A growing proportion of young adults report regularly playing video games and using electronic nicotine delivery systems (ENDS). Although video gaming is often normative and adaptive, excessive gaming is associated with adverse health outcomes and dependency, as seen in gaming disorder/internet gaming disorder (GD/IGD). Possible additive detrimental effects of ENDS use on the physical outcomes of GD/IGD lend particular concern to these concurrent behaviors. The present study explored group differences in concurrent ENDS and GD/IGD dependency by demographic factors, including age, sex, gender, sexual orientation, racial identity, relationship status, and year in school. The interaction effect of symptoms of attention-deficit hyperactivity disorder (ADHD) on the association between ENDS dependency and GD/IGD was also examined. Lastly, group differences in ADHD symptoms for individuals who endorse (1) neither GD/IGD nor ENDS dependency, (2) either GD/IGD or ENDS dependency, or (3) both GD/IGD and ENDS dependency were explored. Data were collected in a large, multi-university sample of college students (N = 1,054). Higher symptoms of GD/IGD were positively associated with greater symptoms of ENDS dependency. Men and individuals with significant symptoms of ADHD were at an increased risk of concurrent GD/IGD and ENDS dependency. These results may be used to identify demographic and psychological associations linked to these comorbidities, ultimately informing future prevention strategies.

Background: Treatment providers have applied contingency management (CM) treatment, an intervention that often rewards individuals for drug abstinence (i.e., ABS CM), to treatment engagement as well. However, we know little about the magnitude of treatment effects when providers target attendance behaviors (i.e., ATT CM). Methods: This study conducted a systematic search to identify studies that included ATT CM, either in isolation or in combination with ABS CM. The study used meta-analysis to estimate the effect size of ATT CM and ABS CM + ATT CM on treatment attendance and drug abstinence. We identified a total of 10 studies including 12 CM treatments (6 ATT CM and 6 ABS CM + ATT CM) with 1841 participants. Results: Results indicated a moderate effect (d = 0.47, 95% confidence interval (CI) [0.25, 0.69]) of ATT CM on attendance relative to non–reward active comparison conditions. Frequency of rewards was significantly associated with larger effect sizes. Results also indicated a small effect (d = 0.22, 95% CI [0.12, 0.33]) of ATT CM on abstinence outcomes relative to nonreward comparisons, p < 0.001. The study found no significant differences in attendance or abstinence between ATT CM and ABS CM + ATT CM (p's > 0.05). Conclusion: Overall, the results supported ATT CM for increasing treatment engagement, with smaller effects on abstinence. Effects on abstinence were smaller than those observed in prior meta-analyses focused on ABS CM. No significant differences existed in attendance or abstinence outcomes between ATT CM and ABS + ATT CM. However, future studies are needed to experimentally compare ABS CM + ATT CM to ABS CM, and ATT CM to determine additive effects. Clinics implementing CM should consider the differential effects between ATT CM and ABS CM when selecting target behavior(s).

Objective: The aims of this systematic review and meta-analysis were to examine the overall prevalence of dropout from psychological treatments for problem gambling and gambling disorder and to examine how study, client, and treatment variables influenced dropout rates. Method: A systematic search was conducted to identify studies of cognitive and/or behavioral therapies and motivational interventions for problem gambling and gambling disorder. Meta-analysis was used to calculate an overall weighted dropout rate. Random effect meta-regressions were used to examine covariates of dropout rates. Mixed-effect subgroup analyses were used to examine moderators of dropout rates. Results: The systematic search identified 24 studies (31 dropout rates) comprising 2,791 participants. Using a random-effects model, the overall weighted dropout rate was 39.1%, 95% CI [33.0%, 45.6%]. Increases in the percentage of married participants were significantly associated with lower dropout rates. Dropout rates were significantly higher when dropout was defined as attending all sessions of a treatment protocol compared to when defined as attending a prespecified number of sessions different from the total in the protocol and when defined as study therapists judging participants to be dropouts. Insufficient reporting of some gambling-related variables and other psychological symptom variables prevented a thorough examination of covariates and moderators. Conclusions: A large proportion of individuals drop out of treatment for problem gambling and gambling disorder. Future research should examine the reasons for dropout across marital statuses and should adopt dropout definitions that consider session-by-session symptom change. (PsycInfo Database Record (c) 2021 APA, all rights reserved) This review suggests that a significant proportion of individuals drop out of psychological treatments for problem gambling and gambling disorder. This review also recommends that the field adopt symptom-based dropout definitions to determine the adequate dosage of psychological treatment for problem gambling and gambling disorder. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Objective: Contingency management (CM) is often criticized for limited long-term impact. This meta-analysis focused on objective indices of drug use (i.e., urine toxicology) to examine the effects of CM on illicit substance use up to 1 year following treatment. Method: Analyses included randomized trials (k = 23) of CM for stimulant, opioid, or polysubstance use disorders that reported outcomes up to 1 year after the incentive delivery had ended. Using random effects models, odds ratios (OR) were calculated for the likelihood of abstinence. Metaregressions and subgroup analyses explored how parameters of CM treatment, namely escalation, frequency, immediacy, and magnitude of reinforcers, moderated outcomes. Results: The overall likelihood of abstinence at the long-term follow-up among participants who received CM versus a comparison treatment (nearly half of which were community-based comprehensive therapies or protocol-based specific therapies) was OR = 1.22, 95% confidence interval [1.01, 1.44], with low to moderate heterogeneity (I² = 36.68). Among 18 moderators, longer length of active treatment was found to significantly improve long-term abstinence. Conclusions: CM showed long-term benefit in reducing objective indices of drug use, above and beyond other active, evidence-based treatments (e.g., cognitive–behavioral therapy, 12-step facilitation) and community-based intensive outpatient treatment. These data suggest that policymakers and insurers should support and cover costs for CM, which is the focus of hundreds of studies demonstrating its short-term efficacy and, now, additional data supporting its long-term efficacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved) What is the public health significance of this article?—This meta-analysis provides a summary of long-term outcomes of contingency management treatment using objective indices of drug use. Contingency management was found to be more efficacious than either standard care or other evidence-based approaches up to 1 year following the discontinuation of incentives. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

A growing literature supports the efficacy of cognitive-behavioral therapies, motivational interventions, and personalized feedback to treat problem and disordered gambling. However, there is currently debate as to how much treatment is necessary. Some studies indicate that attending a greater number of sessions is related to enhanced therapeutic outcomes, while other studies indicate that one session produces equivalent therapeutic outcomes to multiple sessions. To contribute to this debate, meta-analysis was used to examine the relation between dose and outcome in studies of cognitive-behavioral, motivational, and personalized feedback interventions (both individual and group treatment formats were included). Fourteen studies of randomized controlled trials representing 1,203 participants across 19 treatmentcontrol comparisons were identified. The intended treatment dose (i.e., the number of sessions prescribed to participants) across the 14 studies ranged from 1 to 30 sessions. Of the 10 studies reporting the received treatment dose (i.e., the number of sessions that participants attended), the weighted mean dose was 6.8 sessions (SD = 2.7). Both intended treatment dose and received treatment dose were positively related to outcome at posttreatment-as the number of sessions increased, so too did the magnitude of the between group effect size. There were an insufficient number of studies reporting outcome at long-term follow up to evaluate the relation between intended dose, received dose, and outcome. Discussion centers on several areas for future research on psychological treatments for problem and disordered gambling. Specific recommendations are made for researchers and practicing clinicians.

Studies have been conducted in both the United States (US) and Argentina to validate the Spanish version of the Gamblers’ Beliefs Questionnaire (GBQ-S). While similar factor structures of the GBQ-S were found in these studies, more detailed measurement invariance has not been explored. Determining measurement invariance across cultural groups would aid researchers in understanding what types of comparisons on latent constructs can be validly made between cultures using the GBQ-S. A secondary analysis was completed with data from two prior studies in Spanish-speaking samples from the US and Argentina. A modified baseline model that captured the two latent factors of Illusion of Control and Luck/Perseverance was selected for invariance testing. The evaluation of measurement invariance within a structural equation modeling framework established configural and metric, but not scalar, invariance. The GBQ-S can be validly used to measure the same latent variables across groups with comparable strengths between its items and factors; however, latent mean comparisons across groups may require further measurement refinement. The GBQ-S demonstrated notable degrees of measurement invariance between markedly different samples, providing further evidence for the existence of similar constructs and portability of the GBQ-S across populations.

The current study examined how multiple dimensions of ethnic-racial identity (ERI) were associated with alcohol use and alcohol use disorder (AUD) symptoms and how these relations varied by individuals’ ethnic-racial group among 1850 diverse emerging adults (M = 18.46, SD = .38). Further, measurement invariance of the Ethnic Identity Scale-Brief (EIS-B) was tested across Latinx, White, Black, Asian, and Multiracial students. Additionally, alternative models were examined that tested whether family factors (i.e., parent education and family history of alcohol problems) moderated the relations between ERI and alcohol problems to further examine nuances in these relations. Results indicated that the EIS-B functioned differently across White students and students of color; therefore, all research questions were tested separately for White students. Findings indicated that there were significant differences by race/ethnicity. ERI affirmation was negatively associated with AUD symptoms for Asian individuals and Black individuals. ERI exploration was positively associated with AUD symptoms among Black individuals. ERI resolution was negatively associated with alcohol use for Latinx individuals and positively associated with alcohol use for Multiracial individuals. For White individuals, ERI exploration was negatively associated with alcohol use and ERI affirmation was negatively associated with AUD symptoms. Regarding the alternative models, parent education was a significant moderator, such that at high parent education, ERI resolution predicted more alcohol use among White students and less AUD symptoms among Minority students. Family history of alcohol problems was not a significant moderator of any relations between ERI dimensions and alcohol problems. Overall, continued research and finding ways to translate findings into interventions with college students that incorporate these nuanced mechanisms underlying alcohol problems is a fruitful and important endeavor.

Negative health effects on an unborn fetus have been related to cigarette smoking during pregnancy. Very little research examines stress, self-esteem, depression, and disordered eating in pregnant women who smoke. A study, Tennessee Intervention for Pregnant Smokers (TIPS), recruited pregnant women from five prenatal practices to help them quit smoking before giving birth. Using an expanded 5A’s (Ask, Advise, Assess, Assist, Arrange) model and motivational interviewing, the intervention was implemented by trained health educators over the course of 4 prenatal visits. Women in the study who successfully stopped smoking before delivery had significantly healthier infants than the women who did not. A subset of the sampled 1063 pregnant women with complete data on measures of interest will be analyzed for the current study. We hypothesize that the following factors will differ significantly among pregnant women who never smoked, women who smoked but quit prior to birth, and women who smoked and did not quit prior to birth: stress, as indicated by the stress subscale of the Prenatal Psychosocial Profile (PPP); self-esteem, as indicated by the self-esteem subscale of the PPP; depressive symptoms, as indicated by the Center for Epidemiologic Studies Depression Scale (CESD-10); and disordered eating, as indicated by the Eating Attitudes Test (EAT-26). Additionally, we hypothesize that the odds of pregnant women quitting smoking prior to birth will be predicted by stress, self-esteem, depressive symptoms, and disordered eating. One-way Analysis of Variance (ANOVA) tests will be conducted to compare scores on respective measures for the three groups based on smoking status. A logistic regression will be conducted to assess the degree to which aforementioned variables predict odds of smoking cessation in pregnant smokers. The implications of this research can be used to improve future intervention programs to reduce the adverse health effects of children born to mothers who smoke.

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