A comparison of stimulus fading and stimulus shaping on perceptual category learning.

Errorless learning strategies such as stimulus fading and stimulus shaping are commonly used to teach complex skills like categorisation and concept formation. Despite widespread use, very few studies have explored the comparative effectiveness of these procedures in well-controlled analyses. The vast majority of existing studies have been undertaken with clinical populations and have involved small numbers of participants (e.g., Single-case designs). The present study sought to compare stimulus fading, stimulus shaping, and trial-and-error learning in a perceptual categorisation task. In Experiment 1, we found robust benefits of stimulus shaping when compared to stimulus fading or trial-and-error learning on measures of initial acquisition of discrimination and one measure of stimulus generalisation. These findings were replicated in a second experiment in which the dimension of fading/shaping was changed from a modification of the comparison stimuli (S-) to a modification of the target stimulus (S +). We discuss the implications of our findings for the selection of errorless learning strategies in clinical settings.

"They loved gambling more than me." Women's experiences of gambling-related harm as an affected other.

BACKGROUND: Gambling poses a global threat to public health due to its far-reaching impacts. Research has demonstrated a ripple effect of harmful gambling on social network members and broader communities. While researchers have documented extreme harms associated with an affected other, limited research has qualitatively investigated how women describe their concerns about the gambling of a social network member, and any subsequent negative impacts on their own lives. METHODS: An online panel survey was conducted with women aged 18 years and older, who gambled at least once in the last 12 months, and resided in the Australian states of Victoria and New South Wales. This paper focused on the open text responses of a subsection of the sample (n = 136) who reported being negatively impacted by someone else's gambling. The study utilised reflexive thematic analysis to interpret the data. RESULTS: Results indicated that women were concerned about the gambling behaviours of a broad range of social network members. Open text responses regarding the nature of these concerns mostly related to individualised paradigms of gambling behaviour - including whether the participant perceived their network member could afford to gamble, was being responsible with their gambling, or were gambling too frequently. Participants experienced a range of negative impacts including significant financial issues, relationship difficulties, poorer emotional wellbeing as a result of worrying about the gambler, and loss of trust. Some described the negative experiences associated with growing up with a parent who gambled. CONCLUSION: The research demonstrates the broad impacts of gambling on affected others. This study enhances our understanding of how women are harmed by gambling and considers the complexities of their experiences and relationships with the gambler. This extends knowledge beyond quantitative descriptors of harm among affected others and provides a critical reflection on the nuances of women's experiences with gambling and gambling harm.

Alcohol-related brain damage: A mixed-method evaluation of an online awareness-raising programme for frontline care and support practitioners.

INTRODUCTION: Alcohol-related brain damage (ARBD) is an umbrella term referring to the neurocognitive impairments caused by excessive and prolonged alcohol use and the associated nutritional deficiencies. This study evaluated the outcomes of an online research-informed training program for ARBD which aimed to improve client outcomes by promoting support staff's awareness and confidence in working with clients who may have (or who are at risk of developing) the condition. METHODS: Staff working within a large non-governmental non-profit housing organisation (n = 883) enrolled in the training program. Questionnaires were used pre- and post-training to collect self-reported awareness of ARBD and confidence in supporting individuals with the condition. Semi-structured interviews were conducted with 27 staff members approximately 10 weeks post-completion of the program. Interviews were audio-recorded, transcribed verbatim and analysed by employing qualitative content analysis. RESULTS: Findings from the questionnaires indicated a significant increase in all measures after completing the training program. Three main themes were developed based on the interview data: changes to awareness and understanding; professional practice; and training-specific characteristics. Participants reported changes in their ability to identify potential service users with ARBD and confidence in doing so. DISCUSSION AND CONCLUSION: Our findings demonstrate that online training programs can be effective in improving support staff's ability to identify ARBD, potentially leading an increase in signposting service users to relevant services. The research-informed nature of the training demonstrates that translating research findings directly to frontline workers can have a substantial impact and may improve outcomes for this client group.

Alcohol-related brain damage: an umbrella (term) for the approaching post-COVID monsoon.

Individuals with alcohol-related brain damage (ARBD) represent a population whose healthcare needs often go unmet. This is the result of a lack of not only an awareness surrounding the condition by healthcare professionals, but also healthcare service inclusion and delivery, more broadly. The Coronavirus 2019 (COVID-19) pandemic and the associated lockdowns dramatically affected the accessibility and availability of addiction services globally, while also driving changes in alcohol consumption among the most vulnerable. In the absence of change, this culmination of increased high-risk drinking behaviour, lack of awareness by healthcare professionals and severely limited service delivery for individuals living with ARBD post COVID-19, represents a perfect storm that is rapidly approaching our health and care services world-wide. Collectively, this will reduce positive health outcomes in an already at-risk group.

The Paradox of the Frontal Lobe Paradox. A Scoping Review.

The "frontal lobe paradox" highlights a phenomenon in which a subset of patients who possess frontal lobe damage and exhibit marked impairments in everyday life are still able to able to verbally describe a logical course of action relating to a task and perform well in interview and test settings. Such cases pose a challenge with regard to the assessment of mental capacity within clinical settings. Recent position articles state that the frontal lobe paradox is a well-known phenomenon within the field of neuropsychology, anecdotal reports from clinicians in the UK suggest this is not the case. Consequently, we conducted a scoping review to examine the breadth and depth of literature relating to the frontal lobe paradox. Searches were conducted using electronic databases and search engines, which were supplemented with a snowball search of the references used within relevant literature. We identified and reviewed 28 documents specifically related to the frontal lobe paradox. Nearly 50% of all identified academic texts published since 2000 were position articles that cited a handful of case studies published between 1936 and 1986 as evidence for the phenomenon. We also observed instances of articles citing position articles as evidence of the frontal lobe paradox. Overall, our findings indicate a lack of readily accessible research specific to the frontal lobe paradox. In particular, there is a lack of contemporary research specific to the subject and an absence of clarification as to which syndromes and disorders are included within the term.

Conceptualising emotional and cognitive dysregulation amongst sports bettors; an exploratory study of 'tilting' in a new context.

Tilting is a poker-related phenomenon that involves cognitive and emotional dysregulation in response to unfavourable gambling outcomes. Tilting is characterised by an increase in irrational, impulsive and strategically weak betting decisions. This study aimed to adapt and investigate the concept of tilting amongst sport bettors in order to provide preliminary insight regarding previously unexplored instances of maladaptive sports betting. The sample consisted of 225 sports bettors who completed an online questionnaire that investigated their reported tilting episodes, awareness of tilting, impulsivity, perceived skill, gambling severity, gambling frequency, and product preferences. Cluster analyses revealed three distinct groups of sports bettors based on their reported tilting episodes and their awareness of this phenomenon. The first group were labelled 'Conscious tilters' due to being cognizant of their own tilting occurrence which was significantly higher than the other two groups. These 'Conscious tilters' had the highest mean problem gambling severity that was indicative of the 'problem gambler' categorisation. The second group were labelled 'Unconscious tilters' due to their underestimation of their own tilting occurrence and were categorised as 'moderate risk gamblers'. The third group were labelled 'Non-tilters' due to a relatively accurate perception of their low to non-existent tilting occurrence and were categorised as 'low-risk gamblers'. Additionally, there were significant differences between these groups in relation to reported gambling frequency, impulsivity, and product preferences. There is evidence of various classifications of 'tilters' within sports betting. Specific sports betting product features may also facilitate tilting and therefore require further research in this context. It is important for this research area to develop in order to mitigate harms associated with the rapidly changing sport betting environment.

Emergent gambling advertising; a rapid review of marketing content, delivery and structural features.

BACKGROUND: Gambling advertising is well-funded and has become increasingly sophisticated in recent years. As the presence and pervasiveness of gambling advertising increases, there is a corresponding need for empirical understanding of the characteristics and trends associated with emergent gambling advertisements and marketing. However, there is limited data on this rapidly evolving phenomenon. METHODS: A rapid review was undertaken of the empirical research (2015-2020) that focused upon the content, delivery and structural features incorporated within emerging gambling advertising. RESULTS: Twenty-five studies were included in the review. The majority of these studies were conducted in either the UK or Australia; two jurisdictions that have unique and particularly liberal gambling environments. The literature suggests that emergent gambling advertising content is targeted, positively framed and in some instances, may overrepresent riskier bets. The sporting and social media spheres are densely populated with such advertisements that involve both direct and indirect marketing strategies. In relation to the online environment, there is evidence to suggest the emergence of more interactive advertisements that prompt user engagement. In addition, financial incentivisation has diversified and is often subject to strict and esoteric conditions. Despite these emergent trends, little provision is devoted to adequately displaying harm reductive or responsible gambling content within gambling advertising. CONCLUSIONS: Overall, there is a paucity of research and lack of methodological diversity concerning the characteristics of advertising within the literature. The barriers to investigating emerging gambling advertising are discussed alongside future research priorities. It is important for this research area to expand in order to appropriately inform ethical industry marketing and effective harm-reduction strategies. [Pre-registered online via Prospero: CRD42020184349].

Does the Fast Alcohol Screening Test Accurately Distinguish Between Harmful and Severely Dependent Tiers of Alcohol Misuse?

AIMS: Primary aim: to determine the efficacy of FAST (the Fast Alcohol Screening Test) for detecting harmful and dependent levels of alcohol use. Secondary aim: to compare the performance of the FAST to two short forms of the Alcohol Use Disorder Identification Test (AUDIT): the AUDIT-C and AUDIT-3. METHODS: Data from 3336 individuals in South Wales, compiled from full AUDIT datasets, were examined. AUROC analysis, alongside measures of sensitivity and specificity of the FAST, AUDIT-C and AUDIT-3 were utilized for the identification of harmful and dependent alcohol use. RESULTS: The FAST demonstrated efficacy in the identification of harmful and dependent levels of alcohol use, with superior performance to both the AUDIT-C and AUDIT-3. CONCLUSION: The present paper demonstrates the potential of the FAST as a cost- and time-effective method for appropriate screening and signposting in the stepped care model utilized by many health care and treatment services. Further studies are needed to ensure validity, both within the general population and for specific services and populations.

'It's basically everywhere': young adults' perceptions of gambling advertising in the UK.

In comparison to jurisdictions, such as Australia, limited research has focused upon the perceptions and reported effects of gambling advertising within the unique gambling environment of the UK. An online qualitative survey was conducted with 62 young adult gamblers in the UK. The survey investigated the place, meaning and influence of gambling advertising within the lives of the participants. Demographic data were analyzed using descriptive statistics, with qualitative data interpreted using inductive thematic analysis techniques. Three themes were identified. Firstly, young adults were highly cognizant of UK gambling advertising strategies. Second, young adults were able to describe the influence of gambling advertising including its normalizing effect and proliferation of misleading messages. Finally, young adults perceived that current harm minimization strategies, including responsible gambling messages, were ineffective. Many were supportive of increased regulation of gambling advertising. The findings indicate that young adults are aware of the potential risks associated with gambling advertising and are supportive of regulatory reform. It is important that the views and perspectives of young adults are fully considered by regulators and policy makers in the UK, particularly as they are a potential target demographic for the industry.

Alcohol-Related Neurocognitive Disorders: A Naturalistic Study of Nosology and Estimation of Prevalence in South Wales, United Kingdom.

OBJECTIVE: Existing studies relating to the prevalence of alcohol-related neurocognitive disorders (ARNDs; e.g., Korsakoff's Syndrome, alcohol-related dementia) are now outdated and few have been undertaken in the United Kingdom. The aim of this study was to estimate the prevalence of ARNDs in South Wales, U.K., and determine the specific diagnostic terms and criteria used in clinical practice. METHOD: A naturalistic, survey-based prevalence study was undertaken wherein data were collected retrospectively for all individuals with ARNDs attending services during all of 2015 and 2016. A diverse sample of health and social care services (N = 60) in South Wales took part in the study. RESULTS: A total of 490 individuals with ARNDs were identified by participating services, equating to an age-specific rate of 34 individuals per 100,000 inhabitants. Variability was observed across age ranges and genders, with most identified in the 45-64 year age range and a male:female ratio of 2.6:1. Twenty-three individuals younger than age 35 were identified, demonstrating an increase in younger cases compared with previous studies. Various diagnostic terms were used, with "alcohol-related brain damage" being most common. Only 6.3% of cases were diagnosed according to specific criteria and 44.3% were reported as having a "probable" ARND, meaning no official diagnosis had been designated but initial assessments indicated that they likely had an ARND. CONCLUSIONS: Findings provide a novel understanding of ARND prevalence in a previously understudied area, although the prevalence estimate is conservative and should be interpreted cautiously for reasons discussed. Findings also highlight an inconsistency between diagnoses presented in nosological systems (e.g., International Classification of Diseases-10th Revision) and those used in practice and therefore a need to evaluate novel diagnostic conceptualizations of alcohol-related neurocognitive impairment.

Gambling Harm as a Global Public Health Concern: A Mixed Method Investigation of Trends in Wales.

Background: Recent research evidence has suggested that gambling is a public health concern. A number of studies report the association between gambling activity and increased instances of various other harms, including substance misuse and psychological disorders. In parallel to alcohol misuse, it is also becoming clear that gambling related harm is more of a continuum of harm, as opposed to traditionally accepted categorisations of gambling behavior: safe and responsible or "problem" and harmful. Previous effective treatment models for alcohol misuse have considered a public health approach to develop interventions. As such, the current research seeks to use a public health approach to both investigate the extent of gambling harm across Wales, and to identify upstream predictors of harm to inform future interventions. Method: A triangulation of data collection methods was utilized across Wales, UK. Two hundred and forty-eight participants completed a quantitative survey relating to gambling behavior and related harm, which included the Problem Severity Gambling Index, the Gambling Commission measure of frequency, The Gambling Motives Questionnaire and the Fast Alcohol Screening tool. Ninety-eight of these participants completed a qualitative subsection. Structured interviews were conducted with 20 individuals from 11 service providers. Semi-structured interviews were conducted for the five case studies of individuals who had previously sought help for gambling. The geographical density and distribution of Licensed Gambling Outlets was also mapped in local areas. Results: The findings provide further evidence of a continuum of gambling related harm. Twenty seven percent of survey participants demonstrate some indicators of risk of gambling harm. Social, cultural and environmental contexts play a role in initiation and maintenance of gambling behavior and the subsequent related harm. Accounts from individuals corroborated the quantitative findings. Conclusions: Findings from this Welsh sample are in line with and add support to the growing international research evidence that gambling harms are a universal issue that cross cultures. It is clear that action is needed by legislators at a policy level and that broadening the focus of intervention to a public health level is necessary to develop effective strategies for harm reduction.

Embedded Gambling Promotion in Football: An Explorative Study of Cue-Exposure and Urge to Gamble.

Limited research has evaluated the psychological effect of sports-betting advertising (such as embedded promotion) upon consumers considered 'higher-risk'. Students are often considered a higher-risk group given the numerous gambling-related risk factors associated with their lifestyle. Furthermore, students studying sports-related subjects may possess a bespoke vulnerability to sports-betting risk, due to contextual factors such as (mis)perceptions regarding advantages of sports-related knowledge. The pilot study investigated whether exposure to embedded gambling promotions during televised football, elicits urges to gamble amongst students, and whether the severity of reported gambling varies between those who study sports-related and non-sports subjects. An experimental methodology was employed. Sixty students from the University of South Wales were shown one of three videos: (a) televised football match highlights containing a high density of embedded promotion; (b) amateur football match highlights containing no gambling-related cues or embedded promotion; (c) a neutral control video containing footage of a live concert. Urge to gamble and risk of gambling problems were measured following video exposure. Sports-students reported significantly higher risk of gambling problem scores than non-sports students. Correspondingly, sport-students who were exposed to embedded gambling promotion reported significantly higher urges to gamble compared to all other conditions. This effect was also observed amongst sports-students who were exposed to an amateur match containing no gambling-related material. These findings provide evidence for the cue-induced urge effect of sports-embedded gambling promotion, amongst vulnerable audiences. Public health interventions and harm reduction strategies should look to counteract these pervasive forms of gambling advertising.

Applications of within-stimulus errorless learning methods for teaching discrimination skills to individuals with intellectual and developmental disabilities: A systematic review.

Errorless learning is an instructional strategy used widely with individuals with intellectual and developmental disabilities. The present systematic review aims to update the literature on the application of 'within-stimulus' errorless procedures. The protocol was registered with PROSPERO (CRD42018118385). Twenty-eight articles including 283 participants met the operationally defined inclusion criteria. In the majority of cases, the errorless learning procedures evaluated led to improvements in acquiring discrimination skills. Most of the reviewed studies evaluated stimulus fading. Results are discussed in relation to the selection of within-stimulus procedures. Areas identified for future research include further evaluations of other within-stimulus tactics, as well as further refinement of procedural parameters.

Development and Initial Validation of a Rock Climbing Craving Questionnaire (RCCQ).

Conceptual similarities have been identified between experiences of extreme sports athletes and those with drug and behavioral addictions. Evidence suggests rock climbers experience craving and other withdrawal-like states when abstinent from their sport. However, no studies have attempted to quantitatively measure the craving experienced by participants of any extreme sports. Such a measure could allow a greater understanding of the craving experienced by extreme sports athletes and a comparison of these across sports (e.g., surfing) and activities (e.g., drug-use). Therefore, using validated craving measures as a template, the aim of the two studies outlined here was to design and preliminarily validate a subjective multidimensional inventory that could be used to measure craving in the sports of rock-climbing and mountaineering ("RCCQ"). The aim of the first study was to investigate the factor structure of a preliminary measure of craving. Climbers (n = 407) completed the RCCQ. A 3-factor model explained 53.65% of the total variance in item scores. All three factors comprised five items each, which were conceptually labeled as "urge to climb" "negative reinforcement" and "positive reinforcement." The aim of the second study was to validate the 15-item 3-factor RCCQ resulting from Study 1 using confirmatory factor analysis (CFA). Climbers (n = 254) completed the questionnaire under a climbing-related cue condition or a cue-neutral condition. CFA revealed a good model fit and that all individual parameter estimates were significant and standard errors were within reasonable limits once item 13 was removed from Factor 1. Study 1 supports the multi-dimensional nature of rock climbing craving and shows parallels with substance-related craving in reflecting intention and positive (desire) and negative (withdrawal) reinforcement. Study 2 confirms this factor structure and gives initial validation to the measure with evidence that these factors are sensitive to cue exposure. Given the preliminary nature of the data, any practical implications are tentative. However, if as shown here, craving for climbing (and potentially other extreme sports) is similar to that experienced by drug-users and addicts, there is the potential that climbing and other extreme sports could be used as a replacement therapy for drug users.

Identification and Evaluation of Neuropsychological Tools Used in the Assessment of Alcohol-Related Cognitive Impairment: A Systematic Review.

Background: Neuropsychological assessment is central to identifying and determining the extent of Alcohol-Related Cognitive Impairment (ARCI). The present systematic review aimed to synthesize and discuss the evidence appraising the neuropsychological tests used to assess ARCI in order to support clinicians and researchers in selecting appropriate tests for use with this population. Methods: We searched for studies investigating the psychometric, diagnostic and practical values of tools used in the screening, diagnosis, and assessment of Korsakoff's Syndrome (KS), Alcohol-Related Dementia (ARD), and those with a specific diagnosis of Alcohol-Related Brain Damage (ARBD). The following databases were searched in March 2016 and again in August 2018: MEDLINE, EMBASE, Psych-INFO, ProQuest Psychology, and Science Direct. Study quality was assessed using a checklist designed by the authors to evaluate the specific factors contributing to robust and clearly reported studies in this area. A total of 43 studies were included following the screening of 3646 studies by title and abstract and 360 at full-text. Meta-analysis was not appropriate due to heterogeneity in the tests and ARCI samples investigated in the studies reviewed. Instead, review findings were narratively synthesized and divided according to five domains of assessment: cognitive screening, memory, executive function, intelligence and test batteries, and premorbid ability. Effect sizes (d) were calculated to supplement findings. Results: Overall, several measures demonstrated sensitivity to the cognitive deficits associated with chronic alcoholism and an ability to differentiate between gradations of impairment. However, findings relating to the other psychometric qualities of the tests, including those important for the accurate assessment and monitoring of ARCI (e.g., test-retest reliability), were entirely absent or limited. Additionally, the synthesis of neuropsychological outcomes presented here supports the recent impetus for a move away from discrete diagnoses (e.g., KS, ARD) and the distinctions between them toward more broad and inclusive diagnostic conceptualizations of ARCI, thereby recognizing the heterogeneity in presentation. Conclusions: Based on the evidence reviewed, provisional recommendations for appropriate tests in each domain of assessment are presented, though further validation of most tests is warranted. Review findings can support efficient and evidenced-based test-selection and guide future research in this area.

The Effectiveness of Brief Information and Self-Efficacy-Based Interventions in Influencing Snack Choices in Homeless Individuals.

BACKGROUND: Homeless adults frequently experience poor nutrition. Research suggests raising self-efficacy and nutritional knowledge can increase healthy eating but that the choice of specific behavioral change techniques (BCTs) is also critical. This study investigated how BCTs, operationalized to increase nutrition knowledge and self-efficacy, might influence the choice of homeless adults when presented with a "healthy" and an "unhealthy" snack. METHODS: A total of 125 homeless adults were randomly allocated to watch 1 of 4 brief films: "control," "[nutrition] information only," "self-efficacy" (aimed at increasing self-efficacy and general healthy eating knowledge), and "enhanced self-efficacy" (as "self-efficacy," but the presenter identified themselves as a homeless adult). Post-film, participants were invited to choose between a healthy and an unhealthy snack. Data were analyzed using ANOVA and chi square. RESULTS: Participants in the "enhanced self-efficacy" condition were significantly more likely to choose the healthy option compared to those in the control condition; for the "self-efficacy" condition, the difference was marginally significant. Perceived knowledge and self-efficacy were significantly associated and those with high self-efficacy were significantly more likely to choose a healthy snack regardless of condition. CONCLUSION: Homeless adults are more likely to make healthy snack choices if their nutritional self-efficacy is increased through encouragement by a peer.

Response to "Nature fix: Addiction to outdoor activities"R. C. Buckley's commentary on Heirene, R. M., Shearer, D., Roderique-Davies, G., & Mellalieu, S. D. (2016). Addiction in extreme sports: An exploration of withdrawal states in rock climbers. Journal of Behavioral Addictions, 5, 332-341.

Buckley's commentary on our study of rock climber's withdrawal experiences raises a number of important questions surrounding the concept of extreme or adventure sports addiction. Drawing on the few available investigations of this topic, we respond to Buckley's questions here, though emphasize the need for further studies of extreme sports addiction in order to provide more empirically informed answers.