Journal of Clinical Medicine

Research

10 pages, 737 KiB

Open AccessArticle

Psychosocial Factors Affecting Drug Relapse among Youth in Punjab, Pakistan

by Najma Iqbal Malik, Sidra Saleem, Irfan Ullah, Syeda Tayyaba Rehan, Domenico De Berardis and Mohsin Atta

J. Clin. Med. 2023, 12(7), 2686; https://doi.org/10.3390/jcm12072686 - 04 Apr 2023

Cited by 2 | Viewed by 2433

Abstract

The present study was intended to examine the effect of psychosocial factors on the stigma of mental illness among people addicted to drugs who have relapsed in Punjab, Pakistan. A sample composed of 116 people addicted to drugs and who have relapsed was [...] Read more.

The present study was intended to examine the effect of psychosocial factors on the stigma of mental illness among people addicted to drugs who have relapsed in Punjab, Pakistan. A sample composed of 116 people addicted to drugs and who have relapsed was collected through the purposive sampling technique. Certain self-report measures were used to assess the pertinent study variables. The results elucidated that self-efficacy, social support, and conscientiousness were found to be negative predictors and neuroticism a positive predictor of stigma. The results also confirmed social support as being a significant moderator in the relationship between self-efficacy and stigma, and self-efficacy as being a significant moderator in the relationship between social support and stigma. It was safe to conclude that psychosocial factors such as self-efficacy, social support, personality traits and stigma have a significant role in causing addiction relapse. The conclusions made have been discussed thoroughly. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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19 pages, 353 KiB

Open AccessArticle

Problematic Internet Use among Adults: A Cross-Cultural Study in 15 Countries

by Olatz Lopez-Fernandez, Lucia Romo, Laurence Kern, Amélie Rousseau, Bernadeta Lelonek-Kuleta, Joanna Chwaszcz, Niko Männikkö, Hans-Jürgen Rumpf, Anja Bischof, Orsolya Király, Ann-Kathrin Gässler, Pierluigi Graziani, Maria Kääriäinen, Nils Inge Landrø, Juan José Zacarés, Mariano Chóliz, Magali Dufour, Lucien Rochat, Daniele Zullino, Sophia Achab, Zsolt Demetrovics, Mark D. Griffiths and Daria J. Kuss Show full author list Hide full author list

J. Clin. Med. 2023, 12(3), 1027; https://doi.org/10.3390/jcm12031027 - 29 Jan 2023

Cited by 3 | Viewed by 3334

Abstract

Background: The present study compared adult usage patterns of online activities, the frequency rate of problematic internet use (PIU), and risk factors (including the psychopathology associated with PIU, i.e., distress and impulsivity) among adults in 15 countries from Europe, America, and Asia. Methods: [...] Read more.

Background: The present study compared adult usage patterns of online activities, the frequency rate of problematic internet use (PIU), and risk factors (including the psychopathology associated with PIU, i.e., distress and impulsivity) among adults in 15 countries from Europe, America, and Asia. Methods: A total of 5130 adults from Belgium, Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Peru, Canada, US, and Indonesia completed an online survey assessing PIU and a number of psychological variables (i.e., depression, anxiety, stress, and impulsivity). The sample included more females, with a mean age of 24.71 years (SD = 8.70). Results: PIU was slightly lower in European countries (rates ranged from 1.1% in Finland to 10.1% in the UK, compared to 2.9% in Canada and 10.4% in the US). There were differences in specific PIU rates (e.g., problematic gaming ranged from 0.4% in Poland to 4.7% in Indonesia). Regression analyses showed that PIU was predicted by problematic social networking and gaming, lack of perseverance, positive urgency, and depression. Conclusions: The differences in PIU between countries were significant for those between continental regions (Europe versus non-European countries). One of the most interesting findings is that the specific PIU risks were generally low compared to contemporary literature. However, higher levels of PIU were present in countries outside of Europe, although intra-European differences existed. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

14 pages, 617 KiB

Open AccessArticle

Problematic Use of Social Networks during the First Lockdown: User Profiles and the Protective Effect of Resilience and Optimism

by Covadonga González-Nuevo, Marcelino Cuesta, José Muñiz, Álvaro Postigo, Álvaro Menéndez-Aller and Daria J. Kuss

J. Clin. Med. 2022, 11(24), 7431; https://doi.org/10.3390/jcm11247431 - 15 Dec 2022

Cited by 1 | Viewed by 1599

Abstract

During the first lockdown, there was an increase in time spent using Social Networking Sites (SNS), which should be studied, as well as problematic SNS use. The present study has three objectives: to evaluate (i) the differences across gender and age and SNS [...] Read more.

During the first lockdown, there was an increase in time spent using Social Networking Sites (SNS), which should be studied, as well as problematic SNS use. The present study has three objectives: to evaluate (i) the differences across gender and age and SNS type in increased SNS use, (ii) problematic SNS use during lockdowns, and (iii) the protective role of resilience and optimism on problematic SNS use. A total of 1003 participants (75.5% women) over 18 years old participated (M = 42.33; SD = 14.32 years). The use of SNS before and during lockdown, anxiety, depression, life satisfaction and problematic SNS use were evaluated. A repeated measures ANOVA and four regression analyses were calculated for the first objective regarding increased SNS use. Another linear regression analysis was calculated for the second objective regarding problematic SNS use. A correlational analysis has been performed to assess the protective roles of resilience and optimism. Differences in the increased use of SNS were found between the two time points and between the different types of SNS. Higher use of Instagram and YouTube was related to younger age. Being female was associated with higher Instagram use. Significant problematic use was found to be associated with younger age but was not dependent on gender. Higher levels of resilience and optimism were related to a lower level of problematic SNS use. SNS use during lockdown needs to be studied in order to understand factors that may protect against undesirable psychological consequences and support prevention programs. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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22 pages, 1017 KiB

Open AccessArticle

Coping and Co-Occurrence of Gaming Disorder and Substance Use in Recovering Substance Users

by Tyrone L. Burleigh, Mark D. Griffiths, Alexander Sumich, Grace Y. Wang and Daria J. Kuss

J. Clin. Med. 2022, 11(24), 7370; https://doi.org/10.3390/jcm11247370 - 12 Dec 2022

Cited by 2 | Viewed by 1654

Abstract

Background: There are a wide range of negative effects associated with both substance use disorders and behavioural disorders and their co-occurrence. Understanding the way in which at-risk populations (e.g., substance-abstinent users) interact with potentially addictive behaviours (e.g., gaming) and substance use—while navigating life [...] Read more.

Background: There are a wide range of negative effects associated with both substance use disorders and behavioural disorders and their co-occurrence. Understanding the way in which at-risk populations (e.g., substance-abstinent users) interact with potentially addictive behaviours (e.g., gaming) and substance use—while navigating life stressors through differing coping styles—can inform preventative strategies. Methods: Therefore, the present study investigated 64 clinical participants and 138 general population participants. Each cohort was required to complete a battery of psychometric scales exploring problematic behaviours, problematic substance use, co-occurrence, and coping styles. Additional exploratory direct comparisons of gamers in the clinical cohort and gamers in the general cohort were carried out. Results: The study’s findings suggest that gamers from different populations (i.e., general and clinical) share similar at-risk behaviours. These problematic behaviours were more pronounced among abstinent substance use gamers, and more specifically among poly-substance use gamers. Conclusions: The findings of the present study add to the literature and suggest that dysfunctional coping style and the co-occurrence of problematic behaviours may have an impact on the assessment and potential treatment of substance abstinent gamers. The findings offer support for an integrated treatment approach, wherein both substance use and the other problematic behaviours (e.g., gaming) are considered in tandem. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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13 pages, 1770 KiB

Open AccessArticle

Social Connectedness and Associations with Gambling Risk in New Zealand

by Grace Y. Wang and Maria E. Bellringer

J. Clin. Med. 2022, 11(23), 7123; https://doi.org/10.3390/jcm11237123 - 30 Nov 2022

Viewed by 1557

Abstract

Multiple factors are associated with disordered gambling, with some populations having a greater risk for developing disordered gambling than others. The present study, utilising data previously collected for a New Zealand (NZ) national gambling survey, explored the associations of social connectedness and leisure [...] Read more.

Multiple factors are associated with disordered gambling, with some populations having a greater risk for developing disordered gambling than others. The present study, utilising data previously collected for a New Zealand (NZ) national gambling survey, explored the associations of social connectedness and leisure activities with risky gambling behaviour and quality of life. Poorer social connectedness and leisure activities were found to be associated with increased gambling risk and poorer quality of life, respectively. Social connectedness and leisure activities strongly predicted type of gambling activities and quality of life. Furthermore, Māori (NZ’s indigenous population) had lower social connectedness and fewer leisure activities, and a greater gambling risk, as well as higher psychological distress, than the NZ European/Other population. These findings indicate that the risk of progressing from recreational gambling to risky gambling is relatively higher for Māori, and that social connectedness and leisure activities could be contributing factors for this increased risk. It is, therefore, important that social connectedness and leisure activities are seriously considered in public health and treatment efforts to reduce gambling harm for vulnerable populations. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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22 pages, 2237 KiB

Open AccessArticle

On the Role of Stimulus-Response Context in Inhibitory Control in Alcohol Use Disorder

by Filippo Ghin, Christian Beste and Ann-Kathrin Stock

J. Clin. Med. 2022, 11(21), 6557; https://doi.org/10.3390/jcm11216557 - 04 Nov 2022

Cited by 1 | Viewed by 1523

Abstract

The behavioral and neural dynamics of response inhibition deficits in alcohol use disorder (AUD) are still largely unclear, despite them possibly being key to the mechanistic understanding of the disorder. Our study investigated the effect of automatic vs. controlled processing during response inhibition [...] Read more.

The behavioral and neural dynamics of response inhibition deficits in alcohol use disorder (AUD) are still largely unclear, despite them possibly being key to the mechanistic understanding of the disorder. Our study investigated the effect of automatic vs. controlled processing during response inhibition in participants with mild-to-moderate AUD and matched healthy controls. For this, a Simon Nogo task was combined with EEG signal decomposition, multivariate pattern analysis (MVPA), and source localization methods. The final sample comprised n = 59 (32♂) AUD participants and n = 64 (28♂) control participants. Compared with the control group, AUD participants showed overall better response inhibition performance. Furthermore, the AUD group was less influenced by the modulatory effect of automatic vs. controlled processes during response inhibition (i.e., had a smaller Simon Nogo effect). The neurophysiological data revealed that the reduced Simon Nogo effect in the AUD group was associated with reduced activation differences between congruent and incongruent Nogo trials in the inferior and middle frontal gyrus. Notably, the drinking frequency (but not the number of AUD criteria we had used to distinguish groups) predicted the extent of the Simon Nogo effect. We suggest that the counterintuitive advantage of participants with mild-to-moderate AUD over those in the control group could be explained by the allostatic model of drinking effects. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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9 pages, 393 KiB

Open AccessArticle

Unconscious Conflict Adaptation of Heroin Abstainers

by Ling Li, Changhu Yan, Hua Cao, Ling Yang, Yuchen Luo, Yu Zhao and Xiao Lu

J. Clin. Med. 2022, 11(21), 6504; https://doi.org/10.3390/jcm11216504 - 02 Nov 2022

Viewed by 1044

Abstract

Conflict adaptation is representative of the dynamic cognitive control process, which reflects the adaptability and flexibility of personal cognitive processing. Cognitive control plays an important role in drug use and relapse in addicts. Previous studies have identified conscious conflict adaptation in drug addicts. [...] Read more.

Conflict adaptation is representative of the dynamic cognitive control process, which reflects the adaptability and flexibility of personal cognitive processing. Cognitive control plays an important role in drug use and relapse in addicts. Previous studies have identified conscious conflict adaptation in drug addicts. The present study examined unconscious conflict adaptation in persons with heroin use disorder using an arrow version meta-contrast masking task. The results found that persons with heroin use disorder had smaller unconscious conflict adaptation compared to the healthy control group. This may be a result of functional brain damage caused by long-term drug use. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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13 pages, 688 KiB

Open AccessArticle

Loneliness and the Degree of Addiction to Shopping and Work among Polish Women: The Mediating Role of Depression

by Kamila Rachubińska, Anna Maria Cybulska, Ewa Kupcewicz, Alina Jurewicz, Mariusz Panczyk, Aneta Cymbaluk-Płoska, Justyna Jurczak and Elżbieta Grochans

J. Clin. Med. 2022, 11(21), 6288; https://doi.org/10.3390/jcm11216288 - 25 Oct 2022

Cited by 4 | Viewed by 1713

Abstract

(1) The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women. (2) The study was conducted among 556 [...] Read more.

(1) The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women. (2) The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory, and our own questionnaire. (3) Depression is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (β = −0.0246, z = −2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (β = −0.0722, z = −4.002, p < 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant. (4) Depression plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. An increase in the level of depression increases the degree of addiction to shopping and work. The mediator’s participation lowers the loneliness feeling level. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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9 pages, 258 KiB

Open AccessArticle

The Relationship between Coping and Expressed Emotion in Substance Users

by Grace Y. Wang

J. Clin. Med. 2022, 11(19), 5766; https://doi.org/10.3390/jcm11195766 - 29 Sep 2022

Cited by 1 | Viewed by 1421

Abstract

The involvement of family is an integral part of the recovery process, and the use of adaptive coping strategies has an important implication for treatment outcomes. Little research to date has examined the relationship between coping and family dynamics in substance users, although [...] Read more.

The involvement of family is an integral part of the recovery process, and the use of adaptive coping strategies has an important implication for treatment outcomes. Little research to date has examined the relationship between coping and family dynamics in substance users, although this may help to unravel the mechanism underlining the increased risk of relapse for individuals from critical family environment. The aim of the present research was to assess the association between the level of expressed emotion (LEE) (i.e., criticism), coping style, and psychological distress (i.e., anxiety, depression) in people with substance use disorder (SUD). Compared to control subjects, persons with SUD reported less use of rational coping and detached coping, and perceived greater criticism and irritability from family. A higher degree of family criticism and lack of emotional support was associated with greater use of emotional and avoidance coping in persons with SUD, while psychological distress was more related to rational and detached coping. The present study reveals the unique connection between family relationships, coping and psychological distress, implicating the need to address the influence of family relationships and stress on persons’ coping in SUD treatment. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

Review

Jump to: Research, Other

23 pages, 1371 KiB

Open AccessReview

Effects of Transcranial Electrical Stimulation on Gambling and Gaming: A Systematic Review of Studies on Healthy Controls, Participants with Gambling/Gaming Disorder, and Substance Use Disorder

by Marija Stanković, Jovana Bjekić and Saša R. Filipović

J. Clin. Med. 2023, 12(10), 3407; https://doi.org/10.3390/jcm12103407 - 11 May 2023

Cited by 2 | Viewed by 1729

Abstract

Gambling disorder (GD) and internet gaming disorder (IGD) are formally recognized behavioral addictions with a rapidly growing prevalence and limited treatment options. Recently, transcranial electrical stimulation (tES) techniques have emerged as potentially promising interventions for improving treatment outcomes by ameliorating cognitive functions implicated [...] Read more.

Gambling disorder (GD) and internet gaming disorder (IGD) are formally recognized behavioral addictions with a rapidly growing prevalence and limited treatment options. Recently, transcranial electrical stimulation (tES) techniques have emerged as potentially promising interventions for improving treatment outcomes by ameliorating cognitive functions implicated in addictive behaviors. To systematize the current state of evidence and better understand whether and how tES can influence gambling and gaming-related cognitive processes, we conducted a PRISMA-guided systematic review of the literature, focusing on tES effects on gaming and gambling in a diverse range of population samples, including healthy participants, participants with GD and IGD, as well as participants with substance abuse addictions. Following the literature search in three bibliographic databases (PubMed, Web of Science, and Scopus), 40 publications were included in this review, with 26 conducted on healthy participants, 6 focusing on GD and IGD patients, and 8 including participants with other addictions. Most of the studies targeted the dorsolateral prefrontal cortex, using transcranial direct current stimulation (tDCS), and assessed the effects on cognition, using gaming and gambling computerized cognitive tasks measuring risk taking and decision making, e.g., balloon analogue risk task, Iowa gambling task, Cambridge gambling task, etc. The results indicated that tES could change gambling and gaming task performances and positively influence GD and IGD symptoms, with 70% of studies showing neuromodulatory effects. However, the results varied considerably depending on the stimulation parameters, sample characteristics, as well as outcome measures used. We discuss the sources of this variability and provide further directions for the use of tES in the context of GD and IGD treatment. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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Other

Jump to: Research, Review

20 pages, 719 KiB

Open AccessSystematic Review

Treatment Modalities for Internet Addiction in Children and Adolescents: A Systematic Review of Randomized Controlled Trials (RCTs)

by Shahana Ayub, Lakshit Jain, Shanli Parnia, Anil Bachu, Rabeea Farhan, Harendra Kumar, Amanda Sullivan and Saeed Ahmed

J. Clin. Med. 2023, 12(9), 3345; https://doi.org/10.3390/jcm12093345 - 08 May 2023

Cited by 7 | Viewed by 4225

Abstract

Background: In recent years, the use of the internet among children and adolescents has dramatically increased, leading to growing concerns regarding the potential risks of excessive internet use and addiction. Addressing these concerns, this systematic review aims to summarize current evidence on the [...] Read more.

Background: In recent years, the use of the internet among children and adolescents has dramatically increased, leading to growing concerns regarding the potential risks of excessive internet use and addiction. Addressing these concerns, this systematic review aims to summarize current evidence on the effectiveness of treatment interventions for internet addiction among children and adolescents. Method: We performed a systematic review using PubMed, Web of Science, PsycInfo, and Google Scholar with search terms including “internet addiction”, “problematic internet use”, “children” or “adolescents”, “treatment” and “randomized controlled trial”. We found 10 Randomized Controlled Trials (RCTs) meeting the criteria and included them in this systematic review. Results: This systematic review analyzed 10 randomized controlled trials focused on treatment interventions for internet addiction in adolescents and young adults. The interventions used were diverse, including cognitive-behavioral therapy (CBT), medication, electro-acupuncture (EA), and solution-focused approaches. The measures used to assess the effectiveness of the interventions also varied, but most studies reported moderate to large effect sizes for at least some outcomes. Overall, the studies suggest that interventions such as CBT and EA can be effective in reducing symptoms of internet addiction, internet gaming disorder, and unspecified internet use disorders. School-based programs and brief manualized CBT programs also show promise, though more research is needed to determine their long-term effectiveness. Conclusion: Promising treatment approaches for internet addiction are emerging, but inconsistencies in conceptualization, language, and diagnostic criteria present some challenges. The growing recognition of problematic internet use, as shown by the DSM-5′s recognition of Internet Gaming Disorder, highlights the need for a multidisciplinary approach and standardized criteria to facilitate accurate reporting across studies. Continued research is needed to identify effective treatments and diagnostic criteria for internet addiction, with the potential to offer practical insights into effective medications and therapies. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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60 pages, 2103 KiB

Open AccessSystematic Review

Risky Decision-Making in Adults with Alcohol Use Disorder—A Systematic and Meta-Analytic Review

by Akke-Marij D. Ariesen, Julia H. Neubert, Geraldina F. Gaastra, Oliver Tucha and Janneke Koerts

J. Clin. Med. 2023, 12(8), 2943; https://doi.org/10.3390/jcm12082943 - 18 Apr 2023

Cited by 1 | Viewed by 1569

Abstract

Alcohol use disorder (AUD) forms a major health concern and is the most common substance use disorder worldwide. The behavioural and cognitive deficits associated with AUD have often been related to impairments in risky decision-making. The aim of this study was to examine [...] Read more.

Alcohol use disorder (AUD) forms a major health concern and is the most common substance use disorder worldwide. The behavioural and cognitive deficits associated with AUD have often been related to impairments in risky decision-making. The aim of this study was to examine the magnitude and type of risky decision-making deficits of adults with AUD, as well as to explore the potential mechanisms behind these deficits. To this end, existing literature comparing risky decision-making task performance of an AUD group to a control group (CG) was systematically searched and analysed. A meta-analysis was performed to address overall effects. In total, 56 studies were included. In the majority of studies (i.e., 68%), the performance of the AUD group(s) deviated from the CG(s) on one or more of the adopted tasks, which was confirmed by a small to medium pooled effect size (Hedges’ g = 0.45). This review therefore provides evidence of increased risk taking in adults with AUD as compared to CGs. The increased risk taking may be due to deficits in affective and deliberative decision-making. Making use of ecologically valid tasks, future research should investigate whether risky decision-making deficits predate and/or are consequential to the addiction of adults with AUD. Full article

(This article belongs to the Special Issue Substance and Behavioral Addictions: Updates on Etiology and Clinical Interventions)

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