Mind the Gap: Interrupting Dissociation of Players Through Real-Time Digital Tasks During Online Gambling.

Background: When people engage in online gambling, they often lose track of time and money spent which is called a “dissociation state”. Literature suggests that intermittent and dynamic messages that interrupt a task can capture the attentional focus. As interactions increase awareness of the here and now, they may be effective in breaking the players’ dissociation state during online gambling and consequently minimise the potential of gambling related harm. To this respect, in this study we investigated the effectiveness of four types of digital tasks (cognitive, dialogue, informative, and standard tasks) in interrupting the dissociation of players during online gambling. Methods: 50 participants were recruited from the general population who were 18 years old and over, fluent in English and scored no more than 8 (which is the cut-off for high-risk gambling) on the Problem Gambling Severity Index (PGSI). Participants responded to an online survey with demographic questions and PGSI. Eligible participants were invited to the computer based online experiment at the lab where they were randomised to five different digital task groups (experimental groups: cognitive, dialogue, informative, standard; and control group: no task) and they received the digital tasks as an interruption while they were playing online slot gambling on a dummy account on the computer. Participants’ response times to the interruptions were recorded during online gambling. After the gambling session their level of dissociation and their acceptance of the digital tasks were measured by using Jacob’s Dissociation Questionnaire (JDQ) and the Acceptability Questionnaire (both Likert scale and open-ended questions) respectively. Results: The analysis revealed that there was a significant main effect of interruptions in terms of response times F (1, 36) = 6.52, p = .015, and a significant interaction between the two interruptions and the digital tasks F (3, 36) = 4.54, p = .008. However, there was no statistically significant difference between the digital tasks in terms of total response times to two interruptions F (3, 36) = 1.81, p = .16. On the other hand, there was a significant effect of the digital tasks on the dissociation level of participants for the five groups F (4, 45) = 15, p <.001. Cognitive tasks (M = 1.30, SD = 0.82) interrupted the dissociation of players more compared to the other digital tasks. Additionally, there was a significant effect of digital tasks on acceptability for the four groups F (3, 36) = 27.1, p < .001. According to the results of acceptability questionnaires, while players accepted the cognitive tasks the most (M = 25.1, SD = 2.73), standard tasks were accepted the least by the participants (M = 38, SD = 3.86). The qualitative data from the open-ended questions in the Acceptability Questionnaire was analysed using Thematic Analysis. Five main themes were generated: 1. distraction, 2. awareness, 3. user experience, 4. considerations for design and 5. considerations for technology. Implications: Cognitive and dialogue digital tasks could be potentially useful digital tools to interrupt players’ dissociation during online gambling and to minimise gambling related harm. These novel digital tasks might be used in online gambling related prevention and intervention strategies in the field

The impact of cue-elicited multisensory imagery on alcohol craving: A randomized controlled trial

Introduction: Elaborated intrusion theory suggests that imagery is central to craving; however, the possibility that cue-elicited multisensory imagery produces such urges has not been studied enough in the literature. Thus, we investigated the role of cue-elicited multisensory imagery on alcohol craving in individuals who are hazardous and social drinkers compared to mental and neutral imagery conditions. Methods: In an online experiment, hazardous and social drinkers (N = 348) between 18 and 45 years old were randomised to multisensory, mental, and neutral imagery exposure. The level of craving intensity was measured before and after imagery exposure. Also, participants rated vividness and sensory features scales after the exposure. Results: The level of craving was significantly higher in multisensory imagery condition compared to neutral condition (b = 1.94, p < 0.001, SE = 0.30, t(344) = 6.52, standardised mean difference [SMD] = 0.89) and in mental imagery condition compared to neutral condition (b = 1.82, SE = 0.30, t(344) = 6.52, p < 0.001, SMD = 0.83). The difference between the level of craving intensity between the multisensory and mental was not significant (b = 0.12, SE = 0.22, t(344) = 0.53, p = 0.594, SMD = 0.06). Moreover, craving intensity in response to multisensory versus neutral imagery was significantly stronger among hazardous drinkers (b = −2.90, SE = 0.83, t(341) = −3.50, p < 0.001). The level of vividness was not significantly different between any conditions. The difference between levels of sensory features was higher in multisensory imagery condition compared to neutral (b = 0.95, SE = 0.30, t(345) = 3.17, p = 0.002, SMD = 0.49) and mental imagery condition (b = 0.67, SE = 0.23, t(345) = 2.36, p = 0.004, SMD = 0.35). Conclusion: Results suggest that cue-elicited multisensory imagery may be a useful tool for eliciting alcohol craving responses and provide an additional means for better understanding the multi-layered mechanism of craving

The Efficacy of Cue Exposure Therapy on Alcohol Use Disorders: A Quantitative Meta-Analysis and Systematic Review

Background: Cue exposure therapy (CET) techniques involves repeated and controlled exposures to alcohol stimuli which rest upon the well-established principles of Pavlovian extinction (Byrne et al., 2019). However, the efficacy of CET while treating alcohol use disorders (AUDs) is still a matter of debate. Therefore, we aimed to investigate the efficacy of CET on AUDs by using previous meta-analysis study on the same topic from Mellentin et al. (2017) as a base. Methods: A computer-assisted search of relevant articles identified 879 studies in Medline, PsycInfo and Embase, of which 11 studies (published between 1992 and 2019) were selected. Three outcome measures were extracted: alcohol consumption defined as drinks per day (drinking intensity) and alcohol reduction defined as drinking days and relapse (drinking frequency). This study is registered with PROSPERO (Registration no: #CRD42021259077). Results: The present meta-analytical review found small to medium effect on drinks per day (g=-.35; 95%CI -.72 to .03), drinking days (g=-.30; 95%CI -.54 to -.06) and relapse (OR=-.58; 95%CI .29 to 1.15) while investigating the efficacy of CET on AUDs. GRADE assessment was used to evaluate the overall quality, and it was assessed as low. Regarding Risk of Bias, the studies in this systematic review were evaluated with “some concerns”. Conclusion: The present meta-analysis demonstrated that CET has small to medium effect on drinks per day, drinking days and relapse. Future research should strive to conduct larger scale multi-site CET trials with additional methodological innovations and increase retention

Interrupting dissociation of players through real-time digital tasks during online gambling

Online gambling is relatively easier to access compared to traditional one, so it can pose specific risks to individuals such as causing isolation, lack of interruption and dissociation. Intermittent interactions that require cognitive process can interrupt a task and capture the attentional focus which can help to break the dissociative state of players while playing. This study proposes an approach of using digital tasks to interrupt the dissociation of players during online gambling. We investigated the effectiveness of the approach through mixed methods where participants (N = 50) were invited to the computerised lab experiment and randomised to five conditions. Participants received digital tasks as an interruption while playing online slot gambling and their response time to the interruptions was measured. After the play, participants completed the Jacob’s Dissociation Questionnaire, and the Acceptability Questionnaire (both Likert scale and open-ended questions). The analysis revealed that there was a significant main effect of the interruptions in terms of response times, and a significant interaction between the interruptions and the digital tasks. Five main themes were generated after Thematic Analysis of the qualitative data: (1) Distraction, (2) Awareness, (3) User experience, (4) Considerations for design and (5) Considerations for technology. Digital tasks could be potentially useful tools to interrupt players’ dissociation during online gambling and support behavioural awareness and change towards more conscious and responsible gambling

Adoption of digital health technologies in supported living services

The adoption of digital health technologies in supported living services has shown great potential to revolutionise the quality of support offered to service users who are predominantly adults with learning disabilities and mental health conditions. Despite these potential benefits, the adoption of these technologies in supported living services remains at a low level. Therefore, this study aimed to address this gap by investigating the factors influencing the adoption of digital health technologies in supported living services. The research employed a mixed-method approach, conducting a case study in two local supported living services with a sample size of six participants, three from each service. Analysis of the collected data, utilizing both descriptive statistics and thematic approaches, revealed that 83.3% of participants acknowledged widespread acceptance of digital health technologies in the services. Notably, 66.7% highlighted the prevalence of health monitoring and assistive technology devices, including blood pressure monitors, blood glucose monitors, mobility scooters, and virtual assistants. Participants attributed the positive adoption environment to facilitation factors such as enhanced funding, training initiatives, and organizational support. Furthermore, most participants emphasized the essential need for a medication reminder app, expressing a preference for an easy-to-use and user-friendly design

The efficacy of cue exposure therapy on alcohol use disorders: a quantitative meta-analysis and systematic review.

BACKGROUND: Cue exposure therapy (CET) techniques involves repeated and controlled exposures to alcohol stimuli which rest upon the well-established principles of Pavlovian extinction (Byrne et al., 2019). However, the efficacy of CET while treating alcohol use disorders (AUDs) is still a matter of debate. Therefore, we aimed to investigate the efficacy of CET on AUDs by using previous meta-analysis study on the same topic from Mellentin et al. (2017) as a base. METHODS: A computer-assisted search of relevant articles identified 879 studies in Medline, PsycInfo and Embase, of which 11 studies (published between 1992 and 2019) were selected. Three outcome measures were extracted: alcohol consumption defined as drinks per day (drinking intensity) and alcohol reduction defined as drinking days and relapse (drinking frequency). RESULTS: The present meta-analytical review found small to medium effect on drinks per day, drinking days and relapse while investigating the efficacy of CET on AUDs. GRADE assessment was used to evaluate the overall quality, and it was assessed as low. Regarding Risk of Bias, the studies in this systematic review were evaluated with "some concerns". CONCLUSION: The present meta-analysis demonstrated that CET has small to medium effect on drinks per day, drinking days and relapse. Future research should strive to conduct larger scale multi-site CET trials with additional methodological innovations and increase retention

Design and Development of a Mobile Application to Combat Digital Addiction and Dissociative States during Phone Usage

Design features such as 'infinite scrolling' and the state which keeps users engaged in this behaviour can be described as a timelessness or dissociative state and has links to the onset of digital addiction. As addiction/dissociation and the effect of these design choices could therefore occur automatically for the user, an active prevention technique is needed to combat this behaviour. In this paper, we present analysis, design and development of a proof-of-concept solution for the interruption of dissociative of users. A mobile application has been designed and developed for an android device which incorporates the prior research and provides features relevant to the prevention of the problem area. The prototype allows to set up interruption time period and to select the applications to interrupt users on a session-based usage viewpoint. An evaluation has been made through useful and constructive feedback received from user testing. Through evaluation of the prototype solution, the application has potential use not only as a product for the general user, but as a tool for research into other methods of digital dissociative state interruptions

Topographical Distribution of Neuroanatomical Abnormalities Following COVID-19 Invasion: A Systematic Literature Review.

PURPOSE: This systematic review is aimed at synthesising the literature base to date on the frequency and topographical distribution of neuroanatomical changes seen on imaging following COVID-19 invasion with a focus on both the acute and chronic phases of the disease. METHODS: In this study, 8 databases were systematically searched to identify relevant articles published from December 2019 to March 2022 and supplemented with a manual reference search. Data were extracted from the included studies and narrative synthesis was employed to integrate the findings. RESULTS: A total of 110 studies met the inclusion criteria and comprised 119,307 participants (including 31,073 acute and 143 long COVID-19 patients manifesting neurological alterations) and controls. Considerable variability in both the localisation and nature of neuroanatomical abnormalities are noted along the continuum with a wide range of neuropathologies relating to the cerebrovascular/neurovascular system, (sub)cortical structures (including deep grey and white matter structures), brainstem, and predominant regional and/or global alterations in the cerebellum with varying degrees of spinal involvement. CONCLUSION: Structural regional alterations on neuroimaging are frequently demonstrated in both the acute and chronic phases of SARS-CoV‑2 infection, particularly prevalent across subcortical, prefrontal/frontal and cortico-limbic brain areas as well as the cerebrovascular/neurovascular system. These findings contribute to our understanding of the acute and chronic effects of the virus on the nervous system and has the potential to provide information on acute and long-term treatment and neurorehabilitation decisions