Cannabis use, mental health, and problematic Internet use in Quebec: A study protocol.

BACKGROUND: Problematic Internet use is characterized by excessive use of online platforms that can result in social isolation, family problems, psychological distress, and even suicide. Problematic Internet use has been associated with cannabis use disorder, however knowledge on the adult population remains limited. In Quebec, cannabis use has significatively increased since 2018, and it is associated with various risks in public safety, public health, and mental health. This study aims to identify factors associated with problematic Internet use among adult cannabis users and to better understand their experiences. METHOD: This project is a mixed explanatory sequential study consisting of two phases. Phase 1 (n = 1500) will be a cross-sectional correlational study using probability sampling to examine variables that predispose individuals to problematic Internet use, characteristics associated with cannabis use, Internet use, and the mental health profile of adult cannabis users in Quebec. Descriptive analyses and regression models will be used to determine the relationship between cannabis use and Internet use. Phase 2 (n = 45) will be a descriptive qualitative study in the form of semi-structured interviews aimed at better understanding the experience and background of cannabis users with probable problematic Internet use. DISCUSSION: The results of this study will support the development of public policies and interventions for the targeted population, by formulating courses of action that contribute to the prevention and reduction of harms associated with cannabis use and problematic Internet use. Furthermore, an integrated knowledge mobilization plan will aid in the large-scale dissemination of information that can result useful to decision-makers, practitioners, members of the scientific community, and the general population regarding the use of cannabis and the Internet.

Gender disparity in prestigious speaking roles: A study of 10 years of international conference programming in the field of gambling studies.

The objective of this study was to examine the distribution of prestigious speaking roles by gender at gambling studies conferences to better understand the state of gender representation within the field. Keyword searches were conducted in the fall of 2019. A total of 16 conferences that occurred between 2010-2019 and comprising 882 prestigious speaking opportunities were included. Quantitative analysis (i.e., t-tests, chi-squared posthoc tests) was undertaken to evaluate the representation of women speakers and if proportions were the same across genders for speakers. There were significantly less women than men within prestigious speaking roles at gambling studies conferences with only 30.2% of speakers being women (p < .001). This underrepresentation of women was consistent across conference location, speaker continent, speaker role, time, and across the majority of conferences. Women held prestigious speaking roles less frequently than men (M = 1.48 vs. 1.76; p < .001). A 9 to 1 (p < .001) ratio of men to women was found among top 10 most frequent prestigious speakers. While there was a higher proportion of women than men among student speakers and there was no significant gender disparity among early career researchers, there was a significantly lower proportion of women than men among speakers who hold more senior academic positions. There is an issue of gender disparity in prestigious speaking roles at conferences within the gambling studies field. This study highlights the need to counteract gender disparities and make room for diversity within the field.

A call for qualitative and mixed-methods research on gambling and cannabis.

Gambling disorder and cannabis use disorder are both considered major public health issues. Despite the well-documented frequency of substance use disorders among people with gambling disorder, little is known about the experiences of those who both engage with gambling and cannabis. A scoping review was undertaken to investigate studies focusing on the experiences of people who gamble and use cannabis. Unexpectedly, no qualitative or mixed-methods studies that included an in-depth qualitative component to study the lived experiences of this population were found. This absence highlights the critical need to diversify research methods and fill the gap in knowledge of the lived experiences of people who both gamble and consume cannabis.

People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile-based approach to care.

INTRODUCTION: People with opioid use disorders (OUD) present with high levels of medical and psychosocial vulnerabilities. In recent years, studies have highlighted a shift in demographic and biopsychosocial profiles of people with OUD. In order to support the development of a profile-based approach to care, this study aims to identify different profiles of people with OUD in a sample of patients admitted to a specialised opioid agonist treatment (OAT) facility. METHODS: Twenty-three categorical variables (demographic, clinical, indicators of health and social precariousness) were retrieved from a sample of 296 patient charts in a large Montréal-based OAT facility (2017-2019). Descriptive analyses were followed by a three-step latent class analysis (LCA) to identify different socio-clinical profiles and examine their association with demographic variables. RESULTS: The LCA revealed three socio-clinical profiles: (i) "polysubstance use with psychiatric, physical and social vulnerabilities" (37% of the sample); (ii) "heroin use with vulnerabilities to anxiety and depression" (33%); (iii) "pharmaceutical-type opioid use with vulnerabilities to anxiety, depression and chronic pain" (30%). Class 3 individuals were more likely to be aged 45 years and older. DISCUSSION AND CONCLUSION: While current approaches (such as low- and regular-threshold services) may be suited for many OUD treatment entrants, there may be a need to improve the continuum of care between mental health, chronic pain, and addiction services for those characterised by the use of pharmaceutical-type opioids, chronic pain and older age. Overall, the results support further exploring profile-based approaches to care, tailored to subgroups of patients with differing needs or abilities.

Experience of LGBTQIA2S+ populations with gambling during the COVID-19 pandemic: protocol for a mixed-methods study.

INTRODUCTION: Research undertaken since the beginning of the COVID-19 pandemic has provided us information about the impact of the pandemic on the gambling habits of the general population. However, very little is known about certain subgroups at increased risk of developing gambling disorder, such as the LGBTQIA2S+ population. The purpose of this study is to describe the impact of the COVID-19 pandemic on gambling behaviours among LGBTQIA2S+ individuals. In addition, we want to understand the experiences of the LGBTQIA2S+ population with gambling disorder and identify interventions that LGBTQIA2S+ people have found to be effective in addressing problem gambling during the COVID-19 pandemic. METHODS AND ANALYSIS: This study has a sequential explanatory mixed-method design in two phases over 2 years. The first phase is a correlational study. We will conduct a cross-sectional survey using a stratified random sampling among Canadian residents who are 18 years of age or older, self-identify as sexually and gender-diverse (ie, LGBTQIA2S+) and have gambled at least once in the previous 12 months. This survey will be administered online via a web panel (n=1500). The second phase is a qualitative study. Semistructured interviews will be conducted with LGBTQIA2S+ people with problematic gambling (n=30). ETHICS AND DISSEMINATION: This research project has been ethically and scientifically approved by the Research Ethics Committee and by the CIUSSS de l'Estrie-CHUS scientific evaluation committee on 3 March 2022 (reference number: 2022-4633-LGBTQ-JHA). Electronic and/or written informed consent, depending on the data collection format (online survey and online or in-person interviews), will be obtained from each participant. A copy of the consent form and contact information will be delivered to each participant.

Relationships between socio-economic status and lottery gambling across lottery types: neighborhood-level evidence from a large city.

BACKGROUND AND AIMS: Lottery gambling participation tends to be higher among lower socio-economic status (SES) individuals, but it is unclear how this relationship differs as a function of lottery type. We estimated how the relationship between SES and lottery gambling rates varies across different types of lottery gambling: fixed-prize, progressive-prize (jackpot) and instant-win (scratch card) lottery tickets in a large Canadian city. DESIGN: Neighborhood-level lottery purchase data obtained from the Ontario Lottery and Gaming Commission were analysed in conjunction with demographic data. Mixed-effects regression was used to assess simultaneously how neighborhood-level SES predicts per-person lottery gambling rates across fixed-prize, progressive-prize lottery and instant-win lotteries. SETTING AND PARTICIPANTS: Neighborhoods in Toronto, Ontario, Canada in the years 2012-15. MEASUREMENTS: Per-capita sales in dollars (CAD) of fixed-prize lottery, progressive-prize lottery and instant-win tickets in Toronto postal codes. SES was estimated as a composite of income, years of education and white-collar employment. FINDINGS: Lower-SES neighborhoods engaged in higher rates of lottery gambling overall [ß = -0.084, standard error (SE) = 0.24, P = 0.0007]. The predictive effect of SES varied significantly by lottery type (fixed-prize: ß = -0.105, SE = 0.004, P < 0.0001, instant-win: ß = -0.054, SE = 0.004, P < 0.0001; relative to progressive-prize). The predictive effect of SES was strongest for fixed-prize lotteries and weakest for progressive-prize lotteries, such that we did not observe a significant predictive effect of SES for progressive-prize lotteries (ß = -0.031, SE = 0.024, P = 0.198). CONCLUSIONS: People in lower socio-economic status neighborhoods in Toronto, Canada appear to engage in more lottery gambling than those in higher socio-economic status neighborhoods, with the difference being largest for fixed prize lotteries followed by instant win lotteries, and no clear difference for progressive prize lotteries.

"It did not apply to me": poker players' perspectives of prevention messages.

OBJECTIVE: Despite the risks associated with poker and its unique characteristics when compared with other forms of gambling, little knowledge exists of poker players' perceptions of prevention strategies. The aim of this study was to explore poker players' perceptions and understandings of existing problem gambling prevention strategies. METHODS: This exploratory qualitative study is a secondary data analysis of interviews conducted as a part of a sequential mixed-methods research project, with 12 poker players. RESULTS: Two main themes emerged from the thematic analysis highlighting a distinction between institutional and personal prevention strategies. When speaking about institutional prevention efforts, players were critical of existing formats, messages, and who these messages were being developed and disseminated by and for. Players believed existing messaging strategies demonstrate an overall lack of awareness concerning the reality of poker. Personal preventive strategies that players themselves put in place to reduce risks included money management, playing for free, maintaining a healthy play-life balance, and managing emotions, to be aware of their relationship with poker, as well as spotting paying opportunities. CONCLUSIONS: Given poker players' lack of receptivity to existing prevention messaging, it is essential to consider the unique nature of poker and its players. It is also imperative to explore the potential benefits of collaborating with players when it comes to targeted prevention strategies.

Where Lies the Harm in Lottery Gambling? A Portrait of Gambling Practices and Associated Problems.

Lotteries are one of the most prevalent forms of gambling and generate substantial state revenues. They are also argued to be one of the least harmful forms of gambling. This paper is one of the first to examine exclusive lottery gamblers and compares their gambling patterns and problems as well other associated risky behaviours to those who are not exclusive lottery gamblers. Data were derived from two large surveys conducted with representative adult samples in France (n = 15,635) and Québec (n = 23,896). Participants were separated into two groups: exclusive lottery gamblers (ELGs) and non-exclusive lottery gamblers. Using multivariate analysis, study results reveal that ELGs, who represent two thirds of gamblers, generally exhibit less intensive gambling patterns and are less likely to report other risky behaviours. However, harms associated with moderate risk and problem gambling are found to be concentrated in specific subpopulations for both groups, primarily males, older individuals, and those who report lower income and education level. Given widespread participation in lotteries and concentration of harm within specific subgroups, these findings point to the need for prevention efforts despite the lower levels of harm associated with lottery gambling.

Longitudinal analysis of quality of life across the trauma spectrum.

OBJECTIVE: Few longitudinal studies have examined the relationship between trauma exposure and posttraumatic stress disorder (PTSD) in relation to quality of life or have been designed to consider the relationships between trauma, PTSD diagnosis, and quality of life in terms of both global scores and specific domains. This article aims to provide an essential longitudinal examination of the effects of trauma and PTSD diagnosis on global as well as specific domains of quality of life in a Canadian sample to better understand the diagnosis and unveil possible routes of research and successful treatment methods for the future. METHOD: Data were drawn from the initial two waves of the Zone d'étude en épidémiologie sociale et psychiatrique du sud-ouest de Montréal (ZEPSOM), an epidemiological catchment area study based in southwest Montréal (N = 2,433 at Wave 1 and N = 1,823 at Wave 2). PTSD diagnosis and global and subscale scores of quality of life outcomes were established by face-to-face structured interviews using standardized instruments. Outcomes were compared among 3 trauma/PTSD categories and healthy controls. RESULTS: This study extends previous cross-sectional findings within the catchment area by demonstrating that the effects of current PTSD diagnosis on quality of life endure with time. Specifically, the negative impact of current diagnosis of PTSD on Wave 2 quality of life is expressed through its influence on Wave 1 quality of life. Subscale findings are discussed. CONCLUSION: Research needs to focus on understanding more than just global indices of quality of life when it comes to the trauma spectrum. Additional research remains necessary to fully understand these complex relationships over time. (PsycINFO Database Record

Effects of Enactment of Legislative (Public) Smoking Bans on Voluntary Home Smoking Restrictions: A Review.

INTRODUCTION: The positive effects of worldwide increases in enactment of legislative bans on smoking in public areas have been well documented. Relatively little is known about the effects of such bans on voluntary home smoking behavior. Meanwhile, private spaces, such as homes, have replaced public spaces as the primary milieu of secondhand smoke exposure. METHODS: A systematic search of peer-reviewed articles was conducted using multiple databases including Cochrane Library, Cinahl, Embase, Global Health, Health Star, Joanna Briggs, MEDLINE, PsycINFO, PAIS International, PubMed, and Web of Science. We examined peer-reviewed studies that considered the impact of legislation-based public smoking bans on enactment of private home smoking restrictions. RESULTS: Sixteen articles published between 2002 and 2014 were identified and included. Our results suggest overall positive effects post-legislative ban with the majority of studies demonstrating significant increases in home smoking restrictions. Studies focusing on smoking and nonsmoking samples as well as child populations are discussed in depth. CONCLUSIONS: Existing evidence indicates an overall significant positive effect post-legislative ban on voluntary home smoking restrictions. While disentangling these effects over space and time remains a challenge, scientific research has converged in dispelling any notion of significant displacement of smoking into the home. Policy makers, especially those in countries without existing public smoking legislation, can rest assured that these types of bans contribute to the minimization of tobacco-related harm. IMPLICATIONS: Findings converge in dispelling notions of displacement of smoking into the home as a consequence of legislative bans that prohibit smoking in public spaces. Evidence from the studies reviewed suggests that through their influence on social norms, legislative bans on smoking in public places may encourage citizens to establish voluntary home smoking restrictions, thus decreasing harm related to secondhand smoke.

Life events and problem gambling severity: A prospective study of adult gamblers.

Several studies have shown that gambling problems are cyclical but few have empirically investigated factors that are associated with change. The purpose of this article is to prospectively examine associations between life events and problem gambling severity in a cohort of gamblers. Occurrence of life events and gambling problem severity were assessed 3 times over a period of 2 years in a cohort of nonproblem and problem gamblers (N = 179) drawn from a representative sample derived from a population survey. Cross-lagged analyses revealed that cumulative number of life events were associated with an increase in severity of problem gambling 12 months later. Regression analyses showed that significant life events in several domains, for example, "change in sleeping habits," "accidental injury or illness" or "retirement," are likely to be associated over time to the increase or the continuation of risky gambling habits. This study's findings on the potential negative influence of cumulative number of life events, or of specific ones, are informative for secondary prevention and treatment. (PsycINFO Database Record

Place and Posttraumatic Stress Disorder.

Research on traumatic stress has focused largely on individual risk factors. A more thorough understanding of risk factors may require investigation of the contribution of neighborhood context, such as the associations between perceived neighbourhood disorder and social cohesion with reported trauma exposure (yes/no) and posttraumatic stress disorder (PTSD) diagnostic status (past-year PTSD, remitted). To examine these associations, we used a cross-sectional analysis of an epidemiological catchment area survey (N = 2,433). Visible cues, indicating a lack of order and social control in the community (neighbourhood disorder), were associated with increased trauma exposure (adjusted odds ratio [AOR] = 1.21, 95% confidence interval [CI] [1.12, 1.31]). For trauma-exposed individuals, neighbourhood disorder was associated with greater odds of lifetime PTSD (AOR = 1.38, 95% CI [1.10, 1.75]), and the willingness of residents who realize common values to intervene for the common good (social cohesion), was associated with lower likelihood of past-year PTSD (AOR = 0.64, 95% CI [0.42, 0.97]). For participants with a lifetime diagnosis of PTSD (including past-year), increased social cohesion was associated with higher odds of remission (AOR = 2.59, 95% CI [1.55, 4.30]). Environmental contexts play a role in the development and progression of PTSD. As such, traumatic stress outcomes may be better understood through a perspective that integrates individual and contextual risk factors.

Assessing trauma and posttraumatic stress disorder: Single, open-ended question versus list-based inventory.

Trauma exposure is a precursor to a diagnosis of posttraumatic stress disorder (PTSD). A dearth of empirical evidence exists on the impact of different measurement practices on estimates of trauma exposure and PTSD within representative epidemiological samples. In the present study, we examined differences in reported trauma exposure and rates of PTSD using single, open-ended question versus list-based trauma assessments in a general community sample. Using data from the third wave of the Montreal epidemiological catchment area study (N = 1029), participants were interviewed in person by a lay interviewer about lifetime history of trauma exposure and PTSD. Prevalence rates of trauma exposure and PTSD diagnosis using single, open-ended question and list-based assessment were compared using a within-subject design. A single, open-ended question versus list-based trauma assessment yielded trauma-exposure rates of 61%, 95% CI [57.8, 63.8] and 78%, 95% CI [75.2, 80.3], respectively. Conditional rates of lifetime PTSD decreased from 6.7%, 95% CI [5.8, 9.4] to 6%, 95% CI [4.4, 7.7], respectively. Increases in trauma exposure were more pronounced in women (33.7%) than men (21.5%), as well as in the younger stratum of study participants (15-24 years old; 36.1%). Underestimation of PTSD using a single, open-ended question assessment was minimal, although all missing cases were women. Our results lend support to the importance of using comprehensive assessments of exposure to potentially traumatic events when conducting epidemiological research, especially when reporting conditional rates of PTSD. Previous research may have underestimated the prevalence of trauma exposure, particularly among young women. (PsycINFO Database Record

Gambling Patterns and Problems of Gamblers on Licensed and Unlicensed Sites in France.

In 2010 France enacted a law to regulate supply and consumption of online gambling. Its primary aim was to protect citizens from gambling-related harm. This study aims to assess differences in gambling patterns and related harm between online gamblers who use licensed versus unlicensed sites. Participants (N = 3860) completed a self-administered online survey on gambling practices. Pairwise logistic regressions examined the association between the legal statuses of gambling sites people patronized and demographic variables and gambling types. Multivariate logistic regression models explored associations between gambling patterns and related problems according to the legal status of sites people have gambled on. Overall, 53.7 % of online gamblers report gambling exclusively on licensed sites. Those who bet on regulated activities on unlicensed sites, versus licensed sites, are more likely to be female, younger, less educated, inactive in the labor market and are more likely to perceive their financial situation to be difficult. Gambling on unlicensed sites is associated with more intense gambling patterns and more gambling-related problems compared to licensed sites. Findings demonstrate that gambling activities carried out on state licensed sites are associated with less overall harm to gamblers. Implications of these findings on future policy are discussed and prospective research directions are outlined.

Domains of quality of life and social support across the trauma spectrum.

PURPOSE: To systematically compare specific domains of quality of life and social support as they pertain to the full trauma spectrum of (i) healthy individuals, (ii) those with ongoing post-traumatic stress disorder (PTSD), (iii) remitted PTSD, or (iv) those who failed to develop PTSD in spite of trauma exposure. METHODS: Data were from the first wave of a psychiatric epidemiological catchment area study based in Montreal, Canada (N = 2 433). PTSD diagnosis, quality of life, and social support outcomes were established by face-to-face structured interviews using standardized instruments. Outcomes were compared across the four groups. RESULTS: Although the between-group contrasts suggested that those currently suffering from PTSD generally had a poorer quality of life across domains, the group in remission from PTSD did not. Exploratory analyses concerning subscales for quality of life showed particular impairments for specific domains dependent on PTSD diagnosis, with remitted and ongoing PTSD showing significantly different quality of life for subscales such as daily life/social relationships, spare time activities and autonomy, but similar scores for subscales of housing/neighborhood and personal relationships. Contrary to most previous findings, individuals suffering from PTSD did not report lower overall social support. CONCLUSIONS: For both outcomes of quality of life and social support, longitudinal research is required to fully understand these complex relationships as they evolve along the full trauma spectrum.

Trauma Exposure and Posttraumatic Stress Disorder in the Canadian Military.

OBJECTIVE: To estimate the lifetime prevalence of trauma exposure and posttraumatic stress disorder (PTSD) among a representative, active military sample, and to identify demographic and military variables that modulate rates of trauma exposure as well as PTSD rates and duration. METHOD: A cross-sectional weighted sample of 5155 regular members and 3957 reservists (n = 8441) of the Canadian Armed Forces (CAF) was face-to-face interviewed using a lay-administered structured interview that generates Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, psychiatric diagnoses. RESULTS: Within this sample, 85.6% reported 1 or more trauma exposure, with a median number of 3 or more exposures. Compared with males, females were less likely (P < 0.05) to be exposed to warlike trauma (adjusted odds ratio [AOR] 0.40), disasters (AOR 0.43), assaultive violence (AOR 0.52), and witnessing trauma (AOR 0.75). However, they were more likely to report sexual assault (AOR 7.36). The lifetime prevalence of PTSD was 6.6% and the conditional rate was 7.7%. Both lifetime and conditional PTSD rates were higher among female soldiers, but lower among the reserve forces, both male and female. Finally, the median duration of PTSD was negatively influenced by younger age of onset, but not influenced by whether the event occurred during deployment. CONCLUSIONS: Active members of the CAF report a high degree of trauma exposure but a moderate rate of lifetime PTSD.

Short sleep duration is associated with poor performance on IQ measures in healthy school-age children.

OBJECTIVE: To examine the associations between habitual sleep duration and intellectual functioning in healthy, well-rested, school-age children. METHODS: The study group consisted of 39 healthy children, aged 7-11 years old. Nightly actigraphic sleep recordings were taken for four consecutive nights to determine habitual week-night sleep duration in the home environment. Objective measures of cognitive functioning and sleepiness were used to measure daytime functioning. RESULTS: Longer habitual sleep duration in healthy school-age participants was associated with better performance on measures of perceptual reasoning and overall IQ, as measured by the WISC-IV, and on reported measures of competence and academic performance. No association between sleep duration and the studied behavioral measures was found. CONCLUSIONS: These findings support the hypothesis that sleep duration is differentially related to some components of cognitive functioning, even in the absence of evidence for sleep deprivation or attention deficits.

Sleep and academic success: mechanisms, empirical evidence, and interventional strategies.

Mounting evidence indicates that sleep is beneficial for learning, memory, attention, and academic success. However, the importance of sleep in these contexts has rarely been addressed in programs aimed at optimizing academic performance. This review aims to describe the role that sleep plays in processes pertaining to academic achievement. We first describe the basic sleep processes and their role with respect to cognitive and behavioral/emotional systems important for academic performance. We next review studies conducted to assess the association between sleep and academic performance, concluding by describing interventional programs being used to optimize sleep in the context of academic success.