Assessing gambling disorder using frequency- and time-based response options: A Rasch analysis of the gambling disorder identification test.

OBJECTIVES: The Gambling Disorder Identification Test (GDIT) is a recently developed self-report measure. The GDIT includes items with multiple response options that are either based on frequency or time, and item response theory evaluations of these could yield vital knowledge on its measurement performance. METHODS: The GDIT was evaluated using Rasch analysis in a study involving 597 Swedish gamblers. RESULTS: In a three-dimensional Rasch model, the item response difficulty range extended from -1.88 to 4.06 and increased with higher time- and frequency-based responses. Differential item functioning showed that some GDIT items displayed age and gender-related differences. Additionally, person-separation reliability indicated the GDIT could reliably be divided into three to four diagnostic levels. CONCLUSIONS: The frequency- and time-based item response options of the GDIT offer excellent measurement, allowing for elaborate assessment across both lower and higher gambling severity. The GDIT can be used to detect DSM-5 Gambling Disorder, thereby holding significance from both epidemiological and clinical standpoints. Notably, the 3-item GDIT Gambling Behavior subscale also shows potential as a brief screening tool for identifying at-risk gambling behavior.

Cluster analysis in gambling disorder based on sociodemographic, neuropsychological, and neuroendocrine features regulating energy homeostasis.

BACKGROUND: The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far. AIMS: This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features. METHODS: 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ2) for categorical variables, and analysis of variance (ANOVA) for quantitative measures. RESULTS: Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2. CONCLUSIONS: To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision.

Do attention-deficit/hyperactivity symptoms influence treatment outcome in gambling disorder?

BACKGROUND AND AIMS: Numerous studies point to the comorbidity between gambling disorder (GD) and attention deficit hyperactivity disorder (ADHD). However, there is a lack of research exploring how ADHD symptoms might influence psychological treatment outcomes for GD. Therefore, we aimed to explore differences between patients with GD with and without self-reported ADHD symptoms regarding psychopathology, personality, sociodemographic and treatment outcome measures. METHOD: This longitudinal study included 170 patients with GD receiving cognitive behavioral therapy. Multiple self-reported instruments were used to assess clinical variables and sociodemographic measures prior to treatment. RESULTS: A clinical profile characterized by greater GD severity, higher psychopathology and impulsivity, and less adaptive personality features was observed in patients with self-reported ADHD symptoms compared to those without. No significant differences in treatment response (measured by dropout and relapse rates) were observed between the two groups. However, patients with self-reported ADHD symptoms experienced more severe relapses (i.e., gambled more money) and GD patients who relapsed scored higher on measures of ADHD, particularly inattention. CONCLUSION: Individuals with GD and self-reported symptoms of ADHD may experience more severe relapses following treatment, suggesting a need for more vigilant follow-up and interventions for patients with this comorbidity.

Dissociative experiences reduce online problem gambling treatment effectiveness.

AIMS: To determine whether dissociative experiences moderate online problem gambling treatment effectiveness, and to characterize the temporal persistence of the relationship between dissociation and problem gambling. DESIGN: Repeatedly measured self-report data on a guided online cognitive behavioral therapy for problem gambling collected on four occasions: before treatment, after treatment, and at 6- and 12-month follow-ups. SETTING AND PARTICIPANTS: The data (N = 1243, 59.2% males) were collected in Finland between 2019 and 2021. MEASUREMENTS: The primary outcome variable was the self-reported level of problem gambling. The predictors were the treatment phase and dissociative experiences, their interaction, and the demographic covariates of age, education, income, and gender. FINDINGS: Problem gambling scores and dissociative experiences declined significantly following treatment and remained low through the follow-ups (retention rates: 52.6% [post-treatment], 26.3% [at the 6-month follow-up], and 16.1% [at the 12-month follow-up]). However, the treatment was significantly less effective in reducing problem gambling for individuals who kept experiencing dissociation after the treatment. CONCLUSIONS: Dissociation is an integral sign of problem gambling severity and sustained dissociative experiences may significantly reduce the long-term effectiveness of online problem gambling treatments. Treatment efforts should be customized to account for individual differences in dissociative tendencies, and future research should broaden the study of dissociative experiences to other behavioral addictions.

The relative risks of different forms of sports betting in a U.S. sample: A brief report.

BACKGROUND: The 21st century has brought substantial changes to the manners in which people gamble and the types of things on which people gamble. These changes are particularly stark in the United States, where, over the past five years, sports betting has gone from being legal in only one location to being legal throughout the majority of the country, often via mobile applications and online betting websites. METHOD: In March of 2022, a sample of the U.S. population (n = 2806, Mage[SD] = 48.9[17.2]; 1365[48.6%] men; response rate = 87.6%) and an oversample of sports-wagering adults in the U.S. (n = 1557, Mage[SD] = 41.7[15.3]; 1043[67%] men; response rate = 78.7%) were recruited via YouGov. Participants completed measures of gambling activities, including various forms of sports betting, as well as measures of problem gambling activities. RESULTS: In general, people who gamble on sports, when compared to people who do not bet on sports, reported greater frequency of gambling engagement (averaging between monthly and weekly play),a wider variety of gambling activities (with the majority reporting past year engagement in four or more gambling activities), and higher rates of problem gambling. Multinomial logistics regression revealed no distinct associations between any specific form of sports gambling and higher risk, instead demonstrating that breadth and depth of gambling engagement were the best predictors of high-risk gambling behaviors. CONCLUSIONS: In general, sports gambling is broadly associated with greater engagement in both breadth of gambling activities and frequency of gambling play. Additionally, people who gamble on sports seem to be at higher risk of problem gambling than people who do not bet on sports. However, in analyses controlling for breadth and depth of gambling activities, these links are attenuated, suggesting that the risks associated with sports gambling behaviors are related to the greater degree of gambling engagement.

Longitudinal joint trajectories of gambling disorder and hypomentalization: A latent class growth analysis among young adults.

INTRODUCTION: Only a few studies have investigated the relationship between risk for gambling disorder (GD) and mentalization difficulties. However, these results on positive correlations were all from cross-sectional studies; therefore, it would be important to investigate the longitudinal relationship between the constructs. AIMS: It was aimed to identify subgroups of gamblers with different joint growth trajectories of risk for GD and hypomentalization (i.e., uncertainty of understanding own and others' mental states) and to compare the identified latent classes along impulsivity, sensation seeking and depression. METHODS: Data from waves 1-3 of the Budapest Longitudinal Study were used. The final sample included 219 young adult gamblers who completed the study questionnaire and reported past-year gambling in all three waves (Females: N = 93 [42.29%]; Mean age: 28.36 years [SD = 4.29]). Standardized questionnaires were administered to measure the main constructs. RESULTS: A four-class model was retained based on latent class growth analysis. Class 1 had consistently moderately high risk for GD and hypomentalization, and Class 4 presented consistently low risk for GD and hypomentalization. Classes 2-3 were characterized by low risk for GD and increasing hypomentalization. Class 1 had significantly higher sensation seeking and depression compared with the other subgroups in multiple cases. Class 4 showed significantly lower impulsivity and sensation seeking than the other classes. CONCLUSIONS: Elevated hypomentalization was presented among individuals with risk for GD. However, there is little empirical evidence to support that the two constructs have convergently changing trajectories. A cautious interpretation of the results is recommended due to low symptom presence.

Mapping the links between sexual addiction and gambling disorder: A Bayesian network approach.

Contemporary literature and recent classification systems have expanded the field of addictions to include problematic behaviours such as gambling and sexual addiction. However, conceptualisation of behavioural addictions is poorly understood and gender-based differences have emerged in relation to how these behaviours are expressed. The current research conducted partial-correlation and Bayesian network analyses to assess the symptomatic structure of gambling disorder and sexual addiction. Convenience community sampling recruited 937 adults aged 18 to 64 years (315 females, Mage = 30.02; 622 males, Mage = 29.46). Symptoms of problematic behaviours were measured using the Online Gambling Disorder Questionnaire (OGDQ) and the Bergen Yale Sex Addiction Scale (BYSAS). Results indicate distinct gender-based differences in the symptom networks of sexual addiction and gambling disorder, with a more complex network observed amongst men for both conditions. Addiction salience, withdrawal and dishonesty/deception were important components of the addictive network. Interpersonal conflict was more central for women while intrapsychic conflict a more prominent issue for men. Differences in the two symptom networks indicate separate disorders as opposed to a single underlying construct. Treating practitioners and community initiatives aimed at addressing sexual addiction and disordered gambling should consider gender, when designing educational or therapeutic interventions.

Working memory performance in disordered gambling and gaming: A systematic review.

BACKGROUND: Converging evidence supports that gaming and gambling disorders are associated with executive dysfunction. The involvement of different components of executive functions (EF) in these forms of behavioural addiction is unclear. AIM: In a systematic review, we aim to uncover the association between working memory (WM), a crucial component of EF, and disordered gaming and gambling. Note that, in the context of this review, gaming has been used synonymously with video gaming. METHODS: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we systematically searched for studies published from 2012 onwards. RESULTS: The search yielded 6081 records after removing duplicates, from which 17 peer-reviewed journal articles were eligible for inclusion. The association between WM and problem or disordered gaming and gambling have been categorized separately to observe possible differences. Essentially, problem gaming or gambling, compared to disorder, presents lesser severity and clinical significance. The results demonstrate reduced auditory-verbal WM in individuals with gambling disorder. Decreased WM capacity was also associated with problem gambling, with a correlation between problem gambling severity and decreased WM capacity. Similarly, gaming disorder was associated with decreased WM. Specifically, gaming disorder patients had lower WM capacity than the healthy controls. CONCLUSION: Working memory seems to be a significant predictor of gambling and gaming disorders. Therefore, holistic treatment approaches that incorporate cognitive techniques that could enhance working memory may significantly boost gambling and gaming disorders treatment success.

New Validity Evidence of the Global Appraisal of Individual Needs-Short Screener for Evaluating Internalizing/Externalizing Behaviors in Spanish Adolescents.

OBJECTIVE: The Global Appraisal of Individual Needs (GAIN-SS) is a screening instrument evaluating internalizing/externalizing behaviors. This study examines the validity evidence of the GAIN-SS in Spanish adolescents and explores sex differences in its performance. METHOD: Participants were 1,547 Spanish adolescents from the community (females = 48.2%, mean [SD] age = 15.20 [0.74]). A cross-sectional online assessment was used to evaluate past-month substance use and gambling involvement. Problems associated to these behaviors were assessed using the GAIN-SS, the South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA), and the Rutgers Alcohol Problem Index (RAPI). Factor analyses were conducted to examine the internal structure of the GAIN-SS. RESULTS: Results revealed four subscales accounting for 47.03% of the variance related to externalizing (EDScr), internalizing (IDScr), substance use disorders (SDScr), and crime/violence problems (CVScr). Concurrent validity was supported through significant correlations between the GAIN-SS subscales, alcohol-related problems, and gambling behavior, with the exception of the IDScr. Past-month gamblers or substance users evidenced higher scores in the CVScr. Females reported more internalizing symptoms, whereas males reported higher scores in CVScr. CONCLUSIONS: The GAIN-SS is a valid screener for substance use and gambling in Spanish adolescents. Sensitivity of the GAIN-SS to sex differences suggests that it may be useful to design gender-sensitive interventions.

The co-morbidity of DSM-V Gambling with DSM-V mental disorders and substance abuse in a Kenyan context of high risk schizophrenia.

INTRODUCTION: There is evidence that gambling disorder shares similarities with other types of addictive behavior, such as occurs in substance abuse. In addition, co-morbidity of gambling with mental disorders has been established in school-going students. AIM: This study aimed at determining the comorbidity of DSM-V gambling disorder with DSM-V mental disorders and substance abuse in high school, college and university students in Kenya. METHODS: This was a cross-sectional study among 536 high school, college and university students. We collected data on socio-demographic characteristics, economic indicators, DSM-V diagnosis including DSM-V gambling disorder and substance use disorders using the WHO ASSIST tool. Descriptive and inferential analyses were done. RESULTS: A total of 536 students participated in the study, of which 11.4% (61 out of 536) had DSM-V gambling disorder. Male gender (AOR = 12.0, 95% CI: 4.99-34.3), antisocial personality disorder (AOR = 3.42, 95% CI: 1.34-8.54), tobacco use (AOR = 4.42, 95% CI: 1.15-18.3) and conduct disorder (AOR = 7.56, 95% CI: 2.34-25.1) were predictors of gambling disorder. CONCLUSION: Gambling is highly prevalent in Kenya learning institutions at 11.4% and is associated with mental disorders and substance use. There is a need for public awareness of gambling among Kenyan youths.

Marital status and gambling disorder: a longitudinal study based on national registry data.

BACKGROUND: Marital status is a robust correlate of disordered gambling, but few studies have examined the direction of this association. METHODS: The present study used a case-control design by including all adults receiving their first gambling disorder (GD) diagnosis between January 2008 to December 2018 (Norwegian Patient Registry, n = 5,121) and compared them against age and gender matched individuals with other somatic/psychiatric illnesses (Norwegian Patient Registry, n = 27,826) and a random sample from the general population (FD-Trygd database, n = 26,695). The study examined marital status before GD, getting divorced as a risk factor for future GD, and becoming married as a protective factor of future GD. RESULTS: The findings indicated an 8-9 percentage points higher prevalence of unmarried people and about a 5 percentage points higher prevalence of separation/divorce among those that subsequently experienced GD compared to controls. Logistic regressions showed that transition through divorce was associated with higher odds of future GD compared to illness controls (odds ratio [OR] = 2.45, 95% CI [2.06, 2.92]) and the general population (OR = 2.41 [2.02, 2.87]). Logistic regressions also showed that transition through marriage was associated with lower odds of future GD compared to illness controls (OR = 0.62, CI [0.55, 0.70]) and the general population (OR = 0.57, CI [0.50, 0.64]). CONCLUSIONS: Social bonds have previously been shown to impact physical and mental health, and the findings of the study emphasize the importance of considering social network history and previous relationship dissolution among individuals with GD.

Obsessive-compulsive, harm-avoidance and persistence tendencies in patients with gambling, gaming, compulsive sexual behavior and compulsive buying-shopping disorders/concerns.

BACKGROUND AND AIMS: There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored. MATERIALS AND METHODS: The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features. RESULTS: Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster. DISCUSSION AND CONCLUSIONS: These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features.

Assessing Gambling Disorder Using Semistructured Interviews or Self-Report? Evaluation of the Structured Clinical Interview for Gambling Disorder Among Swedish Gamblers.

The Structured Clinical Interview for Gambling Disorder (SCI-GD) has the potential to bridge a diagnostic clinical gap, but psychometric evaluations have been scarce, in particular in relation to self-reported diagnostic criteria. This study analyzed existing data, including Swedish gamblers (N = 204) from treatment- and help-seeking contexts, self-help groups, and the general population, who were interviewed with the SCI-GD and completed self-report measures. The results indicated that fewer individuals fulfilled the diagnostic criteria for gambling disorder (GD) with the SCI-GD (n = 110, 54%), compared to a self-report Diagnostic and Statistical Manual of Mental Disorders:5th Edition (DSM-5) questionnaire on GD (n = 145, 71%; p < .001). Agreement between interviews and self-reported criteria was generally low (Fleiss kappa range: 0.31-0.52; r range: 0.35-0.55). A Rasch analysis showed that specific diagnostic criteria varied in difficulty, indicating a general pattern of higher item difficulty for the SCI-GD compared to self-reported DSM-5 criteria. Both the SCI-GD and the self-reported DSM-5 criteria performed well in terms of internal consistency, convergent, and discriminant validity. We conclude that the SCI-GD is a reliable and valid diagnostic tool to assess GD among individuals with various gambling behavior patterns. Further research-related and clinical implications are discussed.

Tecnotest: A screening tool for technological addictions and gambling disorder. / Tecnotest: Desarrollo de una herramienta de screening de adicciones tecnológicas y juego.

One of the most pressing social and scientific issues, as reflected in the current priority lines of the National Drugs Plan (PNSD), is the development of screening tools for the early detection of addictions, particularly behavioral addictions, due to the impact that these problems are having on the growth of addictions in recent years, especially in adolescents and young people. GOAL: The main goal of this research was to develop a screening tool for technological addictions (video games, mobile and social networks) and gambling for early detection in people suffering this kind of behavioral addiction. PROCEDURE: With technologies, in the absence of agreed clinical criteria, those participants who perceived themselves as having problems and, in addition, had received treatment for it, were selected. Regarding gambling, the diagnostic criteria of the DSM-5 were used. The three items that scored the highest Positive Predictive Values (PPV) in each of the four validated tests were selected. These indicators serve to distinguish those who use the technologies and/or gamble in a functional way and do not have any problems from those who already have an addictive problem with video games, mobile, social networks or gambling. RESULTS: This paper shows the finished screening tool with its main psychometric properties, which can be used by professionals working with adolescents in order to detect people who could have some addictive problem, in which case the psychologist can refer them to a specialized healthcare resource.

Una de las demandas sociales y científicas más acuciantes, que se plasma en las actuales líneas prioritarias del Plan Nacional sobre Drogas (PNSD) es el desarrollo de herramientas de screening para la detección temprana de adicciones, singularmente adicciones sin sustancia, debido al impacto que estas están teniendo en el desarrollo de adicciones desde hace unos años, especialmente en adolescentes y jóvenes. Objetivo. El objetivo principal de esta investigación fue el desarrollo de una herramienta de screening de adicciones tecnológicas (videojuegos, móvil y redes sociales) y al juego para vincular la detección temprana con la intervención y la prevención en el campo de las adicciones conductuales. Método. Participantes. Participaron en el estudio 1.813 estudiantes de entre 11 y 19 años de 13 comunidades autónomas. Instrumentos. Se desarrolló una encuesta con cuatro pruebas validadas sobre adicciones tecnológicas y al juego. Procedimiento. Para la construcción de la herramienta de screening se seleccionaron los tres elementos que obtuvieron mayor Valor Predictivo Positivo (VPP) de cada una de las cuatro pruebas validadas para diferenciar entre quienes utilizaban las tecnologías y/o jugaban de un modo social y no tenían ningún problema de aquellos que ya tenían un problema adictivo. Resultados. Se obtuvo una herramienta de uso de las tecnologías y juego que consta de 24 ítems (12 ítems de cribado de las cuatro tecnologías y 12 de uso de las mismas) con sus principales propiedades psicométricas (fiabilidad, estructura factorial). Discusión. La escala tiene unas adecuadas propiedades psicométricas y es congruente teóricamente. Se presenta la herramienta definitiva de screening, la cual queda a disposición de las/os psicólogas/os para la detección temprana de personas que puedan padecer alguna de estas adicciones, en cuyo caso podrían ser derivados a los recursos sanitarios especializados.

The Gambling Disorders Identification Test (GDIT): Psychometric Evaluation of a New Comprehensive Measure for Gambling Disorder and Problem Gambling.

The novel gambling disorder identification test (GDIT) was recently developed in an international Delphi and consensus process. In this first psychometric evaluation, gamblers (N = 603) were recruited from treatment- and support-seeking contexts (n = 79 and n = 185), self-help groups (n = 47), and a population sample (n = 292). Participants completed self-report measures, a GDIT retest (n = 499), as well as diagnostic semistructured interviews assessing gambling disorder (GD; n = 203). The GDIT showed excellent internal consistency reliability (α = .94) and test-retest reliability (6-16 days, intraclass correlation coefficient = 0.93). Confirmatory factor analysis yielded factor loadings supporting the three proposed GDIT domains of gambling behavior, gambling symptoms, and negative consequences. Receiver operator curves and clinical significance indicators were used to estimate GDIT cut-off scores in relation to recreational (<15) and problem gambling (15-19), any GD (≥20), mild GD (20-24), moderate GD (25-29), and severe GD (≥30). The GDIT can be considered a valid and reliable measure to identify and predict GD severity, as well as problem gambling. In addition, the GDIT improves content validity in relation to an international research agreement concerning features of gambling outcome measures, known as the Banff Consensus Agreement.

Psychometric Properties of the South Oaks Gambling Screen Revised for Adolescents in Chinese Adolescent Gamblers.

Objectives: Adolescent gambling is a public health concern of increasing importance. The lack of comprehensive evaluations on adolescent gambling disorder (GD) assessment tools hinders the timely detection of Chinese adolescents with gambling problems. This study aimed to evaluate the psychometric properties of South Oaks Gambling Screen-Revised for Adolescents (SOGS-RA) and determine its optimal screening cutoff score among Chinese adolescent gamblers to address this gap. Methods: We surveyed 1407 Chinese secondary school students aged 11-19 years in Macao, China, among which 258 past-year gamblers' data was used for assessing SOGS-RA's performance in detecting risk for adolescent GD. Results: SOGS-RA displayed satisfactory reliability and validity for assessing probable GD among Chinese adolescent gamblers. Under the DSM-5 GD framework, we proposed ≥4 as SOGS-RA's optimal cutoff score of screening for probable GD and further identified 5.8% of past-year gamblers prone to probable GD in the present study. Conclusion: SOGS-RA can provide a reliable and valid assessment of adolescent' GD risk in the Chinese context, facilitate early identification of probable GD cases, and alleviate the public health concern for Chinese adolescents.

Assessing potential brief screening questions for use within different social care-related contexts to identify individuals experiencing gambling-related harms: A scoping review.

Gambling-related harms are increasingly recognised as public health concerns internationally. One response is to improve identification of and support for those affected by gambling-related harms, including individuals who gamble and those close to them, 'affected others'. Adult social care services have been identified as a setting in which screening for gambling-related harms is suitable and desirable. To achieve this, a tool is required which can identify gambling-related harms experienced by individuals and affected others. This scoping review aimed to identify whether any brief (i.e. three questions or less) screening tools are being used and, if so, how brief screening for gambling-related harm is being implemented in health and social care-related contexts. An international English language scoping review of research and grey literature was undertaken between April and July 2021. The search included single-item and brief screening tools which have been developed to identify gambling-related harms for individuals and affected others across a range of health and social care-related contexts. Findings show that screening tools for gambling-related harms have been developed for use in health settings rather than in social care contexts. For example within gambling, mental health or substance misuse support services. We found no evidence of a brief or single-item screening tool for identifying harms to individuals and affected others which is of adequate quality to strongly recommend for use in an adult social care setting. Development of a validated brief or single-item screening tool is recommended to assist adult social care practitioners to effectively screen, identify, support and signpost people affected by gambling-related harms.

Prevalence and comorbidity in a Swedish adolescent community sample - gambling, gaming, substance use, and other psychiatric disorders.

BACKGROUND: This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity. METHODS: We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls), out of which 758 adolescents (57.0% girls) were selected for interview with at least one of four instruments: M.I.N.I., ADDIS, NODS and IGDS. Of these, 387 (61.2% girls) were interviewed. Gender separated prevalence was estimated on the assumption that those selected but not interviewed had the same distribution as those interviewed based on similar outcomes above screening cut-offs. Comorbidity between types of disorders was estimated on similar assumptions. In addition, comorbidity between dyads of the ten most common specified disorders was calculated based on recorded data without these assumptions. RESULTS: We estimated that 14.6% met the criteria of a substance use disorder (SUD), mostly concerning alcohol and more frequent in girls than in boys. Those meeting the criteria lifetime of at least one of 16 other psychiatric disorders were 26.7%, more than twice as frequent in girls compared to boys, and with depression being the most common disorder. Gambling and gaming disorders were found almost exclusively in boys, of which 5.8% met the criteria for gambling, and 2.3% for gaming disorders. Of girls with a SUD, 40% also had a psychiatric disorder, while on the other hand more than 28% of girls with a psychiatric disorder also had a SUD. In boys with a SUD, 22% had another psychiatric disorder, while 15% of those with a psychiatric disorder also had a SUD. CONCLUSIONS: Psychiatric comorbidity is common in SUDs in adolescents, which calls for screening and diagnostic efforts in young patients presenting with symptoms of SUDs. Girls with SUDs are at higher risk of also suffering from psychiatric conditions. Gambling and gaming disorders appear in a substantial minority of adolescents and warrant further study of their comorbidity. Since prevalences and comorbidity were estimated on the assumptions mentioned, some caution in interpreting the results is needed.