Systematic review: The relationship between gabapentinoids, etizolam, and drug related deaths in Scotland.

In recent years Scotland has been experiencing a disproportionally high number of drug related deaths compared to other European countries, causing significant individual, societal and economic burden. A possible cause of this is the increase in average number of substances involved in Scottish drug related deaths, as well as the changing pattern of substances involved. Opioids, cocaine, and alcohol have been consistently involved in the culture of drug use in Scotland, however recently National Records Scotland have identified that designer benzodiazepines such as etizolam, and prescription drugs such as gabapentinoids are increasingly being detected in Scottish toxicology reports. A systematic literature review following PRISMA guidelines was conducted through searching PubMed and Google Scholar to identify peer-reviewed articles published in English between 2013 and 2023 that investigated Scottish population data on gabapentinoids and etizolam to establish their contribution to the rise in Scottish drug related deaths. 18 studies were included in the review. A high use prevalence of etizolam and gabapentinoids in Scotland has been identified, with both substance-related deaths showing recent increase, marked since 2015. This pattern is replicated in the Scottish prison system. There has also been a significant increase of gabapentinoids prescriptions in Scotland. Polydrug use was identified as the most common determinant of both etizolam and gabapentinoids related adverse effects and fatality in Scotland, especially concurrent opioid use. The results indicate the literature on individual characteristics of Scottish at-risk users of gabapentinoids and etizolam is limited, however the data shows both substances are being used by older cohort, with adverse effects seen more in older women.

Risk factors for momentary loss of control and subsequent abandonment of self-devised dietary restraint plans in adults with weight-loss goals: a behaviour sequence analysis approach.

OBJECTIVE: The current study aims to improve understanding of events leading to lapses of dietary restraint, and to identify pathways to perseverance or abandonment of weight loss efforts in response to lapses. In addition, Behaviour Sequence Analysis (BSA) was also evaluated as an analytical tool in dietary behaviour. DESIGN: A sample of 176 adults who were engaging in self-imposed dietary restraint for weight loss were recruited to participate. MAIN OUTCOME MEASURES: Participants were instructed to provide a detailed written timeline of an episode where they lapsed in their dietary restraint plan. They were instructed to report their preceding behaviours and internal states, and social and environmental contexts, leading up to and after their lapse in dietary restraint. RESULTS: Lapses in dietary restraint were precipitated by negative internal states in the presence of cues for highly palatable foods. In addition, abandonment of weight loss efforts after lapsing was preceded by dichotomous thinking, whereas perseverance was preceded by a more neutral, flexible interpretation of the lapse in self-control. CONCLUSION: BSA has identified that neutral evaluation of inevitable lapses in dietary restraint are predictive of continuation with weight loss efforts, highlighting the importance of individual tolerance of lapses in self-regulation.

Behavior Sequencing Violent Episodes in Forensic Youth Populations.

Every year, more children and youths are sent to Secure Children's Homes while moving through the criminal justice system. Aggressive and violent incidents in these settings are common, and staff are often required to intervene and restrain violent individuals. The research literature has many examples of aggression and violence questionnaires and measures; however, for staff in communal areas it is the observable behaviors that they react to most. The current research, therefore, analyzed observable behaviors leading-up to violent episodes, and used Behavior Sequence Analysis to highlight the typical chains of behaviors that tend toward violence. The outcomes of this research show pathways to violence that staff can use to highlight potential spirals of aggression and violence. The current results show the links between non-confrontational behaviors (e.g., talking) through to more confrontational (staring, approaching, and pushing others). Overall, the research forms the foundation for future investigation into these and similar settings and outlines a novel approach to understanding violence escalation in a way that can be interpreted and used by service staff.

The Effect of Motion Direction and Eccentricity on Vection, VR Sickness and Head Movements in Virtual Reality.

Virtual Reality (VR) experienced through head-mounted displays often leads to vection, discomfort and sway in the user. This study investigated the effect of motion direction and eccentricity on these three phenomena using optic flow patterns displayed using the Valve Index. Visual motion stimuli were presented in the centre, periphery or far periphery and moved either in depth (back and forth) or laterally (left and right). Overall vection was stronger for motion in depth compared to lateral motion. Additionally, eccentricity primarily affected stimuli moving in depth with stronger vection for more peripherally presented motion patterns compared to more central ones. Motion direction affected the various aspects of VR sickness differently and modulated the effect of eccentricity on VR sickness. For stimuli moving in depth far peripheral presentation caused more discomfort, whereas for lateral motion the central stimuli caused more discomfort. Stimuli moving in depth led to more head movements in the anterior-posterior direction when the entire visual field was stimulated. Observers demonstrated more head movements in the anterior-posterior direction compared to the medio-lateral direction throughout the entire experiment independent of motion direction or eccentricity of the presented moving stimulus. Head movements were elicited on the same plane as the moving stimulus only for stimuli moving in depth covering the entire visual field. A correlation showed a positive relationship between dizziness and vection duration and between general discomfort and sway. Identifying where in the visual field motion presented to an individual causes the least amount of VR sickness without losing vection and presence can guide development for Virtual Reality games, training and treatment programmes.

Mapping the pathways between recreational cannabis use and mood disorders: A Behaviour Sequence Analysis approach.

ISSUES ADDRESSED: Although cannabis use is still illegal in most places around the world, it remains a widely used drug. The recreational use of cannabis has been linked to multiple mental wellbeing issues, including psychosis, depression and anxiety. The objective of this study was to investigate the temporal dynamics of cannabis use in relation to mental health issues. METHODS: The current research uses a novel methodological approach, behaviour sequence analysis, to understand the temporal relationship between recreational cannabis use and surrounding issues related to mental wellbeing, in a sample of 61 participants who had written autobiographical accounts online. RESULTS: The results indicated a bi-directional temporal ordering between cannabis use and mood disorders. Cannabis use preceded psychosis and can also exacerbate symptoms of psychosis, depression and anxiety. Findings also suggested that low self-esteem may be a predictor of future cannabis use. CONCLUSIONS: Research shows a link between mood disorders and recreational cannabis use. The BSA method can be used in applied settings to map pathways in individuals' life histories. SO WHAT?: The current study shows the sequential links between cannabis use and psychosis, depression and anxiety. Results show there is no single clear pathway and clinical practitioners should focus on a wider range of factors in individual's case histories.

Negative Experiences of Non-Drinking College Students in Great Britain: an Interpretative Phenomenological Analysis.

Research relating to alcohol use amongst university students primarily examines the effects of binge drinking. Researchers rarely focus on a range of drinking styles including light or non-drinking. This study was designed to gain an in-depth understanding of the lived experiences of female, first year UK undergraduates, who do not drink alcohol. Semi-structured interviews were conducted with eight participants. Narratives were analysed using interpretative phenomenological analysis (IPA; by Smith and Osborn (Sage 51-80, 2003). Three superordinate themes were identified: "managing the feeling that you don't belong" highlights the importance of managing social interactions as a non-drinker; "experiencing social exclusion" recognises the impact on social bonding as a result of insufficient socialising opportunities; and "experiencing peer pressure and social stigma" highlights the scrutiny and labelling participants endured. These findings provide an understanding of some of the difficulties experienced by these undergraduates as a result of their non-drinking status. Implications of this research are discussed and areas for future research are outlined.

The Case for Using Personally Relevant and Emotionally Stimulating Gambling Messages as a Gambling Harm-Minimisation Strategy.

Emotions typically exert powerful, enduring, and often predictable influences over decision-making. However, emotion-based decision-making is seen as a mediator of impulsive and reckless gambling behaviour, where emotion may be seen as the antithesis of controlled and rational decision-making, a proposition supported by recent neuroimaging evidence. The present paper argues that the same emotional mechanisms can be used to influence a gambler to cease gambling, by focusing their emotional decision-making on positive external and personally relevant factors, such as familial impact or longer term financial factors. Emotionally stimulating messages may also have the advantage of capturing attention above and beyond traditionally responsible gambling messaging. This is important given the highly emotionally aroused states often experienced by both gamblers and problem gamblers, where attentional activation thresholds for external stimuli such as messages may be increased.

Age-related physical and psychological vulnerability as pathways to problem gambling in older adults.

Background To inform clinical treatment and preventative efforts, there is an important need to understand the pathways to late-life gambling disorder. Aims This study assesses the association between age-related physical health, social networks, and problem gambling in adults aged over 65 years and assesses the mediating role of affective disorders in this association. Methods The sample comprised 595 older adults (mean age: 74.4 years, range: 65-94 years; 77.1% female) who were interviewed using a structured questionnaire to assess physical frailty, geriatric pain, loneliness, geriatric depression, geriatric anxiety, and problem gambling. Results Pathway analysis demonstrated associations between these variables and gambling problems, providing a good fit for the data, but that critically these relationships were mediated by both anxiety and depression symptoms. Conclusions This study indicates that late-life problem gambling may develop as vulnerable individuals gamble to escape anxiety and depression consequent to deteriorating physical well-being and social support. When individuals develop late-life problem gambling, it is recommended that the treatment primarily focuses upon targeting and replacing avoidant coping approaches.

The experience of high-frequency gambling behavior of older adult females in the United Kingdom: An interpretative phenomenological analysis.

The prevalence of older adult female gambling participation and gambling disorder is increasing in the UK, and there is a paucity of published research available to understand possible risk factors for frequent gambling in this demographic. The aim of the current study was to identify and explore motivations and patterns of gambling behavior in high-frequency older adult female gamblers in the UK, from the perspective of the individual and in the context of their experience of aging. Ten UK older adult female high-frequency gamblers were recruited via stratified purposive sampling, with a mean age of 70.4 years. Data was collected via semistructured interviews and analyzed using interpretative phenomenological analysis. Three core themes representative of the experience of this phenomenon emerged from the transcripts, including: Filling voids, emotional escape, and overspending. The present study has provided a contextualized understanding of motivating factors and several age-related vulnerabilities that may account for high gambling frequency in this population.

Understanding Within-Session Loss-Chasing: An Experimental Investigation of the Impact of Stake Size on Cognitive Control.

Loss-chasing is a central feature of problematic gambling, yet it remains a poorly conceived and understood concept. Loss-chasing is believed to stem from an erosion of cognitive control when gambling. The opportunity to gamble at significantly disparate stake sizes on a gambling activity is considered to be a risk factor for loss-chasing. This study investigated the impact of gambling at disparate stake sizes on executive processes integral to maintaining cognitive control when gambling, namely response inhibition and reflection impulsivity. Frequent adult non-problem gamblers (n = 32) participated in a repeated measures experiment; and gambled at three disparate stake sizes (£20, £2 and no stake per bet) on a simulated gambling task. Participants' response inhibition performance and reflection impulsivity levels after gambling at various stake sizes were compared via a go/no-go task and information sampling task, respectively. Quality of decision-making i.e. the evaluation of available information to make probability judgements was impaired after gambling at higher stakes in comparison to lower stakes, indicating an increase in reflection impulsivity. No effect on response inhibition was observed. Although exploratory, this suggests that the opportunity for participants to substantially increase stake size on a gambling activity may be a risk factor for impaired cognitive performance when gambling, and perhaps create vulnerability for within-session loss-chasing in some players.

Experiences of time loss among videogame players: an empirical study.

Playing videogames is now a major leisure pursuit, yet research in the area is comparatively sparse. Previous correlational evidence suggests that subjective time loss occurs during playing videogames. This study examined experiences of time loss among a relatively large group of gamers (n = 280). Quantitative and qualitative data were collected through an online survey. Results showed that time loss occurred irrespective of gender, age, or frequency of play, but was associated with particular structural characteristics of games such as their complexity, the presence of multi-levels, missions and/or high scores, multiplayer interactions, and plot. Results also demonstrated that time loss could have both positive and negative outcomes for players. Positive aspects of time loss included helping players to relax and temporarily escape from reality. Negative aspects included the sacrificing of other things in their lives, guilty feelings about wasted time, and social conflict. It is concluded that for many gamers, losing track of time is a positive experience and is one of the main reasons for playing videogames.

Aggressive behaviour in slot machine gamblers: a preliminary observational study.

Gambling is acknowledged to have many negative effects on individuals. However, from a psychological perspective, aggression as an outcome of gambling has been largely overlooked to date. The incidence of aggressive behaviour was monitored in 303 slot machine players over four 6-hr. observation periods. Analysis identified four types of common aggressive behaviour. These were (1) verbal aggression towards the gambling arcade staff, (2) verbal aggression towards the slot machines, (3) verbal aggression towards other slot machine players, and (4) physical aggression towards the slot machines. The findings add support to the increasing number of studies highlighting a possible link between gambling and aggression.