Involving Older Adults During COVID-19 Restrictions in Developing an Ecosystem Supporting Active Aging: Overview of Alternative Elicitation Methods and Common Requirements From Five European Countries.

Background: Information and communication technology solutions have the potential to support active and healthy aging and improve monitoring and treatment outcomes. To make such solutions acceptable, all stakeholders must be involved in the requirements elicitation process. Due to the COVID-19 situation, alternative approaches to commonly used face-to-face methods must often be used. One aim of the current article is to share a unique experience from the Pharaon project where due to the COVID-19 outbreak alternative elicitation methods were used. In addition, an overview of common functional, quality, and emotional goals identified by six pilot sites is presented to complement the knowledge about the needs of older adults. Methods: Originally planned face-to-face co-creation seminars were impossible to carry out, and all pilot sites chose alternative requirements elicitation methods that were most suitable in their situation. The elicited requirements were presented in the form of goal models. In one summary goal model, we provide an overview of common functional, quality, and emotional goals. Results: Different elicitation methods were combined based on the digital literacy of the target group and their access to digital tools. Methods applied without digital technologies were phone interviews, reviews of literature and previous projects, while by means of digital technologies online interviews, online questionnaires, and (semi-)virtual co-creation seminars were conducted. The combination of the methods allowed to involve all planned stakeholders. Virtual and semi-virtual co-creation seminars created collaborative environment comparable to face-to-face situations, while online participation helped to save the time of the participants. The most prevalent functional goals elicited were "Monitor health," "Receive advice," "Receive information." "Easy to use/comfortable," "personalized/tailored," "automatic/smart" were identified as most prevalent quality goals. Most frequently occurring emotional goals were "involved," "empowered," and "informed." Conclusion: There are alternative methods to face-to-face co-creation seminars, which effectively involve older adults and other stakeholders in the requirements elicitation process. Despite the used elicitation method, the requirements can be easily transformed into goal models to present the results in a uniform way. The common requirements across different pilots provided a strong foundation for representing detailed requirements and input for further software development processes.

Decision-making (in)flexibility in gambling disorder.

BACKGROUND: Behavioral flexibility -the ability to dynamically readjust our behavior in response to reward contingency changes- is often investigated using probabilistic reversal learning tasks (PRLT). Poor PRLT performance has been proposed as a proxy for compulsivity, and theorized to be related to perseverative gambling. Previous attempts to measure inflexibility with the PRLT in patients with gambling disorder have, however, used a variety of indices that may conflate inflexibility with more general aspects of performance in the task. METHODS: Trial-by-trial PRLT acquisition and reacquisition curves in 84 treatment-seeking patients with gambling disorder and 64 controls (non-gamblers and non-problem recreational gamblers) were analyzed to distinguish between (a) variability in acquisition learning, and (b) reacquisition learning in reversed contingency phases. Complementarily, stay/switch responses throughout the task were analyzed to identify (c) premature switching, and (d) sensitivity to accumulated negative feedback. RESULTS AND INTERPRETATION: Even after controlling for differences in acquisition learning, patients were slower to readjust their behavior in reversed contingency phases, and were more prone to maintain their decisions despite accumulated negative feedback. Inflexibility in patients with gambling disorder is thus a robust phenomenon that could predate gambling escalation, or result from massive exposure to gambling activities.

Sex differences in the association between impulsivity and driving under the influence of alcohol in young adults: The specific role of sensation seeking.

INTRODUCTION: There is an outstanding need to identify predictors of driving under the influence of alcohol (DUI) among young adults, particularly women. Impulsivity, or the tendency to act without thinking, is a predictor of DUI, but the specific facets of impulsivity that predict DUI and their interaction with sex differences remain unclear. We aimed to investigate sex differences in the link between impulsivity facets and DUI. Moreover, we sought to replicate previous findings regarding sex differences on impulsivity, and associations between impulsivity facets and DUI. METHOD: A total of 506 university students participated in the study (males, n = 128; females, n = 378). Participants completed measures of impulsivity (UPPS-P short version), alcohol use (AUDIT-C), frequency of DUI episodes and related perception of risk. The UPPS-P assesses five facets of impulsivity: sensation seeking, (lack of) premeditation and perseverance and positive and negative urgency. RESULTS: Men showed higher sensation seeking and lack of perseverance, alcohol use and DUI frequency and lower risk perception than women. DUI frequency was negatively associated with perception of risk and positively associated with alcohol use and the five impulsivity facets. After controlling for alcohol use and risk perception, only lack of premeditation was associated with DUI frequency in the whole sample. Sensation seeking was positively associated with DUI frequency only in women. DISCUSSION: The link between lack of premeditation and DUI suggest that pre-drinking planning strategies can contribute to prevent risky driving. In women, specific links between sensation seeking and DUI suggest the need for personality-tailored prevention strategies.

Electroencephalographic Evidence of Abnormal Anticipatory Uncertainty Processing in Gambling Disorder Patients.

Putting money at stake produces anticipatory uncertainty, a process that has been linked to key features of gambling. Here we examined how learning and individual differences modulate the stimulus preceding negativity (SPN, an electroencephalographic signature of perceived uncertainty of valued outcomes) in gambling disorder patients (GDPs) and healthy controls (HCs), during a non-gambling contingency learning task. Twenty-four GDPs and 26 HCs performed a causal learning task under conditions of high and medium uncertainty (HU, MU; null and positive cue-outcome contingency, respectively). Participants were asked to predict the outcome trial-by-trial, and to regularly judge the strength of the cue-outcome contingency. A pre-outcome SPN was extracted from simultaneous electroencephalographic recordings for each participant, uncertainty level, and task block. The two groups similarly learnt to predict the occurrence of the outcome in the presence/absence of the cue. In HCs, SPN amplitude decreased as the outcome became predictable in the MU condition, a decrement that was absent in the HU condition, where the outcome remained unpredictable during the task. Most importantly, GDPs' SPN remained high and insensitive to task type and block. In GDPs, the SPN amplitude was linked to gambling preferences. When both groups were considered together, SPN amplitude was also related to impulsivity. GDPs thus showed an abnormal electrophysiological response to outcome uncertainty, not attributable to faulty contingency learning. Differences with controls were larger in frequent players of passive games, and smaller in players of more active games. Potential psychological mechanisms underlying this set of effects are discussed.

Trait and neurobiological underpinnings of negative emotion regulation in gambling disorder.

BACKGROUND AND AIMS: Gambling disorder is characterized by poor regulation of negative emotions and impulsive behaviours. This study aimed to (1) compare gambling disorder patients (GDPs) and healthy controls (HCs) in self-report and brain activation measures of emotion regulation; and (2) establish its relationship with negative emotion-driven impulsivity. DESIGN: Two cross-sectional case-control studies including GDPs and HCs. SETTING AND PARTICIPANTS: GDPs and HCs were recruited from specialized gambling clinics in Andalusia (Spain), where they were following out-patient treatment, and from the community, respectively. Study 1 included 41 GDPs and 45 HCs [All males; Mage  = 35.22, 33.22; standard deviation (SD) = 11.16, 8.18; respectively]. Study 2 included 17 GDPs and 21 HCs (16/20 males; Mage  = 32.94, 31.00; SD = 7.77, 4.60; respectively). MEASUREMENTS: In study 1, we compared both groups on suppression and re-appraisal emotion regulation strategies [Emotion Regulation Questionnaire (ERQ)]. In study 2, we compared GDPs with HCs on brain activation associated with down-regulation of negative emotions in a cognitive re-appraisal task, measured with functional magnetic resonance imaging (fMRI). In both studies, we correlated the measures of emotion regulation with mood-related impulsivity indicated by negative urgency (UPPS-P impulsive behaviour scale). FINDINGS: GDPs relative to HCs showed higher levels of emotional suppression [F = 4.525; P = 0.036; means difference MHCs -MGDPs  = -2.433, 95% confidence interval (CI) = -4.706, -0.159] and higher activation of the premotor cortex and middle frontal gyrus during negative emotion regulation in the fMRI task [P ≤ 0.005, cluster size (CS) > 50 voxels]. Negative urgency correlated positively with emotional suppression (r = 0.399, 95% CI = 0.104, 0.629, one-tailed P = 0.005) and middle frontal gyrus activation during negative emotion regulation (P ≤ 0.005, CS > 50) in GDPs. CONCLUSIONS: Gambling disorder is associated with greater use of emotional suppression and stronger pre-motor cortex and middle frontal gyrus activation for regulating negative emotions, compared with healthy controls. Emotional suppression use and middle frontal gyrus activation during negative emotion regulation are linked with negative emotion-driven impulsivity in this disorder.