Relationship Between Social Withdrawal (Hikikomori), Personality, and Coping in an Adult Population.

OBJECTIVE: The aim of this study was to investigate the relationships between personality dimensions, coping strategies, and Hikikomori while controlling for the presence of depression and anxiety. METHODS: Two groups, recruited on social networks, were compared: the control group (n=101, mean age±standard deviation [SD]= 36.2±12.8 years) and the Hikikomori group (n=28, mean age±SD=30.1±9.1 years). Participants of both groups completed the Big Five Inventory, the Brief Coping Orientation to Problems Experienced, and the Hospital Anxiety and Depression Scale. RESULTS: The Hikikomori group had higher depression, anxiety, neuroticism, and dysfunctional coping dimension (self-blame and behavioral disengagement) scores than the control group. Being alone and depression were positively associated with Hikikomori while extraversion and instrumental support were negatively associated with Hikikomori. CONCLUSION: These findings contribute to a better understanding of the psychological functioning of Hikikomori as well as to treatment elaboration and confirm that some psychological characteristics are transcultural.

Non-Suicidal Self-Injury and Emotional Dysregulation in Male and Female Young Adults: A Qualitative Study.

Objectives: Non-suicidal self-injury (NSSI) has been theoretically, clinically, and empirically associated with emotional dysregulation. NSSI is a means of regulating emotional states, particularly negative emotions. However, empirical studies on this topic are scarce and the literature lacks qualitative research on individuals' perceptions and comprehension of the function of self-injury. Thus, this qualitative study aimed to provide novel insights into the relationship between NSSI and emotional dysregulation in young adults. Methods: Twelve participants (mean age=22.7 years, 9 females and 3 males) from different support groups and a healthcare center participated in semi-structured interviews on NSSI-related emotional processes. Three aspects were investigated: reasons for NSSI, function of NSSI, and emotions. Each interview was voice recorded and typically lasted between 20 and 40 minutes. All responses were analyzed using thematic analysis. Results: Four major themes were identified. The results showed that NSSI had both intrapersonal and interpersonal functions, within which emotional regulation played a significant role. NSSI was also used to regulate positive emotions. The results also showed a sequence of emotions among the participants, going from feeling overwhelmed to feeling relatively calm but guilty. Conclusion: NSSI has several functions for the same individual. Thus, it would be interesting to provide integrative therapy, such as emotion-focused therapy, which focus on improving intrapersonal and interpersonal emotion regulation skills and strategies.

Relationship Between Non-Suicidal Self-Injury and Emotion Dysregulation Among Male and Female Young Adults.

Over recent years, non-suicidal self-injury (NSSI) has been associated with emotion dysregulation. However, only a few quantitative studies have empirically investigated differences in emotion dysregulation among people who self-harm, while none have explored gender differences in this regard. Thus, this research study aimed to further examine the association between NSSI and emotion regulation deficits and strategies in young adults. A total of 201 participants (mean age = 21.82 years) were recruited from different support groups dedicated to NSSI and from health care centres and were divided into two groups: a control group (CG, n = 100, mean age = 21.92 years, comprised of 30% males) and an NSSI group (NSSIG, n = 101, mean age = 21.72 years, comprised of 16% males). All participants completed the Deliberate Self-Harm Inventory, the Difficulties in Emotion Regulation Scale, and the Emotion Regulation Questionnaire. The results showed that compared to the CG participants, those from the NSSIG had increased emotion regulation deficits, higher expressive suppression scores, and lower cognitive re-evaluation scores. Within the NSSIG, females had higher impulse control difficulties and limited access to emotion regulation strategies, while males had higher expressive suppression scores. Factors associated with NSSI also differed by gender. These results indicate the necessity to take gender into account when planning treatment, since treatment protocols must be adapted to the specific emotion regulation difficulties concerned.

Gambling and Aging: An Overview of a Risky Behavior.

Gambling is a field of study that has grown since the 2000s. Much research has focused on adolescents and youth as a vulnerable population. The rate of aging gamblers is increasing; however, evidence-based knowledge of this population is still too sparse. After introducing the issue (1), this article provides a narrative review of older adults' gambling through three sections: (2) older adult gamblers (age, characteristics, and motivations), (3) gambling as a risky decision-making situation, and (4) gambling disorder related to older adults. By drawing on the existing literature from a problematization perspective, this type of review can highlight complex and original research topics and provoke thought and controversy to generate avenues for future research. This narrative review provides an overview of the existing literature on gambling among older adults and offers perspectives on how aging can affect decision-making and thus gambling for this population. Older adults are a specific population, not only in terms of the consequences of gambling disorders but also in terms of the motivations and cognitions underlying gambling behaviors. Studies on behavioral science focusing on decision-making in older adults could help in the development of public policy in terms of targeted prevention.

Alcohol Use, Anxiety and Depression among French Grandes Écoles Engineering Students during the COVID-19 Pandemic.

In French Grandes Écoles, heavy alcohol consumption seems to be generalized and largely tolerated, leading to particular concerns about Alcohol Use Disorder and harmful alcohol practices among students. The COVID-19 pandemic led to increased psychological difficulties, and two coexisting scenarios seemed to emerge regarding alcohol consumption: A decrease in alcohol consumption linked to the absence of festive events, and an increase in solitary alcohol consumption to cope with lockdowns. The aim of this exploratory study is to investigate the evolution of alcohol consumption, consumption motives and the relationship of these factors to the anxiety and the depression of French Grandes Écoles students during the COVID-19 pandemic, depending on their residential status. After the last lockdown, 353 students completed a questionnaire measuring alcohol consumption, motivation to drink, anxiety and depression during and after the COVID-19 period. Although students confined to campus were more likely to increase their alcohol use, they also presented higher well-being scores than those who lived off campus. A significant proportion of students were aware of their increased alcohol use due to the COVID-19 pandemic, and the motives attributed to their increased consumption highlight the need for vigilance and specialized support facilities.

Spending Money in Free-to-Play Games: Sociodemographic Characteristics, Motives, Impulsivity and Internet Gaming Disorder Specificities.

Free-to-Play games (F2P) have spread widely all over the world in recent years. The current economic model for these games is based on microtransactions, where gamers can purchase additional items or services inside the game. The aim of the present study was (1) to describe the profiles and gaming patterns of F2P gamers, and (2) to compare F2P gamers who spend money and those who do not, in terms of sociodemographic characteristics, gaming experience, motivations, impulsivity, and risk of Internet gaming disorder (IGD), in a representative sample of 5062 French online gamers. Among the total sample, 68.6% were past-year F2P gamers. Among the F2P gamers, 26.1% had spent money in the game. Spending in the game was strongly associated with IGD (6.9% of F2P gamers were disordered gamers). Flow (gaming experience) and escape (motivation) were strongly associated with spending in the game and IGD. Negative urgency (impulsivity) was positively associated with spending in the game while positive urgency was positively associated with IGD. Given the strong association between spending in the game and IGD, these results highlight the importance of prevention and regulation in the field.

An empirical investigation of the Pathways Model of problem gambling through the conjoint use of self-reports and behavioural tasks.

Background and aims: Blaszczynski and Nower (2002) conceptualized their Pathways Model by postulating the existence of three subtypes of problem gamblers who share common characteristics, but also present specific ones. Methods: This study investigated how the psychological mechanisms postulated in the Pathways Model predict clinical status in a sample that combined treatment-seeking gamblers (n = 59) and non-problematic community gamblers (n = 107). To test the Pathways Model, we computed a hierarchic logistic regression in which variables associated with each postulated pathway were entered sequentially to predict the status of the treatment-seeking gambler. Self-report questionnaires measured gambling-related cognitions, alexithymia, emotional reactivity, emotion regulation strategies and impulsivity. Behavioural tasks measured gambling persistence (slot machine task), decision-making under uncertainty (Iowa Gambling Task) and decision-making under risk (Game of Dice Task). Results: We showed that specific factors theorized as underlying mechanisms for each pathway predicted the status of clinical gambler. For each pathway, significant predictors included gambling-related cognitive distortions and behaviourally measured gambling persistence (behaviourally conditioned pathway), emotional reactivity and emotion regulation strategies (emotionally vulnerable pathway), and lack of premeditation impulsivity facet (impulsivist-antisocial pathway). Discussion and conclusions: Our study adds to the body of literature confirming the validity of the Pathways Model and hold important implications in terms of assessment and treatment of problem gambling. In particular, a standardized assessment based on the Pathways Model should promote individualized treatment strategies to allow clinicians to take into account the high heterogeneity that characterizes gambling disorder.

Impulsivity, Emotion Regulation, Cognitive Distortions and Attentional Bias in a Spanish Sample of Gambling Disorder Patients: Comparison between Online and Land-Based Gambling.

Several risk factors have been related to the onset and maintenance of gambling disorder (GD). The aim of this study was to explore the differences in emotion dysregulation, impulsivity, cognitive distortions, and attentional bias between online and land-based gamblers. The sample consisted of 88 treatment-seeking patients from the Behavioral Addictions Unit at the Hospital de la Santa Creu i Sant Pau, Barcelona (Spain). Patients were divided into two groups by considering their main type of gambling, i.e., online (n = 26) and land-based gambling (n = 62). Online gamblers were younger, more often employed, with a higher educational level than land-based gamblers. Regarding the rest of the variables, statistically significant differences were only found in Positive Urgency, one of the UPPS-P subscales, in which the land-based gambling group scored higher than the online gambling group. In this exploratory study, individuals with online and land-based GD phenotypes did not differ either in difficulties in emotion regulation or in attentional and cognitive biases. However, land-based GD patients showed a higher tendency to succumb to strong impulses under the influence of positive emotions. These preliminary findings warrant the need to continue investigating GD phenotypes in larger patient samples.

Internet Gaming Disorder: Exploring Its Impact on Satisfaction in Life in PELLEAS Adolescent Sample.

Among adolescents, heavy video game use and socializing online may be valued socially by peers, depending on gender and age, which can increase life satisfaction. However, heavy video gaming may also be linked to symptoms of Internet Gaming Disorder, which can decrease life satisfaction. Overall, when symptoms of Internet Gaming Disorder are present, do subjects experience decreased or increased life satisfaction, all other things being equal? The aim of this study was to explore the association between Internet Gaming Disorder symptoms and life satisfaction, while controlling for gender, age, and other conditions that may impact life satisfaction. More than 2000 adolescents filled out an anonymous questionnaire at school, and 43 patients in a care center filled out the same questionnaire. Sociodemographic characteristics, family life conditions, use of screens (videos, video games, and social networks), mental health screenings, and a life satisfaction measure were collected. Distribution of participants' characteristics was provided, and stratified multivariate analyses by young male, older male, young female, and older female school populations were carried out. Results suggested that Internet Gaming Disorder symptoms had similar prevalence before and after the age of 15 in males (21% vs. 19%) and in females (6% vs. 7%) respectively and was significantly associated with decreased life satisfaction in older males, even after adjusting for parental support, depression, and economic conditions. Associations between symptoms of Internet Gaming Disorder and life satisfaction may be different depending on adolescent gender and age group.

Effects of a prevention intervention concerning screens, and video games in middle-school students: Influences on beliefs and use.

BACKGROUND AND AIMS: The aim of this study was to evaluate the effects of a prevention intervention on French adolescents' Internet and video games use and on their beliefs concerning gaming and Internet Gaming Disorder (IGD), in order to adjust prevention programs further. METHODS: The study comprised a prevention intervention group (PIG) and a control group assessed at three times - baseline, post-test, and 4-month follow-up. At baseline, a total of 434 junior high adolescents from five secondary schools were assessed (Mage = 13.2 years; SD = 0.5). The main outcome measures were adolescents' gaming and Internet use (amount of time spent during the week and the weekend), the number of adolescents with IGD, and beliefs about gaming and IGD. RESULTS: The results showed significant effects of the prevention intervention on Internet and gaming use (at T2, time spent was significantly lower in the PIG), an important increase of IGD prevalence between baseline and follow-up in the control group, and decreased rates of IGD among adolescents in the PIG between post-intervention and follow-up. Between baseline and follow-up, the control group showed a more significant increase of minutes per day during the week and the weekend on Internet versus during the week on video games. The impact of the prevention intervention on adolescents' beliefs varied according to gender. Girls had a better understanding generally of the potential dangers of and reasons for IGD. DISCUSSION: Implications for future research and prevention approaches are discussed in this study.

Why and how to include parents in the treatment of adolescents presenting Internet gaming disorder?

BACKGROUND AND AIMS: Clinicians and researchers are increasingly interested in investigating excessive use of video gaming recently named Internet gaming disorder (IGD). As is the case with extensively researched adolescent problem behaviors such as substance use disorder, several studies associate IGD with the young person's family environment and the parent-adolescent relationship in particular. Evidence-based treatments for a range of adolescent clinical problems including behavioral addictions demonstrate efficacy, the capacity for transdiagnostic adaptation, and lasting impact. However, less attention has been paid to developing and testing science-based interventions for IGD, and at present most tested interventions for IGD have been individual treatments (cognitive behavioral therapy). METHODS: This article presents the rationale for a systemic conceptualization of IGD and a therapeutic approach that targets multiple units or subsystems. The IGD treatment program is based on the science-supported multidimensional family therapy approach (MDFT). Following treatment development work, the MDFT approach has been adapted for IGD. RESULTS: The article discusses recurring individual and family-based clinical themes and therapeutic responses in the MDFT-IGD clinical model, which tailors interventions for individuals and subsystems within the young person's family. DISCUSSION AND CONCLUSIONS: Basic science developmental research can inform conceptualization of IGD and a systemic logic model of intervention and change. This paper aims to expand treatment theorizing and intervention approaches for practitioners working with frequently life-altering behaviors of excessive Internet gaming. We operationalize this aim by addressing the question of why and how parents should be involved in youth IGD treatment.

Internet gaming disorder in male and female young adults: The role of alexithymia, depression, anxiety and gaming type.

The aim of this study is to investigate the relationship between alexithymia and Internet Gaming Disorder (IGD) (while controlling for depression and anxiety), explore the presence of gender differences, and the potential differences between MOBA and MMORPG gamers. A total of 429 young adults (mean age 20.7 years) recruited from different forums dedicated to video games took part in the study and filled a questionnaire including type of video game use, the Game Addiction Scale, the TAS-20 (evaluating alexithymia) and the HADS (evaluation anxiety and depression). In the whole sample, being alexithymic, depression scores, and anxiety scores were associated with IGD. Nevertheless, results differed depending on gender and type of games played. In male gamers, being alexithymic, being young, and having high anxiety and depression scores was associated with IGD. In female gamers, having less than a high school education and a high depression score was associated with IGD. In MOBA gamers, only the difficulty describing feelings factor was associated with IGD while in MMORPGs gamers, graduation from high school and anxiety scores were associated with IGD. Playing MOBA games could be a strategy to regulate emotions while playing MMORPG appears to be a maladaptive coping strategy to deal with negative affective disturbances. Gender and gaming type are important factors in the relationship between alexithymia, depression, anxiety and IGD. These results have some interesting clinical implications, which are discussed.

Are online poker problem gamblers sensation seekers?

The purpose of this research was to examine the relationship between sensation seeking and online poker gambling in a community sample of adult online poker players, when controlling for age, gender, anxiety and depression. In total, 288 online poker gamblers were recruited. Sociodemographic data, gambling behavior (CPGI), sensation seeking (SSS), depression and anxiety (HADS) were evaluated. Problem online poker gamblers have higher sensation seeking scores (total, thrill and adventure, disinhibition and boredom susceptibility subscores) and depression scores than non-problem online poker gamblers. Being male, with total sensation seeking, disinhibition and depression scores are factors associated with online poker problem gambling. These findings are interesting in terms of harm reduction. For example, because disinhibition could lead to increased time and money spent, protective behavioral strategies like setting time and monetary limits should be encouraged in poker online gamblers.

Relationships between parental attitudes, family functioning and Internet gaming disorder in adolescents attending school.

While recent data suggest a high prevalence of adolescent with Internet gaming disorder, little is known about interpersonal factors that contributes or protect to this disorder. Thus, the aim of this study was to examine the relationships between parental attitudes, adolescent perception of family functioning and Internet gaming disorder (IGD) and explore gender differences. From a sample of 434 adolescents attending school (n =434; age 13.2 years), 383 non-problematic gamers (NPG, 196 males; 187 females) were compared with 37 problematic gamers (PG, 29 males; 8 females). Family functioning was assessed with the Family Relationship Index and parental attitudes with a questionnaire measuring rules, access to video games, monitoring and banning of video games. NPG have a better family cohesion while PG have more family conflict and a poorer family relationship. While rules about gaming use are important in males, for females, banning is associated with IGD. For both sex, parental monitoring, conflicts and family relationship are associated with IGD. These findings highlight the strong influence of parental attitudes and family functioning on the occurrence of IGD in adolescents and their gender specificities. Thus, prevention programs need to take into account the importance of parents, parenting and gender specificities.

Relationship between pathological gambling, alexithymia, and gambling type.

BACKGROUND AND OBJECTIVES: The aim of this study is to see if: (i) alexithymia is associated with PG and with the severity of gambling behavior; (ii) alexithymia is associated with strategic and non-strategic gambling. METHODS: Two hundred and twenty-six gamblers were recruited in different gambling locations. First, pathological gamblers (PGs) (n = 106) were compared to non-pathological gamblers (NPGs) (n = 120). Second, strategic gamblers (n = 92) were compared to non-strategic gamblers (n = 96). RESULTS: After controlling for being or not depressed, PGs have significantly higher alexithymia scores. Alexithymia is positively correlated to the intensity of gambling behavior and associated with PG: being alexithymic (OR = 4.21, SEB = .32, p < .001), "difficulty identifying feelings" (OR = 1.07, SEB = .03, p = .038), and "externally-oriented thinking" (OR = 1.07, SEB = .03, p = .026) factors. Nevertheless, while alexithymia is associated with PG in strategic gamblers (being alexithymic (OR = 6.80, SEB = .50 p < .001) and "difficulty identifying feelings" (OR = 1.12, SEB = .05 p = .026) factor), this is not the case in non-strategic gamblers. In the latter, only depression is associated with PG (OR = 3.43, SEB = .50 p = .013). DISCUSSION AND CONCLUSION: The results highlight the importance of taking into account the gambling type in the relationship between alexithymia, depression, and PG. SCIENTIFIC SIGNIFICANCE: In non-strategic PGs, specific therapies targeting depression could be appropriate, while for strategic PGs, specific psychotherapeutic techniques like body-centered psychotherapy could help them to differentiate feelings from bodily sensations. (Am J Addict 2017;26:152-160).

Anxiety, Depression and Emotion Regulation Among Regular Online Poker Players.

Poker is a type of gambling that has specific features, including the need to regulate one's emotion to be successful. The aim of the present study is to assess emotion regulation, anxiety and depression in a sample of regular poker players, and to compare the results of problem and non-problem gamblers. 416 regular online poker players completed online questionnaires including sociodemographic data, measures of problem gambling (CPGI), anxiety and depression (HAD scale), and emotion regulation (ERQ). The CPGI was used to divide participants into four groups according to the intensity of their gambling practice (non-problem, low risk, moderate risk and problem gamblers). Anxiety and depression were significantly higher among severe-problem gamblers than among the other groups. Both significantly predicted problem gambling. On the other hand, there was no difference between groups in emotion regulation (cognitive reappraisal and expressive suppression), which was linked neither to problem gambling nor to anxiety and depression (except for cognitive reappraisal, which was significantly correlated to anxiety). Our results underline the links between anxiety, depression and problem gambling among poker players. If emotion regulation is involved in problem gambling among poker players, as strongly suggested by data from the literature, the emotion regulation strategies we assessed (cognitive reappraisal and expressive suppression) may not be those involved. Further studies are thus needed to investigate the involvement of other emotion regulation strategies.

Sensation seeking in a community sample of French gamblers: Comparison between strategic and non-strategic gamblers.

The purpose of this research is to examine the relationship between sensation seeking and gambling disorder (GD) in a community sample of gamblers (when controlling for the effect of substance use, gender and age) and see whether sensation seeking scores depend on the gambling activity when comparing strategic and non-strategic gamblers. A total of 380 gamblers was recruited. First, pathological gamblers (PGs) (n =143) were compared to non-pathological gamblers (NPGs) (n =237). Second, strategic gamblers (n =93) were compared to non-strategic gamblers (n =110). Sociodemographic data, gambling behavior (SOGS, DSM-IV), tobacco and alcohol use (CAGE), and sensation seeking (SSS) were evaluated. PGs have higher boredom susceptibility scores than NPGs and this factor is associated with GD. Nevertheless, the relationship between sensation seeking and GD depends on the gambling activity. In fact, sensation seeking is associated with GD in strategic gamblers only. PGs playing strategic games display different profiles from non-strategic PGs. Thus, factors associated with GD differ when the gambling activity is taken into account. These findings are consistent with the idea of it being essential to identify clinically distinct subgroups of PGs in the treatment of GD.

The impact of alexithymia on pathological gamblers' decision making: a preliminary study of gamblers recruited in "sportsbook" casinos.

OBJECTIVE: We investigated whether alexithymia is at the root of the decision-making deficit classically reported in pathological gamblers. BACKGROUND: Alexithymia has been shown to be a recurrent personality trait of pathological gamblers and to impair the decision-making abilities of nonpathological gamblers, but no previous studies have investigated whether alexithymia significantly affects pathological gamblers' decision making. Although investigations of pathological gamblers typically have studied those seeking treatment, most pathological gamblers do not seek treatment. Thus, to study people representative of the general population of pathological gamblers, we conducted our study in "sportsbook" casinos with a small sample of gamblers who were not seeking treatment. METHODS: We recruited gamblers in sportsbooks and classified them based on their scores on the South Oaks Gambling Screen and the Toronto Alexithymia Scale: 3 groups of pathological gamblers (6 alexithymic, 8 possibly alexithymic, and 6 nonalexithymic) and 8 healthy controls. All of the participants completed an adaptation of the Iowa Gambling Task. RESULTS: The alexithymic group chose less advantageously on the task than the other groups. The severity of the deficit in decision-making abilities was related to the severity of alexithymia, even when we controlled for the effects of anxiety and depression. CONCLUSIONS: Our findings provide preliminary evidence that alexithymia might be a critical personality trait underlying pathological gamblers' decision-making deficits.

Alexithymia and gambling: a risk factor for all gamblers?

The purpose of this study was to investigate alexithymia (in relation with depression) in three groups of French gamblers (n = 186) recruited in their gambling location: at the racetracks (n = 80 males; mean age 28.1 years), in the slot machine rooms (n = 65; 29 males, 36 females; mean age 34.6 years), and in the traditional gaming rooms (n = 41 males; mean age 36 years). Gambling behavior was measured by the South Oaks Gambling Screen and DSM-IV criteria for pathological gambling, Alexithymia by the Toronto Alexithymia Scale (TAS-20) and depression with the Beck Depression Inventory (BDI-13). For racetracks and slot machine gambling, pathological gamblers differed from non-pathological gamblers, regarding their alexithymia scores. These results remained stable after controlling for depression scores among the racetracks gamblers only. The relationship between alexithymia and depression depends on the type of pathological gambler. These findings are consistent with the idea of identifying clinically distinct subgroups of gamblers.