Jörg Wolstein

Identifying Problematic Internet Users: Development and Validation of the Internet Motive Questionnaire for Adolescents (IMQ-A)

Background Internationally, up to 15.1% of intensive Internet use among adolescents is dysfunctional. To provide a basis for early intervention and preventive measures, understanding the motives behind intensive Internet use is important. Objective This study aims to develop a questionnaire, the Internet Motive Questionnaire for Adolescents (IMQ-A), as a theory-based measurement for identifying the underlying motives for high-risk Internet use. More precisely, the aim was to confirm the 4-factor structure (ie, social, enhancement, coping, and conformity motives) as well as its construct and concurrent validity. Another aim was to identify the motivational differences between high-risk and low-risk Internet users. Methods A sample of 101 German adolescents (female: 52.5%, 53/101; age: mean 15.9, SD 1.3 years) was recruited. High-risk users (n=47) and low-risk users (n=54) were identified based on a screening measure for online addiction behavior in children and adolescents (Online-Suchtverhalten-Skala, OSVK-S). Here, “high-risk” Internet use means use that exceeds the level of intensive Internet use (OSVK-S sum score ≥7). Results The confirmatory factor analysis confirmed the IMQ-A’s 4-factor structure. A reliability analysis revealed good internal consistencies of the subscales (.71 up to .86). Moreover, regression analyses confirmed that the enhancement and coping motive groups significantly predicted high-risk Internet consumption and the OSVK-S sum score. A mixed-model ANOVA confirmed that adolescents mainly access the Internet for social motives, followed by enhancement and coping motives, and that high-risk users access the Internet more frequently for coping and enhancement motives than low-risk users. Low-risk users were primarily motivated socially. Conclusions The IMQ-A enables the assessment of motives related to adolescent Internet use and thus the identification of populations at risk. The questionnaire enables the development of preventive measures or early intervention programs, especially dealing with internal motives of Internet consumption.

Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication — A randomized controlled trial

The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in accordance with their drinking motives as indicated at baseline (e.g. alternative ways of spending leisure time or dealing with stress). Exercises for the CG contained alcohol-related information in general (e.g. legal issues). The data of 81 adolescents (age: M = 15.6, SD = 1.0; 42.0% female) who participated in both the baseline and the follow-up were compared using ANOVA with repeated measurements and effect sizes (available case analyses). Adolescents reported lower alcohol use at the four-week follow-up independently of the kind of intervention. Significant interaction effects between time and IG were found for girls in terms of drinking frequency (F = 7.770, p < 0.01) and binge drinking (F = 7.0005, p < 0.05) but not for boys. For the former, the proportional reductions and corresponding effect sizes of drinking frequency (d = − 1.18), binge drinking (d = − 1.61) and drunkenness (d = − 2.87) were much higher than the .8 threshold for large effects. Conducting psychosocial interventions in a motive-tailored way appears more effective for girls admitted to hospital due to alcohol intoxication than without motive-tailoring. Further research is required to address the specific needs of boys in such interventions. (German Clinical Trials Register, DRKS ID: DRKS00005588).

Effectiveness of a brief intervention with and without booster session for adolescents hospitalized due to alcohol intoxication

Abstract Background: The Hart-am-LimiT (HaLT) project is a brief intervention program for adolescents hospitalized due to alcohol intoxication in Germany. Objective: To test whether a booster session has an impact on participants’ drinking behavior compared with the standard HaLT program. Methods: On the morning after their admission due to alcohol intoxication, 411 adolescents in the Federal State of Bavaria were interviewed between October 2008 and January 2010 and socio-demographic data and information on previous drinking behavior were recorded (t1). Eleven to 25 months (M = 16.4) after their hospital treatment, 106 adolescents completed an online questionnaire (t2). Results: Subgroup analysis (ANOVA with repeated measurements) indicated that adolescents who took part in the booster session did not increase episodic heavy drinking (EHD; t1: M = 1.68 EHD d; t2: 1.59 EHD d) in contrast to the non-participating group (t1: M = 1.08 d EHD; t2: 2.66 d EHD; F = 4.383, p = 0.039). Conclusion: Considering the study’s limitations (e.g. no randomization, low response rate, etc.), the results indicate a positive effect of a booster session following a brief intervention for adolescents who have been treated in hospital due to alcohol intoxication. Adolescents should therefore be motivated and encouraged to participate in booster sessions.

Psychometrische Evaluation des deutschen Kurzfragebogens für suchtbelastete Familienmitglieder SQFM-AA (Version Glücksspiel)

INTRODUCTION Affected others of disordered gamblers are often heavily impacted because of the illness. Up till now, there is no standardized German instrument to assess this impact. Internationally, the Short Questionnaire for Family Members-affected by addiction (SQFM-AA) is often used which is based on the Stress-Strain-Coping-Support-Modell. That is why we translated this questionnaire into the German Kurzfragebogen für suchtbelastete Familienmitglieder SQFM-AA (Version Glücksspiel) to be able to assess the impact on affected others and to compare our results internationally. METHODS The SQFM-AA was translated and retranslated and tested in an online convenience sample of affected others. Essential psychometric properties, discriminatory power, and internal consistency were calculated. Factor structure was analysed using an exploratory factor analysis (principal axis analysis, varimax rotation). RESULTS Data collected from 122 affected others (87% female; 67% partners; 61% joint household) were analysed. Discriminatory power ranges between 0.30-0.94, Cronbachs alpha between 0.61-0.95. Factor analysis shows that 69% of variance can be explained in a solution with 9 factors. DISCUSSION Due to the methods used when translating and back-translating the SQFM-AA, it can be assumed that both versions are comparable. Internal consistency of all scales is in an acceptable to good range. In our sample, the postulated 11 sub-scales cannot be reproduced. The 9 factors found here can be derived based on theoretical preliminary considerations. 4 of the scales are reflected well in the analysis, 3 more factors show a relevant load on other scales. Furthermore, one item each does not load on the proposed factor for the 2 remaining scales. All in all, the factors can be interpreted well regarding their content. A modification of the questionnaire would improve some of the statistical values, but the international comparability would no longer be possible. CONCLUSION With the adaptation presented here, impact on affected others of disordered gamblers can be assessed and relevant areas for therapy and counselling can be identified.

Was tun bei Alkoholintoxikation im Kindes- und Jugendalter?

Riskante Alkoholkonsummuster sind in den letzten Jahren stark in das Zentrum des medialen Interesses gerückt. Die Thematik wird mit besorgniserregenden Begriffen wie „Komatrinken“ oder „saufen bis der Notarzt kommt“ umschrieben. Einseitige Berichterstattungen führen zu einer Verunsicherung der ohnehin schon alarmierten Leser.

Vergleich von Patienten mit und ohne Migrationshintergrund am Anfang und Ende einer Suchttherapie

Fragestellung: Gibt es Unterschiede zwischen Migranten aus Osteuropa und Deutschen mit einer Suchterkrankung in der subjektiv erlebten Belastung, in depressiven Beschwerden, Personlichkeitseigenschaften und Stress- und Argerreaktionen? Wie unterscheiden sich diese Faktoren am Ende einer abgeschlossenen 9-monatigen stationaren Therapie? Methodik: Von den Patienten einer Suchtklinik wurden 20 Migranten aus der GUS bzw. Polen und 20 Klienten deutscher Herkunft gematcht. Anhand der durchgefuhrten Testdiagnostik wurden diese Gruppen retrospektiv hinsichtlich der erfassten subjektiv erlebten Belastung, depressiven Beschwerden, Personlichkeitsfaktoren, Argerreaktionen und Stressverarbeitung in Quer- und Langsschnitt verglichen. Ergebnisse: Es lies sich eine signifikant hohere subjektiv erlebte Belastung der Migranten und eine haufigere Nutzung von negativen Stressverarbeitungsstrategien feststellen. Im Laufe der Therapie verbesserten sich beide Gruppen in ahnlicher Weise. Schlussfolgerung...

Is an e-mental health programme a viable way to reach affected others of disordered gamblers? A feasibility study focusing on access and retention

ABSTRACT Although affected family members (AFMs) of disordered gamblers suffer from highly stressful living conditions and are in need of specialized help, access to and knowledge of professional support is limited. To improve this situation, an e-mental health programme called EfA with one information module and five consecutive training modules was developed. The study investigated (1) promotion of and referral to EfA, (2) duration of visits and conversion rate, and (3) participants’ characteristics and retention in EfA. In 9 months, 6357 visits were counted. Most visitors arrived at the website via direct access. Those using search terms most commonly used phrases that were used in promotional materials. Per month, 16.1 new potential participants registered. The final sample consisted of 126 participants, most of them female, with high daily Internet usage and low use of prior professional support or self-help. More than one-third finished all modules. This is the first time that data on an e-mental health programme for this clientele was collected in Germany. Findings imply the importance of promoting such a programme in order to reach a clientele that has not had prior help and also show that it is a viable way to reach AFMs.

Development and validation of the Amphetamine-Type Stimulants Motive Questionnaire in a clinical population

Approximately 35.7 million people world-wide use amphetamine-type stimulants (ATS) leading to a high demand for effective treatment. Understanding the motives behind ATS use is a necessary basis for preventive and therapeutic treatment. The objective of this study is to develop the Amphetamine-Type stimulants Motive Questionnaire (AMQ) and to confirm its construct and concurrent validity in respect to the first and the latest month of ATS use based on answers of 233 patients with ATS disorders (74.2% male; mean age: 31.1 years). Confirmatory factor analyses were employed to test for the construct validity of the AMQ. Nested models of confirmatory factor analyses with increasing constraints for gender and age were estimated to test the equivalence of the factor structure in different subgroups. Independent sample t-tests were conducted to test for mean differences in the motive dimensions. A structural equation model was estimated to confirm the concurrent validity using the latent four motive factors (i.e., enhancement, coping, social, and conformity motives) as independent variables and frequency of ATS use in the first and the latest month of use as a dependent variable. The results confirmed the AMQ’s four-dimensional factor structure in general, and across gender and age groups for both periods of time. Men (first month: M = 4.21, SD = 0.75; latest month: M = 3.86, SD = 0.93) use ATS more frequently due to enhancement motives than women (first month: M = 3.85, SD = 1.12; latest month: M = 3.46, SD = 1.29) at both periods of time [first month: t(77) = −2.33, p = 0.022; latest month: t(80) = −2.19, p = 0.031]. Structural equation modeling confirmed an association between coping motives and use frequency, for both periods of time (first and latest month: β = 0.32, p < 0.001), as well as between social motives and frequency of use for the latest month of use (β = 0.30, p < 0.01). To conclude, the AMQ is a valid and reliable instrument for assessing motives of ATS use in a clinical population. It can provide important insights into the motivational structure of the first and latest months of ATS use which are useful for preventive and therapeutic treatments as well as the development of abstinence skills.

Effectiveness of an email-based intervention helping parents to enhance alcohol-related parenting skills and reduce their children’s alcohol consumption – A randomised controlled trial

Abstract Aims: Developing and evaluating an email-based intervention (EBI) to enhance alcohol-related parenting skills and reduce alcohol consumption among adolescents. Methods: Over four weeks, participating parents received a weekly email containing scientific findings, practical advice and exercises in relation to such topics as alcohol-related rule-setting and communication. Using a randomised controlled trial (ID: DRKS00007763), data from 467 parents and 173 adolescents were collected via self-report online questionnaires and analysed by means of repeated measures analysis of variance. Findings: Controlling for baseline, parents in the intervention group (IG) scored higher for being informed (parents of girls: F = 19.023, p = 0.000; parents of boys: F = 30.294, p = 0.000) and for self-efficacy (parents of girls: F = 6.122, p = 0.014; parents of boys: F = 10.195, p = 0.002) at follow-up and, in the case of boys, were more successful in maintaining strict rules on alcohol consumption (F = 13.704, p = 0.000) than parents in the control group (CG) (girls: F = 1.627; p = 0.204). Boys whose parents were in the IG reported less heavy episodic drinking at follow-up (F = 4.192, p = 0.043), controlled for baseline, than those with parents in the CG (girls: F = 0.567; p = 0.454). Conclusions: The EBI has positive effects on alcohol-related parenting and may reduce heavy episodic drinking among boys. Since it is delivered via email, the programme has considerable potential to reach many parents at low cost.

Entlastung für Angehörige von problematischen und pathologischen Glücksspielern - Das E-Mental-Health-Programm EfA

Einleitung: Das Problembewusstsein bezuglich problematischen und pathologischen Glucksspielens ist in den vergangenen Jahren in Deutschland gestiegen. Fur betroffene Glucksspieler hat sich die Behandlungssituation stark verbessert, allerdings existieren kaum Angebote fur ihre Angehorigen (Uberblick bei Buchner et al., 2012). Dabei konnte ihr Einbezug im Sinne des CRAFT-Ansatzes (Community Reinforcement and Family Training; Meyers et al., 1999) dazu beitragen, betroffene Spieler zu einer Behandlungsaufnahme zu motivieren. Auserdem sind Angehorige durch die Erkrankung stark belastet und befinden sich in hoch stressreichen Lebensumstanden (Buchner et al. 2012). Im deutschsprachigen Raum liegt mit dem Entlastungstraining fur Angehorige problematischer und pathologischer Glucksspieler – psychoedukativ (ETAPPE) neuerdings ein manualisiertes Gruppenangebot mit positiven Evaluationsergebnissen fur den Einsatz in Beratungsstellen o.a. vor (Buchner et al., 2013; Buchner et al., 2012). Dennoch konnen damit nicht alle betroffenen Angehorigen erreicht werden. Da inzwischen positive Befunden zu E-Mental-Health-Programmen existieren (Eichenberg & Ott, 2012), wird mit „Verspiel nicht mein Leben“ – Entlastung fur Angehorige (EfA) ein entsprechendes Angebot fur diese Zielgruppe entwickelt und evaluiert. Methode: In der Pilotphase steht das E-Mental-Health-Programm allen interessierten Angehorigen offen, die bereit sind, sich an der Begleitstudie zu beteiligen. Neben modulspezifischen Ruckmeldungen wird eine begleitende Befragung durchgefuhrt, die u.a. soziodemographische Angaben, Spielverhalten und Auswirkungen auf die Beziehung und das Wohlbefinden sowie die Wahrnehmung, Bewertung und Weiterverarbeitung von Stressoren umfasst. Diskussion/Ergebnisse: EfA ist fur betroffene Angehorige seit Juni 2013 unter www.verspiel-nicht-mein-leben.de kostenfrei online zuganglich. Erste Erfahrungen zur Inanspruchnahme des Projekts, Ruckmeldungen zu den Modulen und zur bislang erreichten Zielgruppe werden vorgestellt. Schlussfolgerung: Derzeit befindet sich das Pilotprojekt in der Durchfuhrungsphase. Sowohl die Ruckmeldungen zu den einzelnen Modulen als auch die begleitende Erhebung werden gesammelt und ausgewertet. Auf Basis der Erkenntnisse wird im Anschluss das E-Mental-Health-Programm uberarbeitet, um eine moglichst gute Passung zur Zielgruppe zu erreichen. Langfristig soll mit EfA ein niedrigschwelliges Angebot fur Angehorige problematischer und pathologischer Glucksspieler zur Verfugung stehen.