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Abstract
Background and Objectives
As the gaming industry experiences exponential growth, concerns about gaming disorder (GD) also grow. It is crucial to understand the structural features of games that can interact with individual characteristics of gamers to promote GD. This research consolidates the views of an international body of panelists to create an assessment tool for gauging the addictive potential of distinct games.
Methods
Utilizing the iterative and structured Delphi method, an international panel of researchers, clinicians, and people with lived experience were recruited to offer a multifaceted viewpoint on the addictive risk associated with specific structural elements in games. Two rounds of surveys facilitated consensus.
Results
The panel initially included 40 members—ten from research, eight from clinical settings, and 22 with lived experiences. The second round included 27 panelists—seven from research, eight from clinical settings, and 11 with lived experiences. The study identified 25 structural features that contribute to potentially addictive gaming patterns.
Discussion and Conclusions
Consensus was found for 25 features, which were distilled into a 23-item evaluation tool. The Saini-Hodgins Addiction Risk Potential of Games Scale (SHARP-G) consists of five overarching categories: ‘Social,’ ‘Gambling-Like Features,’ ‘Personal Investment,’ ‘Accessibility,’ and ‘World Design.’ SHARP-G yields a total score indicating level of addiction risk. A case study applying the scale to three games of differing perceived risk levels demonstrated that that score corresponded to game risk as expected. While the SHARP-G scale requires further validation, it provides significant promise for evaluating gaming experiences and products.
Abstract
Objective
To investigate the rates of problematic mobile phone use (PMPU) and chronotypes in young adults, and examine the associations of PMPU with chronotypes, as well as its gender differences. Furthermore, we explored the moderating role of PER3 gene DNA methylation on the associations.
Methods
From April to May 2019, a total of 1,179 young adults were selected from 2 universities in Anhui and Jiangxi provinces. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and reduced Morningness-Eveningness Questionnaire (rMEQ) were adopted to investigate PMPU and chronotypes in young adults, respectively. Moreover, 744 blood samples were collected to measure PER3 gene DNA methylation. Multivariate logistic regression models were established to analyze the associations between PMPU and chronotypes. Moderating analysis was used to determine whether PER3 gene DNA methylation moderated the relationships between PMPU and chronotypes.
Results
The prevalence of PMPU, morning chronotypes (M-types), neutral chronotypes (N-types), and evening chronotypes (E-types) of young adults were 24.6%, 18.4%, 71.1%, and 10.5%, respectively. Multivariate logistic regression results indicated that PMPU was positively correlated with E-types (OR = 3.53, 95%CI: 2.08–6.00), and the association was observed only in females after stratified by gender (OR = 5.36, 95%CI: 2.70–10.67). Furthermore, PER3 gene DNA methylation has a negative moderating role between PMPU and chronotypes and has a sex-based difference.
Conclusions
This study can provide valuable information for the prevention and control of circadian rhythm disturbance among young adults from the perspective of epidemiology and biological etiology.
Abstract
Background and aims
Ibogaine, an alkaloid extracted from the root of the Tabernanthe Iboga shrub, holds promise in treating addictive disorders. Individuals receiving ibogaine treatment report decreased withdrawal symptoms, cravings, and addiction severity. These changes are often attributed to ibogaine's psychedelic properties: subjectively meaningful, dream-like experiences. Research demonstrates that ibogaine experiences impact multiple social-ecological dimensions and influence addiction and recovery trajectories. No studies have explored the multidimensional experiences of individuals seeking ibogaine treatment for addictions. The current study examines acute and enduring ibogaine experiences at individual, interpersonal, and behavioral health systems levels.
Methods
Fifteen individuals (5 female, 10 male) who received ibogaine treatment at a medical clinic in Ensenada, Mexico completed semi-structured interviews asking about individual, interpersonal, and behavioral health system experiences post-ibogaine within 12 months of ibogaine treatment (Mdn = 169 days). Transcripts were coded and analyzed using a Consensual Qualitative Research approach.
Results
Many participants reported seeking ibogaine treatment after exhausting other addiction services. Outcomes reported following treatment included alleviated cravings and withdrawal symptoms. Participants indicated that ibogaine experiences prompted insight into their addictions and contributed to their recovery. Self-support and disclosing ibogaine experiences to professional and non-professional supporters were important to participants' recovery post-ibogaine.
Conclusions
Intersecting experiences across social-ecological levels had an enduring impact on participants' addiction recovery after ibogaine treatment. Despite negative experiences with behavioral health systems prior to receiving ibogaine treatment, most participants sought the support of mental health professionals post-ibogaine. Findings are informative for mental health professionals and clients interested in ibogaine treatment.
Abstract
Background and aims
Psychedelic-assisted psychotherapy (PAP) is currently being studied as a possible treatment option for multiple disorders. Despite promising safety and efficacy findings, the high costs of the current PAP model makes it questionable if the treatment will be scalable. Non-hallucinogenic psychedelic analogs have been developed as a potential cost-effective alternative, but it is unclear what psychedelic users perceive as a reasonable cost for treatment and whether they would be open to trying a non-hallucinogenic analog.
Methods
We queried a large sample of people using psychedelics naturalistically (N = 1,221) about their attitudes regarding the role of altered states of consciousness in PAP outcomes, costs of treatment, and their openness to trying a non-hallucinogenic psychedelic analog for treating a mental health condition.
Results
We found that most (76%) participants considered altered states of consciousness as very or extremely important to the therapeutic effects of psychedelics. Despite this, most (61%) were also moderately, very, or extremely likely to try a non-hallucinogenic substance if given the chance. Lastly, participants considered approximately $70–80 per hour to be a reasonable cost for various aspects of psychedelic services (e.g., preparation, integration, and dosing sessions).
Conclusions
Participants valued the role of altered states of consciousness in therapeutic changes attributed to psychedelics, but were still open to trying a non-hallucinogenic analog. Notably, the price participants considered to be a reasonable amount for PAP is well below current market projections. Future research is needed to address limitations of the study as well as to identify ways of lowering treatment costs.
Abstract
Background and aims
This qualitative ethnographic study of a psychedelic integration group in the Southeastern United States contributes to an understanding of the role of supportive communities in processing psychedelic experiences. This article proposes the concept of ‘social efficacy’ to capture the importance of social relationships to the efficacy of psychedelics. Social efficacy refers to a source of efficacy that includes not just the immediate social environment in which psychedelics are experienced and processed, but also the broad range of social relationships and political economic and historical contexts that frame their use.
Methods
This year-long ethnographic research project took place with a psychedelic integration group in an urban center in the Southeastern United States. It was based on observation, interviews, and a focus group.
Results
Overall, the participants in the integration group see the group as critical to their ability to effectively process their psychedelic experiences. The group is important as a supportive community of like-minded people that facilitates enduring cognitive and affective transformation.
Conclusions
Community-based non-therapeutic integration groups can play a vital role in the positive integration of psychedelic experiences, improving mental health and quality of life for users. The important role of community-based groups has significance for both the legalization and the medicalization of psychedelics. It highlights the need for safe and legal spaces in which people can talk about their psychedelic experiences and for medical models of efficacy that include social, relational elements.
Abstract
Over the past decade, numerous open-label studies and early clinical trials have shown that psychedelics hold promise for the fast and possibly lasting relief of a wide range of conditions ranging from major depressive disorder, end-of-life anxiety, and obsessive-compulsive disorder to smoking, alcohol use, and eating disorders. Among the questions still to be resolved in this endeavor are questions related to the importance of the metaphysical and phenomenological aspects of the psychedelic experience. Are the hallucinatory experiences engendered by classical psychedelics necessary to their therapeutic action, or could a trip that doesn't go anywhere have the same effect on depression and other conditions? This commentary considers the value of the phenomenological psychedelic experience and asks the larger question, what are any of our phenomenological experiences for?
Abstract
With a surge in critiques levelled against the evidence generated by randomised controlled trials in the study of psychedelic-assisted therapy (PAT), and the legalization of PAT in select jurisdictions such as Australia, and Oregon and Colorado in the United States, we consider what form the real-world evidence of its effects could take. Specifically, we propose to complement individual-level data-gathering (the usual remit of pharmacovigilance procedures) with evidence of PAT's collective effects. Taking our cue from long-standing claims that psychedelics are agents of social transformation, we draw upon the ‘transformative paradigm’ of evaluation, an approach that is itself oriented around social justice and change vis-à-vis marginalised expertise – or what we approach as ‘the grassroots’. To illustrate the potential of such grassroots evaluations, we offer eight examples of social issues that have been discussed in relation to PAT and psychedelics use and, for each, discuss the kinds of expertise that could be brought into the evaluation team and the kinds of questions that could be asked. We further describe our grassroots approach according to three values inspired by the qualities of grass roots themselves: rhizomatic accountability, dark reflexivity, and more-than-human hosting. We argue that these values align with the contemporary experience, practice, and context of PAT. We hope to generate discussion, innovation, and – ultimately – action toward specific study designs that are adequate to the task of documenting, and working with, the transformative potential of psychedelics in contemporary medicalized societies.
Abstract
Aims
Understanding how gambling harm is distributed is essential to inform effective harm reduction measures. This first national Australian study of gambling harm-to-self examined the extent, distribution, risk factors, and health related quality of life (HRQoL) impacts of this harm.
Methods
A Random Digit Dialling sample of 15,000 Australian adults was weighted to key population variables. Key measures included the Gambling Harms Scale-10 (GHS-10), PGSI, SF-6D, gambling behaviours, and demographics. Analyses included ordinal logistic regression.
Results
Amongst gamblers, 14.7% reported harm on the GHS-10, including 1.9% reporting high-level harm. While high-level harm occurred mainly in the problem gambling group (77.3%), other PGSI groups accounted for most of the more prevalent low (98.5%) and moderate (87.2%) harms reported. Proximal predictors of greater harm were use of online gambling and more frequent gambling on electronic gaming machines (EGMs), race betting sports betting, poker, skin gambling, scratchies, and loot box purchasing. Distal predictors were being younger, male, single, Aboriginal or Torres Strait Islander, and speaking a non-English language at home. At the population level, the greatest aggregate HRQoL impacts were amongst lower-risk gamblers, confirming the results of other studies regarding the ‘prevention paradox’.
Conclusions
The distribution of harm across gambler risk groups indicates the need for preventive measures, not just interventions for problem gambling. Reducing harm requires modifying product features that amplify their risk, especially for EGMs, race betting and sports betting that are both inherently risky and widely used. Gambling harm exacerbates health disparities for disadvantaged and vulnerable groups, requiring targeted resources and support.
Abstract
This commentary addresses the potential for a nocebo effect arising from the public discourse on psychedelics, especially considering the increasing interest and engagement with these substances. The resurgence of psychedelics in the public and scientific arenas has led to a proliferation of discussions, both positive and cautionary, about their use. However, an imbalance in this discourse, particularly a focus on potential harms without adequate contextualisation, might inadvertently create a nocebo effect. This effect could manifest in naturalistic settings, influencing individuals' experiences with psychedelics, possibly leading to adverse outcomes. The paper discusses the importance of a balanced narrative that equally acknowledges the benefits and risks associated with psychedelic use. It advocates for comprehensive and transparent information dissemination to enable informed decision-making by users.
