Video Game Playing and Internet Gaming Disorder: A Profile of Young Adolescents.

In recent times, growing concern has arisen regarding the utilization of technology, video games, and the emergence of internet gaming disorder (IGD), particularly among young adolescents. This worry arises from the ambiguity in distinguishing between "normal" and "problematic" video game behavior, despite efforts to establish clear criteria for defining both. The goal of this study is to outline distinct profiles of adolescent video game players and identify variables associated with their gaming practices that correlate with problematic gaming. The study utilizes a substantial sample of adolescents drawn from a representative cross-section of educational institutions in the city of Madrid, ranging in age from 12 to 16 years. In total, 1516 participants (75%) acknowledged engaging in video game activities. The research delves into characterizing prevailing profiles of video game participants within this cohort and scrutinizes the profile that aligns with issues of IGD. In summary, approximately three-quarters of young adolescents participate in video gaming, with males constituting the majority. Typically, participants immerse themselves in action genre games for over three days per week, with males exhibiting a higher frequency than their female counterparts. Elevated gaming frequency correlates with heightened IGD scores, particularly among females. Young adolescents show a preference for game consoles (males) and mobile phones (females) and often play alone at home. Specific factors such as the device used, online mode, company, and gaming location impact the IGD scores. These profiles aim to assist families and educators in recognizing potential risk behaviors and IGD concerns; however, it is crucial to emphasize the necessity for case-specific screening and evaluation before deliberating on such behaviors.

Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis.

BACKGROUND: Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse. METHOD: A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference. RESULTS: The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP. CONCLUSIONS: The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.

The "Why" in Mental Health, Stigma, and Addictive Behaviors: Causal Inferences in Applied Settings.

Mental health problems, broadly understood, are highly prevalent [...].

The stigma of mental health problems: A cross-sectional study in a representative sample of Spain.

BACKGROUND: Mental health stigma is a relevant phenomenon with implications for the people who suffer from it. Despite its importance, no studies have been carried out in Spain at national level with a representative sample of the population. AIMS: The aim of this research is to analyze the stigma associated with MHPs in a representative sample of the Spanish population for the first time. METHOD: A cross-sectional quantitative descriptive study was carried out with a representative sample of the population (N = 2746). Descriptive analyses and regressions are carried out on the different dimensions of stigma such as attitude, attribution and intention of social distance. RESULTS: Medium levels of stigma are obtained in stigmatizing attitudes and attributions, and medium-low levels in the intention of social distance. The best predictors of stigma in its different dimensions are attitudes, attributions and intention of social distance themselves. Progressive political ideology is related to less stigma in all dimensions. Knowing someone with mental health problems and talking openly about it together with higher education are also relevant protectors. Mixed results are obtained regarding age, gender and help-seeking. CONCLUSION: National programs and campaigns focused on attitudes, attributions and behavioral intentions are necessary to reduce the stigma still present in Spanish society.

Significant Differences and Experimental Designs Do Not Necessarily Imply Clinical Relevance: Effect Sizes and Causality Claims in Antidepressant Treatments.

Clinical trials are the backbone of medical scientific research. However, this experimental strategy has some drawbacks. We focused on two issues: (a) The internal validity ensured by clinical trial procedures does not necessarily allow for generalization of efficacy results to causal claims about effectiveness in the population. (b) Statistical significance does not imply clinical or practical significance; p-values should be supplemented with effect size (ES) estimators and an interpretation of the magnitude of the effects found. We conducted a systematic review (from 2000 to 2020) on Scopus, PubMed, and four ProQuest databases, including PsycINFO. We searched for experimental studies with significant effects of pharmacological treatments on depressive symptoms, measured with a specific scale for depression. We assessed the claims of effectiveness, and reporting and interpreting of effect sizes in a small, unbiased sample of clinical trials (n = 10). Only 30% of the studies acknowledged that efficacy does not necessarily translate to effectiveness. Only 20% reported ES indices, and only 40% interpreted the magnitude of their findings. We encourage reflection on the applicability of results derived from clinical trials about the efficacy of antidepressant treatments, which often influence daily clinical decision-making. Comparing experimental results of antidepressants with supplementary observational studies can provide clinicians with greater flexibility in prescribing medication based on patient characteristics. Furthermore, the ES of a treatment should be considered, as treatments with a small effect may be worthwhile in certain circumstances, while treatments with a large effect may be justified despite additional costs or complications. Therefore, researchers are encouraged to report and interpret ES and explicitly discuss the suitability of their sample for the clinical population to which the antidepressant treatment will be applied.

Regulating Gambling Use through the Overton Window: From an Addictive Behavior to a Social and Epidemiological Problem.

During the last decade, gambling (online and offline) regulation has become a social and epidemiological problem all around Europe. The aftermaths of this addiction have increased since the so-called "responsible gambling law", in the second decade of the 21st century. The Overton window (OW) strategy is a political theory that describes how the perception of public opinion can be modified so that ideas that are inconceivable for society become accepted over time. The objective of this study is to identify whether an OW has been used to bias the adequacy of the gambling debate, as well as its scientific, legal, and political bases and the main consequences for both the general population and the major risk groups, especially the consequences in social and health contexts. The study was conducted by the application of the historical-logical method as the central axis of analysis and reflection, and the technique of qualitative research content analysis as a procedure in the process of execution of the scientific task, related to a historical trend study of the research object. The main consequences found were: the political acceptance of gambling for economical causes and taxes benefits, the use of popular characters to increase the acceptance of the pattern of behavior, the inclusion of the gambling operators as agents in the risks control, and the absence of intervention until the main consequences have been transformed into an epidemiological problem (with social aftermaths higher than the previously identified related to the gambling problems). Furthermore, the results suggest the need to implement prevention and health promotion strategies and the adoption of specific legal measures that regulate the access and the marketing of gambling operators' activities.

Effectiveness of trauma-informed care interventions at the organizational level: A systematic review.

Due to the recognition of the high prevalence and widespread effects of trauma, trauma-informed care (TIC) framework has emerged to address its impact and prevent retraumatization in the systems of care. Since organizational support has been identified as crucial in TIC implementation and sustainability, this systematic review assessed the status quo of TIC interventions which explicitly incorporate an organizational component. Our search yielded 880 articles, and 15 met the inclusion criteria. All the studies were carried out in the United States, more than half in mental health and Child Welfare Services, through longitudinal designs with no randomization or control group. All the studies utilized one to six organizational components, the most frequent related to presence of a defined leadership, procedures against retraumatization and provision of strength-based services. A wide variety of measures were used to assess the effectiveness of TIC interventions, with staff perceptions and safety management indicators being the most frequently used. In summary, the review indicates a positive trend in relation to the effectiveness of the interventions included in the study, with an improved functioning of beneficiaries, enhanced accessibility, and quality of services. However, the low quality and high heterogeneity of the studies make it difficult to draw conclusions with certainty. Therefore, the primary endeavor in TIC research is to provide more solid evidence. Partnerships between academic and community stakeholders will be of high value in this process. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using a robotic exoskeleton at home: An activity tolerance case study of a child with spinal muscular atrophy.

PURPOSE: Spinal Muscular Atrophy (SMA) Type II is a neurodegenerative disease that leads to progressive muscle weakness. It prevents children from walking and affects their respiratory function and their activity tolerance, among other health problems. We aimed to assess the activity tolerance showed by a child with SMA using a pediatric gait exoskeleton at home when walking and performing activities. DESIGN AND METHODS: This study presents the case of a 6-year-old boy with SMA Type II and respiratory failure who used a pediatric gait exoskeleton at home for a period of two months. A nursing assessment was done before and during the use of the device to evaluate the child's activity tolerance during the sessions. Nursing interviews, performance, vital signs, fatigue, field notes, and functional scales were analyzed. RESULTS: The nursing assessment showed a good activity tolerance of the child. Performance using the device improved over time; vital signs did not vary significantly during the sessions; fatigue perception decreased over time; and the child reached a higher score on some functional outcomes. CONCLUSIONS: A first step has been taken to evaluate the impact of exoskeleton technology in children with SMA Type II from the nursing point of view, exposing the potential of this technology for the care of children with neuromuscular diseases, and the need for more research on the topic. PRACTICE IMPLICATIONS: The information in this study will be useful to nurses to know the effects of gait exoskeletons in pediatric care of children with neuromuscular diseases like SMA.

Women and videogames: What do they play? / Mujeres y videojuegos: ¿A qué juegan las mujeres?

La información sobre el uso de Videojuegos (VJ) en muestras generales refleja fundamentalmente las características de los hombres, por su mayor participación en VJ, dificultando identificar las características de las mujeres y su actividad de juego. Objetivo: Describir el comportamiento lúdico de adolescentes y jóvenes madrileñas y su relación con el desarrollo de problemas de juego. Método: Se aplicó un cuestionario de autoinforme (Gamertest) a una muestra de 1.228 mujeres (12 -22 años) (M = 14.84; DT= 2.469), seleccionadas mediante muestreo aleatorio en centros educativos de la Comunidad de Madrid. Resultados: el 51% de las mujeres admite jugar. El perfil típico es una mujer que juega a VJ de forma esporádica y por cortos periodos de tiempo, preferiblemente juegos de Acción y Aventura o Puzles y Plataformas; principalmente en smartphones, en casa y sola, con el propósito de divertirse. Las principales variables predictivas de problemas de juego, identificadas con el Trastorno del Juego de Internet (TJI) en mujeres son: mayor número de horas de uso, participación en juegos de rol multijugador masivo online (MMORPG) y VJ de estrategia. El factor protector más importante es jugar a VJ acompañado. Se discuten los resultados.(AU)

The information on the use of Videogames (VG) in general samples fundamentally reflects the characteristics of men, because of their greater participation in VG, making it difficult to identify the characteristics of women and their gaming activity. Objective: To describe the gaming behaviour of adolescent and young women in Madrid, and its relation with the development of gaming problems. Method: A self-report questionnaire(Gamertest) was applied to a sample of 1,228 women (12 -22 years old) (M= 14.84; SD= 2.469), selected by randomized sampling in schools in the Community of Madrid. Results: 51% of women admit gaming. The typical profile is a woman who plays VG sporadically and for short periods of time, preferably Action and Adventure games or Puzzlesand Platforms, mainly on smartphones, at home and alone, with the purpose of having fun. The main predictive variables of gaming problems, identified with the Internet Gaming Disorder (IGD) in women are: a greater number of hours of use, playing MassivelyMultiplayer Online Role-Playing Game (MMORPG), and Strategy VG. The most protective factor is playing VG accompanied. The results are discussed.(AU)

What Aspects of Religion and Spirituality Affect the Physical Health of Cancer Patients? A Systematic Review.

In recent years, the literature on the relationship between religion and spirituality (R/S) and the health of cancer patients has been flourishing. Although most studies focus on mental health, many study the physical health of these individuals. In order to summarize the findings of these studies, we reviewed the most recent research on this subject using the PubMed and PsycInfo databases. The objective of this systematic review was to recognize the primary R/S variables studied in research on physical health in cancer contexts. We found that spiritual well-being was the most-researched variable in studies of these characteristics, followed by R/S struggles and other variables such as religious coping; religious commitment or practice; or self-rated R/S. In general, R/S seems to have a positive association with the physical health of cancer patients, although the results are quite heterogeneous, and occasionally there are no relationships or the association is negative. Our results may assist in improving interventions that include spirituality in clinical settings as well as the development of holistic approaches, which may have a positive impact on the quality of life and well-being of cancer patients.

Religiosity, Emotions and Health: The Role of Trust/Mistrust in God in People Affected by Cancer.

Trust in God implies the conviction that God looks after a person's own interests. The first evidence of a relationship between this construct and people's psychological and emotional health dates back several centuries. However, the literature on this is limited, especially for people with physical health conditions, such as cancer. Therefore, the purpose of this study is to test the relationships between trust/mistrust in God, social support and emotions in people affected by cancer. The sample consisted of 177 women and men in Spain diagnosed with cancer. The instruments used were the Trust/Mistrust in God Scale, the Positive and Negative Affect Schedule and the Multidimensional Scale of Perceived Social Support. Correlation analysis and hierarchical regression analysis were performed to compare several explanatory models for the dependent variables: positive and negative emotions. The results show significant relationships between all variables. It was observed that, when trust/mistrust in God is included in the model, only mistrust in God predicts both types of emotions. In addition, both social support and some sociodemographic variables help to predict the dependent variables. This study shows that valuing the religiosity and spirituality of oncology patients in healthcare settings can have a significant positive impact on the health of these individuals. Moreover, it represents an important approach to the study of trust/mistrust in God in the context of a traditionally Catholic country.

Reporting and Interpreting Effect Sizes in Applied Health-Related Settings: The Case of Spirituality and Substance Abuse.

Inferential analysis using null hypothesis significance testing (NHST) allows accepting or rejecting a null hypothesis. Nevertheless, rejecting a null hypothesis and concluding there is a statistical effect does not provide a clue as to its practical relevance or magnitude. This process is key to assessing the effect size (ES) of significant results, be it using context (comparing the magnitude of the effect to similar studies or day-to-day effects) or statistical estimators, which also should be sufficiently interpreted. This is especially true in clinical settings, where decision-making affects patients' lives. We carried out a systematic review for the years 2015 to 2020 utilizing Scopus, PubMed, and various ProQuest databases, searching for empirical research articles with inferential results linking spirituality to substance abuse outcomes. Out of the 19 studies selected, 11 (57.9%) reported no ES index, and 9 (47.4%) reported no interpretation of the magnitude or relevance of their findings. The results of this review, although limited to the area of substance abuse and spiritual interventions, are a cautionary tale for other research topics. Gauging and interpreting effect sizes contributes to a better understanding of the subject under scrutiny in any discipline.

PSIXPORT: Mobile App for Ecological Momentary Assessment of Psychological Dimensions in Sport Injury.

Retrospective self-reports have been commonly used to assess psychological variables such as feelings, thoughts, or emotions. Nevertheless, this method presents serious limitations to gather accurate information about variables that change over time. The Ecological Momentary Assessment (EMA) approach has been used to deal with some of the limitations these retrospective assessment methods present, and for gathering real-time information about dynamic psychological variables, such as feelings, thoughts, or behaviors. In the sports injury rehabilitation context, athletes' thoughts, feelings, behaviors, and pain perceptions during the rehabilitation process can influence the outcomes of this process. These responses change over different stages of the rehabilitation and taking them into account can help therapists to adapt the rehabilitation process and increasing their effectiveness. With this aim, an EMA mobile app (PSIXPORT) was designed to gather real-time information about severely injured athletes' cognitive appraisals, emotional responses, behaviors, and pain perceptions during their rehabilitation process. The goals of this study were to evaluate Psixport's ability to gather real-time information about injured athletes' psychological responses during the rehabilitation, to test the users' perceived usability of Psixport, and to compare the reliability and differences between real-time data gathered with Psixport and the data gathered through the one-time retrospective method. Twenty-eight severely injured athletes (10 men and 18 women) were assessed using Psixport, a retrospective questionnaire, and the uMARS usability test. Results showed that Psixport can be considered as a good tool to gather information about injured athletes' cognitive appraisals, emotional responses, behaviors, and pain perceptions. Moreover, multiple data assessments gathered with the app showed to be more accurate information about injured athletes' psychological responses than one-time retrospective reports.

Cross-Cultural Analysis of Spiritual Bypass: A Comparison Between Spain and Honduras.

Religion and spirituality (R/S) serve as coping mechanisms for circumstances that threaten people's psychological well-being. However, using R/S inappropriately to deal with difficulties and problems in daily life may include the practice of Spiritual Bypass (SB). SB refers to avoiding addressing emotional problems and trauma, rather than healing and learning from them. On the other hand, coping strategies may be determined by the cultural context. This study aims to describe the presence of SB in individuals who may have experienced stressful situations and to understand the influence of culture on SB by comparing SB in two culturally different groups. The sample consists of a total of 435 people, 262 of Honduran nationality and 173 of Spanish nationality. Both groups are approximately equivalent in age and gender. The degree of SB, stressful events, perception of social support and spiritual well-being are examined, respectively, through the Spiritual Bypass Scale, and specific items and subscales from the Social Readjustment Rating Scale, Multidimensional Scale of Perceived Social Support, and the Functional Assessment of Chronic Illness Therapy - Spiritual Wellbeing. The results showed a higher spiritual well-being and use of SB in the Honduran sample as compared to the Spanish sample, but similar social support and stressful events. Furthermore, some of the factors predicting SB were different between the two samples. While age and a greater number of R/S practices were important in both samples, for the Honduran sample the variables that best explained SB were being a Christian, having greater social support, fewer stressful events, and greater attendance at church or temple. For the Spanish sample, however, the variable that best explained SB was studying R/S texts. Therefore, SB must be understood within the culture in which it develops, since in different cultural contexts it appears to relate to differing factors. Thus, SB becomes a possible functional or dysfunctional coping strategy depending on the social context.

Religiosity and Suicide: A Large-Scale International and Individual Analysis Considering the Effects of Different Religious Beliefs.

In a cohort of 82,898 participants from 60 countries, this study examined attitudes towards suicide among five religions (Buddhism, Christianity, Hinduism, Islam, and other non-specific religions), while simultaneously considering two different dimensions of religiosity: subjective religiosity and religious practices. At the national level, religiosity was an important negative predictor variable for suicide rates and an important positive predictor variable for negative attitudes towards suicide. At the individual level, however, attitudes towards suicide were found to vary significantly across the different religions. The findings emphasize the importance of considering religion perspectives and religiosity, along with its practices and subjective dimensions, in prevention and attention programmes to suicidal behaviour.

Exposición de jóvenes y adolescentes a la publicidad de los juegos de azar: una revisión sistemática / Exposure of adolescents and youth to Gambling advertising: a sys-tematic review

Los posibles efectos negativos de la publicidad de juegos de azar (JdA), sobre todo en Adolescentes y Jóvenes (AyJ), generan alarma social. Se realizó una revisión sistemática de las investigaciones sobre publicidad y juego en AyJ, en los últimos 10 años, siguiendo las directrices PRISMA, seleccionándose 31 trabajos. Los resultados destacan que AyJ, en contra de la legislación, participan con frecuencia en JdA, presentando problemas de juego. La publicidad de JdA es variada e intensa en especial en TV, eventos deportivos y redes sociales, estando dirigida a JyA, aunque suelen ser críticos con ella. Afecta más a varones jóvenes y con conductas de juego inadecuadas, consolidándolas. Los contenidos principales tratan de normalizar el juego y resaltar ganancias (sociales o económicas). El nivel de recuerdo y las actitudes sobre la publicidad del juego se asocian a incrementos en la intención de jugar, comportamientos de juego, y problemas de juego. Los incentivos más eficaces para jugar incluyen promociones económicas. La publicidad parece tener efecto, aunque reducido, para mejorar la actitud hacia los JdA e incrementar la participación en éstos, pero es difícil identificar sus efectos a medio y largo plazo. Son necesarios más estudios sobre JdA y publicidad, en especial en España

The possible negative effects of gambling Advertising (GA), especially in Adolescents and Youth (A&Y), generate social alarm. A systematic review of the research on advertising and gambling in A&Y in the last 10 years was carried out, following the PRISMA guidelines, including 31 studies. The results highlight that A&Y, against the law, frequently participate in gambling, with some having gambling problems. GA is varied and intense, especially on TV, sporting events and social networks, also targeting A&Y, although they are often critical of it. It affects more young men and people with inappropriate gambling behaviours, consolidating those behaviours. The main messages try to normalise gambling and highlight profits (social or economic). The levels of recall, as well as the attitudes about GA are associated with an increase in gambling intentions, behaviours, and problems. The most effective incentives to gamble include economic promotions. Advertising seems to have an effect, albeit reduced, to improve the attitude towards gambling and increase participation, but it is difficult to identify its effects in the medium and long term. More studies on gambling and advertising are necessary, especially in Spain

Spanish Validation and Scoring of the Internet Gaming Disorder Scale - Short-Form (IGDS9-SF).

Since the inclusion of the Internet Gaming Disorder (IGD) in the Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5), the Internet Gaming Disorder Scale-Short Form (IGDS9-SF), a short nine items test, has become one of the most used standardized instruments for its psychometric evaluation. This study presents a validation and psychometric evaluation of the Spanish version of the IGDS9-SF. A sample of 2173 videogame players between 12 and 22 years old, comprising both genders, was employed, achieved with a randomized selection process from educational institutions in the city of Madrid. Participants completed the adapted version of the IGDS9-SF, the General Health Questionnaire (GHQ-12) and a negative cognitions scale associated with videogame use, as well as sociodemographic data and frequency of videogame play. A unifactorial structure with sufficient reliability and internal consistency was found through exploratory and confirmatory analyses. In addition, the instrument was found to have good construct validity; the scoring of the IGDS9-SF were found to show a positive association with gaming frequency, with general health problems, and to a greater extent, with problematic cognitions with regard to videogames. Factorial invariance was found concerning the age of participants. However, even though the factorial structure was consistent across genders, neither metric nor scalar invariance were found; for this reason, we present a scale for the whole sample and a different one for gender. These results suggest that this Spanish version of the IGDS9-SF is a reliable and valid instrument, useful to evaluate the severity of IGD in Spanish students, and we provide a scoring scale for measurement purposes.

Measurement instruments of online gaming disorder in adolescents and young people according to DSM-5 criteria: a systematic review. / Instrumentos de medida del trastorno de juego en internet en adolescentes y jóvenes según criterios DSM-5: una revisión sistemática.

The inclusion of Internet Gaming Disorder (IGD) in the DSM-5 has generated controversy over its diagnosis, and it therefore seems necessary to establish a clear cut-off point to identify when excessive gaming becomes problematic. Such identification is especially difficult in adolescents and young people, who frequently dedicate a great deal of time to online games. The goal of this systematic review was to analyze the instruments developed to assess IGD in adolescents and young people since its inclusion in the DSM-5. We identified 13 studies which included validations of seven assessment instruments for IGD in adolescents and young people. Each instrument and its validations in different languages are described. In comparison to previous reviews, a lower diversity of assessment instruments, a reduction in the number of items and a more uniform form of measurement was observed, maintaining high internal consistency and good criterion validity. However, problems related to sample selection, the lack of sensitivity and specificity studies, and the establishment of cut points and profiles of gamers remain. Advances in the analysis of the psychometric qualities of the instruments and their validation in different countries are needed, and cultural differences should be considered in order to allow the prevalence of this problem to be compared.

La inclusión del Trastorno de Juego en Internet (TJI) en el DSM-5 ha generado polémica sobre su diagnóstico, no obstante parece necesario establecer un punto de corte claro para identificar cuando este juego excesivo se convierte en problemático. Esta identificación se hace especialmente difícil en adolescentes y jóvenes, entre los que suele ser frecuente la dedicación a este tipo de juegos. El objetivo de esta revisión sistemática fue analizar los instrumentos que desarrollados para la evaluación del TJI en adolescentes y jóvenes desde su inclusión en el DSM-5. Se identificaron 13 estudios que incluían validaciones de 7 instrumentos de evaluación del TJI en adolescentes y jóvenes. Se describió cada instrumento y sus validaciones en distintos idiomas. En relación con revisiones previas, se observó una menor diversidad de instrumentos de evaluación, una reducción en el número de ítems y una forma de medida más uniforme, manteniéndose una alta consistencia interna y una buena validez de criterio. Sin embargo, siguen presentes los problemas referidos a la selección de muestras, la falta de estudios de sensibilidad y especificidad, y el establecimiento de puntos de corte y perfiles de jugadores. Se recomienda avanzar en el análisis de las cualidades psicométricas de los instrumentos, y su validación en distintos países para considerar las diferencias culturales y poder comparar la presencia de este problema.

Impact of routine right parasternal electrocardiographic screening in assessing eligibility for subcutaneous implantable cardioverter-defibrillator.

INTRODUCTION: Between 7% and 15% of patients with an indication for an implantable cardioverter-defibrillator (ICD) are not eligible for implantation of a subcutaneous implantable cardioverter-defibrillator (S-ICD) on the basis of the result of the conventional left parasternal electrocardiographic screening (LPES). Our objective was to determine the impact of systematically performing right parasternal electrocardiographic screening (RPES) in addition to conventional LPES, in terms of increasing both the total percentage of potentially eligible patients for S-ICD implantation and the number of suitable vectors per patient. METHODS AND RESULTS: Consecutive patients from the outpatient device clinic who already had an implanted ICD, and no requirement for pacing were enrolled. Conventional left parasternal electrode position and right parasternal electrode positions were used. The automatic screening tool was used to analyze the recordings. Screenings were performed in the supine and standing positions. Overall, 209 patients were included. The mean age was 63.4 ± 13 years, 59.8% had ischemic heart disease, mean QRS duration was 100 ± 31 ms, and 69.9% had a primary prevention ICD indication. Based on conventional isolated LPES, 12.9% of patients were not eligible for S-ICD compared with 11.5% based on RPES alone (P = .664). Considering LPES and RPES together, only 7.2% of patients were not eligible for S-ICD (P < .001). Moreover, the number of patients with more than one suitable vector increased from 66.5% with isolated LPES to 82.3% (23.7% absolute increase [P < .001]). CONCLUSION: Adding an automated RPES to the conventional automated LPES increased patient eligibility for the S-ICD significantly. Moreover, combined screening increased the number of suitable vectors per eligible patient.