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1.
Science ; 367(6484): 1362-1366, 2020 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-32193325

RESUMEN

Stimulants such as methylphenidate are increasingly used for cognitive enhancement but precise mechanisms are unknown. We found that methylphenidate boosts willingness to expend cognitive effort by altering the benefit-to-cost ratio of cognitive work. Willingness to expend effort was greater for participants with higher striatal dopamine synthesis capacity, whereas methylphenidate and sulpiride, a selective D2 receptor antagonist, increased cognitive motivation more for participants with lower synthesis capacity. A sequential sampling model informed by momentary gaze revealed that decisions to expend effort are related to amplification of benefit-versus-cost information attended early in the decision process, whereas the effect of benefits is strengthened with higher synthesis capacity and by methylphenidate. These findings demonstrate that methylphenidate boosts the perceived benefits versus costs of cognitive effort by modulating striatal dopamine signaling.


Asunto(s)
Cognición/efectos de los fármacos , Cuerpo Estriado/metabolismo , Dopamina/metabolismo , Metilfenidato/farmacología , Motivación/efectos de los fármacos , Sulpirida/farmacología , Adolescente , Núcleo Caudado/metabolismo , Conducta de Elección , Toma de Decisiones , Dopamina/biosíntesis , Antagonistas de los Receptores de Dopamina D2/farmacología , Inhibidores de Captación de Dopamina/farmacología , Femenino , Fijación Ocular , Humanos , Masculino , Memoria , Recompensa , Movimientos Sacádicos , Transducción de Señal/efectos de los fármacos , Adulto Joven
2.
Nat Protoc ; 15(4): 1542-1559, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32203485

RESUMEN

It is difficult to translate results from animal research on addiction to an understanding of the behavior of human drug users. Despite decades of basic research on neurobiological mechanisms of drug addiction, treatment options remain largely unchanged. A potential reason for this is that mechanistic studies using rodent models do not incorporate a critical facet of human addiction: volitional choices between drug use and non-drug social rewards (e.g., employment and family). Recently, we developed an operant model in which rats press a lever for rewarding social interaction with a peer and then choose between an addictive drug (heroin or methamphetamine) and social interaction. Using this model, we showed that rewarding social interaction suppresses drug self-administration, relapse to drug seeking, and brain responses to drug-associated cues. Here, we describe a protocol for operant social interaction using a discrete-trial choice between drugs and social interaction that causes voluntary abstinence from the drug and tests for incubation of drug craving (the time-dependent increase in drug seeking during abstinence). This protocol is flexible but generally requires 8-9 weeks for completion. We also provide a detailed description of the technical requirements and procedures for building the social self-administration and choice apparatus. Our protocol provides a reliable way to study the role of operant social reward in addiction and addiction vulnerability in the context of choices. We propose that this protocol can be used to study brain mechanisms of operant social reward and potentially impairments in social reward in animal models of psychiatric disorders and pain.


Asunto(s)
Conducta de Elección/fisiología , Condicionamiento Operante/fisiología , Comportamiento de Búsqueda de Drogas/fisiología , Modelos Psicológicos , Autoadministración/métodos , Animales , Modelos Animales de Enfermedad , Femenino , Heroína/administración & dosificación , Masculino , Metanfetamina/administración & dosificación , Ratas , Ratas Long-Evans , Ratas Sprague-Dawley , Remifentanilo/administración & dosificación , Conducta Social , Trastornos Relacionados con Sustancias/psicología
4.
Am J Surg ; 219(4): 557-562, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32007235

RESUMEN

BACKGROUND: The "white-flight" phenomenon of the mid-20th century contributed to the perpetuation of residential segregation in American society. In light of recent reports of racial segregation in our healthcare system, could a contemporary "white-flight" phenomenon also exist? METHODS: The New York Statewide Planning and Research Cooperative System was used to identify all Manhattan and Bronx residents of New York city who underwent elective cardiothoracic, colorectal, general, and vascular surgeries from 2010 to 2016. Primary outcome was borough of surgical care in relation to patient's home borough. Multivariable analyses were performed. RESULTS: White patients who reside in the Bronx are significantly more likely than racial minorities to travel into Manhattan for elective surgical care, and these differences persist across different insurance types, including Medicare. CONCLUSIONS: Marked race-based differences in choice of location for elective surgical care exist in New York city. If left unchecked, these differences can contribute to furthering racial segregation within our healthcare system.


Asunto(s)
Conducta de Elección , Grupos de Población Continentales/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Ubicación de la Práctica Profesional/estadística & datos numéricos , Femenino , Disparidades en Atención de Salud , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Medicaid/estadística & datos numéricos , Medicare/estadística & datos numéricos , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Participación del Paciente , Factores Raciales , Estados Unidos
5.
PLoS One ; 15(2): e0229069, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32078646

RESUMEN

Home births in high risk pregnancies and unassisted childbirth seem to be increasing in the Netherlands. There is a lack of qualitative data on women's partners' involvement in these choices in the Dutch maternity care system, where integrated midwifery care and home birth are regular options in low risk pregnancies. The majority of available literature focuses on the women's motivations, while the partner's influence on these decisions is much less well understood. We aimed to examine partners' involvement in the decision to birth outside the system, in order to provide medical professionals with insight and recommendations regarding their interactions with these partners in the outpatient clinic. An exploratory qualitative research design with a constructivist approach and a grounded theory method were used. In-depth interviews were performed with twenty-one partners on their involvement in the decision to go against medical advice in choosing a high risk childbirth setting. Open, axial and selective coding of the interview data was done in order to generate themes. Four main themes were found: 1) Talking it through, 2) A shared vision, 3) Defending our views, and 4) Doing it together. One overarching theme emerged that covered all other themes: 'She convinced me'. These data show that the idea to choose a high risk birth setting almost invariably originated with the women, who did most of the research online, filtered the information and convinced the partners of the merit of their plans. Once the partners were convinced, they took a very active and supportive role in defending the plan to the outside world, as well as in preparing for the birth. Maternity care providers can use these findings in cases where there is a discrepancy between the wishes of the woman and the advice of the professional, so they can attempt to involve partners actively during consultations in pregnancy. That will ensure that partners also receive information on all options, risks and benefits of possible birth choices, and that they are truly in support of a final plan.


Asunto(s)
Consejo Dirigido , Parto Domiciliario , Servicios de Salud Materna , Partería , Adulto , Entorno del Parto , Conducta de Elección , Femenino , Humanos , Persona de Mediana Edad , Países Bajos/epidemiología , Parto , Vigilancia en Salud Pública , Investigación Cualitativa , Medición de Riesgo , Adulto Joven
6.
PLoS One ; 15(2): e0228934, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32059042

RESUMEN

Limited empirical data exists on why women and minority students enter Biomedical Career Enrichment Programs (BCEPs) and how program variables-such as duration of research-influence their intention to pursue research careers. This exploratory study reports motivators for participation in BCEPs among women and racial/ethnic minority students-historically underrepresented groups-and the influence of program and personal variables on their research-career intent and self-efficacy beliefs. We studied the program variables of research experience, research duration, and mentor influence; and the personal variables of race, gender, family, and peers. Using the conceptual framework of planned behavior theory and social cognitive career theory, we interviewed students from underrepresented groups participating in BCEPs that offered research experience for short duration (Group A), long duration (Group B), and no research experience (Group C). We utilized Atlas Ti, a qualitative methodological software tool, to analyze the interview responses. Students choosing a BCEP with research experience cited "opportunity to gain experience" and "interest or curiosity in research" as motivators. Duration of research experience had a positive relationship with enhancement in research skills and self-efficacy beliefs, but did not change the initial research-career intent of these BCEP participants. The study revealed an interesting and unexpected theme of "perceived deterrents" to a career in research that included stress of competition (e.g. grants), the instability of projects, and the isolation of scientific research. Importantly, the study findings indicate the need to reform program design and science policies that challenge the current biomedical workforce and dissuade interested students from underrepresented groups from entering the field.


Asunto(s)
Selección de Profesión , Grupos Minoritarios/psicología , Mujeres/psicología , Investigación Biomédica/educación , Investigación Biomédica/tendencias , Conducta de Elección/ética , Toma de Decisiones , Grupos Étnicos/psicología , Femenino , Identidad de Género , Humanos , Intención , Motivación , Proyectos Piloto , Autoeficacia , Factores Sexuales , Estudiantes/psicología , Encuestas y Cuestionarios , Estados Unidos
7.
Nat Hum Behav ; 4(3): 317-325, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32015487

RESUMEN

Understanding how people rate their confidence is critical for the characterization of a wide range of perceptual, memory, motor and cognitive processes. To enable the continued exploration of these processes, we created a large database of confidence studies spanning a broad set of paradigms, participant populations and fields of study. The data from each study are structured in a common, easy-to-use format that can be easily imported and analysed using multiple software packages. Each dataset is accompanied by an explanation regarding the nature of the collected data. At the time of publication, the Confidence Database (which is available at https://osf.io/s46pr/) contained 145 datasets with data from more than 8,700 participants and almost 4 million trials. The database will remain open for new submissions indefinitely and is expected to continue to grow. Here we show the usefulness of this large collection of datasets in four different analyses that provide precise estimations of several foundational confidence-related effects.


Asunto(s)
Bases de Datos Factuales/estadística & datos numéricos , Procesos Mentales/fisiología , Metacognición/fisiología , Psicometría , Análisis y Desempeño de Tareas , Adulto , Conducta de Elección/fisiología , Conjuntos de Datos como Asunto/estadística & datos numéricos , Humanos , Psicometría/instrumentación , Psicometría/estadística & datos numéricos , Tiempo de Reacción/fisiología
8.
Nat Hum Behav ; 4(2): 121, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32071414
9.
PLoS One ; 15(2): e0229458, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32092120

RESUMEN

Sharing the use of a bicycle in China has changed people's daily travel modes. Existing studies mainly explored the factors affecting individuals' initial intentions to start using a shared bicycle, but few looked at the likelihood that a user would continue using one. Based on a post-acceptance model of information system (IS) continuance, this investigation proposed a research model to investigate factors influencing riders' intentions to continued usage of shared bikes. Analysis involved structural equation modeling (SEM) and fuzzy-set qualitative comparative analysis (fsQCA) on data from 376 shared bicycle riders. The results from SEM showed that perceived usefulness, service quality, riders' habits, overall satisfaction and the nature of the weather were the most important factors positively influencing users' intentions to continue bike sharing. The results from fsQCA showed that six combinations of these variables were sufficient to explain continued usage. The conclusions of this study can be useful for operators to improve shared bicycle services.


Asunto(s)
Ciclismo , Conducta Cooperativa , Intención , Viaje , Adulto , Conducta , Ciclismo/psicología , Ciclismo/estadística & datos numéricos , China/epidemiología , Conducta de Elección/fisiología , Comportamiento del Consumidor/estadística & datos numéricos , Femenino , Humanos , Masculino , Probabilidad , Asunción de Riesgos , Factores Socioeconómicos , Viaje/psicología , Viaje/estadística & datos numéricos
10.
PLoS One ; 15(2): e0225617, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32040474

RESUMEN

Two fundamental goals of decision making are to select actions that maximize rewards while minimizing costs and to have strong confidence in the accuracy of a judgment. Neural signatures of these two forms of value: the subjective value (SV) of choice alternatives and the value of the judgment (confidence), have both been observed in ventromedial prefrontal cortex (vmPFC). However, the relationship between these dual value signals and their relative time courses are unknown. Twenty-eight men and women underwent fMRI while performing a two-phase approach-avoidance (Ap-Av) task with mixed-outcomes of monetary rewards paired with painful shock stimuli. Neural responses were measured during offer valuation (offer phase) and choice valuation (commit phase) and analyzed with respect to observed decision outcomes, model-estimated SV and confidence. During the offer phase, vmPFC tracked SV and the decision but not confidence. During the commit phase, vmPFC tracked confidence, computed as the quadratic extension of SV, but not the offer valuation nor the decision. In fact, vmPFC responses from the commit phase were selective for confidence even for reject decisions wherein confidence and SV are inversely related. Conversely, activation of the cognitive control network, including within lateral prefrontal cortex (lPFC) and dorsal anterior cingulate cortex (dACC) was associated with ambivalence, during both the offer and commit phases. Taken together, our results reveal complementary representations in vmPFC during value-based decision making that temporally dissociate such that offer valuation (SV) emerges before decision valuation (confidence).


Asunto(s)
Conducta de Elección/fisiología , Corteza Prefrontal/fisiología , Autoimagen , Mapeo Encefálico/métodos , Femenino , Giro del Cíngulo/fisiología , Humanos , Juicio/fisiología , Imagen por Resonancia Magnética/métodos , Masculino , Castigo , Recompensa , Adulto Joven
11.
PLoS One ; 15(1): e0226181, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31918437

RESUMEN

BACKGROUND: U.S. children are failing to meet the recommended daily 4 cups of fruits and vegetables. New federal guidelines were implemented for healthier school lunches for the National School Lunch Programs (NSLP). Consequently, students waste large amounts of fruits and vegetables. Several organizations advocate implementation of classroom nutrition education programs as a school nutrition policy. METHODS: We conducted a randomized control trial to evaluate the effectiveness of a classroom nutrition education on food consumption behavior of public elementary school students. Our intervention was designed to improve students' preferences for fruits and vegetables. We collected data using digital-photography, and estimated the amount of fruits and vegetables selected and wasted using ordinary least squares. RESULTS: The nutrition education program had no impact on the amount of fruits and vegetables selected by the students in the treatment group. We also find no significant difference in the amount of fruits and vegetables wasted by students in the treatment and control group. CONCLUSION: Nutrition education did not change students' consumption behavior, implying the proposed policy might not be optimal. Inducing a behavioral change in elementary school students is an intricate process and might require more than classroom lessons to change their dietary habits.


Asunto(s)
Conducta de Elección , Dieta Saludable/estadística & datos numéricos , Asistencia Alimentaria/estadística & datos numéricos , Preferencias Alimentarias/psicología , Servicios de Alimentación/normas , Estudiantes/psicología , Residuos/estadística & datos numéricos , Estudios de Casos y Controles , Niño , Ingestión de Energía , Femenino , Humanos , Masculino , Política Nutricional , Instituciones Académicas
12.
PLoS One ; 15(1): e0227036, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31940399

RESUMEN

This paper explores the role of cheap excuses in product choice. If agents feel that they fulfill one ethical aspect, they may care less about other independent ethical facets within product choice. Choosing a product that fulfills one ethical aspect may then suffice for maintaining a high moral self-image in agents and render it easier to ignore other ethically relevant aspects they would otherwise care about more. The use of such cheap excuses could thus lead to a "static moral self-licensing" effect, and this would extend the logic of the well-known dynamic moral self-licensing. Our experimental study provides empirical evidence that the static counterpart of moral self-licensing exists. Furthermore, effects spill over to unrelated, ethically relevant contexts later in time. Thus, static moral self-licensing and dynamic moral self-licensing can exist next to each other. However, it is critical that agents do not feel that they fulfilled an ethical criterion out of sheer luck, that is, agents need some room so that they can attribute the ethical improvement at least partly to themselves. Outsiders, although monetarily incentivized for correct estimates, are completely oblivious to the effects of moral self-licensing, both static and dynamic.


Asunto(s)
Conducta de Elección/ética , Comportamiento del Consumidor , Ropa de Cama y Ropa Blanca/economía , Femenino , Alimentos Orgánicos/economía , Humanos , Masculino , Principios Morales , Personalidad , Distribución Aleatoria , Factores Socioeconómicos , Encuestas y Cuestionarios , Textiles/economía
13.
West J Emerg Med ; 21(1): 4-7, 2020 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-31913810

RESUMEN

INTRODUCTION: The "stable marriage" algorithm underlying the National Residency Match Program (NRMP) has been shown to create optimal outcomes when students submit true preference lists. Previous research has shown students may allow external information to affect their rank lists. The objective of this study was to determine whether medical students consistently make rank lists that reflect their true preferences. METHODS: A voluntary online survey was sent to third-year students at a single midwestern medical school. Students were given hypothetical scenarios that either should or should not affect their true residency preferences and rated the importance of six factors to their final rank list. The survey was edited by a group of education scholars and revised based on feedback from a pilot with current postgraduate year 1 residents. RESULTS: Of 175 students surveyed, 140 (80%) responded; 63% (88/140) reported that their "perceived competitiveness" would influence their rank list at least a "moderate amount. Of 135 students, 31 (23%) moved a program lower on their list if they learned they were ranked "low" by that program, while 6% (8/135) of respondents moved a program higher if they learned they were ranked "at the top of the list." Participants responded similarly (κ = 0.71) when presented with scenarios asking what they would do vs what a classmate should do. CONCLUSION: Students' hypothetical rank lists did not consistently match their true residency preferences. These results may stem from a misunderstanding of the Match algorithm. Medical schools should consider augmenting explicit education related to the NRMP Match algorithm to ensure optimal outcomes for students.


Asunto(s)
Conducta de Elección , Internado y Residencia , Criterios de Admisión Escolar , Estudiantes de Medicina/psicología , Algoritmos , Estudios Transversales , Femenino , Humanos , Masculino , Facultades de Medicina , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos
14.
Proc Natl Acad Sci U S A ; 117(2): 943-949, 2020 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-31888990

RESUMEN

Do negative feelings in general trigger addictive behavior, or do specific emotions play a stronger role? Testing these alternative accounts of emotion and decision making, we drew on the Appraisal Tendency Framework to predict that sadness, specifically, rather than negative mood, generally, would 1) increase craving, impatience, and actual addictive substance use and 2) do so through mechanisms selectively heightened by sadness. Using a nationally representative, longitudinal survey, study 1 (n = 10,685) revealed that sadness, but not other negative emotions (i.e., fear, anger, shame), reliably predicted current smoking as well as relapsing 20 years later. Study 2 (n = 425) used an experimental design, and found further support for emotion specificity: Sadness, but not disgust, increased self-reported craving relative to a neutral state. Studies 3 and 4 (n = 918) introduced choice behavior as outcome variables, revealing that sadness causally increased impatience for cigarette puffs. Moreover, study 4 revealed that the effect of sadness on impatience was more fully explained by concomitant appraisals of self-focus, which are specific to sadness, than by concomitant appraisals of negative valence, which are general to all negative emotions. Importantly, study 4 also examined the topography of actual smoking behavior, finding that experimentally induced sadness (as compared to neutral emotion) causally increased the volume and duration of cigarette puffs inhaled. Together, the present studies provide support for a more nuanced model regarding the effects of emotion on tobacco use, in particular, as well as on addictive behavior, in general.


Asunto(s)
Conducta Adictiva , Emociones/efectos de los fármacos , Tristeza/efectos de los fármacos , Trastornos Relacionados con Sustancias , Adolescente , Adulto , Afecto , Conducta de Elección , Fumar Cigarrillos/efectos adversos , Toma de Decisiones , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Tristeza/psicología , Adulto Joven
15.
PLoS One ; 15(1): e0228148, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31990930

RESUMEN

INTRODUCTION: Zimbabwe is scaling up HIV differentiated service delivery (DSD) to improve treatment outcomes and health system efficiencies. Shifting stable patients into less-intensive DSD models is a high priority in order to accommodate the large numbers of newly-diagnosed people living with HIV (PLHIV) needing treatment and to provide healthcare workers with the time and space needed to treat people with advanced HIV disease. DSD is also seen as a way to improve service quality and enhance retention in care. National guidelines support five differentiated antiretroviral treatment models (DART) for stable HIV-positive adults, but little is known about patient preferences, a critical element needed to guide DART scale-up and ensure person-centered care. We designed a mixed-methods study to explore treatment preferences of PLHIV in urban Zimbabwe. METHODS: The study was conducted in Harare, and included 35 health care worker (HCW) key informant interviews (KII); 8 focus group discussions (FGD) with 54 PLHIV; a discrete choice experiment (DCE) in which 500 adult DART-eligible PLHIV selected their preferences for health facility (HF) vs. community location, individual vs. group meetings, provider cadre and attitude, clinic operation times, visit frequency, visit duration and cost to patient; and a survey with the 500 DCE participants exploring DART knowledge and preferences. RESULTS: Patient preferences were consistent in the FGDs, DCE and survey. Participants strongly preferred respectful HCWs, HF-based services, individual DART models, and less costly services. Patients also preferred less frequent visits and shorter wait times. They were indifferent to variations in HCW cadre and distances from home to HF. These preferences were mostly homogenous, with only minor differences between male vs. female and older vs. younger patients. HCWs in the KII correctly characterized facility-based individual models as the one most favored by patients; HCWs also preferred this model, which they felt decongested HFs and reduced their workload. CONCLUSIONS: DART-eligible PLHIV in Harare found it relatively easy to access HFs, and preferred attributes associated with facility-based individual models. Prioritizing these for scale-up in urban areas may be the most efficient way to sustain positive patient outcomes and increase health system performance.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Atención Ambulatoria/psicología , Atención Ambulatoria/estadística & datos numéricos , Conducta de Elección , Confidencialidad , Femenino , Grupos Focales , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Masculino , Encuestas y Cuestionarios , Adulto Joven , Zimbabwe/epidemiología
16.
Nat Commun ; 11(1): 183, 2020 01 10.
Artículo en Inglés | MEDLINE | ID: mdl-31924799

RESUMEN

The basolateral amygdala (BLA) and ventral hippocampal CA1 (vCA1) are cellularly and functionally diverse along their anterior-posterior and superficial-deep axes. Here, we find that anterior BLA (aBLA) and posterior BLA (pBLA) innervate deep-layer calbindin1-negative (Calb1-) and superficial-layer calbindin1-positive neurons (Calb1+) in vCA1, respectively. Photostimulation of pBLA-vCA1 inputs has an anxiolytic effect in mice, promoting approach behaviours during conflict exploratory tasks. By contrast, stimulating aBLA-vCA1 inputs induces anxiety-like behaviour resulting in fewer approaches. During conflict stages of the elevated plus maze task vCA1Calb1+ neurons are preferentially activated at the open-to-closed arm transition, and photostimulation of vCA1Calb1+ neurons at decision-making zones promotes approach with fewer retreats. In the APP/PS1 mouse model of Alzheimer's disease, which shows anxiety-like behaviour, photostimulating the pBLA-vCA1Calb1+ circuit ameliorates the anxiety in a Calb1-dependent manner. These findings suggest the pBLA-vCA1Calb1+ circuit from heterogeneous BLA-vCA1 connections drives approach behaviour to reduce anxiety-like behaviour.


Asunto(s)
Ansiolíticos/farmacología , Complejo Nuclear Basolateral/metabolismo , Región CA1 Hipocampal/metabolismo , Calbindina 1/metabolismo , Conducta de Elección/fisiología , Enfermedad de Alzheimer/metabolismo , Animales , Ansiedad , Conducta Animal , Calbindina 1/genética , Toma de Decisiones , Masculino , Aprendizaje por Laberinto/fisiología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Neuronas/fisiología , Proteómica
17.
J Forensic Sci ; 65(1): 97-102, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31386191

RESUMEN

Understanding trends in substance use by gender among jail-based treatment program participants can inform policies and programs tailored to this population. Preprogram assessment data from 3509 individuals entering a jail-based substance use disorder treatment program in Missouri between 1998 and 2016 were analyzed. Primary outcome was program participants' strongly preferred substances. Demographic covariates and drug preferences were compared between males and females. Average yearly trends in preferred substances were calculated. While 25.8% of the sample preferred heroin, it was more strongly preferred by women (36.4%) than men (22.0%, p < 0.0001). Alcohol and marijuana were preferred more by males. Overall, preferences for heroin and methamphetamine increased over time while alcohol, marijuana, and other stimulants decreased. Women being more likely to prefer heroin and the increasing preference for heroin over time are consistent with national trends. Offering evidence-based treatment like pharmacotherapy and gender-sensitive approaches can help address the needs of this vulnerable population.


Asunto(s)
Conducta de Elección , Prisioneros , Factores Sexuales , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Distribución por Edad , Consumo de Bebidas Alcohólicas , Cannabis , Cocaína , Cocaína Crack , Femenino , Heroína , Humanos , Masculino , Metanfetamina , Missouri/epidemiología , Medicamentos bajo Prescripción , Distribución por Sexo , Trastornos Relacionados con Sustancias/rehabilitación , Adulto Joven
18.
Z Kinder Jugendpsychiatr Psychother ; 48(1): 15-23, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30777484

RESUMEN

This study investigates the relationship between adverse childhood experiences (ACEs), age, and sex with respect to their avatar preference in online games. The analyses comprise a subsample of n = 1817 adolescents and adults from 14 to 60 years within a representative German population-based study. Results indicate that 14 % of this sample uses avatars in online games, with significantly more males (22.6 %) than females (7.7 %) doing so. Persons with multiple ACEs (≥ 4) have a higher OR of 2.05 (95 % CI: 1.418-2.956) to use avatars in online games. Regarding avatar preference, females are more likely to play supporters than males, and males are more likely to choose damagers and mixed-type avatars than females. Participants with an experience of parental divorce during their childhood reported higher preference of playing supporter or mixed-type avatars in comparison with damager avatars. Moreover, participants with mental illness or suicide in the family show a higher preference of mixed-type avatars compared to damager, but not to supporter avatars. Knowledge about the use of avatars can be an interesting source of information for supporting psychotherapeutic treatment in a young age group.


Asunto(s)
Experiencias Adversas de la Infancia , Conducta de Elección , Internet , Juegos de Video/psicología , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
19.
Neuron ; 105(4): 700-711.e6, 2020 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-31859030

RESUMEN

Deciding between stimuli requires combining their learned value with one's sensory confidence. We trained mice in a visual task that probes this combination. Mouse choices reflected not only present confidence and past rewards but also past confidence. Their behavior conformed to a model that combines signal detection with reinforcement learning. In the model, the predicted value of the chosen option is the product of sensory confidence and learned value. We found precise correlates of this variable in the pre-outcome activity of midbrain dopamine neurons and of medial prefrontal cortical neurons. However, only the latter played a causal role: inactivating medial prefrontal cortex before outcome strengthened learning from the outcome. Dopamine neurons played a causal role only after outcome, when they encoded reward prediction errors graded by confidence, influencing subsequent choices. These results reveal neural signals that combine reward value with sensory confidence and guide subsequent learning.


Asunto(s)
Conducta de Elección/fisiología , Neuronas Dopaminérgicas/metabolismo , Aprendizaje/fisiología , Corteza Prefrontal/metabolismo , Recompensa , Animales , Neuronas Dopaminérgicas/química , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Optogenética/métodos , Corteza Prefrontal/química
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