Browsing by Author "Hodgins, David C"
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- ItemOpen AccessDeveloping and testing the effectiveness of a novel online integrated treatment for problem gambling and tobacco smoking: a protocol for an open-label randomized controlled trial(2020-11-19) Bilevicius, Elena; Single, Alanna; Baumgartner, Chris; Bui, Van; Kempe, Tyler; Schaub, Michael P; Stewart, Sherry H; MacKillop, James; Hodgins, David C; Wardell, Jeffrey D; O’Connor, Roisin; Read, Jennifer; Hadjistavropoulos, Heather; Sundstrom, Christopher; Keough, Matthew TAbstract Background Gambling and tobacco smoking are highly comorbid among North American adults. However, there is a paucity of treatment options that are integrated (i.e. targeting both gambling and tobacco smoking simultaneously), accessible, and evidence based. Methods The aim of this two-arm open-label randomized controlled trial is to examine the effectiveness of an online, self-guided integrated treatment for problem gambling and tobacco smoking. A target sample of 214 participants will be recruited and be randomized into either an 8-week integrated or gambling only control condition. Both conditions will consist of seven online modules following cognitive behavioural therapy and motivational interviewing principles. Our three primary outcomes are (1) the number of days gambled, (2) money spent on gambling activities, and (3) time spent in gambling activities. Secondary outcomes include gambling disorder symptoms, cigarette use, and nicotine dependence symptoms. Assessments will be completed at baseline, at completion (i.e. 8 weeks from baseline), and at follow-up (i.e. 24 weeks from baseline). Generalized linear mixed modelling will be used to evaluate our primary and secondary outcomes. We expect that participants receiving online integrated treatment will show larger reductions in gambling relative to those receiving a control gambling only intervention. We further hypothesize that reductions in smoking will mediate these group differences. Discussion The rates of problem gambling and tobacco smoking are high in North America; yet, the treatment options for both are limited, with no integrated treatments available. If supported, our pilot study will be a cost-effective and accessible way to improve treatments for co-occurring problem gambling and tobacco use. Trial registration ClinicalTrials.gov NCT03614884 . Registered on August 3, 2019
- ItemOpen AccessInsights from individuals successfully recovered from cannabis use disorder: natural versus treatment-assisted recoveries and abstinent versus moderation outcomes(2018-07-30) Hodgins, David C; Stea, Jonathan NAbstract Background Increasing understanding of the pathways and processes of recovery from cannabis use disorder may help in designing effective and attractive interventions to promote recovery. We report insights from individuals who had successfully recovered from cannabis use disorder with a variety of pathways. Recovered individuals describe their perceptions of why they developed the problem, why they were successful in recovering, and the advice they would offer to individuals with similar problems. Methods Media announcements were used to recruit 119 volunteers who met lifetime but not past year criteria for cannabis use disorder. Participants were asked open-ended questions which were content analyzed and compared between individuals who whose recoveries were treatment-assisted (45%) versus natural (55%) and between individuals who were abstinent (57%) versus those who continued non-problematic consumption (43%). Results Participants most frequently described their problems as having developed due to the use of cannabis to cope, because of environmental and social influences, and enjoyment of the positive effects. Success in recovery was attributed to focusing on reasons for change, goal commitment to change, and conquering denial/self-deception. Treatment-assisted participants were more likely to perceive that they overcame their cannabis problem due to treatment/self-help and conquering underlying issues, whereas naturally recovered participants were more likely to describe focusing on reasons for change, will power, and lost enjoyment/lifestyle change. Treatment-assisted participants were more likely to recommend seeking help/social support and naturally recovered participants were more likely to endorse reflecting on reasons for change, engaging in hobbies/distracting activities, and stimulus control/avoidance/change social environment. The majority recommended professional treatment (79.1%) and self-help materials (76.9%), and a little over half (53.2%) would also recommend natural recovery. Conclusions These insights from people with lived experience further support previous research that treatment-assisted and natural recoveries are for the most part similar with respect to the recovery process. However, participants, whether or not they had had treatment involvement, recommended the use of treatment and self-help materials to sharpen their focus on the reasons to change and to enhance their commitment to change. At the same time, they saw value in the efforts of individuals to recovery without help.
- ItemOpen AccessThe ‘light drugs’ of gambling? Non-problematic gambling activities of pathological gamblers(Taylor & Francis Online, 2013-10-30) Konkoly-Thege, Barna; Hodgins, David COur aim was to investigate whether harmless gambling activities exist for pathological gamblers. A total of 169 pathological gamblers who recently quit were recruited by media announcements. Respondents were asked at baseline to report any gambling activities not causing them problems, as well as those causing problems. The gambling activities were categorized as follows: lottery, scratch tickets, bingo, betting or card games with friends/family, horse racing, raffle, casino games and video lottery terminals. Only a small proportion (16%) of respondents reported not having any non-problematic gambling activities, 45% reported one, 28% two, 10% three, and 1% four non-problematic activities. Further, involvement in most of these activities was unrelated to both baseline and follow-up gambling problem severity (NODS, SOGS), depression level (CES-D), frequency of gambling and extent of gambling losses. However, some exceptions were observed in case of involvement in casino (higher NODS and SOGS scores and gambling-related losses) and bingo games (higher gambling-related losses). These findings provide some support for the idea that pathological gamblers who wish to give up harmful gambling can continue involvement in some types of gambling and that this is a ‘good enough’ goal for pathological gamblers; complete abstinence may not be necessary.
- ItemOpen AccessNatural course of behavioral addictions: a 5-year longitudinal study(BMC Psychiatry, 2015-01-22) Konkoly-Thege, Barna; Woodin, Erica M; Hodgins, David C; Williams, Robert JBackground Resolving the theoretical controversy on the labeling of an increasing number of excessive behaviors as behavioral addictions may also be facilitated by more empirical data on these behavioral problems. For instance, an essential issue to the classification of psychiatric disorders is information on their natural course. However, longitudinal research on the chronic vs. episodic nature of behavioral addictions is scarce. The aim of the present study, therefore, was to provide data on prevalence, substance use comorbidity, and five-year trajectories of six excessive behaviors—namely exercising, sexual behavior, shopping, online chatting, video gaming, and eating. Methods Analyses were based on the data of the Quinte Longitudinal Study, where a cohort of 4,121 adults from Ontario, Canada was followed for 5 years (2006 to 2011). The response rate was 21.3%, while retention rate was 93.9%. To assess the occurrence of each problem behavior, a single self-diagnostic question asked people whether their over-involvement in the behavior had caused significant problems for them in the past 12 months. To assess the severity of each problem behavior reported, the Behavioral Addiction Measure was administered. A mixed design ANOVA was used to investigate symptom trajectories over time for each problem behavior and whether these symptom trajectories varied as a function of sex. Results The large majority of people reported having problematic over-involvement for just one of these behaviors and just in a single time period. A main effect of time was found for each problem behavior, indicating a moderately strong decrease in symptom severity across time. The time x sex interaction was insignificant in each model indicating that the decreasing trend is similar for males and females. The data also showed that help seeking was very low in the case of excessive sexual behavior, shopping, online chatting, and video gaming but substantially more prevalent in the case of excessive eating and exercising. Conclusions The present results indicate that self-identified excessive exercising, sexual behavior, shopping, online chatting, video gaming, and/or eating tend to be fairly transient for most people. This aspect of the results is inconsistent with conceptualizations of addictions as progressive in nature, unless treated.
- ItemOpen AccessOnline interventions for problem gamblers with and without co-occurring problem drinking: study protocol of a randomized controlled trial(2018-05-25) Cunningham, John A; Hodgins, David C; Keough, Matthew; Hendershot, Christian S; Bennett, Kylie; Bennett, Anthony; Godinho, AlexandraAbstract Background The current randomized controlled trial seeks to evaluate whether providing access to an Internet intervention for problem drinking in addition to an Internet intervention for problem gambling is beneficial for participants with gambling problems who do or do not have co-occurring problem drinking. Methods Potential participants will be recruited online via a comprehensive advertisement strategy, if they meet the criteria for problem gambling. As part of the baseline measures, problem drinking will also be assessed. Eligible participants (N = 280) who agree to partake in the study and to be followed up for 6 months will be randomized into one of two versions of an Internet intervention for gamblers: an intervention that targets only gambling issues (G-only) and one that combines a gambling intervention with an intervention for problem drinking (G + A). For problem gamblers who exhibit co-occurring problem drinking, it is predicted that participants who are provided access to the G + A intervention will demonstrate a significantly greater level of reduction in gambling outcomes at 6 months compared to those provided access to the G-only intervention. Discussion This trial will expand upon the current research on Internet interventions for addictions and inform the development of treatments for those with co-occurring problem drinking and gambling. Trial Registration ClinicalTrials.gov, NCT03323606 . Registered on 24 October 2017.
- ItemOpen AccessPerceptions of plain packaging and health warning labels for cannabis among young adults: findings from an experimental study(2018-12-10) Mutti-Packer, Seema; Collyer, Brianne; Hodgins, David CAbstract Background There is strong evidence that plain cigarette packaging and health warning labels (HWLs) reduce brand appeal and increase health knowledge. There is limited evidence examining this population-level public health approach for cannabis packaging. This issue is of particular importance in light of the recent legalization of recreational cannabis in Canada. The current study examined perceptions of plain packaging and HWLs for cannabis packages among young adults. Methods An online experimental study was conducted with a sample of university students in Alberta, Canada (n = 656). Respondents were randomly assigned to view cannabis packages in one of four conditions: Condition 1: branded pack, Condition 2: plain pack (uniform color, brand imagery removed, standardized font), Condition 3: branded pack with a HWL, and Condition 4: plain pack with a HWL. Respondents in Conditions 3 and 4 viewed five text-based HWLs, each corresponding to a health effect associated with cannabis use: (1) brain development, (2) mental health issues, (3) impaired driving, (4) nonlethal overdose, and (5) addiction. After viewing packs, respondents rated packs and health warnings on various measures. Results Branded packages without HWLs were rated as most appealing compared to all other packs (p < 0.001 for all contrasts). No differences were found in ratings of appeal when comparing branded and plain packs with HWLs. Warning messages for cognitive development and impaired driving were rated highest on levels of perceived effectiveness, believability, and fear, whereas the addiction warning was rated among the lowest. In general, there were gaps in health knowledge related to cannabis use, however after viewing packs with warnings (compared to viewing packs without warnings) levels of health knowledge increased across all health effects (p < 0.01 for all). Lastly, a significant majority of young adults reported they would purchase the branded pack without a HWL (39.5%), compared to all other pack types (p < 0.05 for all contrasts). The lowest proportion of young adults reported they would purchase a plain pack with a HWL (1.1%). Conclusions Plain packaging and health warnings may reduce brand appeal and increase health knowledge among young adults.
- ItemOpen AccessPredicting future harm from gambling over a five-year period in a general population sample: a survival analysis(2021-01-07) Currie, Shawn R; Hodgins, David C; Williams, Robert J; Fiest, KirstenAbstract Background There is little longitudinal evidence on the cumulative risk of harm from gambling associated with excess spending and frequency of play. The present study sought to assess the risk of gambling problems over a five-year period in adults who exceed previously derived low-risk gambling limits compared to those who remain within the limits after controlling for other modifiable risk factors. Methods Participants were adults (N = 4212) drawn from two independent Canadian longitudinal cohort studies who reported gambling in the past year and were free of problem gambling at time 1. Multivariate Cox regression was employed to assess the impact over time of gambling above low-risk gambling thresholds (frequency ≥ 8 times per month; expenditure ≥75CAD per month; percent of household income spent on gambling ≥1.7%) on developing moderate harm and problem gambling. Covariates included presence of a DSM5 addiction or mental health disorder at time 1, irrational gambling beliefs, number of stressful life events in past 12 months, number of game types played each year, and playing electronic gaming machines or casino games. Results In both samples, exceeding the low-risk gambling limits at time 1 significantly increased the risk of moderate harm (defined as ≥2 consequences on the Problem Gambling Severity Index [PGSI]) within 5 years after controlling for other modifiable risk factors. Other significant predictors of harm were presence of a mental disorder at time 1, cognitive distortions about gambling, stressful life events, and playing electronic gaming machines or casino games. In one sample, the five-year cumulative survival rate for moderate harm among individuals who stayed below all the low-risk limits was 95% compared to 83% among gamblers who exceeded all limits. Each additional low-risk limit exceeded increased the cumulative probability of harm by 30%. Similar results were found in models when the outcome was problem gambling. Conclusions Level of gambling involvement represents a highly modifiable risk factor for later harm. Staying below empirically derived safe gambling thresholds reduces the risk of harm over time.
- ItemOpen AccessRelationship between interpersonal trauma exposure and addictive behaviors: a systematic review(2017-05-04) Konkolÿ Thege, Barna; Horwood, Lewis; Slater, Linda; Tan, Maria C; Hodgins, David C; Wild, T. CAbstract Background The aim of this study was to systematically summarize knowledge on the association between exposure to interpersonal trauma and addictive behaviors. Extant reviews on this association focused on a restricted range of substance-related addictions, and/or used a narrative instead of a systematic approach. Methods Systematic searches of 8 databases yielded 29,841 studies, of which 3054 studies were included and subsequently classified in relation to study design (scoping review). A subset of observational studies (N = 181) prospectively investigating the relationship between exposure to interpersonal traumata and subsequent behavioral or substance-related addiction problems were characterized. Heterogeneity in study methodologies and types of addictive behaviors and traumatic experiences assessed precluded meta-analysis. Instead, the proportions of associations tested in this literature that revealed positive, negative, or null relationships between trauma exposure and subsequent addictive behaviors were recorded, along with other methodological features. Results Of 3054 included studies, 70.7% (n = 2160) used a cross-sectional design. In the 181 prospective observational studies (407,041 participants, 98.8% recruited from developed countries), 35.1% of the tested associations between trauma exposure and later addictive behaviors was positive, 1.3% was negative, and 63.6% was non-significant. These results were primarily obtained among non-treatment seeking samples (80.7% of studies; n = 146), using single and multi-item measures of addictive behaviors of unknown psychometric quality (46.4% of studies). Positive associations were more frequently observed in studies examining childhood versus adult traumatization (39.7% vs. 29.7%). Conclusions Longitudinal research in this area emphasizes alcohol abuse, and almost no research has examined behavioral addictions. Results provide some support for a positive association between exposure to interpersonal trauma and subsequent addictive behaviors but this relationship was not consistently reported. Longitudinal studies typically assessed trauma exposure retrospectively, often after addictive behavior onset, thus precluding robust inferences about whether traumatization affects initial onset of addictive behaviors.
- ItemOpen AccessSocial judgments of behavioral versus substance-related addictions: A population-based study(Science Direct, 2014-11-01) Konkoly-Thege, Barna; Colman, Ian; el-Guebaly, Nady; Hodgins, David C; Patten, Scott B; Schopflocher, Don; Wolfe, Jody; Wild, T CameronBackground Recently, the concept of addiction has expanded to include many types of problematic repetitive behaviors beyond those related to substance misuse. This trend may have implications for the way that lay people think about addictions and about people struggling with addictive disorders. The aim of this study was to provide a better understanding of how the public understands a variety of substance-related and behavioral addictions. Methods A representative sample of 4000 individuals from Alberta, Canada completed an online survey. Participants were randomly assigned to answer questions about perceived addiction liability, etiology, and prevalence of problems with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (problematic gambling, eating, shopping, sexual behavior, video gaming, and work). Results Bivariate analyses revealed that respondents considered substances to have greater addiction liability than behaviors and that most risk factors (moral, biological, or psychosocial) were considered as more important in the etiology of behavioral versus substance addictions. A discriminant function analysis demonstrated that perceived addiction liability and character flaws were the two most important features differentiating judgments of substance-related versus behavioral addictions. Perceived addiction liability was judged to be greater for substances. Conversely, character flaws were viewed as more associated with behavioral addictions. Conclusions The general public appreciates the complex bio–psycho-social etiology underlying addictions, but perceives substance-related and behavioral addictions differently. These attitudes, in turn, may shape a variety of important outcomes, including the extent to which people believed to manifest behavioral addictions feel stigmatized, seek treatment, or initiate behavior changes on their own.
- ItemOpen AccessSubstance-related and behavioural addiction problems: Two surveys of Canadian adults(Addiction Research & Theory, 2014-06-13) Konkoly-Thege, Barna; Colman, Ian; El-guebaly, Nady; Hodgins, David C; Patten, Scott B; Schopflocher, Don; Wolfe, Jody; Wild, T CameronObjectives: To describe absolute and relative prevalence of 10 self-attributed substance-related and behavioural addiction problems among Canadian adults, to describe perceived prevalence of these problems in the general population, and to examine whether estimates varied by survey mode. Methods: Sample 1 included 4000 adults recruited from an online research panel; Sample 2 included 2000 randomly selected adults who completed a computer-assisted telephone interview. Respondents in both samples were asked (1) whether or not they had experienced a problem in the preceding year with each of four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviours (gambling, eating, shopping, sex, video gaming, and work), (2) whether they had ever personally knew someone exhibiting a problem with each behaviour, and (3) perceived prevalence of problems in the general population. Results: About half of the respondents reported experiencing any past-year addiction problems. Tobacco and alcohol were the most common substance-related problems, while the most common behavioural problems were related to eating and work. Respondents consistently overestimated perceived population prevalence relative to self-attributed problems; however, the magnitude of overestimation was significantly greater among those who personally reported a problem with these behaviours. Online survey participants consistently reported higher self-attributed problem rates compared with CATI respondents, but rank-order correlations across self-, acquaintances-, and population-attributed prevalence estimates were very high in both samples. Conclusions: Both survey modes provided accurate relative prevalence estimates, but further research should explore determinants of higher prevalence rates among online participants and respondents’ consistent tendency to overestimate perceived population prevalence.
- ItemOpen AccessThe protective role of religiosity against problem gambling: findings from a five-year prospective study(2017-11-06) Mutti-Packer, Seema; Hodgins, David C; Williams, Robert J; Konkolÿ Thege, BarnaAbstract Background Little research has examined the potential protective influence of religiosity against problem gambling; a common addictive behavior, and one with a host of associated negative health and social outcomes. The aims of this study were to examine (1) the potential longitudinal association between religiosity and problem gambling among adults and (2) the potential moderating role of gender on this association. Methods Data were from five waves of the Quinte Longitudinal Study (QLS), between 2006 and 2010. Participants were Canadian adults from Belleville, Ontario, Canada (n = 4121). A multiple group (based on gender) latent growth curve analysis was conducted to examine the overall trajectory of problem gambling severity. Two models were tested; the first examined the influence of past-year religious service attendance, and the second examined an overall measure of personal religiosity on the trajectory of problem gambling. The Problem and Pathological Gambling Measure (PPGM) was used as a continuous measure. The Rohrbaugh-Jessor Religiosity Scale (RJRS) was used to assess past-year frequency of religious service attendance and personal religiosity. Religious affiliation (Protestant, Catholic, Atheist/Agnostic, Other, Prefer not to say) was also included in the models. Results At baseline, higher frequency of past-year religious service attendance (males: β= −0.54, females: β= −0.68, p < 0.001 for both) and greater overall personal religiosity (males: β= −0.17, females: β= −0.13, p < 0.001 for both) were associated with lower PPGM scores. The moderating effect of gender indicated that the influence of past-year religious service attendance was greater among females (χ2diff(44) = 336.8, p < 0.001); however, the effect of overall religiosity was greater among males (χ2diff(36) = 213.4, p < 0.001). Findings were mixed with respect to religious affiliation. No measures of religiosity or religious affiliation were associated with the overall decline in problem gambling severity. Conclusions These findings suggest that religiosity may act as a static protective factor against problem gambling severity but may play a less significant role in predicting change in problem gambling severity over time.