Framework proposal for Role-Playing Games as mental health intervention: the Critical Skills methodology.

Gamified interventions are an emerging approach in mental health treatment and prevention. Their positive effects on managing various clinical conditions stem from enhancing social skills. However, cost-effective options like Table-top Role-Playing Games (TTRPGs), which offer similar benefits to other game-based interventions, lack standardized methods for ensuring replicability. In this regard, the method outlined in this study endeavors, in a structured and guided manner drawing from the Consolidated Framework for Implementation Research (CFIR), to establish a six-step protocol for developing an intervention method utilizing TTRPGs. In all Steps, we aim to anchor ourselves in robust literature concerning social skills training (SST), cognitive behavioral therapy (CBT), and gamification comprehensively. Thus, the method presented encompasses the objectives of SST, the strategies of CBT, and the dynamics of gamification via TTRPGs. Furthermore, we demonstrate a possible application of the method to illustrate its feasibility. Ultimately, the final method is structured, evidence-based, easily applicable, cost-effective, and thus viable. Mental health professionals seeking a structured and instructional tool for protocol development will find support in the method proposed here.

Comparison of two magnetic resonance imaging spectroscopy postprocessing methods.

OBJECTIVE: The aim of this study was to compare the results obtained using SpectroView® (SV) and J-Magnetic Resonance User Interface (jMRUI) from the same magnetic resonance (MR) spectroscopy of hydrogen data. METHODS: Data from 23 males with alcohol use disorder (AUD) and 23 healthy non-AUD males were acquired by a 1.5 Tesla MR using a PRESS sequence (TE=30 ms) in four voxels located in the right frontal and left frontal (RF and LF) lobes, and posterior cingulate (AC and PC). The ratio of the signals from both N-acetyl-aspartate (NAA) and choline (Cho) over creatine (Cr) was calculated automatically using SV and semiautomatically by an expert neuroradiologist using jMRUI. The software' agreement was calculated by the 95% limits of agreement (LoA) of the ratio of the obtained values. RESULTS: The standard deviation was greater in jMRUI than in SV. Although there was a correlation between the results from both methods, it was not possible to predict their variance from one another. Additionally, the 95% LoA showed that jMRUI values were expected to vary from 38 to 190% of those obtained using SV for NAA/Cr in RF of AUD subjects and from 48 to 196% for NAA/Cr in CA of non-AUD individuals. CONCLUSIONS: The difference between the methods may represent clinically significant magnitudes. We suggest the use of the same method when comparing spectroscopic data. We also suggest that in clinical practice, the automatic method should be preferred.

Lower Choline Rate in the Left Prefrontal Cortex Is Associated With Higher Amount of Alcohol Use in Alcohol Use Disorder.

Excessive and long-term alcohol consumption produce metabolic changes, such as of choline, in many brain regions in alcohol use disorder (AUD) and in non-AUD subjects as well. This study examined the association of choline proportion in the prefrontal cortex with pattern of alcohol use in AUD patients. The choline metabolite was acquired through a single voxel Proton Magnetic Resonance Spectroscopy (1H MRS). Between-groups comparison corrected by age showed that the ratio of Choline/Creatine (Cho/Cr) was significantly smaller (p = 0.005) in the Left Prefrontal (LPF) of AUD patients when compared to paired non-AUD subjects. A multiple regression analysis corrected by age showed that decreasing ratios of Cho/Cr in the LPF was associated with increasing amount of alcohol consumption in drinks per day (p < 0.01) in AUD patients. Rates of Cho/Cr in the LPF was inversely related to amounts of alcohol consumption possibly indicating the severity of the AUD. Thus, low proportion of Cho/Cr in the LPF could indicate more severe AUD (higher alcohol intake).