Anorexia nervosa: Enhancing motivation to change with self-determination theory.

Motivational deficits (little or no motivation to change) are often reported in patients with eating disorders, particularly anorexia nervosa. The motivational approaches frequently used by French clinicians rely solely on a dichotomous view of motivation (intrinsic vs. extrinsic). In self-determination theory, certain forms of extrinsic motivation can strengthen an individual's commitment to an activity, providing they are self-determined. This theory therefore extends and enriches the dual motivational approach by highlighting potentially useful forms of extrinsic motivation and by emphasizing the importance of behavioral regulation. Empirical work is now needed to assess how clinicians can use self-determination theory to enhance motivation to change among patients with anorexia nervosa and encourage their adherence to care management plans.

Neuropsychological assessment fails to predict relapse among cigarette smokers: A prospective study of neurocognitive abilities.

OBJECTIVES: Understanding the factors that lead to relapse is a major challenge for the clinical support of smoking cessation. Neurocognitive abilities such as attention, executive functioning and working memory, are possible predictors of relapse and can be easily assessed in everyday clinical practice. In this prospective longitudinal study, we investigated the relationship between pre-smoking cessation neurocognitive performance and relapse at six months in a sample of patients being treated for their tobacco dependence. METHODS: 130 tobacco consumers were included in the study. They completed a comprehensive neuropsychological and clinical assessment before smoking cessation. The targeted abilities were intelligence, inhibition, shifting, working memory updating, verbal fluency and decision-making. RESULTS: The rate of tobacco relapse at 6 months was 58%. Logistic regressions were used to assess which variables best explained relapse. None of the neuropsychological tests was a significant predictor of relapse at either 1, 3 or 6 months, either alone, or controlling for other covariates acting as significant predictors of relapse. CONCLUSIONS: Common neuropsychological tests, even those specifically targeting executive functioning such as inhibition, are not useful predictors of the success of a smoking cessation program in a clinical setting. Other variables, such as motivation to quit smoking or the presence of comorbid depression or anxiety disorders, appear to be more useful predictors of relapse.

Cannabis Use in Physicians: A Systematic Review and Meta-Analysis.

Background: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by medical doctors (MDs)/students. Method: PubMed, Cochrane, Embase, PsycInfo and ScienceDirect were searched for studies reporting cannabis use in MDs/students. For each frequency of use (lifetime/past year/past month/daily), we stratified a random effect meta-analysis depending on specialties, education level, continents, and periods of time, which were further compared using meta-regressions. Results: We included 54 studies with a total of 42,936 MDs/students: 20,267 MDs, 20,063 medical students, and 1976 residents. Overall, 37% had used cannabis at least once over their lifetime, 14% over the past year, 8% over the past month and 1.1 per thousand (‱) had a daily use. Medical students had a greater cannabis use than MDs over their lifetime (38% vs. 35%, p < 0.001), the past year (24% vs. 5%, p < 0.001), and the past month (10% vs. 2%, p < 0.05), without significance for daily use (0.5% vs. 0.05%, NS). Insufficient data precluded comparisons among medical specialties. MDs/students from Asian countries seemed to have the lowest cannabis use: 16% over their lifetime, 10% in the past year, 1% in the past month, and 0.4% daily. Regarding periods of time, cannabis use seems to follow a U-shape, with a high use before 1990, followed by a decrease between 1990 and 2005, and a rebound after 2005. Younger and male MDs/students had the highest cannabis use. Conclusions: If more than a third of MDs tried cannabis at least once in their lifetime, this means its daily use is low but not uncommon (1.1‱). Medical students are the biggest cannabis users. Despite being common worldwide, cannabis use is predominant in the West, with a rebound since 2005 making salient those public health interventions during the early stage of medical studies.

Crossed clinical features between eating disorders and types of bipolar disorder: Results from the FondaMental Advanced Centers of Expertise - Bipolar Disorder cohort.

BACKGROUND: Eating disorders (EDs) are liable to alter the disease course of bipolar disorder (BD). We explored the crossed clinical features between EDs and BD, particularly as a function of BD type (BD1 vs. BD2). METHODS: 2929 outpatients attending FondaMental Advanced Centers of Expertise were assessed for BD and lifetime EDs with a semi-structured interview, and their sociodemographic, dimensional and clinical data were collected according to a standardized procedure. For each ED type, bivariate analyses were used to investigate associations between these variables and the type of BD type followed by multinomial regressions with the variables associated with EDs and BDs after Bonferroni correction. RESULTS: Comorbid EDs were diagnosed in 478 (16.4 %) cases, and were more prevalent in patients with BD2 than in those with BD1 (20.6 % vs. 12.4 %, p < 0.001). Regression models showed no difference according to the subtype of bipolar disorder on the characteristics of patients with anorexia nervosa (AN), bulimia nervosa (BN) or binge eating disorder (BED). After multiple adjustments, the factors differentiating BD patients with versus without ED were primarily age, gender, body mass index, more affective lability and comorbidity with anxiety disorders. BD patients with BED also scored higher regarding childhood trauma. BD patients with AN also showed higher risk of past suicide attempts than those with BED. CONCLUSIONS: In a large sample of patients with BD, we found a high prevalence of lifetime EDs, especially for the BD2 type. EDs were associated with several severity indicators, but not with BD type-specific characteristics. This should prompt clinicians to carefully screen patients with BD for EDs, regardless of BD and ED types.

Selflife: A Life Skills Development Tool to Prevent Sexual Violence among Healthcare Students.

BACKGROUND: in France, 14.5% of women and 3.9% of men aged 20-69 years have experienced sexual violence. Of these, 40% will go on to develop posttraumatic stress disorder. Sexual violence is therefore a major public health issue. In the present study, we tested a life skills development tool (Selflife) designed to prevent sexual violence in a population of healthcare students. METHODS: a total of 225 French healthcare students were randomly divided into a control group using case studies (n = 114) and a group using Selflife (n = 111) to discuss the topic of sexual violence. After the session, they completed self-report questionnaires collecting sociodemographic data and probing their feelings about their participation, their life skills, and their verdict on the intervention. RESULTS: compared with controls, participants in the Selflife group reported gaining more knowledge about sexual violence, a greater sense of improving their life skills, and greater satisfaction with the intervention. CONCLUSIONS: these results suggest that, in addition to providing information about sexual violence, Selflife helped students develop their life skills, thereby empowering them to act when confronted with sexual violence. Its impact on prevalence and on the psychological and psychiatric consequences remains to be assessed.

The effects of exposure to social media images of thin and average size women on body satisfaction among young women: Emotion regulation and self-efficacy as modulating factors.

Although appearance comparison has emerged as an important mechanism underlying the detrimental effects of exposure to idealized social media images on body image among young women, little is known regarding the role of the direction of these comparisons. In addition, to date, little attention has been paid to the role of self-regulation processes in these effects. A sample of 260 female students (Mage = 19.6) from a University in Paris completed an online survey where they were randomly assigned to view thin-ideal or average size social media images of women. Participants reported on state body satisfaction before and after exposure, as well as state appearance comparison and direction of appearance comparison, and trait emotion regulation difficulties and self-efficacy. Findings revealed no main effect of condition. However, among participants who engaged in upwards appearance comparison the thin-ideal condition was associated with greater decreases in body satisfaction. In addition, three-way interactions revealed that emotional regulation difficulties and self-efficacy both further moderated these effects. These findings suggest that self-regulation processes may be important to account for in the effects of exposure to social media images on body satisfaction among young women.

The Role of Attentional Networks in Smoking Behavior Among Young Adults: Specific Contribution of Executive Control.

INTRODUCTION: The exploration of cognitive impairments associated with tobacco use disorder has expanded during the last decades, centrally showing working memory and executive deficits among smokers. Despite their critical role in everyday life and in the smoking cessation process, attentional abilities have seldom been explored. Previous studies yielded discordant results, and the involvement of attentional deficits in smoking habits remains unclear. AIMS AND METHODS: Capitalizing on the Attention Network Test, a theory-grounded task allowing the simultaneous but distinct evaluation of three attentional networks (alerting, orienting, executive control), we explored attentional abilities in three groups of 25 college students (nonsmokers, light smokers, heavy smokers), matched for demographic and psychopathological characteristics. RESULTS: While light smokers did not present any deficit compared with nonsmokers, heavy smokers showed a specific impairment of the executive control subcomponent of attention, contrasting with preserved alerting and orienting attentional abilities. The executive control deficit was not related to current craving or to smoking duration. CONCLUSIONS: Beyond the already explored memory and executive deficits, tobacco use disorder is associated with attentional impairments, characterized by a reduced ability to focus attentional resources on pertinent stimuli and resist to distractors interference. Given the assumed role of attentional impairments in smoking, our findings suggest that a critical step in future translational iterations is to develop neuropsychological rehabilitation programs tapping into the executive network of attention among smokers. IMPLICATIONS: This study clarifies the presence and extent of attentional impairments in tobacco use disorder. We measured three attention networks (alerting, orienting, executive control) in light smokers, heavy smokers and matched healthy controls through a theory-grounded task (Attention Network Test). Heavy smokers (but not light ones) present a specific deficit for the executive control of attention. This deficit, uncorrelated with psychopathological comorbidities or current craving, appears directly related to smoking. Given the currently scattered literature on this topic, attentional processes deserve a thorough audit in tobacco use disorder, notably to develop specific neurocognitive rehabilitation.

Evaluation of a Smartphone Application on the Reduction of Attentional Bias Toward Alcohol Among Students†.

CONTEXT: The recent development of "serious games" has produced encouraging results in maintaining adherence to health-related interventions. In alcohol research, several studies have shown that computerized training on attentional bias decreases alcohol consumption bias among students. However, these highly controlled experimental situations, do not allow for direct large-scale dissemination. Our objective is to evaluate an attentional bias remediation program using a gamified smartphone training procedure. METHODS: Fifty students from Clermont-Ferrand University were invited to participate in the study. After a cognitive assessment in the laboratory, the smartphone application was installed on each Student's smartphone. Participants were randomly assigned to either the alcohol attentional training group or the control group Each student had to complete the 2-min program at least once a day for 15 days. After 15 days, a new cognitive assessment of attention bias was conducted in the laboratory. Forty-seven students were included in the study. RESULTS: Our analyses did not show any effect of the cognitive remediation program on attentional bias reduction between the two group [F (1, 44) < 1, p = 0.87], attentional performance [F (1, 45) = 1.63, p = 0.20] or inhibitory abilities [F (1, 45) < 1, p = 0.73]. These results were confirmed by Bayesian analyses. DISCUSSION: Despite the absence of group effects, both the alcohol and control (non-alcohol) version of this program appeared to reduce attentional bias and increase inhibition capacities in the subset of participants who had attentional bias for alcohol at baseline This pilot study identifies areas for improvement in smartphone applications for future developments. Attentional bias remediation programs remain an interesting way to explore.

Effect of the COVID-19 pandemic on the psychotropic drug consumption.

Importance: Although the COVID-19 pandemic has had a negative impact on mental health, there is no comprehensive longitudinal study of the entire population of a country without selection bias. Objective: The objective of this study was to evaluate the prescription of psychotropic drugs during the COVID-19 pandemic, using data from the French national health data system (SNDS). Design settings and participants: Prescriptions for psychotropic drugs (antidepressants, anxiolytics, hypnotics, and antipsychotics) from 1 January 2015 to 30 September 2021 were collected from administrative data provided by the SNDS. This database includes more than 99% of the French population, i.e., 67 million people. The data were analyzed using an interrupted time series analysis (ITSA) model. Main outcomes and measures: Consumption of psychotropic drugs was aggregated in months and expressed in number of boxes per thousand inhabitants. Results: During the study period, more than 1.3 billion boxes of psychotropic medications were dispensed. Comparison of psychotropic drug dispensing before and after the pandemic showed a relative increase of 0.76 (95 CI 0.57 to 0.95, p<0.001) boxes per month per thousand inhabitants, all classes of psychotropic drugs combined. Three classes saw their consumption increase in an almost similar proportion, respectively, by 0.23 (0.15 to 0.32, p<0.001) boxes for antidepressants, 0.27 (0.20 to 0.34, p<0.001) boxes for anxiolytics and 0.23 (0.17 to 0.30, p<0.001) boxes for hypnotics. The change in antipsychotic consumption was very small, with an increase of 0.04 boxes (0.02 to 0.06, p = 0.001) per month per thousand population. Conclusion and relevance: The COVID-19 pandemic had led to an increase in the consumption of psychotropic drugs, confirming the significant impact of the pandemic on the mental health of the general population.

Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis.

BACKGROUND: Smoking is a major public health problem. Although physicians have a key role in the fight against smoking, some of them are still smoking. Thus, we aimed to conduct a systematic review and meta-analysis on the prevalence of smoking among physicians. METHODS: PubMed, Cochrane, and Embase databases were searched. The prevalence of smoking among physicians was estimated and stratified, where possible, by specialties, continents, and periods of time. Then, meta-regressions were performed regarding putative influencing factors such as age and sex. RESULTS: Among 246 studies and 497,081 physicians, the smoking prevalence among physicians was 21% (95CI 20 to 23%). Prevalence of smoking was 25% in medical students, 24% in family practitioners, 18% in surgical specialties, 17% in psychiatrists, 16% in medical specialties, 11% in anesthesiologists, 9% in radiologists, and 8% in pediatricians. Physicians in Europe and Asia had a higher smoking prevalence than in Oceania. The smoking prevalence among physicians has decreased over time. Male physicians had a higher smoking prevalence. Age did not influence smoking prevalence. CONCLUSION: Prevalence of smoking among physicians is high, around 21%. Family practitioners and medical students have the highest percentage of smokers. All physicians should benefit from targeted preventive strategies.

Self-Efficacy Mediates the Effect of Framing Eating Disorders Prevention Message on Intentions to Have a Sufficient Weight: A Pilot Study.

BACKGROUND: In the context of social marketing, the effectiveness of prevention messages is a major issue. The main objective of the present study was to assess the effect of prevention messages framing on self-efficacy reinforcement in order to improve intentions to reach or maintain sufficient weight in a non-clinical sample. It thus focuses on testing the mediating role of self-efficacy. METHODS: Two hundred and thirty-three university student women were randomly assigned to one of the two conditions (gain-framed versus loss-framed message). They were exposed to a short persuasive message and surveyed on self-efficacy and intention to maintain sufficient weight. RESULTS: Loss-framed messages elicited higher levels of self-efficacy than gain-framed messages, which led to higher intentions to reach or maintain sufficient weight. This study sheds light on the mediating role of self-efficacy. CONCLUSIONS: The results suggest ways to improve the persuasiveness of prevention campaigns, thereby opening up further research avenues.

Stigmatization toward People with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder: A Scoping Review.

Research about stigmatization in eating disorders (EDs) has highlighted stereotypes, prejudices, and discrimination against people with EDs, as well as their harmful effects on them, including self-stigma and a difficult recovery process. Whereas a recent review focused on the consequences of ED stigma, our work aimed to provide a broader synthesis of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs-namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals' eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.

Cognitive function in binge eating disorder and food addiction: A systematic review and three-level meta-analysis.

BACKGROUND: An extensive body of recent research has focused on the contribution of cognitive functioning to eating behaviors. In binge eating disorder (BED) and food addiction (FA), the extent of cognitive impairment is still unclear. This study aimed to characterize, among those with BED and FA, neurocognitive functions using performances based on neuropsychological tasks in the context of neutral stimuli in adults. METHOD: MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, CINAHL and gray literature (ProQuest and OpenGrey) were used to identify studies that reported neurocognitive assessments in BED or FA up to December 2019. A three-level meta-analysis was conducted. RESULTS: A significant overall effect was found for global cognitive impairments, suggesting that individuals with BED or FA have poorer performances when completing cognitive tasks. Analyses for specific cognitive domains revealed that individuals with BED showed poorer performances at tasks assessing cognitive flexibility, inhibitory control, attention and planning. Analyses regarding FA were inconclusive due to a lack of studies. Thus, the results were described qualitatively. CONCLUSION: Our meta-analysis highlighted the cognitive weaknesses that seem to come with BED and the necessity to integrate them in the assessment and treatment of this condition. It also stressed the lack of quality studies surrounding the cognitive features of FA.

The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise.

OBJECTIVES: The comorbidity of alcohol use disorder (AUD) and bipolar disorder (BD) has been repeatedly associated with poorer clinical outcomes than BD without AUD. We aimed to extend these findings by focusing on the characteristics associated with the sequence of onset of BD and AUD. METHODS: 3,027 outpatients from the Fondamental Advanced Centres of Expertise were ascertained for BD-1, BD-2 and AUD diagnoses, including their respective ages at onset (AAOs, N =2,804). We selected the variables associated with both the presence and sequence of onset of comorbid AUD using bivariate analyses corrected for multiple testing to enter a binary regression model with the sequence of onset of BD and AUD as the dependent variable (AUD first - which also included 88 same-year onsets, vs. BD first). RESULTS: BD patients with comorbid AUD showed more severe clinical profile than those without. Compared to BD-AUD (N =269), AUD-BD (N =276) was independently associated with a higher AAO of BD (OR =1.1, p <0.001), increased prevalence of comorbid cannabis use disorder (OR =2.8, p <0.001) a higher number of (hypo)manic/mixed BD episodes per year of bipolar illness (OR =3, p <0.01). LIMITATIONS: The transversal design prevents from drawing causal conclusions. CONCLUSION: Increased severity of BD with AUD compared to BD alone did not differ according to the sequence of onset. A few differences, though, could be used to better monitor the trajectory of patients showing either one of these disorders.

The Early Impact of the COVID-19 Lockdown on Stress and Addictive Behaviors in an Alcohol-Consuming Student Population in France.

Background: This study evaluated factors linked with perceived stress related to the COVID-19 pandemic and lockdown and addictive behaviors prior to and during lockdown in a sample of students who indicated engaging in alcohol consumption behaviors before lockdown. Methods: Cross-sectional study. French students from four universities participated in this study, and 2,760 students reported alcohol use. During the first week of lockdown, students reported their perceived levels of stress regarding COVID-19. Substance use and addictive behaviors were reported before and during lockdown, and media exposure, demographical, living conditions, and environmental stressors were reported during lockdown. Results: Women reported greater levels of stress (95% CI: 1.18 to 1.93, p < 0.001). Highly-stressed students also report less social support (95% CI: -1.04 to -0.39, p < 0.001) and were more likely to worry about the lockdown (95% CI: 0.27 to -0.65, p < 0.001). Alcohol-related problemswere more prevalent among the most stressed students (95% CI: 0.02 to 0.09, p = 0.004) as well as eating problems (95% CI: 0.04 to 0.36, p = 0.016) and problematic internet use (95% CI, 0.06 to 0.14, p < 0.001). Students reporting the highest levels of stress also indicated more compulsive eating during the previous seven days (95% CI, 0.21 to 1.19, p = 0.005). Conclusions: The level of stress was strongly related to four categories of variables: (i) intrinsic characteristics, (ii) addictive behaviors before lockdown, (iii) lockdown-specific conditions, and (iv) addictive behaviors during the lockdown. Several variables linked to COVID-19 were not directly linked with perceived stress, while perceived stress was found to correlate with daily life organization-related uncertainty and anticipated consequences of lockdown. Importantly, social support seems to be a protective factor on high level of stress.

Lockdown Impact on Stress, Coping Strategies, and Substance Use in Teenagers.

BACKGROUND: In response to the COVID-19 pandemic, the French government took many measures, the most notable of which was a national lockdown on 17 March 2020. Its effects have been widely studied, but to our knowledge, no study has sought to determine how adolescents have adapted to cope with this situation. The present study set out to explore teenagers' stress levels, coping strategies, and substance use during this period. METHODS: This paper is a cross-sectional study that rides on an existing prevention program interviewed 348 French middle school students (209 girls and 139 boys) in grade 8 (M age = 13.45; SDage = 0.54) using an online questionnaire between March 17 and May 11, 2020 (COVID-19 lockdown). The study examined the teenagers' perceived stress, coping strategies they had used, including recent use of tobacco, alcohol and cannabis, during COVID-19 lockdown. RESULTS: Teenagers reported lower perceived stress during lockdown than usually, with a significant decrease for girls. Those who perceived the least social support reported the highest levels of stress. The strategies of planning, behavioral disengagement, self-distraction, positive reframing, acceptance, and religion were used more than usual, while active coping and self-blame were used less. Acceptance was the most often used strategy and a source of decreased stress during lockdown. A significant decrease in recent tobacco, alcohol and cannabis use was also observed. CONCLUSION: Changes in the use of coping strategies, withdrawal from the stressful school environment, and greater exposure to parents than to peers caused adolescents to be less stressed and to decrease their substance use during the lockdown.

Social Networking Sites and Perceived Content Influence: An Exploratory Analysis from Focus Groups with French Adolescents.

Social networking sites (SNSs) are invested in heavily by marketers aiming to reach a growing number of consumers. Concerns regarding the influence of posts displayed on SNSs in relation to behaviour were raised, in particular the promotion of ill-health behaviour directed to adolescents who may be at risk from suggestible practices. Although adolescents tend to be critical towards traditional forms of advertising, little is known about their perception of influencing strategies developed online, especially where sponsor- and user-generated content coexist. This exploratory study aims to gather information directly from adolescents about their use of SNSs their awareness of the influence that SNS content may have, particularly when it comes to tobacco and alcohol messages. Ten focus groups were conducted with 39 adolescents (11-16 years old; 56.4% male). Qualitative analysis documents the differences associated with adolescents' favourite SNSs. The different parameters linked to each SNS and the expectation to find entertaining content and values associated with friendship may decrease adolescents' perception of potential risk for health associated with SNS use. Authors advocate for the development of educational programs based on eHealth literacy and the use of social marketing techniques to facilitate and motivate adolescents to develop their competences.

COVID-19 pandemic lockdown and problematic eating behaviors in a student population.

BACKGROUND AND AIMS: Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement. METHODS: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days. RESULTS: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder. DISCUSSION AND CONCLUSION: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.

Reducing Attentional Bias in Individuals With Alcohol Use Disorders With a Tablet Application: A Randomized Controlled Trial Pilot Study.

AIMS: Cognitive bias modification (CBM) training has been considered a promising and effective intervention tool for reducing cognitive biases toward alcohol. However, the link between the cognitive process and actual behavior remains statistically insignificant because computerized tasks do not have sufficient ecological validity and suffer from high dropout rates. The recent development of 'serious games' has shown encouraging results in maintaining adherence to health-related interventions. We aim to evaluate a CBM program using a gamified attentional bias (AB) training procedure on a touchpad for individuals with alcohol use disorders. METHODS: Forty-one patients were included in this study, 33 of whom displayed an AB and were randomly assigned into the 'CBM group' (N = 18, 16.7% women) or 'Memory group'-which involved playing a memory game-(N = 15, no woman). Eight other participants (12.5% women) with no AB comprised the 'Without AB group'. Efficacy was assessed for AB, craving, and inhibition and attentional capacities before and after the program. RESULTS: We observed that the reduction of AB was higher for the 'CBM group' (Mbefore = 153.61, SD = 172.21; Mafter = 18.00, SD = 77.71; t (17) = 4.21, P = 0.001) than for the 'Memory group' (Mbefore = 73.20, SD = 66.65; Mafter =42.47, SD = 113.77; ts < 1). The analysis showed that for the 'Without AB group', there was no significant difference in AB (t (7) = -2.15, P = .07) after the program. CONCLUSIONS: This study demonstrated an increased reduction of AB for patients included in the CBM program on a touchpad than for patients playing only a memory game.

Craving Mediates the Relation Between Impulsivity and Alcohol Consumption Among University Students.

BACKGROUND AND OBJECTIVES: The relationship between impulsivity and craving in severe alcohol use disorders is well established, but the presence and characteristics of this link in University students are still to be established. The present study aims to better understand the relationship between impulsivity and craving in university students and to determine the influence of these variables on alcohol consumption characteristics. METHODS: A large sample of university students (N = 1055, mean age: 20.9 years; 713 women) completed an online questionnaire to evaluate alcohol use, impulsivity, and craving. RESULTS: Linear regression analysis demonstrated that the compulsive dimensions of craving (P < .001), sensation seeking (P < .001), and lack of premeditation (P < .001) constitute strong predictors of current consumption. A receiver operating characteristic (ROC) curve analysis determined the threshold level above which craving intensity can identify specific high-risk populations. A mediation analysis showed that craving has a partial mediator effect on the impact of impulsivity on alcohol consumption for this population (37,8%, P < .001). DISCUSSION AND CONCLUSIONS: The sensation seeking and lack of premeditation dimensions of impulsivity, coupled with compulsive craving, are efficient predictors of excessive alcohol consumption for university students. The partial mediator effect of craving is important in terms of characterizing the relationship between impulsivity and alcohol consumption. SCIENTIFIC SIGNIFICANCE: Our study centrally shows that the interaction between elevated levels of impulsivity and craving constitute a crucial risk factor for alcohol consumption in university students, and should thus constitute a target for primary prevention programs (Am J Addict 2019;00:00-00).