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CORK Bibliography: Behavioral Addictions

92 citations. July 2012 to present

Prepared: December 2012

Adams PJ. Commentary on Brunborg et al. (2012): Future possibilities for investigating gambling and diminished aversive conditioning. (editorial). Addiction 107(9): 1667-1668, 2012. (9 refs.)

Adinoff B. Should we be targeting potential addictive behaviors in tanning bed users? (editorial). Neuropsychiatry 2(1): 1-4, 2012. (20 refs.)

Andreassen CS; Griffiths MD; Hetland J; Pallesen S. Development of a work addiction scale. Scandinavian Journal of Psychology 53(3): 265-272, 2012. (44 refs.)

Research into excessive work has gained increasing attention over the last 20 years. Terms such as workaholism,work addiction and excessive work have been used interchangeably. Given the increase in empirical research, this study presents the development of the Bergen Work Addiction Scale (BWAS), a new psychometrically validated scale for the assessment of work addiction. A pool of 14 items, with two reflecting each of seven core elements of addiction (i.e., salience, mood modification, tolerance, withdrawal, conflict, relapse, and problems) was initially constructed. The items were then administered to two samples, one recruited by a web survey following a television broadcast about workaholism (n = 11,769) and one comprising participants in the second wave of a longitudinal internet-based survey about working life (n = 368). The items with the highest corrected item-total correlation from within each of the seven addiction elements were retained in the final scale. The assumed one-factor solution of the refined seven-item scale was acceptable (root mean square error of approximation = 0.077, Comparative Fit Index = 0.96, Tucker-Lewis Index = 0.95) and the internal reliability of the two samples were 0.84 and 0.80, respectively. The scores of the BWAS converged with scores on other workaholism scales, except for a Work Enjoyment subscale. A suggested cut-off for categorization of workaholics showed good discriminative ability in terms of working hours, leadership position, and subjective health complaints. It is concluded that the BWAS has good psychometric properties.

Ashrafioun L; McCarthy A; Rosenberg H. Assessing the impact of cue exposure on craving to gamble in university students. Journal of Gambling Studies 28(3): 363-375, 2012. (34 refs.)

We recruited a sample of university student gamblers (n = 48) to complete a web-based battery of instruments in a study designed to assess the impact of imagery-based versus photographic cue exposure on acute craving to gamble using the multi-item Gambling Urge Scale (GUS; Raylu and Oei 2004). Although self-reported craving increased following both forms of cue exposure, the imagery script had a more pronounced impact than did examination of photographs of gambling-related stimuli. We also evaluated the association of the post-cue exposure GUS with other relevant measures, and found it correlated highly both with other questionnaires assessing craving to gamble and with other gambling-relevant characteristics (e.g., gambling-related problems, preoccupation with gambling, distorted gambling beliefs, gambling refusal self-efficacy, sensation seeking), but was not associated with social desirability bias. These findings support the use of the GUS-a brief multi-item scale that shows several key elements of construct, convergent, criterion and discriminant validity-to study the experience of craving in university student gamblers.

Ashrafioun L; Rosenberg H. Methods of assessing craving to gamble: A narrative review. Psychology of Addictive Behaviors 26(3): 536-549, 2012. (92 refs.)

Although the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) does not explicitly list craving as a diagnostic criterion for pathological gambling, theories of disordered gambling and research on relapse precipitants suggest that cravings-among other factors-provoke and maintain episodes of gambling. Assessment of craving to gamble is complicated by questions regarding (a) the emotional, cognitive, behavioral, and physiological components of such craving; (b) the degree to which craving is viewed as an acute and fluctuating experience or as a relatively stable preoccupation with or inclination to gamble; (c) the threshold separating mild desire from pathological craving to gamble; and (d) the degree to which disordered gamblers are aware of, and able to report on, their experience of craving. Our literature search revealed various self-report methods that could be used to assess craving to gamble, including single-item rating scales, multi-item questionnaires, and application of the think-aloud procedure. In addition, psychophysiological reactivity (e.g., heart rate, brain activation) to gambling-related stimuli and reaction time (RI) tasks (e.g., gambling Stroop, Lexical Salience Task) may serve as proxy measures of subjective craving to gamble. Although researchers have assessed elements of reliability and validity of many measures, most require additional evaluation to examine their predictive and construct validity and their utility across different modes of gambling. The field would also benefit from further research to develop and evaluate additional self-report and proxy measures.

Atkinson J; Sharp C; Schmitz J; Yaroslavsky I. Behavioral activation and inhibition, negative affect, and gambling severity in a sample of young adult college students. Journal of Gambling Studies 28(3): 437-449, 2012. (43 refs.)

The prevalence of pathological gambling among college students is increasing. Few studies have directly examined the relation between reward processing and gambling severity while concurrently examining the effects of co-occurring negative affect in this at risk population. This study used Structural Equation Modeling (SEM) techniques to analyze results from an online survey of 352 female and 96 male students age 18-25. Participants completed measures of past year gambling behavior and severity of gambling problems using the Canadian Problem Gambling Index and the Problem Gambling Severity Index. Negative affect and reward processing were measured by the 21-item version of the Depression, Anxiety, and Stress Scales and the Behavioral Inhibition System and Behavioral Activation System (BIS/BAS) scales, respectively. Thirty-five percent of participants reported gambling in the previous 12 months, and 11% had gambling severity scores indicative of "moderate-risk" or "problem gambling." Gambling severity was associated with negative affect. Negative affect, in turn, was correlated with the unitary BIS scale and inversely associated with the BAS reward responsiveness scale. Reward responsiveness was also inversely associated with gambling severity. In the SEM models, the association between reward responsiveness and gambling severity was mediated by negative affect among males but not among females. Potential explanations for these findings and their implications for addressing problem gambling are discussed.

Augner C; Hacker GW. Associations between problematic mobile phone use and psychological parameters in young adults. International Journal of Public Health 57(2): 437-441, 2012. (22 refs.)

Objectives: This study aims to address possible associations between excessive or dysfunctional use of mobile phones and certain psychological variables. Methods: Our study focuses on Problematic Mobile Phone Use (PU) in 196 young adults. A survey was arranged to measure PU, daily mobile phone use in minutes, use of short message service (SMS) and also included psychological and health variables (e.g., chronic stress, depression). Results Statistic analysis indicates that chronic stress, low emotional stability, female gender, young age, depression, and extraversion are associated with PU. Conclusions: Future research needs to clarify the causality of these findings and should also intend to develop concepts for a more meaningful use of mobile phone and related technologies.

Balodis IM; Lacadie CM; Potenza MN. A preliminary study of the neural correlates of the intensities of self-reported gambling urges and emotions in men with pathological gambling. Journal of Gambling Studies 28(3): 493-513, 2012. (83 refs.)

Although self-reported gambling urge intensities have clinical utility in the treatment of pathological gambling (PG), prior studies have not investigated their neural correlates. Functional magnetic resonance imaging (fMRI) was conducted while 10 men with PG and 11 control comparison (CON) men viewed videotaped scenarios of gambling, happy or sad content. Participants rated the intensity of their emotions and motivations and reported the qualities of their responses. Relative to the CON group, the PG group reported similar responses to sad and happy scenarios, but stronger emotional responses and gambling urges when viewing the gambling scenarios. Correlations between self-reported responses and brain activations were typically strongest during the period of reported onset of emotional/motivational response and more robust in PG than in CON subjects for all conditions. During this epoch, corresponding with conscious awareness of an emotional/motivational response, subjective ratings of gambling urges in the PG group were negatively correlated with medial prefrontal cortex activation and positively correlated with middle temporal gyrus and temporal pole activations. Sadness ratings in the PG group correlated positively with activation of the medial orbitofrontal cortex, middle temporal gyrus, and retrosplenial cortex, while self-reported happiness during the happy videos demonstrated largely inverse correlations with activations in the temporal poles. Brain areas identified in the PG subjects have been implicated in explicit, self-referential processing and episodic memory. The findings demonstrate different patterns of correlations between subjective measures of emotions and motivations in PG and CON subjects when viewing material of corresponding content, suggesting in PG alterations in the neural correlates underlying experiential aspects of affective processing.

Berczik K; Szabo A; Griffiths MD; Kurimay T; Kun B; Urban R et al. Exercise addiction: Symptoms, diagnosis, epidemiology, and etiology. Substance Use & Misuse 47(4): 403-417, 2012. (101 refs.)

Regular physical activity plays a crucial role in health maintenance and disease prevention. However, excessive exercise has the potential to have adverse effects on both physical and mental health. The scholastic and empirical discussion of excessive physical activity focuses on obsessive and compulsive exercising, and uses several labels. However, in this review, we argue that the most appropriate term for this phenomenon is exercise addiction, emphasizing that excessive physical exercise fits the typical and most common characteristics of behavioral addictions. The aim of this review is to synthesize the current knowledge on symptomology, diagnosis, epidemiology, and etiology of exercise addiction.

Bickel WK. The emerging new science of psychopathology. (editorial). Addiction 107(10): 1738-1739, 2012. (12 refs.)

Billieux J; Van der Linden M; Khazaal Y; Zullino D; Clark L. Trait gambling cognitions predict near-miss experiences and persistence in laboratory slot machine gambling. British Journal of Psychology 103: 412-427, 2012. (53 refs.)

Near-miss outcomes (i.e., unsuccessful outcomes close to the jackpot) have been shown to promote gambling persistence. Although there have been recent advances in understanding the neurobiological responses to gambling near-misses, the psychological mechanisms involved in these events remain unclear. The goal of this study was to explore whether trait-related gambling cognitions (e.g., beliefs that certain skills or rituals may help to win in games of chance) influence behavioural and subjective responses during laboratory gambling. Eighty-four individuals, who gambled at least monthly, performed a simplified slot machine task that delivered win, near-miss, and full-miss outcomes across 30 mandatory trials followed by a persistence phase in extinction. Participants completed the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004), as well as measures of disordered gambling (South Oaks Gambling Screen [SOGS]; Lesieur & Blume, 1987) and social desirability bias (DS-36; Tournois, Mesnil, & Kop, 2000). Skill-oriented gambling cognitions (illusion of control, fostered by internal factors such as reappraisal of losses, or perceived outcome sequences), but not ritual-oriented gambling cognitions (illusion of control fostered by external factors such as luck or superstitions), predicted higher subjective ratings of desire to play after near-miss outcomes. In contrast, perceived lack of self-control predicted persistence on the slot machine task. These data indicate that the motivational impact of near-miss outcomes is related to specific gambling cognitions pertaining to skill acquisition, supporting the idea that gambling near-misses foster the illusion of control.

Brunborg GS; Johnsen BH; Mentzoni RA; Myrseth H; Molde H; Lorvik IM et al. Diminished aversive classical conditioning in pathological gamblers. Addiction 107(9): 1660-1666, 2012. (33 refs.)

Aims: Impaired ability to form associations between negative events in gambling and aversive somatic reactions may be a predisposing factor for pathological gambling. The current study investigated whether a group of pathological gamblers and a control group differed in aversive classical conditioning. Design: A differential aversive classical conditioning paradigm, which consisted of three phases. In the habituation phase, one 850-Hz tone stimulus and one 1500-Hz tone stimulus were presented three times each in random order. In the acquisition phase, the two tones were presented 10 times each in random order, and one was always followed by a 100-dB burst of white noise. In the extinction phase the two tones were presented three times each without the white noise. Setting: University laboratory testing facilities and out-patient treatment facilities. Participants Twenty pathological gamblers and 20 control participants. Measurements: Duration of seven cardiac interbeat-intervals (IBIs) following tone offset, gambling severity, tobacco and alcohol use, anxiety and depression. Findings: No group differences were found in the habituation and acquisition phases. However, a significant group x stimuli x trials x IBIs interaction effect was found in the extinction phase (P < 0.049). Follow-up analysis indicated that the pathological gamblers did not show aversive classical conditioning, but that the control group did. Conclusions: Pathological gamblers have a diminished capacity to form associations between aversive events and stimuli that predict aversive events. Aversion learning is likely to be an ineffective treatment for pathological gamblers.

Brunelle N; Leclerc D; Cousineau MM; Dufour M; Gendron A; Martin I. Internet gambling, substance use, and delinquent behavior: An adolescent deviant behavior involvement pattern. Psychology of Addictive Behaviors 26(2): 364-370, 2012. (70 refs.)

Internet gambling among adolescents is a growing phenomenon that has received little attention to date. This study examines associations between Internet gambling and the severity of gambling, substance use (SU), and delinquent behavior among 1,870 Quebec students aged 14 to 18. The results show a higher proportion of Internet-gambling (IG) students reporting problematic substance use and delinquency, compared with nongamblers (NG) and non-Internet gamblers (NIG). Furthermore, a higher proportion of at-risk and probable pathological gamblers are found among 10 compared with NIG. A moderating effect (Baron & Kenny, 1986) of the gambler categories (NIG, IG) was found in the relationship between the associated problems and the severity of gambling. Among IG, the severity of delinquency and of substance use contributes to explaining gambling severity whereas, among NIG, the severity of delinquency is the only factor that significantly contributes to such an explanation. Discussion of the results is based on Jessor, Donovan, and Costa's (1991) general deviance syndrome theory.

Carnes PJ. Out of the Shadows: Understanding Sexual Addiction, 3rd edition. Center City MN: Hazelden, 2012. (32 refs.)

Catford J. Battling big booze and big bet: Why we should not accept direct funding from the alcohol or gambling industries. (editorial). Health Promotion International 27(3): 307-310, 2012. (20 refs.)

Chen VCH; Stewart R; Lee CTC. Weekly lottery sales volume and suicide numbers: A time series analysis on national data from Taiwan. Social Psychiatry and Psychiatric Epidemiology 47(7): 1055-1059, 2012. (28 refs.)

To investigate the association between weekly lottery sales and number of suicide deaths in Taiwan. All suicides aged 15+ years during 2004-2006 in Taiwan were included. Poisson autoregression time series models investigated associations of weekly numbers with contemporaneous and recent sales from two national lotteries in operation. Adjustments were made for seasonal fluctuation, temperature, monthly unemployment and autocorrelation. In fully adjusted models, suicide deaths were negatively correlated with sales of tickets for a low-prize, low-cost lottery system. However, they were correlated positively with recent sales for a higher-cost, larger-prize system. Both correlations were stronger for male than female suicide numbers but differed in terms of age groups most strongly implicated. Associations between lottery sales and suicide numbers differed according to the nature of the lottery. A low-prize, low-publicity system appeared to be more benign than a high-prize, high-publicity one.

Conticello C; Martinetti D; Adamo L; Buccheri S; Giuffrida R; Parrinello N et al. Disulfiram, an old drug with new potential therapeutic uses for human hematological malignancies. International Journal of Cancer 131(9): 2197-2203, 2012. (29 refs.)

Disulfiram (DSF) is an aldehyde dehydrogenase inhibitor currently used for the treatment of alcoholism. Here, we show that multiple myeloma (MM) cell lines and primary cells from newly diagnosed and relapsed/resistant patients affected by MM, acute myeloid and lymphoblastic leukemia are significantly sensitive to DSF alone and in combination with copper. These effects are present at doses lower than those achievable in vivo after DSF standard administration. The cytotoxic effect achieved by this treatment is comparable to that obtained by conventional chemotherapy and is absent in normal hematopoietic cells. In addition, we found that DSF plus copper induces loss of mitochondrial membrane potential, triggers reactive oxygen species (ROS) production and activates executioner caspases. DSF-copper-induced apoptosis and caspases activation are strongly reversed by antioxidant N-acetylcysteine, thus indicating a critical role of ROS. These results might suggest the use of the old drug DSF, alone or in combination with copper, in the treatment of hematological malignancies.

Conversano C; Marazziti D; Carmassi C; Baldini S; Barnabei G; Dell'Osso L. Pathological gambling: A systematic review of biochemical, neuroimaging, and neuropsychological findings. (review). Harvard Review of Psychiatry 20(3): 130-148, 2012. (245 refs.)

Pathological gambling is an emerging psychiatric disorder that has recently gained much attention because of its increasing prevalence and devastating personal, familial, and social consequences. Although its pathophysiology is largely unknown, the shared similarities with both addiction and obsessive-compulsive spectrum disorders have suggested the possibility of common psychobiological substrates. As with many other psychiatric disorders, it is believed that pathological gambling may result from the interplay between individual vulnerability and environmental factors. The aim of this article is to offer a comprehensive review of the main neurobiological aspects of pathological gambling, with particular attention to neuropsychological and related findings. A deeper understanding of the biological correlates of pathological gambling is required in order to develop effective treatment strategies.

Dawson GN; Warren DE. Evaluating and treating sexual addiction. (editorial). American Family Physician 86(1): 74+, 2012. (12 refs.)

Delfabbro P; King D. Gambling in Australia: Experiences, problems, research and policy. Addiction 107(9): 1556-1561, 2012. (47 refs.)

Aims: The aim of this paper is to provide a critical overview of the development and current status of gambling in Australia. Methods: The paper examines the history and current status of gambling in Australia with a particular focus on the prevalence of problem gambling in the community and developments in policy and treatment services. Results: The paper highlights the contradictory role of State governments as both providers of treatment services as well as agents for the liberalization for gambling. It also shows how the notion of addiction is conceptualized in Australian research and treatment services, including the preference for harm-based and public health approaches. Such perspectives view problem gambling as having multiple pathways and determinants that extend beyond the pathology of individuals. Conclusions: Gambling in Australia provides a curious paradox. Highly liberalized State government policies that allow the proliferation of high intensity gambling coexist with extensive policy, regulation and research designed to address the negative impact of gambling on the Australian community.

Demetrovics Z; Urban R; Nagygyorgy K; Farkas J; Griffiths MD; Papay O et al. The development of the Problematic Online Gaming Questionnaire (POGQ). PLoS ONE 7(5): e-article 36417, 2012. (29 refs.)

Background: Online gaming has become increasingly popular. However, this has led to concerns that these games might induce serious problems and/or lead to dependence for a minority of players. Aim: The aim of this study was to uncover and operationalize the components of problematic online gaming. Methods: A total of 3415 gamers (90% males; mean age 21 years), were recruited through online gaming websites. A combined method of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was applied. Latent profile analysis was applied to identify persons at-risk. Results: EFA revealed a six-factor structure in the background of problematic online gaming that was also confirmed by a CFA. For the assessment of the identified six dimensions - preoccupation, overuse, immersion, social isolation, interpersonal conflicts, and withdrawal - the 18-item Problematic Online Gaming Questionnaire (POGQ) proved to be exceedingly suitable. Based on the latent profile analysis, 3.4% of the gamer population was considered to be at high risk, while another 15.2% was moderately problematic. Conclusions: The POGQ seems to be an adequate measurement tool for the differentiated assessment of gaming related problems on six subscales.

Edger K. Evangelicalism, sexual morality, and sexual addiction: Opposing views and continued conflicts. Journal of Religion & Health 51(1): 162-178, 2012. (81 refs.)

While much of the Christian evangelical movement fosters judgmental attitudes surrounding sexuality, disapproving of other individuals who exhibit behaviors deemed morally reprehensible, other evangelical denominations embrace different viewpoints about human sexuality. In spite of the existence of ecumenical evangelical groups, the majority defines sexual morality through a narrow and prescriptive outlook and pathologizes certain sexual behaviors. Solutions to identified sexual problems are often provided through restrictive viewpoints despite the existence of largely opposing positions within this movement. Reaction formation and authoritarian personality theory are theorized as the primary explanations for individuals failing to conform to stringent religious sexual expectations.

el-Guebaly N; Mudry T; Zohar J; Tavares H; Potenza MN. Compulsive features in behavioural addictions: The case of pathological gambling. Addiction 107(10): 1726-1734, 2012. (130 refs.)

Aims: To describe, in the context of DSM-V, how a focus on addiction and compulsion is emerging in the consideration of pathological gambling (PG). Methods: A systematic literature review of evidence for the proposed re-classification of PG as an addiction. Results: Findings include: (i) phenomenological models of addiction highlighting a motivational shift from impulsivity to compulsivity associated with a protracted withdrawal syndrome and blurring of the ego-syntonic/ego-dystonic dichotomy; (ii) common neurotransmitter (dopamine, serotonin) contributions to PG and substance use disorders (SUDs); (iii) neuroimaging support for shared neurocircuitries between behavioural and substance addictions and differences between obsessive compulsive disorder (OCD), impulse control disorders (ICDs) and SUDs; (iv) genetic findings more closely related to endophenotypic constructs such as compulsivity and impulsivity than to psychiatric disorders; (v) psychological measures such as harm avoidance identifying a closer association between SUDs and PG than with OCD; (vi) community and pharmacotherapeutic trials data supporting a closer association between SUDs and PG than with OCD. Adapted behavioural therapies, such as exposure therapy, appear applicable to OCD, PG or SUDs, suggesting some commonalities across disorders. Conclusions: PG shares more similarities with SUDs than with OCD. Similar to the investigation of impulsivity, studies of compulsivity hold promising insights concerning the course, differential diagnosis and treatment of PG, SUDs, and OCD.

Engel RJ; Bechtold J; Kim Y; Mulvaney E. Beating the odds: Preparing graduates to address gambling-related problems. Journal of Social Work Education 48(2): 321-335, 2012. (36 refs.)

As gambling opportunities proliferate, social workers are likely to see clients with gambling-related problems, but they often lack the expertise to address these concerns. This descriptive study assessed the inclusion of content on gambling-related problems in graduate social work curricula. Responses to an online survey from 86 (43.7%) of the 197 accredited MSW programs were received. Thirty-three (38.4%) schools include gambling-related content typically taught in an addictions, mental health, or practice course. Fifty-three (61.6%) lacked such content, noting a lack of faculty expertise, low-priority content, and the lack of interest in gambling-related issues. Recommendations are offered as to how to infuse gambling identification, treatment, and policy content in social work curricula.

Fioravanti G; Dettore D; Casale S. Adolescent internet addiction: Testing the association between self-esteem, the perception of internet attributes, and preference for online social interactions. Cyberpsychology, Behavior and Social Networking 15(6): 318-323, 2012. (45 refs.)

There is a general consensus that Internet addiction (IA) is mainly related to social aspects of the Web, especially among adolescents. The empirical link between poor social skills and Internet addiction is well documented; however, theoretical explanations for this relationship are less developed. One possibility is that people with poor social skills are especially prone to develop a preference for online social interaction (POSI), which, in turn, predicts problematic usage. This hypothesis has been tested for loneliness and social anxiety, but not for self-esteem -- one of the main antecedents of Internet addiction. Furthermore, the mediating role of the perceived relevance of some Internet features (e. g., anonymity) in the relationship between self-esteem and preference for online social interaction has never been investigated. A cross-sectional study was conducted with 257 adolescents. Using mediation analyses, we found evidence among females for the mediating role of (a) preference for online social interaction in the relationship between self-esteem and Internet addiction, and (b) the subjective relevance of some Internet features in the association between self-esteem and preference for online social interaction. No significant effects were found for males.

Floros G; Siomos K. Patterns of choices on video game genres and internet addiction. Cyberpsychology, Behavior, and Social Networking 15(8): 417-424, 2012. (22 refs.)

In this study, we attempt to identify motives pivotal in choices made regarding online and offline game genres and assess whether they are meaningful predictors of Internet addiction. A separate goal was to determine how an assessment of Internet-related cognitions compares to criteria-based research instruments on Internet addiction, and demonstrate its clinical usefulness. We are using data from a cross-sectional study of the entire adolescent student population aged 12-18 of the island of Kos. Results indicate that specific game genres and motives for choosing a game are important predictors of Internet addiction, even after accounting for sociodemographic and Internet-use-related variables. Gender differences are not statistically important when we account for genre choices and motives for choosing them. Boys' thought content tends to revolve more around their Internet use compared to girls. Several patterns of motives to play specific genres were identified with the help of a canonical correlation analysis, demonstrating the fact that the simple observation of overt behavior is not enough to deduce the meaning of these actions for the individual. Using multiple measures of online addiction, examining genre preferences and underlying motives for choosing a game can be helpful in reaching a better understanding of the individual game player.

Fong TW; Reid RC; Parhami I. Behavioral addictions where to draw the lines? Psychiatric Clinics of North America 35(2), 2012. (118 refs.)

Recognizing the signs and symptoms of behavioral addictions can be confusing, at times, because the line between normative and pathological behaviors is not well defined. Behavioral addictions are conditions that create significant harm to individuals, families, and society. This article reviews the current and proposed diagnostic criteria of 3 prevalent behavioral addictions: (1) pathological gambling, (2) hypersexual disorders, and (3) compulsive shopping. Differential diagnoses are discussed and clinical characteristics are presented to facilitate clinicians in clarifying the difference between pathology and habit. Treatment options for these behavioral addictions are presented along with case studies.

Ford JJ; Durtschi JA; Franklin DL. Structural therapy with a couple battling pornography addiction. American Journal of Family Therapy 40(4): 336-348, 2012. (28 refs.)

Pornography increasingly affects couples' relationships commensurately with the increasing availability of pornographic material. Relationships can be adversely affected by the addictive influences of pornography, and therefore therapists are likely to encounter this concern with their clients. It is suggested that addiction to pornography can be characterized by withdrawal and tolerance, and can have neurological impacts and negatively influence relationships. However, clinicians sometimes fail to recognize pornography addiction to be equally as troublesome as other addictions. This paper explores the implementation of successful structural therapy treatment of pornography addiction using an actual case study with a married couple.

Fortune EE; Goodie AS. Cognitive distortions as a component and treatment focus of pathological gambling: A review. (review). Psychology of Addictive Behaviors 26(2): 298-310, 2012. (98 refs.)

The literature on the role of cognitive distortions in the understanding and treatment of pathological gambling (PG) is reviewed, with sections focusing on (a) conceptual underpinnings of cognitive distortions, (b) cognitive distortions related to PG, (c) PG therapies that target cognitive distortions, (d) methodological factors and outcome variations, and (e) conclusions and prescriptive recommendations. The conceptual background for distortions related to PG lies in the program of heuristics and biases (Kahneman & Tversky, 1974) as well as other errors identified in basic psychology. The literature has focused on distortions arising from the representativeness heuristic (gambler's fallacy, overconfidence, and trends in number picking), the availability heuristic (illusory correlation, other individuals' wins, and inherent memory bias), and other sources (the illusion of control and double switching). Some therapies have incorporated cognitive restructuring within broader cognitive-behavioral therapies, with success. Other therapies have focused more narrowly on correcting distorted beliefs, more often with limited success. It is concluded that the literature establishes the role of cognitive distortions in PG and suggests therapies with particularly good promise, but is in need of further enrichment.

Frings D. The effects of sleep debt on risk perception, risk attraction and betting behavior during a blackjack style gambling task. Journal of Gambling Studies 28(3): 393-403, 2012. (31 refs.)

Gamblers often gamble while experiencing fatigue due to sleep deprivation or cumulative sleep debt. Such fatigue has been shown to make decision makers behave more riskily. The present study aimed to test the role of two cognitive processes, risk perception and risk attraction, in this effect. Two hundred and two participants played twelve hands of a black-jack style card game while either fatigued or reasonably alert. Findings showed that both fatigued and alert participants rated higher risk bets as more risky than lower risk bets, suggesting risk perception was unaffected by fatigue. However, fatigued participants did not rate higher risk bets as less attractive than lower risk bets, and reduced the size of their wager to a lesser extent when objective risk increased. These findings are discussed in relation to the effects of fatigue on motivated tasks and the need for gamblers to be aware of the effects of fatigue.

Gencer SL; Koc M. Internet abuse among teenagers and its relations to internet usage patterns and demographics. Educational Technology & Society 15(2): 25-36, 2012. (33 refs.)

This study focused on exploring Internet abuse among teenagers and its relations to some Internet usage patterns and demographic characteristics in a digitalizing country, Turkey. It was designed as a cross-sectional research on three types of school that differ in their academic performances. The data were collected from 1380 high school students through a paper-based questionnaire. The results identified a small portion of students as Internet abusers experiencing severe problems and one fourth as possible abusers experiencing occasional problems in their lives. Excessive use, tolerance, preoccupation with the Internet, and using the Internet to escape from negative feelings were the most frequently reported symptoms of disturbed patterns of online behaviors. One-way between-groups ANOVA tests revealed that Internet abuse differed significantly based on gender and perceived academic achievement with small effect sizes, and frequency of Internet use, dominant place of Internet use and dominant purpose for Internet use with medium and large effect sizes. On the contrary, no significant differences were found based on perceived socio-economic status and the type of school attended.

Gomez-Pena M; Penelo E; Granero R; Fernandez-Aranda F; Alvarez-Moya E; Santamaria JJ et al. Correlates of motivation to change in pathological gamblers completing cognitive-behavioral group therapy. Journal of Clinical Psychology 68(7): 732-744, 2012. (79 refs.)

Objectives The present study analyzes the association between the motivation to change and the cognitive-behavioral group intervention, in terms of dropouts and relapses, in a sample of male pathological gamblers. The specific objectives were as follows: (a) to estimate the predictive value of baseline University of Rhode Island Change Assessment scale (URICA) scores (i.e., at the start of the study) as regards the risk of relapse and dropout during treatment and (b) to assess the incremental predictive ability of URICA scores, as regards the mean change produced in the clinical status of patients between the start and finish of treatment. Method The relationship between the URICA and the response to treatment was analyzed by means of a pre-post design applied to a sample of 191 patients who were consecutively receiving cognitive-behavioral group therapy. The statistical analysis included logistic regression models and hierarchical multiple linear regression models. Results: The discriminative ability of the models including the four URICA scores regarding the likelihood of relapse and dropout was acceptable (area under the receiver operating haracteristic curve: .73 and .71, respectively). No significant predictive ability was found as regards the differences between baseline and posttreatment scores (changes in R2 below 5% in the multiple regression models). Conclusions The availability of useful measures of motivation to change would enable treatment outcomes to be optimized through the application of specific therapeutic interventions.

Granero R; Tarrega S; Fernandez-Aranda F; Aymami N; Gomez-Pena M; Moragas L et al. Gambling on the stock market: An unexplored issue. Comprehensive Psychiatry 53(6): 666-673, 2012. (49 refs.)

Objective: Stock market investment (SMI) is one of the most socially acceptable types of gambling, which, however, can turn into a gambling problem. Because it is barely examined, we compared a series of clinical, psychopathologic, and personality variables in SMI gambling patients (both as primary and secondary problem) with a group of traditional pathologic gamblers (PGs). Method: A total sample of 1470 PGs (1376 patients without SMIs [PG-SMI], 76 patients with SMI as a secondary gambling problem [PG+SMI], and 18 patients with SMI as a primary gambling problem [SMI+PG]) participated in this study. All participants were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. The following instruments were used: the South Oaks Gambling Screen, the Symptom Check List-90 Items-Revised, the Temperament and Character Inventory-Revised, and other clinical and psychopathologic indices. Results: The 3 patient groups' profiles were statistically similar in psychometrical measures. The risk of having SMI increased for patients with higher education, and the presence of SMI as a primary problem in PGs increased with university study level and higher scores on the personality trait of cooperativeness. Conclusions: The results of this study indicate comparability of SMI gamblers with PGs in their general clinical profile and in psychopathology and personality.

Gupta R; Pinzon JL. Gambling in children and adolescents. (editorial). Paediatrics & Child Health 17(5): 263-264, 2012. (0 refs.)

Despite the fact that minors in Canada are prohibited from legalized gambling, adolescents commonly engage in both legalized (lottery products, casino, video lottery terminals) and self-organized (cards, sports betting, dice) gambling activities both at home and in school. Lifetime prevalence rates of pathological gambling for adults range from 1% to 2%, and existing data suggest that the prevalence among adolescents may be two to four times higher. Very little is known about risk factors in the development and perpetuation of problematic and pathological gambling. This statement is intended to educate paediatricians, family physicians and other health care providers about the emerging knowledge around gambling in childhood and adolescence and the potential serious consequences of this activity. It also urges federal, provincial and territorial governments to include this specific issue in their agendas and to address the socio-political factors associated with gambling.

Harris JK; Carothers BJ; Luke DA; Silmere H; McBride TD; Pion M. Exempting casinos from the Smoke-free Illinois Act will not bring patrons back: They never left. Tobacco Control 21(3): 373-376, 2012. (34 refs.)

Objective: The Smoke-free Illinois Act was implemented in January 2008, one month after the beginning of a national recession. In December 2010, the Illinois legislature proposed new legislation that would provide an exemption for casinos from the act until neighbouring states also implement smoke-free casino policies. Lobbyists and gaming commission representatives argued that Illinois casinos were losing patrons to casinos in neighbouring states that allow smoking. This study examined the influence of the act on casino admissions in Illinois and neighbouring states in light of the economy. Methods: A multilevel model was developed to examine monthly casino admissions from January 2007 to December 2008. Results: There was no difference in changes in admissions across the four states over time after accounting for the economic downturn. Conclusions: The Smoke-Free Illinois Act did not have a detectable effect on Illinois casino admissions.

Hillhouse JJ; Baker MK; Turrisi R; Shields A; Stapleton J; Jain S et al. Evaluating a measure of tanning abuse and dependence. Archives of Dermatology 148(7): 815-819, 2012. (24 refs.)

Objective: To evaluate the Structured Interview for Tanning Abuse and Dependence (SITAD). Design: Longitudinal survey. Setting: College campus. Participants: A total of 296 adults. Main Outcome Measures: The SITAD modified items from the Structured Clinical Interview for DSM-IV Axis I Disorders that focus on opiate abuse and dependence. Indoor tanning (IT) behavioral patterns and opiate-like reactions to tanning were measured, and IT behavior was measured 6 months later. Results: Of 296 participants, 32 (10.8%) met the SITAD criteria for tanning abuse (maladaptive pattern of tanning as manifested by failure to fulfill role obligations, physically hazardous tanning, legal problems, or persistent social or interpersonal problems) and 16 (5.4%) for tanning dependence as defined by 3 or more of the following: loss of control, cut down, time, social problems, physical or psychological problems, tolerance, and withdrawal. The IT frequency in dependent tanners was more than 10 times the rate in participants who do not meet the SITAD criteria for tanning abuse or dependence. Tanning-dependent participants were more likely to report being regular tanners (75%; odds ratio, 7.0). Dependent tanners scored higher on the opiate-like reactions to tanning scale than did abuse tanners, who scored higher than those with no diagnosis. Conclusions: The SITAD demonstrated some evidence of validity, with tanning-dependent participants reporting regular IT, higher IT frequency, and higher scores on an opiate-like reactions to tanning scale. A valid tanning dependence screening tool is essential for researchers and physicians as a tanning-dependent diagnosis may facilitate a better understanding of tanning motivations and aid in the development of efficacious intervention programs.

Hing N; Breen H; Gordon A. A case study of gambling involvement and its consequences. Leisure Sciences 34(3): 217-235, 2012. (110 refs.)

Gambling has attracted minimal recent research in leisure studies. Focusing on Indigenous Australian gambling, this article draws on theoretical frameworks in leisure and gambling to develop gambling involvement profiles. Using qualitative methods, 169 Indigenous Australians were interviewed. Thematic analysis generated three typical gambler profiles-light, binge and heavy gamblers-distinguishable by different gambling behaviors, motivations and consequences. Analysis of the dimensions of leisure involvement revealed that light and heavy gamblers differed according to importance/interest, pleasure, centrality, self-expression, social bonding, risk probability, and risk consequence. The article demonstrates the application to gambling of certain leisure involvement constructs.

Hwang JY; Shin YC; Lim SW; Park HY; Shin NY; Jang JH et al. Multidimensional comparison of personality characteristics of the big five model, impulsiveness, and affect in pathological gambling and obsessive-compulsive disorder. Journal of Gambling Studies 28(3): 351-362, 2012. (50 refs.)

The phenomenological resemblance between pathological gambling (PG) and obsessive-compulsive disorder (OCD) has led to suggestions that PG be categorized as an obsessive-compulsive-spectrum disorder (OCSD). This study aimed to explore whether PG resembles OCD in terms of personality and temperament. Fifteen patients with PG, 18 patients with OCD, and 33 healthy control subjects were included in the study. The study subjects were all male and drug na < ve. We analyzed data obtained from three self-report questionnaires assessing personality, impulsiveness, and affect: the short version of the NEO Personality Inventory-Revised (NEO-PI-R), the Barratt Impulsiveness Scale-11 (BIS-11), and the Positive Affect and Negative Affect Schedule (PANAS). Participants with PG and OCD demonstrated less conscientiousness (F = 7.089, P = .002) and less openness to experience (F = 6.268, P = .003) and less positive affect (F = 15.816, P < .001) than did healthy controls. The two diagnostic groups did not differ from each other with respect total BIS-11 scores, but those with OCD showed more neuroticism than did those with PG and healthy controls ( F = 9.556, P < .001), and those with PG obtained higher scores on the non-planning impulsiveness factor of BIS-11 than did those with OCD or healthy controls ( F = 9, 835, P < .001). PG and OCD share similar profiles in terms of personality and temperament. This study provides phenomenological evidence supporting the conceptualization of PG as an OCSD.

Jager S; Muller KW; Ruckes C; Wittig T; Batra A; Musalek M; Mann K et al. Effects of a manualized short-term treatment of internet and computer game addiction (STICA): study protocol for a randomized controlled trial. Trials 13: article 43, 2012. (48 refs.)

Background: In the last few years, excessive internet use and computer gaming have increased dramatically. Salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse have been defined as diagnostic criteria for internet addiction (IA) and computer addiction (CA) in the scientific community. Despite a growing number of individuals seeking help, there are no specific treatments of established efficacy. Methods/design: This clinical trial aims to determine the effect of the disorder-specific manualized short-term treatment of IA/CA (STICA). The cognitive behavioural treatment combines individual and group interventions with a total duration of 4 months. Patients will be randomly assigned to STICA treatment or to a wait list control group. Reliable and valid measures of IA/CA and co-morbid mental symptoms (for example social anxiety, depression) will be assessed prior to the beginning, in the middle, at the end, and 6 months after completion of treatment. Discussion: A treatment of IA/CA will establish efficacy and is desperately needed. As this is the first trial to determine efficacy of a disorder specific treatment, a wait list control group will be implemented. Pros and cons of the design were discussed.

Jelenchick LA; Becker T; Moreno MA. Assessing the psychometric properties of the Internet Addiction Test (IAT) in US college students. Psychiatry Research 196(2-3): 296-301, 2012. (29 refs.)

Internet addiction is a growing concern: however, both a clear understanding of the mechanisms driving problematic behaviors and a gold standard instrument for assessing symptoms are lacking. The purpose of this study was to perform a psychometric analysis of the most widely used screening instrument, the Young Internet Addiction Test (IAT), using a sample of US college students. 215 (70% response rate) undergraduate college students were recruited from two US universities to complete an online version of the IAT. Using exploratory factor analysis, two factors were extracted. "dependent use" and "excessive use" which together explained 91% of the total variance. Participants who scored into the problematic user category of the IAT scored items on the dependent use scale an average of 0.8 +/- 1.5 points higher and items on the excessive use scale an average of 1.4 +/- 1.5 points higher than participants who scored in the average user category. Results suggest that Internet addiction symptoms may cluster into two separate components, dependent and excessive use. Further, the IAT appears to be a valid instrument for assessing Internet addiction in US college students.

Kalkan M. Predictiveness of interpersonal cognitive distortions on university students' problematic Internet use. Children and Youth Services Review 34(7): 1305-1308, 2012. (32 refs.)

Objective: This study examines correlation between problematic Internet use and interpersonal cognitive distortions among university students. Methods: This study was conducted among 351 students from the Ondokuz Mayis University Faculty of Education. The Online Cognition Scale and Interpersonal Cognitive Distortions Scale were employed in the collection of data. Results: Pearson correlation analysis results reveal a significant positive correlation between problematic Internet use and interpersonal rejection (r=0.249. p<0.01), and unrealistic relationship expectation (r=0.278, p<0.01). Simple linear regression analysis in which the problematic Internet use scores were predicted from interpersonal cognitive distortions was conducted. Interpersonal rejection (R-2=0.062, t=4.809, p<0.000) and unrealistic relationship expectation (R-2=0.077, t=5.398, p<0.000) predicted significantly university students' problematic Internet use. Conclusions: Interpersonal cognitive distortions emerged as a significant predictor of problematic Internet usage.

Keenan PR. Card-playing and gambling in eighteenth-century Russia. European History Quarterly 42(3): 385-402, 2012. (82 refs.)

Although gambling was a prominent, not to say infamous, feature of nineteenth-century literary depictions of elite social life, the study of how the social and cultural relevance of certain games developed in the earlier period has been relatively neglected. This article examines the emergence of card-playing as a form of entertainment at the court and amongst the urban elite during the watershed period of the early to mid-eighteenth century as part of a broader engagement with European forms and fashions, catalysed by the reign of Peter I (1689-1725). The emphasis was essentially on the sociable nature of cards, but it was an activity fraught with potential risks for more 'committed' players. The Russian state's role in restricting the potential excesses of any gambling, particularly (but not exclusively) amongst non-elite social groups, reflects the wider European concern about the financial and moral dangers of challenging Fate.

Kerber CH; Hickey KL; Astroth KM; Kim M. Gambling behaviors and perceived health among incarcerated older adults. Journal of Psychosocial Nursing and Mental Health Services 50(8): 32-39, 2012. (29 refs.)

The proliferation of lotteries and casinos has led to increased participation in gambling. Older adults who have opportunities to gamble may be vulnerable to gambling problems, and incarcerated older adults may be the most vulnerable. Furthermore, research has linked decreased health to gambling problems. This study compared perceived health and gambling problems among 43 incarcerated older adults from two county jails in the midwestern United States. Results from the South Oaks Gambling Screen indicated 48.83% of the sample scored in the problem or pathological range. Short Form-36 results were compared with U.S. norms for ages 55 to 64 and showed significantly lower perceived health scores on Role-Physical, Bodily Pain, Mental Health, Social Functioning, and Role-Emotional subscales. The problem and pathological gamblers showed significantly lower social functioning than the recreational gamblers. Assessment of health conditions and gambling behaviors is important for quantifying current and anticipated burdens of these conditions on correctional health care systems and the community.

King DL; Ejova A; Delfabbro PH. Illusory control, gambling, and video gaming: An investigation of regular gamblers and video game players. Journal of Gambling Studies 28(3): 421-435, 2012. (34 refs.)

There is a paucity of empirical research examining the possible association between gambling and video game play. In two studies, we examined the association between video game playing, erroneous gambling cognitions, and risky gambling behaviour. One hundred and fifteen participants, including 65 electronic gambling machine (EGM) players and 50 regular video game players, were administered a questionnaire that examined video game play, gambling involvement, problem gambling, and beliefs about gambling. We then assessed each groups' performance on a computerised gambling task that involved real money. A post-game survey examined perceptions of the skill and chance involved in the gambling task. The results showed that video game playing itself was not significantly associated with gambling involvement or problem gambling status. However, among those persons who both gambled and played video games, video game playing was uniquely and significantly positively associated with the perception of direct control over chance-based gambling events. Further research is needed to better understand the nature of this association, as it may assist in understanding the impact of emerging digital gambling technologies.

Kuss DJ; Louws J; Wiers RW. Online gaming addiction? Motives predict addictive play behavior in massively multiplayer online role-playing games. Cyberpsychology, Behavior and Social Networking 15(9): 480-485, 2012. (31 refs.)

Recently, there have been growing concerns about excessive online gaming. Playing Massively Multiplayer Online Role-Playing Games (MMORPGs) appears to be particularly problematic, because these games require a high degree of commitment and time investment from the players to the detriment of occupational, social, and other recreational activities and relations. A number of gaming motives have been linked to excessive online gaming in adolescents and young adults. We assessed 175 current MMORPG players and 90 nonplayers using a Web-based questionnaire regarding their gaming behavior, problems as consequences of gaming, and game motivations and tested their statistical associations. Results indicated that (a) MMORPG players are significantly more likely to experience gaming-related problems relative to nonplayers, and that (b) the gaming motivations escapism and mechanics significantly predicted excessive gaming and appeared as stronger predictors than time investment in game. The findings support the necessity of using measures that distinguish between different types of online games. In addition, this study proves useful regarding the current discussion on establishing (online) gaming addiction as a diagnosis in future categorizations of psychopathology.

Lee C; Aiken KD; Hung HC. Effects of college students' video gaming behavior on self-concept clarity and flow. Social Behavior and Personality 40(4): 673-679, 2012. (20 refs.)

We explored time spent playing and other video gamer behavior in relation to the psychological constructs of self-concept clarity and flow. Survey data were collected from a paper-and-pencil survey of a student sample from a university in northwestern United States. We found that compared with garners with high self-concept clarity, garners with low self-concept clarity spent more time playing video games. Furthermore, flow was positively associated with time spent playing. Garners who spent more time playing reported more flow experiences. This research contributes to understanding of the relationship between gamer psychologies and gaming behavior amongst college students.

Lee HW; Choi JS; Shin YC; Lee JY; Jung HY; Kwon JS. Impulsivity in internet addiction: A comparison with pathological gambling. Cyberpsychology, Behavior and Social Networking 15(7): 373-377, 2012. (38 refs.)

Internet addiction has been considered to be associated with poor impulse control. The aim of this study is to compare the trait impulsivity of those suffering from Internet addiction with that of individuals suffering from pathological gambling. Twenty-seven patients diagnosed with Internet addiction (age: 24.78 +/- 4.37 years), 27 patients diagnosed with pathological gambling (age: 25.67 +/- 3.97 years), and 27 healthy controls (age: 25.33 +/- 2.79 years) were enrolled in this study. All patients were men seeking treatment. Trait impulsivity and the severity of the Internet addiction and pathological gambling were measured by the Barratt Impulsiveness Scale-11, the Young's Internet Addiction Test, and the South Oaks Gambling Screen, respectively. The Beck Depression Inventory and the Beck Anxiety Inventory were also administered to all subjects. Our results show that those suffering from Internet addiction showed increased levels of trait impulsivity which were comparable to those of patients diagnosed with pathological gambling. Additionally, the severity of Internet addiction was positively correlated with the level of trait impulsivity in patients with Internet addiction. These results state that Internet addiction can be conceptualized as an impulse control disorder and that trait impulsivity is a marker for vulnerability to Internet addiction.

Levine SB. Problematic sexual excesses. (review). Neuropsychiatry 2(1): 69-79, 2012. (46 refs.)

Known since ancient times, sexual excess has been referred to as 'sexual addiction' for three decades. DSM-5 has proposed a new category of 'hypersexual disorder' to bring together disturbing situations of masturbation, pornography use, strip club attendance, multiple affairs, internet procurement of partners, prostitution use, unprotected sex with multiple partners and other sexually arousing behaviors. The conditions under which patients come for assessment differ between single and married, heterosexual and homosexual, paraphilic and nonparaphilic, and sex criminals and law-abiding patients. Treatment depends on apparent causes, comorbidities and the patient's capacities. While questions have been raised about the validity of hypersexual disorder, the numerous requests for assistance from patients should remind the field of psychiatry that utility also drives the employment of a diagnosis.

Li H; Zhang JJ; Mao LL; Min SD. Assessing corporate social responsibility in China's sports lottery administration and its influence on consumption behavior. Journal of Gambling Studies 28(3): 515-540, 2012. (106 refs.)

The purpose of this study was to identify and examine consumer perception of corporate social responsibility (CSR) in China's sports lottery industry, and the effect of perceived CSR initiatives on sports lottery consumption behavior. Research participants (N = 4, 980), selected based on a computer-generated, randomly stratified multistage sampling process, comprised Chinese residents who had purchased sports lottery tickets in the past 12 months. They completed a questionnaire that was derived from a qualitative research process. A factor analysis extracted two factors associated with perceptions of CSR in China's sports lottery administration: Regulatory and Prevention Responsibilities and Product Development Responsibility. Logistic regression analyses revealed that these two factors were influential of consumer behavior (i.e., relative and absolute expenditure, purchasing frequency, and time commitment). This study represents an initial effort to understand the dimensions of perceived CSR associated with Chinese sports lottery. The findings signify the importance of enforcing CSR in sports lottery administration.

Lim S; Ha J; Choi SW; Kang SG; Shin YC. Association study on pathological gambling and polymorphisms of dopamine D1, D2, D3, and D4 receptor genes in a Korean population. Journal of Gambling Studies 28(3): 481-491, 2012. (47 refs.)

Several studies have reported that some dopaminergic receptor polymorphisms are associated with pathological gambling (PG). Considering that there are major race and ethnic group difference in dopaminergic polymorphisms, the result of genetic association studies should be confirmed in more homogeneous population to avoid problems of population stratification. The present study aimed to investigate whether selected polymorphisms in the dopamine receptors genes (DRD1, DRD2, DRD3, and DRD4) are associated with PG in Korean population which is consisted of only Korean ancestry. Subjects were 104 men with a diagnosis of PG and 114 unrelated age-matched normal control men. Genotyping was performed for the DRD1 gene -48 A/G, DRD2 gene TaqI A, DRD3 gene Ser9Gly, and DRD4 gene exon III variable number tandem repeat polymorphisms. The method of multifactor dimensionality reduction (MDR) was used to analyze gene-gene interactions. There were no differences in the frequencies of any studied polymorphisms between patients with PG and normal controls. MDR analysis did not show a significant effect of the 4 dopamine receptor gene polymorphisms on susceptibility to PG (P > 0.05). The present study suggests that the analyzed polymorphisms of the dopamine receptor genes might not be associated with PG in a Korean population.

Ling IL; Chuang SC; Hsiao CH. The effects of self-diagnostic information on risk perception of internet addiction disorder: Self-positivity bias and online social support. Journal Of Applied Social Psychology 42(9): 2111-2136, 2012. (49 refs.)

This article demonstrates how self-diagnostic information (presence of symptoms on an inventory) influences the risk perception of Internet addiction disorder (IAD). The authors also highlight 2 tendencies -- self-positivity bias and online social support -- that are characteristics of risk perception of IAD. In 3 studies, it was found that if no contextual information was provided, respondents estimated their risk of IAD as higher than when contextual information (symptoms) was provided. They were also less prone to self-positivity (i.e., the disposition for people to estimate their risk as lower than others). Finally, our research provides evidence that online social support moderates these effects.

Linskiy IV; Minko AI; Artemchuk AP; Grinevich EG; Markova MV; Musienko GA et al. Addictive behavior among young people in Ukraine: A pilot study. Substance Use & Misuse 47(10): 1151-1158, 2012. (21 refs.)

The AUDIT-like tests system was created for complex assessment and evaluation of the addictive status of adolescents in a Ukrainian population. The AUDIT-like tests system has been created from the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. The AUDIT-like tests were minimally modified from the original AUDIT. Attention was brought to similarities between stages of different addictions (TV, computer games, the Internet, etc.) and alcohol addiction. Seventeen AUDIT-like tests were created to detect the different types of chemical and non-chemical addictions.

Littel M; van den Berg I; Luijten M; van Rooij AJ; Keemink L; Franken IHA. Error processing and response inhibition in excessive computer game players: An event-related potential study. Addiction Biology 17(5): 934-947, 2012. (79 refs.)

Excessive computer gaming has recently been proposed as a possible pathological illness. However, research on this topic is still in its infancy and underlying neurobiological mechanisms have not yet been identified. The determination of underlying mechanisms of excessive gaming might be useful for the identification of those at risk, a better understanding of the behavior and the development of interventions. Excessive gaming has been often compared with pathological gambling and substance use disorder. Both disorders are characterized by high levels of impulsivity, which incorporates deficits in error processing and response inhibition. The present study aimed to investigate error processing and response inhibition in excessive gamers and controls using a Go/NoGo paradigm combined with event-related potential recordings. Results indicated that excessive gamers show reduced error-related negativity amplitudes in response to incorrect trials relative to correct trials, implying poor error processing in this population. Furthermore, excessive gamers display higher levels of self-reported impulsivity as well as more impulsive responding as reflected by less behavioral inhibition on the Go/NoGo task. The present study indicates that excessive gaming partly parallels impulse control and substance use disorders regarding impulsivity measured on the self-reported, behavioral and electrophysiological level. Although the present study does not allow drawing firm conclusions on causality, it might be that trait impulsivity, poor error processing and diminished behavioral response inhibition underlie the excessive gaming patterns observed in certain individuals. They might be less sensitive to negative consequences of gaming and therefore continue their behavior despite adverse consequences.

Majamaki MH; Poysti VK. Vocabularies of gambling justification among Finnish and French players. European Journal of Cultural Studies 15(4): 496-512, 2012. (38 refs.)

Psychological studies have tended to understand gambling motives as preconceived and individualistic. However, from a sociological point of view motives can only be conceived after the act has taken place, forming vocabularies of justifying one's action to make it rational in the eyes of others. Motives cannot be taken at face value but as expressions of what is thought to be culturally acceptable. Using group interview data, this comparative study between Finnish and French gamblers asks how gambling is justified in these two cultural contexts. Different vocabularies of justification were found. While the French emphasised the dream of winning large sums of money, the Finns highlighted personal development. The results confirm that cultural aspects should be considered more in gambling research as the vocabularies of justifying gambling are connected to the cultural and institutional context in question.

Markham F; Young M; Doran B. The relationship between alcohol consumption, gambling behaviour and problem gambling during a single visit to a gambling venue. Drug and Alcohol Review 31(6): 770-777, 2012. (31 refs.)

Introduction and Aims. Despite the well-documented comorbidity between disordered alcohol use and problem gambling, little is known about the co-occurrence of drinking and gambling in gambling venues. This paper appears to be the first to investigate the association between drinking and gambling behaviour among a large sample of gamblers during a specific, non-laboratory gambling episode. Design and Methods. We conducted a mail survey of all available households in the Northern Territory of Australia, including questions on drinking and gambling behaviour on the last visit to a gambling venue. We estimate the effect of moderate (14 standard drinks) and risky (>4 standard drinks) alcohol consumption on gambling participation and gambling duration for both problem and non-problem gamblers using regression analysis of 7044 survey responses. Results. The probability of participating in electronic gaming machine (EGM) gambling decreased with alcohol consumption for non-problem gamblers, while the probability of participating in TAB (Totalisator Agency Board, off-course totalisator) gambling increased with risky alcohol consumption for all gamblers. Alcohol consumption was not associated with EGM gambling participation for problem gamblers. Moderate alcohol consumption was negatively associated with EGM gambling duration, with a stronger effect observed for problem gamblers. Discussion and Conclusions. Moderate alcohol consumption is inversely correlated with both the duration of play and probability of participation for EGM gambling. Current laboratory studies do not predict the drinking-gambling behaviour of the general population in non-laboratory settings. Future research on alcohol and gambling co-occurrence must explicitly consider the drinking and gambling environment in order to produce policy-relevant findings.

McGrath DS; Barrett SP; Stewart SH; McGrath PR. A comparison of gambling behavior, problem gambling indices, and reasons for gambling among smokers and nonsmokers who gamble: Evidence from a Provincial Gambling Prevalence Study. Nicotine & Tobacco Research 14(7): 833-839, 2012. (36 refs.)

Numerous epidemiological and clinical studies have found that tobacco use and gambling frequently co-occur. Despite high rates of smoking among regular gamblers, the extent to which tobacco potentially influences gambling behavior and vice versa is poorly understood. The current study aimed to provide more insight into this relationship by directly comparing nonsmoking and smoking gamblers on gambling behavior, problem gambling indices, and reasons for gambling. The data for this study came from the 2005 Newfoundland and Labrador Gambling Prevalence Study. Gamblers identified as nonsmokers (N = 997) were compared with gamblers who smoke (N = 622) on numerous gambling-related variables. Chi-square analyses were used to compare groups on demographic variables. Associations between smoking status and gambling criteria were assessed with a series of binary logistic regressions. The regression analyses revealed several significant associations between smoking status and past 12-month gambling. Higher problem gambling severity scores, use of alcohol/drugs while gambling, amount of money spent gambling, use of video lottery terminals, and reasons for gambling which focused on positive reinforcement/reward and negative reinforcement/relief were all associated with smoking. The findings suggest an association between smoking and potentially problematic gambling in a population-based sample. More research focused on the potential reinforcing properties of tobacco on the development and treatment of problematic gambling is needed.

McNamara J; McCabe MP. Striving for success or addiction? Exercise dependence among elite Australian athletes. Journal of Sports Sciences 30(8): 755-766, 2012. (28 refs.)

Exercise dependence is a condition that involves a preoccupation and involvement with training and exercise, and has serious health and performance consequences for athletes. We examined the validity of a biopsychosocial model to explain the development and maintenance of exercise dependence among elite Australian athletes. Participants were 234 elite Australian athletes recruited from institutes and academies of sport. Thirty-four percent of elite athletes were classified as having exercise dependence based on high scores on the measure of exercise dependence. These athletes had a higher body mass index, and more extreme and maladaptive exercise beliefs compared to non-dependent athletes. They also reported higher pressure from coaches and teammates, and lower social support, compared to athletes who were not exercise dependent. These results support the utility of a biopsychosocial model of exercise dependence in understanding the aetiology of exercise dependence among elite athletes. Limitations of the study and future research directions are highlighted.

Meule A; Heckel D; Kubler A. Factor structure and item analysis of the Yale Food Addiction Scale in obese candidates for bariatric surgery. European Eating Disorders Review 20(5): 419-422, 2012. (25 refs.)

Converging research suggests phenomenological and neurobiological similarities between excessive food consumption and addictive behaviour in substance dependence. Recently, the Yale Food Addiction Scale (YFAS) has been proposed for the assessment of addictive eating behaviour. The German version of the YFAS was administered to obese individuals seeking bariatric surgery (N?=?96). Factor structure, internal consistency, and item statistics were analysed. Forty participants (41.70%) received a food addiction diagnosis. The one-factorial structure of the YFAS, which has been found in non-clinical samples, could be confirmed. All but three items had factor loadings >.50. Internal consistency was a?=?.82. Item analysis revealed that items related to unsuccessful attempts to cut down and consumption despite physical and emotional problems were endorsed by the majority of participants. Findings support the use of the YFAS in clinical populations, while applicability of some items differs between clinical and non-clinical samples.

Meule A; Kubler A. Food cravings in food addiction: The distinct role of positive reinforcement. Eating Behaviors 13(3): 252-255, 2012. (31 refs.)

Craving for a particular substance is an essential characteristic of addictive behavior. Increasing evidence suggests that food cravings and excessive food consumption could similarly be due to addictive processes. Recently, the Yale Food Addiction Scale (YFAS) was introduced for identifying individuals with addictive eating patterns. We conducted an online study (n=616, 75.8% female) in which participants filled out the YFAS and the Food Cravings Questionnaire-Trait (FCQ-T). Participants diagnosed as being addicted to food using the YFAS had higher scores on all food craving subscales except for anticipation of positive reinforcement that may result from eating. In a subsequent regression analysis, all food craving subscales positively predicted food addiction symptoms while positive reinforcement negatively predicted food addiction symptoms. Similar to other addictive behaviors, results indicate that individuals with addictive eating patterns experience more food cravings, but concurrently do not expect a positive reinforcement through eating.

Mihordin R. Behavioral addiction: Quo Vadis? Journal of Nervous and Mental Disease 200(6): 489-491, 2012. (19 refs.)

Behavioral addiction is a new class of psychiatric disorders being considered for inclusion in the next edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In this article, pathological model railroading disorder is introduced as a vehicle for highlighting and discussing the foreseeable risks and benefits of legitimizing behavioral addiction as a diagnostic class in DSM-5.

Montag C; Kirsch P; Sauer C; Markett S; Reuter M. The role of the CHRNA4 gene in internet addiction: A case-control study. Journal of Addiction Medicine 6(3): 191-195, 2012. (38 refs.)

Recent studies from Asia provided first evidence for a molecular genetic link between serotonergic and dopaminergic neurotransmission and Internet addiction. The present report offers data on a new candidate gene in the investigation of Internet addiction-the gene coding for the nicotinic acetylcholine receptor subunit alpha 4 (CHRNA4). A case-control study was carried out. The participants were recruited from a large gene data bank, including people from the general population and from a university setting. A total of 132 participants with problematic Internet use and 132 age- and sex-matched controls participated in the study. Participants provided DNA samples and filled in the Internet Addiction Test Questionnaire. The T- variant (CC genotype) of the rs1044396 polymorphism on the CHRNA4 gene occurred significantly more frequently in the case group. Further analyses revealed that this effect was driven by females. Combined with the findings from other studies, the present data point in the direction that rs1044396 exerts pleiotropic effects on a vast range of behaviors, including cognition, emotion, and addiction.

Moore SM; Thomas AC; Kyrios M; Bates G. The self-regulation of gambling. Journal of Gambling Studies 28(3): 405-420, 2012. (21 refs.)

Despite the prevalence of gambling world-wide, relatively few individuals become problem gamblers. Additionally many problem gamblers recover without professional assistance. The current study aim was to examine how individuals self-manage their gambling through (a) assessing frequency of use of a range of self-regulation strategies (b) examining how these strategies cluster and (c) exploring relationships between strategies, gambling frequency, amount spent and problem gambling severity. A sample of 303 gamblers was recruited, over-sampling for problem gamblers as assessed by the Problem Gambling Severity Index (PGSI) of the Canadian Problem Gambling Index (mean age 26.4 years, SD = 10.1 years; 119 males, 184 females; 238 social gamblers, 63 problem gamblers, 2 unclassified). They rated extent of usage of 27 gambling self-management techniques and completed the PGSI and other gambling measures. Factor analysis of items produced five factors, named Cognitive Approaches, Direct Action, Social Experience, Avoidance and Limit Setting. The relationships between these factors and key gambling variables were consistent with hypotheses that problem gamblers trying to reduce their gambling would be more likely to use the strategies than other gambler groups. The potential for developing the factors into a Gambling Self-regulation Measure was explored.

Myrseth H; Tvera R; Hagatun S; Lindgren C. A comparison of impulsivity and sensation seeking in pathological gamblers and skydivers. Scandinavian Journal of Psychology 53(4): 340-346, 2012. (35 refs.)

The aim of this study was to compare pathological gamblers and skydivers in relation to measures of impulsivity and sensation seeking. The Eysenck Impulsivity Scale Narrow Impulsiveness Subscale and the Arnett Inventory of Sensation Seeking were administered to pathological gamblers (n = 29), skydivers (n = 93), and a control group (n = 43). A two-way multivariate analysis of variance was conducted to explore differences in impulsivity and sensation seeking between the groups and possible group by gender and group by age interaction effects. The significant effects were further investigated using follow-up univariate analysis of variance. The results showed significant main effects of Group, Gender and Age, and a significant Group by Gender interaction effect. The results showed no statistically significant differences in impulsivity between pathological gamblers and skydivers; however, both groups scored higher than the controls. The skydivers scored higher compared to the pathological gamblers and controls on both sensation seeking subscales. Pathological gamblers scored higher than the controls on the subscale Need for Stimulus Intensity, although lower than the controls on the subscale Need for Novelty. We conclude that skydivers and pathological gamblers do not seem to differ in terms of impulsivity, but that the two groups differ in terms of sensation seeking. Skydivers are hence characterized by more sensation seeking compared to pathological gamblers. Skydiving, as opposed to pathological gambling, is not considered a psychiatric disorder, and skydiving may represent a more non-pathological way to fulfill the need for stimulus intensity.

Oakes J; Pols R; Battersby M; Lawn S; Pulvirenti M; Smith D. A focus group study of predictors of relapse in electronic gaming machine problem gambling, Part 2: Factors that 'pull' the gambler away from relapse. Journal of Gambling Studies 28(3): 465-479, 2012. (41 refs.)

This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine (EGM) problem gambling (PG) by describing the processes and factors that 'pull' the problem gambler away from relapse contrasted with the 'push' towards relapse. These conceptualisations describe two opposing, interacting emotional processes occurring within the problem gambler during any relapse episode. Each relapse episode comprises a complex set of psychological and social behaviours where many factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behaviour events that end (1) with relapse where 'push' overcomes 'pull' or (2) continued abstinence where 'pull' overcomes 'push'. Four focus groups comprising thirty participants who were EGM problem gamblers, gamblers' significant others, therapists and counsellors described their experiences and understanding of relapse. The groups were recorded, recordings were then transcribed and analysed using thematic textual analysis. It was established that vigilance, motivation to commit to change, positive social support, cognitive strategies such as remembering past gambling harms or distraction techniques to avoid thinking about gambling to enable gamblers to manage the urge to gamble and urge extinction were key factors that protected against relapse. Three complementary theories emerged from the analysis. Firstly, a process of reappraisal of personal gambling behaviour pulls the gambler away from relapse. This results in a commitment to change that develops over time and affects but is independent of each episode of relapse. Secondly, relapse may be halted by interacting factors that 'pull' the problem gambler away from the sequence of mental and behavioural events, which follow the triggering of the urge and cognitions to gamble. Thirdly, urge extinction and apparent 'cure' is possible for EGM gambling. This study provides a qualitative, empirical model for understanding protective factors against gambling relapse.

Oakes J; Pols R; Battersby M; Lawn S; Pulvirenti M; Smith D. A focus group study of predictors of relapse in electronic gaming machine problem gambling, Part 1: Factors that 'push' towards relapse. Journal of Gambling Studies 28(3): 451-464, 2012. (58 refs.)

This study aimed to develop an empirically based description of relapse in Electronic Gaming Machine problem gambling. In this paper the authors describe part one of a two part, linked relapse process: the 'push' towards relapse. In this two-part process, factors interact sequentially and simultaneously within the problem gambler to produce a series of mental and behavioural events that ends with relapse when the 'push' overcomes 'pull' (part one); or as described in part two, continued abstinence when 'pull' overcomes 'push'. In the second paper, the authors describe how interacting factors 'pull' the problem gambler away from relapse. This study used four focus groups comprising thirty participants who were gamblers, gamblers' significant others, therapists and counsellors. The groups were recorded, recordings were then transcribed and analysed using thematic, textual analysis. With the large number of variables considered to be related to relapse in problem gamblers, five key factors emerged that 'push' the gambler towards relapse. These were urge, erroneous cognitions about the outcomes of gambling, negative affect, dysfunctional relationships and environmental gambling triggers. Two theories emerged: (1) each relapse episode comprised a sequence of mental and behavioural events, which evolves over time and was modified by factors that 'push' this sequence towards relapse and (2) a number of gamblers develop an altered state of consciousness during relapse described as the 'zone' which prolongs the relapse.

Odlaug BL; Schreiber LRN; Grant JE. Personality disorders and dimensions in pathological gambling. Journal of Personality Disorders 26(3): 381-392, 2012. (58 refs.)

Comorbid DSM-IV Axis II personality disorders appear to be common in pathological gambling (PG) and may contribute to the chronic problems often associated with the disorder. This study sought to examine the relationship between PG, personality disorders, and impulsivity in a sample of pathological gamblers. Personality assessments included the SCID-II, Eysenck Impulsiveness Questionnaire, Tridimensional Personality Questionnaire, and Barratt Impulsiveness Scale. A total of 77 individuals with DSM-IV PG were included in this study, of which 35 (45.5%) met criteria for at least one personality disorder. Specific aspects of impulsivity were associated with certain personality disorders in PG when grouped by cluster, yet the presence of a personality disorder was not positively correlated with gambling severity. It remains unclear how the presence of a personality disorder and aspects of impulsivity may affect treatment outcome. Further exploration of these disorders and dimensions of personality may encourage a more inclusively global treatment approach.

O'Keeffe GS. Overview: New media. Pediatric Clinics of North America 59(3): 589+, 2012. (20 refs.)

Pediatricians care for children's growth and development from the time they are born until they become adults. In addition, pediatricians must be vigilant for external influences. Technology influences children of all ages. Seventy-five percent of teenagers own cell phones, with 25% using them for social media. Technology can lead to an increase in skills and social benefits but there is also the potential for harm such as sexting, cyberbullying, privacy issues, and Internet addiction, all of which can affect health. Pediatricians must become well versed in the new media to provide media-oriented anticipatory guidance and advice on media-related issues.

Rahman AS; Pilver CE; Desai RA; Steinberg MA; Rugle L; Krishnan-Sarin S. The relationship between age of gambling onset and adolescent problematic gambling severity. Journal of Psychiatric Research 46(5): 675-683, 2012. (52 refs.)

The aim of this study was to characterize the association between problem gambling severity and multiple health, functioning and gambling variables in adolescents aged 13-18 stratified by age of gambling onset. Survey data in 1624 Connecticut high school students stratified by age of gambling onset (<= 11 years vs. >= 12 years) were analyzed in descriptive analyses and in logistic regression models. Earlier age of onset was associated with problem gambling severity as indexed by a higher frequency of at-risk/problem gambling (ARPG). Most health, functioning and gambling measures were similarly associated with problem gambling severity in the earlier- and later-age-of-gambling-onset groups with the exception of participation in non-strategic forms of gambling, which was more strongly associated with ARPG in the earlier-onset (OR = 1.74, 95%CI = [1.26, 2.39]) as compared to later-onset (OR = 0.94, 95% CI = [0.60, 1.48]) group (Interaction OR = 1.91, 95%CI = [1.18, 3.26]). Post-hoc analysis revealed that earlier-onset ARPG was more strongly associated with multiple forms of non-strategic gambling including lottery (instant, traditional) and slot-machine gambling. The finding that problem gambling severity is more closely associated with multiple non-strategic forms of gambling amongst youth with earlier-onset gambling highlights the relevance of these types of youth gambling. The extent to which non-strategic forms of gambling may serve as a gateway to other forms of gambling or risk behaviors warrants additional study, and efforts targeting youth gambling should consider how best to address non-strategic gambling through education, prevention, treatment and policy efforts.

Ramowski SK; Nystrom RJ; Rosenberg KD; Gilchrist J; Chaumeton NR. Health risks of Oregon eighth-grade participants in the "choking game": Results from a population-based survey. Pediatrics 129(5): 846-851, 2012. (18 refs.)

Objective: To examine the risk behaviors associated with participation in the "choking game" by eighth-graders in Oregon. Methods: We obtained data from the 2009 Oregon Healthy Teens survey, a cross-sectional weighted survey of 5348 eighth-graders that questioned lifetime prevalence and frequency of choking game participation. The survey also included questions about physical and mental health, gambling, sexual activity, nutrition, physical activity/body image, exposure to violence, and substance use. Results: Lifetime prevalence of choking game participation was 6.1% for Oregon eighth-graders, with no differences between males and females. Of the eighth-grade choking game participants, 64% had engaged in the activity more than once and 26.6% >5 times. Among males, black youth were more likely to participate than white youth. Among both females and males, Pacific Islandander youth were much more likely to participate than white youth. Multivariate logistic regression revealed that sexual activity and substance use were significantly associated with choking game participation for both males and females. Conclusions: At >6%, the prevalence of choking game participation among Oregon youth is consistent with previous findings. However, we found that most of those who participate will put themselves at risk more than once. Participants also have other associated health risk behaviors. The comprehensive adolescent well visit, as recommended by the American Academy of Pediatrics, is a good opportunity for providers to conduct a health behavior risk assessment and, if appropriate, discuss the dangers of engaging in this activity.

Reid RC; McKittrick HL; Davtian M; Fong TW. Self-reported differences on measures of executive function in a patient sample of pathological gamblers. International Journal of Neuroscience 122(9): 500-505, 2012. (27 refs.)

Patients seeking help for pathological gambling often exhibit features of impulsivity, cognitive rigidity, poor judgment, deficits in emotion regulation, and excessive preoccupation with gambling. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive deficits. Evidence of executive deficits have been confirmed in pathological gamblers using objective neurocognitive tests, however, it remains to be seen if such findings will emerge in self-report measures of executive control. These observations led to the current investigation of differences between a group of pathological gamblers (n = 62) and a comparison group (n = 64) using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). Significant differences between the groups emerged over all nine subscales of executive functioning with the most dramatic differences on BRIEF-A subscales Inhibit, Plan/Organize, Shift, Emotion Control, Self-Monitor, and Initiate among the pathological gamblers. These results provide evidence that support findings among pathological gamblers using objective neuropsychological measures and suggest that the BRIEF-A may be an appropriate instrument to assess possible problems with executive control in this population.

Reith G. Beyond addiction or compulsion: The continuing role of environment in the case of pathological gambling. (editorial). Addiction 107(10): 1736-1737, 2012. (19 refs.)

Rodda S; Lubman D. Ready to change: A scheduled telephone counselling programme for problem gambling. Australasian Psychiatry 20(4): 338-342, 2012. (18 refs.)

Objective: This study describes the implementation of an innovative 4-6 week cognitive behavioural therapy (CBT) programme for problem gambling, Ready to Change (RTC), delivered via telephone and workbook. Method: Participants referred into the programme during the first three years of operation had a mean age of 45 years (range 19-81 years). The majority of participants were female (56%, n=129) and had problems associated with gaming machines (81.7%, n=188). Results: Between January 2008 and December 2010, 230 people were assessed and offered the RTC programme. The main reason for referral of a person into the programme was difficulty in accessing a face-to-face agency. Conclusions: We describe the components and challenges of a 4-6 week programme for the treatment of problem gambling delivered via telephone. While distance-based treatments address concerns over access to services, further research investigating their effectiveness is required.

Schwarz MT. Fire rock: Navajo prohibitions against gambling. Ethnohistory 59(3): 515-540, 2012. (50 refs.)

Shortly after Congress passed the Indian Gaming Regulatory Act (IGRA) in 1988, casinos started appearing on reservations across North America and generating billions of dollars for some formerly destitute tribes. Despite general enthusiasm about gaming in Indian country, the Navajo Nation, the largest Native American nation in the United States, was one of the last holdouts against gaming until quite recently. Some Navajos voiced concerns over the danger of compromising sovereignty through state gaming compacts. Others feared that gaming would attract social ills to their communities. Among those who opposed gaming on what can be termed traditional grounds, many reiterated age-old prohibitions against excess, warnings about witchcraft, statements about the importance of family, fundamental tensions between the simultaneous desire for personal agency and the need for group consensus which operate within the framework of strong interdictions against any person attempting to control another and narratives from Navajo oral tradition about a deity known as The Gambler that focus on the dangers of gambling and the various forms of "enslavement" it can cause. It is relevant that Navajo elders and traditionalists focused heavily on this concern because, although Congress ignored it when passing the IGRA, subsequent research reveals that due to the treatment they have received historically, colonized or previously colonized peoples have a greater risk of developing problematic relationships with gambling than members of the conquering populations.

Shek DTL; Chan EML; Wong RHY. Associations between pathological gambling and psychiatric comorbidity among help-seeking populations in Hong Kong. Scientific World Journal : article 571434, 2012. (63 refs.)

Problem gambling is complex and often comorbid with other mental health problems. Unfortunately, gambling studies on comorbid psychiatric disorders among Chinese communities are extremely limited. The objectives of this study were to (a) determine the prevalence of comorbid psychiatric disorders among treatment-seeking pathological gamblers; (b) compare the demographic profiles and clinical features of pathological gamblers with and without comorbid psychiatric disorders; (c) explore the associations between pathological gambling and psychiatric disorders and their temporal relationship. Participants (N = 201) who sought gambling counseling were examined by making Axis-I diagnoses including mood disorders, schizophrenia spectrum disorders, substance use disorders, anxiety disorders, and adjustment disorder. Results showed that 63.7% of participants had lifetime comorbid psychiatric disorder. The most common comorbid psychiatric mental disorders were mood disorders, adjustment disorder, and substance use disorders. Pathological gamblers with psychiatric comorbidities were significantly more severe in psychopathology, psychosocial functioning impairment, and gambling problems than those without the disorders.

Shek DTL; Yu L. Internet addiction phenomenon in early adolescents in Hong Kong. Scientific World Journal : article 104304, 2012. (33 refs.)

The present study investigated the prevalence and demographic correlates of Internet addiction in Hong Kong adolescents as well as the change in related behavior at two time points over a one-year interval. Two waves of data were collected from a large sample of students (Wave 1: 3,328 students, age = 12.59 +/- 0.74 years; Wave 2: 3,580 students, age = 13.50 +/- 0.75 years) at 28 secondary schools in Hong Kong. Comparable to findings at Wave 1 (26.4%), 26.7% of the participants met the criterion of Internet addiction at Wave 2 as measured by Young's 10-item Internet Addiction Test. The behavioral pattern of Internet addiction was basically stable over time. While the predictive effects of demographic variables including age, gender, family economic status, and immigration status were not significant, Internet addictive behaviors at Wave 1 significantly predicted similar behaviors at Wave 2. Students who met the criterion of Internet addiction at Wave 1 were 7.55 times more likely than other students to be classified as Internet addicts at Wave 2. These results suggest that early detection and intervention for Internet addiction should be carried out.

Snir R; Harpaz I. Beyond workaholism: Towards a general model of heavy work investment. Human Resource Management Review 22(3): 232-243, 2012. (122 refs.)

Although the term workaholism is widely used, little consensus exists about its meaning, and there is a great need for further theoretical and methodological advancement. We attempt to address this need by introducing the concept of Heavy Work Investment (HWI), and viewing workaholism as only one of its subtypes. Furthermore, we propose a model consisting of four main components: HWI, its possible predictors, its types, and its outcomes. In this model, using Weiner's (1985) attributional framework, we differentiate between situational and dispositional types of HWI, each with its own subtypes, as based on the predictors of such an investment. For example, financial-needs-based and employer-directed are situational subtypes, whereas workaholism and work-devotion are dispositional subtypes. Based on the proposed HWI model, we compare dispositional investors with situational investors. Finally, the measurement of HWI, as well as future research directions (study of situational investors, research across time and cultures, and exploration of inter-generational similarity/difference) is also discussed.

Song HJ; Lee CK; Norman WC; Han H. The role of responsible gambling strategy in forming behavioral intention: An application of a model of goal-directed behavior. Journal of Travel Research 51(4): 512-523, 2012. (76 refs.)

By examining the perception of a responsible gambling strategy, this study developed an extended model of goal-directed behavior (EMGB) with respect to the behavioral intentions of casino visitors. The results of the EMGB, which uses structural equation modeling, indicate that desire had the strongest relationship with casino visitors' intention to gamble, followed by positive anticipated emotion, perceived behavioral control, perceptions of a responsible gambling strategy, negative anticipated emotion, and attitude. The perception of a responsible gambling strategy was also a significant predictor of both desire and behavioral intention, as casino visitors had positive perceptions of casinos that implemented responsible gambling strategies. Casino managers should consider a responsible gambling strategy as an important long-term business activity to increase casino visitor's intention to gamble.

Squires EC; Sztainert T; Gillen NR; Caouette J; Wohl MJA. The problem with self-forgiveness: Forgiving the self deters readiness to change among gamblers. Journal of Gambling Studies 28(3): 337-350, 2012. (69 refs.)

Self-forgiveness is generally understood to be a mechanism that restores and improves the self. In the current study, we examine the possible deleterious consequences of forgiving the self among gamblers-specifically in regard to gamblers' readiness to change their problematic behavior. At a large Canadian university, 110 young adult gamblers' level of gambling pathology was assessed, along with their readiness to change and self-forgiveness for their gambling. Participants were 33 females and 75 males (2 unspecified) with a mean age of 20.33. Results revealed that level of pathology (at risk vs. problem gamblers) significantly predicted increased readiness to change. Self-forgiveness mediated this relationship, such that level of gambling pathology increased readiness to change to the extent that participants were relatively unforgiving of their gambling. Implications for seeking professional assistance as well as treatment and recovery are discussed.

Stevens M; Bailie R. Gambling, housing conditions, community contexts and child health in remote indigenous communities in the Northern Territory, Australia. BMC Public Health 12: article 377, 2012. (41 refs.)

Background: Recent government reports have identified gambling, along with alcohol abuse, drug abuse and pornography, as contributing to child neglect and abuse in Indigenous communities in the Northern Territory (NT). These reports also identify gaps in empirical evidence upon which to base sound policy. To address this shortfall, data from ten remote Indigenous communities was analysed to determine the relationship between gambling problems, housing conditions, community contexts and child health in indigenous communities. Methods: Logistic regression was used to assess associations between gambling problems, community contexts, housing conditions and child health. Separate multivariable models were developed for carer reported gambling problems in houses and six child health outcomes. Results: Carer reported gambling problems in households across the ten communities ranged from 10% to 74%. Inland tropical communities had the highest level of reported gambling problems. Less access to a doctor in the community showed evidence of a multivariable adjusted association with gambling problems in houses. No housing variables showed evidence for a multivariable association with reported gambling problems. There was evidence for gambling problems having a multivariable adjusted association with carer report of scabies and ear infection in children. Conclusions: The analyses provide evidence that gambling is a significant problem in Indigenous communities and that gambling problems in households is related to poor child health outcomes. A comprehensive (prevention, treatment, regulation and education) public health approach to harm minimisation associated with gambling amongst the Indigenous population is required that builds on current normative community regulation of gambling.

Taghva A; Corrigan JD; Rezai AR. Obesity and brain addiction circuitry: Implications for deep brain stimulation. (review). Neurosurgery 71(2): 224-238, 2012. (167 refs.)

Obesity is a growing health problem worldwide and is responsible for a significant proportion of health expenditures in developed nations. It is also notoriously difficult to treat. Prior attempts at pharmacological or neurological modulation, including deep brain stimulation, have primarily targeted homeostatic mechanisms of weight control centered in the hypothalamus. To date, these attempts have had limited success. Multiple lines of independent data suggest that dysregulated reward circuitry in the brain underlies behaviors leading to obesity. Here, we review the existing data and related neurocircuitry, as well as the scope of obesity and currently available treatments. Finally, we suggest a neuromodulation strategy geared toward regulating these dysfunctional circuits, primarily by alteration of frontolimbic circuits.

Tse S; Hong SI; Wang CW; Cunningham-Williams RM. Gambling behavior and problems among older adults: A systematic review of empirical studies. (review). Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 67(5): 639-652, 2012. (110 refs.)

Objectives. With the rapid aging of the population and the increased availability of gambling facilities over the past three decades, older adults may gamble more and may be increasingly at risk for problem gambling (PG) or pathological gambling disorder (POD). To facilitate a better understanding of gambling behavior among older adults that will inform preventive strategies, this article systematically examined empirical studies on issues related to older adults' gambling. Method. This article reviewed 75 empirical studies including data on the distribution and determinants of PG and POD and the outcomes of gambling. Results. This review used the broad term of "disordered gambling" as a means to explain a continuum of problems caused by PG and POD. The analyses covered seven topics concerning older adults' gambling behaviors: Participation rates for gambling, prevalence rates of disordered gambling, motivation for initially beginning to gamble, risk and protective factors for disordered gambling, and negative and positive health outcomes from gambling. Discussion. Based on research gaps identified in the review, this article proposes six recommendations for future studies focusing on well-being of older adults who gamble, research method issues, and taking into account older adults' inspirations and adjustment to the aging process in the 21st century.

Turel O; Serenko A. The benefits and dangers of enjoyment with social networking websites. European Journal of Information Systems 21(5): 512-528, 2012. (134 refs.)

Information systems enjoyment has been identified as a desirable phenomenon, because it can drive various aspects of system use. In this study, we argue that it can also be a key ingredient in the formation of adverse outcomes, such as technology-related addictions, through the positive reinforcement it generates. We rely on several theoretical mechanisms and, consistent with previous studies, suggest that enjoyment can lead to presumably positive outcomes, such as high engagement. Nevertheless, it can also facilitate the development of a strong habit and reinforce it until it becomes a 'bad habit', that can help forming a strong pathological and maladaptive psychological dependency on the use of the IT artifact (i.e., technology addiction). We test and validate this dual effect of enjoyment, with a data set of 194 social networking website users analyzed with SEM techniques. The potential duality of MIS constructs and other implications for research and practice are discussed.

van Holst RJ; de Ruiter MB; van den Brink W; Veltman DJ; Goudriaan AE. A voxel-based morphometry study comparing problem gamblers, alcohol abusers, and healthy controls. Drug and Alcohol Dependence 124(1-2): 142-148, 2012. (59 refs.)

Background: Alcohol use disorders (AUDs) are associated with smaller grey matter volumes in cortical and subcortical brain regions which are related to cognitive impairments often found in these disorders. Similar cognitive impairments have been found in patients suffering from problem gambling behaviour. However, in contrast to AUDs, gambling behaviour does not entail brain exposure to toxic agents. Although there are many clinical, neuropsychological, and neurobiological similarities between PG and substance use disorders it has not yet been established whether pathological gambling, similar to alcohol use disorders, is associated with abnormal regional grey matter volumes. Methods: With whole-brain voxel-based morphometry we compared a group of 40 treatment seeking problem gamblers, 36 subjects with an alcohol use disorder, and 54 healthy controls to evaluate potential group differences in regional grey matter volumes, corrected for age. IQ, smoking status, and total intracranial volume (TIV). Results: Significantly smaller grey matter volumes in left superior frontal cortex, left precentral cortex, right insula, right putamen, left thalamus, bilateral superior parietal cortex and right supramarginal cortex were present in subjects with an alcohol use disorder compared to healthy controls and problem gamblers. No significant grey matter volume differences were present between problem gamblers and healthy controls. Conclusion: In conclusion, we replicated previous findings of smaller grey matter volumes in subjects with an alcohol use disorder and found no significant morphological brain abnormalities in problem gamblers.

van Holst RJ; Lemmens JS; Valkenburg PM; Peter J; Veltman DJ; Goudriaan AE. Attentional bias and disinhibition toward gaming cues are related to problem gaming in male adolescents. Journal of Adolescent Health 50(6): 541-546, 2012. (40 refs.)

Purpose: The aim of this study was to examine whether behavioral tendencies commonly related to addictive behaviors are also related to problematic computer and video game playing in adolescents. The study of attentional bias and response inhibition, characteristic for addictive disorders, is relevant to the ongoing discussion on whether problematic gaming should be classified as an addictive disorder. Methods: We tested the relation between self-reported levels of problem gaming and two behavioral domains: attentional bias and response inhibition. Ninety-two male adolescents performed two attentional bias tasks (addiction-Stroop, dot-probe) and a behavioral inhibition task (go/no-go). Self-reported problem gaming was measured by the game addiction scale, based on the Diagnostic and Statistical Manual of Mental Disorders-fourth edition criteria for pathological gambling and time spent on computer and/ or video games. Results: Male adolescents with higher levels of self-reported problem gaming displayed signs of error-related attentional bias to game cues. Higher levels of problem gaming were also related to more errors on response inhibition, but only when game cues were presented. Conclusions: These findings are in line with the findings of attentional bias reported in clinically recognized addictive disorders, such as substance dependence and pathological gambling, and contribute to the discussion on the proposed concept of "Addiction and Related Disorders" (which may include non-substance-related addictive behaviors) in the Diagnostic and Statistical Manual of Mental Disorders-fourth edition.

van Holst RJ; van Holstein M; van den Brink W; Veltman DJ; Goudriaan AE. Response inhibition during cue reactivity in problem gamblers: An fMRI study. PLoS ONE 7(3): e-article 30909, 2012. (81 refs.)

Disinhibition over drug use, enhanced salience of drug use and decreased salience of natural reinforcers are thought to play an important role substance dependence. Whether this is also true for pathological gambling is unclear. To understand the effects of affective stimuli on response inhibition in problem gamblers (PRGs), we designed an affective Go/Nogo to examine the interaction between response inhibition and salience attribution in 16 PRGs and 15 healthy controls (HCs). Four affective blocks were presented with Go trials containing neutral, gamble, positive or negative affective pictures. The No-Go trials in these blocks contained neutral pictures. Outcomes of interest included percentage of impulsive errors and mean reaction times in the different blocks. Brain activity related to No-Go trials was assessed to measure response inhibition in the various affective conditions and brain activity related to Go trials was assessed to measure salience attribution. PRGs made fewer errors during gamble and positive trials than HCs, but were slower during all trials types. Compared to HCs, PRGs activated the dorsolateral prefrontal cortex, anterior cingulate and ventral striatum to a greater extent while viewing gamble pictures. The dorsal lateral and inferior frontal cortex were more activated in PRGs than in HCs while viewing positive and negative pictures. During neutral inhibition, PRGs were slower but similar in accuracy to HCs, and showed more dorsolateral prefrontal and anterior cingulate cortex activity. In contrast, during gamble and positive pictures PRGs performed better than HCs, and showed lower activation of the dorsolateral and anterior cingulate cortex. This study shows that gambling-related stimuli are more salient for PRGs than for HCs. PRGs seem to rely on compensatory brain activity to achieve similar performance during neutral response inhibition. A gambling-related or positive context appears to facilitate response inhibition as indicated by lower brain activity and fewer behavioural errors in PRGs.

Victor SE; Glenn CR; Klonsky ED. Is non-suicidal self-injury an "addiction"? A comparison of craving in substance use and non-suicidal self-injury. Psychiatry Research 197(1-2): 73-77, 2012. (48 refs.)

There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n = 58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or use substances. We conclude that, while both behaviors have powerful reinforcement contingencies, NSSI appears to be almost exclusively maintained by negative reinforcement (e.g., the reduction of aversive emotions). Findings are more consistent with emotion regulation than addiction models of NSSI.

Walther B; Morgenstern M; Hanewinkel R. Co-occurrence of addictive behaviours: Personality factors related to substance use, gambling and computer gaming. European Addiction Research 18(4): 167-174, 2012. (44 refs.)

Aim: To investigate co-occurrence and shared personality characteristics of problematic computer gaming, problematic gambling and substance use. Methods: Cross-sectional survey data were collected from 2, 553 German students aged 12-25 years. Self-report measures of substance use (alcohol, tobacco and cannabis), problematic gambling (South Oaks Gambling Screen - Revised for Adolescents, SOGS-RA), problematic computer gaming (Video Game Dependency Scale, KFN-CSAS-II), and of twelve different personality characteristics were obtained. Results: Analyses revealed positive correlations between tobacco, alcohol and cannabis use and a smaller positive correlation between problematic gambling and problematic computer gaming. Problematic computer gaming co-occurred only with cannabis use, whereas problematic gambling was associated with all three types of substance use. Multivariate multilevel analyses showed differential patterns of personality characteristics. High impulsivity was the only personality characteristic associated with all five addictive behaviours. Depression and extraversion were specific to substance users. Four personality characteristics were specifically associated with problematic computer gaming: irritability/aggression, social anxiety, ADHD, and low self-esteem. Conclusions: Problematic gamblers seem to be more similar to substance users than problematic computer gamers. From a personality perspective, results correspond to the inclusion of gambling in the same DSM-V category as substance use and question a one-to-one proceeding for computer gaming.

Wan YKP. The social, economic and environmental impacts of casino gaming in Macao: the community leader perspective. Journal of Sustainable Tourism 20(5): 737-755, 2012. (73 refs.)

This study describes the global casino and casino tourism boom. It investigates in detail the social, economic and environmental consequences of casino gaming in Macao since casino license liberalization in 2002. Building on earlier quantitative studies, in-depth face-to-face interviews with 17 key community leaders elicited their professional views on the impact of casino gaming on the community. The community leaders suggest that although casino gaming does make positive social, economic and environment contributions to the community, greater effort is needed to minimize its negative social and environmental consequences. Issues that need addressing include the changing values of teenagers, the high student drop-out rate, problem gambling and crime, changing family relationships, increasing tension between public needs and casino land requirements, traffic congestion, and air and noise pollution. Macao residents' acceptance level of the further development of casino gaming is found to be high, and their perceptions of its impact can be explained by the social exchange theory, rather than by social disruption theory. The results of this paper shed light on the community impact of casinos, and offer policy and governance implications for destination managers in Macao and other destinations with, or intentions to develop, casinos and gaming-related tourism.

Weinstein A; Weizman A. Emerging association between addictive gaming and Attention-Deficit/Hyperactivity Disorder. Current Psychiatry Reports 14(5): 590-597, 2012. (67 refs.)

Children's and adolescent's use of computer games and videogames is becoming highly popular and has increased dramatically over the last decade. There is growing evidence of high prevalence of addiction to computer games and videogames among children, which is causing concern because of its harmful consequences. There is also emerging evidence of an association between computer game and videogame addiction and attention deficit/hyperactivity disorder (ADHD). This is indicated by the occurrence of gaming addiction as a co-morbid disorder of ADHD, common physiological and pharmacological mechanisms, and potential genetic association between the two disorders. A proper understanding of the psychological and neurotransmitter mechanisms underlying both disorders is important for appropriate diagnostic classification of both disorders. Furthermore, it is important for development of potential pharmacological treatment of both disorders. Relatively few studies have investigated the common mechanisms for both disorders. This paper reviews new findings, trends, and developments in the field. The paper is based on a literature search, in Medline and PUBMED, using the keywords addictive gaming and ADHD, of articles published between 2000 and 2012.

Wong IA; Fong HIV; Liu MT. Understanding perceived casino service difference among casino players. International Journal of Contemporary Hospitality Management 24(4-5): 753-773, 2012. (105 refs.)

Purpose - This paper aims to investigate customers' perceptions of four service quality aspects service environment, service delivery, game service, and food service in the casino setting among Chinese players. Design/methodology/approach - The study examined the proposed model through a 2(gambler type: leisure versus hardcore) x 2(gender: male versus female) multivariate analysis of variance of the four casino service quality aspects. Findings - Based on a sample of leisure and hardcore casino players, the results show significant differences between the two types of patrons on the four casino service dimensions. In addition, significant gender-by-player interaction is revealed. Research limitations/implications - This study sheds new light on the understanding of the direct and moderating roles of gender and type of casino players on service evaluation in the literature. The research findings should be interpreted with caution as the results are derived from a Vegas-like casino in Macau among a mass-market Chinese casino clientele. Practical implications - The findings extend service research by illuminating perceptual differences in different casino service quality dimensions in the Asian leisure milieu. Casino operators should take customers' gender and player type into account and design service offerings that are more attractive to female and leisure consumers, as they represent a large potential casino clientele. Originality/value - The findings extend the customer contact model and further the understanding in regard to the service quality perception in the burgeoning casino gambling industry in the Far East.

Zheng V; Hung EPW. Evaluating the economic impact of casino liberalization in Macao. Journal of Gambling Studies 28(3): 541-559, 2012. (24 refs.)

This paper aims to evaluate the economic impact after Macao decided to liberalize its gaming industry. By analysing both objective data of official statistics and subjective data of the perceptions of quality of life, we painted a picture of mixed blessings. Although objective indicators showed strong economic growth in terms of a rise in per capita GDP and public revenue as well as a decline in unemployment rate, subjective indicators revealed that local residents were less than optimistic about their own employment outlook and did not perceive any improvement in their overall economic situation. While casino liberalization brought forth tremendous economic gain, the general population did not subjectively feel the benefits. An integrative analysis of both objective and subjective indicators would therefore allow us to look closer how residents' lives in the micro-level could have been adversely affected by the prosperous economic outlook at the macro-level.

Zhou K; Tang H; Sun Y; Huang GH; Rao LL; Liang ZY et al. Belief in luck or in skill: Which locks people into gambling? Journal of Gambling Studies 28(3): 379-391, 2012. (53 refs.)

According to the social axioms framework, people's beliefs about how the world functions (i.e., internal or external locus of control) are related to their social behaviors. Previous researchers have attempted to relate locus of control to gambling behavior, but the results have not been clear-cut. The present study speculated that the effects of perceived control (i.e., belief in luck and belief in skill) on gambling behavior are domain-specific and vary with the type of gambling. A total of 306 adult Macau residents ranging in age from 18 to 65 with casino gambling experience were recruited by going door to door. Empirical data on gambling frequency and perceived control relating to 13 types of gambling were collected. Our results demonstrated that the effects of belief in luck or skill on gambling behavior varied across different gambling categories. Specifically, for football lottery, Chinese lottery, and baccarat, it was not belief in skill but rather belief in luck that was a positive significant predictor of gambling frequency. Only for slot machines and stud poker did belief in skill significantly predict gambling frequency. For the remaining eight gambling categories, neither belief in luck nor belief in skill could predict gambling frequency. Our findings indicate that neither internal nor external locus of control can consistently explain people's gambling behaviors. Instead, which factor plays a greater role in a person's gambling behavior is dependent on the gambling type. Therefore, the finding that not all gambles are created equal might be a promising avenue for further research and treatment approaches.