A 5-year longitudinal examination of the co-occurring patterns of gambling and other addictive behaviors

OBJECTIVE

We examined the co-occurring patterns of problem gambling and substance/behavioral addiction severity over a five-year period and the predictors of the different co-occurring patterns of problem gambling and addiction severity.

METHODS

We conducted a secondary analysis of the Quinte Longitudinal Study (QLS) data. The QLS is a 5-year prospective longitudinal study of gambling and problem gambling in the Quinte Region in Southern Ontario. The QLS consists of a total of 4,121 participants, including a sample of participants at risk of developing problem gambling. Severity of problem gambling, substance use, and behavioral addictions were used to examine their co-occurring patterns over time. Predictors of the co-occurring patterns included the presence of mental health disorders, personality, stress, happiness, lifesatisfaction, social support, family history, and demographics.

RESULTS

Six co-occurring patterns of problem gambling and addiction severity were identified. The largest co-occurring pattern was characterized by concurrent decrease in gambling and other addictive behaviors. Several co-occurring patterns were characterized by moderate-to-severe problem gambling and other addiction severity that remained stable over time. No co-occurring pattern represented a decrease in gambling followed by increase in other addictive behaviors (e.g., addiction substitution). The presence of mental health disorders, stress, and lifesatisfaction significantly predicted the different co-occurring patterns.

CONCLUSIONS

Taken together, the results suggest that in a non-clinical sample, gambling and other co-occurring addictive behaviors are likely to simultaneously decrease over time. Comorbidity of mental health disorders significantly influences co-occurring patterns of gambling and other addictive behaviors.

Incident commander decision making: Quantitative evaluation of instantaneous and considered decisions

The Incident Commander (IC) decision-making process has previously been modeled primarily by qualitative evaluation methods, which has made it difficult to generalize an objective model. In this study, we took a quantitative approach to elucidate a decision-making model based on the "dual-process" model that consists of instantaneous decisions ("System 1") and considered decisions ("System 2") to gain new insights regarding the IC decision-making process. High-fidelity simulation data from eight mass-casualty incidents (MCIs) were analyzed in two categories. The first category represents cues of new information and the IC's actions, divided into three main subcategories: actions following the MCI protocol, responses following cues, and actions without a cue. The second category divides the simulation into three MCI management phases: (1) evaluation and triage, (2) treatment and preparedness for evacuation, and (3) evacuation. Actions that followed the MCI protocol were significantly higher in the first phase compared to the other two phases (p<0.01 for both phases). Responses following cues were significantly higher in the second phase compared to the first (p<0.01). Actions without a cue were significantly higher in both the second and third phases compared to the first (p<0.01 for both phases). The results reveal that the IC followed MCI protocol guidance in the simulation initiation and immediately responded to cues, which fits "System 1". As the simulation evolved, the IC made more planned tasks and initiated actions without leading cues, which fits "System 2". The study found that ICs can change their decision-making mode, and this understanding can serve to improve their decision-making process and increase casualty survival rates.

Learning facilitates dual-process face recognition regardless of holistic processing

Much evidence suggests that faces are recognized based on their global familiarity in a signal-detection manner. However, experiments drawing this conclusion typically present study lists of faces only once or twice, and the nature of face recognition at higher levels of learning remains unclear. Here, three experiments are reported in which participants studied some faces eight times and others twice and then took a recognition test containing previously viewed faces, entirely new faces, and faces which recombined the parts of previously viewed faces. Three measures converged to suggest that study list repetition increased the likelihood of participants rejecting recombined faces as new by recollecting that their parts were studied but in a different combination, and that manipulating holistic or Gestalt-like processing-a hallmark of face perception-qualitatively preserved its effect on how memory judgments are made. This suggests that face learning causes a shift from the use of a signal-detection strategy to the use of a dual-process strategy of face recognition regardless of holistic processing.

Spontaneous and deliberate modes of creativity: Multitask eigen-connectivity analysis captures latent cognitive modes during creative thinking

Despite substantial progress in the quest of demystifying the brain basis of creativity, several questions remain open. One such issue concerns the relationship between two latent cognitive modes during creative thinking, i.e., deliberate goal-directed cognition and spontaneous thought generation. Although an interplay between deliberate and spontaneous thinking is often implicated in the creativity literature (e.g., dual-process models), a bottom-up data-driven validation of the cognitive processes associated with creative thinking is still lacking. Here, we attempted to capture the latent modes of creative thinking by utilizing a data-driven approach on a novel continuous multitask paradigm (CMP) that widely sampled a hypothetical two-dimensional cognitive plane of deliberate and spontaneous thinking in a single fMRI session. The CMP consisted of eight task blocks ranging from undirected mind wandering to goal-directed working memory task, while also included two widely-used creativity tasks, i.e., alternate uses task (AUT) and remote association task (RAT). Using eigen-connectivity (EC) analysis on the multitask whole-brain functional connectivity (FC) patterns, we embedded the multitask FCs into a low-dimensional latent space. The first two latent components, as revealed by the EC analysis, broadly mapped onto the two cognitive modes of deliberate and spontaneous thinking, respectively. Further, in this low-dimensional space, both creativity tasks were located in the upper right corner of high deliberate and spontaneous thinking (creative cognitive space). Neuroanatomically, the creative cognitive space was represented by not only increased intra-network connectivity within executive control and default mode network, but also by higher coupling between the two canonical brain networks. Further, individual differences reflected in the low-dimensional connectivity embeddings were related to differences in deliberate and spontaneous thinking abilities. Altogether, using a continuous multitask paradigm and a data-driven approach, we provide initial empirical evidence for the contribution of both deliberate and spontaneous modes of cognition during creative thinking.

Critical tests of the continuous dual-process model of recognition

Dual process recognition models assume recognition depends upon context recollection and/or item familiarity. While most assume recollection is more highly valued or weighted than familiarity during judgment, we tested a continuous dual process (CDP) model that instead assumes recollection and familiarity are equally weighted during recognition judgment. Experiments 1a and 1b used a joint rating scale in which each probe was rated for recollection and familiarity strength, which were then used to predict overall recognition confidence. In both, recollection dominated familiarity such that familiarity ratings were only predictive of confidence when recollection ratings were relatively weaker. In contrast, when recollection ratings were stronger, familiarity made no contribution to recognition confidence. Experiment 2 used a different, bifurcated rating scale previously demonstrating that strong ratings of familiarity can lead to better recognition yet worse contextual source memory than weak ratings of recollection. However, the current study failed to find this dissociation, instead demonstrating that weak recollection ratings were as or more accurate than the strongest familiarity ratings in both recognition and source memory. Replacing the CDP model equal weighting decision rule with one incorporating a strong relative preference for recollection over familiarity yielded simulation data more consistent with the empirical data and is more optimal if recollection is in fact more diagnostic of recognition than familiarity. Overall, these findings suggest that observers have a strong preference for relying on recollection over familiarity during recognition, presumably because it better situates the probe within a specific episode.

Dual-Process Bereavement Group Intervention (DPBGI) for Widowed Older Adults

BACKGROUND AND OBJECTIVES

To examine the primary and secondary outcomes of a theory-driven group bereavement intervention for widowed older adults through a cluster-randomized controlled trial.

RESEARCH DESIGNS AND METHODS

Twelve community centers providing health and social services for elderly people were randomly assigned to the experimental condition, the dual-process bereavement group intervention-Chinese (DPBGI-C) and to the control condition, the loss-oriented bereavement group intervention-Chinese (LOBGI-C). Both interventions comprised weekly, 2-hr sessions for 7 weeks followed by a 4-hr outing in the eighth week. Of 215 widowed older adults contacted and assessed, 125 eligible participants were interviewed three times-preintervention, postintervention, and at a 16-week follow-up-to assess complicated grief symptoms, anxiety, depression, loneliness, and social support.

RESULTS

Using intention-to-treat analysis, both interventions produced improvements in grief, depression, and social support, but effect sizes were larger with the DPBGI-C. The participants in the DPBGI-C condition also reported reduced anxiety, emotional loneliness, and social loneliness, whereas those in the LOBGI-C condition did not. There were interactions between intervention type and time with respect to grief, anxiety, emotional loneliness, and social loneliness.

DISCUSSION AND IMPLICATIONS

Although traditional LOBGI-C can help to reduce grief and depression in bereaved older adults, the DPBGI-C was found to be superior as it had a greater and more extensive impact on outcomes. This is the first study of the effectiveness of this evidence-based, theory-driven intervention for widowed Chinese older adults and has implications for theory building and practice.

Sexual Arousal and Implicit and Explicit Determinants of Condom Use Intentions

Being sexually aroused may be an important risk factor contributing to sexual decision making. Dual-process cognitive models, such as the reflective-impulsive model of Strack and Deutsch (2004), could be used to explain the effect of sexual arousal on intentions to use a condom. In this study, we investigated whether explicit and implicit attitudes toward condom use can predict intentions to use a condom when participants are sexually aroused and not aroused. In a within-subjects experimental design, male participants (N = 27) watched both a neutral and an erotic movie clip in counterbalanced order. After each clip, participants completed a questionnaire assessing their intentions to use a condom and explicit condom attitudes, followed by a wanting Implicit Association Test (IAT; Greenwald et al., 2003) and a liking IAT to assess their implicit attitudes to unsafe sex. In concordance with the reflective-impulsive model, we found that when participants were not sexually aroused, their intentions to use a condom were solely predicted by their explicit attitudes. However, when they were sexually aroused, intentions to use a condom were predicted by both explicit and implicit attitudes toward condom use.

Let's Open the Decision-Making Umbrella: A Framework for Conceptualizing and Assessing Features of Impaired Decision Making in Addiction

Decision-making impairments play a pivotal role in the emergence and maintenance of addictive disorders. However, a sound conceptualization of decision making as an umbrella construct, encompassing its cognitive, affective, motivational, and physiological subcomponents, is still lacking. This prevents an efficient evaluation of the heterogeneity of decision-making impairments and the development of tailored treatment. This paper thus unfolds the various processes involved in decision making by adopting a critical approach of prominent dual- or triadic-process models, which postulate that decision making is influenced by the interplay of impulsive-automatic, reflective-controlled, and interoceptive processes. Our approach also focuses on social cognition processes, which play a crucial role in decision making and addictive disorders but were largely ignored in previous dual- or triadic-process models. We propose here a theoretical framework in which a range of coordinated processes are first identified on the basis of their theoretical and clinical relevance. Each selected process is then defined before reviewing available results underlining its role in addictive disorders (i.e., substance use, gambling, and gaming disorders). Laboratory tasks for measuring each process are also proposed, initiating a preliminary process-based decision-making assessment battery. This original approach may offer an especially informative view of the constitutive features of decision-making impairments in addiction. As prior research has implicated these features as risk factors for the development and maintenance of addictive disorders, our processual approach sets the scene for novel and transdiagnostic experimental and applied research avenues.

Implicit and Explicit Associations with Erotic Stimuli in Women with and Without Sexual Problems

Conceptual models of sexual functioning have suggested a major role for implicit cognitive processing in sexual functioning. The present study aimed to investigate implicit and explicit cognition in sexual functioning in women. Gynecological patients with (N = 38) and without self-reported sexual problems (N = 41) were compared. Participants performed two Single-Target Implicit Association Tests (ST-IAT), measuring the implicit association of visual erotic stimuli with attributes representing, respectively, valence and motivation. Participants also rated the erotic pictures that were shown in the ST-IATs on the dimensions of valence, attractiveness, and sexual excitement, to assess their explicit associations with these erotic stimuli. Participants completed the Female Sexual Functioning Index and the Female Sexual Distress Scale for continuous measures of sexual functioning, and the Hospital Anxiety and Depression Scale to assess depressive symptoms. Compared to nonsymptomatic women, women with sexual problems were found to show more negative implicit associations of erotic stimuli with wanting (implicit sexual motivation). Across both groups, stronger implicit associations of erotic stimuli with wanting predicted higher level of sexual functioning. More positive explicit ratings of erotic stimuli predicted lower level of sexual distress across both groups.

An experimental investigation of breaking learnt habits with verbal implementation intentions

The interplay between inflexible habits and flexible goal-directed control can be modelled in lab-settings using the slips-of-action task. In this task, participants are required to selectively respond to still-valuable outcomes while suppressing responding towards no-longer valuable outcomes, thereby overriding learned stimulus-response associations. Here we examined in the slips-of-action task whether learnt habits can be changed using a planning technique - so-called implementation intentions - whereby people instruct themselves to enact a certain behaviour (or not) in the presence of a specific critical stimulus. Such simple 'if-then' instructions have previously been shown to support behavioural change in real-life settings, possibly because people verbally create new stimulus-response associations. Across four experiments we manipulated the intrinsic value of the stimuli and outcomes in the slips-of-action task: abstract stimuli and outcomes (Experiment 1), snack food stimuli and outcomes (Experiment 2), or a combination of both types (Experiment 3-4). Implementation intentions improved the ability to suppress previously learnt responses towards no-longer-valuable abstract outcomes (Experiment 1 and 3). However, when snacks were used as outcomes (Experiment 2 and 4) no beneficial effect of implementation intentions versus goal intentions was observed. The slips-of-action task is thus sensitive to planning techniques under certain circumstances. Yet, the absence of effects when using snacks as outcomes implies the possible importance of its hedonic outcome value for implementation intentions' effectiveness, which warrants further investigation.

Pupil old/new effects reflect stimulus encoding and decoding in short-term memory

We conducted five pupil old/new experiments to examine whether pupil old/new effects can be linked to familiarity and/or recollection processes of recognition memory. In Experiments 1-3, we elicited robust pupil old/new effects for legal words and pseudowords (Experiment 1), positive and negative words (Experiment 2), and low-frequency and high-frequency words (Experiment 3). Importantly, unlike for old/new effects in ERPs, we failed to find any effects of long-term memory representations on pupil old/new effects. In Experiment 4, using the words and pseudowords from Experiment 1, participants made lexical decisions instead of old/new decisions. Pupil old/new effects were restricted to legal words. Additionally requiring participants to make speeded responses (Experiment 5) led to a complete absence of old/new effects. Taken together, these data suggest that pupil old/new effects do not map onto familiarity and recollection processes of recognition memory. They rather seem to reflect strength of memory traces in short-term memory, with little influence of long-term memory representations. Crucially, weakening the memory trace through manipulations in the experimental task significantly reduces pupil/old new effects.

The role of subcortical structures in recited speech: Studies in Parkinson's disease

The role of subcortical structures in language function is complex and dependent on language task, with studies increasingly showing subcortical involvement for the production of formulaic language, including recited speech. Individuals with Parkinson's disease (PD), with (n = 6) and without (n = 7) surgical treatment, deep brain stimulation (DBS), were compared to healthy adults (n = 14) to determine whether individuals with subcortical dysfunction produce more errors during a recitation speech task. Participants were asked to recite poems, prayers, and rhymes familiar to them in order to determine the effects of subcortical disease on recited speech ability. When compared with healthy controls, the DBS-OFF group produced significantly more error words, suggesting that deficits in recitation arise with severe states of subcortical dysfunction. Individuals with DBS in the ON or OFF conditions did not differ significantly during the recited speech task. Results support a model of language where large units of overlearned language are at least partially modulated by subcortical structures.

Temporal dynamics of interference in Simon and Eriksen tasks considered within the context of a dual-process model

Behavioral and brain potential measures were employed to compare interference in Eriksen and Simon tasks. Assuming a dual-process model of interference elicited in speeded response tasks, we hypothesized that only lateralized stimuli in the Simon task induce fast S-R priming via direct unconditional processes, while Eriksen interference effects are induced later via indirect conditional processes. Delays to responses for incongruent trials were indeed larger in the Eriksen than in the Simon task. Only lateralized stimuli in the Simon task elicited early S-R priming, maximal at parietal areas. Incongruent flankers in the Eriksen task elicited interference later, visible as a lateralized N2. Eriksen interference also elicited an additional component (N350), which accounted for the larger behavioral interference effects in the Eriksen task. The findings suggest that interference and its resolution involve different processes for Simon and Eriksen tasks.

Formulaic Language in Alzheimer's Disease

BACKGROUND

Studies of productive language in Alzheimer's disease (AD) have focused on formal testing of syntax and semantics but have directed less attention to naturalistic discourse and formulaic language. Clinical observations suggest that individuals with AD retain the ability to produce formulaic language long after other cognitive abilities have deteriorated.

AIMS

This study quantifies production of formulaic expressions in the spontaneous speech of individuals with AD. Persons with early- and late-onset forms of the disease were compared.

METHODS & PROCEDURES

Conversational language samples of individuals with early- (n = 5) and late-onset (n = 6) AD and healthy controls (n = 5) were analyzed to determine whether formulaic language, as measured by the number of words in formulaic expressions, differs between groups.

OUTCOMES & RESULTS

Results indicate that individuals with AD, regardless of age of onset, used significantly more formulaic expressions than healthy controls. The early- and late-onset AD groups did not differ on formulaic language measures.

CONCLUSIONS

These findings contribute to a dual process model of cerebral function, which proposes differing processing principles for formulaic and novel expressions. In this model, subcortical areas, which remain intact into late in the progression of Alzheimer's disease, play an important role in the production of formulaic language. Applications to clinical practice include identifying preserved formulaic language and providing informed counseling to patient and family.