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Objectives: The use of image and performance enhancement drugs (IPEDs) in recreational sport represents an emerging public health and societal problem. The present study investigated whether self-affirmation changed exercisers' intentions to use IPEDs, via the effects of mental construal and message acceptance. Method: Sixty-eight exercisers who self-reported IPEDs use participated in the study and were randomly assigned to either a self-affirmation or a control group. All participants read a health-related message about the 10 consequences of IPEDs and subsequently completed a survey measuring message acceptance, mental construal, doping intentions and IPEDs-related social cognitive variables. Results: There were no significant differences between the self-affirmed and the control groups. Hierarchical linear regression analysis further showed that message acceptance, subjective norms, and situational temptation were significantly associated with intentions to use IPEDs. Conclusion: Our findings raise the possibility that for recreational exercisers IPED's use is seen mostly as a health-related matter than a socio-moral transgression.

A growing body of work indicates that sleep problems are associated with antisocial behaviour in young people. This opens up the opportunity for interventions that improve sleep to reduce antisocial behaviour. Brown et al. (2022) provide important new leads that can help to target interventions, highlighting that the relationship may be most relevant to aggressive offending and that it is consistent across adolescence and young adulthood. The within-individual design adopted in this study has a number of methodological strengths. This commentary evaluates the effectiveness of the approach in terms of accounting for confounding effects and addressing temporal ordering. Directions for future research to build on the target paper are considered.

Mental health inequalities along ethnic and socioeconomic groupings are well documented. The extent to which these observed inequalities are genuine or reflect measurement differences is unclear. In the current study we sought to investigate this in a large population-based sample of children and adolescents in the United Kingdom. The main objective of the study was to establish whether the parent-report Strengths and Difficulties Questionnaire (SDQ) was invariant across ethnicity and socioeconomic status groupings at six time points from 3 to 17 years (maximum N = 17,274). First, we fitted a series of confirmatory factor analysis models to the data and confirmed that the five-factor structure (emotional problems; peer problems; conduct problems; hyperactivity/inattention; and prosocial behaviour) had acceptable fit at ages 5, 7, 11, and 14 years. Next, we tested configural, metric, and scalar invariance at these time points and demonstrated scalar invariance across household income, parent highest education, and ethnicity categories. The five-factor structure did not fit well at ages 3 and 17 years; therefore invariance was not tested at these ages. These findings suggest the parent-report SDQ can be used to measure socioeconomic and ethnic inequalities in mental health from ages 5–14 years but more consideration is required outside these ages.

Adverse childhood experiences (ACEs) commonly co-occur, and researchers often estimate their impact using a cumulative risk approach. The person-centered approach offers another approach to operationalize the co-occurrence of ACEs. This study aims to estimate latent classes of ACEs in a sample of U.K. children, examine their relationship with emotional and behavioral problems, and compare the explanatory value of the latent classes to cumulative risk scores. Data were collected among a general population sample of British 10-year-old children extracted from the U.K. Household Longitudinal Study ( N = 601). Seven items characterized ACEs, comprising parent-report physical discipline, emotional abuse, supervisory neglect, maternal psychological distress, child-report parental educational disinterest, bullying victimization, and adverse neighborhood. Outcome measures were derived from the self-report Strengths and Difficulties Questionnaire including total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. Latent class analysis resulted in a three-class solution: low ACEs, household challenges, and community challenges. Compared to the other classes, the community challenges class scored substantially worse on total difficulties, emotional symptoms, and peer subscales. The cumulative risk score was associated with all outcomes except prosocial behavior. Cumulative risk models accounted for a larger proportion of variance compared with the latent class models, except for peer problems which the person-centered model explained better. This study confirms that ACEs are associated with impairment in child functioning, and that both person-centered and cumulative risk approaches can capture this relationship well. Specifically, the person-centered approach demonstrated how co-occurring risk factors in the community challenges class produced particularly poor internalizing outcomes.

Objective\ud \ud To evaluate an interactive group psychoeducation programme for children treated for leukaemia.\ud \ud \ud \ud Methods\ud \ud A longitudinal randomised controlled study across four UK hospitals with an immediate (N=26) and delay control group (N=32). The intervention covered the pathophysiology of leukaemia, its treatment, side effects and the importance of positive health behaviours. Primary outcomes were parent-reported child health related quality of life (HRQoL) and behavioural difficulties. Secondary outcomes were child-reported HRQoL, cancer-specific HRQoL, child confidence, caregiver burden, and treatment anxiety. Measures were completed pre- and immediately post-intervention, and at 13 and 26-weeks follow-up. Change over time was analysed using multilevel modelling. Acceptability questionnaires rated the intervention on benefits, recommendations, and barriers to participation.\ud \ud \ud \ud Results\ud \ud The intervention significantly improved parent-reported child HRQoL but did not have a significant effect on other outcomes. Acceptability of the intervention was high.\ud \ud \ud \ud Conclusions\ud \ud This study provides initial evidence that interactive group psychoeducation is acceptable to families and improves HRQoL in children with leukaemia. Difficulties with recruitment removed power to detect effect sizes that are plausible for psychoeducational interventions.\ud \ud \ud \ud Practise implications\ud \ud Further studies to explore the potential of psychoeducation to improve outcomes for children with leukaemia and an examination of barriers to participation within this population are warranted.\ud \ud \ud \ud Data availability statement\ud \ud The data that support the findings of this study is not publicly available as it contains potentially identifiable and sensitive information about participants. Data is available from the corresponding author upon request.

It is expected that the detection of peripheral objects, a key visual task for safe driving, is affected by cognitive distraction, by observer age and by the manner in which action is undertaken following detection. An experiment was conducted to measure these effects, using a fixation cross and peripheral target discs displayed on a screen. The experiment was repeated with young (18–25 years) and old (60+years) age groups, with six distraction tasks, and with simple and choice response modes. The older group was found to respond more slowly than the younger group and detected fewer targets. The results suggest that distraction impairs detection, with the degree of impairment depending on the difficulty of the distraction task. Participants were generally slower at responding with choice response but this did not lead to a greater number of missed targets. Where lighting standards are informed by the ability to detect peripheral hazards, the research should represent older people, choice responses and impaired detection due to distraction.

Objective\ud \ud Novice driver crash risk diminishes steeply over the first few months of driving. We explore the characteristics of driving over this period to identify behaviours that might underlie this change in risk.\ud \ud \ud \ud Methods\ud \ud We conducted a cross-sectional study of 1456 UK drivers aged 17–21 within six months of gaining their licence. We examined how various forms of driving exposure, such as weekly mileage and driving at night, were related to duration of licencing. We explored the factor structure of the Early Driving Development Questionnaire (EDD-Q); a new instrument designed to measure safety relevant attitudes and behaviours in recently qualified drivers. We examined the relationship of the derived factors to licence duration.\ud \ud \ud \ud Results\ud \ud There was little evidence that greater exposure to risky driving situations was more common in those with shorter licence durations. Exploratory and Confirmatory Factor Analyses identified EDD-Q factors measuring risky style (12 items), skill deficiencies (8 items) and driving confidence (4 items). Licence duration was positively correlated with both risky style and confidence, with these relationships stronger for older novices. Licence duration was also negatively related to skill deficiencies (i.e., positively correlated with perceived driving skill development): this relationship was stronger in younger novices.\ud \ud \ud \ud Conclusions\ud \ud The negative correlation between license duration and skill deficiencies is consistent with the observation of decreasing novice crash involvement as experience is gained. The EDD-Q offers a new brief measure of aberrant driving that is specifically tailored for newly qualified drivers.

Background: Interventions that include action planning are more effective than others to reduce aggression among at-risk adolescents. However, they often include other behaviour change techniques. The efficiency of interventions could be improved if action planning on its own could reduce aggression. The current study investigates the effect of a volitional help sheet (VHS) that prompts the creation of action plans to manage anger in response to specific or generic anger triggers. It was hypothesised that participants completing the VHS would have lower levels of aggression and anger at follow-up. The moderation effects of violent intentions, callous-unemotional traits and negative urgency were also tested.Methods: One hundred adolescents (10-17 years old) with behavioural problems were recruited and randomised to three conditions: specific anger triggers, generic anger trigger or active control. An active control group was used to blind participants and teachers to group allocation. Self-reported data on anger and aggression was collected at baseline, one month and six months after intervention at the participants’ schools. This trial was registered at www.clinicaltrials.gov (identification number NCT03693209).Results: Eighty-one participants completed at least one follow-up and were included in the analysis. Neither VHS had a significant effect on anger or aggression overall, but moderator effects were found; both VHS were effective for participants with high callous-unemotional traits and low negative urgency. There were no differences between specific and generic triggers.Conclusions: Adolescents with high callous-unemotional traits have traditionally been seen as a difficult population to treat. The VHS is a cost-effective technique to reduce aggression in this population which is easy to implement. Future studies are needed to identify which behaviour change techniques are needed for other groups.

BackgroundSleep apnea is one of the most common sleep disorders and it is related to multiple negative health consequences. Previous studies have shown that sleep apnea is influenced by genetic factors. However, studies have not investigated the genetic and environmental influences of symptoms of sleep apnea in young adults. Furthermore, the underpinnings of the relationship between apnea symptoms and internalizing/externalizing problems are unknown. The objectives of this study were to estimate the magnitude of: (1) genetic and environmental influences on self-reported apnea symptoms; (2) the relationship between self-reported apnea symptoms and internalizing/externalizing traits; (3) genetic and environmental influences on the associations between self-reported apnea symptoms, internalizing behaviors and externalizing behaviors.MethodsIn a twin/sibling study, univariate and multivariate models were fitted to estimate both individual variance and sources of covariance between symptoms of sleep apnea and internalizing/externalizing behaviors.ResultsOur results show that genetic influences account for 40% of the variance in sleep apnea symptoms. Moreover, there are modest associations between depression, anxiety and externalizing behaviors with apnea symptoms (ranging from r = 0.22–0.29). However, the origins of these associations differ. For example, whereas most of the covariation between symptoms of depression and sleep apnea can be explained by genes (95%), there was a larger role for the environment (53%) in the association between symptoms of anxiety and sleep apnea.ConclusionsGenetic factors explain a significant proportion of variance in symptoms of apnea and most of the covariance with depression.

Intelligent Speed Assistance (ISA) offers a technological solution to reduce speeding that will become more common in vehicles in the short to medium term. Many implementations allow drivers to override the system’s speed control and minimising such interventions can optimise safety benefits. This paper aims to inform behaviour change interventions to reduce ISA overriding targeted to drivers as they obtain vehicles fitted with ISA. We explore the beliefs underlying intentions to override ISA to exceed the speed limit in drivers with limited ISA experience using the Theory of Planned Behaviour. In a sample of 121 drivers (mean age 36 years), regression modelling showed that attitudes strongly predicted intentions with an additional contribution from subjective norms but not perceived behavioural control. Behavioural beliefs underlying attitudes addressed overriding ISA for (1) responsibly controlling the car to minimise crash risk and (2) reducing journey times and enjoying fast driving. Salient normative beliefs focussed on groups that would disapprove of overriding ISA including emergency services and parents. We discuss how these beliefs might be addressed in interventions to maximise the safe adoption of ISA.

Objective This systematic review and meta-analysis evaluated the effectiveness of psychoeducational interventions in improving quality of life (QoL) for children with chronic conditions. Methods We identified 25 randomized controlled trials of psychoeducational interventions for children with chronic conditions that reported a QoL outcome and were published 1980–2018. Due to small numbers of interventions in other chronic conditions, comparisons between chronic conditions were limited to 17 studies addressing interventions for asthma and diabetes. Results Psychoeducational interventions were associated with a small, statistically significant improvement in QoL (standardized mean difference = 0.14; 95% confidence interval: 0.06–0.23). The effect was significantly larger for asthma interventions compared to diabetes interventions, and in interventions delivered to younger (under 12 years) rather than older children (12 years and over). Conclusions These results suggest that currently evaluated psychoeducational interventions improve QoL for children with asthma but not for children with diabetes. Children with diabetes may require tailored interventions with additional components alongside psychoeducation. Further intervention studies are needed to generalize to other conditions and to draw conclusions about which settings and modes of delivery are most effective in improving QoL.

Adverse childhood experiences (ACEs) have been associated with causes of early death, addiction, mental illness, and poor health. However, studies investigating underlying mechanisms often rely on cross-sectional data or inappropriate study designs. To prevent the negative sequelae associated with ACEs, it is imperative to understand the mechanisms underlying the prospective relationship. The aim of this present review was to provide a synthesis and critical evaluation of the literature regarding the mechanisms underlying this relationship. A search in SCOPUS, MedLine via Ovid, PsycINFO via Ovid, and Web of Science was performed. Studies that utilised a prospective design assessing ACEs in childhood or adolescence, outcomes in adulthood, and analysed either a mediating or moderating relationship were included, unless the study relied on informant report or official records to assess childhood maltreatment types of ACEs. Twenty-two studies examining a longitudinal mediation or moderation were included in a systematic review. A review of the studies found links to psychopathology, delinquent and problem behaviours, poor physical health, and poor socioeconomic outcomes. A clear image of underlying mechanisms is not forthcoming due to (a) poor study design in relation to assessing longitudinal mechanisms, and (b) heterogeneity in the adversities, mechanisms, and outcomes assessed. Based on the review, several gaps and limitations are highlighted and discussed.

Objective: Acts of relational aggression cause significant social and personal costs, and interventions are needed to reduce relational aggression in community as well as clinical settings. The present study used a persuasive message coupled with a self-affirmation manipulation to reduce relational aggression among a group of adolescents recruited from the community. Method: Participants (N = 503) all received a persuasive message designed to reduce relational aggression and were randomly allocated to participate in a self-affirming or nonaffirming task. Results: Findings demonstrated a significant reduction in relational aggression over 1-month among participants who were randomized to the self-affirmation condition (d = −0.50) in contrast with a small increase in relational aggression in the control condition (d = +0.20). Contrary to expectations, these effects were not mediated by message processing or changes in interpersonal affect. Conclusion: The present study used the novel approach of asking pupils to self-affirm following a persuasive message and showed that it was possible to reduce relational aggression. Self-affirmation shows considerable promise as a means of augmenting the delivery of interventions to reduce antisocial behavior in addition to other social and health behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.

The present study empirically examined a novel dual process model of self-reported aberrant driving behaviour in young and novice drivers that incorporates both impulsive and self-regulatory processes. Four hundred and nine participants aged 18-25 years (M age = 21.18 years, SD = 2.12; 65.5% females) completed online questionnaires on impulsivity, normlessness, sensation seeking, emotion and self-regulation, and attitudes towards driving safety. Path analysis showed that motor impulsivity was associated with self-reported driving violations, errors, and lapses, whereas sensation seeking was uniquely directly associated with self-reported errors. Non-planning impulsivity, normlessness and sensation seeking had significant indirect effects on self-reported errors, via self-regulation. Finally, motor impulsivity and normlessness had a significant indirect effect on self-reported violations, errors and lapses, via attitudes to driving safety. Based on our findings we suggest that a dual-process approach is relevant to the study of aberrant driving behaviour in young and novice drivers, and the results of the present study have important implications for initiatives to promote driving safety in this population.

Objectives: While there is a growing body of literature on crash risks in the developed world, little is known about how well these models apply to motoring in developing countries, the context in which the majority of road traffic fatalities occur. This qualitative study explores factors perceived to influencinge crash risks for commercial drivers in Ghana. \ud \ud Method: Twenty commercial drivers of varied ages and experience were sampled from 7 major lorry terminals in 3 regions (Greater Accra, Ashanti, and Volta) of Ghana. Data were collected through semi-structured interviews. \ud \ud Results: The participants identified some issues that are shared with drivers in the developed world, though moderated by the Ghanaian context. These included working pressures (e.g., fatigued driving), speeding, distracted driving and inadequate vehicle maintenance. Other factors identified by the participants are infrequently less frequently considered in research addressing driving behavior in developed countries. These included aggressive competition over passengers and corruption (e.g., improper licensing practices) among others. \ud \ud Conclusion: The findings have implications for building a research base to support the development of road safety policy and interventions in developing countries.

Little is known about how well models of driver crash risks from the developed world apply to motoring in African low and middle income countries. The Manchester Driver Behaviour Questionnaire (DBQ; Reason et al., 1990), which distinguishes deliberate violations of accepted safety practices and unintentional errors in its measurement of risky driving has been demonstrated to measure crash liability across a range of cultures. However, its applicability to Africa is currently unknown. The present study examines the psychometric properties of the DBQ in a sample of 453 Ghanaian drivers. A combination of exploratory and confirmatory factor analyses produced a 24 item 2-factor model of the DBQ with mainly violation items loading onto one factor and error items loading onto the other. Both violations and errors were independently correlated with self-reported crash involvement and violations correlated with self-reported traffic citations. Higher frequencies of violations and errors were reported by the Ghanaian sample than typically observed in the UK. The findings are consistent with the usefulness of the DBQ in characterising behaviours underlying crash risk in Ghana. The extent to which these risky behaviours may be targeted by behavioural, enforcement and engineering interventions is discussed.

BackgroundImplementation intentions link triggers for self-harm with coping skills and appear to create an automatic tendency to invoke coping responses when faced with a triggering situation.AimsTo test the effectiveness of implementation intentions in reducing suicidal ideation and behaviour in a high-risk group.MethodTwo hundred and twenty-six patients who had self-harmed were randomised to: (a) forming implementation intentions with a ‘volitional help sheet’; (b) self-generating implementation intentions without help; or (c) thinking about triggers and coping, but not forming implementation intentions. We measured self-reported suicidal ideation and behaviour, threats of suicide and likelihood of future suicide attempt at baseline and then again at the 3-month follow-up.ResultsAll suicide-related outcome measures were significantly lower at follow-up among patients forming implementation intentions compared with those in the control condition (ds>0.35). The volitional help sheet resulted in fewer suicide threats (d = 0.59) and lowered the likelihood of future suicide attempts (d = 0.29) compared with patients who self-generated implementation intentions.ConclusionsImplementation intention-based interventions, particularly when supported by a volitional help sheet, show promise in reducing future suicidal ideation and behaviour.

Dimensions of irritability and defiant behavior, though correlated within the structure of ODD, convey separable developmental risks through adolescence and adulthood. Irritability predicts depression and anxiety, whereas defiant behavior is a precursor to antisocial outcomes. Previously we demonstrated that a bifactor model comprising irritability and defiant behavior dimensions, in addition to a general factor, provided the best-fitting structure of ODD symptoms in five large datasets. Herein we extend our previous work by externally validating the bifactor model of ODD using multiple regression and multivariate behavior genetic analyses. We used parent ratings of DSM IV ODD symptoms, and symptom dimensions for ADHD (i.e., inattention and hyperactivity−impulsivity), conduct disorder (CD), depression/dysthymia, and generalized anxiety disorder (GAD) from 846 6−18-year-old twin pairs. We found that the ODD irritability factor was associated only with depression/dysthymia and GAD and the ODD defiant behavior factor was associated only with inattention, hyperactivity−impulsivity, and CD, whereas the ODD general factor was associated with all five symptom dimensions. Multivariate behavior genetic analyses found all five symptom dimensions shared genetic influences in common with the ODD general, irritability, and defiant behavior factors. In contrast, the defiant behavior factor shared genetic influences uniquely with inattention and hyperactivity−impulsivity, whereas the irritability factor shared genetic influences uniquely with depression/dysthymia and GAD, but not vice versa. This suggests that genes that influence irritability in early childhood also predispose to depression and anxiety in adolescence and adulthood. These multivariate genetic findings also support the external validity of the three ODD dimensions at the etiological level. Our study provides additional support for subtyping ODD based on these symptom dimensions, as in the revisions in the ICD-11, and suggests potential mechanisms underlying the development from ODD to behavioral or affective disorders.

Background music is often present in gambling environments and has been found to influence gamblers’ behaviour. However, little is known about gamblers’ perception of environmental influences, including music, and whether gamblers believe that such influences can impact upon their gambling behaviour. An online questionnaire was administered to 136 gamblers to probe the perceived effects of gambling operator-selected and self-selected music on the cognitive, emotional, and behavioural aspects of gambling. In general, few respondents believed that music influences aspects of gambling participation. However, the analysis indicated that some gamblers, particularly those classified as moderate-risk and problem gamblers, self-select music to accompany gambling, and analysis of free-text responses indicated that this was undertaken to match their musical preferences or out of habit. Some gamblers believed that self-selected music promoted positive moods and supported concentration. Furthermore, some poker players thought that music may serve unique functions such as helping them to mask outward emotions and filling time between games. This study demonstrates that self-selected music is sometimes purposefully used by gamblers to support the cognitive and emotional aspects of gambling. However, as few gamblers believed that music could influence the cognitive, emotional, and behavioural aspects of gambling, this research reveals a disparity between subjective opinions and objective evidence, as gathered in published empirical laboratory experiments. This indicates the need to improve gamblers' awareness of the potential influence of background music on the gambling experience.Résumé Dans les environnements de jeu, il y a souvent une musique de fond, et on a constaté qu’elle influençait le comportement des joueurs. Cependant, on sait peu de choses de la perception qu’ont les joueurs des influences environnementales, notamment la musique, et de leur avis quant aux influences que ces facteurs environnementaux peuvent avoir sur leur comportement de jeu. Un questionnaire en ligne a été soumis à 136 joueurs compulsifs afin de sonder les effets perçus de la musique sélectionnée et choisie par les opérateurs de jeux d’argent, d’une part, et celle choisie par le joueur, d’autre part, sur les aspects cognitifs, émotionnels et comportementaux du jeu. En général, peu de répondants interrogés pensent que la musique influence certains aspects de la participation au jeu. Toutefois, l’analyse a montré que certains joueurs, en particulier ceux classés à risque modéré et à problème, choisissaient eux-mêmes leur musique pour accompagner les jeux de hasard, et l’analyse des réponses en texte libre indiquait que cela était fait pour correspondre à leurs préférences musicales ou par habitude. Certains joueurs étaient d’avis que la musique qu’ils choisissaient eux-mêmes favorisait une humeur positive et la concentration. De plus, certains joueurs de poker étaient d’avis que la musique pouvait potentiellement servir à des fonctions particulières, comme les aider à masquer leurs émotions et à combler le temps entre les parties. Cette étude démontre que les joueurs utilisent parfois délibérément de la musique qu’ils ont eux-mêmes choisie pour soutenir les aspects cognitifs et émotionnels du jeu. Cependant, comme peu de joueurs étaient d’avis que la musique pouvait influencer les aspects cognitifs, émotionnels et comportementaux du jeu, cette recherche révèle une disparité entre les opinions subjectives et les preuves objectives recueillies dans le cadre d’expériences empiriques de laboratoire publiées. Cette étude montre qu’il est nécessaire de sensibiliser davantage les joueurs à l’influence potentielle de la musique de fond sur l’expérience de jeu.

Highlights • Newly qualified drivers’ crash risk declines over the first three months of independent driving. • The current study aimed to better understand the factors underpinning this safety improvement. • A longitudinal qualitative design identified possible contributing factors to this decline in crash risk. • Developments in skill, thrill-seeking and feelings of driving status were reported. • Implications for research and application are discussed., Drivers are at high crash risk when they begin independent driving, with liability decreasing steeply over the first three months. Their behavioural development, and other changes underlying improved safety are not well understood. We adopted an innovative longitudinal qualitative design, with thirteen newly qualified drivers completing a total of 36 semi-structured interviews, one, two and three months after acquiring a full UK driving license. The interviews probed high-risk factors for new drivers, as well as allowing space for generating novel road safety issues. Analysis adopted a dual deductive and inductive interpretative thematic approach, identifying three super-ordinate themes: (1) Improvements in car control skills and situation awareness; (2) A reduction in the thrill of taking risks when driving against a background of generally increasing driving speed; (3) Early concerns about their social status in the eyes of other road users during the early stages of driving, which may put pressure on them to drive faster than they felt comfortable with. The study provides important new leads towards understanding how novice driving becomes safer over the first few months of driving, including how well-studied concepts of driving skill and style may change during development of independent driving, and bringing the less rigorously studied concept of social status into focus.

Music is ubiquitous in retail and commercial environments, with some managers believing that music can enhance the customer experience, increase footfall and sales and improve consumer satisfaction. Casino gambling is popular in the United Kingdom and anecdotal evidence suggests that music is often present. However, little is known about the rationale for music use from the perspective of casino managers. In this study semi-structured interviews were conducted with five casino managers to establish their motivations for utilising music, the factors informing their choice of music and the extent to which music is used with the intention of influencing gambling behaviour. Results showed that casino managers utilised two types of music-recorded background music, often sourced via external music supply companies and live music. Live music was often situated away from the gaming floor and used primarily to accompany participation in non-gambling activities. Recorded background music was not used with the direct aim of influencing customers' gambling behaviour, but to create the right atmosphere for gambling and to promote certain moods within the casinos. To achieve these aims casino managers manipulated the tempo, volume and genre of the recorded background music. Casino managers also reported that some gamblers listen to music via portable music players, possibly with the intention of customising their gambling experience. This study is unique as it has provided a first-hand account of casino managers' implicit theories with regards to why they utilise music and the roles which music is considered to fulfil in casinos.

Acts of self-harm are not routinely tracked in Malaysia. The present study investigates the prevalence of self-harm in Kuala Lumpur, Malaysia, over a 7-year period. The aims were to: (a) assess the prevalence of self-harm; (b) examine any changes over a period of 7 years, and (c) identify correlates of methods of self-harm. Data were extracted from the hospital records of Kuala Lumpur Hospital to review trends in self-harm between 2005 and 2011. There were 918 episodes of self-harm across the 7-year period, with a significant peak in 2007-2009. The average rate of self-harm (7.7 per 100,000 population per year) was similar or lower than the rate of suicide (6-8 or 8-13 per 100,000) suggesting that genuine cases of self-harm are often attributed to other causes. Nevertheless, over-representation of young people, women and Indians suggest areas in which resources to prevent self-harm might usefully be targeted. Estimating rates of self-harm are fraught with problems and further research is needed to understand the economic and cultural barriers around seeking treatment for self-harm, reporting self-harm and classifying self-harm.

PURPOSE: Smoking is a major cause of lung cancer, and continued smoking may compromise treatment efficacy and quality of life (health-related quality of life (HRQoL)) in patients with advanced lung cancer. Our aims were to determine (i) preference for treatments which promote quality over length of life depending on smoking status, (ii) the relationship between HRQoL and smoking status at diagnosis (T1), after controlling for demographic and clinical variables, and (iii) changes in HRQoL 6 months after diagnosis (T2) depending on smoking status. METHODS: Two hundred ninety-six patients with advanced lung cancer were given questionnaires to assess HRQoL (EORTC QLQ-C30), time-trade-off for life quality versus quantity (QQQ) and smoking history (current, former or never smoker) at diagnosis (T1) and 6 months later (T2). Medical data were extracted from case records. RESULTS: Questionnaires were returned by 202 (68.2 %) patients at T1 and 114 (53.3 %) at T2. Patients favoured treatments that would enhance quality of life over increased longevity. Those who continued smoking after diagnosis reported worse HRQoL than former smokers or those who never smoked. Smoking status was a significant independent predictor of coughing in T1 (worse in smokers) and cognitive functioning in T2 (better in never smokers). CONCLUSIONS: Smoking by patients with advanced lung cancer is associated with worse symptoms on diagnosis and poorer HRQoL for those who continue smoking. The results have implications to help staff explain the consequences of smoking to patients.

Previous research on the association between socioeconomic status (SES) and child and adolescent antisocial behaviour has produced mixed findings showing variation in the strength of association. This systematic review and meta-analysis aimed to summarise evidence on the relationship between socioeconomic status and broadly conceptualised antisocial behaviour, investigating variation across a range of antisocial subtypes and other potential moderators, including age, sex and informant. We identified 133 studies containing data suitable for effect size calculation, and 139 independent effect sizes were analysed (total N=339868). The global meta-analysis showed that lower family socioeconomic status was associated with higher levels of antisocial behaviour. Moderation analyses revealed this relationship was stronger where callous–unemotional traits were the outcome, and where antisocial behaviour was reported by parents or teachers rather than self-reported. The relationship between family SES and antisocial behaviour, however, was independent of higher-level constructs such as national income inequality. These results indicate that SES can be considered a robust correlate of broadly conceptualised antisocial behaviour but the strength of this relationship may depend on the antisocial subtype under investigation and the design of the study.

Background: Parents and teachers often disagree on the presence of Oppositional Defiant Disorder (ODD) in children. It has been argued that ODD should be treated as an informant-specific disorder. This study compared the characteristics of children identified with ODD by parent- and teacher-report. Methods: We used the 1999 British Child and Adolescent Mental Health Survey, including more than 10000 observations aged 5-15 years, to investigate symptom profiles, risk factors, comorbidities and three-year outcomes of parent- and teacher-reported ODD. Results: Parents and teachers poorly agreed on ODD diagnosis. Parent-reported ODD was more strongly associated with a concurrent anxiety disorder at time1 and a successive diagnosis of ODD at time2. Beyond these differences, parent- and teacher- reported ODD showed similar symptom profiles, risk factors, comorbidities, and outcomes. Conclusions: Children identified by parent-report and teacher-report share more similarities than differences in the characteristics of their disorder. This does not support the formation of informant-specific ODD disorders.

Dimensions of irritability and defiant behavior, though correlated within the structure of ODD, convey separable developmental risks through adolescence and adulthood. Irritability predicts depression and anxiety, whereas defiant behavior is a precursor to antisocial outcomes. Previously we demonstrated that a bifactor model comprising irritability and defiant behavior dimensions, in addition to a general factor, provided the best-fitting structure of ODD symptoms in five large datasets. Herein we extend our previous work by externally validating the bifactor model of ODD using multiple regression and multivariate behavior genetic analyses. We used parent ratings of DSM IV ODD symptoms, and symptom dimensions for ADHD (i.e., inattention and hyperactivity-impulsivity), conduct disorder (CD), depression/dysthymia, and generalized anxiety disorder (GAD) from 846 6-18-year-old twin pairs. We found that the ODD irritability factor was associated only with depression/dysthymia and GAD and the ODD defiant behavior factor was associated only with inattention, hyperactivity-impulsivity, and CD, whereas the ODD general factor was associated with all five symptom dimensions. Multivariate behavior genetic analyses found all five symptom dimensions shared genetic influences in common with the ODD general, irritability, and defiant behavior factors. In contrast, the defiant behavior factor shared genetic influences uniquely with inattention and hyperactivity-impulsivity, whereas the irritability factor shared genetic influences uniquely with depression/dysthymia and GAD, but not vice versa. This suggests that genes that influence irritability in early childhood also predispose to depression and anxiety in adolescence and adulthood. These multivariate genetic findings also support the external validity of the three ODD dimensions at the etiological level. Our study provides additional support for subtyping ODD based on these symptom dimensions, as in the revisions in the ICD-11, and suggests potential mechanisms underlying the development from ODD to behavioral or affective disorders.

In 671 mother–child (49% male) pairs from an epidemiological birth cohort, we investigated (a) prospective associations between DNA methylation (at birth) and trajectories (ages 7–13) of oppositional defiant disorder (ODD), and the ODD subdimensions of irritable and headstrong; (b) common biological pathways, indexed by DNA methylation, between ODD trajectories and attention deficit hyperactivity disorder (ADHD); (c) genetic influence on DNA methylation; and (d) prenatal risk exposure associations. Methylome‐wide significant associations were identified for the ODD and headstrong, but not for irritable. Overlap analysis indicated biological correlates between ODD, headstrong, and ADHD. DNA methylation in ODD and headstrong was (to a degree) genetically influenced. DNA methylation associated with prenatal risk exposures of maternal anxiety (headstrong) and cigarette smoking (ODD and headstrong).