"It Runs in Your Blood": Reflections from Treatment Seeking Gamblers on Their Family History of Gambling.

There are considerable gaps in our understanding of the familial transmission of gambling problems. This convergent mixed-methods study aimed to explore the: (1) sources of heterogeneity in the familial (paternal, maternal, and sibling) transmission of gambling problems; (2) degree to which family-of-origin characteristics are associated with family-of-origin problem gambling; and (3) beliefs of gamblers about the nature of the familial transmission of problem gambling. The sample consisted of 97 treatment-seeking gamblers in Australia. One-quarter (25.5%) of participants reported that at least one family member (16.5% father, 7.5% mother, 7.6% siblings) living with them when they were growing up had a gambling problem. Most participants reported that family members with a positive history of problem gambling were biological relatives, lived with them full-time, and experienced long-term difficulties with gambling. Participants with a family history of problem gambling were young (less than 12 years of age) at the onset of parental, but not sibling, problem gambling, were women, and reported difficulties with the same gambling activity as their family member. Participants raised in families with problem gambling were more likely to report parental separation (risk ratio [RR] = 2.32) and divorce (RR = 2.83), and extreme family financial hardship (RR = 1.80), as well as low levels of paternal authoritative parenting than participants raised in non-problem gambling families. Qualitatively, both social learning and genetics were perceived to play a central role in the familial transmission of gambling problems. These findings inform theories of the familial transmission of gambling problems and the design of targeted prevention and intervention strategies.

The intergenerational transmission of problem gambling: The mediating role of offspring gambling expectancies and motives.

INTRODUCTION: The risk for developing a gambling problem is greater among offspring who have a problem gambling parent, yet little research has directly examined the mechanisms by which this transmission of problem gambling occurs. For this reason, the present study sought to examine the degree to which children's expectancies and motives relating to gambling explain, at least in part, the intergenerational transmission of problem gambling. METHODS: Participants (N=524; 56.5% male) were recruited from educational institutions, and retrospectively reported on parental problem gambling. Problem gambling was measured using the Problem Gambling Severity Index and a range of positive and negative expectancies and gambling motives were explored as potential mediators of the relationship between parent-and-participant problem gambling. RESULTS: The relationship between parent-and-participant problem gambling was significant, and remained so after controlling for sociodemographic factors and administration method. Significant mediators of this relationship included self-enhancement expectancies (feeling in control), money expectancies (financial gain), over-involvement (preoccupation with gambling) and emotional impact expectancies (guilt, shame, and loss), as well as enhancement motives (gambling to increase positive feelings) and coping motives (gambling to reduce or avoid negative emotions). All mediators remained significant when entered into the same model. CONCLUSIONS: The findings highlight that gambling expectancies and motives present unique pathways to the development of problem gambling in the offspring of problem gambling parents, and suggest that gambling cognitions may be potential candidates for targeted interventions for the offspring of problem gamblers.

The intergenerational transmission of problem gambling: The mediating role of parental psychopathology.

The present study investigated the intergenerational transmission of problem gambling and the potential mediating role of parental psychopathology (problem drinking, drug use problems, and mental health issues). The study comprised 3953 participants (1938 males, 2015 females) recruited from a large-scale Australian community telephone survey of adults retrospectively reporting on parental problem gambling and psychopathology during their childhood. Overall, 4.0% [95%CI 3.0, 5.0] (n=157) of participants reported paternal problem gambling and 1.7% [95%CI 1.0, 2.0] (n=68) reported maternal problem gambling. Compared to their peers, participants reporting paternal problem gambling were 5.1 times more likely to be moderate risk gamblers and 10.7 times more likely to be problem gamblers. Participants reporting maternal problem gambling were 1.7 times more likely to be moderate risk gamblers and 10.6 times more likely to be problem gamblers. The results revealed that the relationships between paternal-and-participant and maternal-and-participant problem gambling were significant, but that only the relationship between paternal-and-participant problem gambling remained statistically significant after controlling for maternal problem gambling and sociodemographic factors. Paternal problem drinking and maternal drug use problems partially mediated the relationship between paternal-and-participant problem gambling, and fully mediated the relationship between maternal-and-participant problem gambling. In contrast, parental mental health issues failed to significantly mediate the transmission of gambling problems by either parent. When parental problem gambling was the mediator, there was full mediation of the effect between parental psychopathology and offspring problem gambling for fathers but not mothers. Overall, the study highlights the vulnerability of children from problem gambling households and suggests that it would be of value to target prevention and intervention efforts towards this cohort.

Adapting a generic coping skills programme for adolescents with type 1 diabetes: a qualitative study.

Few qualitative studies have examined the views of adolescents with type 1 diabetes mellitus (T1DM) regarding psychosocial programme development and content. We conducted focus groups with 13 adolescents with T1DM to explore stressors and gain feedback on adapting a generic coping skills programme. The following prevalent stressors were identified: parental/adolescent conflict, balancing self-management and daily life, and health concerns. Prevalent views on programme adaptation included enhancing social support and adding diabetes-specific information and skills. Based on these data, the programme was adapted to address stressors and support self-management, thus better meeting the needs of, and appeal to, adolescents with T1DM.

An anterior expandable titanium cage in Mycobacterium avium vertebral osteomyelitis.

Mycobacterial infection is most commonly caused by Mycobacterium tuberculosis. M. avium and M. intracellulare are two other organisms within the Mycobacteria group often classified together as the mycobacterium avium-intracellulare complex (MAC). MAC is of low virulence and usually causes disease in immunocompromised patients such as those with the human immunodeficiency virus. Isolated vertebral osteomyelitis secondary to MAC infection is rare with only 18 previous reports, only one of which required surgical intervention. There is increasing evidence that vertebral body osteomyelitis with other pathogens can be treated with decompression, debridement and reconstruction with titanium vertebral body cages in the setting of active infection. We present a 70-year-old Caucasian male with a pathological fracture of T6 vertebral body and a kyphosis of 60° and MRI findings consistent with granulomatous osteomyelitis. Vertebrectomies of T5 and T6 were performed and an expandable titanium cage was inserted with supplementary lateral fixation using plate and screws. This is the first report of a single-stage decompression and fusion with a titanium vertebral body cage for active MAC vertebral osteomyelitis.

Spinal epidural lipomatosis due to a bronchial ACTH-secreting carcinoid tumour.

Spinal epidural lipomatosis (SEL) is a rare condition characterized by abnormal deposits of fat in the epidural space. In a severe form this may cause compression of neural elements. This is the second report of SEL secondary to a carcinoid tumour. Our patient was a 34-year-old Caucasian male farm worker presenting with acute spinal cord compression. He had gained 11kg, and had developed Type II diabetes mellitus in the preceding 12months. On examination he displayed characteristic features of Cushing's syndrome. MRI demonstrated posterior epidural lipomatosis, with cord compression from T3 to T8. Urgent spinal cord decompression was performed. Further investigation confirmed a biochemical Cushing's syndrome secondary to an ACTH-producing pulmonary carcinoid tumour.

A rosette-forming glioneuronal tumour of the pineal gland.

A rosette-forming glioneuronal tumour (RGNT) is a rare tumour with new information emerging. We review the literature and describe the second patient with a RGNT arising from the pineal gland. This is also the fifth report of a RGNT arising from outside the fourth ventricle. The prognosis of RGNT remains guarded, as long-term follow-up is not yet available for most patients reported. With only one of 35 patients having a documented recurrence at 10 years, the prognosis seems favourable with appropriate, but not necessarily total, surgical resection.

Overachievement and coping strategies in adolescent males.

How to assist young people to achieve to their potential is a universal concern of educators. The relationship between achievement above that expected on the basis of IQ alone (often referred to as overachievement) in school assessment and preferred coping style, as assessed by the Adolescent Coping Scale (ACS, Frydenberg & Lewis, 1993a), was investigated in a group of 374 boys in Grades 9, 10 and 11 at an independent boys' school in metropolitan Melbourne. Separate partial correlation analyses for each of the three year levels showed that three of the coping strategies, Work and Achieve, Solve the Problem, and Social Support positively correlated with overachievement at all three levels. Other subscales also correlated significantly at one or other of the grade levels. It was concluded that overachievement may be better regarded as approaching one's full potential by the use of optimal coping strategies and avoidance of alternative responses to stress which appear to be non-productive.

Boys play sport and girls turn to others: age, gender and ethnicity as determinants of coping.

This paper reports a conceptualization of and our research to date in the area of adolescent coping. In particular, it reports on a study of Australian secondary students who completed an 80-item questionnaire which captures the range of adolescent coping behaviour by assessing eighteen strategies and three coping styles. When the relationship between coping behaviour and the respondents' gender, age and ethnicity was investigated, it was found that older students use more Self-blame and Tension-reduction techniques than do younger students; and younger students use more work related strategies than do older students; males report using more Physical Recreation than do females whilst females use more Seeking Social Support, Wishful Thinking and Tension-reduction strategies. In general, the pattern of usage of different coping strategies, for the students participating in this investigation, indicates that adolescents' foremost response to their general concerns comprises attempts to deal directly with the causes of concerns while attending to both their own physical and social well-being.

Adolescent coping: the different ways in which boys and girls cope.

In order to investigate the ways in which boys and girls cope with their concerns, 650 Year 11 and Year 12 students from seven post-primary schools in Melbourne, Australia were asked to describe how they cope with the main concerns in their lives. In addition to elicitation of spontaneous responses, a modified form of the Ways of Coping Checklist (Folkman and Lazarus, 1980; 1985b) was also administered to obtain an assessment of students coping strategies. Clear differences were found between the ways in which boys and girls cope. Girls seek more social support and generally are more likely than boys to focus on relationships. They also employ more strategies related to hoping for the best and wishful thinking. The question of how boys and girls can develop their coping repertoire so as to increase the adaptability of their responses in difficult situations is also addressed.