Transforming global approaches to chronic disease prevention and management across the lifespan : integrating genomics, behavior change, and digital health solutions
- Thomas, Shane, Browning, Collette, Charchar, Fadi, Klein, Britt, Ory, Marcia, Bowden-Jones, Henrietta, Chamberlain, Samuel
- Authors: Thomas, Shane , Browning, Collette , Charchar, Fadi , Klein, Britt , Ory, Marcia , Bowden-Jones, Henrietta , Chamberlain, Samuel
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
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- Description: Chronic illnesses are a major threat to global population health through the lifespan into older age. Despite world-wide public health goals, there has been a steady increase in chronic and non-communicable diseases (e.g., cancer, cardiovascular and metabolic disorders) and strong growth in mental health disorders. In 2010, 67% of deaths worldwide were due to chronic diseases and this increased to 74% in 2019, with accelerated growth in the COVID-19 era and its aftermath. Aging and wellbeing across the lifespan are positively impacted by the presence of effective prevention and management of chronic illness that can enhance population health. This paper provides a short overview of the journey to this current situation followed by discussion of how we may better address what the World Health Organization has termed the “tsunami of chronic diseases.” In this paper we advocate for the development, validation, and subsequent deployment of integrated: 1. Polygenic and multifactorial risk prediction tools to screen for those at future risk of chronic disease and those with undiagnosed chronic disease. 2. Advanced preventive, behavior change and chronic disease management to maximize population health and wellbeing. 3. Digital health systems to support greater efficiencies in population-scale health prevention and intervention programs. It is argued that each of these actions individually has an emerging evidence base. However, there has been limited research to date concerning the combined population-level health effects of their integration. We outline the conceptual framework within which we are planning and currently conducting studies to investigate the effects of their integration. Copyright © 2023 Thomas, Browning, Charchar, Klein, Ory, Bowden-Jones and Chamberlain.
- Authors: Thomas, Shane , Browning, Collette , Charchar, Fadi , Klein, Britt , Ory, Marcia , Bowden-Jones, Henrietta , Chamberlain, Samuel
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 11, no. (2023), p.
- Full Text:
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- Description: Chronic illnesses are a major threat to global population health through the lifespan into older age. Despite world-wide public health goals, there has been a steady increase in chronic and non-communicable diseases (e.g., cancer, cardiovascular and metabolic disorders) and strong growth in mental health disorders. In 2010, 67% of deaths worldwide were due to chronic diseases and this increased to 74% in 2019, with accelerated growth in the COVID-19 era and its aftermath. Aging and wellbeing across the lifespan are positively impacted by the presence of effective prevention and management of chronic illness that can enhance population health. This paper provides a short overview of the journey to this current situation followed by discussion of how we may better address what the World Health Organization has termed the “tsunami of chronic diseases.” In this paper we advocate for the development, validation, and subsequent deployment of integrated: 1. Polygenic and multifactorial risk prediction tools to screen for those at future risk of chronic disease and those with undiagnosed chronic disease. 2. Advanced preventive, behavior change and chronic disease management to maximize population health and wellbeing. 3. Digital health systems to support greater efficiencies in population-scale health prevention and intervention programs. It is argued that each of these actions individually has an emerging evidence base. However, there has been limited research to date concerning the combined population-level health effects of their integration. We outline the conceptual framework within which we are planning and currently conducting studies to investigate the effects of their integration. Copyright © 2023 Thomas, Browning, Charchar, Klein, Ory, Bowden-Jones and Chamberlain.
Gambling disorder in the UK : key research priorities and the urgent need for independent research funding
- Bowden-Jones, Henrietta, Hook, Roxanne, Grant, Jon, Ioannidis, Konstantinos, Corazza, Ornella, Fineberg, Naomi, Singer, Bryan, Roberts, Amanda, Bethlehem, Richard, Dymond, Simon, Romero-Garcia, Rafa, Robbins, Trevor, Cortese, Samuele, Thomas, Shane, Sahakian, Barbara, Dowling, Nicki, Chamberlain, Samuel
- Authors: Bowden-Jones, Henrietta , Hook, Roxanne , Grant, Jon , Ioannidis, Konstantinos , Corazza, Ornella , Fineberg, Naomi , Singer, Bryan , Roberts, Amanda , Bethlehem, Richard , Dymond, Simon , Romero-Garcia, Rafa , Robbins, Trevor , Cortese, Samuele , Thomas, Shane , Sahakian, Barbara , Dowling, Nicki , Chamberlain, Samuel
- Date: 2022
- Type: Text , Journal article , Review
- Relation: The Lancet Psychiatry Vol. 9, no. 4 (2022), p. 321-329
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- Description: Gambling in the modern era is pervasive owing to the variety of gambling opportunities available, including those that use technology (eg, online applications on smartphones). Although many people gamble recreationally without undue negative effects, a sizeable subset of individuals develop disordered gambling, which is associated with marked functional impairment including other mental health problems, relationship problems, bankruptcy, suicidality, and criminality. The National UK Research Network for Behavioural Addictions (NUK-BA) was established to promote understanding of, research into, and treatments for behavioural addictions including gambling disorder, which is the only formally recognised behavioural addiction. In this Health Policy paper, we outline the status of research and treatment for disordered gambling in the UK (including funding issues) and key research that should be conducted to establish the magnitude of the problem, vulnerability and resilience factors, the underlying neurobiology, long-term consequences, and treatment opportunities. In particular, we emphasise the need to: (1) conduct independent longitudinal research into the prevalence of disordered gambling (including gambling disorder and at-risk gambling), and gambling harms, including in vulnerable and minoritised groups; (2) select and refine the most suitable pragmatic measurement tools; (3) identify predictors (eg, vulnerability and resilience markers) of disordered gambling in people who gamble recreationally, including in vulnerable and minoritised groups; (4) conduct randomised controlled trials on psychological interventions and pharmacotherapy for gambling disorder; (5) improve understanding of the neurobiological basis of gambling disorder, including impulsivity and compulsivity, genetics, and biomarkers; and (6) develop clinical guidelines based on the best contemporary research evidence to guide effective clinical interventions. We also highlight the need to consider what can be learnt from approaches towards mitigating gambling-related harm in other countries. © 2022 Elsevier Ltd
- Authors: Bowden-Jones, Henrietta , Hook, Roxanne , Grant, Jon , Ioannidis, Konstantinos , Corazza, Ornella , Fineberg, Naomi , Singer, Bryan , Roberts, Amanda , Bethlehem, Richard , Dymond, Simon , Romero-Garcia, Rafa , Robbins, Trevor , Cortese, Samuele , Thomas, Shane , Sahakian, Barbara , Dowling, Nicki , Chamberlain, Samuel
- Date: 2022
- Type: Text , Journal article , Review
- Relation: The Lancet Psychiatry Vol. 9, no. 4 (2022), p. 321-329
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- Description: Gambling in the modern era is pervasive owing to the variety of gambling opportunities available, including those that use technology (eg, online applications on smartphones). Although many people gamble recreationally without undue negative effects, a sizeable subset of individuals develop disordered gambling, which is associated with marked functional impairment including other mental health problems, relationship problems, bankruptcy, suicidality, and criminality. The National UK Research Network for Behavioural Addictions (NUK-BA) was established to promote understanding of, research into, and treatments for behavioural addictions including gambling disorder, which is the only formally recognised behavioural addiction. In this Health Policy paper, we outline the status of research and treatment for disordered gambling in the UK (including funding issues) and key research that should be conducted to establish the magnitude of the problem, vulnerability and resilience factors, the underlying neurobiology, long-term consequences, and treatment opportunities. In particular, we emphasise the need to: (1) conduct independent longitudinal research into the prevalence of disordered gambling (including gambling disorder and at-risk gambling), and gambling harms, including in vulnerable and minoritised groups; (2) select and refine the most suitable pragmatic measurement tools; (3) identify predictors (eg, vulnerability and resilience markers) of disordered gambling in people who gamble recreationally, including in vulnerable and minoritised groups; (4) conduct randomised controlled trials on psychological interventions and pharmacotherapy for gambling disorder; (5) improve understanding of the neurobiological basis of gambling disorder, including impulsivity and compulsivity, genetics, and biomarkers; and (6) develop clinical guidelines based on the best contemporary research evidence to guide effective clinical interventions. We also highlight the need to consider what can be learnt from approaches towards mitigating gambling-related harm in other countries. © 2022 Elsevier Ltd
The development of a competency assessment standard for general practitioners in China
- Rao, Xin, Lai, Jinming, Wu, Hua, Li, Yang, Xu, Xingzhi, Browning, Colette, Thomas, Shane
- Authors: Rao, Xin , Lai, Jinming , Wu, Hua , Li, Yang , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 8, no. (2020), p.
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- Description: This paper describes the development of a competency assessment standard for General Practitioners in Shenzhen, China. The standard is to be used for developing and delivering the training curriculum for General Practitioners and to enable rigorous assessment of the mastery of the standards by GP trainees. The requirement for the training of General Practitioners in China is mandated by government policy requires an international standard curriculum to meet the needs of patients and the community. A modified Delphi process was employed to arrive at a curriculum consensus. An expert panel and 14 expert working groups derived from the expert panel were established to review and evaluate national and international competency standards for General Practice and develop a set of standards, through a modified Delphi methodology. Forty three experts were involved in the project. The project resulted in a detailed curriculum statement. The curriculum was then used in 2017 and 2018 where pilot examinations of GP trainees (n = 298 and n = 315, respectively) were conducted to assess the trainee's competencies against the Standards. The examination included two modules, a written test (Module A) and a practical test (Module B). The success rate for participants was relatively low with the majority not successfully completing the assessments. The assessments will be further refined in subsequent work. The project achieved its goal of developing a rigorously evaluated standard to support clinical practice and the training and assessment of GPs. © Copyright © 2020 Rao, Lai, Wu, Li, Xu, Browning and Thomas.
- Authors: Rao, Xin , Lai, Jinming , Wu, Hua , Li, Yang , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 8, no. (2020), p.
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- Description: This paper describes the development of a competency assessment standard for General Practitioners in Shenzhen, China. The standard is to be used for developing and delivering the training curriculum for General Practitioners and to enable rigorous assessment of the mastery of the standards by GP trainees. The requirement for the training of General Practitioners in China is mandated by government policy requires an international standard curriculum to meet the needs of patients and the community. A modified Delphi process was employed to arrive at a curriculum consensus. An expert panel and 14 expert working groups derived from the expert panel were established to review and evaluate national and international competency standards for General Practice and develop a set of standards, through a modified Delphi methodology. Forty three experts were involved in the project. The project resulted in a detailed curriculum statement. The curriculum was then used in 2017 and 2018 where pilot examinations of GP trainees (n = 298 and n = 315, respectively) were conducted to assess the trainee's competencies against the Standards. The examination included two modules, a written test (Module A) and a practical test (Module B). The success rate for participants was relatively low with the majority not successfully completing the assessments. The assessments will be further refined in subsequent work. The project achieved its goal of developing a rigorously evaluated standard to support clinical practice and the training and assessment of GPs. © Copyright © 2020 Rao, Lai, Wu, Li, Xu, Browning and Thomas.
Food, eating, and happy aging : the perceptions of older Chinese people
- Browning, Colette, Qiu, Zeqi, Yang, Hui, Zhang, Touhong, Thomas, Shane
- Authors: Browning, Colette , Qiu, Zeqi , Yang, Hui , Zhang, Touhong , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. APR (2019), p.
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- Description: China's government and its people have for a long time focused on food security for its population as one of the most important issues in economic and social development. Many older people in China have lived in times when food security was not stable. Thus, while food has a central position in Chinese culture for all Chinese people, it is of particular pertinence to older people. In this paper we explore the meaning of food and eating in the lives of older Chinese people in China and how it contributes to healthy, thus happy aging. Focus groups and qualitative interviews were used in this study. Participants were recruited from the rural Yongfu Province of Southwest China, and the urban Fangzhuang and Haidan districts in Beijing. Forty-two participants were recruited aged 62-83 years of age. All focus groups and interviews were conducted in Mandarin and audiotaped with the participants' permission. Audio-tapes were transcribed by a Chinese speaking researcher and then were translated into English. Data were analyzed continuously and comparatively, transcripts were coded, and themes and sub-themes were identified. The initial analysis and interpretation were then presented and discussed at a workshop with all the authors. Two major themes emerged-the quantity of food and the quality of food required to have a happy old age. Participants discussed the desire to eat "until you are full" because of their experiences of famine during childhood. However, they also believed that as an older person they should eat less for their health, particularly less high fat foods. The importance of the food quality and food affordability was also discussed. Grain and meat were characterized as "good" foods and important in their diets for a happy old age. The participants, especially those from urban areas, were concerned with food safety. The high cultural importance of food for older Chinese in China was confirmed in this study. Social and economic lifespan experiences continue to impact on the food and eating attitudes and practices of older Chinese. The food related life experiences of older Chinese in China are quite different from younger Chinese and health promotion messaging needs to be informed by these unique perspectives in order to maximize its effectiveness. © 2019 Browning, Qiu, Yang, Zhang and Thomas.
- Authors: Browning, Colette , Qiu, Zeqi , Yang, Hui , Zhang, Touhong , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. APR (2019), p.
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- Description: China's government and its people have for a long time focused on food security for its population as one of the most important issues in economic and social development. Many older people in China have lived in times when food security was not stable. Thus, while food has a central position in Chinese culture for all Chinese people, it is of particular pertinence to older people. In this paper we explore the meaning of food and eating in the lives of older Chinese people in China and how it contributes to healthy, thus happy aging. Focus groups and qualitative interviews were used in this study. Participants were recruited from the rural Yongfu Province of Southwest China, and the urban Fangzhuang and Haidan districts in Beijing. Forty-two participants were recruited aged 62-83 years of age. All focus groups and interviews were conducted in Mandarin and audiotaped with the participants' permission. Audio-tapes were transcribed by a Chinese speaking researcher and then were translated into English. Data were analyzed continuously and comparatively, transcripts were coded, and themes and sub-themes were identified. The initial analysis and interpretation were then presented and discussed at a workshop with all the authors. Two major themes emerged-the quantity of food and the quality of food required to have a happy old age. Participants discussed the desire to eat "until you are full" because of their experiences of famine during childhood. However, they also believed that as an older person they should eat less for their health, particularly less high fat foods. The importance of the food quality and food affordability was also discussed. Grain and meat were characterized as "good" foods and important in their diets for a happy old age. The participants, especially those from urban areas, were concerned with food safety. The high cultural importance of food for older Chinese in China was confirmed in this study. Social and economic lifespan experiences continue to impact on the food and eating attitudes and practices of older Chinese. The food related life experiences of older Chinese in China are quite different from younger Chinese and health promotion messaging needs to be informed by these unique perspectives in order to maximize its effectiveness. © 2019 Browning, Qiu, Yang, Zhang and Thomas.
Perspectives on the training of Chinese Primary Health Care Physicians to reduce chronic illnesses and their burden
- Sun, Wenmin, Li, Yang, Hu, Yitting, Rao, Xin, Xu, Xingzhi, Browning, Colette, Thomas, Shane
- Authors: Sun, Wenmin , Li, Yang , Hu, Yitting , Rao, Xin , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. (2019), p. 1-7
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- Description: This paper is a commentary on the training of Chinese Primary Health Care Doctors to reduce chronic illness and its burden. First, we will consider the policy position of the Chinese government concerning the development of a competent and enlarged primary physician workforce to deliver the proposed primary health care system reforms. We then turn to a review of the drivers of the high burden of chronic illnesses especially in older people in China. We argue that the curriculum for the training of primary health care medical practitioners should match the demonstrated high prevalence chronic illnesses and their risk factors and that there needs to specific competencies in prevention and mitigation of the diseases and their risk factors.
- Authors: Sun, Wenmin , Li, Yang , Hu, Yitting , Rao, Xin , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. (2019), p. 1-7
- Full Text:
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- Description: This paper is a commentary on the training of Chinese Primary Health Care Doctors to reduce chronic illness and its burden. First, we will consider the policy position of the Chinese government concerning the development of a competent and enlarged primary physician workforce to deliver the proposed primary health care system reforms. We then turn to a review of the drivers of the high burden of chronic illnesses especially in older people in China. We argue that the curriculum for the training of primary health care medical practitioners should match the demonstrated high prevalence chronic illnesses and their risk factors and that there needs to specific competencies in prevention and mitigation of the diseases and their risk factors.
Effect of a health coach intervention for the management of individuals with type 2 diabetes mellitus in China : a pragmatic cluster randomized controlled trial
- Chapman, Anna, Browning, Colette, Enticott, Joanne, Yang, Hui, Liu, Shuo, Zhang, Tuohong, Thomas, Shane
- Authors: Chapman, Anna , Browning, Colette , Enticott, Joanne , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 6, (2018)
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- Description: Aim: To determine the effect of a health coach intervention for the management of glycemic control, as well as physiological, psychological and self-care outcomes of patients with type 2 diabetes mellitus (T2DM), compared with usual care. Methods:This pragmatic cluster RCT was conducted in the Fengtai district of Beijing from August 2011 to December 2013. Forty-one community health stations (CHSs) were cluster randomized (stratified geographically, 1:1 ratio) and eligible, randomly selected T2DM patients were sequentially contacted by CHSs. Control participants received usual care according to the Chinese Guideline for Diabetes Prevention and Management. Intervention participants received 18-months of health coaching based on principles of Motivational Interviewing (MI) plus usual care. Medical and pathology fees were waived for both groups. Outcome assessment was performed at baseline, 6, 12, and 18-months. The primary outcome was glycated hemoglobin (HbA1c); secondary outcomes encompassed a suite of physiological, psychological and self-care measures. Results:No differential treatment effect was found at 18-months for HbA1c (adj. difference -0.07, 95% CI -0.53 to 0.39, p = 0.769) or any specified secondary outcomes. Interestingly, both groups displayed a statistically and clinically significant within-group improvement of the same magnitude at 18-months for HbA1c (intervention: mean change -3.65, 95% CI -3.92 to -3.37; control: mean change -3.38, 95% CI -3.67 to -3.08). Conclusions:The lack of differential treatment effects observed indicate that it may be premature to recommend the routine delivery of health coach interventions based on MI principles for the management of T2DM in China. However, the large, comparable within-group improvement in mean HbA1c promotes the establishment of free, regular clinical health assessments for individuals with T2DM in China. © 2018 Chapman, Browning, Enticott, Yang, Liu, Zhang and Thomas.
- Authors: Chapman, Anna , Browning, Colette , Enticott, Joanne , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 6, (2018)
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- Description: Aim: To determine the effect of a health coach intervention for the management of glycemic control, as well as physiological, psychological and self-care outcomes of patients with type 2 diabetes mellitus (T2DM), compared with usual care. Methods:This pragmatic cluster RCT was conducted in the Fengtai district of Beijing from August 2011 to December 2013. Forty-one community health stations (CHSs) were cluster randomized (stratified geographically, 1:1 ratio) and eligible, randomly selected T2DM patients were sequentially contacted by CHSs. Control participants received usual care according to the Chinese Guideline for Diabetes Prevention and Management. Intervention participants received 18-months of health coaching based on principles of Motivational Interviewing (MI) plus usual care. Medical and pathology fees were waived for both groups. Outcome assessment was performed at baseline, 6, 12, and 18-months. The primary outcome was glycated hemoglobin (HbA1c); secondary outcomes encompassed a suite of physiological, psychological and self-care measures. Results:No differential treatment effect was found at 18-months for HbA1c (adj. difference -0.07, 95% CI -0.53 to 0.39, p = 0.769) or any specified secondary outcomes. Interestingly, both groups displayed a statistically and clinically significant within-group improvement of the same magnitude at 18-months for HbA1c (intervention: mean change -3.65, 95% CI -3.92 to -3.37; control: mean change -3.38, 95% CI -3.67 to -3.08). Conclusions:The lack of differential treatment effects observed indicate that it may be premature to recommend the routine delivery of health coach interventions based on MI principles for the management of T2DM in China. However, the large, comparable within-group improvement in mean HbA1c promotes the establishment of free, regular clinical health assessments for individuals with T2DM in China. © 2018 Chapman, Browning, Enticott, Yang, Liu, Zhang and Thomas.
Problem gambling and family violence : findings from a population-representative study
- Dowling, Nicki, Ewin, Carrie, Youssef, George, Merkouris, Stephanie, Thomas, Shane
- Authors: Dowling, Nicki , Ewin, Carrie , Youssef, George , Merkouris, Stephanie , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Behavioral Addictions Vol. 7, no. 3 (2018), p. 806-813
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- Description: Background and aims: Few studies have investigated the association between problem gambling (PG) and violence extending into the family beyond intimate partners. This study aimed to explore the association between PG and family violence (FV) in a population-representative sample. It was hypothesized that: (a) PG would be positively associated with FV, even after adjusting for sociodemographic variables and comorbidities and (b) these relationships would be significantly exacerbated by substance use and psychological distress. A secondary aim was to explore whether gender moderated these relationships. Methods: Computer-assisted telephone interviews were conducted with a population-representative sample of 4,153 Australian adults. Results: Moderate-risk (MR)/problem gamblers had a 2.73-fold increase in the odds of experiencing FV victimization (21.3%; 95% CI: 13.1-29.4) relative to nonproblem gamblers (9.4%; 95% CI: 8.5-10.4). They also had a 2.56-fold increase in the odds of experiencing FV perpetration (19.7%; 95% CI: 11.8-27.7) relative to non-problem gamblers (9.0%; 95% CI: 8.0-10.0). Low-risk gamblers also had over a twofold increase in the odds of experiencing FV victimization (20.0%; 95% CI: 14.0-26.0) and perpetration (19.3%; 95% CI: 13.5-25.1). These relationships remained robust for low-risk gamblers, but were attenuated for MR/problem gamblers, after adjustment for substance use and psychological distress. MR/problem gamblers had a greater probability of FV victimization, if they reported hazardous alcohol use; and low-risk gamblers had a greater probability of FV perpetration if they were female. Discussion and conclusion: These findings provide further support for routine screening, highlight the need for prevention and intervention programs, and suggest that reducing alcohol use may be important in these efforts. © 2018 The Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
- Authors: Dowling, Nicki , Ewin, Carrie , Youssef, George , Merkouris, Stephanie , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Behavioral Addictions Vol. 7, no. 3 (2018), p. 806-813
- Full Text:
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- Description: Background and aims: Few studies have investigated the association between problem gambling (PG) and violence extending into the family beyond intimate partners. This study aimed to explore the association between PG and family violence (FV) in a population-representative sample. It was hypothesized that: (a) PG would be positively associated with FV, even after adjusting for sociodemographic variables and comorbidities and (b) these relationships would be significantly exacerbated by substance use and psychological distress. A secondary aim was to explore whether gender moderated these relationships. Methods: Computer-assisted telephone interviews were conducted with a population-representative sample of 4,153 Australian adults. Results: Moderate-risk (MR)/problem gamblers had a 2.73-fold increase in the odds of experiencing FV victimization (21.3%; 95% CI: 13.1-29.4) relative to nonproblem gamblers (9.4%; 95% CI: 8.5-10.4). They also had a 2.56-fold increase in the odds of experiencing FV perpetration (19.7%; 95% CI: 11.8-27.7) relative to non-problem gamblers (9.0%; 95% CI: 8.0-10.0). Low-risk gamblers also had over a twofold increase in the odds of experiencing FV victimization (20.0%; 95% CI: 14.0-26.0) and perpetration (19.3%; 95% CI: 13.5-25.1). These relationships remained robust for low-risk gamblers, but were attenuated for MR/problem gamblers, after adjustment for substance use and psychological distress. MR/problem gamblers had a greater probability of FV victimization, if they reported hazardous alcohol use; and low-risk gamblers had a greater probability of FV perpetration if they were female. Discussion and conclusion: These findings provide further support for routine screening, highlight the need for prevention and intervention programs, and suggest that reducing alcohol use may be important in these efforts. © 2018 The Author(s). **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
Cognitive distortions among older adult gamblers in an Asian context
- Subramaniam, Mythily, Chong, Siow, Browning, Colette, Thomas, Shane
- Authors: Subramaniam, Mythily , Chong, Siow , Browning, Colette , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 12, no. 5 (2017), p.
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- Description: Aims: The study aims to describe the construct of cognitive distortions based on the narratives of older adult gamblers (aged 60 years and above) in Singapore. Methods: Singapore residents (citizens or permanent residents) aged 60 years and above, who were current or past regular gamblers were included in the study. Participants were recruited using a combination of venue based approach, referrals from service providers as well as by snowball sampling. In all, 25 in-depth interviews were conducted with older adult gamblers. The six-step thematic network analysis methodology was adopted for data analysis. Results: The mean age of the participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), with a mean age of gambling initiation at 24.5 years. Among older adult gamblers, cognitive distortions emerged as a significant global theme comprising three organizing themes-illusion of control, probability control and interpretive control. The organizing themes comprised nine basic themes: perception of gambling as a skill, near miss, concept of luck, superstitious beliefs, entrapment, gambler's fallacy, chasing wins, chasing losses, and beliefs that wins are more than losses. Conclusions: Cognitive distortions were endorsed by all gamblers in the current study and were shown to play a role in both maintaining and escalating the gambling behaviour. While the surface characteristics of the distortions had a culture-specific appearance, the deeper characteristics of the distortions may in fact be more universal than previously thought. Future research must include longitudinal studies to understand causal relationships between cognitive distortions and gambling as well as the role of culture-specific distortions both in the maintenance and treatment of the disorder. © 2017 Subramaniam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Authors: Subramaniam, Mythily , Chong, Siow , Browning, Colette , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 12, no. 5 (2017), p.
- Full Text:
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- Description: Aims: The study aims to describe the construct of cognitive distortions based on the narratives of older adult gamblers (aged 60 years and above) in Singapore. Methods: Singapore residents (citizens or permanent residents) aged 60 years and above, who were current or past regular gamblers were included in the study. Participants were recruited using a combination of venue based approach, referrals from service providers as well as by snowball sampling. In all, 25 in-depth interviews were conducted with older adult gamblers. The six-step thematic network analysis methodology was adopted for data analysis. Results: The mean age of the participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), with a mean age of gambling initiation at 24.5 years. Among older adult gamblers, cognitive distortions emerged as a significant global theme comprising three organizing themes-illusion of control, probability control and interpretive control. The organizing themes comprised nine basic themes: perception of gambling as a skill, near miss, concept of luck, superstitious beliefs, entrapment, gambler's fallacy, chasing wins, chasing losses, and beliefs that wins are more than losses. Conclusions: Cognitive distortions were endorsed by all gamblers in the current study and were shown to play a role in both maintaining and escalating the gambling behaviour. While the surface characteristics of the distortions had a culture-specific appearance, the deeper characteristics of the distortions may in fact be more universal than previously thought. Future research must include longitudinal studies to understand causal relationships between cognitive distortions and gambling as well as the role of culture-specific distortions both in the maintenance and treatment of the disorder. © 2017 Subramaniam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Gambling and family : a two-way relationship
- Subramaniam, Mythily, Chong, Siow, Satghare, Pratika, Browning, Colette, Thomas, Shane
- Authors: Subramaniam, Mythily , Chong, Siow , Satghare, Pratika , Browning, Colette , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Behavioral Addictions Vol. 6, no. 4 (2017), p. 689-698
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- Description: Background and aims: Families play an important role in the evolution of gambling and are also adversely affected by the disordered gambling of any one of their members. The aims of this study were to explore both the role families play in gambling initiation, maintenance, and help-seeking, and the harm caused to families by the gambling behavior using a qualitative approach. Methods: Regular older adult gamblers were included in the study. In-depth interviews were conducted with 25 older adults to gain an understanding of gambling from their perspective. Older adult gamblers described their lived experience of gambling ranging from initiation to harm and attempts to cut down or limit gambling. Data were analyzed using thematic network analysis. Results: The mean age of the 25 participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), had secondary education (n = 9), were married (n = 20), and currently employed (n = 15). Four organizing themes related to the role of families in initiation and maintenance of gambling, harm caused to family members, and their role in help-seeking were identified. Discussion and conclusions: The study emphasizes the role of Asian families in both initiation and maintenance of gambling. Hence, families must be involved in prevention and outreach programs. Family members must be educated, so that they can encourage help-seeking to ensure early treatment and recovery. There is a need for interventional studies for reducing stress and improving coping among family members. © 2017 The Author(s).
- Authors: Subramaniam, Mythily , Chong, Siow , Satghare, Pratika , Browning, Colette , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: Journal of Behavioral Addictions Vol. 6, no. 4 (2017), p. 689-698
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- Description: Background and aims: Families play an important role in the evolution of gambling and are also adversely affected by the disordered gambling of any one of their members. The aims of this study were to explore both the role families play in gambling initiation, maintenance, and help-seeking, and the harm caused to families by the gambling behavior using a qualitative approach. Methods: Regular older adult gamblers were included in the study. In-depth interviews were conducted with 25 older adults to gain an understanding of gambling from their perspective. Older adult gamblers described their lived experience of gambling ranging from initiation to harm and attempts to cut down or limit gambling. Data were analyzed using thematic network analysis. Results: The mean age of the 25 participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), had secondary education (n = 9), were married (n = 20), and currently employed (n = 15). Four organizing themes related to the role of families in initiation and maintenance of gambling, harm caused to family members, and their role in help-seeking were identified. Discussion and conclusions: The study emphasizes the role of Asian families in both initiation and maintenance of gambling. Hence, families must be involved in prevention and outreach programs. Family members must be educated, so that they can encourage help-seeking to ensure early treatment and recovery. There is a need for interventional studies for reducing stress and improving coping among family members. © 2017 The Author(s).
Responsible gambling among older adults : a qualitative exploration
- Subramaniam, Mythily, Satghare, Pratika, Vaingankar, Janhavi, Picco, Louisa, Browning, Colette, Chong, Siow, Thomas, Shane
- Authors: Subramaniam, Mythily , Satghare, Pratika , Vaingankar, Janhavi , Picco, Louisa , Browning, Colette , Chong, Siow , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
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- Description: Background: Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods: Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results: This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions: The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. © 2017 The Author(s).
- Authors: Subramaniam, Mythily , Satghare, Pratika , Vaingankar, Janhavi , Picco, Louisa , Browning, Colette , Chong, Siow , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods: Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results: This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions: The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. © 2017 The Author(s).
Barriers and enablers to the delivery of psychological care in the management of patients with type 2 diabetes mellitus in China : a qualitative study using the theoretical domains framework
- Chapman, Anna, Yang, Hui, Thomas, Shane, Searle, Kendall, Browning, Colette
- Authors: Chapman, Anna , Yang, Hui , Thomas, Shane , Searle, Kendall , Browning, Colette
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p.
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- Description: Background: China has the largest number of type 2 diabetes mellitus (T2DM) cases globally and individuals with T2DM have an increased risk of developing mental health disorders and functional problems. Despite guidelines recommending that psychological care be delivered in conjunction with standard T2DM care; psychological care is not routinely delivered in China. Community Health Centre (CHC) doctors play a key role in the management of patients with T2DM in China. Understanding the behavioural determinants of CHC doctors in the implementation of psychological care recommendations allows for the design of targeted and culturally appropriate interventions. As such, this study aimed to examine barriers and enablers to the delivery of psychological care to patients with T2DM from the perspective of CHC doctors in China. Methods: Two focus groups were conducted with 23 CHC doctors from Shenzhen, China. The discussion guide applied the Theoretical Domains Framework (TDF) that examines current practice and identifies key barriers and enablers perceived to influence practice. Focus groups were conducted with an interpreter, and were digitally recorded and transcribed. Two researchers independently coded transcripts into pre-defined themes using deductive thematic analysis. Results: Barriers and enablers perceived by doctors as being relevant to the delivery of psychological care for patients with T2DM were primarily categorised within eight TDF domains. Key barriers included: CHC doctors' knowledge and skills; time constraints; and absence of financial incentives. Other barriers included: societal perception that treating psychological aspects of health is less important than physical health; lack of opinion leaders; doctors' intentional disregard of psychological care; and doubts regarding the efficacy of psychological care. In contrast, perceived enablers included: Training of CHC doctors in psychological skills; identification of afternoon/evening clinic times when recommendations could be implemented; introduction of financial incentives; and the creation of a professional role (e.g. diabetes educator), that could implement psychological care recommendations to patients with T2DM. © 2016 Chapman et al..
- Authors: Chapman, Anna , Yang, Hui , Thomas, Shane , Searle, Kendall , Browning, Colette
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p.
- Full Text:
- Reviewed:
- Description: Background: China has the largest number of type 2 diabetes mellitus (T2DM) cases globally and individuals with T2DM have an increased risk of developing mental health disorders and functional problems. Despite guidelines recommending that psychological care be delivered in conjunction with standard T2DM care; psychological care is not routinely delivered in China. Community Health Centre (CHC) doctors play a key role in the management of patients with T2DM in China. Understanding the behavioural determinants of CHC doctors in the implementation of psychological care recommendations allows for the design of targeted and culturally appropriate interventions. As such, this study aimed to examine barriers and enablers to the delivery of psychological care to patients with T2DM from the perspective of CHC doctors in China. Methods: Two focus groups were conducted with 23 CHC doctors from Shenzhen, China. The discussion guide applied the Theoretical Domains Framework (TDF) that examines current practice and identifies key barriers and enablers perceived to influence practice. Focus groups were conducted with an interpreter, and were digitally recorded and transcribed. Two researchers independently coded transcripts into pre-defined themes using deductive thematic analysis. Results: Barriers and enablers perceived by doctors as being relevant to the delivery of psychological care for patients with T2DM were primarily categorised within eight TDF domains. Key barriers included: CHC doctors' knowledge and skills; time constraints; and absence of financial incentives. Other barriers included: societal perception that treating psychological aspects of health is less important than physical health; lack of opinion leaders; doctors' intentional disregard of psychological care; and doubts regarding the efficacy of psychological care. In contrast, perceived enablers included: Training of CHC doctors in psychological skills; identification of afternoon/evening clinic times when recommendations could be implemented; introduction of financial incentives; and the creation of a professional role (e.g. diabetes educator), that could implement psychological care recommendations to patients with T2DM. © 2016 Chapman et al..
Management of type 2 diabetes in China : the happy life club, a pragmatic cluster randomised controlled trial using health coaches
- Browning, Colette, Chapman, Anna, Yang, Hui, Liu, Shuo, Zhang, Tuohong, Enticott, Joanne, Thomas, Shane
- Authors: Browning, Colette , Chapman, Anna , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Enticott, Joanne , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Vol. 6, no. 3 (2016), p.
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- Description: Objective: To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care. Design: Pragmatic cluster randomised controlled trial (RCT). Setting: Community Health Stations (CHSs) in Fengtai district, Beijing, China. Participants: Of the 41 randomised CHSs (21 intervention and 20 control), 21 intervention CHSs (372 participants) and 18 control CHSs (296 participants) started participation. Intervention: Intervention participants received telephone and face-to-face MI health coaching in addition to usual care from their CHS. Control participants received usual care only. Medical fees were waived for both groups. Outcome measures: Outcomes were assessed at baseline, 6 and 12 months. Primary outcome measure was glycated haemoglobin (HbA1c). Secondary outcomes included a suite of anthropometric, blood pressure (BP), fasting blood, psychosocial and self-care measures. Results: At 12 months, no differential treatment effect was found for HbA1c (adjusted difference 0.02, 95% CI -0.40 to 0.44, p=0.929), with both treatment and control groups showing significant improvements. However, two secondary outcomes: psychological distress (adjusted difference -2.38, 95% CI -4.64 to -0.12, p=0.039) and systolic BP (adjusted difference -3.57, 95% CI -6.08 to -1.05, p=0.005) were robust outcomes consistent with significant differential treatment effects, as supported in sensitivity analyses. Interestingly, in addition to HbA1c, both groups displayed significant improvements in triglycerides, LDL cholesterol and HDL cholesterol. Conclusions: In line with the current Chinese primary healthcare reform, this study is the first large-scale cluster RCT to be implemented within real-world CHSs in China, specifically addressing T2DM. Although a differential treatment effect was not observed for HbA1c, numerous outcomes (including HbA1c) improved in both groups, supporting the establishment of regular, free clinical health checks for people with T2DM in China. Trial registration number: ISRCTN01010526; Preresults.
- Authors: Browning, Colette , Chapman, Anna , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Enticott, Joanne , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Vol. 6, no. 3 (2016), p.
- Full Text:
- Reviewed:
- Description: Objective: To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care. Design: Pragmatic cluster randomised controlled trial (RCT). Setting: Community Health Stations (CHSs) in Fengtai district, Beijing, China. Participants: Of the 41 randomised CHSs (21 intervention and 20 control), 21 intervention CHSs (372 participants) and 18 control CHSs (296 participants) started participation. Intervention: Intervention participants received telephone and face-to-face MI health coaching in addition to usual care from their CHS. Control participants received usual care only. Medical fees were waived for both groups. Outcome measures: Outcomes were assessed at baseline, 6 and 12 months. Primary outcome measure was glycated haemoglobin (HbA1c). Secondary outcomes included a suite of anthropometric, blood pressure (BP), fasting blood, psychosocial and self-care measures. Results: At 12 months, no differential treatment effect was found for HbA1c (adjusted difference 0.02, 95% CI -0.40 to 0.44, p=0.929), with both treatment and control groups showing significant improvements. However, two secondary outcomes: psychological distress (adjusted difference -2.38, 95% CI -4.64 to -0.12, p=0.039) and systolic BP (adjusted difference -3.57, 95% CI -6.08 to -1.05, p=0.005) were robust outcomes consistent with significant differential treatment effects, as supported in sensitivity analyses. Interestingly, in addition to HbA1c, both groups displayed significant improvements in triglycerides, LDL cholesterol and HDL cholesterol. Conclusions: In line with the current Chinese primary healthcare reform, this study is the first large-scale cluster RCT to be implemented within real-world CHSs in China, specifically addressing T2DM. Although a differential treatment effect was not observed for HbA1c, numerous outcomes (including HbA1c) improved in both groups, supporting the establishment of regular, free clinical health checks for people with T2DM in China. Trial registration number: ISRCTN01010526; Preresults.
Problem gambling and intimate partner violence : a systematic review and meta-analysis
- Dowling, Nicki, Suomi, Aino, Jackson, Alun, Lavis, Tiffany, Thomas, Shane
- Authors: Dowling, Nicki , Suomi, Aino , Jackson, Alun , Lavis, Tiffany , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: Trauma, Violence, and Abuse Vol. 17, no. 1 (2016), p. 43-61
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- Description: This study provides a systematic review of the empirical evidence related to the association between problem gambling and intimate partner violence (IPV). We identified 14 available studies in the systematic search (8 for victimisation only, 4 for perpetration only and 2 for both victimisation and perpetration). Although there were some equivocal findings, we found that most of the available research suggests that there is a significant relationship between problem gambling and being a victim of IPV. There was more consistent evidence that there is a significant relationship between problem gambling and perpetration of IPV. Meta-analyses revealed that over one third of problem gamblers report being victims of physical IPV (38.1%) or perpetrators of physical IPV (36.5%) and that the prevalence of problem gambling in IPV perpetrators is 11.3%. Although the exact nature of the relationships between problem gambling and IPV is yet to be determined, the findings suggest that less than full employment and clinical anger problems are implicated in the relationship between problem gambling and IPV victimization and that younger age, less than full employment, clinical anger problems, impulsivity, and alcohol and substance use are implicated in the relationship between problem gambling and IPV perpetration. The findings highlight the need for treatment services to undertake routine screening and assessment of problem gambling, IPV, alcohol and substance use problems, and mental health issues and provide interventions designed to manage this cluster of comorbid conditions. Further research is also required to investigate the relationship between problem gambling and violence that extends into the family beyond intimate partners. © 2014, The Author(s) 2014. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
- Authors: Dowling, Nicki , Suomi, Aino , Jackson, Alun , Lavis, Tiffany , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: Trauma, Violence, and Abuse Vol. 17, no. 1 (2016), p. 43-61
- Full Text:
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- Description: This study provides a systematic review of the empirical evidence related to the association between problem gambling and intimate partner violence (IPV). We identified 14 available studies in the systematic search (8 for victimisation only, 4 for perpetration only and 2 for both victimisation and perpetration). Although there were some equivocal findings, we found that most of the available research suggests that there is a significant relationship between problem gambling and being a victim of IPV. There was more consistent evidence that there is a significant relationship between problem gambling and perpetration of IPV. Meta-analyses revealed that over one third of problem gamblers report being victims of physical IPV (38.1%) or perpetrators of physical IPV (36.5%) and that the prevalence of problem gambling in IPV perpetrators is 11.3%. Although the exact nature of the relationships between problem gambling and IPV is yet to be determined, the findings suggest that less than full employment and clinical anger problems are implicated in the relationship between problem gambling and IPV victimization and that younger age, less than full employment, clinical anger problems, impulsivity, and alcohol and substance use are implicated in the relationship between problem gambling and IPV perpetration. The findings highlight the need for treatment services to undertake routine screening and assessment of problem gambling, IPV, alcohol and substance use problems, and mental health issues and provide interventions designed to manage this cluster of comorbid conditions. Further research is also required to investigate the relationship between problem gambling and violence that extends into the family beyond intimate partners. © 2014, The Author(s) 2014. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
The intergenerational transmission of problem gambling : the mediating role of parental psychopathology
- Dowling, Nicki, Shandley, Kerrie, Oldenhof, Erin, Youssef, George, Thomas, Shane
- Authors: Dowling, Nicki , Shandley, Kerrie , Oldenhof, Erin , Youssef, George , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: Addictive Behaviors Vol. 59, no. (2016), p. 12-17
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- Description: The present study investigated the intergenerational transmission of problem gambling and the potential mediating role of parental psychopathology (problem drinking, drug use problems, and mental health issues). The study comprised 3953 participants (1938 males, 2015 females) recruited from a large-scale Australian community telephone survey of adults retrospectively reporting on parental problem gambling and psychopathology during their childhood. Overall, 4.0% [95%CI 3.0, 5.0] (n = 157) of participants reported paternal problem gambling and 1.7% [95%CI 1.0, 2.0] (n = 68) reported maternal problem gambling. Compared to their peers, participants reporting paternal problem gambling were 5.1 times more likely to be moderate risk gamblers and 10.7 times more likely to be problem gamblers. Participants reporting maternal problem gambling were 1.7 times more likely to be moderate risk gamblers and 10.6 times more likely to be problem gamblers. The results revealed that the relationships between paternal-and-participant and maternal-and-participant problem gambling were significant, but that only the relationship between paternal-and-participant problem gambling remained statistically significant after controlling for maternal problem gambling and sociodemographic factors. Paternal problem drinking and maternal drug use problems partially mediated the relationship between paternal-and-participant problem gambling, and fully mediated the relationship between maternal-and-participant problem gambling. In contrast, parental mental health issues failed to significantly mediate the transmission of gambling problems by either parent. When parental problem gambling was the mediator, there was full mediation of the effect between parental psychopathology and offspring problem gambling for fathers but not mothers. Overall, the study highlights the vulnerability of children from problem gambling households and suggests that it would be of value to target prevention and intervention efforts towards this cohort. © 2016 Elsevier Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
- Authors: Dowling, Nicki , Shandley, Kerrie , Oldenhof, Erin , Youssef, George , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: Addictive Behaviors Vol. 59, no. (2016), p. 12-17
- Full Text:
- Reviewed:
- Description: The present study investigated the intergenerational transmission of problem gambling and the potential mediating role of parental psychopathology (problem drinking, drug use problems, and mental health issues). The study comprised 3953 participants (1938 males, 2015 females) recruited from a large-scale Australian community telephone survey of adults retrospectively reporting on parental problem gambling and psychopathology during their childhood. Overall, 4.0% [95%CI 3.0, 5.0] (n = 157) of participants reported paternal problem gambling and 1.7% [95%CI 1.0, 2.0] (n = 68) reported maternal problem gambling. Compared to their peers, participants reporting paternal problem gambling were 5.1 times more likely to be moderate risk gamblers and 10.7 times more likely to be problem gamblers. Participants reporting maternal problem gambling were 1.7 times more likely to be moderate risk gamblers and 10.6 times more likely to be problem gamblers. The results revealed that the relationships between paternal-and-participant and maternal-and-participant problem gambling were significant, but that only the relationship between paternal-and-participant problem gambling remained statistically significant after controlling for maternal problem gambling and sociodemographic factors. Paternal problem drinking and maternal drug use problems partially mediated the relationship between paternal-and-participant problem gambling, and fully mediated the relationship between maternal-and-participant problem gambling. In contrast, parental mental health issues failed to significantly mediate the transmission of gambling problems by either parent. When parental problem gambling was the mediator, there was full mediation of the effect between parental psychopathology and offspring problem gambling for fathers but not mothers. Overall, the study highlights the vulnerability of children from problem gambling households and suggests that it would be of value to target prevention and intervention efforts towards this cohort. © 2016 Elsevier Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**
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