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1.
J Gambl Stud ; 2024 Jun 04.
Article in English | MEDLINE | ID: mdl-38831237

ABSTRACT

Gambling disorder is a severe condition that significantly compromises the lives of those affected. In light of this clinical relevance, the literature on the antecedents of this form of addiction is constant and continually evolving. Consistently with this framework, the present research aimed at investigating the role of some risk factors in gambling disorder, with a specific focus on alexithymia, dissociation, and locus of control. The research involved a sample of 290 participants (183 males and 107 females; Mage = 34.43, SD = 14.65) who practice gambling at least occasionally. They completed an online survey including the South Oaks Gambling Screen, Twenty-Items Toronto Alexithymia Scale, Dissociative Experience Scale-II, and Locus of Control of Behavior. ANOVA and a moderated-mediation model were implemented to analyse the collected data. Results showed that 19.0% of the participants were At Risk and Problem Gamblers, while 27.6% fell into the category of Problematic Gamblers. Problematic Gamblers showed significantly higher levels of alexithymia, dissociation, and external locus of control. Moreover, a significant association between alexithymia and the severity of problematic gambling behaviour was found and was significantly mediated by absorption (a dissociation feature). Furthermore, the external locus of control significantly moderated this indirect effect. The role of gender as a covariate was also investigated. Such findings may offer further insights into the field of clinical research on gambling disorder and may provide useful information for effective clinical practice.

2.
Psychol Trauma ; 2024 Feb 29.
Article in English | MEDLINE | ID: mdl-38421754

ABSTRACT

OBJECTIVE: The general aim of the present study was the exploration of the relationships between childhood trauma subdimensions (physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect), unbalanced family functioning patterns (disengaged, enmeshed, rigid, and chaotic), and love addiction. METHOD: A sample of 910 individuals (76.6% female; Mage = 30 years, SD = 10.55) engaged in a romantic relationship participated in the research and completed the Love Addiction Inventory-Short Form, Family Adaptability and Cohesion Evaluation Scales-IV, and Childhood Trauma Questionnaire-Short Form. RESULTS: Among the childhood trauma subdimensions, emotional and physical abuse showed significant and positive associations with love addiction levels. Furthermore, the path analysis showed that unbalanced family functioning patterns parallelly mediated the relationship between emotional (enmeshed, rigid, and chaotic patterns) and physical abuse (chaotic patterns) and love addiction. Gender as a covariate was controlled for. CONCLUSIONS: The present study offers insight into the mechanisms by which specific forms of childhood trauma could lead to love addiction in adulthood. The findings offer valuable insights for developing customized interventions when working with individuals struggling with love addiction, as well as for implementing effective preventive activities for the condition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

3.
Addict Behav Rep ; 19: 100533, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38357528

ABSTRACT

The internet has facilitated significant transformations in interpersonal interactions, and offers new possibilities for finding romantic partners through the use of online dating apps. However, as with other technology-based tools, some individuals can develop problematic patterns of dating apps use, exhibiting symptoms resembling addiction. Consequently, the aim of the present study was the development of a new psychometric instrument to assess problematic dating apps use, the Problematic Online Dating Apps Use Scale (PODAUS), and the examination of its psychometric properties. The sample comprised 384 participants (254 females and 130 males; Mage=25.90 years; SD=5.21) who used dating apps daily. They completed an online survey including the PODAUS, Bergen Social Media Addiction Scale, Cyber Pornography Addiction Test, Love Addiction Inventory-Short-Form, and Ten-Item Personality Inventory. The PODAUS showed a one-factor structure with good indications of validity, reliability, and gender measurement invariance. Problematic online dating apps use was significantly associated with problematic social media use, problematic cyberpornography use, love addiction, and three personality traits (i.e., agreeableness, conscientiousness, and openness). The PODAUS is a new and succinct self-report measure that assesses problematic dating apps use, and can be easily used in both research and clinical practice.

4.
Cyberpsychol Behav Soc Netw ; 27(5): 340-346, 2024 May.
Article in English | MEDLINE | ID: mdl-38407872

ABSTRACT

Problematic social media use (PSMU) can have profound and detrimental effects across various domains of life. As a result, scientific investigations into the risk factors associated with this phenomenon can hold substantial practical implications within the clinical and preventive realms. Consistently with this framework, this study aimed to examine the relationship between certain variables and PSMU, with a specific focus on alexithymia, defense mechanisms, and fear of missing out (FoMO). A sample of 340 young adults (Mage = 26.42 years; SD = 3.689) completed an online survey, including the Bergen Social Media Addiction Scale, FoMO scale, 40-Item Defense Style Questionnaire, and 20-Item Toronto Alexithymia Scale. Results showed a statistically significant mixed serial-parallel mediation model. A significant total effect in the association between alexithymia and FoMO emerged. Furthermore, defense mechanisms and FoMO significantly and totally mediated this relationship. These findings have the potential to provide valuable insights in the field of clinical research on PSMU, and can offer practical information for enhancing clinical practice.


Subject(s)
Affective Symptoms , Defense Mechanisms , Fear , Social Media , Humans , Affective Symptoms/psychology , Male , Female , Adult , Young Adult , Fear/psychology , Social Media/statistics & numerical data , Internet Addiction Disorder/psychology , Internet Addiction Disorder/epidemiology , Surveys and Questionnaires
5.
Eur J Investig Health Psychol Educ ; 14(1): 148-163, 2024 Jan 03.
Article in English | MEDLINE | ID: mdl-38248130

ABSTRACT

Physical exercise is a widely recommended practice for promoting health, but for some individuals, this activity can result in pathological and morbid behaviour. Therefore, the study of the factors contributing to the onset, development, and progression of exercise addiction is particularly relevant. Within this framework, the present study assessed the effect of family functioning, body image concerns, age, and gender on exercise addiction. A sample of 300 regular exercisers (Mage = 30.3 years, SD = 11.6; 69.7% females, 30.3% males) participated in the study and completed the Family Adaptability and Cohesion Evaluation Scales-IV, Body Image Concern Inventory, and Exercise Addiction Inventory. Data were analysed by implementing a series of moderated moderated-mediations. Results showed that three significant models were relevant. First, positive associations of disengaged (p < 0.05), enmeshed (p < 0.05), and rigid (p < 0.01) family functioning with exercise addiction were found. Furthermore, body image concerns mediated all these relationships, and the interaction between gender and age significantly moderated the effects of body image concerns on exercise addiction (p < 0.05). Such data may be useful for a deeper understanding of the variables associated with the development of exercise addiction, suggesting key elements on which it might be useful to focus in clinical and/or preventive activity.

6.
Psychol Trauma ; 16(Suppl 1): S72-S80, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37956030

ABSTRACT

OBJECTIVE: Experiences of direct and indirect victimization can be very common among children and adolescents of the general population and can have an important impact on their behavior. The general aim of this study was to analyze the possible association between childhood victimization and the development of antisocial behaviors during adolescence. The prevalence of child victimization and antisocial behaviors self-reported by adolescents is shown. Therefore, the individual associations between different types of childhood victimization and antisocial behaviors were explored. METHOD: The sample comprised 459 general population adolescents. Data on six types of childhood victimization were collected using the Spanish version of the Juvenile Victimization Questionnaire, and information on five types of antisocial behaviors was gathered using the short version of the Antisocial Behavior Questionnaire. RESULTS: More than 90% of the adolescents had been victimized at least once, while almost half of them had engaged in at least one type of antisocial behavior in the last 12 months. Witnessing and indirect victimization is the only type of childhood victimization associated with the antisocial behaviors analyzed. CONCLUSIONS: These results corroborate previous findings suggesting that witnessing and indirect victimization may have the same or similar impact to that of direct victimization on adolescents' social adjustment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Antisocial Personality Disorder , Crime Victims , Child , Humans , Adolescent , Antisocial Personality Disorder/epidemiology , Surveys and Questionnaires , Self Report
7.
Eur J Investig Health Psychol Educ ; 13(11): 2478-2497, 2023 Nov 02.
Article in English | MEDLINE | ID: mdl-37998063

ABSTRACT

Therapist expertise is a complex, multifaceted, and continually evolving concept. Defining this construct and its constituent components can yield a substantial contribution to the field of psychotherapy, consequently enhancing the comprehension of the fundamental factors that underlie its effectiveness. Within this framework, the present research aimed at developing and assessing the psychometric properties of the Psychotherapy Expertise Questionnaire (PEQ), a self-report measure to assess therapist expertise. A sample of 260 psychotherapists of various theoretical orientations were involved in this research. They completed a survey that included the PEQ as well as other self-reported measures aimed at evaluating personality traits, self-efficacy, self-esteem, and insight orientation. The analysis provided evidence of a good fit for both a correlational model with eight factors and a higher-order model, where the eight subdimensions were grouped into subjective (performance; cognitive functioning; personal and relational qualities of the therapist; therapist self-assessment) and objective (experience; reputation with clients and colleagues; training and professional updating; deontological ethics and setting rules) factors. The eight dimensions, two higher-order factors, and total score all showed excellent levels of internal consistency. Furthermore, significant associations were found between PEQ scores and insight orientation, general self-efficacy, self-esteem, personality traits, and time exercising clinical practice. To conclude, the Psychotherapy Expertise Questionnaire (PEQ) is a valuable, theoretically guided, and psychometrically robust self-report measure designed to assess therapist expertise and its constitutive dimensions. This measure can have practical applications in guiding tailored training and customised supervision.

8.
BMC Psychol ; 11(1): 383, 2023 Nov 08.
Article in English | MEDLINE | ID: mdl-37941011

ABSTRACT

BACKGROUND: The use of social media became a daily activity for many individuals, with recreational, informational, and social purposes, to name a few. However, for some subjects, the use of these platforms may become problematic and generate functioning impairments in many life areas. Given this, the present research aimed at investigating the factor that may contribute to Social Media Addiction, by focusing on Fear of Missing Out and Family Functioning Patterns. METHODS: A sample of 303 social media users (Mage = 35.29; SD = 14.87; 65% females, 35% males) completed a survey including the Bergen Social Media Addiction Scale, Family Adaptability and Cohesion Evaluation Scales-IV, and Fear of Missing Out Scale. Data were analysed by implementing Pearson correlation and testing a mediation with the Structural Equation Model approach. RESULTS: Cohesion, flexibility, and disengagement family functioning patterns were significantly associated with the levels of social media addiction. These dimensions were inserted in the structural equation model, where the full mediation of fear of missing out in their relationship with social media addiction was shown. CONCLUSIONS: The data showed the protective effect of flexible and cohesive family functioning patterns, as well as the role of disengagement and, sequentially, fear of missing out as risk factors. These findings may provide useful indications to elaborate tailored and effective therapeutic and preventive activity.


Subject(s)
Internet Addiction Disorder , Social Media , Female , Male , Humans , Adult , Fear , Activities of Daily Living , Risk Factors
9.
J Pers Med ; 13(10)2023 Oct 07.
Article in English | MEDLINE | ID: mdl-37888080

ABSTRACT

The aim of this meta-analysis was to compare psychodynamic with other treatments in studies of substance addiction. The literature search was conducted using the PubMed, Web of Science, Cohcrane library, SCOPUS, and Onesearch databases. All studies comparing psychodynamic therapy with other types of psychological interventions for Substance Use Disorder were eligible. Three outcomes were considered to compare intervention performance: substance use, participation in treatment and other symptomatic conditions (OSCs). Hedges' G was used to measure effect size. The Revised Cochrane Risk of Bias tool for randomized trials was used to assess quality of evidence and possible bias, Egger regression analyses for publication bias, and Q and I-square statistics were used to assess heterogeneity. The alcohol group showed no differences between treatments on the three outcomes. The cocaine group showed no significant differences in the two outcomes, while for OSCs, available data was insufficient. The opioids group showed small but significant differences regarding participation in favor of non-psychodynamic interventions and no significant results for other outcomes. Based on the three measures of recovery considered in this meta-analysis, psychodynamic interventions were shown to be as effective as other psychological treatments in treating substance dependence and proved to be an empirically-supported treatment for the above addictions.

11.
Eur J Investig Health Psychol Educ ; 13(6): 975-985, 2023 Jun 04.
Article in English | MEDLINE | ID: mdl-37366778

ABSTRACT

Although experiences of loss and the consequent grief are natural in human life, some individuals may have difficulty managing these events, to the point of developing significant impairment in their functioning in important life areas. Given this, the present research aimed to explore the psychometric properties of the Italian version of the Adult Attitude to Grief scale (AAG) to facilitate research on adult vulnerability to grief among Italian-speaking populations. A sample of 367 participants (Mage = 30.44, SD = 11.21; 78% females) participated in this research. A back-translation procedure was implemented to develop the Italian AAG. Then, participants completed the Italian AAG alongside a battery of other self-report psychometric scales in order to assess aspects of the construct validity of the AAG: the Forty-Item Defense Style Questionnaire, the Impact of Event Scale-Revised, and the Beck Depression Inventory-II. A bifactor structure was found to have the best fit to the data, supporting the possibility of using both the general factor (i.e., vulnerability) and three dimensions (i.e., overwhelmed, controlled, and resilient). Unlike the original version, the control dimension emerged as a "protective" factor in the Italian population, together with the resilient factor. Furthermore, results provided satisfactory indications of internal consistency and construct validity. In conclusion, the Italian AAG was shown to be a valid, reliable, quick, and easy-to-use scale that can be used both for research and clinical practice in the Italian context.

12.
Data Brief ; 48: 109298, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37304328

ABSTRACT

The present research article provides data about the differences in post-traumatic stress symptoms, and defense mechanisms based on the levels of perceived stress (low, average, high), using a large national sample of 1100 Italian individuals, collected during the first wave of the COVID-19 pandemic. Participants completed an online survey through the Google Form platform, where the Ten-Item Perceived Stress Scale, Impact of Event Scale - Revised, and Forty Item Defense Style Questionnaire were included. First, the cut-offs of the perceived stress scale were calculated by determining the 25th and 75th percentile scores for the sample of this survey. Then, MANOVA analyses were performed, together with ANOVAs and the Bonferroni Post hoc analyses as a follow-up. The dataset (.xlsx) includes the survey scores, while the tables and figures provide the analysed data, where the differences are shown. This data article may provide useful bases for future research on perceived stress and for suggesting associated factors on which focus clinical intervention and preventive programs.

13.
Eur J Investig Health Psychol Educ ; 13(3): 512-524, 2023 Feb 21.
Article in English | MEDLINE | ID: mdl-36975391

ABSTRACT

This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial-parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.

14.
Article in English | MEDLINE | ID: mdl-36981653

ABSTRACT

Mentalization is a complex and multifaceted trans-theoretical and trans-diagnostic construct that has found increasing application in the clinical context. This research aimed at deepening the psychometric properties of the Multidimensional Mentalizing Questionnaire (MMQ), a 33-item theoretically based self-report questionnaire allowing for a comprehensive assessment of mentalizing, by integrating factor analysis and network analysis approaches. A sample of 1640 participants (Mage = 33 years; SD = 13.28) was involved in the research. The six-factor structure was confirmed for the MMQ, and both the total and the subdimensions demonstrated good reliability. The network analysis has further enriched these results, showing the central role of the items attributable to Emotional Dysregulation or Reflexivity in influencing the network as well as the contribution of aspects related to Relational Discomfort in managing the flow of communication flow. Such findings may have useful clinical implications and emphasize the usefulness of the MMQ in both research and clinical practice.


Subject(s)
Mentalization , Humans , Adult , Mentalization/physiology , Psychometrics , Reproducibility of Results , Surveys and Questionnaires , Self Report
15.
Addict Behav ; 141: 107633, 2023 06.
Article in English | MEDLINE | ID: mdl-36753932

ABSTRACT

The present study investigated the factors that may be associated with a dysfunctional use of social media use, by exploring the association between adult attachment patterns and problematic social media use and analyzing the sequential mediation of self-esteem, fear of missing out (FoMO), and time spent on social media. A sample of 470 social media users (Mage = 33.76 years; SD = 14.267; 70 % women) completed the Bergen Social Media Addiction Scale, Fear of Missing Out Scale, Rosenberg Self-Esteem Scale, and Relationship Questionnaire. Results showed a path analysis model providing an excellent fit to the data (χ2 = 2.939, p = 0.230; GFI = 0.998, TLI = 0.987, CFI = 0.998, RMSEA = 0.032, SRMR = 0.016). A significant and positive total effect in the associations between preoccupied and fearful attachment patterns and problematic social media use emerged. Both preoccupied and fearful attachment patterns were also related to self-esteem, FoMO, and time spent on social media, which were sequentially associated and were, in turn, significantly related to problematic social media use. Finally, when self-esteem, FoMO, and time spent on social media were added into the model, they totally mediated the relationships between preoccupied and fearful attachment patterns and problematic social media use, suggesting a full multiple mediation model (R2 = 0.33). Such data may provide useful information for clinical practice to develop tailored interventions and prevention programs to address the compensatory and problematic use of social media.


Subject(s)
Social Media , Adult , Humans , Female , Male , Health Expenditures , Fear , Self Concept , Surveys and Questionnaires
16.
J Pers Med ; 13(2)2023 Jan 28.
Article in English | MEDLINE | ID: mdl-36836471

ABSTRACT

Post-traumatic stress disorder (PTSD) is a pathological condition that may lead to a significant deterioration in the quality of life over time. Therefore, the study of the elements that can characterize the disorder could be considered of great clinical interest and relevance. The aim of the present research was to empirically discriminate the influence of perceived stress, state anxiety, worry, and defense mechanisms (mature, neurotic, and immature) at different levels of post-traumatic stress symptoms. A sample of 1250 participants (69.5% women, 30.5% men; Mage = 34.52, SD = 11.857) completed an online survey including the Impact of Event Scale-Revised, Ten-Item Perceived Stress Scale, Penn State Worry Questionnaire, Forty Item Defense Style Questionnaire, and State-Trait Anxiety Inventory-Form X3. Data were analysed by implementing MANOVA and discriminant analysis. Results showed significant differences in the levels of perceived stress, state anxiety, and worry, as well as neurotic and immature defenses based on the levels of post-traumatic stress symptoms: F(12,2484) = 85.682, p < 0.001; Wilk's Λ = 0.430. Furthermore, these variables discriminate significant accuracy between participants who reported a mild psychological impact and those with a probable presence of PTSD, with perceived stress, which was found to be the best predictor. Classification results indicated that the original grouped cases were classified with 86.3% overall accuracy. Such findings may provide useful insight for clinical practice.

17.
J Pers Med ; 13(2)2023 Jan 29.
Article in English | MEDLINE | ID: mdl-36836480

ABSTRACT

Love addiction is a dysfunctional relational modality that takes on the addiction characteristics and which, for the individuals who suffer from it, can have a negative and pervasive impact on various areas of functioning. The objective of this research was the analysis the factors that can be associated with love addiction, particularly focusing on adult attachment patterns and self-esteem. A sample group of 300 individuals who declared themselves to have a romantic relationship was involved in this research (Mage = 37.83 years, SD = 12.937). They completed an online survey including the Love Addiction Inventory-Short form, Relationship Questionnaire, and Rosenberg Self-Esteem Scale. Results showed significant and positive associations between preoccupied and fearful adult attachment and love addiction. Furthermore, these relationships were totally mediated by self-esteem. Gender and age were controlled as potential covariates and showed significant effects in influencing the levels of self-esteem and love addiction. Such findings may provide useful information for orienting future research and supporting an effective clinical practice.

18.
J Pers Med ; 13(1)2023 Jan 12.
Article in English | MEDLINE | ID: mdl-36675813

ABSTRACT

Given the popularity of social media and the growing presence of these tools in the daily lives of individuals, research about the elements that can be linked to their problematic use appears to be of great importance. The objective of this study was to investigate the factors that may contribute to the levels of social media addiction, by focusing on the role of alexithymia, body image concern, and self-esteem, controlled for age and gender. A sample of 437 social media users (32.5% men, 67.5% women; Mage = 33.44 years, SD = 13.284) completed an online survey, including the Bergen Social Media Addiction Scale, Body Image Concern Inventory, Rosenberg Self-Esteem Scale, and Twenty-Item Toronto Alexithymia Scale, together with a demographic questionnaire. Results showed a significant association between alexithymia and social media addiction, with the total mediation of body image concern (and more in detail, body dissatisfaction) and the significant moderation of self-esteem. Gender and age showed significant effects in these relationships. Such findings may offer further insights into the field of clinical research on social media addiction and may provide useful information for effective clinical practice.

19.
Psychol Trauma ; 2023 Jan 23.
Article in English | MEDLINE | ID: mdl-36689381

ABSTRACT

OBJECTIVE: The general aim of this study was to examine the psychological variables associated with post-traumatic stress disorder (PTSD) symptomatology, focusing on perceived stress, worry, as well as mature, neurotic, and immature defenses. Therefore, the differences in the study variables based on the levels of posttraumatic stress were explored, and a moderated mediation model was tested, controlling for gender and SARS-CoV-2 infection as covariates. METHOD: A sample of 1,864 Italian participants completed the Impact of event scale-revised (IES-R), the 10-Item Perceived Stress Scale (PSS-10), the Penn State Worry Questionnaire (PSWQ), and the 40-Item Defense Style Questionnaire (DSQ-40). RESULTS: 41% (n = 764) of participants showed scores indicative of a probable presence of PTSD. They reported significantly higher levels of perceived stress, worry, neurotic and immature defenses than participants with lower PTSD symptomatology. Perceived stress was significantly associated with PTSD symptomatology, both directly and indirectly through the mediation of worry. Furthermore, neurotic and immature defenses were significant moderators in some relationships of this model. CONCLUSIONS: Such data can provide useful indications to elaborate tailored interventions and specific prevention activities for PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

20.
J Addict Dis ; 41(1): 98-109, 2023.
Article in English | MEDLINE | ID: mdl-35616192

ABSTRACT

BACKGROUND: The clinical relevance of the degree of severity in addiction disorders supports the need to investigate the variables underlying this aspect of the phenomenon. OBJECTIVE: This study aimed to explore the relationships between factors that may influence the severity of addiction disorder, with a particular focus on temperamental disinhibition, emotion dysregulation, interpersonal vulnerability, and their interactions. METHODS: A clinical sample of 502 (77% males and 22% females) was involved. All participants received a DSM-5 clinical diagnosis of "Substance-Related and Addictive Disorders" and were recruited from the Italian National Health System. The collected data were analyzed by implementing a chained mediation model using structural equation modeling. RESULTS: The statistical appropriateness of the hypothesized latent 4- factors model was confirmed. Specifically, temperamental disinhibition (composed of impulsiveness, compulsiveness, and obsessiveness), emotion dysregulation (composed of affect dysregulation, alexithymia, and dissociation), interpersonal vulnerability (composed of traumatic experiences, preoccupied, avoidant and unresolved attachment), and Addictive Disorders Severity (composed by substance use severity, alcohol use severity, gambling severity, and Internet use severity) were the four factors which have been identified. Furthermore, a total chained mediation model emerged, where emotion dysregulation and interpersonal vulnerability mediated the relationship between temperamental disinhibition and Addictive Disorders Severity. CONCLUSIONS: Our findings offer a better understanding of the variables associated with addictive disorder severity, providing important indications for therapeutic interventions.


Subject(s)
Behavior, Addictive , Gambling , Substance-Related Disorders , Male , Female , Humans , Mediation Analysis , Latent Class Analysis , Behavior, Addictive/psychology , Substance-Related Disorders/psychology , Gambling/psychology
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