Violence - suicide and suicidal ideation as sequelae of trauma in substance use disorder inpatients.

Experience with psychological trauma is overrepresented among substance use disorder (SUD) patients. SUDs may also be a risk factor for violent behaviors, suicidal ideation and suicide. This study proposes a link between these phenomena. Based on data from the EuropASI clinical interview of 137 SUD inpatients we computed a composite variable of trauma experience from being abused. We report descriptive data and cross tabulated problems controlling violent behavior, suicidal ideation or suicide attempts variables with trauma experience. Hypothesizing an association between experienced trauma and the outcome variables. We also examined the correlation between three outcome variables in inpatients. Our data suggested high incidents of experienced psychological trauma in the sample (66.7%). Chi-square tests suggested a significant difference in controlling violent behavior, suicidal ideation and suicide attempts, dependent on trauma experience. Spearman Roh correlations suggested asscociations between suicdal ideation and suicide attempts, and suicdal ideation and problems controlling violent behavior, but not with suicide attempts. Our data suggests that past trauma is a risk factor for violent and suicidal behaviors in the SUD population. Based on our findings we propose that former trauma should be considered in risk assessments and help guide treatment interventions.

A Randomized Controlled Trial of Attentional Control Training for Treating Alcohol Use Disorder.

Background: There is consistent evidence that community and clinical samples of individuals with an alcohol use disorder (AUD) have attentional biases toward alcohol cues. The alcohol attentional control training program (AACTP) has shown promise for retraining these biases and decreasing alcohol consumption in community samples of excessive drinkers. However, there is a lack of evidence regarding the effectiveness of ACTP in clinical AUD samples. The main aim of the present study is to investigate whether primary pharmacological and psychological, evidence-based alcohol treatment can be enhanced by the addition of a gamified AACTP smartphone application for patients with an AUD. Design and Methods: The study will be implemented as a randomized controlled trial. A total of 317 consecutively enrolled patients with AUD will be recruited from alcohol outpatient clinics in Denmark. Patients will be randomized to one of three groups upon initiation of primary alcohol treatment: Group A: a gamified AACTP smartphone application + treatment as usual (TAU); Group B: a gamified AACTP sham-control application + TAU; or Group C: only TAU. Treatment outcomes will be assessed at baseline, post-treatment, and at 3- and 6-month follow-ups. Repeated measures MANOVA will be used to compare the trajectories of the groups over time on alcohol attentional bias, alcohol craving, and drinking reductions. It is hypothesized that Group A will achieve better treatment outcomes than either Group B or Group C. Perspectives: Because attentional bias for alcohol cues is proportional to the amount of alcohol consumed, and these biases are not addressed within current evidence-based treatment programs, this study is expected to provide new evidence regarding the effectiveness of the gamified AACTP in a clinical population. Furthermore, due to promising results found using AACTP in community samples of excessive drinkers, there is a high probability that the AACTP treatment in this study will also be effective, thereby allowing AACTP to be readily implemented in clinical settings. Finally, we expect that this study will increase the effectiveness of evidence-based AUD treatment and introduce a new, low-cost gamified treatment targeting patients with an AUD. Overall, this study is likely to have an impact at the scientific, clinical, and societal levels. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05102942?term=NCT05102942&draw=2&rank=1, identifier: NCT05102942.

The relationship between explicit and implicit attitudes towards drunk driving.

Despite downward trends, driving under the influence (DUI) remains one of the most salient traffic safety problems. It is crucial to identify the processes behind a problem behaviour to target the most effective measures to address it. One way of exploring precursors of behaviour is measuring attitudes. All persons hold two types of attitudes, explicit and implicit. Although only one of these (explicit) lays the groundwork for current understandings of DUI, it is imperative to explore both types of attitudes. We explore the relationship between explicit and implicit attitudes towards DUI for the first time in the field. Explicit attitudes (what we say we mean) are measured by a questionnaire. Implicit attitudes (which are introspectively unidentified or inaccurately identified traces of past experience) are measured by the Go/No-go Association Task (GNAT) in a sample of young male drivers (n = 101). The results show a relationship between the two types of attitudes, but not completely in the expected way. Depending whether the amount of alcohol is over or under the legal limit, the relationship between explicit and implicit attitudes varies. We discuss the findings and provide directions for future investigations.

Consistency between subjectively and objectively measured hazard perception skills among young male drivers.

Young male drivers have lower hazard perception skills (HPS) than older and more experienced drivers and a tendency to overestimate their skills in hazardous situations. Both factors contribute to an over-representation in traffic accidents. Based on a sample of 63 drivers aged 18-24, this study compares the consistency of HPS measured by objective and subjective measures and the link between these measures is the key contribution of the study. Both visible and hidden hazards are included. Objective measures of HPS include responsiveness and eye movements while driving in a driving simulator. Subjective measures of HPS include self-reports derived based on the Hazard Perception Questionnaire (HPQ), Driving Skill Questionnaire (DSQ), and Brief Sensation Seeking Scale (BSSS). Results show that drivers who respond to the hazards on time, as compared to drivers who do not respond, have higher scores on subjective measures of HPS and higher driving skills in the visible but not in the hidden condition. Eye movement analysis confirms the difference and shows that response in time to hazards indicate higher HPS and young drivers are poor at detecting hidden hazards. Drivers with a response in time locate the hazard faster, have more fixations, but dwell less on the hazard. At the same time, those who do not respond have a later first fixation and fewer but longer fixations on the hazard. High sensation seeking drivers respond to visible hazards on time, suggesting that sensation seeking does not affect HPS negatively when the hazard is visible. To enhance the HPS among young drivers, the results of this study suggest that specific hazard perception training is relevant, especially for hazards that require more advanced HPS.

Developing a model for measuring fear of pain in Norwegian samples: The Fear of Pain Questionnaire Norway.

BACKGROUND: Fear of pain is highly correlated with pain report and physiological measures of arousal when pain is inflicted. The Fear of Pain Questionnaire III (FPQ-III) and The Fear of Pain Questionnaire Short Form (FPQ-SF) are self-report inventories developed for assessment of fear of pain (FOP). A previous study assessed the fit of the FPQ-III and the FPQ-SF in a Norwegian non-clinical sample and proved poor fit of both models. This inspired the idea of testing the possibility of a Norwegian FOP-model. AIMS AND METHODS: A Norwegian FOP-model was examined by Exploratory Factor Analysis (EFA) in a sample of 1112 healthy volunteers. Then, the model fit of the FPQ-III, FPQ-SF and the Norwegian FOP-model (FPQ-NOR) were compared by Confirmatory Factor Analysis (CFA). Sex neutrality was explored by examining model fit, validity and reliability of the 3 models amongst male and female subgroups. RESULTS: The EFA suggested either a 4-, a 5- or a 6-factor Norwegian FOP model. The eigenvalue criterion supported the suggested 6-factor model, which also explained most of the variance and was most interpretable. A CFA confirmed that the 6-factor model was better than the two 4- and 5-factor models. Furthermore, the CFA used to test the fit of the FPQ-NOR, the FPQ-III and the FPQ-SF showed that the FPQ-NOR had the best fit of the 3 models, both in the whole sample and in sex sub-groups. CONCLUSION: A 6-factor model for explaining and measuring FOP in Norwegian samples was identified and termed the FPQ-NOR. This new model constituted six factors and 27 items, conceptualized as Minor, Severe, Injection, Fracture, Dental, and Cut Pain. The FPQ-NOR had the best fit overall and in male- and female subgroups, probably due to cross-cultural differences in FOP. IMPLICATIONS: This study highlights the importance on exploratory analysis of FOP-instruments when applied to different countries or cultures. As the FPQ-III is widely used in both research and clinical settings, it is important to ensure that the models construct validity is high. Country specific validation of FOP in both clinical and non-clinical samples is recommended.

The Fear of Pain Questionnaire-III and the Fear of Pain Questionnaire-Short Form: a confirmatory factor analysis.

BACKGROUND: The Fear of Pain Questionnaire-III (FPQ-III) is a widely used instrument to assess the fear of pain (FOP) in clinical and nonclinical samples. The FPQ-III has 30 items and is divided into three subscales: Severe Pain, Minor Pain and Medical Pain. Due to findings of poor fit of the original three-factor FPQ-III model, the Fear of Pain Questionnaire-Short Form (FPQ-SF) four-factor model has been suggested as an alternative. The FPQ-SF is a revised version of the FPQ-III, reduced to 20 items and subdivided into four subscales: Severe Pain, Minor Pain, Injection Pain and Dental Pain. AIMS AND METHODS: The purpose of the study was to investigate the model fit, reliability and validity of the FPQ-III and the FPQ-SF in a Norwegian nonclinical sample, using confirmatory factor analysis (CFA). The second aim was to explore the model fit of the two scales in male and female subgroups separately, since previous studies have uncovered differences in how well the questionnaires measure FOP across sex; thus, the questionnaires might not be sex neutral. It has been argued that the FPQ-SF model is better because of the higher fit to the data across sex. To explore model fit across sex within the questionnaires, the model fit, validity and reliability were compared across sex using CFA. RESULTS: The results revealed that both models' original factor structures had poor fit. However, the FPQ-SF had a better fit overall, compared to the FPQ-III. The model fit of the two models differed across sex, with better fit for males on the FPQ-III and for females on the FPQ-SF. CONCLUSION: The FPQ-SF is a better questionnaire than the FPQ-III for measurement of FOP in Norwegian samples and across sex subgroups. However, the FPQ-III is a better questionnaire for males than for females, whereas the FPQ-SF is a better questionnaire for females than for males. The findings are discussed and directions for future investigations outlined.

Age, gender, mileage and the DBQ: the validity of the Driver Behavior Questionnaire in different driver groups.

The Driver Behavior Questionnaire (DBQ) is one of the most widely used instruments for measuring self-reported driving behaviors. Despite the popularity of the DBQ, the applicability of the DBQ in different driver groups has remained mostly unexamined. The present study measured aberrant driving behavior using the original DBQ (Reason, J.T., Manstead, A., Stradling, S.G., Baxter, J., Campbell, K., 1990. Errors and violations on the road - a real distinction. Ergonomics, 33 (10/11), 1315-1332) to test the factorial validity and reliability of the instrument across different subgroups of Danish drivers. The survey was conducted among 11,004 Danish driving license holders of whom 2250 male and 2190 female drivers completed the questionnaire containing background variables and the DBQ. Exploratory and confirmatory factor analysis showed that the original three-factor solution, a four-factor solution and a two-factor solution had acceptable fit when using the whole sample. However, fit indices of these solutions varied across subgroups. The presents study illustrates that both the original DBQ and a Danish four-factor DBQ structure is relatively stable across subgroups, indicating factorial validity and reliability of the DBQ. However, as the Danish DBQ structure has an overall better fit, the present study highlights the importance of performing an explorative analysis when applying the DBQ in order to assess the problem areas within a driving population.

Short and user-friendly: The development and validation of the Mini-DBQ.

The Driver Behavior Questionnaire (DBQ) is used to measure aberrant driver behavior by asking drivers how often they engage in various aberrant driver behaviors. Since the development of the original DBQ, several modified versions have been developed. The difference between the various versions is that new items are added or existing items modified or excluded. However, despite the differences, all versions are relatively long and therefore time-consuming and tiring to answer, which might limit the usability of the instrument. The main purpose of the present study was to develop a mini DBQ version by reducing the 27-item original DBQ to the shortest possible DBQ version. A second aim was to explore the feasibility of a second-order structure within the data, which means that violations, errors and lapses factors load on a higher-order aberrant driver behavior factor. The presence of a second-order structure further indicates the validity of the DBQ and its theoretical structure. Confirmatory factor analysis (CFA) was used to test the fit (i.e., how well the models explain the data) of the original DBQ versus the fit of the shortest possible DBQ, as well as the presence of a second-order structure for the DBQ. The results indicated a nine-item Mini-DBQ. In addition, a second-order structure was established in the data. These findings indicate that the Mini-DBQ is a valid and useful short measure of aberrant driver behavior.