling disorder to undergo treatment. We are interested in exploring motives that trigger change; identifying factors determining choice of facility; recognising barriers and facilitators appearing during treatment. DESIGN: Semi-structured interviews were conducted in Poland with people with gambling disorder, as well as with social workers, therapists, General Practitioners (GP) and psychiatrists. Purposive sampling was applied in selecting respondents. In total, 90 interviews were completed. RESULTS: Internal and external motives that trigger change were identified. Among the internal motives were individuals' own reflections often combined with a sense of guilt, and among the external motives, pressure from significant others, financial problems, law problems and somatic and mental problems. The choice of facility was made by those suffering from gambling disorder or by close family members. Factors which influenced the choice of clinics were availability (distance to the facility, sessions schedule), quality of infrastructure, assured anonymity, opinions on provided assistance, the renown of such a facility, apparent experience in treatment of gambling disorder, and the context behind the problems experienced. Individual (related to emotions and convictions,) and structural barriers (related to the treatment offer, infrastructure, personnel, and therapy programme) were identified along with the facilitators in the access to treatment. CONCLUSIONS: The identification of circumstances and determinants may contribute to improvements in the availability and quality of assistance provided, which could result in an increase in the percentage of patients undertaking treatment. There is a need for education aimed at increasing awareness of the problem and the possibilities of assistance as GPs and social workers very rarely recognise gambling disorder among their clients.

Health and Social Problems Associated with Recent Novel Psychoactive Substance (NPS) Use Amongst Marginalised, Nightlife and Online Users in Six European Countries.

Continued diversification and use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes health and social consequences of recent NPS use as reported in a survey of marginalised, nightlife and online NPS users in the Netherlands, Hungary, Portugal, Ireland, Germany and Poland (n = 3023). Some respondents were unable to categorise NPS they had used. Use of 'herbal blends' and 'synthetic cannabinoids obtained pure' was most reported in Germany, Poland and Hungary, and use of 'branded stimulants' and 'stimulants/empathogens/nootropics obtained pure' was most reported in the Netherlands. Increased heart rate and palpitation, dizziness, anxiety, horror trips and headaches were most commonly reported acute side effects. Marginalised users reported substantially more acute side effects, more mid- and long-term mental and physical problems, and more social problems. Development of country-specific NPS awareness raising initiatives, health and social service needs assessments, and targeted responses are warranted.

Barriers in the access to alcohol treatment in outpatient clinics in urban and rural community. / Bariery w dostepie do leczenia w poradniach terapii uzaleznienia od alkoholu w miescie i malej miejscowosci.

OBJECTIVES: The aim of the study was identification of the barriers making it notably more challenging to access clinics in urban and rural communities. METHODS: The method, which was used in this study adopts the qualitative research perspective. The research tool was an interview with a standardized list of desired information. The interviews were conducted with alcohol dependent patients and therapists. 64 interviews were performed in two outpatient clinics located in Warsaw, and in rural area. RESULTS: Respondents identified similar barriers for the clinics located in Warsaw and in the rural community. Those were: shame associated with seeking help, waiting time for stationary support, meeting intensity, and general clinic condition. Barriers identified by respondents from Warsaw were associated with long waiting time for outpatient treatment and individual appointment, therapeutic offer excluding deaf and mentally ill individuals from the therapy, and unattractive program requiring complete abstinence. Barriers in access to treatment spotted by the respondents from the rural community related to the lack of anonymity of treatment associated with too low number of clinics in the district, lack of choice in terms of preferred facility, commutation time and costs, as well as no inter-institutional cooperation. CONCLUSIONS: The barriers identified in the study were similar to the ones specified in the research conducted in Poland in the 1990s, and at the end of first decade of 21st century. Barriers were psychological in character and had the form of internal withdrawal and anxiety to start treatment. Certain structural barriers were indicated as well.