Tuuli Lahti

Factors associated with disordered gambling in Finland

BackgroundThe purpose of this study was to compare the socio-demographic characteristics of non-problem gamblers, problem gamblers and pathological gamblers, to investigate the association between gambling related factors and perceived health and well-being among the three subgroups of gamblers, and to analyse simultaneously socio-demographic characteristics, gambling related factors and perceived health and well-being and the severity of disordered gambling (problem gamblers and pathological gamblers).MethodsThe data were collected through a nationwide telephone survey in 2011. Participants were selected through a random population sample of 15-74-year-old Finns. From that sample, persons with any past-year gambling involvement (Nu2009=u20093451) were selected for a subsample for the descriptive and inferential analysis in the present paper. Gambling was assessed using the South Oaks Gambling Screen. Statistical significance was determined by chi-squared tests. The odds ratio and effect size were computed by using multivariate-adjusted multinomial logistic regression analysis.ResultsThe most significant socio-demographic characteristics (male gender, young age, education ≤12xa0years), gambling related factors (slot machine gambling, internet gambling) and perceived health and well-being (feeling lonely, smoking daily, risky alcohol consumption, mental health problems) explained 22.9 per cent of the variation in the severity of disordered gambling.ConclusionMale gender and loneliness were found to be associated with problem gambling in particular, along with smoking and risky alcohol consumption. Mental health problems and risky alcohol consumption were associated with pathological gambling. These identified associations between disordered gambling, mental health problems and risky alcohol consumption should be taken into consideration when implementing screenings of disordered gambling.

Late bedtimes weaken school performance and predispose adolescents to health hazards

STUDY OBJECTIVESnOur study explored if bedtimes influenced school performance and motivation, as well as the odds ratio (OR) for health-related concerns in adolescents.nnnMETHODSnThe School Health Promotion Study was based on an anonymous self-report questionnaire conducted in 90% of the municipalities in Finland. The study was conducted during 2008 and 2010 in Southern Finland, Eastern Finland, and Lapland, and during 2009 and 2011 in Western Finland, Northern Finland, and Åland. Several indicators were used to measure school performance and motivation. Accidents and health-related complaints, such as depressive symptoms, sleep quality, neck or shoulder pains, lower back pains, stomachaches, anxiety or nervousness, irritation or tantrums, headaches, and tiredness or dizziness were analyzed in relation to the usual bedtime. Our study had a relatively large sample size (N=384,076), consisting of students in the eighth and the ninth grades of secondary schools and the first and the second grades of upper secondary and vocational schools (ages 14-20 years) in Finland.nnnRESULTSnAll of the various indicators used to assess school performance and motivation suggest that the later the bedtime of adolescents, the lower their school performance and their motivation. Similarly later bedtimes increase the OR for depressive symptoms and other negative health consequences in adolescents as well as a tendency towards accidents. All of these problems were emphasized in students with bedtimes of 11:30 PM and later.nnnCONCLUSIONSnLate bedtimes, especially those after 11:30 PM, indicate poor sleep which deteriorates school performance and motivation and increases the OR for depressive symptoms and other health-related issues in adolescents.

An analysis of problem gambling among the Finnish working-age population: a population survey

BackgroundGambling problems currently affect approximately 100 000 Finns. In order to prevent and reduce gambling-related harms it is crucial for the Finnish public health authorities to gain a stronger understanding of the association between gambling problems and related socio-demographic factors, other commonly co-occurring dependencies (e.g. alcohol and nicotine) and the type of games gambled. In this article the prevalence of problem gambling in Finland and the socio-demographic profiles of problem gamblers are studied.MethodAn annual postal survey entitled Health Behaviour and Health among the Finnish Adult Population AVTK was sent to a random sample of Finnish adults (N=5000) aged between 15 and 64. The sample was derived from the Finnish Population Register. The survey was mailed to the participants in April 2010. Gender differences in socio-demographic variables and Problem Gambling Severity Index PGSI were assessed. A multinomial regression model was created in order to explore the association between socio-demographic factors and the severity of gambling.ResultsA total of 2826 individuals (1243 males and 1583 females) replied to the survey. Of the respondents, 1.1% (2.1% of males, 0.3% of females) were identified as problem gamblers. Those who were of younger age, gender, had less than twelve years of education, consumed alcohol at risk level and smoked had higher odds of having low or moderate levels of gambling problems. Whereas, unemployment and smoking predicted significantly for problem gambling. Females gambled Lotto and slot machines less frequently than males and had more low level gambling problems. Males gambled more with a higher frequency and had a more severe level of gambling problems. Females were more attracted to scratch card gambling and daily Keno lotteries compared to males. In comparison, males gambled more on internet poker sites than females. Overall, a high frequency of gambling in Lotto, daily lotteries, slot machines, horse race betting and internet gambling was significantly associated with a more severe level of problem gambling.ConclusionGambling problems affect tens of thousands of individuals annually, therefore certain vulnerabilities should be noted. Comorbid dependencies, smoking in particular, ought to be screened for and recognised in the public health sector. Regulating the availability of slot machine gambling and enforcement of the age limit should be acknowledged. In establishing new gambling venues, prevalence rates in those particular areas should be actively monitored.

Behavioral trait of morningness-eveningness in association with articular and spinal diseases in a population.

Earlier studies have revealed that the more the preference to schedule daily activities towards the evening hours is, the higher the odds for a range of health hazards are. Therefore, we wanted to analyze, whether the behavioral trait of morningness-eveningness is associated with articular and spinal diseases or those with musculoskeletal disorders. Participants (nu200a=u200a6089), as part of the National FINRISK 2007 Study, were derived from the general population, aged 25 to 74 years, living in Finland. Chronotype was assessed based on six items from the original Horne-Östberg Morningness-Eveningness Questionnaire. Information about risk factors and the diagnoses of articular and spinal diseases were based on the self-reported information. Our results suggest that Evening-types have higher odds for articular and spinal diseases as compared with Morning-types, and this risk is heightened especially regarding spinal disease and backache (odds ratios of 1.8 to 2.1, and 1.6 to 1.8, respectively) and remains significant after controlling for the sex, age, education, civil status, physical activity, alcohol use, and smoking, and additionally for the body-mass index, insufficient sleep, or depressive symptoms.

At-risk and problem gambling among adolescents: a convenience sample of first-year junior high school students in Finland

BackgroundAdolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG.MethodsThis study examined 988 adolescents (mean age 13.4xa0years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used.Results‘Illegal acts’ was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J scoreu2009≥u20092), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers.ConclusionsOverall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.

Internet-based CBT intervention for gamblers in Finland: experiences from the field.

From September 2007 to May 2011 a total of 471 participants (325 males and 146 females) signed up for an 8-week Internet-based cognitive behavioral therapy offered for gamblers in Finland. Sixty-four percent of the participants were pathological gamblers (PGs) (NODS 5> points), 14% were problem gamblers (NODS 3-4 points) and 10% were at risk of gambling problems (NODS 1-2 points). Two hundred and twenty four participants completed the treatment and after the treatment period significant changes were found in the following variables: gambling related problems (NODS), gambling urge, impaired control of gambling, alcohol consumption (AUDIT-C), social consequences, gambling-related cognitive erroneous thoughts and depression (MARD-S). In this sample co-morbid alcohol consumption was stronger among males. The main finding of this study was that the onset age of gambling was associated with a greater amount of gambling-related cognitive erroneous thoughts.

Concerned significant others of people with gambling problems in Finland: a cross-sectional population study.

BackgroundProblem gambling not only impacts those directly involved, but also the concerned significant others (CSOs) of problem gamblers. The aims of this study were to investigate the proportion of male and female CSOs at the population level; to investigate who the CSOs were concerned about; and to investigate sociodemographic factors, gender differences, gambling behaviour, and health and well-being among CSOs and non-CSOs.MethodsThe data (nu2009=u20094484) were based on a cross-sectional population study. Structured telephone interviews were conducted in 2011–2012. The data were weighted based on age, gender and residency. The respondents were defined as CSOs if they reported that at least one of their significant others (father, mother, sister/brother, grandparent, spouse, own child/children, close friend) had had gambling problems. Statistical significance was determined by chi-squared and Fisher’s exact tests, and logistic regression analysis.ResultsAltogether, 19.3% of the respondents were identified as CSOs. Most commonly, the problem gambler was a close friend (12.4%) of the CSO. The percentage of close friends having a gambling problem was larger among male CSOs (14.4%) compared with female CSOs (10.3%; pu2009≤u20090.001), while the percentage of partners with gambling problem was larger among females (2.6%) than among males (0.8%; pu2009≤u20090.001). In the best fitting model, the odds ratio (95% CI) of being a male CSO was 2.03 (1.24–3.31) for past-year gambling problems, 1.46 (1.08–1.97) for loneliness and 1.78 (1.38–2.29) for risky alcohol consumption. The odds ratio (95% CI) of being a female CSO was 1.51 (1.09–2.08) for past-year gambling involvement, 3.05 (1.18-7.90) for past-year gambling problems, 2.21 (1.24–3.93) for mental health problems, 1.39 (1.03–1.89) for loneliness and 1.97 (1.43–2.71) for daily smoking.ConclusionsCSOs of problem gamblers often experience cumulating problems such as their own risky gambling behaviour, health problems and other addictive disorders. The clearest gender difference was seen in smoking by CSO. In order to develop efficient and targeted support and services for CSOs, it is necessary to understand the correlates related to different subgroups of CSOs.

Characteristics of Treatment Seeking Finnish Pathological Gamblers: Baseline Data from a Treatment Study

This article describes the socio-demographic characteristics and gambling behavior of 39 pathological gamblers who participated in our treatment study in 2009. The inclusion criteria of the study were: score of five or more on both the South Oaks Gambling Screen (SOGS) and a pathological gambling screen based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The first 39 patients meeting the inclusion criterion were recruited into the study. The average age of the subjects was 39xa0years, and 80xa0% were males. The lag-time between active gambling (at least three times per week) and the onset of a pathological gambling problem was short: within 2xa0years of active gambling, 62xa0% of the subjects reported having become pathological gamblers. Our results also indicated certain gender-specific differences in the age at initiation and in the severity of the gambling problem.

Effect of opioid antagonists on sex hormone secretion.

Background: Endogenous opioids have roles in various functions in different parts of the body, including intestinal motility, suppression of pain, reinforcement of behavior, and regulation of the hypothalamic-pituitary-gonadal axis. The endogenous opioid system is also recognized to be involved in the negative-feedback regulation of the release of LH and testosterone. Aim: The reviewed articles herein show the development of the current model of this regulation, the evidence supporting it, and also the observed effects of opioid antagonist (naloxone, naltrexone, and nalmefene) on the system. Materials and methods: Review of the studies published during the years 1979–1996 (no significant studies made after that). Search from databases Pubmed, SciFinder, and Medline with search words opioid antagonists, hormones, LH, testosterone, and GnRH, in different combinations. Results/conclusions: Opioid antagonists seem to increase the secretion of GnRH in the hypothalamus which then causes a pulsatile release of LH in the pituitary and secretion of testosterone. According to the experiments, the frequency of pulses and concentration of LH and testosterone in plasma seem to increase. These effects are seen in both men and women (at early follicular phase). More research is needed to investigate the consequences of these effects in general.

Past-year gambling behaviour among patients receiving opioid substitution treatment

BackgroundSubstance abuse and gambling problems are associated, however, studies on gambling problems among opioid substitution treatment (OST) patients are scarce. The aims of this study are to explore the association of gender, age, treatment medication and treatment program with gambling behaviour, including gambling participation and gambling problems, among OST patients.FindingsAll OST patients (nu2009=u2009244) in three Finnish outpatient clinics were recruited in Marchu2009-u2009April 2014. The response rate was 64.3%. OST programs included two choices of orientation (rehabilitative/harm reduction) and two choices for treatment medication (methadone/buprenorphine-naloxone). Of 144 respondents, 70.1% had gambled during the past year and 12.5% were identified as potential past-year problem gamblers. Gambling was statistically significant more commonly among males (79.8%) compared with females (53.7%). Similarly patients in the rehabilitative program gambled (75.9%) more than those in the harm reduction program (50.0%). Gender, age, treatment medication or treatment program was not associated with past-year gambling problems.ConclusionsGambling participation of the OST patients seemed to be somewhat similar compared with the Finnish general population, but gambling problems were more common among OST patients. Gender and age may not be very strong indicators of risk while screening problem gamblers among OST patients. Institution of a problem gambling screening program is recommended, and additional intervention for gambling problems should be implemented for that need as a part of OST.