Search

The meaning of the word craving varies as illustrated by Kozlowski and Wilkinson's reports of ambiguities in use amongst cigarette smokers. We extended this line of investigation to problem drinkers who sought a goal of controlled drinking versus abstinence, to professionals involved in the addictions area, and to university students. Significant differences in meaning were noted particularly among the problem drinkers (N = 256 between 17 and 60 years of age). Reasons for this are offered.

Background and Aims: A definition of gaming disorder (GD) was introduced in ICD-11. The purpose of this study was to develop a short screening test for GD, utilizing a reference GD group. It also sought to estimate the prevalence of GD among individuals, representative of the general young population in Japan. Methods: Two hundred eighty one men and women selected from the general population, aged between 10 and 29 years, and 44 treatment seekers at our center completed a self-reported questionnaire comprising candidate questions for the screening test. The reference group with ICD-11 GD was established, based on face-to-face interviews with behavioral addiction experts, using a diagnostic interview instrument. The questions in the screening test were selected to best differentiate those who had GD from those who did not, and the cutoff value was determined using the Youden index. Results: A nine-item screening test (GAMES test) was developed. The sensitivity and specificity of the test were both 98% and the positive predictive value in the study sample was 91%. The GAMES test comprised two factors, showed high internal consistency and was highly reproducible. The estimated prevalence of GD among the general young population was 7.6% (95% confidence interval; 6.6-8.7%) for males and 2.5% (1.9-3.2%) for females, with a combined prevalence of 5.1% (4.5-5.8%). Discussion and Conclusion: The GAMES test shows high validity and reliability for screening of ICD-11 GD. The estimated prevalence of 5.1% among the general young population was comparable to the pooled estimates of young people globally. [ABSTRACT FROM AUTHOR]

Abstract Background Hazardous alcohol consumption is a leading modifiable cause of mortality and morbidity among young people. Screening and brief intervention (SBI) is a key strategy to reduce alcohol-related harm in the community, and web-based approaches (e-SBI) have advantages over practitioner-delivered approaches, being cheaper, more acceptable, administrable remotely and infinitely scalable. An efficacy trial in a university population showed a 10-minute intervention could reduce drinking by 11% for 6 months or more among 17-24 year-old undergraduate hazardous drinkers. The e-SBINZ study is designed to examine the effectiveness of e-SBI across a range of universities and among Māori and non-Māori students in New Zealand. Methods/Design The e-SBINZ study comprises two parallel, double blind, multi-site, individually randomised controlled trials. This paper outlines the background and design of the trial, which is recruiting 17-24 year-old students from seven of New Zealand's eight universities. Māori and non-Māori students are being sampled separately and are invited by e-mail to complete a web questionnaire including the AUDIT-C. Those who score >4 will be randomly allocated to no further contact until follow-up (control) or to assessment and personalised feedback (intervention) via computer. Follow-up assessment will occur 5 months later in second semester. Recruitment, consent, randomisation, intervention and follow-up are all online. Primary outcomes are (i) total alcohol consumption, (ii) frequency of drinking, (iii) amount consumed per typical drinking occasion, (iv) the proportions exceeding medical guidelines for acute and chronic harm, and (v) scores on an academic problems scale. Discussion The trial will provide information on the effectiveness of e-SBI in reducing hazardous alcohol consumption across diverse university student populations with separate effect estimates for Māori and non-Māori students. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12610000279022

Background: Gaming Disorder (GD) is a newly listed addictive disorder in ICD-11. Its diagnosis requires the presence of (i) impaired control (IC) over gaming, (ii) increasing priority (IP) over other activities, (iii) continued gaming (CG) despite adverse consequences, (iv) demonstrable impairment (IM), and (v) a course of 12 months or more. This presentation will describe the nature and characteristics of GD, how it compares with substance use disorders in ICD-11, and will present the findings from a four-country study which aimed to identify key features that contribute to the assessment and diagnosis of GD. Method: A sample of 796 adults who played online games for at least three hours per week was recruited from Australia, Canada, the United States and the United Kingdom. Participants completed a survey of GD features (76 items) and measures of duration and frequency of gaming. After exploratory factor analysis, GD domains were appraised by Item Response Theory (IRT) analyses. Results: Items which reflected the more severe end of the IC spectrum included (i) gaming despite others pleading, and (ii) spending more money than was affordable (IRT coefficients >0.5), whereas longer duration or more frequent gaming reflected the milder end (~0.2). IP items reflecting more severe gaming included (i) losing an important relationship and (ii) forgetting to eat (0.6-0.7). For CG this was continued gaming despite evident problems with family or friends (0.6). The most severe IM items included (i) trouble at school or work and (ii) lost relationships (0.9-1.0), whereas sleep disturbance and physical pain represented the less severe end (0.5). Conclusions: Within the GD symptom domains, there is a wide spectrum of severity. Caution must be taken in devising screening and diagnostic instruments not to include items that are commonly seen across a spectrum of videogamers in order to avoid diagnostic hyperinflation. [ABSTRACT FROM AUTHOR]

A coherent framework for addressing risk arising from new technologies is needed. In proposing a framework of broad application and future focus, where empirical evidence is scarce, reliance on strong theory becomes all the more important. Some technologies are more prone to excessive engagement than others (i.e. more addictive). Some users are also more susceptible to excessive engagement than others. Impulsivity theory emphasises the importance of reinforcement magnitude in determining the risk associated with a new technology, and that an individual's sensitivity to reinforcement (reward drive) and capacity to inhibit previously reinforced behaviour (rash impulsiveness) determines their susceptibility to problematic engagement. Online gaming provides a good example of how such theory can be applied to facilitate intervention efforts and develop policy. [ABSTRACT FROM AUTHOR]

Why Evidence-Based Guidelines Are Urgently Needed Mental, neurological, and substance use (MNS) disorders are highly prevalent and are responsible for 14% of the global burden of disease expressed in disability-adjusted [...]

In this paper the authors discuss the meaning of social marketing and its essential differences from "conventional" marketing. Further, by reference to a current campaign which seeks to maximize adoption by medical general practitioners of an "early intervention" package to prevent development of alcohol-related problems in patients, the authors discuss the merits of the application of social marketing principles to such a public health campaign. The difficulties experienced in both the application of social marketing principles to this campaign and in empirically assessing the effectiveness of this and similar campaign and in empirically assessing the effectiveness of this and similar campaigns are also discussed. The authors conclude that, although the validity of social marketing as a theoretical construct is unimpeachable, there is much further work to be done in establishing empirically the effectiveness of the application of the principles of social marketing as a social change strategy. [ABSTRACT FROM AUTHOR]

It has already been more than three years since it was decided that gaming disorder be included in ICD-11. At that time, there were objections from the game industry and some related academia, and it was a social issue. However, such discussions were not conducted in scientific ways or produced productive conclusions. This is also due to the lack of a basis for the biological pathophysiology of behavioral addiction, but there was also a limitation that the opposition originated from the interests of the digital media industry such as games. In any case, health problems caused by excessive use of games are an existential problem, so mental and behavioral health experts in each country, including the WHO consultation team, have continued to make their own efforts to develop the diagnosis, prevention, and treatment system of gaming disorders. In particular, in the area of the diagnostic system, the WHO consultation team conducted well-designed research internationally, and standardized diagnostic interview tools were almost developed. In addition, a similar type of behavioral addiction-related monitoring system to the Global Information System on Alcohol and Health is being discussed. In addition, there are cases in which prevention policies and responses to game addiction are well underway in various countries such as Indonesia, Japan, and Switzerland. The WHO Symposium introduces these efforts, and aims to help behavioral addiction experts from each country share information with each other and effectively cope with game addiction problems. [ABSTRACT FROM AUTHOR]