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Journal of Behavioral Addictions
Authors:
Maja Friedemann
,
Celine A. Fox
,
Anna K. Hanlon
,
Daniel Tighe
,
Nick Yeung
, and
Claire M. Gillan

Abstract

Background and aims

Subjective confidence plays an important role in guiding behaviour, especially when objective feedback is unavailable. Systematic misjudgements in confidence can foster maladaptive behaviours and have been linked to various psychiatric disorders. In this study, we adopted a transdiagnostic approach to examine confidence biases in problem gamblers across three levels: local decision confidence, global task performance confidence, and overall self-esteem. The importance of taking a transdiagnostic perspective is increasingly recognised, as it captures the dimensional nature of psychiatric symptoms that often cut across diagnostic boundaries. Accordingly, we investigated if any observed confidence biases could be explained by transdiagnostic symptom dimensions of Anxiety-Depression and Compulsive Behaviour and Intrusive Thought. This approach allows us to gain a more comprehensive understanding of the role of metacognitive processes in problem gambling, beyond the constraints of traditional diagnostic categories.

Methods

Thirty-eight problem gamblers and 38 demographically matched control participants engaged in a gamified metacognition task and completed self-report questionnaires assessing transdiagnostic symptom dimensions.

Results

Compared to controls, problem gamblers displayed significantly elevated confidence at the local decision and global task levels, independent of their actual task performance. This elevated confidence was observed even after controlling for the heightened symptom levels of Anxiety-Depression and Compulsive Behaviour and Intrusive Thought among the problem gamblers.

Discussion

The results reveal a notable disparity in confidence levels between problem gamblers and control participants, not fully accounted for by the symptom dimensions Anxiety-Depression and Compulsive Behaviour and Intrusive Thought. This suggests the contribution of other factors, perhaps linked to gambling-specific cognitive distortions, to the observed confidence biases.

Conclusion

The findings highlight the intricate link between metacognitive confidence and psychiatric symptoms in the context of problem gambling. It underscores the need for further research into metacognitive biases, which could enhance therapeutic approaches for individuals with psychiatric conditions.

Open access
Journal of Behavioral Addictions
Authors:
Anna-Chiara Schaub
,
Maximilian Meyer
,
Amos Tschopp
,
Aline Wagner
,
Undine E. Lang
,
Marc Walter
,
Flora Colledge
, and
André Schmidt

Abstract

Background

Exercise dependence (ED) is characterised by behavioural and psychological symptoms that resemble those of substance use disorders. However, it remains inconclusive whether ED is accompanied by similar brain alterations as seen in substance use disorders. Therefore, we investigated brain alterations in individuals with ED and inactive control participants.

Methods

In this cross-sectional neuroimaging investigation, 29 individuals with ED as assessed with the Exercise Dependence Scale (EDS) and 28 inactive control participants (max one hour exercising per week) underwent structural and functional resting-state magnetic resonance imaging (MRI). Group differences were explored using voxel-based morphometry and functional connectivity analyses. Analyses were restricted to the striatum, amygdala, and inferior frontal gyrus (IFG). Exploratory analyses tested whether relationships between brain structure and function were differently related to EDS subscales among groups.

Results

No structural differences were found between the two groups. However, right IFG and bilateral putamen volumes were differently related to the EDS subscales “time” and “tolerance”, respectively, between the two groups. Resting-state functional connectivity was increased from right IFG to right superior parietal lobule in individuals with ED compared to inactive control participants. Furthermore, functional connectivity of the angular gyrus to the left IFG and bilateral caudate showed divergent relationships to the EDS subscale “tolerance” among groups.

Discussion

The findings suggest that ED may be accompanied by alterations in cognition-related brain structures, but also functional changes that may drive compulsive habitual behaviour. Further prospective studies are needed to disentangle beneficial and detrimental brain effects of ED.

Open access

Abstract

Despite growing interest in psychedelic-assisted therapy (PAT) research, there remains a lack of consensus about key issues relevant to difficulties in predicting acute drug effects, and the role of therapeutic support in clinical trials. In the absence of a clear theoretical model to conceptualize multifaceted components in PAT research, dialogue across contexts (e.g., popular media, peer reviewed journals, conference settings) is becoming increasingly polarized and siloed. This has even contributed to somewhat unusual recommendations by the FDA and others that removing critical aspects of psychological and medical safety could enhance our ability to investigate the impact of these drugs on clinical outcomes. Considering the importance of determining and maximizing safety in ongoing PAT research, this commentary suggests that an ecological systems theory (EST) approach provides a structure to make contextual and practical factors a more explicit and testable component of research. Utilizing systems theory and Bronfenbrenner’s EST approach adapted for healthcare settings, we propose that a more detailed conceptual model in PAT research would enable more explicit consideration of contextual factors informing and influencing outcomes. This commentary is accompanied by a custom figure that illustrates application of this model for psychedelic research and highlights the limitations of current measurement of acute subjective experience.

Open access
Journal of Behavioral Addictions
Authors:
Nirav Saini
,
Cam Adair
,
Daniel L. King
,
Daria J. Kuss
,
Douglas A. Gentile
,
Hyoun S. Kim
,
Jeremy Edge
,
Joël Billieux
,
John Ng
,
Juliana P. S. Yun
,
Lisa Henkel
,
Linda Faulcon
,
Michelle Nogueira
,
Rune K. L. Nielsen
,
Shannon Husk
,
Shawn Rumble
,
Trey R. Becker
,
Zsolt Demetrovics
, and
David C. Hodgins

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.

Open access

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.

Open access
Journal of Psychedelic Studies
Authors:
Evan E. Ozmat
,
Alicia K. McDonough
,
Guy M. Ladouceur
,
Darin S. Roy
,
Dana M. Bozek
,
Junsung Oh
, and
Jessica L. Martin

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.

Open access

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.

Open access

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.

Open access

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?

Open access

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.

Open access