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Scheggi S, Concas L, Corsi S, Carta M, Melis M, Frau R. Expanding the therapeutic potential of neuro(active)steroids: a promising strategy for hyperdopaminergic behavioral phenotypes. Neurosci Biobehav Rev 2024; 164:105842. [PMID: 39103066 DOI: 10.1016/j.neubiorev.2024.105842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/10/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024]
Abstract
Imbalances in dopamine activity significantly contribute to the pathophysiology of several neuropsychiatric disorders, including addiction, ADHD, schizophrenia, impulse control disorders, and Parkinson's Disease. Neuro(active)steroids, comprising endogenous steroids that finely modulate neuronal activity, are considered crucial regulators of brain function and behavior, with implications in various physiological processes and pathological conditions. Specifically, subclasses of Neuro(active)steroids belonging to the 5α reductase pathway are prominently involved in brain disorders characterized by dopaminergic signaling imbalances. This review highlights the neuromodulatory effects of Neuro(active)steroids on the dopamine system and related aberrant behavioral phenotypes. We critically appraise the role of pregnenolone, progesterone, and allopregnanolone on dopamine signaling. Additionally, we discuss the impact of pharmacological interventions targeting 5α reductase activity in neuropsychiatric conditions characterized by excessive activation of the dopaminergic system, ranging from psychotic (endo)phenotypes and motor complications to decision-making problems and addiction.
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Affiliation(s)
- Simona Scheggi
- Dept. of Molecular and Developmental Medicine, University of Siena, Italy
| | - Luca Concas
- Dept. Of Biomedical Sciences, University of Cagliari, Italy
| | - Sara Corsi
- Dept. of Developmental and Regenerative Neurobiology, Lund University, Sweden
| | - Manolo Carta
- Dept. Of Biomedical Sciences, University of Cagliari, Italy
| | - Miriam Melis
- Dept. Of Biomedical Sciences, University of Cagliari, Italy
| | - Roberto Frau
- Dept. Of Biomedical Sciences, University of Cagliari, Italy; Guy Everett Laboratory, University of Cagliari, Cagliari, Italy.
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Snippe L, Boffo M, Galvin H, Willemen R, Pronk T, Dom G, Wiers RW. How We Lost 90% of Participants on a Bad Bet: Results from a Pilot Randomized Controlled Trial on Cognitive Bias Modification in Problem Gamblers. J Gambl Stud 2024; 40:521-554. [PMID: 38006537 DOI: 10.1007/s10899-023-10263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/27/2023]
Abstract
Whilst opportunities to participate in gambling have increased, access to support for problem gamblers is lacking behind. This lack of balance calls for improved and accessible intervention methods. The present double-blind randomized controlled trial (RCT) explored the effectiveness of two interventions targeting automatic cognitive processes, known as Attentional Bias Modification (AtBM) and Approach Bias Modification (ApBM). It was hypothesized these interventions would reduce gambling behavior and reduce or reverse targeted biases. Participants (N = 331) were community-recruited Flemish (35%) and Dutch (65%) adult problem gamblers motivated to reduce or stop their gambling who received either six sessions of active training (AtBM or ApBM) or of the corresponding sham-training (sham-AtBM or sham-ApBM). Due to high attrition rates (90.1% up to the intervention phase) the study was terminated before completion, since it would greatly limit the validity of any results. A post hoc qualitative study was performed on a subset of participants to gain insight into contributing factors for the high attrition rate. Issues negatively impacting participants' motivation to complete the program were identified, as well as elements of the program that received approval. The results from this study provide a first insight into the potential of the use of online cognitive bias modification (CBM) interventions in problem gambling (PG). Suggestions and directions for future studies are discussed.
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Affiliation(s)
- Leroy Snippe
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands.
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Wilrijk, Belgium.
| | - Marilisa Boffo
- Department of Psychology, Education and Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Harriet Galvin
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands
- Department of Psychology, Education and Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Thomas Pronk
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Wilrijk, Belgium
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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Farr Z, Broomfield NM, Coventry KR. A Systematic Review of Attentional Bias in Problem Gambling. J Gambl Stud 2024; 40:493-519. [PMID: 37943393 PMCID: PMC11272818 DOI: 10.1007/s10899-023-10260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
A large body of previous research has provided support for the role of attentional bias as a maintaining factor in addiction. This systematic review aimed to investigate the extent and nature of attentional bias as a phenomenon which exists within problem gamblers. Studies were identified through searches of three databases (MedLine, PSYCHINFO, and Web of Science) and examination of the reference lists of the final studies meeting criteria for inclusion. The scope of the review included empirical studies making experimental comparisons of problem gamblers and non-problem gamblers across a range of attentional paradigms. A comparison of effect sizes was conducted across studies comparing problem to non-problem gamblers within and between attention paradigms. Twenty-two studies were reviewed systematically across ten experimental paradigms. Attentional bias was demonstrated in 16 of the 22 studies, with attentional bias effects varying across paradigms. Quality assessment revealed two main limitations across studies: lack of a priori power analysis, and failure to control for gambling frequency as a possible confounding variable. Findings support the role of attentional bias as a potential maintaining factor in problem gambling behaviour, in line with evidence for substance addiction. Recommendations for future studies are outlined alongside a discussion of clinical implications.
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Affiliation(s)
- Zoe Farr
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Niall M Broomfield
- Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK
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Ciccarelli M, Pizzini B, Griffiths MD, Cosenza M, Nigro G, D'Olimpio F. Attentional disengagement, craving, and mentalizing: a preliminary experimental study among older-aged male gamblers. BMC Psychol 2024; 12:164. [PMID: 38504324 PMCID: PMC10949650 DOI: 10.1186/s40359-024-01651-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION Empirical studies have demonstrated the role that attentional bias, the mutual excitatory relationship between attentional bias and craving, and mentalizing play in problem gambling. Although problem gambling rates among older-aged adults have steadily increased in recent years, research studies among this cohort are scarce. The present study is the first to empirically investigate attentional bias, as well as the joint role of attentional bias, craving, and mentalizing among older-aged gamblers. METHOD Thirty-six male older-aged gamblers were administered the South Oaks Gambling Screen (SOGS), the Gambling Craving Scale (GACS), and the Reflective Functioning Questionnaire (RFQ-8) to assess gambling severity, craving levels, and mentalizing, respectively. Participants also performed a modified Posner Task to investigate attentional biases. RESULTS Hierarchical linear regression analysis showed that among older-aged male gamblers, GACS Anticipation and RFQ-8 Uncertainty about mental states, as well as disengagement bias at 100 ms, significantly predicted gambling severity. CONCLUSION The present study provides the first empirical support for the role of attentional bias, craving, and mentalizing among older-aged gambling. More specifically, a difficult in disengaging attention away from gambling, the anticipation of pleasure deriving from gambling, and hypomentalizing predicted gambling severity among older-aged gamblers. The findings make an important contribution, by identifying the factors responsible for problem gambling among this specific age cohort and suggesting that timely interventions for mentalizing and attentional bias may be necessary to prevent problem gambling in old age.
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Affiliation(s)
- Maria Ciccarelli
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy.
| | - Barbara Pizzini
- Università Giustino Fortunato, Via Raffaele Delcogliano, 12, Benevento, 82100, Italy
| | - Mark D Griffiths
- Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Marina Cosenza
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy
| | - Giovanna Nigro
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy
| | - Francesca D'Olimpio
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, Caserta, 81100, Italy
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Nadeau L, Valleur M. Addiction: A treatise from 1561. Addiction 2023; 118:2235-2241. [PMID: 37482901 DOI: 10.1111/add.16298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/18/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND AND AIMS In 1561, physician and philosopher Pascasius Justus Turq published a monograph on the description and treatment of pathological gambling. When the monograph came to the attention of the authors in 2006, there existed no known translation of it in any modern language. In 2014, it was translated and published in French. This paper analyses the monograph's key content elements and its place in the history of the concept of addiction. METHODS A contextual analysis of the late Italian Renaissance, followed by key excerpts from the text and commentaries on the meaning and significance of the monograph. FINDINGS AND CONCLUSIONS Pascasius Justus Turq's 1561 monograph on pathological gambling outlines a disease view of gambling, identifies cognitive processes and biological vulnerabilities as aetiological factors, avoids religious or moral judgements and recommends cognitive treatment to change the beliefs and expectancies of gamblers. This study shows that a 'disease formulation' of addiction was enunciated as early as the 16th century, and its contemporary resonance suggests that current clinical features of addictive disorders have existed for centuries.
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Affiliation(s)
- Louise Nadeau
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
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Coelho SG, Sears CR, Kim HS, McGrath DS. The reliability of attentional biases for gambling-related images in free-viewing eye-tracking paradigms. Addict Behav 2023; 139:107575. [PMID: 36528963 DOI: 10.1016/j.addbeh.2022.107575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/05/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Attentional biases for gambling-related stimuli are a robust correlate of problem gambling. Free-viewing eye-tracking paradigms are considered the gold standard for measuring attentional bias in addiction research, but their reliability in measuring biases for gambling-related stimuli remains unclear. Using secondary data from two different free-viewing eye-tracking paradigms (two-image and four-image displays), this study examined the internal consistency of fixation indices in samples with varying degrees of gambling involvement and problem gambling risk. Cronbach's alpha, McDonald's omega, and split-half reliability coefficients were used to assess internal consistency of several fixation indices (total dwell time, total dwell time percent, total fixation count, time of first fixation) for gambling-related images, neutral images, and computed attentional bias difference scores. For both two- and four-image displays, internal consistency estimates for total dwell time, total dwell time percent, and total fixation count were good to excellent for gambling-related images, neutral images, and attentional bias scores. Only time of first fixation exhibited low internal consistency. These findings indicate that both two-image and four-image free-viewing eye-tracking paradigms can reliably measure attentional biases for gambling-related stimuli among participants reporting varying degrees of gambling involvement and problem gambling risk.
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Affiliation(s)
- Sophie G Coelho
- Department of Psychology, York University, Toronto, Ontario, Canada
| | | | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada; University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, Ontario, Canada
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
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Relationship between virtual reality balloon analogue risk task and risky decision-making. PLoS One 2023; 18:e0282097. [PMID: 36812220 PMCID: PMC9946223 DOI: 10.1371/journal.pone.0282097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
The balloon analogue risk task (BART) is widely used to assess risk-taking tendencies on behavioral tests. However, biases or unstable results are sometimes reported, and there are concerns about whether the BART can predict risk behavior in the real world. To address this problem, the present study developed a virtual reality (VR) BART to enhance the reality of the task and narrow the gap between performance on the BART and risk behavior in the real world. We evaluated the usability of our VR BART through assessments of the relationships between BART scores and psychological metrics and additionally implemented an emergency decision-making VR driving task to investigate further whether the VR BART can predict risk-related decision-making in emergency situations. Notably, we found that the BART score significantly correlated with both sensation-seeking and risky driving behavior. Additionally, when we split participants into groups with high and low BART scores and compared their psychological metrics, we found that the high-score BART group included more male participants and exhibited higher sensation-seeking and more risky decision-making in an emergency situation. Overall, our study shows the potential of our new VR BART paradigm to predict risky decision-making in the real world.
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Wolfschlag M, Håkansson A. Drug-Induced Gambling Disorder: Epidemiology, Neurobiology, and Management. Pharmaceut Med 2023; 37:37-52. [PMID: 36611111 PMCID: PMC9825131 DOI: 10.1007/s40290-022-00453-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 01/09/2023]
Abstract
Problematic gambling has been suggested to be a possible consequence of dopaminergic medications used mainly in neurological conditions, i.e. pramipexole and ropinirole, and possibly by one antipsychotic compound, aripiprazole. Patients with Parkinson's disease, restless legs syndrome and other conditions potentially treated with dopamine agonists, as well as patients treated for psychotic disorders, are vulnerable patient groups with theoretically increased risk of developing gambling disorder (GD), for example due to higher rates of mental ill-health in these groups. The aim of the present paper is to review the epidemiological, clinical, and neurobiological evidence of the association between dopaminergic medications and GD, and to describe risk groups and treatment options. The neurobiology of GD involves the reward and reinforcement system, based mainly on mesocorticolimbic dopamine projections, with the nucleus accumbens being a crucial area for developing addictions to substances and behaviors. The addictive properties of gambling can perhaps be explained by the reward uncertainty that activates dopamine signaling in a pathological manner. Since reward-related learning is mediated by dopamine, it can be altered by dopaminergic medications, possibly leading to increased gambling behavior and a decreased impulse control. A causal relationship between the medications and GD seems likely, but the molecular mechanisms behind this association have not been fully described yet. More research is needed in order to fully outline the clinical picture of GD developing in patient groups with dopaminergic medications, and data are needed on the differentiation of risk in different compounds. In addition, very few interventional studies are available on the management of GD induced by dopaminergic medications. While GD overall can be treated, there is need for treatment studies testing the effectiveness of tapering of the medication or other gambling-specific treatment modalities in these patient groups.
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Affiliation(s)
- Mirjam Wolfschlag
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02 Malmö, Sweden ,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden
| | - Anders Håkansson
- Malmö-Trelleborg Addiction Center, Competence Center Addiction, Region Skåne, Södra Förstadsgatan 35, plan 4, S-205 02, Malmö, Sweden. .,Faculty of Medicine, Dept of Clinical Sciences Lund, Lund University, Psychiatry, Lund, Sweden.
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Ciccarelli M, Cosenza M, Nigro G, D'Olimpio F. Does craving increase gambling severity? The role of attentional bias. J Affect Disord 2022; 317:403-408. [PMID: 36029881 DOI: 10.1016/j.jad.2022.08.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 05/18/2022] [Accepted: 08/21/2022] [Indexed: 10/31/2022]
Affiliation(s)
- Maria Ciccarelli
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100 Caserta, Italy.
| | - Marina Cosenza
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100 Caserta, Italy
| | - Giovanna Nigro
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100 Caserta, Italy
| | - Francesca D'Olimpio
- Department of Psychology, Università degli studi della Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100 Caserta, Italy
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Kim HS, Ritchie EV, Sears CR, Hodgins DC, Kowatch KR, McGrath DS. Affective impulsivity moderates the relationship between disordered gambling severity and attentional bias in electronic gaming machine (EGM) players. J Behav Addict 2022; 11:386-395. [PMID: 35895477 PMCID: PMC9295233 DOI: 10.1556/2006.2022.00043] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/06/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS Attentional bias to gambling-related stimuli is associated with increased severity of gambling disorder. However, the addiction-related moderators of attentional bias among those who gamble are largely unknown. Impulsivity is associated with attentional bias among those who abuse substances, and we hypothesized that impulsivity would moderate the relationship between disordered electronic gaming machine (EGM) gambling and attentional bias. METHODS We tested whether facets of impulsivity, as measured by the UPPS-P (positive urgency, negative urgency, sensation seeking, lack of perseverance, lack of premeditation) and the Barratt Impulsiveness Scale-11 (cognitive, motor, non-planning) moderated the relationship between increased severity of gambling disorder, as measured by the Problem Gambling Severity Index (PGSI), and attentional bias. Seventy-five EGM players participated in a free-viewing eye-tracking paradigm to measure attentional bias to EGM images. RESULTS Attentional bias was significantly correlated with Barratt Impulsiveness Scale-11 (BIS-11) motor, positive urgency, and negative urgency. Only positive and negative urgency moderated the relationship between PGSI scores and attentional bias. For participants with high PGSI scores, higher positive and negative urgency were associated with larger attentional biases to EGM stimuli. DISCUSSION The results indicate that affective impulsivity is an important contributor to the association between gambling disorder and attentional bias.
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Affiliation(s)
- Hyoun S. Kim
- Department of Psychology, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | | | | | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, Canada
| | | | - Daniel S. McGrath
- Department of Psychology, University of Calgary, Calgary, Canada,Corresponding author. E-mail:
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He J, Jin L, Guan Y, Zi H. Attentional bias toward waiting time information among individuals with high and low trait self-control when making intertemporal choices. JOURNAL OF COGNITIVE PSYCHOLOGY 2020. [DOI: 10.1080/20445911.2020.1807998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jiamei He
- Department of Psychology, Liaoning Normal University, Dalian, People’s Republic of China
- Collaborative Innovation Center of Healthy Personality Assessment and Cultivation of Children and Adolescents in Liaoning Province, Dalian, People’s Republic of China
| | - Lei Jin
- Department of Psychology, Liaoning Normal University, Dalian, People’s Republic of China
- Collaborative Innovation Center of Healthy Personality Assessment and Cultivation of Children and Adolescents in Liaoning Province, Dalian, People’s Republic of China
| | - Yuan Guan
- Department of Psychology, Liaoning Normal University, Dalian, People’s Republic of China
- Collaborative Innovation Center of Healthy Personality Assessment and Cultivation of Children and Adolescents in Liaoning Province, Dalian, People’s Republic of China
| | - Hongyan Zi
- Department of Psychology, Liaoning Normal University, Dalian, People’s Republic of China
- Collaborative Innovation Center of Healthy Personality Assessment and Cultivation of Children and Adolescents in Liaoning Province, Dalian, People’s Republic of China
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