Prevalence, risk factors, and psychosocial adjustment of problematic gambling in adolescents: Results from two representative German samples.

Background and aims Gambling disorder is a significant public health concern. Especially, male minors have been shown to gamble in a problematic way, despite legal prohibitions. Methods We examined representative samples of students aged from 12 to 18 years (N = 9,309) in two German federal states to provide prevalence data and clinical description of risk factors for problematic gambling. Results We found that about 40% of the adolescents reported engaging in gambling activities within the past 12 months and found prevalence rates of 1.7% and 2.2% for problematic gambling. Especially, use of online gambling and slot machines was found to be related to problematic gambling. Male adolescents with a migration background were of higher risk for problematic gambling and psychopathological symptoms were significantly elevated among that group. Discussion The results indicate that participation in gambling activities is common among underaged adolescents and that prevalence of problematic gambling exceeds rates of adults. Similarly, problematic gambling is associated with increased psychopathological strain. Conclusion Given that a high proportion of adult gamblers report having started gambling in adolescents, our data emphasize the need for prevention and early intervention strategies for problematic gambling.

Prevalence and determinants of online-sex use in the German population.

INTRODUCTION: The unlimited access to sexual features in the World Wide Web has raised concerns about excessive and problematic online-sex use. However, little is known about antecedents of internet-sex use of different intensity. Based on a representative German sample of 2,522 participants between the ages of 14 and 97 years, the aims of the present study were (1) to determine the prevalence rates of online-sex users with the short version (ISSTGSV) of the Internet Sex Screening Test and (2) to associate online-sex use with anxious vs. avoidant partner attachment patterns and "Big Five" personality traits as potential antecedents. RESULTS: The ISST is a brief, one-dimensional and reliable measure of online-sex activities (rtt = .69). Overall, 14.7% of respondents reported occasional and 4.2% intensive online-sex use. In multivariate analysis, online-sex use was significantly positively associated with male sex, younger age, unemployment and an anxious partner attachment pattern and negatively with conscientiousness and agreeableness. CONCLUSIONS: Arousal and satisfaction by virtual enactment of sexual phantasies may be attractive for anxiously attached persons who find it difficult to commit to a real life relationship due to fear of rejection or low self-esteem. More knowledge about the individual antecedents of intensive online-sex use may also be helpful for the development of consultation and treatment strategies for excessive and addictive online-sex use.

Adding Clinical Validity to the Statistical Power of Large-Scale Epidemiological Surveys on Internet Addiction in Adolescence: A Combined Approach to Investigate Psychopathology and Development-Specific Personality Traits Associated With Internet Addiction.

OBJECTIVE: Research has indicated that internet addiction is associated with psychosocial maladjustment in adolescence. Many epidemiologic surveys are lacking representativeness, and knowledge on disorder-specific risk factors is scarce. One weakness of epidemiologic studies often regards their lack of generalizability to clinical reality. The aim of this study was to provide a detailed description of internet addiction among adolescents, focusing on its prevalence in a population-based context, psychopathological correlates, and predisposing factors. METHODS: The main analyses were based on 2 large representative samples of German adolescents (N = 9,293; 12-19 years) collected in 2012, and the results were validated on a consecutive sample of 237 treatment-seeking adolescents (from 2009-2014). The Scale for the Assessment of Internet and Computer Game Addiction (AICA-S), Strengths and Difficulties Questionnaire (SDQ), Symptom Checklist-90 Revised (SCL-90R), and NEO-Five Factor Inventory (NEO-FFI) were administered. RESULTS: Internet addiction occurred in 2.6% of adolescents, with almost comparable rates in both genders, whereas female patients (1.3%) were underrepresented among the treatment seekers. Internet-addicted adolescents from the clinical and the nonclinical setting displayed higher psychopathology (SDQ: P < .001) and functional impairment (Global Assessment of Functioning: P < .001) than adolescents with nonproblematic internet use. Low conscientiousness (in boys: ß = -0.161 to -0.220; in girls: ß = -0.103 to -0.240) and high negative affect (in boys: ß = 0.141 to -0.193; in girls: ß = 0.175 to 0.290) were personality correlates of internet addiction. CONCLUSIONS: Internet addiction is a widespread problematic behavior among male and female adolescents, and it is related to psychopathological symptoms. Low conscientiousness and high negative affect were identified as stable correlates for internet addiction independent of age and gender and can therefore be considered as risk factors for internet addiction.

Prevalence and correlates of depersonalization in students aged 12-18 years in Germany.

BACKGROUND: Depersonalization (DP) involves unpleasant experiences of detachment from one's sense of self or unreality in the environment. DP may occur in a broad range of conditions, among healthy persons due to sleep loss, drug induced, secondary to anxiety disorders or primary in depersonalization disorder. Although DP has an early age of onset, little is known about the prevalence and correlates of DP among adolescents. METHODS: Between January and June 2011, we conducted a questionnaire-based representative survey of pupils aged 12-18 years in the federal state Rhineland-Palatinate of Germany. The final sample comprised 3,809 pupils. We analyzed the prevalence of depersonalization and its correlates regarding sociodemographic characteristics, substance abuse, global mental distress and resilience factors. RESULTS: One-third of the sample showed severe global mental distress, and 11.9 % were in the range of clinically significant depersonalization. Depersonalized students were less often living with both parents (67.3 vs. 75.7 %), came more often from an disadvantaged socioeconomic background, had a very severe level of global mental distress (comparable to psychiatric inpatients), were more often smoking and abusing cannabis and they suffered from specific impairments regarding social insecurity, global self-efficacy and active coping abilities. CONCLUSIONS: Experiences of depersonalization were very common among adolescents and may indicate an increased risk for poor academic achievement and mental health in the long term. Prospective studies are needed to investigate the course and clinical relevance of depersonalization for the development of the adolescents.