| 1. |
- André, Frida, et al.
(författare)
-
Game Addiction Scale for Adolescents-Psychometric Analyses of Gaming Behavior, Gender Differences and ADHD
- 2022
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundInternet gaming disorder (IGD) was recently added in the Diagnostic and Statistical Manual of Mental Disorder as a "condition for further studies." There is no consensus regarding which rating scales should be used but many scholars suggest the GASA (Game Addiction Scale for Adolescents) and a ranking of the criteria, "the core approach" to avoid over-diagnosing of disordered gaming. Male gender and ADHD are commonly listed as risk factors for disordered gaming but little is known about sex differences in gaming and gender specific health correlates. PurposeThe present study aims to evaluate the core approach and the specific indicators of gaming behavior in GASA from a multifactorial perspective and explore the gender differences in a clinical setting, focusing on ADHD. Patients and MethodsChildren and adolescents aged 8-18 years (n = 144) from Child and adolescent psychiatry (CAP) in Skane were assessed with the GASA. Psychometric analyses including confirmatory factor analyses (CFA) and structural equation modeling (SEM) were used to identify well-defined constructs and gender differences. Refined factor scores for single constructs were the outcome of alignment, a procedure for assessing measurement equivalence across gender. New model-based gaming behavior variables were used for descriptive statistics and ANOVA testing of gender differences. ResultsThe results confirm that the core approach two-factor model is valid for the CAP sample, as well as a theory based psycho-social model for gaming behavior with over consumption and negative social and emotional consequences. Our findings suggest that negative consequences of over consumption take a social direction for boys and an emotional direction for girls. Also, ADHD was significantly associated with over consumption of video games and the negative consequences thereof for girls. ConclusionGuided by psychometric analyses, the GASA could be strengthened by advancing the questionnaire design and by adding complementary items in order to illuminate the complexity of gaming behavior. Our findings suggest that additional research on potential gender related discrepancies of disordered gaming is needed.
|
|
| 2. |
- Ek, Hanna, et al.
(författare)
-
Transitioning from conventional photon therapy to proton therapy for primary brain tumors
- 2023
-
Ingår i: Acta oncologica (Stockholm, Sweden). - 1651-226X. ; 62:4, s. 391-399
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Proton radiation therapy (PT) has become a treatment option alongside photon therapy (XRT) for lower-grade gliomas (LGG). In this single-institution retrospective study, we investigate the patient characteristics and treatment outcomes, including pseudo-progression (PsP), for LGG patients selected for PT. Method: Adult patients with grade 2–3 glioma consecutively treated with radiotherapy (RT) from May 2012 to December 2019 were retrospectively included in this cohort study. Tumor characteristics and treatment data were collected. The groups treated with PT and XRT were compared regarding treatment characteristics, side effects, occurrence of PsP, and survival outcomes. PsP was defined as new or growing lesions followed by either decrease or stabilization during a 12 month-period with no treatment. Results: Out of 143 patients meeting the inclusion criteria, 44 were treated with PT, 98 with XRT and one with mixed PT + XRT. The patients receiving PT were younger, had a lower tumor grade, more oligodendrogliomas and received a lower mean brain and brainstem dose. PsP was observed in 21 out of 126 patients, with no difference between XRT and PT (p =.38). The rate of fatigue in immediate connection to RT (zero to three months after) was higher for XRT than for PT (p =.016). The PT patients had a significantly better PFS and OS than the XRT patients (p =.025 and.035), but in multivariate analysis radiation modality was non-significant. Higher average dose to both brain and brainstem was associated with inferior PFS and OS (p <.001). Median follow-up time were 69 months and 26 months for XRT and PT patients, respectively. Conclusion: Contrary to previous studies, there was no difference in risk of PsP for XRT and PT. PT was associated with lower rates of fatigue <3 months after RT. The superior survival outcomes for PT indicates that the patients with the best prognosis were referred to PT.
|
|
| 3. |
- Jonsson, Jakob, et al.
(författare)
-
GamTest : Psychometric Evaluation and the Role of Emotions in an Online Self-Test for Gambling Behavior
- 2017
-
Ingår i: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 33:2, s. 505-523
-
Tidskriftsartikel (refereegranskat)abstract
- Recent increases in the number of online gambling sites have made gambling more available, which may contribute to an increase in gambling problems. At the same time, online gambling provides opportunities to introduce measures intended to prevent problem gambling. GamTest is an online test of gambling behavior that provides information that can be used to give players individualized feedback and recommendations for action. The aim of this study is to explore the dimensionality of GamTest and validate it against the Problem Gambling Severity Index (PGSI) and the gambler's own perceived problems. A recent psychometric approach, exploratory structural equation modeling (ESEM) is used. Well-defined constructs are identified in a two-step procedure fitting a traditional exploratory factor analysis model as well as a so-called bifactor model. Using data collected at four Nordic gambling sites in the autumn of 2009 (n = 10,402), the GamTest ESEM analyses indicate high correspondence with the players' own understanding of their problems and with the PGSI, a validated measure of problem gambling. We conclude that GamTest captures five dimensions of problematic gambling (i.e., overconsumption of money and time, and monetary, social and emotional negative consequences) with high reliability, and that the bifactor approach, composed of a general factor and specific residual factors, reproduces all these factors except one, the negative consequences emotional factor, which contributes to the dominant part of the general factor. The results underscore the importance of tailoring feedback and support to online gamblers with a particular focus on how to handle emotions in relation to their gambling behavior.
|
|
| 4. |
- Jonsson, Jakob, 1968-
(författare)
-
Preventing problem gambling: Focus on overconsumption
- 2019
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A proportion of gamblers experience problems. The role of overconsumption in developing gambling problems is sparsely described in the literature and there is little scientific knowledge about the prevention of gambling problems. There are some promising results regarding personalized feedback on gambling habits, and there is a need for more research. The overall aim of this thesis was to explore the role of overconsumption in problem gambling and target it in a preventive intervention. The preventive intervention was to give gambling consumption feedback to high consumers in order to make them reflect upon their gambling habits and enhance their motivation for change. Study I aimed to explore the dimensionality of GamTest, an online test of gambling behaviour, and validate it against PGSI and the gambler’s own perceived problems. Data came from four Nordic gambling sites, n = 10,402. In an ESEM analyses, GamTest had a high degree of correspondence with the players’ own perceived problems and with the PGSI. In an EFA, GamTest captured five dimensions of problematic gambling (i.e. overconsumption of money and time, and negative financial, social and emotional consequences). A bifactor approach showed a general factor and four specific residual factors, negative emotional consequences contribute to the dominant part of the general factor. Study II aimed to examine both the psychometric properties of the Jonsson-Abbot Scale (JAS) and its predictive validity with respect to increased gambling risk and problem gambling onset. The results are based on repeated interviews with 3,818 participants within the Swedish longitudinal gambling study. The results indicate an acceptable fit of a three-factor solution in a CFA, with ‘Overconsumption (OC),’ ‘Gambling fallacies (GF),’ and ‘Reinforcers (RI)’ as factors. When controlled for risk potential measured at baseline, GF and RI were significant predictors of gambling risk potential, and GF and OC were significant predictors of problem gambling onset at 12-month follow up. Study III’s primary objective was to investigate the effects of providing personalized feedback on gambling intensity among high consumers in Norway. An RCT design was used to evaluate how behavioural feedback by telephone or letters affects subsequent gambling expenditure. A sample of 1,003 statistical matched triplets, from the top 0.5 % of customers, were randomly assigned to telephone, letter, or a no-contact control condition. Over 12 weeks, theoretical loss decreased 29 % for the telephone, and 15 % for the letter, conditions, compared with 3 % for the control group. Study IV was a 12-month follow-up of Study III, aimed to investigate the relative effects over twelve months. The telephone group showed a 30 % reduction in theoretical loss, the letter group 13 %, both outperforming the control group with a 7 % reduction. Less than 1% in all groups stopped playing at Norsk Tipping. These four studies indicate that overconsumption of gambling plays different roles in problem gambling. The role of overconsumption in preventing gambling problems is discussed. Contacting high consumers about their gambling expenditure appears to be an effective method for gambling companies to meet their duty of care for customers. Technical evolution has made it possible for gambling companies to fulfil their duty of care, but this has to be regulated and mandatory if it is to be effective.
|
|
| 5. |
- Jonsson, Jakob, 1968-, et al.
(författare)
-
Reaching out to big losers : Brief motivational contact leads to sustained reductions in gambling over one year
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims: We previously demonstrated that phone and letter-based motivational interventions with high expenditure gamblers had significant short term positive effects on gambling and use of responsible gambling tools. This report examines outcomes over twelve months.Design: A randomized controlled trial design with three conditions: feedback intervention by telephone, letter, or a no-contact control condition.Setting: Customers of Norsk Tipping gambling platforms.Participants: 1,003 statistical triplets from the top .5% of customers based upon annual expenditure, matched on sex, age, and net losses.Measurements: Primary outcome measure was gambling theoretical loss, derived from the Norsk Tipping customer database. Secondary outcomes were responsible gambling customer actions and whether the participant was retained as a NT customer.Findings: The results showed a positive and sustained effect of the phone and letter interventions over 12 months - the telephone group showed a 30% reduction in theoretic loss (d =0.44) and the letter group 13% (d =0.18), both outperforming the control group with a 7% reduction (d =0.11). The phone condition was superior to both the letter and control conditions in per protocol (p<0.001) and intention to treat analyses (ITT) (p< 0.018 and 0.001). Individuals in the phone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT only (p<0.001). Over 99% in the intervention groups were still customers during the follow-up year.Conclusions: A targeted telephone intervention with high expenditure customers effectively reduced theoretical losses over a 12 month period. Gambling companies can utilize this type of intervention as a response to their duty to care for customers.
|
|
| 6. |
- Jonsson, Jakob, et al.
(författare)
-
Reaching Out to Big Losers : How Different Types of Gamblers are Affected by a Brief Motivational Contact Initiated by the Gambling Provider
- 2021
-
Ingår i: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 37, s. 387-401
-
Tidskriftsartikel (refereegranskat)abstract
- Telephone and letter-based motivational interventions with high expenditure gamblers have significant short and long term positive effects on gambling and use of responsible gambling tools. This report examines how different subtypes of gamblers, based upon patterns of play, are differentially affected. A randomized controlled trial design with three conditions (n = 1003 in each): feedback intervention by letter, telephone or a no-contact control condition. Subtypes of gamblers were derived by latent class analyses (LCA) based upon gambling behavior pre intervention. The participants were customers of Norsk Tipping gambling platforms. 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age, and net losses. Primary outcome measure was gambling theoretical loss (TL), derived from the Norsk Tipping customer database. The LCA identified six subtypes: High Casino, High Sport, High Lottery, High Video lottery terminal (VLT), Lottery/Mix and Bingo/Casino. There were almost no differences in change in TL between the six subtypes of gamblers receiving the letter or telefone interventions respectively. However, the choice of contact by letter or telephone did have different effects for the different gambling subtypes. Sending a letter seems like a cost effective alternative to telephone contact for the High Lottery type, but telephone contact performs better for High Casino, High Sport and High VLT customers. Responsible gambling interventions can be improved by subtyping of gamblers.
|
|
| 7. |
- Jonsson, Jakob, 1968-, et al.
(författare)
-
Reaching Out to Big Losers : Exploring Intervention Effects Using Individualized Follow-Up
- 2023
-
Ingår i: Psychology of Addictive Behaviors. - : American Psychological Association (APA). - 0893-164X .- 1939-1501. ; 37:7, s. 886-893
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Previous research suggests that a brief duty-of-care telephone call to high expenditure customers was associated with lower gambling over the subsequent year. The current aim was to assess effects on individual trajectories rather than overall group effects reported previously. The objective was to identify different patterns of individual change over the follow-up year and explore differential responses of subgroups of individuals. Method: A matched pair design contrasting the outcome for telephone intervention with a no-intervention control condition. Five hundred and ninety-six statistical pairs randomly drawn from the top 0.5% of customers based upon annual expenditure at Norsk Tipping, Norway. Primary outcome measure was gambling theoretical loss (TL), derived from the Norsk Tipping gambling data warehouse. Player trajectories across time were identified using growth mixture modeling to assess differential intervention effects on homogenous subgroups of individuals. Results: Relatively low, medium, and high TL subgroups were identified. The telephone intervention was associated with greater reductions than the control condition for all three subgroups but showed the strongest effect for the subgroup with the highest TL. The intervention was most effective for casino and sport gamblers, male, young, and middle-aged. Conclusions: A brief duty of care telephone contact with high expenditure customers showed sustained effects over 12 months, in particular for individuals showing the highest level of TL. Examining trajectories using advanced statistical models identified customer characteristics most strongly associated with reduced TL. These findings can guide prevention strategies with evidence-based knowledge about differential effects.Public Health Significance StatementA brief contact intervention with high expenditure customers showed sustained positive effects, in particular for individuals showing the highest level of expenditure. Findings about differential effects for individuals with specific profiles can guide evidence-based knowledge prevention strategies to provide duty of care for gambling customers.
|
|
| 8. |
- Jonsson, Jakob, et al.
(författare)
-
Reaching Out to Big Losers: A Randomized Controlled Trial of Brief Motivational Contact Providing Gambling Expenditure Feedback
- 2019
-
Ingår i: Psychology of Addictive Behaviors. - : American Psychological Association (APA). - 0893-164X .- 1939-1501. ; 33:3, s. 179-189
-
Tidskriftsartikel (refereegranskat)abstract
- Gambling disorder is a public health issue in many countries, and expectations that the gambling industry protects individuals from harm are increasing. The primary objective of this study was to investigate the effects of providing personalized feedback on gambling intensity among high consumers of venue-based and online gambling in Norway. A randomized controlled trial design was used to evaluate how behavioral feedback by telephone or letters sent via surface mail affects subsequent gambling expenditure and use of responsible gambling tools and whether a follow-up contact increases the effect. Gambling expenditure, the primary outcome, was measured using theoretical loss, which is the actual cost to the player, adjusted for the house advantage. From the top .5% of customers based upon annual expenditure, a sample of 1,003 statistical triplets, matched on sex, age, and net losses, were randomly assigned to the feedback intervention by telephone, letter, or a no-contact control condition. Participants assigned to the phone call or letter were also randomly assigned to receive or not receive a subsequent follow-up contact. The results showed that over 12 weeks, theoretical loss decreased 29% for the phone and 15% for the letter conditions, compared with 3% for the control group. A positive effect of the follow-up contact was limited to participants who at the initial call indicated an interest in receiving a follow-up call. Contacting high consumers about their gambling expenditure appears to be an effective method for gambling companies to meet their duty to care for customers.
|
|
| 9. |
- Jonsson, Jakob, et al.
(författare)
-
Reaching out to big losers leads to sustained reductions in gambling over 1 year: a randomized controlled trial of brief motivational contact
- 2020
-
Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 115:8, s. 1522-1531
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aims A previous randomized controlled trial demonstrated that telephone- and letter-based motivational interventions with high-expenditure gamblers had significant short-term positive effects on gambling and use of responsible gambling tools. This post-trial follow-up examined outcomes in gambling expenditure over 12 months. Design Observational study following a three-arm randomized controlled trial. Setting Customers of Norsk Tipping (NT) gambling platforms, Norway. Participants A total of 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age and net losses. Mean age was 53.4 years; 19% were women, mean yearly loss for 2016 was 88 197 NoK. Interventions and comparator Feedback intervention by telephone, letter or a no-contact control condition. Measurements Primary outcome measure was gambling theoretical loss, derived from the NT customer database. Secondary outcomes were responsible gambling customer actions and whether or not the participant was retained as an NT customer. Findings Per-protocol analyses of triplets who received the telephone call or letter as randomly assigned (n = 596) showed a positive and sustained effect over 12 months: the telephone group showed a 30% reduction in theoretical loss (d = 0.44) and the letter group 13% (d = 0.18), both outperforming the control group with a 7% reduction (d = 0.11). The telephone condition was superior to both the letter and control conditions in per-protocol (P < 0.001) and to control condition in intention-to-treat analyses (ITT) (P < 0.001). Individuals in the telephone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT-only analysis (P < 0.001). More than 93% were still customers a year after the intervention. Conclusions Personal contact with high-expenditure gambling customers in Norway that provided individualized feedback on expenditures was associated with reduced theoretical losses and greater use of responsible gambling tools over a 12-month period, compared with no contact. Telephone intervention with customers had a larger impact than a mailed letter.
|
|
| 10. |
|
|
