Risk Factors Associated with Gambling on Loot Boxes.

BACKGROUND: Loot boxes (LBs) are virtual objects that players open without knowing the value of the item they will obtain. Because of their features, studies have explored their association with gambling, finding commonalities. However, risk factors have been overlooked. This study examined risk factors associated with gambling as applied to LBs (gambling in the past year, having family/friends who use LBs/gamble, trait impulsivity, and sensation-seeking). METHOD: 253 participants (82.2% men) with a mean age of 28 years ( SD = 12.11)­in three groups: gamblers ( n = 89), LB purchasers ( n = 63), and free-LB openers ( n = 101)­completed a self-report. RESULTS: Having family/friends who used LBs was related to increased engagement in opening LBs at no cost. However, having gambled in the past year or having family/friends who used LBs or who gambled was not associated with increased purchasing. Gamblers, LB purchasers, and LB openers scored equally highly on impulsivity and sensation-seeking. Because some gamblers used LBs, and LB purchasers also opened free-LBs, further analyses were performed to control for the effects of overlapping groups. Loot boxers had higher scores in sensation-seeking than gamblers. CONCLUSIONS: The results can contribute to the development of prevention and intervention strategies for LB users.

How to improve attitudes towards dementia? Reframing as a tool to overcome the stigma around Alzheimer's disease.

OBJECTIVE: This article aims to determine how Alzheimer's disease (AD) framing impacts on attitudes and self-reported emotions towards the disease. METHODS: We designed posters with framed messages based on the person with AD: Dualism of body and mind, Unity of body and mind, and control (Study 1, N = 261) and based on the relationship person with AD-family: No reciprocation, Good Mother, and control (Study 2, N = 240). To analyse the effect of the different frames, attitudes towards AD were measured twice (before and after the posters display). Emotions emerging from this exposure were also recorded. RESULTS: Data analysis yielded four significant findings regarding communication on AD: (1) deproblematizing frames (i.e., Unity of body and mind and Good Mother) lead to a positive attitude change; (2) Non reciprocation frame reduces positive attitudes; (3) problematizing frames (i.e., Dualism body and mind and Non reciprocation) trigger negative emotions; (4) deproblematizing frames induce higher positive feelings, which increase positive attitudes. CONCLUSIONS: Negative representations about AD reinforce the negative attitudes towards it. Reframing AD is essential to achieve a positive attitudinal change. PRACTICE IMPLICATIONS: The use of deproblematizing frames (i.e., Unity of body and mind or Good Mother) should be considered when developing and implementing policies targeted at communication and awareness of AD to reduce the stigma associated with this disease.

Cost-effectiveness of transdiagnostic group cognitive behavioural therapy versus group relaxation therapy for emotional disorders in primary care (PsicAP-Costs2): Protocol for a multicentre randomised controlled trial.

Several randomised controlled trials (RCT) have demonstrated the superiority of transdiagnostic group cognitive-behavioural therapy (TD-CBT) to treatment as usual (TAU) for emotional disorders in primary care. To date, however, no RCTs have been conducted to compare TD-CBT to another active intervention in this setting. Our aim is to conduct a single-blind RCT to compare group TD-CBT plus TAU to progressive muscle relaxation (PMR) plus TAU in adults (age 18 to 65 years) with a suspected emotional disorder. We expect that TD-CBT + TAU will be more cost-effective than TAU + PMR, and that these gains will be maintained at the 12-month follow-up. Seven therapy sessions (1.5 hours each) will be offered over a 24-week period. The study will be carried out at four primary care centres in Cantabria, Spain. The study will take a societal perspective. Psychological assessments will be made at three time points: baseline, post-treatment, and at 12-months. The following variables will be evaluated: clinical symptoms (anxiety, depression, and/or somatic); functioning; quality of life (QoL); cognitive-emotional factors (rumination, worry, attentional and interpretative biases, emotion regulation and meta-cognitive beliefs); and satisfaction with treatment. Data on health service use, medications, and sick days will be obtained from electronic medical records. Primary outcome measures will include: incremental cost-effectiveness ratios (ICER) and incremental cost-utility ratios (ICURs). Secondary outcome measures will include: clinical symptoms, QoL, functioning, and treatment satisfaction. Bootstrap sampling will be used to assess uncertainty of the results. Secondary moderation and mediation analyses will be conducted. Two questionnaires will be administered at sessions 1, 4, and 7 to assess therapeutic alliance and group satisfaction. If this trial is successful, widespread application of this cost-effective treatment could greatly improve access to psychological treatment for emotional disorders in the context of increasing demand for mental healthcare in primary care. Trial registration: ClinicalTrials.gov: Cost-effectiveness of a Transdiagnostic Psychological Treatment for Emotional Disorders in Primary Care (PsicAP). NCT05314920.

Psychological Effects of Professional Exposure to Trauma and Human Suffering: Systematic Review and Meta-Analysis.

Over the past decades, a growing interest has emerged toward understanding the impact that the exposure to human suffering produces in mental health professionals, leading to the identification of three constructs: vicarious traumatization (VT), compassion fatigue (CF), and secondary trauma (ST). However, little is known about how these conditions affect psychologists. A systematic review and a meta-analysis were conducted to examine the evidence about the effects of occupational exposure to trauma and suffering in studies that included psychologists among their samples. Fifty-two studies were included comprising 10,233 participants. Overall, the results showed that most professionals did not experience relevant distress due to their work, yet some of them developed clinically significant symptoms (i.e., PTSD). However, solid conclusions could not be drawn due to the numerous methodological difficulties found in this research field (i.e., group heterogeneity, lack of comparison groups, and conceptual overlap). Thus, it is necessary to further investigate this topic with scientific rigor to understand these stressors and develop evidence-based interventions.

El consumo de loot boxes como una nueva forma de azar en los videojuegos / Loot boxes use as a new form of gambling within video games

Las loot boxes son cajas dentro de los videojuegos que los usuarios pagan por abrir y obtener, al azar, un objeto cuyo valor inicialmente desconocen. Tanto la población adolescente como la adulta tiene fácil acceso a ellas, y se han relacionado con el juego de azar. El objetivo de este estudio fue examinar el consumo de loot boxes y explorar si se asociaba con culpabilidad, pérdida de control y malestar. Para ello, 475 participantes (266 adolescentes y 209 adultos) respondieron a un cuestionario ex profeso de elaboración propia. Los resultados mostraron que son los adolescentes los que más dinero invierten en cajas botín. Este gasto se ve aumentado cuando se anuncia nuevo contenido en las plataformas multimedia online (entre ellas, Twitch, YouTube). Además, no obtener los ítems que desean, lo cual es frecuente por su aleatoriedad, predice mayores niveles de culpabilidad y malestar, mientras que su obtención predice la posterior pérdida de control. Así, el 45,5% de los participantes refirieron culpabilidad tras la compra, el 50% malestar y el 17% pérdida de control. En síntesis, las loot boxes están cada vez más presentes en los entornos virtuales de los adolescentes y adultos, y dadas las consecuencias psicológicas y emocionales que parecen tener, es necesario seguir abordando esta problemática en futuras investigaciones en aras de prevenir y apoyar a la población vulnerable. (AU)

Loot boxes are items within video games which players pay to open and, ultimately, to randomly obtain an object whose value is initially unknown. Being easily accessible for both teenagers and adults, loot boxes have been associated with gambling. The purpose of this study was to explore the use of loot boxes and to analyze whether it is associated with guilt, loss of control, and emotional distress. To this end, 475 participants (266 adolescents and 209 adults) were surveyed on their habits regarding loot boxes and gaming. The results showed that teenagers invest more money in loot boxes than adults. This expenditure increases when a new item is announced on online platforms (Twitch, YouTube). Additionally, not obtaining the coveted items, which is common due to loot box randomness, predicts greater levels of guilt and emotional distress, while obtaining them predicts subsequent loss of control. Thus, 45.5% reported guilt over purchasing, 50% distress and 17% loss of control. Summarizing, loot boxes are increasingly present in video games, and owing to their psycho-emotional outcomes, it is necessary for future research to address this matter in order to develop prevention strategies and to provide support to vulnerable populations. (AU)

Risk Factors Associated with Gambling on Loot Boxes / Factores de Riesgo Asociados al Juego de Azar en Cajas Botín

Background: Loot boxes (LBs) are virtual objects that players open without knowing the value of the item they will obtain. Because of their features, studies have explored their association with gambling, finding commonalities. However, risk factors have been overlooked. This study examined risk factors associated with gambling as applied to LBs (gambling in the past year, having family/friends who use LBs/gamble, trait impulsivity, and sensation-seeking). Method: 253 participants (82.2% men) with a mean age of 28 years (SD = 12.11)—in three groups: gamblers (n = 89), LB purchasers (n = 63), and free-LB openers (n = 101)—completed a self-report. Results: Having family/friends who used LBs was related to increased engagement in opening LBs at no cost. However, having gambled in the past year or having family/friends who used LBs or who gambled was not associated with increased purchasing. Gamblers, LB purchasers, and LB openers scored equally highly on impulsivity and sensation-seeking. Because some gamblers used LBs, and LB purchasers also opened free-LBs, further analyses were performed to control for the effects of overlapping groups. Loot boxers had higher scores in sensation-seeking than gamblers. Conclusions: The results can contribute to the development of prevention and intervention strategies for LB users.(AU)

Antecedentes: Las loot boxes (LBs) son objetos virtuales que se abren desconociendo el valor del artículo que contienen. Aunque se han relacionado con el juego de azar, sus factores de riesgo apenas han sido explorados. Este estudio examina los factores de riesgo del juego de azar en LBs (jugar a juegos de azar, tener familiares/amigos que usan LBs/juegan a juegos de azar, impulsividad-rasgo y búsqueda de sensaciones). Método: 253 participantes (M = 28, DT = 12.11, 82.2% hombres), distribuidos en tres grupos: jugadores de azar (n = 89), compradores de LBs (n = 63) y abridores de LBs gratuitas (n = 101), completaron un autoinforme. Resultados: Tener familiares/amigos que usaban LBs se relacionaba con la apertura gratuita, pero jugar a juegos de azar o tener familiares/amigos que usaban LBs/jugaron a juegos de azar no se relacionaba con la compra. Los tres grupos puntuaron igual en impulsividad y búsqueda de sensaciones. Tras controlar el solapamiento (algunos jugadores de azar usaban LBs, y los compradores de LBs abrían LBs gratuitas), los loot boxers puntuaron más alto en búsqueda de sensaciones que los jugadores de azar. Conclusiones: Conocer las comunalidades entre LBs y juegos de azar puede contribuir a su prevención e intervención.(AU)

The effect of framing on attitudes towards Alzheimer's disease. A comparative study between younger and older adults.

The stigma and negative attitudes surrounding Alzheimer's disease (AD) are reinforced by the prevalence of their negative representations. This study aimed to determine how AD framing influences attitudes towards AD and whether this influence differs between younger and older people. Additionally, the elaboration likelihood model (ELM) was used to examine the mediating role that emotions induced by different frames may have in bringing about attitude change. Posters with framed messages on AD (dualism and unity) were designed and shown to 136 participants (68 younger and 68 older adults). Both the younger and older participants were randomly divided into two sub-groups. Each sub-group was shown posters of a campaign with different AD frames: one group viewed posters with messages of the dualism frame and the other group viewed posters with messages of the unity frame. To analyse the effect of the different frames, a mixed design of repeated measures (ANOVA) was used in which attitudes towards AD were measured on two occasions. Both the impact and the emotions produced by exposure to the messages were recorded after the presentation of the posters and a MANOVA test was performed on them. Attitudes, impact and emotions experienced by the younger and older participants were compared. Older adults displayed positive attitudes towards AD but less than younger people. Unity-framed messages produced a positive change in attitudes regardless of the audience's age and led to higher levels of happiness, whereas dualism-framed messages had a greater impact and produced feelings of sadness, anger and fear but did not change attitudes. These findings suggest that reframing of AD may be essential to achieve a positive attitudinal change in both younger and older populations and foster positive emotions. The use of unity-framed messages should be considered when developing and implementing policies targeted at communication and awareness of AD in order to reduce the stigma associated with this form of dementia.

Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol.

BACKGROUND: Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). METHODS: A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. DISCUSSION: This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021).

Loot boxes use as a new form of gambling within video games. / El consumo de loot boxes como una nueva forma de azar en los videojuegos.

Loot boxes are items within video games which players pay to open and, ultimately, to randomly obtain an object whose value is initially unknown. Being easily accessible for both teenagers and adults, loot boxes have been associated with gambling. The purpose of this study was to explore the use of loot boxes and to analyze whether it is associated with guilt, loss of control, and emotional distress. To this end, 475 participants (266 adolescents and 209 adults) were surveyed on their habits regarding loot boxes and gaming. The results showed that teenagers invest more money in loot boxes than adults. This expenditure increases when a new item is announced on online platforms (Twitch, YouTube). Additionally, not obtaining the coveted items, which is common due to loot box randomness, predicts greater levels of guilt and emotional distress, while obtaining them predicts subsequent loss of control. Thus, 45.5% reported guilt over purchasing, 50% distress and 17% loss of control. Summarizing, loot boxes are increasingly present in video games, and owing to their psycho-emotional outcomes, it is necessary for future research to address this matter in order to develop prevention strategies and to provide support to vulnerable populations.

Las loot boxes son cajas dentro de los videojuegos que los usuarios pagan por abrir y obtener, al azar, un objeto cuyo valor inicialmente desconocen. Tanto la población adolescente como la adulta tiene fácil acceso a ellas, y se han relacionado con el juego de azar. El objetivo de este estudio fue examinar el consumo de loot boxes y explorar si se asociaba con culpabilidad, pérdida de control y malestar. Para ello, 475 participantes (266 adolescentes y 209 adultos) respondieron a un cuestionario ex profeso de elaboración propia. Los resultados mostraron que son los adolescentes los que más dinero invierten en cajas botín. Este gasto se ve aumentado cuando se anuncia nuevo contenido en las plataformas multimedia online (entre ellas, Twitch, YouTube). Además, no obtener los ítems que desean, lo cual es frecuente por su aleatoriedad, predice mayores niveles de culpabilidad y malestar, mientras que su obtención predice la posterior pérdida de control. Así, el 45,5% de los participantes refirieron culpabilidad tras la compra, el 50% malestar y el 17% pérdida de control. En síntesis, las loot boxes están cada vez más presentes en los entornos virtuales de los adolescentes y adultos, y dadas las consecuencias psicológicas y emocionales que parecen tener, es necesario seguir abordando esta problemática en futuras investigaciones en aras de prevenir y apoyar a la población vulnerable.

Visual preference for social vs. non-social images in young children with autism spectrum disorders. An eye tracking study.

Autism Spectrum Disorders (ASD) are associated to social attention (SA) impairments. A gaze bias to non-social objects over faces has been proposed as an early marker of ASD. This bias may be related to the concomitant circumscribed interests (CI), which question the role of competing objects in this atypical visual behavior. The aim of this study was to compare visual attention patterns to social and non-social images in young children with ASD and matched typical controls (N = 36; age range 41-73 months) assessing the role of emotion in facial stimuli and the type of competing object. A paired preference task was designed pairing happy, angry, and neutral faces with two types of objects (related or not related to autism CI). Eye tracking data were collected, and three indexes were considered as dependent variables: prioritization (attentional orientation), preference, and duration (sustained attention). Results showed that both groups had similar visual pattern to faces (prioritization, more attention and longer visits to faces paired with objects non-related to their CI); however, the ASD group attended to faces significantly less than controls. Children with ASD showed an emotional bias (late orientation to angry faces and typical preference for happy faces). Finally, objects related to their CI captured attention in both groups, significantly reducing SA in children with ASD. Atypical SA is present in young children with ASD regardless the competing non-social object. Identifying strengths and difficulties in SA in this population may have substantial repercussion for early diagnosis, intervention, and ultimately prognosis.

Percepción de las personas transexuales sobre la atención sanitaria / Healthcare perception in transsexual people

OBJETIVO PRINCIPAL: conocer la percepción del colectivo transexual acerca de la atención sanitaria recibida. METODOLOGÍA: se realizó un estudio cualitativo siguiendo un diseño fenomenológico. Para la recogida de datos y su posterior análisis, se realizaron siete entrevistas semiestructuradas individuales y una entrevista grupal. La información recogida fue transcrita y categorizada resguardando el rigor científico mediante el proceso de triangulación. RESULTADOS PRINCIPALES: las principales percepciones del colectivo transexual con respecto a la atención sanitaria recibida son la aceptación, falta de capacitación adicional sobre transexualidad del personal sanitario, no informar adecuadamente al colectivo transexual y demora o tiempo de espera. CONCLUSION PRINCIPAL: se han superado ciertas barreras a las que se enfrenta el colectivo transexual en el sistema sanitario. Sin embargo, el nivel de formación del personal con respecto a la transexualidad no es adecuado. Este estudio propone una mejora en la formación de los profesionales sanitarios, a la vez que subraya la necesidad revisar y aumentar las investigaciones sobre el tratamiento hormonal que recibe el colectivo transexual

OBJECTIVE: knowing the perception on health care received in transsexual adults. METHODS: a qualitative study with phenomenological approach, using seven individual semi-structured interviews and one group interview in order to collect data and carry out the analysis of the same. The information was transcribed and categorized preserving the scientific rigor by means of the triangulation process. RESULTS: the following perceptions of the transsexual collective regarding the healthcare received stand out acceptance, lack of additional training on transsexualism, not adequately inform the transsexual collective and delay or waiting time. CONCLUSIONS: Although certain barriers to the transsexual collective have already been overcomed in the health system, the level of training of the health professionals regarding transsexualism is not adequate. Therefore, this study proposes an improvement in the training of health professionals, while it emphasizes the need for more research on the hormonal treatment they receive

Giving Meaning to Alzheimer's Disease: An Experimental Study Using a Framing Approach.

The prejudices and stereotypes associated with Alzheimer's disease (AD) are based on contents that highlight the most negative and dramatic aspects of the symptoms of this disease. This is reinforced by the preponderance of negative representations related to AD. In this paper, these representations have been analyzed as frames. The most dominant frame used to represent dementia is "body-mind dualism," and its alternative is the "body-mind unity" counter-frame. This study aims to define the impact of different messages inspired by the Dualism frame and the Unity counter-frame in the collective representation and meaning given to AD. Posters of simulated health campaigns about AD were designed, combining contents related to the Dualism frame and the Unity counter-frame, and were shown to 85 participants. To analyze the impact of both types of frameworks, a pre-post record of the attitudes of the participants toward AD was conducted using the Attitudes toward Dementia Scale. The assessment of the campaign and the self-report emotions were also registered. Participants' eye movements were measured during exposure to the posters. Attitudes toward dementia were found to be significantly more positive following exposure to discourses characteristic of the Unity counter-frame. Likewise, the dualism discourse evoked more sadness and anger. Moreover, the posters that used the discourse of the Unity counter-frame were considered more useful. We concluded that attitudes toward dementia are influenced by framing. Designing suitable health campaigns using these frames could help mitigate the attitudes and stigma associated with AD.