Solitary gambling mediates the risk pathway from anxiety sensitivity to excessive gambling: Evidence from a longitudinal ecological momentary assessment study.

Anxiety and gambling problems co-occur at high rates. Social learning theory (SLT) suggests that people high in anxiety engage in excessive gambling to reduce negative affect. Because anxiety sensitivity (AS) is a vulnerability factor associated with addictive behaviors, it is important to identify mediators in this high-risk pathway. Emerging research shows that social context mediates associations between anxiety vulnerability and addictive behaviors. This literature shows that anxiety-prone people are at increased risk for substance problems because they engage in frequent solitary substance use. Theory would predict a similar pathway to gambling problems, but this remains to be tested. Accordingly, this study aimed to examine solitary gambling as an explanatory variable in the anxiety pathway to gambling problems. We used a longitudinal ecological momentary assessment (EMA) design. After completing baseline measures, young adults (N = 108) were asked to report daily on their gambling behavior over a 30-day period. Bias corrected bootstrapped confidence intervals (CI) supported 1 hypothesized indirect effect from baseline AS (Time 1) to EMA time spent gambling (Time 2) via EMA solitary gambling (Time 2; B = 0.019, 95% CI [0.002, 0.045]). This suggests that emerging adults with high levels of AS at baseline engaged in frequent solitary gambling over the 30-day EMA sampling period, which in turn predicted more time spent gambling over this same time period. Our results show that solitary gambling mediates the relation between anxiety vulnerability and excessive gambling. Understanding how social context relates to excessive gambling can help create interventions to reduce solitary gambling among anxiety-prone individuals. (PsycINFO Database Record

Intimate partner violence-related hospitalizations in Appalachia and the non-Appalachian United States.

The highly rural region of Appalachia faces considerable socioeconomic disadvantage and health disparities that are recognized risk factors for intimate partner violence (IPV). The objective of this study was to estimate the rate of IPV-related hospitalizations in Appalachia and the non-Appalachian United States for 2007-2011 and compare hospitalizations in each region by clinical and sociodemographic factors. Data on IPV-related hospitalizations were extracted from the State Inpatient Databases, which are part of the Healthcare Cost and Utilization Project. Hospitalization day, year, in-hospital mortality, length of stay, average and total hospital charges, sex, age, payer, urban-rural location, income, diagnoses and procedures were compared between Appalachian and non-Appalachian counties. Poisson regression models were constructed to test differences in the rate of IPV-related hospitalizations between both regions. From 2007-2011, there were 7,385 hospitalizations related to IPV, with one-third (2,645) occurring in Appalachia. After adjusting for age and rurality, Appalachian counties had a 22% higher hospitalization rate than non-Appalachian counties (ARR = 1.22, 95% CI: 1.14-1.31). Appalachian residents may be at increased risk for IPV and associated conditions. Exploring disparities in healthcare utilization and costs associated with IPV in Appalachia is critical for the development of programs to effectively target the needs of this population.