Commentary on Horn et al.: The outcome expectancy in the 'alcohol-gambling cocktail' Within the f... more Commentary on Horn et al.: The outcome expectancy in the 'alcohol-gambling cocktail' Within the framework of alcohol outcome expectancy theory, Horn and colleagues provide strong empirical evidence that alcohol outcome expectancy is a pathway for the effect of alcohol intake on gambling behaviour. Gambling and alcohol intake often co-occur in gambling venues such as casinos and pubs. As acute alcohol intake increases risk-taking behaviour [1-3], there is concern that the 'alcohol-gambling cocktail'
Current Opinion in Endocrinology, Diabetes and Obesity, Sep 16, 2021
Purpose of review To systematically review and meta-synthesize current (2019–2021) literature on ... more Purpose of review To systematically review and meta-synthesize current (2019–2021) literature on aggression and criminality in androgen abusers. Results from 13 empirical human studies are discussed. Recent findings Some androgen abusers engage in aggressive and criminal behavior. Here, results show positive effects and associations between the administration of androgens and aggression, and descriptions of various patterns and kinds of aggression and criminality in androgen abusers. Still, this positive relationship seems to be mediated by various factors, such as cognition, neurobiology, personality, polypharmacy, and study methods. Summary The current literature on aggression and criminality in androgen abusers shows methodical diversity and underlines the need to synthesize the current evidence in order to draw overall conclusions as well as identify relevant and important knowledge gaps. On the basis of a systematic literature search, we identified 13 studies and categorized them by methodology. Of the 13 studies, 4 were meta-analyses and systematic reviews, 1 was a randomized controlled trial, 4 were cross-sectional studies, and 4 constituted case reports. Evidence on the relationship between androgen abuse and involvement in aggressive behavior seems to be mediated by cognition, neurobiology, personality, and polypharmacy as well as methodical factors, such as study design, aggression severity, type of measurement, and temporal proximity. Implications for practice and future research are presented.
Current Opinion in Endocrinology, Diabetes and Obesity, Jul 7, 2023
Purpose of review To investigate the prevalence and correlates of androgen dependence among users... more Purpose of review To investigate the prevalence and correlates of androgen dependence among users. A meta-analysis, meta-regression analysis, and qualitative synthesis were conducted based on a systematic literature search in Google Scholar, ISO Web of Science, PsycNET, and PubMed. Recent findings Twenty-six studies were included in the review and 18 studies (N = 1782) in the statistical analysis. The overall lifetime androgen dependence prevalence was 34.4% [95% confidence interval (CI): 27.8–41.7, Q = 113.1, I 2 = 85.0, P < 0.001]. Although males (36.1%, P < 0.001) and females (37.0%, P = 0.188) did not differ (Q = 0.0, P = 0.930) in dependence prevalence, controlling for other study characteristics, higher study male sample proportion was related to higher dependence prevalence. Combined interview and questionnaire assessments showed higher prevalence compared to interviews only. Publications from 1990–1999 generated higher prevalence compared to 2000–2009 and 2010–2023 publications. Dependents were associated with a wide array of demographic inequalities, and biophysical, cognitive, emotional, and psychosocial problems. Summary One of three persons who initiate androgen use experiences dependence along with various serious disorders. Androgen use and dependence should be considered an important public health issue requiring targeted health interventions.
Users obtain anabolic-androgenic steroids (AAS) from various sources and it is unclear if observe... more Users obtain anabolic-androgenic steroids (AAS) from various sources and it is unclear if observers' perception of these sources has an effect on their construal of users' personality. We investigated the influence of observers' perceived source of AAS on their construal of users' personality. A total of 283 individuals (209 females; mean age = 26.84 years) recruited online were randomized to three independent experimental scenarios or vignettes differing only in the source of AAS used by the protagonist: the Internet (n = 91), trainer/coach (n = 91), and physician/doctor (n = 101). Participants in all three conditions rated their protagonist on the NEO Five-Factor Inventory. Multivariate analysis of variance results indicated no significant between-group differences on personality ratings of the protagonists. It is evident that observers' perceived source of AAS does not influence their construal of users' personality.
There is a dearth of longitudinal studies on risk factors for anabolic-androgenic steroid (AAS) u... more There is a dearth of longitudinal studies on risk factors for anabolic-androgenic steroid (AAS) use and intent. We conducted a longitudinal investigation of factors associated with AAS use intent from age 18 to 19, examining particularly the role of physical and verbal aggression. A sample of Norwegians completed questionnaires containing demographic, AAS use and intent, other addictions, aggression, and health measures at ages 18 (N = 1333, females = 58.9%) and 19 (N = 1277, females = 61.7%). The data were analyzed using descriptive statistics, correlations, and hierarchical multiple regression. Results show that AAS use prevalence increased from 1 person at age 18 to 4 persons at age 19. Intent to use AAS, being male, living alone, and AAS use (all at 18 years) were associated with higher AAS use intent at 19 years. We found no associations between physical or verbal aggression and AAS use intent from ages 18 to 19. Our findings indicate temporal stability in AAS use intent, as well as the influence of demographic and health factors on AAS use intent from ages 18 to 19. Implications of findings for practice and future research are discussed.
Research examining gambling behavior via experiments, self-report, and/or observation presents ma... more Research examining gambling behavior via experiments, self-report, and/or observation presents many methodical challenges particularly in relation to objectivity. However, the use of player account-based gambling data provides purely objective data. Based on this real-world data, the primary aim of the present study was to examine gambling behavior in gambling venues with different numbers of gambling terminals (i.e., venues with one terminal; 2-5 terminals; 6-10 terminals; 11-16 terminals). Player account-based gambling data aggregated over a year (2015) amounting to 153,379 observations within 93,034 individual gamblers (males = 74%; mean age = 44.1, SD = 16.4 years) were analyzed. Gambling frequency was highest in venues with 2-5 terminals (54.5%) and lowest in venues with 11-16 terminals (1.6%). Approximately half of the sample (52.5%) gambled in only one venue category, with the majority (81.5%) preferring venues with 2-5 terminals present. Only 0.8% of the sample gambled in all four venue categories. Compared to venues with one terminal, venues with two or more terminals were associated with gamblers placing more bets, and spending more time and money per session. However, gamblers had higher losses (albeit small) in venues with one terminal compared to venues with 2-5 terminals. No differences in net outcome were found between venues with one terminal and those with 6-10 and 11-16 terminals. Overall, the present study demonstrates that in the natural gambling environment, gambling behavior is reinforced in venues with multiple terminals.
had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a ... more had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a significant positive association with AAS use prevalence. Moreover, male sample percentage (lower than 75%) was associated with lower prevalence compared to studies with percentage of males not provided. The second study involved a cross-sectional survey of 2,597 (1,146 male and 1,412 female) high school students in Ghana. The response rate was 96.8%. Participants' ages ranged between 11 to 35 years (M = 17.2, SD = 1.4). In addition to questions about nonmedical AAS use, participants answered questions about demography and sports participation. Standard descriptive statistics and multinomial logistic regression were used to analyze the data. The lifetime prevalence of AAS use was 3.8% (4.9% for males and 3.1% for females). Moreover, 18.5% admitted that they had an acquaintance that had used or did use AAS while 6.0% of the sample disclosed that they had been offered AAS previously. However, no valid AAS name was provided by users. Use and contemplation to use AAS was also significantly higher among males, teenagers, athletes (versus recreational sportspeople and nonathletes), and ball game players (versus other sports). Participation in martial arts, and swimming had significant negative association with AAS use attitudes. Conversely, female gender, living alone, religiosity, and participation in jogging had significant positive association with AAS use attitudes. Study 3 was an experimental investigation of ratings of the perceived personality (Five-Factor Model) of an AAS-using protagonist, an EPO-using protagonist, a protein powderusing protagonist and a nonuser of any of these ergogenic aids. The sample included 328 (236 females) non-substance use students drawn from three institutions of higher education in Norway. Participants were aged between 18 and 52 years (M = 21.88, SD = 4.13) and were randomly allocated into four separate experimental conditions: food (n = 82), protein powder (n = 83), erythropoietin (n = 83), and AAS (n = 80). In all four conditions, 10
The scope and variety of video games and monetary gambling opportunities are expanding rapidly. I... more The scope and variety of video games and monetary gambling opportunities are expanding rapidly. In many ways, these forms of entertainment are converging on digital and online video games and gambling sites. However, little is known about the relationship between video gaming and gambling. The present study explored the possibility of a directional relationship between measures of problem gaming and problem gambling, while also controlling for the influence of sex and age. In contrast to most previous investigations which are based on cross-sectional designs and non-representative samples, the present study utilized a longitudinal design conducted over 2 years (2013, 2015) and comprising 4601 participants (males 47.2%, age range 16-74) drawn from a random sample from the general population. Video gaming and gambling were assessed using the Gaming Addiction Scale for Adolescents and the Canadian Problem Gambling Index, respectively. Using an autoregressive cross-lagged structural equation model, we found a positive relationship between scores on problematic gaming and later scores on problematic gambling, whereas we found no evidence of the reverse relationship. Hence, video gaming problems appear to be a gateway behavior to problematic gambling behavior. In future research, one should continue to monitor the possible reciprocal behavioral influences between gambling and video gaming.
Aim: Contextual factors, such as venue characteristics appear to influence gambling behavior. How... more Aim: Contextual factors, such as venue characteristics appear to influence gambling behavior. However, few studies have compared the relationship between gambling behavior in alcohol-serving venues (ASVs) and nonalcohol serving venues (NASVs). The aim of the study was to examine individual gambling behavior in ASVs and NASVs. Method: A repeated-measures design was used to examine individual gambling behavior in ASVs and NASVs covering a month. The sample comprised 1,452 observations of 726 individuals (25.2% female). A quantile regression model was conducted to examine individual differences in gambling behavior (number of days, sessions, bets made, stake and time spent, net balance, and average bet size) across ASVs and NASVs. Analyses were broken down by gambler category (those that reached legal mandatory spending limits and those that did not) as well as on time frame (overall gambling behavior and average in-session gambling behavior). Results: Individuals gambled regularly in NASVs and occasionally in ASVs. Compared to NASVs, in-session gambling behavior was more variable in ASVs. In-session analysis showed that non-limit reaching gamblers staked less money in ASVs than in NASVs but lost more money in ASVs than in NASVs. Limit reaching gamblers showed no differences in gambling behavior across venues. Conclusion: The findings show that in-session gambling behavior is more variable in ASVs compared to NASVs regardless of gambling category. Non-limit reaching gamblers may be more sensitive to contextual factors than limit reaching gamblers and appear to be more willing to take more risk in ASVs compared to NASVs. The contextual implications are discussed.
Ratings of the perceived personality (Five-Factor Model) of an anabolic-androgenic steroid(s) (AA... more Ratings of the perceived personality (Five-Factor Model) of an anabolic-androgenic steroid(s) (AAS) user, an erythropoietin (EPO) user, a protein powder user and a nonuser of these ergogenic aids were investigated. The sample of 328 (236 females) non-substance use participants providing the ratings was students aged 18-52 years. They were drawn from three Norwegian higher education institutions and were randomized to four independent experimental conditions, each comprising a specific scenario/description [food (n ¼ 82), protein powder (n ¼ 83), EPO (n ¼ 83), and AAS (n ¼ 80)] similar in number, age and gender distribution. Participants in all conditions rated their protagonist on the NEO Five-Factor Inventory. Multivariate analysis of variance results indicated, consistent with our prediction, that the protagonist who consumed food was perceived as least neurotic whereas the AAS and EPO protagonists were rated similarly on neuroticism. The food and protein powder protagonists were rated similarly on openness albeit higher than the EPO protagonist. The food protagonist was regarded as more agreeable than protagonists of the ergogenic aids. Our findings indicate that perceived AAS use negatively impacts the construal of the perceived user's personality or social image. Implications of findings are discussed.
The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological d... more The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological distress requires further elucidation. No previous study has examined whether the latent patterns of aggression and psychological distress are the same in male and female AAS users. Multigroup latent class analysis (MLCA) can be used to classify individuals into groups based on their responses on a set of variables, and to investigate measurement invariance across subgroups. We therefore conducted a MLCA to identify discrete subgroups of aggression and psychological distress in AAS users, and used measurement invariance to examine whether the identified subgroups can be applied to both sexes. We also examined the relationship between sex and subgroup belongingness. The sample comprised 206 AAS users (females = 58.30%) aged 14-56 (mean = 26.86, SD = 7.12) years. They completed questionnaires assessing demographics, AAS use, aggression, and psychological distress. Based on the MLCA, five subgroups were identified: high aggression moderate distress users (HAMoD: 07.63%), moderate aggression distress users (18.64%), moderate direct aggression-mild indirect aggression moderate distress users (22.95%), mild direct aggression-moderate indirect aggression-distress users (11.71%), and low aggression mild distress users (LAMiD: 39.06%). Although a homogenous five-class solution was the best model for both sexes, sex was significantly associated with the probability of subgroup membership. In particular, members of the HAMoD subgroup were more likely to be male whereas members of the LAMiD subgroup were more likely to be female. Our study provides novel empirical evidence of the idiosyncratic patterns of aggression and psychological distress among male and female AAS users.
To our knowledge, no previous large-scale study has examined the prevalences and correlates of ha... more To our knowledge, no previous large-scale study has examined the prevalences and correlates of having only easily concealed tattoos, or readily visible tattoos. We conducted an exploratory online survey in Norway asking 15,654 (6,151 females) persons aged 16-91 (m = 33.65 AE 12.27) about various demographic, sports, substance use, mental health, personality, and tattooing questions. The estimated prevalence of tattooing was 20.8% (females: 23.8%, males: 17.9%), of which 13.3% had readily visible tattoos. Results of multivariate logistic regression analysis indicated that females, being older than 19 years, higher body mass index, lifetime anabolic-androgenic steroid use (AAS), and higher scores on extraversion were associated with higher odds of having a tattoo. Factors associated with higher odds of having only easily concealed tattoos were being 40-49 (versus those ≤ 19) years old, being only high school or tertiary (versus being only primary school) educated, often or not (versus always) exercising in a gymnasium, and high scores on agreeableness. Females, and higher scores on extraversion and neuroticism were associated with higher odds of having at least one readily visible tattoo. Our findings delineate the significance of demographic variables, gymnasium exercise, AAS, and personality in the practice of tattooing.
There is a paucity of longitudinal investigations of gambling behavior in the transition from ado... more There is a paucity of longitudinal investigations of gambling behavior in the transition from adolescence to emerging adulthood. We conducted a longitudinal investigation of the associations and patterns of change between mental health symptoms and gambling behavior. A representative sample of Norwegians completed questionnaires containing demographic, mental health, and gambling measures at age 17 (N = 2055), and at ages 18 (N = 1334) and 19 (N = 1277). Using latent class analysis, three classes of gambling behavior were identified: consistent non-gambling (71.1%), consistent nonrisk gambling (23.8%), and risky-and-problem gambling (5.1%). Being male, showing higher physical and verbal aggression and having more symptoms of depression were associated with greater odds of belonging to the risky-and-problem gambling class at age 17. Overall, the risky-and-problem gambling class had the highest physical and verbal aggression, anxiety, and depression at 19 years. Our findings elucidate the reciprocal relationship between mental health and gambling behavior in the transition from adolescence to emerging adulthood, and the importance of recognizing these factors in designing targeted interventions.
had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a ... more had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a significant positive association with AAS use prevalence. Moreover, male sample percentage (lower than 75%) was associated with lower prevalence compared to studies with percentage of males not provided. The second study involved a cross-sectional survey of 2,597 (1,146 male and 1,412 female) high school students in Ghana. The response rate was 96.8%. Participants' ages ranged between 11 to 35 years (M = 17.2, SD = 1.4). In addition to questions about nonmedical AAS use, participants answered questions about demography and sports participation. Standard descriptive statistics and multinomial logistic regression were used to analyze the data. The lifetime prevalence of AAS use was 3.8% (4.9% for males and 3.1% for females). Moreover, 18.5% admitted that they had an acquaintance that had used or did use AAS while 6.0% of the sample disclosed that they had been offered AAS previously. However, no valid AAS name was provided by users. Use and contemplation to use AAS was also significantly higher among males, teenagers, athletes (versus recreational sportspeople and nonathletes), and ball game players (versus other sports). Participation in martial arts, and swimming had significant negative association with AAS use attitudes. Conversely, female gender, living alone, religiosity, and participation in jogging had significant positive association with AAS use attitudes. Study 3 was an experimental investigation of ratings of the perceived personality (Five-Factor Model) of an AAS-using protagonist, an EPO-using protagonist, a protein powderusing protagonist and a nonuser of any of these ergogenic aids. The sample included 328 (236 females) non-substance use students drawn from three institutions of higher education in Norway. Participants were aged between 18 and 52 years (M = 21.88, SD = 4.13) and were randomly allocated into four separate experimental conditions: food (n = 82), protein powder (n = 83), erythropoietin (n = 83), and AAS (n = 80). In all four conditions, 10
Losses disguised as wins (LDWs) appear to reinforce gambling persistence. However, little researc... more Losses disguised as wins (LDWs) appear to reinforce gambling persistence. However, little research has examined this phenomenon with real gamblers in natural gambling settings. We aimed to examine the relationship between within-session outcome size and subsequent gambling persistence. Account-based gambling data of individuals playing LDW games over a randomly selected day (2,035,339 bets made by 8636 individuals) was examined. We used a logistic mixed effects model to examine the relationship between the outcome of the previous bet (loss, LDW and real wins) and the odds of continuing betting in a game session. The odds of continuing betting in a game session were positively associated with the outcome of the previous bet. Compared to LDWs, losses lowered the odds of continuing a game session. In contrast, real wins implied greater odds of continuing a game session compared to LDWs. It is concluded that LDWs increase the likelihood of continuing betting compared to losses, but decrease the likelihood of continuing to gamble compared to real wins. As LDWs increase the number of bets made within a gambling session, and hence within-session gambling persistence, LDWs may potentially play an etiological role in the development of gambling problems over time.
International Journal of Epidemiology, Sep 23, 2015
INTRODUCTION: The worldwide prevalence of anabolic-androgenic steroid (AAS) use is poorly documen... more INTRODUCTION: The worldwide prevalence of anabolic-androgenic steroid (AAS) use is poorly documented, and geographical distribution of studies concerning AAS use is mostly limited to the USA, Canada, Brazil and some European countries. In addition, no quantitative meta-analysis has been conducted on the global prevalence rate of AAS use. METHODS: We performed the first ever meta-analysis and metaregression analysis of AAS use using studies gathered from searches in PsycINFO, PubMed, ISI Web of Science, Google Scholar among others. Included were 187 studies that provided original data on 271 lifetime prevalence rates. Studies were coded for publication year, region, sample type, age range, sample size, assessment method, and sampling method. Heterogeneity was assessed by the I 2 index and the Q-statistic. Random effect-size modeling was used. Subgroup comparisons were conducted using Bonferroni correction. RESULTS: The global lifetime prevalence rate obtained was 3.3% (95 CI, 2.8-3.8, I 2 ¼ 99.7, P < 0.001]. The prevalence rate for males, 6.4% (95% CI, 5.3-7.7, I 2 ¼ 99.2, P < 0.001), was significantly higher (Q bet ¼ 100.1, P < 0.001) than the rate for females, 1.6% (95% CI, 1.3-1.9, I 2 ¼ 96.8, P < 0.001). Sample type (athletes), assessment method (interviews only and interviews and questionnaires), sampling method, and male sample percentage were significant predictors of AAS use prevalence. There was no indication of publication bias. CONCLUSION: Non-medical AAS use is a serious widespread public health problem.
Commentary on Horn et al.: The outcome expectancy in the 'alcohol-gambling cocktail' Within the f... more Commentary on Horn et al.: The outcome expectancy in the 'alcohol-gambling cocktail' Within the framework of alcohol outcome expectancy theory, Horn and colleagues provide strong empirical evidence that alcohol outcome expectancy is a pathway for the effect of alcohol intake on gambling behaviour. Gambling and alcohol intake often co-occur in gambling venues such as casinos and pubs. As acute alcohol intake increases risk-taking behaviour [1-3], there is concern that the 'alcohol-gambling cocktail'
Current Opinion in Endocrinology, Diabetes and Obesity, Sep 16, 2021
Purpose of review To systematically review and meta-synthesize current (2019–2021) literature on ... more Purpose of review To systematically review and meta-synthesize current (2019–2021) literature on aggression and criminality in androgen abusers. Results from 13 empirical human studies are discussed. Recent findings Some androgen abusers engage in aggressive and criminal behavior. Here, results show positive effects and associations between the administration of androgens and aggression, and descriptions of various patterns and kinds of aggression and criminality in androgen abusers. Still, this positive relationship seems to be mediated by various factors, such as cognition, neurobiology, personality, polypharmacy, and study methods. Summary The current literature on aggression and criminality in androgen abusers shows methodical diversity and underlines the need to synthesize the current evidence in order to draw overall conclusions as well as identify relevant and important knowledge gaps. On the basis of a systematic literature search, we identified 13 studies and categorized them by methodology. Of the 13 studies, 4 were meta-analyses and systematic reviews, 1 was a randomized controlled trial, 4 were cross-sectional studies, and 4 constituted case reports. Evidence on the relationship between androgen abuse and involvement in aggressive behavior seems to be mediated by cognition, neurobiology, personality, and polypharmacy as well as methodical factors, such as study design, aggression severity, type of measurement, and temporal proximity. Implications for practice and future research are presented.
Current Opinion in Endocrinology, Diabetes and Obesity, Jul 7, 2023
Purpose of review To investigate the prevalence and correlates of androgen dependence among users... more Purpose of review To investigate the prevalence and correlates of androgen dependence among users. A meta-analysis, meta-regression analysis, and qualitative synthesis were conducted based on a systematic literature search in Google Scholar, ISO Web of Science, PsycNET, and PubMed. Recent findings Twenty-six studies were included in the review and 18 studies (N = 1782) in the statistical analysis. The overall lifetime androgen dependence prevalence was 34.4% [95% confidence interval (CI): 27.8–41.7, Q = 113.1, I 2 = 85.0, P &lt; 0.001]. Although males (36.1%, P &lt; 0.001) and females (37.0%, P = 0.188) did not differ (Q = 0.0, P = 0.930) in dependence prevalence, controlling for other study characteristics, higher study male sample proportion was related to higher dependence prevalence. Combined interview and questionnaire assessments showed higher prevalence compared to interviews only. Publications from 1990–1999 generated higher prevalence compared to 2000–2009 and 2010–2023 publications. Dependents were associated with a wide array of demographic inequalities, and biophysical, cognitive, emotional, and psychosocial problems. Summary One of three persons who initiate androgen use experiences dependence along with various serious disorders. Androgen use and dependence should be considered an important public health issue requiring targeted health interventions.
Users obtain anabolic-androgenic steroids (AAS) from various sources and it is unclear if observe... more Users obtain anabolic-androgenic steroids (AAS) from various sources and it is unclear if observers' perception of these sources has an effect on their construal of users' personality. We investigated the influence of observers' perceived source of AAS on their construal of users' personality. A total of 283 individuals (209 females; mean age = 26.84 years) recruited online were randomized to three independent experimental scenarios or vignettes differing only in the source of AAS used by the protagonist: the Internet (n = 91), trainer/coach (n = 91), and physician/doctor (n = 101). Participants in all three conditions rated their protagonist on the NEO Five-Factor Inventory. Multivariate analysis of variance results indicated no significant between-group differences on personality ratings of the protagonists. It is evident that observers' perceived source of AAS does not influence their construal of users' personality.
There is a dearth of longitudinal studies on risk factors for anabolic-androgenic steroid (AAS) u... more There is a dearth of longitudinal studies on risk factors for anabolic-androgenic steroid (AAS) use and intent. We conducted a longitudinal investigation of factors associated with AAS use intent from age 18 to 19, examining particularly the role of physical and verbal aggression. A sample of Norwegians completed questionnaires containing demographic, AAS use and intent, other addictions, aggression, and health measures at ages 18 (N = 1333, females = 58.9%) and 19 (N = 1277, females = 61.7%). The data were analyzed using descriptive statistics, correlations, and hierarchical multiple regression. Results show that AAS use prevalence increased from 1 person at age 18 to 4 persons at age 19. Intent to use AAS, being male, living alone, and AAS use (all at 18 years) were associated with higher AAS use intent at 19 years. We found no associations between physical or verbal aggression and AAS use intent from ages 18 to 19. Our findings indicate temporal stability in AAS use intent, as well as the influence of demographic and health factors on AAS use intent from ages 18 to 19. Implications of findings for practice and future research are discussed.
Research examining gambling behavior via experiments, self-report, and/or observation presents ma... more Research examining gambling behavior via experiments, self-report, and/or observation presents many methodical challenges particularly in relation to objectivity. However, the use of player account-based gambling data provides purely objective data. Based on this real-world data, the primary aim of the present study was to examine gambling behavior in gambling venues with different numbers of gambling terminals (i.e., venues with one terminal; 2-5 terminals; 6-10 terminals; 11-16 terminals). Player account-based gambling data aggregated over a year (2015) amounting to 153,379 observations within 93,034 individual gamblers (males = 74%; mean age = 44.1, SD = 16.4 years) were analyzed. Gambling frequency was highest in venues with 2-5 terminals (54.5%) and lowest in venues with 11-16 terminals (1.6%). Approximately half of the sample (52.5%) gambled in only one venue category, with the majority (81.5%) preferring venues with 2-5 terminals present. Only 0.8% of the sample gambled in all four venue categories. Compared to venues with one terminal, venues with two or more terminals were associated with gamblers placing more bets, and spending more time and money per session. However, gamblers had higher losses (albeit small) in venues with one terminal compared to venues with 2-5 terminals. No differences in net outcome were found between venues with one terminal and those with 6-10 and 11-16 terminals. Overall, the present study demonstrates that in the natural gambling environment, gambling behavior is reinforced in venues with multiple terminals.
had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a ... more had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a significant positive association with AAS use prevalence. Moreover, male sample percentage (lower than 75%) was associated with lower prevalence compared to studies with percentage of males not provided. The second study involved a cross-sectional survey of 2,597 (1,146 male and 1,412 female) high school students in Ghana. The response rate was 96.8%. Participants' ages ranged between 11 to 35 years (M = 17.2, SD = 1.4). In addition to questions about nonmedical AAS use, participants answered questions about demography and sports participation. Standard descriptive statistics and multinomial logistic regression were used to analyze the data. The lifetime prevalence of AAS use was 3.8% (4.9% for males and 3.1% for females). Moreover, 18.5% admitted that they had an acquaintance that had used or did use AAS while 6.0% of the sample disclosed that they had been offered AAS previously. However, no valid AAS name was provided by users. Use and contemplation to use AAS was also significantly higher among males, teenagers, athletes (versus recreational sportspeople and nonathletes), and ball game players (versus other sports). Participation in martial arts, and swimming had significant negative association with AAS use attitudes. Conversely, female gender, living alone, religiosity, and participation in jogging had significant positive association with AAS use attitudes. Study 3 was an experimental investigation of ratings of the perceived personality (Five-Factor Model) of an AAS-using protagonist, an EPO-using protagonist, a protein powderusing protagonist and a nonuser of any of these ergogenic aids. The sample included 328 (236 females) non-substance use students drawn from three institutions of higher education in Norway. Participants were aged between 18 and 52 years (M = 21.88, SD = 4.13) and were randomly allocated into four separate experimental conditions: food (n = 82), protein powder (n = 83), erythropoietin (n = 83), and AAS (n = 80). In all four conditions, 10
The scope and variety of video games and monetary gambling opportunities are expanding rapidly. I... more The scope and variety of video games and monetary gambling opportunities are expanding rapidly. In many ways, these forms of entertainment are converging on digital and online video games and gambling sites. However, little is known about the relationship between video gaming and gambling. The present study explored the possibility of a directional relationship between measures of problem gaming and problem gambling, while also controlling for the influence of sex and age. In contrast to most previous investigations which are based on cross-sectional designs and non-representative samples, the present study utilized a longitudinal design conducted over 2 years (2013, 2015) and comprising 4601 participants (males 47.2%, age range 16-74) drawn from a random sample from the general population. Video gaming and gambling were assessed using the Gaming Addiction Scale for Adolescents and the Canadian Problem Gambling Index, respectively. Using an autoregressive cross-lagged structural equation model, we found a positive relationship between scores on problematic gaming and later scores on problematic gambling, whereas we found no evidence of the reverse relationship. Hence, video gaming problems appear to be a gateway behavior to problematic gambling behavior. In future research, one should continue to monitor the possible reciprocal behavioral influences between gambling and video gaming.
Aim: Contextual factors, such as venue characteristics appear to influence gambling behavior. How... more Aim: Contextual factors, such as venue characteristics appear to influence gambling behavior. However, few studies have compared the relationship between gambling behavior in alcohol-serving venues (ASVs) and nonalcohol serving venues (NASVs). The aim of the study was to examine individual gambling behavior in ASVs and NASVs. Method: A repeated-measures design was used to examine individual gambling behavior in ASVs and NASVs covering a month. The sample comprised 1,452 observations of 726 individuals (25.2% female). A quantile regression model was conducted to examine individual differences in gambling behavior (number of days, sessions, bets made, stake and time spent, net balance, and average bet size) across ASVs and NASVs. Analyses were broken down by gambler category (those that reached legal mandatory spending limits and those that did not) as well as on time frame (overall gambling behavior and average in-session gambling behavior). Results: Individuals gambled regularly in NASVs and occasionally in ASVs. Compared to NASVs, in-session gambling behavior was more variable in ASVs. In-session analysis showed that non-limit reaching gamblers staked less money in ASVs than in NASVs but lost more money in ASVs than in NASVs. Limit reaching gamblers showed no differences in gambling behavior across venues. Conclusion: The findings show that in-session gambling behavior is more variable in ASVs compared to NASVs regardless of gambling category. Non-limit reaching gamblers may be more sensitive to contextual factors than limit reaching gamblers and appear to be more willing to take more risk in ASVs compared to NASVs. The contextual implications are discussed.
Ratings of the perceived personality (Five-Factor Model) of an anabolic-androgenic steroid(s) (AA... more Ratings of the perceived personality (Five-Factor Model) of an anabolic-androgenic steroid(s) (AAS) user, an erythropoietin (EPO) user, a protein powder user and a nonuser of these ergogenic aids were investigated. The sample of 328 (236 females) non-substance use participants providing the ratings was students aged 18-52 years. They were drawn from three Norwegian higher education institutions and were randomized to four independent experimental conditions, each comprising a specific scenario/description [food (n ¼ 82), protein powder (n ¼ 83), EPO (n ¼ 83), and AAS (n ¼ 80)] similar in number, age and gender distribution. Participants in all conditions rated their protagonist on the NEO Five-Factor Inventory. Multivariate analysis of variance results indicated, consistent with our prediction, that the protagonist who consumed food was perceived as least neurotic whereas the AAS and EPO protagonists were rated similarly on neuroticism. The food and protein powder protagonists were rated similarly on openness albeit higher than the EPO protagonist. The food protagonist was regarded as more agreeable than protagonists of the ergogenic aids. Our findings indicate that perceived AAS use negatively impacts the construal of the perceived user's personality or social image. Implications of findings are discussed.
The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological d... more The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological distress requires further elucidation. No previous study has examined whether the latent patterns of aggression and psychological distress are the same in male and female AAS users. Multigroup latent class analysis (MLCA) can be used to classify individuals into groups based on their responses on a set of variables, and to investigate measurement invariance across subgroups. We therefore conducted a MLCA to identify discrete subgroups of aggression and psychological distress in AAS users, and used measurement invariance to examine whether the identified subgroups can be applied to both sexes. We also examined the relationship between sex and subgroup belongingness. The sample comprised 206 AAS users (females = 58.30%) aged 14-56 (mean = 26.86, SD = 7.12) years. They completed questionnaires assessing demographics, AAS use, aggression, and psychological distress. Based on the MLCA, five subgroups were identified: high aggression moderate distress users (HAMoD: 07.63%), moderate aggression distress users (18.64%), moderate direct aggression-mild indirect aggression moderate distress users (22.95%), mild direct aggression-moderate indirect aggression-distress users (11.71%), and low aggression mild distress users (LAMiD: 39.06%). Although a homogenous five-class solution was the best model for both sexes, sex was significantly associated with the probability of subgroup membership. In particular, members of the HAMoD subgroup were more likely to be male whereas members of the LAMiD subgroup were more likely to be female. Our study provides novel empirical evidence of the idiosyncratic patterns of aggression and psychological distress among male and female AAS users.
To our knowledge, no previous large-scale study has examined the prevalences and correlates of ha... more To our knowledge, no previous large-scale study has examined the prevalences and correlates of having only easily concealed tattoos, or readily visible tattoos. We conducted an exploratory online survey in Norway asking 15,654 (6,151 females) persons aged 16-91 (m = 33.65 AE 12.27) about various demographic, sports, substance use, mental health, personality, and tattooing questions. The estimated prevalence of tattooing was 20.8% (females: 23.8%, males: 17.9%), of which 13.3% had readily visible tattoos. Results of multivariate logistic regression analysis indicated that females, being older than 19 years, higher body mass index, lifetime anabolic-androgenic steroid use (AAS), and higher scores on extraversion were associated with higher odds of having a tattoo. Factors associated with higher odds of having only easily concealed tattoos were being 40-49 (versus those ≤ 19) years old, being only high school or tertiary (versus being only primary school) educated, often or not (versus always) exercising in a gymnasium, and high scores on agreeableness. Females, and higher scores on extraversion and neuroticism were associated with higher odds of having at least one readily visible tattoo. Our findings delineate the significance of demographic variables, gymnasium exercise, AAS, and personality in the practice of tattooing.
There is a paucity of longitudinal investigations of gambling behavior in the transition from ado... more There is a paucity of longitudinal investigations of gambling behavior in the transition from adolescence to emerging adulthood. We conducted a longitudinal investigation of the associations and patterns of change between mental health symptoms and gambling behavior. A representative sample of Norwegians completed questionnaires containing demographic, mental health, and gambling measures at age 17 (N = 2055), and at ages 18 (N = 1334) and 19 (N = 1277). Using latent class analysis, three classes of gambling behavior were identified: consistent non-gambling (71.1%), consistent nonrisk gambling (23.8%), and risky-and-problem gambling (5.1%). Being male, showing higher physical and verbal aggression and having more symptoms of depression were associated with greater odds of belonging to the risky-and-problem gambling class at age 17. Overall, the risky-and-problem gambling class had the highest physical and verbal aggression, anxiety, and depression at 19 years. Our findings elucidate the reciprocal relationship between mental health and gambling behavior in the transition from adolescence to emerging adulthood, and the importance of recognizing these factors in designing targeted interventions.
had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a ... more had lower prevalence (compared to questionnaire only studies). Sampling method (nonrandom) had a significant positive association with AAS use prevalence. Moreover, male sample percentage (lower than 75%) was associated with lower prevalence compared to studies with percentage of males not provided. The second study involved a cross-sectional survey of 2,597 (1,146 male and 1,412 female) high school students in Ghana. The response rate was 96.8%. Participants' ages ranged between 11 to 35 years (M = 17.2, SD = 1.4). In addition to questions about nonmedical AAS use, participants answered questions about demography and sports participation. Standard descriptive statistics and multinomial logistic regression were used to analyze the data. The lifetime prevalence of AAS use was 3.8% (4.9% for males and 3.1% for females). Moreover, 18.5% admitted that they had an acquaintance that had used or did use AAS while 6.0% of the sample disclosed that they had been offered AAS previously. However, no valid AAS name was provided by users. Use and contemplation to use AAS was also significantly higher among males, teenagers, athletes (versus recreational sportspeople and nonathletes), and ball game players (versus other sports). Participation in martial arts, and swimming had significant negative association with AAS use attitudes. Conversely, female gender, living alone, religiosity, and participation in jogging had significant positive association with AAS use attitudes. Study 3 was an experimental investigation of ratings of the perceived personality (Five-Factor Model) of an AAS-using protagonist, an EPO-using protagonist, a protein powderusing protagonist and a nonuser of any of these ergogenic aids. The sample included 328 (236 females) non-substance use students drawn from three institutions of higher education in Norway. Participants were aged between 18 and 52 years (M = 21.88, SD = 4.13) and were randomly allocated into four separate experimental conditions: food (n = 82), protein powder (n = 83), erythropoietin (n = 83), and AAS (n = 80). In all four conditions, 10
Losses disguised as wins (LDWs) appear to reinforce gambling persistence. However, little researc... more Losses disguised as wins (LDWs) appear to reinforce gambling persistence. However, little research has examined this phenomenon with real gamblers in natural gambling settings. We aimed to examine the relationship between within-session outcome size and subsequent gambling persistence. Account-based gambling data of individuals playing LDW games over a randomly selected day (2,035,339 bets made by 8636 individuals) was examined. We used a logistic mixed effects model to examine the relationship between the outcome of the previous bet (loss, LDW and real wins) and the odds of continuing betting in a game session. The odds of continuing betting in a game session were positively associated with the outcome of the previous bet. Compared to LDWs, losses lowered the odds of continuing a game session. In contrast, real wins implied greater odds of continuing a game session compared to LDWs. It is concluded that LDWs increase the likelihood of continuing betting compared to losses, but decrease the likelihood of continuing to gamble compared to real wins. As LDWs increase the number of bets made within a gambling session, and hence within-session gambling persistence, LDWs may potentially play an etiological role in the development of gambling problems over time.
International Journal of Epidemiology, Sep 23, 2015
INTRODUCTION: The worldwide prevalence of anabolic-androgenic steroid (AAS) use is poorly documen... more INTRODUCTION: The worldwide prevalence of anabolic-androgenic steroid (AAS) use is poorly documented, and geographical distribution of studies concerning AAS use is mostly limited to the USA, Canada, Brazil and some European countries. In addition, no quantitative meta-analysis has been conducted on the global prevalence rate of AAS use. METHODS: We performed the first ever meta-analysis and metaregression analysis of AAS use using studies gathered from searches in PsycINFO, PubMed, ISI Web of Science, Google Scholar among others. Included were 187 studies that provided original data on 271 lifetime prevalence rates. Studies were coded for publication year, region, sample type, age range, sample size, assessment method, and sampling method. Heterogeneity was assessed by the I 2 index and the Q-statistic. Random effect-size modeling was used. Subgroup comparisons were conducted using Bonferroni correction. RESULTS: The global lifetime prevalence rate obtained was 3.3% (95 CI, 2.8-3.8, I 2 ¼ 99.7, P < 0.001]. The prevalence rate for males, 6.4% (95% CI, 5.3-7.7, I 2 ¼ 99.2, P < 0.001), was significantly higher (Q bet ¼ 100.1, P < 0.001) than the rate for females, 1.6% (95% CI, 1.3-1.9, I 2 ¼ 96.8, P < 0.001). Sample type (athletes), assessment method (interviews only and interviews and questionnaires), sampling method, and male sample percentage were significant predictors of AAS use prevalence. There was no indication of publication bias. CONCLUSION: Non-medical AAS use is a serious widespread public health problem.
We investigated the relationship between aggression and anabolic-androgenic steroid (AAS) use int... more We investigated the relationship between aggression and anabolic-androgenic steroid (AAS) use intent among adolescents. A nationally representative sample of Norwegian 18-year-olds (N = 1,334, females = 58.7%) took part in a survey in 2013 (response rate = 64.9%). Participants completed the physical and verbal subscales of the Short-Form Buss-Perry Aggression Questionnaire, the Intent to Use AAS Scale, the Alcohol Use Disorders Identification Test-Consumption, and the Hospital Anxiety and Depression Scale. They also provided demographic information and answered questions about AAS use, gambling participation, as well as cigarette and snus use. Descriptive statistics and multinomial logistic regression were used to analyze the data. Lifetime and past year prevalence of AAS use was 0.1%. Between 0.4% and 1.7% of participants disclosed intent to use while between 1.1% and 2.5% expressed neutral intent to initiate AAS use. Compared to persons low on aggression, individuals high on aggression were more likely to report intent and curiosity towards initiating AAS use. Our findings indicate that aggression is a risk factor for AAS use contemplation among adolescents.
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Papers by Dominic Sagoe