Olivia Metcalf

Attentional bias in excessive massively multiplayer online role-playing gamers using a modified Stroop task

There is considerable dispute regarding the nature of excessive or problematic Internet-related behaviour and whether it constitutes a clinical addiction. Classification of excessive gaming is hindered by a lack of experimental research investigating behavioural responses from gamers and comparing these patterns to those found in established addictions. We investigated whether an attentional bias for gaming-related words existed for addicted Massively Multiplayer Online Role-Playing Gamers (MMORPGers) identified using the Addiction-Engagement Questionnaire. Forty frequent MMORPGers (15 female) and 19 non-MMORPGers (eight female) completed a computerised modified Stroop task comprised of game-related, negative and neutral word lists, Addiction-Engagement Questionnaire, Depression, Anxiety and Stress Scale 21, gaming-related variables. The results indicated that addicted MMORPGers had significantly longer reaction times to negative and MMORPG words compared to neutral words, whereas highly engaged and non-MMORPG participants showed no such bias. The presence of an attentional bias in addicted MMORPGers is comparable with research investigating this behavioural response in established addictions.

Impulsivity and Related Neuropsychological Features in Regular and Addictive First Person Shooter Gaming

Putative cyber addictions are of significant interest. There remains little experimental research into excessive use of first person shooter (FPS) games, despite their global popularity. Moreover, the role between excessive gaming and impulsivity remains unclear, with previous research showing conflicting findings. The current study investigated performances on a number of neuropsychological tasks (go/no-go, continuous performance task, Iowa gambling task) and a trait measure of impulsivity for a group of regular FPS gamers (n=25), addicted FPS gamers (n=22), and controls (n=22). Gamers were classified using the Addiction-Engagement Questionnaire. Addicted FPS gamers had significantly higher levels of trait impulsivity on the Barratt Impulsiveness Scale compared to controls. Addicted FPS gamers also had significantly higher levels of disinhibition in a go/no-go task and inattention in a continuous performance task compared to controls, whereas the regular FPS gamers had better decision making on the Iowa gambling task compared to controls. The results indicate impulsivity is associated with FPS gaming addiction, comparable to pathological gambling. The relationship between impulsivity and excessive gaming may be unique to the FPS genre. Furthermore, regular FPS gaming may improve decision making ability.

Efficacy of Fifteen Emerging Interventions for the Treatment of Posttraumatic Stress Disorder: A Systematic Review.

Although there is an abundance of novel interventions for the treatment of posttraumatic stress disorder (PTSD), often their efficacy remains unknown. This systematic review assessed the evidence for 15 new or novel interventions for the treatment of PTSD. Studies that investigated changes to PTSD symptoms following the delivery of any 1 of the 15 interventions of interest were identified through systematic literature searches. There were 19 studies that met the inclusion criteria for this study. Eligible studies were assessed against methodological quality criteria and data were extracted. The majority of the 19 studies were of poor quality, hampered by methodological limitations, such as small sample sizes and lack of control group. There were 4 interventions, however, stemming from a mind-body philosophy (acupuncture, emotional freedom technique, mantra-based meditation, and yoga) that had moderate quality evidence from mostly small- to moderate-sized randomized controlled trials. The active components, however, of these promising emerging interventions and how they related to or were distinct from established treatments remain unclear. The majority of emerging interventions for the treatment of PTSD currently have an insufficient level of evidence supporting their efficacy, despite their increasing popularity. Further well-designed controlled trials of emerging interventions for PTSD are required.

Physiological arousal deficits in addicted gamers differ based on preferred game genre

Background/Aims: There has been significant discussion surrounding the psychopathology of excessive gaming and whether it constitutes an addiction. The current study investigated physiological and subjective levels of arousal in gamers of two genres and the relationship between sensation seeking and gaming addiction. Methods: Heart rate (HR), blood pressure (BP) and skin conductance were recorded at baseline, during gaming for 15 min and after gaming in 30 massively multiplayer online role-playing game (MMORPG) and 30 first-person shooter (FPS) male gamers. Gamers were identified as addicted using the Addiction-Engagement Questionnaire. Sensation seeking was measured using the Arnett Inventory of Sensation Seeking. Results: Addicted MMORPG gamers (n = 16) displayed significant decreases in cardiovascular activity during gaming compared to baseline and showed significant increases after gaming. Addicted FPS gamers (n = 13) had significant increases in BP during gaming which decreased significantly after gaming. In comparison, non-addicted MMORPG gamers (n = 14) had significant decreases in HR during gaming, whereas BP in non-addicted MMORPG and FPS gamers (n = 17) increased during gaming and after gaming. There were no significant relationships between sensation seeking and addiction. Conclusion: There are physiological arousal deficits in addicted gamers, and these patterns differ according to the genre of game played.

Independence in the processing of first- and second-order motion signals at the local-motion-pooling level

The interaction of first- and second-order motion signals at the local-motion-pooling level were investigated using locally-paired dots that moved orthogonally to each other. Dots were either luminance-defined, which could, potentially drive both first- and second-order local-motion units, or contrast-defined, which only drive second-order local-motion units. The response measure used was the nature of the motion percept: either unidirectional or transparent motion. The likelihood of perceiving transparent motion was varied by adjusting the trajectory length of the dots. Increasing the trajectory length increased the likelihood that observers would perceive transparency. The results, taken as a whole, support the notion of independent first-order and second-order local-motion-pooling units, with the spatial extent of the second-order units being larger than that of the first-order units.

Key patterns and predictors of response to treatment for military veterans with post-traumatic stress disorder: a growth mixture modelling approach

BACKGROUND To determine the patterns and predictors of treatment response trajectories for veterans with post-traumatic stress disorder (PTSD). METHODS Conditional latent growth mixture modelling was used to identify classes and predictors of class membership. In total, 2686 veterans treated for PTSD between 2002 and 2015 across 14 hospitals in Australia completed the PTSD Checklist at intake, discharge, and 3 and 9 months follow-up. Predictor variables included co-morbid mental health problems, relationship functioning, employment and compensation status. RESULTS Five distinct classes were found: those with the most severe PTSD at intake separated into a relatively large class (32.5%) with small change, and a small class (3%) with a large change. Those with slightly less severe PTSD separated into one class comprising 49.9% of the total sample with large change effects, and a second class comprising 7.9% with extremely large treatment effects. The final class (6.7%) with least severe PTSD at intake also showed a large treatment effect. Of the multiple predictor variables, depression and guilt were the only two found to predict differences in response trajectories. CONCLUSIONS These findings highlight the importance of assessing guilt and depression prior to treatment for PTSD, and for severe cases with co-morbid guilt and depression, considering an approach to trauma-focused therapy that specifically targets guilt and depression-related cognitions.

A Systematic Review of the Efficacy of Creative Arts Therapies in the Treatment of Adults With PTSD.

Objective: There is a growing body of literature supporting the use of creative arts therapies; however, the efficacy of creative arts therapies in the treatment of posttraumatic stress disorder (PTSD) has not been systematically evaluated. The aim of this systematic review was to examine the efficacy of creative arts therapy including music therapy, art therapy, dance/movement therapy, and drama therapy, in the treatment of PTSD. Method: Ten databases were searched for peer-reviewed literature published from inception to December 2016. Studies were included in the review if they used a randomized controlled trial (RCT), a pseudo RCT, or a controlled study design; tested the efficacy of one of the creative arts therapies described above; and reported changes to PTSD diagnosis or symptomatology. Results: From an initial yield of 1,918 records, 1,653 records were screened on title and abstract and 125 were screened at full-text. Seven studies met the inclusion criteria for review, with four studies investigating art therapy, two studies investigating music therapy, and a final study investigating drama therapy. Individual studies were initially rated on a standardized quality and bias checklist, and then GRADE was used to rate the overall evidence for each intervention. The evidence for music therapy, art therapy, and drama therapy was ranked as low to very low, with no studies found for dance/movement therapy. Generally, the quality of the trials was very poor. Future directions for this field of research are to improve the scientific quality of the research trials in this area.

Research into Australian emergency services personnel mental health and wellbeing: An evidence map:

Background: Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. Aims: ‘Evidence-mapping’ methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. Methods: A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. Results: In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. Conclusion: This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations’ wellbeing policies and procedures.

Effectiveness of an Anger Intervention for Military Members with PTSD: A Clinical Case Series

Objective Problematic anger is a significant clinical issue in military personnel, and is further complicated by comorbid post-traumatic stress disorder (PTSD). Despite increasing numbers of military personnel returning from deployment with anger and aggression difficulties, the treatment of problematic anger has received scant attention. There are currently no interventions that directly target problematic anger in the context of military-related PTSD. The aim of this case series is to examine the effectiveness of an intervention specifically developed for treating problematic anger in current serving military personnel with comorbid PTSD. Methods Eight Australian Defence Force Army personnel with problematic anger and comorbid PTSD received a manualized 12-session cognitive behaviorally based anger intervention, delivered one-to-one by Australian Defence Force mental health clinicians. Standardized measures of anger, PTSD, depression, and anxiety were administered pre- and post-treatment. Results The initial mean severity scores for anger indicated a high degree of pre-treatment problematic anger. Anger scores reduced significantly from pre to post-treatment (d = 1.56), with 88% of participants exhibiting meaningful reduction in anger scores. PTSD symptoms also reduced significantly (d= 0.96), with 63% of participants experiencing a clinically meaningful reduction in PTSD scores. All of those who took part in the therapy completed all therapy sessions. Conclusions This brief report provides preliminary evidence that an intervention for problematic anger not only significantly reduces anger levels in military personnel, but can also significantly reduce PTSD symptoms. Given that anger can interfere with PTSD treatment outcomes, prioritizing anger treatment may improve the effectiveness of PTSD interventions.

A Systematic Review of Psychological and Pharmacological Treatments for Adjustment Disorder in Adults

Adjustment disorder is a common psychiatric disorder, yet knowledge of the efficacious treatments for adjustment disorder is limited. In this systematic review, we aimed to examine psychological and pharmacological interventions that target adjustment disorder in adults to determine which interventions have the best evidence for improving adjustment disorder symptoms. We performed database searches for literature published between January 1980 and September 2016 and identified studies that included both a sample majority of individuals diagnosed with adjustment disorder and findings on adjustment disorder symptom outcomes. There were 29 studies that met the inclusion criteria for qualitative synthesis; the majority of studies (59%) investigated psychological therapies rather than pharmacological treatments (35%). The range of psychological therapies tested was diverse, with the majority containing cognitive behavioral therapy (CBT) components (53%), followed by three studies that were psychodynamic-related, three studies that were behavioral therapy-based, and two studies that involved relaxation techniques. We rated individual studies using a modified National Health and Medical Research Council quality and bias checklist and then used the Grading of Recommendations Assessment, Development and Evaluation (GRADE; Grade Working Group, 2004) system to rate the overall quality of the evidence. Despite several randomized controlled trials, the quality of the evidence for positive effects of all psychological and pharmacological treatments on symptoms of adjustment disorder was ranked as low to very low. Future high-quality research in the treatment of adjustment disorder has the potential to make a significant difference to individuals who struggle to recover after stressful events.