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Engagement in underage gambling remains a public health concern. Risk factors for the development of gambling behaviours in adolescence include the presence of externalizing and/or internalizing problems. This study aims to better understand the role of co-occurrence between externalizing and internalizing symptoms from childhood to adolescence in adolescent gambling. Participants were drawn from an ongoing longitudinal study of children with and without early conduct problems. Externalizing and internalizing problems were measured annually using teacher and parent reports. Gambling behaviours were measured using self-report when participants were approximately 15 years old. Latent class growth trajectory analyses identified five mental health trajectory classes: (1) a co-occurring trajectory characterized by stable clinical levels of both externalizing and internalizing problems, (2) an externalizing trajectory characterized by stable high clinical levels of externalizing problems, (3) an internalizing trajectory characterized by stable at-risk levels of internalizing problems, (4) an at-risk externalizing trajectory characterized by decreasing levels of externalizing problems, and (5) a non-clinical trajectory. Invariance analyses suggested that this model remained valid in both boys and girls. Logistic regression analyses suggested that youth who belonged in the externalizing trajectory reported a greater likelihood of past-year gambling behaviours when compared to youth who belong in the comorbid trajectory. No other mental health trajectory was significantly associated with adolescent gambling. Stable high externalizing behaviours in development appear to increase one's risk of gambling behaviours in adolescence. Efforts to target these throughout development could help decrease one's future risk of engaging in these behaviours. [ABSTRACT FROM AUTHOR]

Behavioural disinhibition and depression symptoms have both been suggested as potential mechanisms linking conduct problems (CP) to adolescent substance use; however, their roles have yet to be conclusively identified. The current project examines whether these mental health characteristics mediate the association between CP and early adolescent substance use. Participants (N = 744) were drawn from an ongoing longitudinal study on children with and without early CP. Structural equation models showed significant associations between CP at T1 (6.3 to 10.6 years old) and both depression symptoms and behavioural disinhibition 3 years later (T4). While depression symptoms at T4 were not associated with substance use at T6, behavioural disinhibition was. A significant partial indirect effect also emerged for behavioural disinhibition in the association between CP and substance use, but this effect disappeared once we controlled for age. Clinical implications of our study include a focus on global CP symptomatology. [ABSTRACT FROM AUTHOR]

Benzodiazepines (BZDs) are a substance commonly misused in adolescence. A significant risk factor for the nonmedical use of BZDs is sex, whereby girls are more likely to misuse such drugs. However, very few studies have examined the mental health correlates of adolescents who engage in the nonmedical use of BZDs. The current study examines whether internalizing or externalizing symptoms explain the relationship between sex and nonmedical BZD use. Self-reported questionnaires were collected in 2018 from 6986 American high-school students between the ages of 12 and 19 years. Analyses were conducted using MPlus. A total of 5.3% (n = 367) adolescents reported using non-prescribed BZDs in the past year. Girls were significantly more likely to report BZD misuse than boys. Indirect effects emerged for both internalizing and externalizing symptoms in the association between sex and nonmedical BZD use. Our results suggest that nonmedical BZD use in adolescence may be indicative of increased mental health and behavioral problems. [ABSTRACT FROM AUTHOR]

Behavioral addictions such as gambling and gaming disorder are significant public health issues that are of increasing importance to policy makers and health care providers. Problem gambling and gaming behaviors have been identified as being associated with externalizing and internalizing problems, with theoretical models suggesting that both conduct problems and depressive symptoms may be significant risk factors in the development of problem gambling and gaming. As such, the purpose of this systematic review is to provide an overview of research identifying the relationship between conduct problems, depressive symptoms and problem gambling and gaming among adolescents and young adults. Systematic literature searches in accordance with PRISMA guidelines found 71 eligible studies that met the inclusion criteria, 47 for problem gambling, 23 for problem gaming and one for both problem behaviors. Based on cross-sectional evidence, both problem gambling and gaming are consistently concurrently associated with conduct problems and depressive symptoms. Longitudinal evidence appears to be clearer for conduct problems as a risk factor for problem gambling, and depressive symptoms as a risk factor for problem gaming. However, both risk factors appear to increase the risk for these problem behaviors. Results from the literature review suggest that problem gambling and gaming are associated with the presence of conduct problems and depressive symptoms, with the potential of sharing common etiological factors. Additional research is necessary to confirm these longitudinal relationships with an emphasis on investigating the interaction of both early conduct problems and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: To validate the Autonomous and Controlled Motivation for Treatment Questionnaire (ACMTQ) for use in women with an eating disorder (ED). Method: Data were available for 463 individuals. We assessed factor structure, internal reliability, test–retest reliability, convergent/divergent validity, and incremental predictive validity. Results: Our data showed acceptable fit to our hypothesized model (comparative fit index = 0.92, root mean square error of approximation = 0.09, standardized root mean square residual = 0.09). We found test–retest reliability of 0.73 for both the autonomous (α = 0.85) and controlled (α = 0.80) subscales. Autonomous scores were more strongly associated with motivation measures (β = 0.37; 0.46) than with ED severity measures (β = −0.10; −0.18). Associations between autonomous motivation and symptom improvement over time supported predictive validity. Controlled motivation was associated with lower motivation (β = 0.02; −0.31) and with higher ED severity (β = 0.12; 0.47). Conclusion: Our results suggest that the ACMTQ is valid for use in women with EDs and lend support to the validity of findings from previous ED studies that have used the ACMTQ. Highlights: Data showed acceptable fit to expected "autonomous motivation" and "controlled motivation" factors.Autonomous and Controlled Motivation for Treatment Questionnaire scores correlated with scores on other measures of motivation.Autonomous motivation predicted eating disorder symptom improvement over time. [ABSTRACT FROM AUTHOR]

Victims of bullying are more likely to engage in addictive behaviors and experience mental health problems. However, the pathway by which bullying victimization and mental health problems predict engagement in multiple addictive behaviors remains unclear. The purpose of this study is to compare two mediation models in their prediction of engagement in multiple addictive behaviors. Survey responses were collected from 6641 high-school students aged 12 to 19. Measures include frequency of bullying victimization, past month use of alcohol, marijuana, cigarettes, past year gambling, and the presence of anxiety, depression, and externalizing problems. Results indicate that the model with mental health symptoms and externalizing problems as mediators provided the better prediction of engagement in multiple addictive behaviors. Overall, the comparison of these mediation models clarifies the relationship between bullying victimization and addictive behaviors and the role of mental health symptoms and externalizing problems in this relationship. [ABSTRACT FROM AUTHOR]

According to Self‐Determination Theory, when motivation to reach an objective is fully internal, it is said to be "autonomous"; when driven by external incentives, it is said to be "controlled". Previous research has indicated that autonomously motivated individuals show better response to treatments for eating disorders. Objective: In individuals undergoing different intensities of outpatient treatment for an eating disorder, we sought to assess associations between autonomous and controlled motivations and response to treatment on the one hand, and likelihood of dropping out of treatment, on the other. Method: Seven hundred seventy adults meeting DSM‐5 criteria for an eating disorder (216 with Anorexia Nervosa, 282 with Bulimia Nervosa, and 272 with Other Specified Feeding or Eating Disorder) were included in this study. Before an interval of outpatient treatment, individuals completed the Eating Disorder Examination Questionnaire and the Autonomous and Controlled Motivations for Treatment Questionnaire. Participants completed the Eating Disorder Examination Questionnaire again at one or two subsequent timepoints. Results: After controlling for diagnosis, treatment intensity, and number of previous treatments, analyses showed that higher autonomous motivation was associated with better response on eating‐disorder overall symptoms and lower likelihood of dropping out of treatment. In contrast, controlled motivation was not associated with response to treatment. Discussion Our results suggest that autonomous motivation has trans‐diagnostic influence upon response to various intensities of treatment for an eating disorder. In support of an autonomy supportive approach to treatment, findings link autonomous motivation with more favorable outcome. [ABSTRACT FROM AUTHOR]

Problematic engagement in video gaming is a prevalent concern among youth with an increasing number of adolescents reporting symptoms of gaming disorder. There is a need for longitudinal research evaluating factors in childhood that increase the risk of endorsing symptoms of gaming disorder in adolescence. Children (N = 744, 53.2% boys, M age = 8.3, SD = 0.93 years old), were followed over five years, with questionnaires for internalizing and externalizing problems being completed yearly (Time 1 to Time 5), and disordered gaming being measured at Time 6. Parallel process growth models were utilized to establish trajectories for externalizing and internalizing problems over time. Findings from regression analyses indicated that initial levels of both internalizing and externalizing problems significantly predicted disordered gaming symptoms six years later. Additionally, the development of internalizing problems over time was significant in predicting disordered gaming symptoms. The interaction effects for intercept and slope of internalizing and externalizing problems were non-significant and no differences based on sex were identified. Children with internalizing and/or externalizing problems appear to be at a greater risk of developing symptoms of disordered gaming in adolescence. A pattern of increasing internalizing problems from childhood to adolescence seems to further exacerbate this risk. • Disordered gaming was predicted by early internalizing and externalizing problems. • A smaller temporal decrease of internalizing problems predicted disordered gaming. • The interaction of these problems did not predict disordered gaming. • Developmentally distal risk factors are present for the development of disordered gaming. [ABSTRACT FROM AUTHOR]

Objective: Identifying modifiable predictors of outcomes following treatment for eating disorders may help to tailor interventions to patients' individual needs, improve treatment efficacy, and develop new interventions. The goal of this meta‐analysis was to quantify the association between pretreatment motivation and posttreatment changes in eating disorder symptomology. Method: We reviewed 196 longitudinal studies reporting on change on indices of overall eating‐disorder symptomatology, weight gain, binge‐eating, vomiting, anxiety/depression, and treatment adherence. Meta‐analyses were performed using two complementary approaches: (a) combined probability analysis using the added Z's method; (b) effect size analyses. Using random‐effect models, effect sizes were pooled when there were at least three studies with the same type of statistical design and reporting statistics on the same outcome. Heterogeneity in study outcome was evaluated using Q and I2 statistics. Studies were reviewed qualitatively when the number of studies or reported data were insufficient to perform a meta‐analysis. Results: Forty‐two articles were included. Although samples and treatments differed substantially across studies, results across studies were remarkably consistent. Both combined‐probability and effect‐size analyses indicated positive effects of pretreatment motivation on improvement in general eating‐disorder symptoms (Cohen's r =.17), and an absence of effects on anxiety/depression symptoms. Remaining outcome indices were subject to selective reporting and/or small sample size bias. Discussion: Our findings underscore the importance of incorporating treatment engagement approaches in the treatment of eating disorders. Optimal reporting of study findings and improving study quality would improve future efforts to obtain an in‐depth understanding of the relationship between motivation and eating disorder symptoms. [ABSTRACT FROM AUTHOR]

We describe the implementation and impact of a province-wide program of knowledge exchange (KE), aimed at developing capacity for the treatment of people with eating disorders (EDs). The program is designed to equip clinicians working in nonspecialized health-care installations with skills to evaluate and treat people with EDs. Trainings were conducted at 21 institutions. The majority of clinicians reported satisfaction with the KE program and indicated that the trainings enhanced their confidence and ability to treat patients with EDs. A subset of clinicians received case supervision with a specialist ED therapist and followed patients with EDs (n = 119). Treated patients showed significant improvements on eating and depressive symptoms, and reported satisfaction with the treatments they received. [ABSTRACT FROM AUTHOR]

Background: Eating Disorders are highly prevalent and widespread mental health problems, with marked risk of chronicity and refractoriness to treatment. Affected individuals are hesitant to change their behaviours and therefore struggle to maintain motivation for therapy. This review aims to produce the first high-quality meta-analysis of the literature on the impact of level of motivation for change on post-treatment outcomes in anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding or eating disorder (OSFED). Methods: A systematic review will be conducted using Cochrane library, Embase, MEDLINE, and PsychINFO. Research registrars and bibliographies of included articles will be screened, and experts will be contacted. The search strategy consists of terms related to eating disorders, motivation, and outcome. Randomized controlled trials, clinical controlled trials, time series, and before-after studies will be included. Participants will be adolescents and adults who are diagnosed with anorexia nervosa, bulimia nervosa, binge-eating disorder or OSFED and who are entering psychotherapy treatment. The predictor studied is defined as motivation for change at the beginning of treatment. The primary outcome will be an overall change in eating-disorder symptomatology at the end of treatment and at less than, and over 6-month follow-up. Other outcomes of interest include change in restricting, binging, and compensatory behaviours, change in shape, weight and eating concerns, change in psychiatric comorbidities, weight restoration, and dropout rates. Articles will be selected, data will be extracted, and the risk of bias will be assessed by independent reviewers using forms pre-created on Eppi-Reviewer 4 software. Results will be combined using a random-effects model. Studies of all sizes and qualities will be included in the analyses. Heterogeneity will be examined by funnel plot, Cochran's Q, and I2 statistic. Sensitivity analyses will be performed to account for clinical and methodological differences across studies. Discussion: This systematic review will help determine the predictive value of motivation for change on treatment outcomes in eating disorders. [ABSTRACT FROM AUTHOR]

The original version of this article unfortunately contained a mistake in EAT-26 values under “Patients Receiving Treatment for an ED in their Sector” section. [ABSTRACT FROM AUTHOR]