[Ethics in the practice of psychedelic-assisted psychotherapy]. / Déontologie de la pratique de la psychothérapie assistée par psychédéliques.

This article proposes 10 points considered essential on the ethics associated with the practice of psychotherapy assisted by psychedelics (PAP) : 1) respect of the legal framework (LStup) of the use of psychotropic drugs ; 2) adequately manage psychedelics (storage, production and safety) ; 3) announce adverse effects to the competent authority ; 4) guarantee a psychotherapeutic follow-up ; 5) guarantee the safety of the patients during the treatment ; 6) establish indications on the basis of scientific evidence ; 7) do not confuse personal recreational use and strict medical use ; 8) avoid proselytizing or bad medical practices ; 9) do not to consider the personal consumption of psychedelics as a competency in care and 10) ensure that access to care is equitable and reasonable.

Cet article propose 10 points jugés essentiels au sujet de la déontologie associée à la pratique de la psychothérapie assistée par psychédéliques (PAP) : 1) Respecter le cadre légal (LStup) de l'utilisation des psychotropes ; 2) gérer les psychédéliques de manière adéquate (stockage, production et sécurité) ; 3) annoncer les effets indésirables à la pharmacovigilance ; 4) garantir un suivi psychothérapeutique ; 5) garantir la sécurité des patients lors du traitement ; 6) poser les indications sur la base des évidences scientifiques ; 7) ne pas confondre l'usage récréatif personnel et un usage médical strict ; 8) éviter le prosélytisme ou les mauvaises pratiques médicales ; 9) ne pas considérer la consommation personnelle de psychédéliques comme faisant office de compétence en matière de soins et 10) veiller à rendre l'accès aux soins équitables et raisonnables.

Cannabis Consumers' View of Regulated Access to Recreational Cannabis: A Multisite Survey in Switzerland.

INTRODUCTION: There is considerable effort in legalizing recreational use of cannabis globally. The successful implementation of a program of regulated access to recreational cannabis (PRAC) depends on the consumers' engagement. The aim of this study was to examine the acceptability of twelve different regulatory aspects by cannabis users including those obtaining cannabis from the illicit market and vulnerable populations such as young adults and problematic users. METHODS: The current study is a multisite online survey conducted in Switzerland. A total of 3,132 adult Swiss residents who consumed cannabis within the previous 30 days represented the studied population. Mean age was 30.5 years, 80.5% were men, and 64.2% of the participants stated that they always or often obtain cannabis from the illicit market. We described consumers' acceptability of twelve regulatory aspects concerning THC content control, disclosure of sensitive personal data, security aspects, and follow-up procedures by applying descriptive statistics and multiple regression models. RESULTS: THC content regulation showed most discrepancy with 89.4% of the participants stating to engage in a PRAC if five different THC contents were available as compared to 54% if only 12% THC was available. The least accepted regulatory aspect was disposal of contact details with an acceptability rate of 18.1%. Consumers mainly obtaining cannabis from the illicit market, young adults, and problematic users showed similar acceptability patterns. Participants obtaining cannabis from the illicit market were more likely to engage in a PRAC if five different THC contents were available as compared to participants obtaining cannabis from other sources (OR 1.94, 95% CI: 1.53-2.46). CONCLUSION: A carefully designed PRAC that takes into account the consumers' perspective is likely to transfer them to the regulated market and to engage vulnerable populations. We cannot recommend the distribution of cannabis with only 12% THC content as this is unlikely to engage the target population.

Does slow release oral morphine have impact on craving and impulsivity in heroin dependent individuals?

Craving and impulsivity are addiction components which explain why heroin-dependant individuals (HDI), continue using heroin despite not wanting to do so. Opioid maintenance treatment (OMT), such as slow-release oral morphine (SROM), is the most effective treatment for opioid dependence. However, the impact of SROM on craving and impulsivity remains unclear. In this observational study, 23 HDI receiving SROM, their usual OMT, took part in the experiment. Each of the participants filled in the perceived level of craving with a visual analog scale. Their impulsivity was assessed via three laboratory tasks, the stop-signal reaction time, the Balloon Analogue Risk Task and delay discounting. Each evaluation was performed before and after SROM administration. Craving was significantly reduced after administration of SROM (difference 2.83; P = 0.0010), whereas there were no significant differences in performance in the three laboratory tasks. In the long term, we observed an improvement on delay discounting correlated with the duration and dosage of SROM. The acute impact of SROM appears to significantly reduce craving, without impacting impulsivity. Observation of the correlation between delay discounting and the duration and dosage of OMT is of great interest and should be studied further.

A century of research on psychedelics: A scientometric analysis on trends and knowledge maps of hallucinogens, entactogens, entheogens and dissociative drugs.

A scientometric analysis was realized to outline clinical research on psychedelics over the last century. Web of Science Core Collection was searched up to March 18, 2022, for publications on psychedelics. Network analyses and bibliometrics were combined, to identify research themes and trends with Bibliometrix and CiteSpace. The primary aim was to measure research trends evolution over time, and the secondary aims were to identify bibliometric performance and influence networks of publications, authors, institutions, and countries. Sensitivity analyses were conducted for 2016-2022, and 2021 time periods. We included 31,687 documents (591,329 references), which aggregated into a well-structured network with credible clustering. Research productivity was split into an early less productive period mainly focusing on safety issues, and a "psychedelic renaissance" after the 1990s. Major trends were identified for hallucinogens/entheogens, entactogens, novel psychoactive substances (NPS), and on dissociative substances. There was a translational evolution from the bench to the bedside, with phase 2 and 3 trials and/or evidence synthesis in particular. The most recent trends concerned NPS, ketamine-associated brain changes, and ayahuasca-assisted psychotherapy. The USA and Canada were the most productive settings for the research overall, and more recently this geographical distribution became more prominent, reflecting legislative context/policy making. A translational evolution of psychedelics has been occurring, that has brought approval of esketamine for depression and will likely lead to approval of additional psychedelics across mental and physical conditions. Toxicology screening tools for NPS are urgently needed, which in turn might follow the same translational evolution of psychedelics in the future.

Predictors of Gaming Disorder or Protective from It, in a French Sample: A Symptomatic Approach to Self-Regulation and Pursued Rewards, Providing Insights for Clinical Practice.

Gaming disorder (GD) is a new health condition still requiring a lot of evidence established around its underlying and related psychological mechanisms. In our study we focused on Massively Multiplayer Online Role Playing Games (MMORPGs), a specific very popular and engaging game genre, to determine that benefit, motivation and control aspects could be predictive of a dysfunctional engagement in gaming. In total, 313 participants were recruited from private forums of gamers between May 2009 and March 2010. They filled out a questionnaire on their socio-demographic data and their weekly gaming time. They also completed different psychometric assessments such as the DSM IV-TR criteria for substance dependence adapted to gaming such as the Dependence Adapted Scale (DAS), the external rewards they expected from gaming (External Motives), the expected internal reward they expected from gaming (Internal Motives), the Zuckerman Sensation Seeking Scale (ZSSS), and the Barratt impulsiveness Scale (BIS-10). Results showed that some psychological factors related to online gaming represented risk factors for GD in participants (i.e., competition and advancement motives, reduced anxiety, solace, greater personal satisfaction, and sense of power), whereas some others were found to be protective factors from GD (i.e., recreation, enjoyment and experience seeking) in participants. Additionally, the study found that disinhibition, boredom susceptibility, thrill and adventure seeking, and high impulsivity were correlated to GD in participants. In conclusion, not only motives for gaming and impulsivity could be predictors for GD, but maladaptive coping strategies based on experienced relief in-game from negative feelings (anxiety and boredom) or experienced improvement in-game of self-perception (personal satisfaction, sense of power) could play as well a role of negative reinforcers for GD. Some benefits from gaming, typically entertainment and enjoyment, are shown to be protective factors from GD, playing the role of positive reinforcing factors. They are worthy of being identified and promoted as functional gaming habits. These findings can feed the clinical and health promotion fields, with a more in-depth understanding of diverse psychological factors in gamers, identifying those at risk for GD and those protective from it. The current work can foster a more balanced approach towards gaming activities, taking their opportunities for mankind and controlling for their adverse effects in some individuals.

Internet Use and Problematic Use in Seniors: A Comparative Study in Switzerland and Poland.

Background: Seniors have been only little considered in studies examining problematic internet use and associated health issues, although they may present risk factors that make them particularly vulnerable for the development of problematic internet use. Objectives: (1) To compare Internet use and problematic use among seniors in Switzerland and Poland; (2) To examine the relationships between problematic internet use, impulsivity traits and well-being as previous studies showed that internet can be used to cope with negative emotions or life dissatisfaction. Methods: A cross-sectional survey conducted between June 2016 and April 2017 with 264 older internet users aged above 60 years old recruited in Switzerland (88) and Poland (176) assessing sociodemographic variables, online activities, problematic internet use, impulsivity traits and well-being. Results: The two groups differed in their reported online activities in that Polish participants reported more searching for information and buying, whereas Swiss participants reported significantly greater problematic internet use than Polish participants. Finally, a multiple linear regression analysis performed on the whole sample indicated that lower well-being and being a Swiss participant were both significantly associated with greater problematic internet use, after age, gender, level of education, impulsivity traits have been controlled for. Discussion: Swiss seniors showed a more problematic internet use than Polish participants who focused more in their online activities on utility use of internet. The relationships between problematic internet use and well-being suggest that older adults use internet mainly to cope with negative emotion or life dissatisfaction. Socio-cultural differences that could account for these group differences as well as difference with young adults are discussed.

Body image concerns and intuitive eating in older women.

Intuitive eating has been described as representing a positive relationship with food that can support health. However, to date, most of the extant research on intuitive eating has been conducted among young women, limiting our understanding of how intuitive eating can contribute to supporting health in aging women. This study aimed to bridge this gap by exploring body image and eating correlates of intuitive eating in older women. The hypotheses were that among older women, intuitive eating would be significantly associated with lower disordered eating, weight and shape concerns, and fewer depressive symptoms, and that an indirect relationship between BMI and intuitive eating via weight and shape concerns would exist. Community women aged 60-75 (N = 200) completed questionnaires assessing intuitive eating, disordered eating, body concern, depressive symptoms and body mass index (BMI). Higher intuitive eating global scores were associated with lower restraint, lower eating concern, lower body concern, fewer depressive symptoms, and lower BMI. An indirect relationship between BMI and intuitive eating via weight and shape concern emerged, suggesting that being preoccupied by one's appearance hinder the ability to practice intuitive eating. These results suggest that intuitive eating is associated with positive outcomes among older women and might be a useful target for interventions designed to increase healthy aging.

Body image and disordered eating in older women: A Tripartite Sociocultural model.

Evidence suggests that body image concerns and disordered eating exist in women even at older ages. Few studies have examined the factors that are related with body image and eating concerns in this age group. In particular, the roles of sociocultural influences and thin-ideal internalization remain unclear. In the present study, we tested a modified tripartite sociocultural model of body image and disordered eating behaviors in a sample of 222 women aged 60 to 75 years, using structural equation modeling. After adjustment, a model similar to that observed in young women was a good fit to the data. Perceived pressure from the media revealed a direct relationship with body image concerns, as well as an indirect relationship mediated by thin-ideal internalization. Peer pressure was directly associated with body image concerns, and thin-ideal internalization was associated with dieting. In older women, pressure to conform to appearance ideals, in particular from the media, may impact the internalization of appearance ideals and body image concerns that might, in turn, increase disordered eating. The usefulness of sociocultural models for framing body image and eating concerns in older women implies that similar prevention interventions to those used in younger women could be adapted to fill a gap in available resources for this group.

Screening for alcohol use disorder among individuals with comorbid psychiatric disorders: Diagnostic accuracy in a sample of young Swiss men.

Alcohol use disorder (AUD) is frequently comorbid with other psychiatric disorders. However, few studies investigated the psychometric properties of AUD screening tools in presence of co-occurring disorders. This study examined the diagnostic accuracy of a short AUD screening tool among young adults, in the presence of high vs. low or moderate symptomatology of other common psychiatric disorders. Data were collected among young Swiss men (n = 233) between 2016 and 2018. Measures included a diagnostic interview for AUD and screening tools for AUD and other psychiatric disorders (attention deficit hyperactivity disorder, antisocial personality disorder, bipolar disorder, borderline personality disorder, major depressive disorder, and social anxiety disorder). We computed receiver operating characteristic curves to test whether the AUD screening tool was an accurate indicator of AUD for groups with high vs. low or moderate symptomatology of each psychiatric disorder. The results showed that the optimal cut-off score was ≥3 (the original cut-off of the scale) for participants with a low or moderate symptomatology and ≥4 for participants with a high symptomatology. Our findings highlighted the urgent need for an integrated approach to screening. Psychiatric comorbidities should be included in the screen for AUD to obtain accurate results.

Factors associated with disordered eating behaviors and attitudes in older women.

PURPOSE: The present study explored the potential factors associated with disordered eating behaviors and attitudes in older women. METHODS: Women aged 60-75 years were recruited in the community (n = 203) and completed questionnaires. The Eating Disorder Examination-Questionnaire (EDE-Q) was used to evaluate disordered eating behaviors and attitudes. The independent variables were BMI, age, importance of appearance, importance of body competence, cognitive reappraisal, and fear of age-related appearance changes. Spearman correlation analyses and zero-inflated negative binomial regression models were used to analyze the data. RESULTS: BMI was positively associated with EDE-Q restraint, EDE-Q eating concern, and EDE-Q frequency of objective binge-eating episodes. Importance of appearance was positively related to EDE-Q restraint, and fear of age-related appearance changes to EDE-Q eating concern and objective binge-eating episodes. Cognitive reappraisal was negatively associated with EDE-Q eating concern and excessive exercise in bivariate associations, but the relationships disappeared in the multivariate analyses. CONCLUSIONS: BMI, importance of appearance, and fear of age-related appearance changes turned out to be positively associated with eating disordered behaviors and attitudes, similarly to what can be observed in middle-aged samples. However, the role of cognitive reappraisal was unclear and should be investigated further. LEVEL OF EVIDENCE: Level V: cross-sectional descriptive study.

Identifying an accurate self-reported screening tool for alcohol use disorder: evidence from a Swiss, male population-based assessment.

BACKGROUND AND AIMS: Short screenings for alcohol use disorder (AUD) are crucial for public health purposes, but current self-reported measures have several pitfalls and may be unreliable. The main aim of our study was to provide empirical evidence on the psychometric performance of self-reports currently used. Our research questions were: compared with a gold standard clinical interview, how accurate are (1) self-reported AUD, (2) self-reported alcohol use over time and (3) biomarkers of alcohol use among Swiss men? Finally, we aimed to identify an alternative screening tool. DESIGN: A single-center study with a cross-sectional design and a stratified sample selection. SETTING: Lausanne University Hospital (Switzerland) from October 2017 to June 2018. PARTICIPANTS: We selected participants from the French-speaking participants of the ongoing Cohort Study on Substance Use and Risk Factors (n = 233). The sample included young men aged on average 27.0 years. MEASUREMENTS: We used the Diagnostic Interview for Genetic Studies as the gold standard for DSM-5 AUD. The self-reported measures included 11 criteria for AUD, nine alcohol-related consequences, and previous 12 months' alcohol use. We also assessed biomarkers of chronic excessive drinking (ethyl glucuronide and phosphatidylethanol). FINDINGS: None of the self-reported measures/biomarkers taken alone displayed both sensitivity and specificity close to 100% with respect to the gold standard (e.g. self-reported AUD: sensitivity = 92.3%, specificity = 45.8%). The best model combined eight self-reported criteria of AUD and four alcohol-related consequences. Using a cut-off of three, this screening tool yielded acceptable sensitivity (83.3%) and specificity (78.7%). CONCLUSIONS: Neither self-reported alcohol use disorder nor heavy alcohol use appear to be adequate to screen for alcohol use disorder among young men from the Swiss population. The best screening alternative for alcohol use disorder among young Swiss men appears to be a combination of eight symptoms of alcohol use disorder and four alcohol-related consequences.

Psychometric properties of the transaddiction craving triggers questionnaire in alcohol use disorder.

OBJECTIVES: We aimed to develop the transaddiction craving triggers questionnaire (TCTQ), which assesses the propensity of specific situations and contexts to trigger craving and to test its psychometric properties in alcohol use disorder (AUD). METHODS: This study included a sample of 111 AUD outpatients. We performed exploratory factor analysis (EFA) and calculated item-dimension correlations. Internal consistency was measured with Cronbach's alpha coefficient. Construct validity was assessed through Spearman correlations with craving, emotional symptoms, impulsivity, mindfulness, and drinking characteristics. RESULTS: The EFA suggested a 3-factor solution: unpleasant affect, pleasant affect, and cues and related thoughts. Cronbach's coefficient alpha ranged from .80 to .95 for the three factors and the total score. Weak positive correlations were identified between the TCTQ and drinking outcomes, and moderate correlation were found between the TCTQ and craving strength, impulsivity, anxiety, depression, and impact of alcohol on quality of life. CONCLUSIONS: The 3-factor structure is congruent with the well-established propensity of emotions and cues to trigger craving. Construct validity is supported by close relations between the TCTQ and psychological well-being rather than between the TCTQ and drinking behaviors. Longitudinal validation is warranted to assess sensitivity to change of the TCTQ and to explore its psychometric properties in other addictive disorders.

Contribution of sexual desire and motives to the compulsive use of cybersex.

BACKGROUND AND AIMS: Cybersex is increasingly associated with concerns about compulsive use. The aim of this study was to assess the roles of motives and sexual desire in the compulsive use of cybersex. METHODS: The sample consisted of 306 cybersex users (150 men and 156 women). The participants were assessed using the Compulsive Internet Use Scale (CIUS) adapted for cybersex, the Cybersex Motives Questionnaire (enhancement, coping, and social motives), and the Sexual Desire Inventory-2 (dyadic and solitary sexual desire). RESULTS: For both genders, coping motive was associated with CIUS score. For women, an additional association with social motives was found whereas an association with sexual desire was found for men. CONCLUSION: The study showed gender differences in the contributors to sex-related CIUS scores.

[About possible contributors and new perspectives to addictive use of cybersex]. / Cybersexe entre usage et addiction : vers de nouveaux modèles conceptuels et thérapeutiques.

The term « cybersex ¼ refers to the use of the Internet for sexual purposes (pornography, webcams, dating). While moderate use of cybersex could have a positive effect on sexual life, a small fraction of these cyber-users could have difficulties to control their consumption with negative consequences. This phenomenon, whose understanding of the mechanisms still raises debates, seems to be influenced by various psychological factors, including avoidant attachment (avoidance of close emotional relationship) and depressed mood. Sexual desire, different types of motivations for using cybersex, and impulsivity could contribute, to some extent, to this phenomenon. Despite of their preliminary character, current available data lead us to recommend an integrated approach of the treatment of the persons facing these difficulties.

Le terme de « cybersexe ¼ fait référence à l'utilisation d'internet pour des motifs sexuels (pornographie, webcams, rencontres). Alors qu'un usage modéré du cybersexe pourrait avoir des effets positifs sur la vie sexuelle, une petite fraction de ses utilisateurs pourrait en avoir une consommation peu contrôlée avec des conséquences négatives. Ce phénomène dont la compréhension est encore sujette à débats semble influencé par différents facteurs psychologiques, notamment l'attachement évitant (fuite des relations trop intimes) et l'humeur dépressive. Le désir sexuel, le type de motivations à l'usage du cybersexe et l'impulsivité pourraient dans une certaine mesure y contribuer. Malgré leur caractère préliminaire, les données disponibles à ce jour invitent à une approche intégrée du traitement des personnes confrontées à ces difficultés.

The gambling craving experience questionnaire: Psychometric properties of a new scale based on the elaborated intrusion theory of desire.

Both research and clinical practice acknowledge the importance of craving as a maintenance and relapse factor in gambling disorder. The elaborated intrusion theory (EIT; Kavanagh et al., 2005) of desire has been extensively investigated in relation to psychoactive substance or food cravings but, to date, has scarcely been studied in relation to gambling. In such a context, developing an assessment tool of gambling craving based on the EIT is warranted. To fill this gap in the literature, we aimed to develop and test the psychometric properties of a gambling-adapted version of the Craving Experience Questionnaire (CEQ; May et al., 2014), which is the best established measure of craving theoretically anchored in the EIT. An online survey that included the gambling CEQ (g-CEQ) and a craving induction procedure was administered to 274 community participants involved in gambling at least a few times a year. Concurrent and convergent validity were explored through correlations with a scale that measured gambling urge and with a series of questionnaires that measured disordered gambling symptoms, gambling cognitions, and gambling motives. The confirmatory factor analyses supported the validity of the expected three-factor model of the "strength" and "frequency" forms of the g-CEQ and showed better model fit than a one-factor solution, corroborating the initial structure of the CEQ. Furthermore, the scale has good internal consistency and its validity is supported by correlations with gambling-related constructs. The g-CEQ is thus a theoretically and psychometrically sound instrument to measure gambling craving based on the EIT.

Sexual Desire, Mood, Attachment Style, Impulsivity, and Self-Esteem as Predictive Factors for Addictive Cybersex.

BACKGROUND: An increasing number of studies are concerned with various aspects of cybersex addiction, the difficulty some persons have in limiting cybersex use despite a negative impact on everyday life. OBJECTIVE: The aim of this study was to assess potential links between the outcome variable cybersex addiction, assessed with the Compulsive Internet Use Scale (CIUS) adapted for cybersex use, and several psychological and psychopathological factors, including sexual desire, mood, attachment style, impulsivity, and self-esteem, by taking into account the age, sex, and sexual orientation of cybersex users. METHODS: A Web-based survey was conducted in which participants were assessed for sociodemographic variables and with the following instruments: CIUS adapted for cybersex use, Sexual Desire Inventory, and Short Depression-Happiness Scale. Moreover, attachment style was assessed with the Experiences in Close Relationships-Revised questionnaire (Anxiety and Avoidance subscales). Impulsivity was measured by using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, Positive Urgency Impulsive Behavior Scale. Global self-esteem was assessed with the 1-item Self-Esteem Scale. RESULTS: A sample of 145 subjects completed the study. Addictive cybersex use was associated with higher levels of sexual desire, depressive mood, avoidant attachment style, and male gender but not with impulsivity. CONCLUSIONS: Addictive cybersex use is a function of sexual desire, depressive mood, and avoidant attachment.

Disentangling the role of users' preferences and impulsivity traits in problematic Facebook use.

The use of social network sites (SNSs) has grown dramatically. Numerous studies have shown that SNS users may suffer from excessive use, associated with addictive-like symptoms. With a focus on the popular SNS Facebook (FB), our aims in the current study were twofold: First, to explore the heterogeneity of FB usage and determine which kind of FB activity predicts problematic usage; second, to test whether specific impulsivity facets predict problematic use of FB. To this end, a sample of FB users (N = 676) completed an online survey assessing usage preferences (e.g., types of activities performed), symptoms of problematic FB use and impulsivity traits. Results indicated that specific usage preferences (updating one's status, gaming via FB, and using notifications) and impulsive traits (positive and negative urgency, lack of perseverance) are associated to problematic FB use. This study underscores that labels such as FB "addiction" are misleading and that focusing on the actual activities performed on SNSs is crucial when considering dysfunctional usage. Furthermore, this study clarified the role of impulsivity in problematic FB use by building on a theoretically driven model of impulsivity that assumes its multidimensional nature. The current findings have identifiable theoretical and public health implications.

Factor structure of the Cybersex Motives Questionnaire.

BACKGROUND AND AIMS: The Internet is widely used for sexual activities and pornography. Little is known, however, about why people look for meetings and sexual interactions through the Internet and about the correlates of cybersex addiction. The goal of this study was to construct a questionnaire for cybersex motives [Cybersex Motives Questionnaire (CysexMQ)] by adapting the Gambling Motives Questionnaire to cybersex use and validating its structure. METHODS: Two online samples of 191 and 204 cybersex users were collected to conduct a principal component analysis (PCA) on the first sample and a confirmatory factor analysis (CFA) on the second. Cronbach's α and composite reliability were computed to assess internal consistency. Correlations between the CysexMQ and the Sexual Desire Inventory (SDI) were also evaluated. RESULTS: Two competing models were retained from the PCA, one with two factors and the other with three factors. The CFA showed better fit for the three-factor solution. After three cross-loading items were removed, the results showed that a final 14-item three-factor solution (enhancement, coping, and social motives) was valid (adjusted goodness-of-fit index: 0.993; normed-fit index: 0.978; Tucker-Lewis index: 0.985; comparative fit index: 0.988; root mean square error of approximation: 0.076). Positive correlations were found between the different motives and the subscales of the SDI. DISCUSSION: The results suggest that the CysexMQ is adequate for the assessment of cybersex motives.

Effects of substance use disorder on treatment process and outcome in a ten-session psychiatric treatment for borderline personality disorder.

BACKGROUND: Dual diagnosis is common in Borderline Personality Disorder (BPD), one of the most common being Substance Use Disorder (SUD). Previous studies have shown that general psychiatric management (GPM) was effective in reducing borderline symptoms. In the present study, we tested whether the short GPM was as effective in the BPD + SUD as in the BPD group. METHODS: We analysed a group of 99 patients presenting a BPD. 51 of these patients presented a SUD. The BPD group and the BPD + SUD group received a manual-based short variant of the GPM treatment. Previous studies have shown that a 10-session version of GPM was effective in reducing borderline symptoms at the end of the treatment (Psychother Psychosom 83:176-86, 2014). RESULTS: We found no significant difference in the reduction of general symptoms, which diminished in both groups. The specific borderline symptoms were also reduced in both groups, but there was a slightly higher reduction of the borderline symptoms in the SUD group. The therapeutic alliance progressed positively in all groups. Moreover, the alliance increased more over time in the SUD group. CONCLUSION: The short variant of GPM seems to be effective in BPD treatment independently from the presence of SUD. Therefore, this treatment could be an effective entry-level treatment for patients with dual diagnosis as well as patients with BPD only. Further studies are needed to confirm efficacy and long-term outcome. TRIAL REGISTRATION: The trial was registered at ClinicalTrial.gov (identifier NCT01896024 ).

Established risk factors for addiction fail to discriminate between healthy gamers and gamers endorsing DSM-5 Internet gaming disorder.

Background and aims The DSM-5 includes criteria for diagnosing Internet gaming disorder (IGD) that are adapted from substance abuse and widely used in research and clinical contexts, although evidence supporting their validity remains scarce. This study compared online gamers who do or do not endorse IGD criteria regarding self-control-related abilities (impulsivity, inhibitory control, and decision-making), considered the hallmarks of addictive behaviors. Method A double approach was adopted to distinguish pathological from recreational gamers: The first is the classic DSM-5 approach (≥5 criteria required to endorse the IGD diagnosis), and the second consists in using latent class analysis (LCA) for IGD criteria to distinguish gamers' subgroups. We computed comparisons separately for each approach. Ninety-seven volunteer gamers from the community were recruited. Self-reported questionnaires were used to measure demographic- and game-related characteristics, problematic online gaming (with the Problematic Online Gaming Questionnaire), impulsivity (with the UPPS-P Impulsive Behavior Scale), and depression (with the Beck Depression Inventory-II). Experimental tasks were used to measure inhibitory control (Hybrid-Stop Task) and decision-making abilities (Game of Dice Task). Results Thirty-two participants met IGD criteria (33% of the sample), whereas LCA identified two groups of gamers [pathological (35%) and recreational]. Comparisons that used both approaches (DSM-5 and LCA) failed to identify significant differences regarding all constructs except for variables related to actual or problematic gaming behaviors. Discussion The validity of IGD criteria is questioned, mostly with respect to their relevance in distinguishing high engagement from pathological involvement in video games.