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Champion H, Pritchard A, Dighton G, Dymond S. Gambling problems and help-seeking in serving United Kingdom military personnel: A qualitative study. Front Psychiatry 2022; 13:1003457. [PMID: 36620678 PMCID: PMC9816802 DOI: 10.3389/fpsyt.2022.1003457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION In military personnel are vulnerable to gambling problems, yet many are reluctant to seek help. The aim of the current study was to explore the lived experience of problem gambling and help-seeking among serving members of the United Kingdom Armed Forces. METHODS Seventeen individuals from a larger, cross-sectional survey of gambling and wellbeing in the Royal Air Force (RAF) completed semi-structured interviews. Interview questions focused on personal experiences, the context of the RAF and its influence, knowledge and experiences of treatment and support services, and the impact of COVID-19. RESULTS Reflexive thematic analysis revealed four themes: (1) harmful and protective occupational factors; (2) socio-cultural and personal influences; (3) organizational attitudes toward mental health and help-seeking, and (4) current support pathways and provision. DISCUSSION Findings also indicated that gambling and alcohol use are common within the RAF, and that personnel are actively coping with mental health challenges.
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Affiliation(s)
- Hannah Champion
- School of Psychology, Swansea University, Swansea, United Kingdom
| | - Amy Pritchard
- School of Psychology, Swansea University, Swansea, United Kingdom.,Department of Mental Health and Social Work, Middlesex University, Hendon, United Kingdom
| | - Glen Dighton
- School of Psychology, Swansea University, Swansea, United Kingdom.,King's Centre for Military Health Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, United Kingdom.,Department of Psychology, Reykjavík University, Reykjavík, Iceland
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52
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Shaw CA, Hodgins DC, Williams RJ, Belanger YD, Christensen DR, el-Guebaly N, McGrath DS, Nicoll F, Smith GJ, Stevens RMG. Gambling in Canada During the COVID Lockdown: Prospective National Survey. J Gambl Stud 2022; 38:371-396. [PMID: 34545513 PMCID: PMC8451724 DOI: 10.1007/s10899-021-10073-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
The current study investigated the impact of the COVID pandemic lockdown on gambling and problem gambling in Canada. The AGRI National Project's online panel participants (N = 3449) provided baseline gambling data 6 months prior to the pandemic. Re-surveying this sample during the lockdown provided an opportunity to make quantitative comparisons of the changes. Nearly one-third of gamblers reported ceasing gambling altogether during the lockdown. For the continuing gamblers, quantitative data indicated significant decreases in gambling frequency, time spent in gambling sessions, money spent, and the number of game types played. Qualitative perceptions of changes in gambling were examined and the accuracy of these reports were not closely aligned with actual changes in gambling. Gambling platform was the only gambling engagement metric where increases were found with ~ 17% of the gambling sample migrating to online gambling during the lockdown. Although problem gambling within the sample generally declined, consistent with previous literature, it was also found that gambling online-among other biopsychosocial factors-was a significant predictor for classification as a problem gambler during the lockdown. COVID-specific influences on health, employment, leisure time and social isolation were moderately associated with problem gambling scores but were not independent predictors of changes in gambling engagement during lockdown. Future studies are required to assess if the pandemic related changes in gambling evidenced in this study remain stable, or if engagement reverts to pre-pandemic levels when the pandemic response allows for the re-opening of land-based gambling venues.
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Affiliation(s)
- Carrie A. Shaw
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Europa Point Campus, Gibraltar, GX11 1AA Gibraltar ,University of Lethbridge, Lethbridge, Canada
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53
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Baenas I, Etxandi M, Codina E, Granero R, Fernández-Aranda F, Gómez-Peña M, Moragas L, Rivas S, Potenza MN, Håkansson A, Del Pino-Gutiérrez A, Mora-Maltas B, Valenciano-Mendoza E, Menchón JM, Jiménez-Murcia S. Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study. Front Psychol 2022; 12:761802. [PMID: 34970193 PMCID: PMC8712884 DOI: 10.3389/fpsyg.2021.761802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/11/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout. Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown). Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p<0.001, respectively). Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.
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Affiliation(s)
- Isabel Baenas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Mikel Etxandi
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Ester Codina
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,Psychiatry and Mental Health Group, Neurosciences Programme, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Laura Moragas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Sandra Rivas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | - Marc N Potenza
- Department of Psychiatry and Child Study Center, Yale University School of Medicine, New Haven, CT, United States.,Connecticut Council on Problem Gambling, Wethersfield, CT, United States.,Connecticut Mental Health Center, New Haven, CT, United States.,Department of Neuroscience, Yale University, New Haven, CT, United States
| | - Anders Håkansson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden.,Region Skåne, Gambling Disorder Unit, Malmö, Sweden
| | - Amparo Del Pino-Gutiérrez
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Bernat Mora-Maltas
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
| | | | - José M Menchón
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,Psychiatry and Mental Health Group, Neurosciences Programme, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain.,Ciber Salut Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.,Psychiatry and Mental Health Group, Neurosciences Programme, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), Barcelona, Spain
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Lopez-Gonzalez H, Jimenez-Murcia S, Rius-Buitrago A, Griffiths MD. Do Online Gambling Products Require Traditional Therapy for Gambling Disorder to Change? Evidence from Focus Group Interviews with Mental Health Professionals Treating Online Gamblers. J Gambl Stud 2022; 38:681-697. [PMID: 34655397 PMCID: PMC8520338 DOI: 10.1007/s10899-021-10064-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 11/26/2022]
Abstract
Online gambling has significantly altered the situational and structural characteristics of gambling products, to the extent that online gamblers might be substantially different from traditional offline gamblers. A growing body of literature has identified the evolving features of online gambling and the individuals who engage in it. However, beyond understanding the individual characteristics of this subgroup, relatively less effort has been made to examine whether existing cognitive-behavioural therapy (CBT) approaches are still entirely relevant for online problem gamblers, or whether changes are needed to adapt according to gambling mode of access. To understand what kind of challenges online gambling poses to mental health professionals dealing with disordered gamblers, four focus groups comprising 28 Spanish participants were carried out. All the treatment providers had ongoing experience with online gamblers undergoing treatment, and included clinical psychologists, mental health social workers, and a medical doctor. The data were examined using thematic analysis. The analysis identified five main themes that characterised online gamblers: (1) being of younger age, (2) lack of conflicts at home and at work/educational centre, rarely presenting violent or aggressive behaviour, (3) gambling disorder only being identified by overdue debt, (4) co-occurring conditions with technology-related abuse rather than other substance-related addictions, and (5) skill-based gambling. The study highlights mental health workers' perceived insecurities about how to best treat online gamblers, and discusses the specific characteristics that CBT for gambling disorder might need to incorporate to adjust for this particular group of gamblers.
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Affiliation(s)
- Hibai Lopez-Gonzalez
- Department of Library, Information Science, and Communication, University of Barcelona, Melcior de Palau 140, 08014 Barcelona, Spain
| | - Susana Jimenez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | | | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
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Risk Factors for Increased Online Gambling during COVID-19 Lockdowns in New Zealand: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412946. [PMID: 34948555 PMCID: PMC8701404 DOI: 10.3390/ijerph182412946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/05/2021] [Accepted: 12/06/2021] [Indexed: 12/02/2022]
Abstract
Recent research investigating changes in gambling behaviors during periods of COVID-19 social restrictions, such as enforced lockdowns, are somewhat limited by methodology, being generally cross-sectional in nature and with participant samples recruited via online panels. The present study overcame these limitations via a secondary analysis of data collected in 2012 and 2015 from a New Zealand (NZ) longitudinal gambling study, with questions related to gambling behaviors due to COVID-19 lockdown periods included in an additional data collection, of participants who had previously scored as a risky gambler, during 2020/21. Almost one-quarter of online gamblers increased their gambling during lockdown with this most likely to be on overseas gambling sites, instant scratch card gambling and Lotto. The only sociodemographic risk factor for increased online gambling was higher education. Behavioral risk factors included being a current low risk/moderate risk/problem gambler, a previously hazardous alcohol drinker or past participation in free-to-play gambling-type games. These past behaviors could act as trigger points for health services or family and friends to monitor a person’s gambling behaviors during lockdown, or future stressful periods when usual terrestrial gambling opportunities are curtailed or unavailable, and to support safer gambling practices.
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56
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Santiago A, Carré A, Miranda R, Lemogne C, LeStrat Y, Benyamina A, Perney P, Luquiens A. Study protocol for an online randomised controlled trial among non-treatment seeking problem gamblers: training inhibition in online problem gambling (TRAIN-online) trial. BMJ Open 2021; 11:e051641. [PMID: 34848517 PMCID: PMC8634281 DOI: 10.1136/bmjopen-2021-051641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Development of fully internet-based programs could provide a new avenue to improve access to healthcare for problem gamblers. In this project, we aim to assess the efficacy of a web-based cognitive intervention targeting inhibitory control among problem gamblers, using a randomised controlled design. As impaired inhibitory control is involved in self-regulation difficulties in behavioural addictions, it represents a particularly relevant cognitive process to target for an online psychological intervention. METHODS AND ANALYSIS This will be a single-blinded, randomised, comparative therapeutic web-based, controlled trial. Up to 200 non-treatment seeking adult problem gamblers with a Problem Gambling Severity Index-recent (PGSI-recent) score ≥5 will be included. The intervention will be a computerised cognitive training program targeting inhibitory skills. The comparator, an active control, will be a computerised neutral sensorial program. Both programs will be carried out under similar conditions: biweekly online training for 6 weeks and optional telephone support will be offered to patients for debriefing. The main objective of the study is to assess the clinical efficacy of the online cognitive training program at 6 weeks, measured with the PGSI-recent. The secondary objectives are to assess the efficacy on the gambling behaviour assessed by the account-based gambling data, on the self-reported gambling practice, and on the inhibition performance at the neuropsychological level at 6, 14 and 52 weeks. We will also assess the acceptability of this program and the preferred level of guidance. Data analysis will be in intention-to-treat. ETHICS AND DISSEMINATION This randomized controlled trial will be executed in compliance with the Helsinki Declaration, and was approved by the local ethics boards (Comité de Protection des Personnes) in October 2017. The findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT03673800.
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Affiliation(s)
- Antoine Santiago
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Department of Addictology, Nîmes University Hospital, Nimes, Languedoc-Roussillon, France
| | - Arnaud Carré
- Addiction Team, CESP, Villejuif, Île-de-France, France
- LIP/PC2S, Université Savoie Mont-Blanc, Chambery, Rhône-Alpes, France
| | - Ruben Miranda
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Adult Neurodeveloppment Center, Department of Psychiatry, Pitié-Salpêtrière Hospital, AP-HP, Paris, Île-de-France, France
| | - Cédric Lemogne
- Department of Psychiatry, Georges Pompidou European Hospital, AP-HP, Paris, Île-de-France, France
| | - Yann LeStrat
- U1266, Institute of Psychiatry and Neurosciences of Paris, Paris, Île-de-France, France
- Department of Psychiatry, Louis-Mourier Hospital, AP-HP, Colombes, Île-de-France, France
| | - Amine Benyamina
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Department of Psychiatry and Addictology, Paul Brousse Hospital, AP-HP, Villejuif, Île-de-France, France
| | - Pascal Perney
- Department of Addictology, Nîmes University Hospital, Nimes, Languedoc-Roussillon, France
| | - Amandine Luquiens
- Addiction Team, CESP, Villejuif, Île-de-France, France
- Department of Addictology, Nîmes University Hospital, Nimes, Languedoc-Roussillon, France
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Månsson V, Wall H, Berman AH, Jayaram-Lindström N, Rosendahl I. A Longitudinal Study of Gambling Behaviors During the COVID-19 Pandemic in Sweden. Front Psychol 2021; 12:708037. [PMID: 34721154 PMCID: PMC8552012 DOI: 10.3389/fpsyg.2021.708037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate changes in gambling behaviors during the first and second waves of the COVID-19 pandemic in Sweden. Participants who had gambled within the past year were recruited from social media and the Swedish National Helpline (n = 325, mean age 39.8 years, 64.8% males, 31.3% with problem gambling) and completed an online survey measuring gambling behaviors, consequences of the pandemic in general and worries related to the pandemic. A sub-sample (n = 139) completed a follow-up survey, during the second wave. The results showed no significant associations between COVID-19 consequences (financial or increased isolation) and increased monthly gambling behavior. No major migrations were observed between game types. However, gambling on a high-risk game (OR = 7.44, p < 0.001) and worrying about mental health due to the pandemic (OR = 2.85, p < 0.001) were significantly associated with past year gambling problems and increased monthly gambling problems from the first to the second wave. More longitudinal research is needed in vulnerable populations, to fully understand the long-term consequences of the pandemic.
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Affiliation(s)
- Viktor Månsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Håkan Wall
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Anne H Berman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Ingvar Rosendahl
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Georgiadou E, Müller A, Koopmann A, Leménager T, Hillemacher T, Kiefer F. Changes in gambling behavior during the COVID-19 lockdown in Germany. INTERNATIONAL GAMBLING STUDIES 2021. [DOI: 10.1080/14459795.2021.1956562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Ekaterini Georgiadou
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Anne Koopmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Heidelberg, Germany
| | - Tagrid Leménager
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Heidelberg, Germany
| | - Thomas Hillemacher
- Department of Psychiatry and Psychotherapy, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Feuerlein Center on Translational Addiction Medicine (FCTS), University of Heidelberg, Heidelberg, Germany
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