Psychometric Validation of the Gambling Craving Scale in a Treatment-Seeking Sample.

The Gambling Craving Scale (GACS) is a multifaceted measure of gambling craving. Initial validation work by Young and Wohl (2009) in university student samples showed that the GACS had a three-factor structure capturing dimensions of Desire, Anticipation, and Relief. Despite its potential clinical utility as a measure of craving, the GACS has yet to be validated in people seeking treatment for gambling problems. Accordingly, we examined the psychometric properties in a sample of people (N = 209; Mage = 37.66; 62.2% female) participating in a randomized controlled trial testing a novel online treatment for problem gambling. We predicted the GACS would have a three-factor structure. In addition, we also examined measurement invariance across sex and problem gambling risk status. Finally, we assessed concurrent validity of the factors with other measures of problem gambling severity and involvement. Exploratory structural equation modeling findings supported a three-factor structure that was invariant across the groups tested. Each of the Desire, Anticipation, and Relief subscales were significant positive predictors of problem gambling severity and symptoms, and some form of gambling behaviour. Findings show the GACS is a promising scale to assess multidimensional craving experiences among people in treatment for gambling problems.

Skewed X-chromosome inactivation in unsolved neurodevelopmental disease cases can guide re-evaluation For X-linked genes.

Despite major advances in genome technology and analysis, >50% of patients with a neurodevelopmental disorder (NDD) remain undiagnosed after extensive evaluation. A point in case is our clinically heterogeneous cohort of NDD patients that remained undiagnosed after FRAXA testing, chromosomal microarray analysis and trio exome sequencing (ES). In this study, we explored the frequency of non-random X chromosome inactivation (XCI) in the mothers of male patients and affected females, the rationale being that skewed XCI might be masking previously discarded genetic variants found on the X chromosome. A multiplex fluorescent PCR-based assay was used to analyse the pattern of XCI after digestion with HhaI methylation-sensitive restriction enzyme. In families with skewed XCI, we re-evaluated trio-based ES and identified pathogenic variants and a deletion on the X chromosome. Linkage analysis and RT-PCR were used to further study the inactive X chromosome allele, and Xdrop long-DNA technology was used to define chromosome deletion boundaries. We found skewed XCI (>90%) in 16/186 (8.6%) mothers of NDD males and in 12/90 (13.3%) NDD females, far beyond the expected rate of XCI in the normal population (3.6%, OR = 4.10; OR = 2.51). By re-analyzing ES and clinical data, we solved 7/28 cases (25%) with skewed XCI, identifying variants in KDM5C, PDZD4, PHF6, TAF1, OTUD5 and ZMYM3, and a deletion in ATRX. We conclude that XCI profiling is a simple assay that targets a subgroup of patients that can benefit from re-evaluation of X-linked variants, thus improving the diagnostic yield in NDD patients and identifying new X-linked disorders.

Investigating Sport Stakeholders' Understanding of Behaviour Management within a Competitive Youth Baseball Team.

The following study employed an instrumental case study to investigate sport stakeholders' understandings of behavioural management strategies used in competitive youth baseball, including the identification of common strategies and interpretations of these as punishment or discipline. Twenty-one participants, from one competitive (AAA) all-boys baseball team, including three coaches, eleven baseball players, and seven parents, were recruited to participate in an individual semi-structured interview. Interviews ranged between 30 and 150 min, and data were analyzed using reflexive thematic analysis. Several behaviour management tactics were identified, of which exercise, benching and yelling negative comments were most often reported. While participants interpreted excessive exercise and benching as punitive and/or disciplinary approaches to behavioural management, yelling was consistently viewed as punitive. Participants confused punishment and discipline as interchangeable, thus suggesting a lack of awareness regarding developmentally appropriate strategies of behavioural management and highlighting the normalization of certain punitive tactics in youth sport. The results underscore the necessity of imparting knowledge to the sports community regarding age-appropriate behavioural management interventions to foster safe and enjoyable athletic experiences for youth competitors.

Listening to Athletes' Voices: National Team Athletes' Perspectives on Advancing Safe Sport in Canada.

With increased media scrutiny, public awareness, and research on the prevalence of maltreatment experiences in sport, sport organizations have faced increased pressures to combat unsafe practices in sport. A consequence has been the emergence of the Safe Sport movement whereby organizations including the International Olympic Committee, Safe Sport International, US Center for SafeSport, Sport Canada, and others, have developed policies, initiatives, and education intended to create safer sport environments for all participants. Most of these policies have been implemented using a top-down approach, driven by government officials and sport leaders. However, if safe sport initiatives are to benefit athletes, consideration and incorporation of athletes' perspectives in the development and implementation of initiatives are imperative. The purpose of this study, therefore, was to examine athletes' perspectives on the challenges and recommendations to advancing safe sport. As part of a large-scale survey of current and retired Canadian National Team Athletes' experiences of maltreatment, open-ended questions were asked about athletes' recommendations and considerations for safe sport. Responses to these questions (n = 386) were analyzed using thematic analysis. According to the participants, barriers and challenges to safe sport included emphasizing performance excellence at-all-costs, normalization and complicity of harm, lack of attention to equity, diversity and inclusion, a culture of fear and silence, and a lack of trust in organizations to handle cases of harm. In an effort to advance safe sport, participants recommended prioritizing holistic athlete development, improving and strengthening accountability measures, implementing an independent 3rd party for disclosure, reporting and support, increased attention to equity, diversity and inclusion, stakeholder education, prohibition of sexual relations between athletes and those in positions of power and authority, and adoption of a broader perspective of harms and perpetrators. Findings are interpreted and critiqued in light of previous literature and recommendations for future research and practice are suggested.

Mistakes in interpersonal perceptions: Social cognition in aggressive forensic psychiatry patients.

BACKGROUND: While there is an established link between untreated psychosis and aggression, an enhanced understanding of the role of social cognition is still needed. AIMS: To examine social cognitive functioning among patients in a specialist forensic mental health service who had been deemed not criminally responsible for acts of violence due to a psychotic disorder. It was hypothesised, first, that such patients would show reduced social cognitive functioning compared with healthy, nonviolent comparison participants and, second, that those who continued to be aggressive while inpatients would demonstrate significant reductions compared to the now nonaggressive group. METHODS: The study samples were of 10 recently aggressive and 15 not-recently aggressive patients and 20 healthy, nonviolent comparison participants. Each completed the Toronto Empathy Questionnaire (TEQ), the Reading the Mind in the Eyes Test-Revised (RMET) and the Interpersonal Perception Task-15 (IPT-15). RESULTS: There was no significance between group differences on the RMET and TEQ. The patient group as a whole, however, showed significant interpersonal misperceptions, with specific misperceptions on IPT-15 deception and kinship subscales, while at the same time lacking self-awareness of their errors. Misperceptions on the IPT-15 competition subscale were unique to recently aggressive patients. CONCLUSIONS: Select aspects of reduced social cognitive functioning were found among not criminally responsible patients with psychosis who had committed violent acts and who continued to act aggressively while forensic inpatients. These findings enhance our understanding of the role of social cognition in predisposing toward violence and the potential importance of incorporating interventions which improve social cognition directly. We suggest also the potential for future research using virtual reality technologies in treatment.

The impact of social media coverage on attitudes towards mental illness and violent offending.

The aim of this study is to better understand stigma towards individuals with mental illness who commit violent offences, and examine ways to mitigate the negative impact of social media news stories of schizophrenia and violent offending. Psychology undergraduate students (N = 255) were exposed to Instagram images and captions of recent real news stories of violent offending by individuals with schizophrenia. In the experimental condition, contextual clinical explanatory information was integrated. Pre- and post-measures of stigma were completed. There was a significant increase in negative attitudes towards individuals with mental illness who committed violent offences following the no-context condition, which was clearly mitigated in the experimental condition where context was provided. In both conditions, there were significant increases in intended social-distancing behaviours towards and perceptions of dangerousness of individuals with schizophrenia, and negative beliefs about mental illness more generally. There appears to be utility in incorporating knowledge-based clinical information to mitigate some facets of stigma.

The relation between adverse childhood experiences and moral injury in the Canadian Armed Forces.

Background: There is increasing evidence that moral injuries (MIs) may affect the mental health of Canadian Armed Forces (CAF) members and veterans. Despite knowledge suggesting that MIs are related to multiple negative mental health outcomes, including the onset of post-traumatic stress disorder (PTSD), it is unknown whether pre-traumatic variables, including the presence of childhood abuse, are related to MIs. Objective: This study seeks to investigate the potential relationship between adverse childhood experiences and later onset MI in military members. Methods: Thirty-three patients newly admitted to an inpatient unit for treatment of trauma-related disorders received a standardized self-assessment package, including the PTSD Checklist for DSM-5 (PCL-5), the Moral Injury Events Scale (MIES; adapted for the Canadian context), and the Adverse Childhood Experiences Questionnaire (ACE-Q), which is a retrospective measure of childhood abuse. Results: Analyses revealed a significant relation between childhood emotional abuse and the presence of MI in adulthood. Specifically, emotional abuse during childhood was correlated with total score on the MIES (p = 0.006) and with its two subscales, perceived betrayals (p = 0.022) and perceived transgressions (p = 0.016). These correlations remained significant when controlling for age and gender. Conclusions: Among CAF members and veterans, childhood events are related to the presence of MI during adulthood. These preliminary data are provocative in suggesting that emotional abuse during childhood may increase the likelihood of endorsing MI during adult military service. Further work is needed to identify pre-traumatic variables that may serve to increase risk or enhance resilience to the development of MI in military members.

Antecedentes: Existe un aumento de la evidencia que los daños morales (MIs, por sus siglas en inglés) pueden afectar la salud mental de los miembros de las Fuerzas Armadas Canadienses (FAC) y veteranos. A pesar que el conocimiento sugiere que las MIs están relacionadas con múltiples consecuencias negativas en la salud mental, incluyendo el inicio del trastorno de estrés postraumático (TEPT), se desconoce si variables pre-traumáticas, incluyendo la presencia de abuso en la infancia, están relacionadas con MIs. Objetivo: Este estudio busca investigar la relación potencial entre experiencias infantiles adversas y el posterior inicio de MIs entre los miembros militares. Método: Treinta y tres pacientes nuevos admitidos a una unidad hospitalaria para tratamiento de los trastornos relacionados con trauma, recibieron un paquete estandarizado de auto-evaluación, incluyendo la lista de chequeo para TEPT del DSM-5 (PCL-5), la Escala de Eventos de Daño Moral (MIES por sus siglas en inglés, adaptada para el contexto canadiense) y el Cuestionario de Experiencias Adversas Condiciones Infantiles (ACE-Q por sus siglas en inglés). Resultados: Los análisis revelaron una relación significativa entre abuso emocional en la infancia y la presencia de MI en la adultez. Específicamente, el abuso emocional durante la infancia estuvo correlacionado con el puntaje total del MIES (p= 0.006) y con sus dos sub-escalas, percepción de traición (p=0.022) y percepción de transgresiones (p= 0.016). Estas correlaciones permanecen significativas cuando se controlan por edad y sexo. Conclusiones: Entre los miembros y veteranos FAC, los eventos en la infancia están relacionados con la presencia de MI durante la adultez. Estos datos preliminares son provocativos en sugerir que el abuso emocional durante la infancia puede incrementar la posibilidad de refrendar MI durante el servicio militar en la adultez. Es necesaria más investigación para identificar las variables pre-traumáticas que pueden servir para incrementar el riesgo o aumentar la resiliencia a desarrollar MI entre los miembros militares.