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Subst Abus ; 42(1): 1-4, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33428560


The COVID-19 pandemic, the ongoing opioid epidemic, rise in substance use, and social and political unrest in the US and globally has impacted how substance use-related health needs are addressed. These issues were driving forces in planning AMERSA's 44th annual conference. True to the multidisciplinary spirit, and with diversity goals and advocacy at the forefront of mind, "together we rise" became the beacon for the AMERSA 2020 conference. This commentary provides an overview of the conference proceedings, topics that were highly relevant for clinicians, educators, researchers, and advocates for change.

Comportamento Aditivo/psicologia , Racismo/psicologia , Humanos , Pandemias
Arch Sex Behav ; 50(2): 711-728, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33403533


A growing number of individuals using online forums are attempting to abstain from pornography (colloquially termed "rebooting") due to self-perceived pornography-related problems. The present qualitative study explored phenomenological experiences of abstinence among members of an online "rebooting" forum. A total of 104 abstinence journals by male forum members were systematically analyzed using thematic analysis. A total of four themes (with a total of nine subthemes) emerged from the data: (1) abstinence is the solution to pornography-related problems, (2) sometimes abstinence seems impossible, (3) abstinence is achievable with the right resources, and (4) abstinence is rewarding if persisted with. Members' primary reasons for initiating "rebooting" involved desiring to overcome a perceived addiction to pornography and/or alleviate perceived negative consequences attributed to pornography use, especially sexual difficulties. Successfully achieving and maintaining abstinence was typically experienced to be very challenging due to habitual behavior patterns and/or cravings triggered by a multiplicity of cues for pornography use, but a combination of internal (e.g., cognitive-behavioral strategies) and external (e.g., social support) resources made abstinence attainable for many members. A range of benefits attributed to abstinence by members suggest that abstaining from pornography could potentially be a beneficial intervention for problematic pornography use, although future prospective studies are needed to rule out possible third variable explanations for these perceived effects and to rigorously evaluate abstinence as an intervention. The present findings shed light on what the "rebooting" experience is like from members' own perspectives and provide insights into abstinence as an approach for addressing problematic pornography use.

Comportamento Aditivo/psicologia , Literatura Erótica/psicologia , Personalidade , Autocontrole/psicologia , Comportamento Sexual/psicologia , Adulto , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Princípios Morais , Estudos Prospectivos , Recompensa , Autoimagem , Apoio Social
Arch Sex Behav ; 50(2): 695-709, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33403534


This study examined the roles of religiosity, shame, obsessive-compulsive symptoms, and scrupulosity in perceived pornography addiction. We theorized that religiosity causes pornography users to feel shame regarding their use, and in turn, self-identify as addicted to pornography, especially for individuals high on one of several proposed moderators. Participants were 645-646 pornography users who believe in a theistic God. Confirmatory analyses indicated that religious primes did not have indirect or moderated indirect effects on perceived addiction. However, exploratory analyses revealed that religious primes were associated with higher shame, and in turn, perceived addiction among individuals high on both organizational religiosity and Obsessive-Compulsive Disorder compulsivity subscales. Additionally, self-reported religiosity had indirect effects on perceived addiction via shame, especially among individuals high on scrupulosity or moral disapproval of pornography.

Comportamento Aditivo/psicologia , Literatura Erótica/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Religião e Psicologia , Vergonha , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Princípios Morais , Autoimagem , Autorrelato , Adulto Jovem
Lancet Public Health ; 6(1): e39-e49, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33417845


BACKGROUND: Suicide rates in young people have increased in England and Wales since 2010. There are a range of possible explanations for this increase, and problem gambling has been suggested as a potential risk factor. We aimed to examine the association between suicidality (suicidal thoughts and suicide attempts) and problem gambling specifically for young adults in Great Britain, where gambling has become more widely available and normalised in the past two decades. METHODS: We analysed data from the Emerging Adults Gambling Survey: a cross-sectional, online, non-probability sample survey of young adults aged 16-24 years living in Great Britain, who were selected from a YouGov online panel. Participants were eligible if they had not taken part in any other YouGov survey on gambling in the past year. We examined associations between problem gambling (defined as a score of 8 or higher on the Problem Gambling Severity Index [PGSI]) and suicidal thoughts and suicide attempts in the year before survey completion in a series of regression models, with and without adjustment for sociodemographic factors, alcohol use, video gaming, anxiety, loneliness, and impulsivity. FINDINGS: 3549 eligible participants completed the survey between June 25 and Aug 16, 2019. 24 (37·0% [95% CI 25·6-50·2]) of 62 men who had attempted suicide in the past year had survey scores that were indicative of problem gambling, compared with 38 (3·6% [2·6-5·0]) of 1077 men who had not attempted suicide or had suicidal thoughts in the past year. 13 (14·5% [8·5-23·6]) of 85 women who had attempted suicide in the past year had survey scores that were indicative of problem gambling, compared with 25 (2·0% [1·4-3·0]) of 1184 women who had not attempted suicide or had suicidal thoughts in the past year. The adjusted odds ratio for attempted suicide was 9·0 (4·1-19·7) in men with scores that indicated problem gambling and 4·9 (2·0-12·0) in women with scores that indicated problem gambling, compared with participants of the same gender with PGSI scores of 0. INTERPRETATION: Problem gambling appears to be associated with suicide attempts in both young men and young women. This association persisted after adjusting for anxiety, impulsivity, life satisfaction, and other factors, which suggests that other mechanisms, such as the severity and multiplicity of harms experienced, or gambling to cope with life stressors, might underpin this relationship. Young people with problem-gambling behaviours should be considered at risk for suicidality. FUNDING: Wellcome Trust.

Comportamento Aditivo/psicologia , Jogo de Azar/psicologia , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Comportamento Aditivo/epidemiologia , Estudos Transversais , Feminino , Jogo de Azar/epidemiologia , Humanos , Masculino , Fatores de Risco , Inquéritos e Questionários , Reino Unido/epidemiologia , Adulto Jovem
Neurosci Lett ; 743: 135555, 2021 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-33352288


Stress enhances cocaine craving. We recently reported that acute restraint stress increases cocaine conditioned place preference (CPP) in mice; however, the underlying mechanisms remain unclear. This study aimed to examine the role of serotonergic transmission in the medial prefrontal cortex (mPFC) in cocaine CPP enhancement by acute restraint stress, which increases extracellular serotonin (5-HT) levels in the mPFC. Intra-mPFC infusion of the selective serotonin reuptake inhibitor (S)-citalopram prior to the test session significantly increased the cocaine CPP score under non-stressed conditions. This is indicative of the substantial role of increased mPFC 5-HT levels in cocaine CPP enhancement. Moreover, intra-mPFC and systemic administration of the 5-HT1A receptor antagonist WAY100635 immediately before restraint stress exposure significantly attenuated stress-induced cocaine CPP enhancement. Our findings suggest that enhanced serotonergic transmission via 5-HT1A receptors in the mPFC is involved in acute stress-induced augmentation of rewarding memory of cocaine; moreover, the 5-HT1A receptor could be a therapeutic target for stress-induced cocaine craving.

Cocaína/administração & dosagem , Memória/fisiologia , Córtex Pré-Frontal/metabolismo , Receptor 5-HT1A de Serotonina/metabolismo , Recompensa , Estresse Psicológico/metabolismo , Animais , Comportamento Aditivo/tratamento farmacológico , Comportamento Aditivo/metabolismo , Comportamento Aditivo/psicologia , Inibidores da Captação de Dopamina/administração & dosagem , Infusões Intraventriculares , Masculino , Memória/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Piperazinas/administração & dosagem , Córtex Pré-Frontal/efeitos dos fármacos , Piridinas/administração & dosagem , Restrição Física/efeitos adversos , Restrição Física/psicologia , Neurônios Serotoninérgicos/efeitos dos fármacos , Neurônios Serotoninérgicos/metabolismo , Serotonina/metabolismo , Antagonistas do Receptor 5-HT1 de Serotonina/administração & dosagem , Estresse Psicológico/psicologia
Rev. esp. drogodepend ; 45(4): 14-28, oct.-dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-199683


El abuso de videojuegos es una conducta de prevalencia creciente que podría variar en función del tipo de videojuego, y que además podría concurrir con otras adicciones como el trastorno de juego o el abuso de sustancias. Por tanto, este estudio tiene como objetivo medir la co-ocurrencia del abuso de videojuegos con estas conductas en función del sexo, rendimiento académico y edad, y analizar estos perfiles en función del tipo de videjuego predominante (Fortnite, FIFA, u otros videojuegos). La muestra estuvo compuesta por 393 usuarios de videojuegos de entre 18 y 36 años (21.6% de mujeres y un 76.8% de hombres). Los resultados mostraron un mayor nivel de trastorno de juego en el grupo de hombres y mayores niveles de abuso de videojuegos y sustancias en el grupo de repetidores de 2 cursos o más. En cuanto a la edad, a mayor edad se halló mayor uso de cartas y apuestas deportivas offline, lotería online, cocaína, y speed, y a menor edad mayor uso de bebidas energéticas y mayor nivel de abuso de videojuegos, especialmente en el caso de los usuarios de Fortnite, en los que también se relacionó con el abuso de sustancias. En el caso de los usuarios de FIFA, se encontró una relación significativa del abuso de videojuegos con el trastorno juego. En este grupo, el trastorno de juego y el abuso de sustancias mostraron una relación significativa con las apuestas deportivas. Estos resultados delimitan perfiles diferenciales de interés para la prevención y la intervención

Video games abuse is a behaviour of increasing prevalence that may vary depending on the type of video game, and may co-occur with other addictions such as gambling disorder or substance use disorder. Therefore, this study aims to analyse the co-occurrence of video game abuse with these behaviours as a function of age, sex, and academic performance, and to analyse these profiles depending on which the main video game that used is (Fornite, FIFA, or other video games). The sample comprised 393 video game users (18-36 years old; 21.6% were female and 76.8% male). The results showed greater degrees of gambling disorder in males and greater degrees of video game and substance abuse in repeaters of 2 or more courses. Regarding age, older participants showed a greater use of offline card and sports betting, online lottery, cocaine, and speed, and younger participants showed greater use of energy drinks and video games, especially in Fortnite users, in which video game abuse was related with substance abuse. In the case of FIFA users, there was a significant relationship of video game abuse with gambling disorder. In this group, gambling disorder and substance abuse showed a significant relationship with sports betting. These results draw differential profiles which are of interest for prevention and intervention

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Comportamento Aditivo/epidemiologia , Jogo de Azar/epidemiologia , Jogos de Vídeo/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Comportamento Aditivo/psicologia , Jogos de Vídeo/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Fatores Sexuais , Fatores Etários , Fatores de Tempo , Inquéritos e Questionários , Escala de Avaliação Comportamental , Fatores de Risco , Desempenho Acadêmico , Espanha/epidemiologia
Rev. esp. drogodepend ; 45(4): 29-48, oct.-dic. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-199684


El Trastorno de juego en Internet (IGD) se ha convertido en objeto de estudio en todo el mundo para ofrecer servicios especializados de salud mental a las personas afectadas. Sin embargo, prima la escasez de estudios relacionados con la efectividad de los tratamientos psicológicos para el IGD. El objetivo principal del presente estudio es evaluar los cambios psicológicos producidos durante el proceso de intervención del "Programa Individualizado Psicoterapéutico para la Adicción a las Tecnologías de la Información y la Comunicación" (PIPATIC) en adolescentes con IGD. MÉTODO: La muestra se compone de 31 adolescentes (de 12 a 18 años) de dos centros públicos de salud mental, asignados a (I) grupo experimental de intervención PIPATIC o (II) grupo de control de Terapia Cognitivo Conductual estándar (TCC). La intervención se evaluó en las fases pre, durante y post-tratamiento. RESULTADOS: No se encontraron diferencias significativas entre ninguno de los grupos en la fase de pretratamiento. En relación con las diferentes intervenciones examinadas, se encontraron diferencias significativas en las pruebas previas y posteriores en las siguientes variables: trastornos comórbidos, habilidades interpersonales y medidas de los terapeutas. Ambos grupos experimentaron una reducción significativa de los síntomas relacionados con el IGD, aunque el grupo PIPATIC experimentó mejoras significativas más relevantes tanto en el IGD cómo en el resto de variables examinadas. DISCUSIÓN Y CONCLUSIONES: Los resultados sugieren que el programa PIPATIC ha estimulado cambios más significativos en el tratamiento del IGD y sus síntomas comórbidos y habilidades sociales que la TCC. Por otro lado, cabe remarcar que la TCC estándar también consiguió mejoras en los participantes respecto al uso de videojuegos y la sintomatología del IGD. En consecuencia, el uso de un enfoque integrador que cuyo foco de intervención refiera tanto al IGD cómo a los síntomas comórbidos, las habilidades intrapersonales e interpersonales y la psicoterapia familiar parece resultar más efectivo en facilitar cambios psicológicos en adolescente que un foco de intervención únicamente centrado en abordar el trastorno adictivo

Internet Gaming Disorder (IGD) has become the subject of study all around the world in order to provide specialist mental health services for affected persons. Nevertheless, there is a definite shortage of studies on the effectiveness of psychological treatments for IGD. The main objective of this paper is to assess the psychological changes that take place during the intervention process on the "Individualised Psycho-therapy Program for Addiction to Information and Communication Technologies" (IPPAICT) in adolescents with IGD. METHOD: The sample consisted of 31 adolescents (aged 12 to 18) from two public mental health centres, assigned to (I) experimental IPPAICT group, or (II) Standard Behavioural Cognitive Therapy (SBCT). Interventional was assessed in the pre, during and post treatment stages. RESULTS: There were no significant differences between either of the groups in the pre-treatment stage. In regard to the different types of intervention, significant differences were observed in tests before and after in relation to the following variables: comorbid disorders, interpersonal skills and therapy measures. Both groups reported a significant reduction in the symptoms related to IGD, although the IPPAICT group reported more relevant significant improvements in IGD and the rest of the variables. DISCUSSION AND CONCLUSIONS: The results suggest that the IPPAICT programme brought about more significant changes in IGD treatment and comorbid symptoms and social skills than SBCT. On the other hand, attention is also brought to the fact that standard SBCT also reported improvements in the participants in regard to the use of videogames and IGD symptoms. Consequently, an integrating approach focussing on IGD and comorbid symptoms, intrapersonal and interpersonal skills and family psychotherapy appear to be more effective in bringing about psychological changes than an approach that exclusively focusses on treating the addiction disorder

Humanos , Masculino , Feminino , Criança , Adolescente , Jogo de Azar/psicologia , Internet/estatística & dados numéricos , Comportamento Aditivo/psicologia , Comportamento Aditivo/terapia , Terapia Cognitivo-Comportamental/métodos , Jogo de Azar/epidemiologia , Comportamento Aditivo/epidemiologia , Resultado do Tratamento , Inquéritos e Questionários , Escala de Avaliação Comportamental , Relações Familiares , Fatores Socioeconômicos , Inteligência Emocional , Habilidades Sociais , Distribuição por Idade , Espanha/epidemiologia
Rev. esp. drogodepend ; 45(4): 49-64, oct.-dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-199685


El diseño de videojuegos es una profesión relativamente nueva. Con todo, en la breve vida de este fenómeno se ha observado su crecimiento incesante y su coronación como uno de los sectores lúdicos por excelencia. A tenor de este ímpetu los diseñadores de juegos han iniciado un camino de estandarización del acto creativo que, en su mayoría, se rige por principios psicológicos con gran bagaje teórico y científico. Desde el entendimiento del videojuego como una experiencia de aprendizaje, los diseñadores han adoptado conceptos como el moldeamiento de la conducta, la autoeficacia y las necesidades psicológicas básicas, entre otros, para asegurar el éxito de sus productos. En muchas ocasiones este éxito se atribuye a los patrones de consumo del jugador y estos son consecuencia natural de la implicación del usuario en el juego. Esta implicación es en ocasiones susceptible de convertirse en adicción. Dado el uso que los desarrolladores de videojuegos hacen de los principios psicológicos, los clínicos y académicos deberíamos tener un conocimiento igualmente extenso sobre cuál es el proceso y métodos que usan los diseñadores de videojuegos al crear sus productos con el objetivo de entender mejor de donde surge su potencial adictivo, más allá de la sintomatología asociada

Video game design is a relatively new profession. This phenomenon has undergone continuous growth during its short lifespan, becoming one of the world's primary entertainment industries. Based on this impetus, game designers have begun a path of standardization of the creative act that is mostly governed by psychological principles with significant theoretical and scientific baggage. Understanding video games as a learning experience, designers have adopted concepts such as behavior shaping, self-efficacy, and underlying psychological needs, among others, to ensure the success of their products. This success is often attributed to the consumption patterns of the player, and these are a natural consequence of the user's engagement with the game. This engagement is sometimes liable to become an addiction. Given the use that video game developers make of psychological principles, clinicians and academics should have an equally extensive knowledge of the process and methods that video game designers use when creating their products, in order to better understand where its addictive 4 potential comes from, beyond the associated symptoms

Humanos , Jogos de Vídeo/psicologia , Design de Software , Comportamento Aditivo/psicologia , Motivação , Aprendizagem
Rev. esp. drogodepend ; 45(4): 65-85, oct.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-199686


Este trabajo propone una conceptualización no adictiva de la necesidad humana de comunicarse mediante redes sociales en línea. Las consecuencias negativas del uso de redes sociales en línea no son lo suficientemente graves para considerar esta conducta como una posible adicción y la falta de estudios longitudinales y de muestras clínicas invitan a la cautela para no patologizar conductas novedosas. Debemos entender el uso problemático de las redes sociales en el contexto del perfil psicológico del usuario, las motivaciones y gratificaciones y su contexto socio-cultural para entender cómo se produce un uso problemático y cómo combatirlo. Pese a estas consideraciones, las redes sociales en línea pueden ser problemáticas para algunas franjas de edad y para personas que padecen algunos trastornos primarios cuando su uso está mediado por el miedo a quedarse fuera (Fear of Missing Out, FOMO), la búsqueda de validación y la evitación del afrontamiento. Parece que la ayuda más efectiva se puede centrar en el tratamiento en los trastornos primarios comórbidos de los cuales el uso problemático de las redes sociales es, a menudo, un efecto secundario

This paper proposes a non-addictive conceptualization of the human need to interact through online social networks. The negative consequences of online social network use have led to much research on social media addiction. However, these consequences are not severe enough to consider problematic social media use as a disorder. Additionally, the lack of longitudinal studies, clinical samples and standardized diagnostic measures require us to be cautious of pathologizing novel technological behaviors such as social media use. We must understand the problematic use of social networks in the context of the user's psychological profile, motivations, gratifications and socio-cultural context in order to understand how problematic use occurs and how to combat it. Despite our argument that social media addiction has not been proven to exist at this time, online social networks have been associated with various problems, particularly in certain age groups and in people who suffer from other primary disorders, especially when their use is mediated by the Fear of Missing Out (FOMO), a search for validation and avoidance coping. It appears that the most effective help for those experiencing problems from social media use may be psychoeducation and treating the primary comorbid disorder of which problematic social media use is often a side effect

Humanos , Redes Sociais Online , Comportamento Aditivo/psicologia , Fatores de Tempo , Acesso à Internet , Motivação
Pap. psicol ; 41(3): 211-218, sept.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-197409


El trastorno de juego por internet (conocida como adicción a videojuegos) se caracteriza por un patrón de comportamiento de juego persistente y recurrente que conlleva un deterioro o malestar clínicamente significativo por un periodo de 12 meses. El objetivo del presente análisis del estado de la cuestión es comentar los retos y oportunidades del DSM-5 y la CIE-11 para su diagnóstico dada su actualidad y su rápida evolución. Para ello se revisan las posibles adicciones tecnológicas que no están incluidas en el DSM-5, sus ventajas y retos y oportunidades y se comentan algunos de ellos: gravedad de los síntomas y del trastorno, el riesgo de patologizar la vida cotidiana, edad de la población afectada, los juegos freemium y los pay-to-play, los e-Sports y la cartera de servicios de salud

Internet gaming disorder (IGD) (formerly known as video game addiction) is characterized by a pattern of persistent and recurring video game behavior leading to clinically significant impairment or distress for a period of 12 months. The objective of the following state-of-the-art analysis is to comment on the challenges and opportunities of the DSM-5 and ICD-11 regarding the diagnosis of IGD that is still being developed. With this purpose in mind, possible technological addictions that are not included in the DSM-5 are reviewed and some of their advantages, challenges, and opportunities are commented on, including severity of effects, age of the most affected population, freemium vs. pay-to-play games, the risk of pathologizing daily life, e-Sports, and the health services portfolio

Humanos , Comportamento Aditivo/diagnóstico , Jogos de Vídeo/classificação , Jogos de Vídeo/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Internet , Comportamento Aditivo/complicações , Comportamento Aditivo/psicologia
BMC Psychol ; 8(1): 120, 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33168098


BACKGROUND: Decisions made by individuals with disordered gambling are markedly inflexible. However, whether anomalies in learning from feedback are gambling-specific, or extend beyond gambling contexts, remains an open question. More generally, addictive disorders-including gambling disorder-have been proposed to be facilitated by individual differences in feedback-driven decision-making inflexibility, which has been studied in the lab with the Probabilistic Reversal Learning Task (PRLT). In this task, participants are first asked to learn which of two choice options is more advantageous, on the basis of trial-by-trial feedback, but, once preferences are established, reward contingencies are reversed, so that the advantageous option becomes disadvantageous and vice versa. Inflexibility is revealed by a less effective reacquisition of preferences after reversal, which can be distinguished from more generalized learning deficits. METHODS: In the present study, we compared PRLT performance across two groups of 25 treatment-seeking patients diagnosed with an addictive disorder and who reported gambling problems, and 25 matched controls [18 Males/7 Females in both groups, Mage(SDage) = 25.24 (8.42) and 24.96 (7.90), for patients and controls, respectively]. Beyond testing for differences in the shape of PRLT learning curves across groups, the specific effect of problematic gambling symptoms' severity was also assessed independently of group assignment. In order to surpass previous methodological problems, full acquisition and reacquisition curves were fitted using generalized mixed-effect models. RESULTS: Results showed that (1) controls did not significantly differ from patients in global PRLT performance nor showed specific signs of decision-making inflexibility; and (2) regardless of whether group affiliation was controlled for or not, gambling severity was specifically associated with more inefficient learning in phases with reversed contingencies. CONCLUSION: Decision-making inflexibility, as revealed by difficulty to reacquire decisional preferences based on feedback after contingency reversals, seems to be associated with gambling problems, but not necessarily with a substance-use disorder diagnosis. This result aligns with gambling disorder models in which domain-general compulsivity is linked to vulnerability to develop gambling-specific problems with exposure to gambling opportunities.

Comportamento Aditivo/psicologia , Comportamento Compulsivo , Jogo de Azar , Reversão de Aprendizagem , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto , Tomada de Decisões , Feminino , Humanos , Comportamento Impulsivo , Masculino , Recompensa , Índice de Gravidade de Doença
PLoS One ; 15(10): e0239761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33035229


BACKGROUND: Addiction medicine consultation services (ACS) may improve outcomes of hospitalized patients with substance use disorders (SUD). Our aim was to examine the difference in length of stay and the hazard ratio for a routine hospital discharge between SUD patients receiving and not receiving ACS. METHODS: Structured EHR data from 2018 of 1,900 adult patients with a SUD-related diagnostic code at an urban academic health center were examined among 35,541 total encounters. Cox proportional hazards regression models were fit using a cause-specific approach to examine differences in hospital outcome (i.e., routine discharge, leaving against medical advice, in-hospital death, or transfer to another level of care). Models were adjusted for age, sex, race, ethnicity, insurance status, and comorbidities. RESULTS: Length of stay was shorter among encounters with a SUD that received a SUIT consultation versus those admissions that did not receive one (5.77 v. 6.54 days, p<0.01). In adjusted analyses, admissions that received a SUIT consultation had a higher hazard of a routine discharge [hazard ratio (95% confidence interval): 1.16 (1.03-1.30)] compared to those not receiving a SUIT consultation. CONCLUSIONS: The SUIT consultation service was associated with a reduced length of stay and an increased hazard of a routine discharge. The SUIT model may serve as a benchmark and inform other health systems attempting to improve outcomes in SUD patient cohorts.

Tempo de Internação/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Comportamento Aditivo/psicologia , Comorbidade , Feminino , Hospitalização/tendências , Humanos , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Modelos de Riscos Proporcionais , Encaminhamento e Consulta
PLoS One ; 15(10): e0238978, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33022001


The recent literature shows that the type of gambling practiced influences problem gambling. This study was aimed at investigating the factors associated with gambling type, including gambling severity, gambling motives, and cognitive distortions. A total of 291 regular male gamblers (229 skill gamblers and 62 mixed gamblers, i.e., those who play at least one game of chance and one skill game) were recruited online and assessed for gambling severity (South Oaks Gambling Screen), gambling motives (Gambling Motives Questionnaire-Financial), cognitive distortions (Gambling-Related Cognition Scale), and psychological distress (Hospital Anxiety and Depression Scale). After controlling for the number of games played and psychological distress, we found that gambling type was significantly associated with gambling severity. Moreover, controlling for psychological distress showed that gambling type was also significantly associated with coping motives and interpretative bias. First, mixed gamblers had higher severity scores and higher coping motivation than skill gamblers; second, skill gamblers seemed more at risk of developing interpretative bias. Thus, the gamblers presented different psychological, motivational, and cognitive profiles according to gambling type, indicating that different clinical interventions may be relevant. Working on coping motives and anxiety and depression symptoms with an abstinence purpose would be more suitable for mixed gamblers. Indeed, working on these points could lead to the gambler reducing or eventually ceasing gambling, as the need to regulate negative emotions through gambling behavior would fade in parallel. Gambling type, psychological distress, gambling motives, and cognitive distortions should be taken into consideration systematically in clinical interventions of patients with plural and mixed practice of games.

Jogo de Azar/psicologia , Adulto , Comportamento Aditivo/psicologia , Cognição , Transtornos Cognitivos/psicologia , França , Jogo de Azar/classificação , Jogo de Azar/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Estresse Psicológico , Inquéritos e Questionários , Adulto Jovem
An. psicol ; 36(3): 435-442, oct. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-195659


The purpose of this study was to examine whether loneliness is a mediator between internet addiction and social self-efficacy among undergraduates. The participants involved 325 undergraduates (female: 57.8%; male, 42.2%). The age of participants ranged between 17 and 30 years (M = 20.54, SD = 1.99). The study data was gathered using the Young's Internet Addiction Test-Short Form, the Social Efficacy and Social Outcome Expectation Scale and the UCLA Loneliness Scale. The data were analyzed using structural equation modeling and bootstrapping method. Structural equation modeling showed that internet addiction had an indirect effect on social self-efficacy, mediated by loneliness. The results of bootstrapping procedure indicated that the indirect effect of loneliness on the relationship between internet addiction and social self-efficacy was significant. The possibility explanations, the research implication, limitations, and future directions were discussed

El propósito de este estudio fue examinar si la soledad es un mediador entre Internet y la autoeficacia entre lo social. Los participantes involucraron a 325 estudiantes universitarios (mujeres: 57.8%; hombres, 42.2%). La edad de los participantes osciló entre 17 y 30 años (M = 20.54, SD = 1.99). Los datos del estudio se obtuvieron mediante el formulario corto de prueba de adicción a Internet de Young, la escala de eficacia social y expectativas de resultados sociales y la escala de soledad de UCLA. Los datos se analizaron utilizando el método de modelado de ecuaciones estructurales y bootstrapping. El modelo de ecuaciones estructurales mostró que había un efecto indirecto sobre la autoeficacia social, mediado por la soledad. Los resultados del procedimiento de arranque indicaron que el efecto indirecto de la soledad fue significativo. Se discutieron las posibles explicaciones, la implicación de la investigación, las limitaciones y las direcciones futuras

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Estudantes/psicologia , Internet , Comportamento Aditivo/psicologia , Solidão/psicologia , Autoeficácia , Escalas de Graduação Psiquiátrica , Valores de Referência , Análise de Classes Latentes
Isr Med Assoc J ; 9(22): 521-528, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32954702


BACKGROUND: Dependence on technology and electronic media devices (EMDs) is a significant phenomenon of modern life with many people experiencing adverse symptoms during abstention. Orthodox Jews abstain from using all forms of EMDs for 25 consecutive hours every week on the Sabbath but do not appear to experience significant adverse reactions during this abstention. OBJECTIVES: To better examine whether Sabbath observant Jews experience fewer and less severe adverse symptoms while abstaining from EMDs on the Sabbath compared to weekdays. METHODS: Ten Sabbath observant Jews abstained from using all forms of EMDs for 25 hours on a Sabbath and again on a weekday. At the end of each 25-hour period participants completed a 12-item Likert-type scale self-assessment of 1-5, once as a report of their condition at 10:00 and again after 25 hours of abstaining. The authors compared the mean results of Sabbath and weekday using Wilcoxon signed ranks test. P ≤ 0.05 was considered significant. RESULTS: Overall, discomfort on Sabbath was less than on weekdays. A statistically significant decrease on the Sabbath was found at both the 10:00 reporting time and after 25 hours in anxiety, restlessness, thoughts and plans of using devices, and overall difficulty to abstain. Significance was found for feelings of not knowing what to do with time (10:00) and moodiness and irritability, being drawn to devices, and cravings achieved significance (after 25 hours). CONCLUSIONS: Sabbath observant Jews reported statistically significant less adverse reactions while abstaining from EMDs on the Sabbath compared to on a weekday.

Comportamento Aditivo/psicologia , Uso do Telefone Celular/estatística & dados numéricos , Judeus/psicologia , Judaísmo , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
Psychiatry Res ; 293: 113463, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32977050


BACKGROUND: The current COVID-19 pandemic and the consequent containment measures are leading to increasing mental health issues both in psychiatric patients and general population. OBJECTIVE: We aimed to compare the number and characteristics of emergency psychiatric consultations during the phase 1 of lockdown with respect to the same period in 2019 in a Department of Mental Health and Addiction (DMHA) located in Lombardy region. METHODS: We conducted a cross-sectional study including subjects consecutively admitted to two psychiatric emergency rooms of DMHA in Monza, Lombardy, Italy. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis and information on patients' illness course following the emergency consultations were collected. No subjects were excluded for the purposes of the study. RESULTS: Between February 21st and May 3rd 2020, there was a marked reduction in the number of psychiatric emergency consultations, if compared to the same period of 2019. Subjects who were living in psychiatric residential treatment facilities, had cannabis addiction and a diagnosis of obsessive-compulsive disorder were significantly more likely to present to emergency psychiatric consultations during lockdown. CONCLUSIONS: COVID-19 epidemic may have a negative impact on more vulnerable individuals. Strategies to enhance relapse prevention and the use of alternative approaches as e-health technologies should be promoted.

Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Serviços de Emergência Psiquiátrica/métodos , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Adulto , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Comportamento Aditivo/terapia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Serviço Hospitalar de Emergência , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Pneumonia Viral/epidemiologia
Subst Use Misuse ; 55(14): 2438-2442, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32957797


BACKGROUND: The overwhelming fatalities of the global COVID-19 Pandemic will have daunting epigenetic sequala that can translate into an array of mental health issues, including panic, phobia, health anxiety, sleep disturbances to dissociative like symptoms including suicide. Method: We searched PUBMED for articles listed using the search terms "COVID 19 Pandemic", COVID19 and genes," "stress and COVID 19", Stress and Social distancing: Results: Long-term social distancing may be neurologically harmful, the consequence of epigenetic insults to the gene encoding the primary receptor for SARS-CoV2, and COVID 19. The gene is Angiotensin I Converting-Enzyme 2 (ACE2). According to the multi-experiment matrix (MEM), the gene exhibiting the most statistically significant co-expression link to ACE2 is Dopa Decarboxylase (DDC). DDC is a crucial enzyme that participates in the synthesis of both dopamine and serotonin. SARS-CoV2-induced downregulation of ACE2 expression might reduce dopamine and serotonin synthesis, causing hypodopaminergia. Discussion: Indeed, added to the known reduced dopamine function during periods of stress, including social distancing the consequence being both genetic and epigenetic vulnerability to all Reward Deficiency Syndrome (RDS) addictive behaviors. Stress seen in PTSD can generate downstream alterations in immune functions by reducing methylation levels of immune-related genes. Conclusion: Mitigation of these effects by identifying subjects at risk and promoting dopaminergic homeostasis to help regulate stress-relative hypodopaminergia, attenuate fears, and prevent subsequent unwanted drug and non-drug RDS type addictive behaviors seems prudent.

Comportamento Aditivo/genética , Infecções por Coronavirus/metabolismo , Dopamina/metabolismo , Pneumonia Viral/metabolismo , Ansiedade/genética , Ansiedade/metabolismo , Comportamento Aditivo/metabolismo , Comportamento Aditivo/psicologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Dopa Descarboxilase/genética , Dopa Descarboxilase/metabolismo , Regulação para Baixo , Epigênese Genética , Humanos , Pandemias , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/psicologia , Recompensa , Estresse Psicológico/genética , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/genética , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Transtornos Relacionados ao Uso de Substâncias/psicologia , Suicídio , Síndrome
PLoS One ; 15(9): e0238459, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32898191


BACKGROUND: Smartphone addiction is a growing social problem with adverse health outcomes. There are few comparative studies in Asia that examine factors associated with smartphone addiction. The current study aimed to address this research gap by presenting a comparative analysis of factors associated with smartphone addiction in Japan and Thailand, two countries heterogeneous in both their level of economic development and culture. METHODS: Participant data were collected using two population-based surveys. Participants were high school students in grade 11, aged 16-17 years old, and were selected using quota sampling in Japan in 2014 and random sampling in Thailand in 2016. The outcome of interest was smartphone addiction, measured using a modified version of the Young Diagnostic Questionnaire for Internet Addiction. Multiple logistic regression analysis was performed to determine factors associated with smartphone addiction (gender; nationality; family connectedness; and average time spent on smartphone per day). RESULTS: This study included a total of 7694 students, 6585 students from Japan and 1109 students from Thailand. The prevalence of smartphone addiction was 35.9% among Thai students and 12% among Japanese students. Thai students were more likely to have smartphone addiction than Japanese students (AOR 2.76; 95% CI: 2.37-3.30). Being female was associated with increased odds of smartphone addiction in both Japanese (AOR 1.53; 95% CI: 1.32-1.78) and Thai students (AOR 1.34; 95% CI: 1.01-1.78). The parental connectedness variables "my parents noticed when I was unhappy" (AOR 0.77; 95% CI: 0.62-0.96) and "my parents noticed when I did something good" (AOR 0.78, 95% CI: 0.61-0.99) were associated with lower odds of smartphone addiction among Japanese students. CONCLUSION: Smartphone addiction was more prevalent among Thai adolescents than Japanese adolescents, and more prevalent among females than males in both countries. Interventions for reducing smartphone addiction should take into account both context and gender, and should leverage the protective effect of parental connectedness.

Comportamento Aditivo/psicologia , Smartphone/tendências , Estudantes/psicologia , Adolescente , Comportamento do Adolescente , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/fisiopatologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pais , Prevalência , Smartphone/estatística & dados numéricos , Inquéritos e Questionários , Tailândia/epidemiologia