Differences in Screen Addiction in the Past 15 Years.

The use of information and communication technologies (ICTs) has become widespread in recent years, leading to an increase in addiction cases. A total of 118 patients who attended the Behavioral Addictions Unit of Consorci Sanitari de Terrassa (Barcelona, Spain) between October 2005 and December 2021 were included in the study. The sample was divided into three groups according to the time period in which they started treatment: between 2005 and 2010 (before the rise in new technologies, named the pre-ICT period), between 2011 and 2019 (a time of major ICT development, named the ICT period) and between 2020 and 2021 (with massive use of the internet due to effects of the pandemic, named the COVID-19 period). We found an increase in the incidence of screen addiction cases related to the development of technology throughout the study years, and this increase was accentuated during the COVID-19 period. This increase was not equal for all types of content consumed via the internet, with patients with video game addiction increasing to a greater extent than patients with internet/social network addiction. In addition, patients with video game addiction were younger and had started gaming at a younger age than those with internet/social network addiction. These results contribute to a better understanding of the phenomenon of technology addiction and to the design of appropriate treatment protocols and preventive programs.

Current Addiction in Youth: Online Sports Betting.

Background: Gambling landscape has changed in recent years with the emergence of online gambling (OG). Greater accessibility and availability of this betting modality can increase the risk of developing a gambling disorder (GD). Online sports betting (OSB) is currently the most common type of OG, but little is known about the clinical characteristics of OSB compared to slot-machine (SM) gamblers, the most common offline gambling disorder. Methods: This was a prospective study conducted between October 2005 and September 2019, and included outpatients diagnosed with GD seen in a Pathological Gambling and Behavioral Addictions referral unit. Only patients with OSB and SM disorders were included. The main objective was to assess the clinical profile of OSB compared to SM gamblers, and to define clinical predictors for developing OSB gambling disorder. Logistic regression was performed to determine the effects of variables on the likelihood of this disorder. Results: Among 1,186 patients attended in our Unit during the study period, 873 patients were included; 32 (3.7%) were OSB gamblers and 841 (96.3%) were SM gamblers. Overall, mean age was 45 ± 13 years and 94.3% were men. Compared to SM patients, OSB patients were younger (34.9 ± 9.5 vs. 45.3 ±13), more frequently single (43.8 vs. 20.6%) and had a university education level (43.8 vs. 4.5%); they were also more frequently non-smokers (18.7 vs. 66.7%) and had fewer psychiatric comorbidities (12.5 vs. 29.4%) than SM gamblers. GD duration before treatment initiation was shorter in OSB patients than in SM gamblers, most of them (81.3 vs. 42.4%) with ≤ 5 years of GD duration. OSB gamblers showed significant differences in weekly gambling expenditure, spending higher amounts than SM patients. Younger age (OR: 0.919; 95% CI: 0.874-0.966), university education level (OR: 10.658; 95% CI: 3.330-34.119), weekly expenditure >100€ (OR: 5.811; 95% CI:1.544-21.869), and being a non-smoker (OR:13.248; 95% CI:4.332-40.517) were associated with an increased likelihood of OSB gambling behavior. Conclusions: We identified different profiles for OSB and SM gamblers. Younger age, university education level, higher weekly expenditure, and non-smoking habit were associated with OSB compared to SM disorders. Prevention strategies should help young people become aware of the severe risks of OSB.

Women with compulsive buying or gambling disorder: Similar profiles for different behavioural addictions.

The aim of the present study was to examine the differences in sociodemographic and clinical characteristics of 104 women diagnosed with compulsive buying behaviour (CBB = 55) or gambling disorder (GD = 49) treated at three public hospitals unit specialized in behavioural addictions from January 2004 to December 2015. Significant between-group differences in sociodemographic variables were observed for cohabitation status (living with a partner or not) and educational level, with a higher percentage of women in the GD group cohabiting (х2 (1), p = .029). By contrast, the CBB group had a significantly higher educational level (х2 (1) = 7.4, p = .007). There were no significant differences between the groups in age of onset, age at treatment initiation, age at the onset of behavioural problems, or in the years elapsed until presenting addiction problems. However, there were significant between-group differences in the amount of money spent weekly (F (1.100) = 4.9, p = .028), with women in the CBB group spending on average €289.4/week (SD, 412.4) versus €151/week (SD, 141.23) in the GD group. The CBB group had significantly more depressive disorders compared to the GD group (х2(1) = 5.4, p = .020). In contrast, the GD group presented significantly more tobacco use than the CBB group (х2(1) = 1.19, p = .000). This study suggests that women with CBB or GD share more characteristics than differences and the treatment approaches must take into account gender related factors.

Impulsivity profiles in pathological slot machine gamblers.

INTRODUCTION: In gambling disorder (GD), impulsivity has been related with severity, treatment outcome and a greater dropout rate. The aim of the study is to obtain an empirical classification of GD patients based on their impulsivity and compare the resulting groups in terms of sociodemographic, clinical and gambling behavior variables. METHODS: 126 patients with slot machine GD attending the Pathological Gambling Unit between 2013 and 2016 were included. The UPPS-P Impulsive Behavior Scale was used to assess impulsivity, and the severity of past-year gambling behavior was established with the Screen for Gambling problems questionnaire (NODS). Depression and anxiety symptoms and executive function were also assessed. A two-step cluster analysis was carried out to determine impulsivity profiles. RESULTS: According to the UPPS-P data, two clusters were generated. Cluster 1 showed the highest scores on all the UPPS-P subscales, whereas patients from cluster 2 exhibited only high scores on two UPPS-P subscales: Negative Urgency and Lack of premeditation. Additionally, patients on cluster 1 were younger and showed significantly higher scores on the Beck Depression Inventory and on the State-Trait Anxiety Inventory questionnaires, worse emotional regulation and executive functioning, and reported more psychiatric comorbidity compared to patients in cluster 2. With regard to gambling behavior, cluster 1 patients had significantly higher NODS scores and a higher percentage presented active gambling behavior at treatment start than in cluster 2. CONCLUSIONS: We found two impulsivity subtypes of slot machine gamblers. Patients with high impulsivity showed more severe gambling behavior, more clinical psychopathology and worse emotional regulation and executive functioning than those with lower levels of impulsivity. These two different clinical profiles may require different therapeutic approaches.

The efficacy of Motivational Intervention and Cognitive-Behavioral Therapy for Pathological Gambling. / Eficacia de la intervención Motivacional y la Terapia Cognitivo-conductual para el tratamiento del Juego Patológico.

The aim of the current study is to determine the effectiveness of an individual psychological intervention based on the motivational interview and cognitive-behavioral therapy for the treatment of pathological gambling. A sample of 18 participants, diagnosed of pathological gambling and without any other associated comorbidity, were assessed, attended at the publicly-funded Gambling and Behavioral Addictions Unit (Consorci Sanitari de Terrassa). Median age was 46 years (SD = 12). All the patients achieved abstinence and completed follow-up. The Screen for Gambling Problems (NODS), Quality of Life Enjoyment and Satisfaction (Q-LES-Q), Impulsive Behavior Scale (UPPS-P), Sheehan Disability Inventory (SDI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were administered pre- and posttreatment. Results showed that patients significantly reduced the problems related to gambling behavior according to the NODS score (p < .000). Regarding impulsive behavior (UPPS-P), we found significant differences in negative urgency (p < .001), positive urgency (p < .001), (lack of) premeditation (p < .029) and (lack of) perseverance (p < .048). Some relevant aspects of quality of life as assessed by the Q-LES-Q had improved. In conclusion, the study shows that psychological intervention based on the motivational interview and cognitive-behavioral therapy not only significantly reduces gambling-related behavior problems but also leads to improvements in impulsivity and quality of life. .

El propósito del presente estudio es analizar la eficacia de una intervención psicológica individual basada en Entrevista Motivacional y Terapia cognitivo-conductual en el tratamiento del Juego Patológico, y evaluar la eficacia de esta intervención psicológica sobre la impulsividad y la calidad de vida de los pacientes. La muestra se compone de 18 pacientes atendidos en la Unidad de Juego Patológico del Consorci Sanitari Terrassa, diagnosticados de Juego Patológico, y sin comorbilidad asociada. La media de edad fue de 46 años (SD=12). Todos ellos alcanzaron la abstinencia y se encontraban en fase de seguimiento. Se administraron pre y post tratamiento los siguientes cuestionarios: Screen for Gambling Problems (NODS), Quality of Life Enjoyment and Satisfaction (Q-LES-Q), UPPS-P Impulsive Behavior Scale, Sheehan Disability Inventory (SDI), Beck Depression Inventory (BDI), State-trait Anxiety Inventory (STAI). Los resultados muestran una reducción significativa de los problemas asociados a la conducta de juego (p<.000). También se encontraron diferencias significativas en la impulsividad (UPPS-P) pre-post: urgencia negativa (p<.001), urgencia positiva (p<.001), (falta de) premeditación (p<.029) y (falta de) perseverancia (p<.048). Así mismo, hay una mejoría significativa en la calidad de vida (Q-LES-Q) de nuestros pacientes en distintas áreas. En conclusión, el estudio pone de manifiesto que la intervención psicológica basada en Entrevista Motivacional y Terapia Cognitivo-conductual permite una mejora significativa del Juego Patológico que repercute no sólo en la conducta de juego sino que también implica otros aspectos como la impulsividad y la calidad de vida.

Eficacia de la intervención Motivacional y la Terapia Cognitivo-conductual para el tratamiento del Juego Patológico / The efficacy of Motivational Intervention and Cognitive-Behavioral Therapy for Pathological Gambling

El propósito del presente estudio es analizar la eficacia de una intervención psicológica individual basada en Entrevista Motivacional y Terapia cognitivo-conductual en el tratamiento del Juego Patológico, y evaluar la eficacia de esta intervención psicológica sobre la impulsividad y la calidad de vida de los pacientes. La muestra se compone de 18 pacientes atendidos en la Unidad de Juego Patológico del Consorci Sanitari Terrassa, diagnosticados de Juego Patológico, y sin comorbilidad asociada. La media de edad fue de 46 años (SD=12). Todos ellos alcanzaron la abstinencia y se encontraban en fase de seguimiento. Se administraron pre y post tratamiento los siguientes cuestionarios: Screen for Gambling Problems (NODS), Quality of Life Enjoyment and Satisfaction (Q-LES-Q), UPPS-P Impulsive Behavior Scale, Sheehan Disability Inventory (SDI), Beck Depression Inventory (BDI), Statetrait Anxiety Inventory (STAI). Los resultados muestran una reducción significativa de los problemas asociados a la conducta de juego (p<.000). También se encontraron diferencias significativas en la impulsividad (UPPS-P) pre-post: urgencia negativa (p<.001), urgencia positiva (p<.001), (falta de) premeditación (p<.029) y (falta de) perseverancia (p<.048). Así mismo, hay una mejoría significativa en la calidad de vida (Q-LES-Q) de nuestros pacientes en distintas áreas. En conclusión, el estudio pone de manifiesto que la intervención psicológica basada en Entrevista Motivacional y Terapia Cognitivoconductual permite una mejora significativa del Juego Patológico que repercute no sólo en la conducta de juego sino que también implica otros aspectos como la impulsividad y la calidad de vida

The aim of the current study is to determine the effectiveness of an individual psychological intervention based on the motivational interview and cognitive-behavioral therapy for the treatment of pathological gambling. A sample of 18 participants, diagnosed of pathological gambling and without any other associated comorbidity, were assessed, attended at the publicly-funded Gambling and Behavioral Addictions Unit (Consorci Sanitari de Terrassa). Median age was 46 years (SD = 12). All the patients achieved abstinence and completed follow-up. The Screen for Gambling Problems (NODS), Quality of Life Enjoyment and Satisfaction (Q-LES-Q), Impulsive Behavior Scale (UPPS-P), Sheehan Disability Inventory (SDI), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) were administered pre- and posttreatment. Results showed that patients significantly reduced the problems related to gambling behavior according to the NODS score (p < .000). Regarding impulsive behavior (UPPS-P), we found significant differences in negative urgency (p < .001), positive urgency (p < .001), (lack of) premeditation (p < .029) and (lack of) perseverance (p < .048). Some relevant aspects of quality of life as assessed by the Q-LES-Q had improved. In conclusion, the study shows that psychological intervention based on the motivational interview and cognitive-behavioral therapy not only significantly reduces gambling-related behavior problems but also leads to improvements in impulsivity and quality of life

Computer-assisted cognitive remediation therapy in schizophrenia: Durability of the effects and cost-utility analysis.

The durability of computer-assisted cognitive remediation (CACR) therapy over time and the cost-effectiveness of treatment remains unclear. The aim of the current study is to investigate the effectiveness of CACR and to examine the use and cost of acute psychiatric admissions before and after of CACR. Sixty-seven participants were initially recruited. For the follow-up study a total of 33 participants were enrolled, 20 to the CACR condition group and 13 to the active control condition group. All participants were assessed at baseline, post-therapy and 12 months post-therapy on neuropsychology, QoL and self-esteem measurements. The use and cost of acute psychiatric admissions were collected retrospectively at four assessment points: baseline, 12 months post-therapy, 24 months post-therapy, and 36 months post-therapy. The results indicated that treatment effectiveness persisted in the CACR group one year post-therapy on neuropsychological and well-being outcomes. The CACR group showed a clear decrease in the use of acute psychiatric admissions at 12, 24 and 36 months post-therapy, which lowered the global costs the acute psychiatric admissions at 12, 24 and 36 months post-therapy. The CACR is durable over at least a 12-month period, and CACR may be helping to reduce health care costs for schizophrenia patients.

Predicting treatment failure in pathological gambling: the role of personality traits.

INTRODUCTION: The aim of this study was twofold: First, to assess the personality profile of treatment-seeking adult outpatients with pathological gambling compared to a matched control group under the Alternative Five Factor Model perspective, and second, to determine which personality variables would predict treatment outcome. METHODS: The final total sample consisted of 44 consecutive treatment-seeking pathological gamblers (PGs) and 88 controls paired by age and sex who completed the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ). Twelve months after starting an open program of individual cognitive-behavioral therapy, PGs were categorized as abstinent or treatment failure. RESULTS: PGs scored significantly higher on Neuroticism-Anxiety. Those who had relapsed or dropped out showed higher Impulsivity and Sensation Seeking scores. Impulsivity emerged as a significant predictor of treatment failure. Treatment-seeking PGs scored higher on Neuroticism-Anxiety and Impulsivity appeared as a risk factor of relapsing or dropping out. CONCLUSIONS: Our findings support the importance of individual differences in personality on therapy outcomes. The ZKPQ may constitute a useful tool to identify these individual differences that might be considered when making personalized treatment decisions to improve the effectiveness and quality of treatment interventions.

Pathological gambling: understanding relapses and dropouts.

There is little available information on the factors that influence relapses and dropouts during therapy for pathological gambling (PG). The aim of this study was to determine socio-demographic, clinical, personality, and psychopathological predictors of relapse and dropout in a sample of pathological gamblers seeking treatment. A total of 566 consecutive outpatients diagnosed with PG according to DSM-IV-TR criteria were included. All patients underwent an individualized cognitive-behavioral treatment program. We analyzed predictors of relapse during 6months of treatment and during the subsequent 6months of follow-up, and predictors of dropout over the entire therapeutic program. Eighty patients (14.1%) experienced at least one relapse during the entire follow-up of the study: 50 (8.8%) within the treatment period and 12 (2.1%) during the subsequent 6-month follow-up period. The main predictors of relapse were single marital status, spending less than 100euros/week on gambling, active gambling behavior at treatment inclusion, and high scores on the TCI-R Harm Avoidance personality dimension. One hundred fifty-seven patients (27.8%) missed 3 or more therapeutic sessions over the entire therapeutic program. The main predictors of dropout were single marital status, younger age, and high scores on the TCI-R Novelty Seeking personality dimension. The presence of these factors at inclusion should be taken into account by physicians dealing with PG patients.

Male and female pathological gamblers: bet in a different way and show different mental disorders

Although in the last years several studies comparing male and female pathological gamblers have been published, most of them have been carried out using only samples of males. The aim of this study was to investigate gender differences in a sample of subjects diagnosed with pathological gambling (PG) attending three specialized outpatient units. Retrospective study was carried out of 96 patients (49% female and 51% male), comparing the main socio-demographic, clinical, and behavioral data. Most subjects (94%) met the criteria for pathological gambling. No significant differences between sexes were found in the severity of gambling behavior or the socio-demographic variables studied. Whereas slot machines were the main type of game for most subjects, a higher percentage of women were addicted to bingo (χ2 (1, 4) = 5.19, p = .029 Cohen’s d = 0.48) and had more than one type of game as a secondary addiction χ2 (1, 4) = 7.63, p = .006; Cohen’s d = 0.59) . Women started gambling at a later age than men (t(94) = 2.95, p = .004; Cohen’s d = 0.60), but developed a pattern of addiction faster ( t(94) = 2.95, p = .004; Cohen's d = -0.61) . Women also had higher comorbidity with other psychiatric disorders (χ2 (1) = 7.28, p = .007; Cohen’s d = 0.57), specifically with affective (χ2 (1) = 11.31, p = .001; Cohen’s d = 0.73) and personality disorders (χ2 (1) = 4.71, p = .030; Cohen’s d = 0.45). Our results indicate the existence of differences between women and men in the pattern of gambling behavior and in psychiatric comorbidity. These aspects should be considered in the design of treatment programs for pathological gamblers (AU)

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Male and female pathological gamblers: bet in a different way and show different mental disorders.

Although in the last years several studies comparing male and female pathological gamblers have been published, most of them have been carried out using only samples of males. The aim of this study was to investigate gender differences in a sample of subjects diagnosed with pathological gambling (PG) attending three specialized outpatient units. Retrospective study was carried out of 96 patients (49% female and 51% male), comparing the main socio-demographic, clinical, and behavioral data. Most subjects (94%) met the criteria for pathological gambling. No significant differences between sexes were found in the severity of gambling behavior or the socio-demographic variables studied. Whereas slot machines were the main type of game for most subjects, a higher percentage of women were addicted to bingo (χ2 (1, 4) = 5.19, p = .029 Cohen's d = 0.48) and had more than one type of game as a secondary addiction χ2 (1, 4) = 7.63, p = .006; Cohen's d = 0.59) . Women started gambling at a later age than men (t (94) = 2.95, p = .004; Cohen's d = 0.60), but developed a pattern of addiction faster ( t (94) = 2.95, p = .004; Cohen's d = -0.61) . Women also had higher comorbidity with other psychiatric disorders (χ2 (1) = 7.28, p = .007; Cohen's d = 0.57), specifically with affective (χ2 (1) = 11.31, p = .001; Cohen's d = 0.73) and personality disorders (χ2 (1) = 4.71, p = .030; Cohen's d = 0.45). Our results indicate the existence of differences between women and men in the pattern of gambling behavior and in psychiatric comorbidity. These aspects should be considered in the design of treatment programs for pathological gamblers.

Computer-assisted cognitive remediation therapy: cognition, self-esteem and quality of life in schizophrenia.

BACKGROUND: Quality of life (QoL) is an important outcome in the treatment of schizophrenia. Cognitive deficits have an impact on functional outcomes. Cognitive remediation therapy is emerging as a psychological intervention that targets cognitive impairment, but the effect of computer-assisted cognitive remediation on neuropsychology and social functioning and wellbeing remains unclear. The aim of the current study is to investigate the neurocognitive outcomes of computer-assisted cognitive remediation (CACR) therapy in a sample of schizophrenia patients, and to measure the quality of life and self-esteem as secondary outcomes. METHODS: Sixty-seven people with schizophrenia were randomly assigned to computer-assisted cognitive remediation or an active control condition. The main outcomes were neuropsychological measures and secondary outcomes (self-esteem and quality of life). Measurements were recorded at baseline and post-treatment. RESULTS: The CACR therapy group improved in speed of processing, working memory and reasoning and problem-solving cognitive domains. QoL and self-esteem measures also showed significant improvements over time in this group. CONCLUSIONS: Computer-assisted cognitive remediation therapy for people with schizophrenia achieved improvements in neuropsychological performance and in QoL and self-esteem measurements.

The role of personality in the prediction of treatment outcome in pathological gamblers: a follow-up study.

The aim of the present study was to determine which domains in NEO Personality Inventory-Revised would predict relapse and dropout in treatment-seeking slot-machine pathological gamblers after 1-year follow-up. The NEO PI-R was completed by 73 consecutive treatment-seeking outpatients before they began an open program of individual cognitive-behavioral therapy. Twelve months after starting treatment, patients were categorized in groups as abstinent versus relapsed or completers versus dropouts. At 1-year follow-up, 29% of patients were abstinent, and 48% had completed treatment. Those who had relapsed showed higher significant scores on Neuroticism and lower scores on Conscientiousness. The dropout group scored significantly higher on Neuroticism and lower on Agreeableness and Conscientiousness than the completer group. Low scores on Conscientiousness emerged as a significant predictor of relapse; while low scores on Conscientiousness and Agreeableness were significant predictors of dropout. It seems as if low Conscientiousness could be considered as a predictor of treatment failure measured by either relapses or dropouts, whereas, low Agreeableness seems to be a prognostic domain specifically for dropouts. Pathological gamblers with lower Conscientiousness and lower Agreeableness seem to be at risk of prematurely dropping out of treatment. Our findings support the importance of individual differences in personality on therapy outcomes. The NEO PI-R may constitute an important tool to identify treatment-seeking pathological gamblers who may be at risk of relapsing or dropping out of treatment.

Pathological gambling in a psychiatric sample.

OBJECTIVE: This study determines the prevalence of gambling difficulties in a consecutive sample of psychiatric inpatients and compares it with a nonpsychiatric inpatient sample. In addition, the gambling prevalence among all psychiatric disorders is analyzed. METHOD: An observational study was conducted in psychiatric patients and sex- and age-matched nonpsychiatric patients. The psychiatric group (n = 100) included all consecutive patients admitted to the psychiatric unit of our hospital. The nonpsychiatric group (n = 100) included psychiatrically healthy inpatients from any other hospital unit. The National Opinion Research Center Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Screen for Gambling Problems was used to screen for gambling behavior. RESULTS: Gambling difficulties were experienced by 3% (2% pathological gambling and 1% problem gambling) of nonpsychiatric inpatients and 9% (8% pathological gambling and 1% problem gambling) of psychiatric inpatients, including 6 with psychotic disorders, 1 with mood disorder, 1 with adjustment disorder, and 1 with eating disorder. There were no statistical differences in gambling prevalence between groups. In terms of comorbidity, patients with psychotic disorder had a higher prevalence of gambling problems than other psychiatric disorders (P = .045). CONCLUSIONS: A higher prevalence of gambling disorders was found in psychiatric inpatients than in nonpsychiatric inpatients. It may be advisable for therapists to routinely assess for gambling difficulties as part of the psychiatric evaluation.

Spanish version of the Delirium Rating Scale-Revised-98: reliability and validity.

OBJECTIVE: The aim of this study was to investigate the reliability and validity of the Spanish translation of the Delirium Rating Scale-Revised-98 (DRS-R-98). METHODS: Thirty patients diagnosed of delirium (DSM-IV) by a variety of general hospital medical wards criteria were assessed using the DRS-R-98, MiniMental State Examination (MMSE), Mini Examen Cognoscitivo (MEC; Spanish version of the MMSE) and the Orientation Scale (OS). Independent ratings between two psychiatrists were used to calculate intraclass correlation coefficients (ICCs) for interrater reliability. RESULTS: The DRS-R-98 had high interrater reliability for both total and severity scale scores (ICC=.96 for each). The DRS-R-98 severity score significantly correlated (P<.001) with MMSE (r=-.67), MEC (r=-.62) and OS (r=.73). Cronbach's alpha (r=.78 ) indicated high internal consistency of the DRS-R-98. CONCLUSION: The Spanish translation of the DRS-R-98 has high interrater reliability for both total and severity scale scores, high internal consistency, and very good concurrent validity in relation to other cognitive measures and therefore can be administered to delirious patients.