Excessive Internet use and Internet addiction are currently increasing in many industrial nations. Verified and validated measuring instruments could contribute to a better understanding of this still quite recent development. The aim of this survey was to investigate the psychometric properties of a German version of the Compulsive Internet Use Scale (CIUS). We surveyed a representative German quota sample of 1,723 adolescents aged between 14 and 17 years, as well as one parent each, with standardized questionnaires. In addition, adolescents and parents were asked whether the media use by the youth was considered problematic or excessive, and whether it led to arguments at home. We conducted confirmatory factor analyses (CFA) with maximum likelihood estimation to examine the factorial validity of the German CIUS, as well as reliability and correlation analyses. The results of the CFA indicate good psychometric properties for the German version of the CIUS. They appear in line with the findings for the original version of the questionnaire. Furthermore, the CIUS showed high internal consistency, and we found significant correlations between the "CIUS-summary score" and different ratings of problems with the media usage by the youth and the parents. The German version of the CIUS seems to be a valid and suitable diagnostic tool for measuring problematic to pathological Internet use.

BackgroundKnowledge of health-related quality of life (HRQOL) of patients receiving opioid substitution treatment (OST) is limited and fragmented. The present study examines the HRQOL of a large national sample of OST patients in Germany and sociodemographic and clinical correlates.MethodsCross-sectional data on the HRQOL of 2176 OST patients was compared with German general population norms. Patients were recruited from 63 OST practices across Germany. To identify correlates of HRQOL, as measured with the SF-12, we performed bi- and multivariate analyses with sociodemographic and clinical variables, including patient- and clinician-reported outcomes on physical and mental health.ResultsPatients’ HRQOL was significantly poorer than in the general population, especially their mental HRQOL. Factors associated with lower physical HRQOL were older age, longer duration of opioid dependence, hepatitis C virus infection, and HIV infection. Benzodiazepine use was associated with lower mental HRQOL, and amphetamine use with higher physical HRQOL, compared to non-use of these substances. For both mental and physical HRQOL, the factor with the strongest positive association was employment and the factors with the strongest negative associations were physical and mental health symptom severity, psychiatric diagnosis, and psychopharmacological medication.ConclusionsCompared to the general population, we found substantially lower HRQOL in OST patients, especially in their mental HRQOL. OST programs can benefit from further improvement, particularly with regard to mental health services, in order to better serve their patients’ needs. Clinicians may consider the use of patient-reported outcome measures to identify patients’ subjective physical and psychological needs. Further research is needed to determine if employment is a cause or consequence of improved HRQOL.Trial registrationClinicalTrials.gov: NCT02395198, retrospectively registered 16/03/2015

Amphetamine-type stimulant users are a highly diverse population, and their drug use careers are shaped by a complex dynamic of individual, social and environmental factors. Tailored, joined-up interventions are needed to address users' overlapping economic, health and social care needs in order to support long-term abstinence.

Background Amphetamine-type stimulants (ATS) are the second most commonly used illicit drugs in Europe and globally. However, there is limited understanding of what shapes patterns of ATS use over the life course. The ATTUNE project “Understanding Pathways to Stimulant Use: a mixed methods examination of the individual, social and cultural factors shaping illicit stimulant use across Europe” aims to fill this gap. Here we report initial findings from the life course chart exercise conducted as part of qualitative interviews with ATS users and nonusers. Methods Two hundred seventy-nine in-depth qualitative interviews were conducted with five ATS user groups (current and former dependent users;current and former frequent users;non-frequent users) and one group of exposed non-ATS users in five European countries (Germany, UK, Poland, Netherlands and Czech Republic). As part of the interviews, we used life course charts to capture key life events and substance use histories. Life events were categorised as either positive, neutral or negative, and associated data were analysed systematically to identify differences between user groups. We applied statistical analysis of variance (ANOVA) and analysis of covariance (ANCOVA) to test for group differences. Results Out of 3547 life events documented, 1523 life events were categorised as neutral, 1005 life events as positive and 1019 life events as negative. Current and formerly dependent ATS users showed more negative life events for the entire life course after age adjustment. Although some group differences could be attributed to the individuals’ life course prior to first ATS use, most negative life events were associated with periods of ATS usage. A detailed analysis of the specific life domains reveals that dominantly, the social environment was affected by negative life events. Conclusions For non-dependent, frequent and non-frequent ATS users, negative life events from the period of ATS use do not become obvious in our analysed data. Besides preventing a pathway into ATS dependency, the aim of an intervention should be to reduce the harm by for example drug testing which offers also the opportunity for interventions to prevent developing a substance use dependency. For the group of dependent ATS users, our study suggests holistic, tailored interventions and specialist treatment services are needed, as a single, simple intervention is unlikely to cover all the life domains affected.

The analytical method used in this study is an innovative epidemiological approach to evaluate person-related register data over the course of several years. Establishing a monitoring system of prescription drugs with potential for dependence may allow for a quicker identification of trends and initiation of appropriate measures.

IntroductionAmphetamine-type stimulants (ATS) including amphetamine, methylenedioxymethamphetamine/‘ecstasy’, methamphetamine, synthetic cathinones and ‘Ritalin’ are the second most commonly used illicit drugs globally. Yet, there is little evidence on which factors are associated with the development of different patterns of ATS use over the life course. This study aims to examine which individual, social and environmental factors shape different pathways and trajectories of ATS consumption. The study will be conducted in five European countries: Germany, the Netherlands, Poland, Czech Republic and the UK.Methods and analysisWe will use a sequential mixed-methods study design to investigate the multiple factors (familial, social and occupational situation, critical life events, general risk behaviour, mental and physical health, satisfaction with life) that shape individual ATS use pathways. A systematic literature review will be performed to provide an overview of the current academic literature on the topic. In module 1, qualitative semistructured interviews (n=ATS users and non-users) will be conducted to explore individual experiences of, and perspectives on, dynamics of change in stimulant consumption patterns. In module 2, structured questionnaires (n=2000 ATS users and non-users) will be administered via tablet computers to validate and enhance the generalisability of the interview findings. Data integration will take place at two key points. First, during the study, where the findings from the first qualitative interviews will inform the design of the structured questionnaire. Second, at the end of the study, where mixed methods data will be brought together to generate an in-depth, contextualised understanding of the research topic.Ethics and disseminationThe study has been approved by the respective responsible ethics committee in each participating country. Data will be treated confidentially to ensure participants’ anonymity. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings for policy and practice.

Few studies have been carried out investigating the interdependence of family structures or interactions and excessive adolescent Internet use. In this study, we surveyed a representative German quota sample of 1,744 adolescents aged between 14 and 17 years with standardized questionnaires. Adolescents assessed their perceived own functioning in the family with the Self-Rating Scale (FB-S) of the German version of the Family Assessment Measure III, and reported on problematic Internet use with the Compulsive Internet Use Scale (CIUS). To predict problematic Internet use (CIUS summary score), we conducted a multiple stepwise linear regression analysis with the seven FB-S scales, the FB-S overall index, and gender and age as explanatory variables. For the full sample, a model with only one predictor (FB-S overall index) that summarizes the quality of family functioning produced a corrected coefficient of determination of 0.239 and explained variance of nearly 24%. t Test results for unpaired samples showed significant differences in the mean values of the FB-S scales and the FB-S overall index for comparisons of both sexes, as well as of a lower age group and higher age group. The prediction of problematic Internet use between both sexes and both age groups showed comparable findings (males: corrected coefficient of determination=0.288; females: corrected coefficient of determination=0.183; lower age group: corrected coefficient of determination=0.231; higher age group: corrected coefficient of determination=0.251), each with a single predictor (FB-S overall index). The results emphasize the importance of family functioning for the occurrence of problematic Internet use in adolescents.

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