Review of the evidence base in relation to early childhood approaches to support children in highly disadvantaged communities for the Children’s Ground Project

The Children’s Ground project aims to develop a place-based approach to support children and their families in highly disadvantaged communities. The project approach is informed by research and evidence, recognising the multiple and multi-level influences on children’s development and the need to support the role of communities in improving outcomes for children. The review of the evidence base, undertaken by the Centre for Community Child Health in collaboration with the Royal Children’s Hospital Education Institute, begins by outlining the changing social and environmental conditions and the influence of these changes on vulnerable children and families. The report then discusses actions undertaken to address these challenges and the reasons why these actions have failed. Next, key factors enabling optimal outcomes for children and contemporary Australian and international evidence-based interventions and approaches that support vulnerable children are examined. The review concludes by summarising the research on the financial and social costs of doing nothing to intervene and improve outcomes for children. In summary, the review endorses the development of a place-based approach with a number of key strategies that simultaneously address families’ immediate needs for support (the foreground factors) and the broader conditions under which families are raising young children (the background factors). The approach needs to promote wrap around, integrated services that are responsive to and driven by the community. Focus must also be given to how services are delivered rather than what is delivered. In order to implement the approach, it is critical that a robust governance structure or entity capable of coordinating and supporting the many stakeholders and services involved is established and a long-term financial and policy commitment is made. Key messages encapsulating broad themes from the literature, supported by concluding statements, have been developed to enable clear communication to a variety of audiences.&nbsp

Obesity and gambling: neurocognitive and clinical associations.

OBJECTIVE: Research on health correlates in gamblers has found an association between gambling and obesity. The neurocognitive underpinnings of impulsivity may be useful targets for understanding and ultimately treating individuals with both gambling and obesity problems. METHOD: 207 non-treatment seeking young adults (18-29 years) with subsyndromal gambling disorder were recruited from the community. Subjects were grouped according to weight ('normal weight' BMI<25, 'overweight' BMI≥25; or 'obese' BMI≥30). Measures relating to gambling behaviour and objective computerized neurocognitive measures were collected. RESULTS: Of the 207 subjects, 22 (10.6%) were obese and 49 (23.7%) were overweight. The obese gamblers consumed more nicotine (packs per day equivalent) and reported losing more money per week to gambling. Obese gamblers exhibited significant impairments in terms of reaction times for go trials on the stop-signal test (SST), quality of decision making and risk adjustment on the Cambridge Gamble Test (CGT), and sustained attention on the rapid visual information processing task (RVP). CONCLUSION: Obesity was associated with decision making and sustained attention impairments in gamblers, along with greater monetary loss due to gambling. Future work should use longitudinal designs to examine the temporal relationship between these deficits, weight, other impulsive behaviour, and functional impairment.This research was supported by a Center for Excellence in Gambling Research grant by the National Center for Responsible Gaming to Dr. Grant.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1111/acps.1235

A systematic review of reviews on the prevalence of anxiety disorders in adult populations.

BACKGROUND: A fragmented research field exists on the prevalence of anxiety disorders. Here, we present the results of a systematic review of reviews on this topic. We included the highest quality studies to inform practice and policy on this issue. METHOD: Using PRISMA methodology, extensive electronic and manual citation searches were performed to identify relevant reviews. Screening, data extraction, and quality assessment were undertaken by two reviewers. Inclusion criteria consisted of systematic reviews or meta-analyses on the prevalence of anxiety disorders that fulfilled at least half of the AMSTAR quality criteria. RESULTS: We identified a total of 48 reviews and described the prevalence of anxiety across population subgroups and settings, as reported by these studies. Despite the high heterogeneity of prevalence estimates across primary studies, there was emerging and compelling evidence of substantial prevalence of anxiety disorders generally (3.8-25%), and particularly in women (5.2-8.7%); young adults (2.5-9.1%); people with chronic diseases (1.4-70%); and individuals from Euro/Anglo cultures (3.8-10.4%) versus individuals from Indo/Asian (2.8%), African (4.4%), Central/Eastern European (3.2%), North African/Middle Eastern (4.9%), and Ibero/Latin cultures (6.2%). CONCLUSIONS: The prevalence of anxiety disorders is high in population subgroups across the globe. Recent research has expanded its focus to Asian countries, an increasingly greater number of physical and psychiatric conditions, and traumatic events associated with anxiety. Further research on illness trajectories and anxiety levels pre- and post-treatment is needed. Few studies have been conducted in developing and under-developed parts of the world and have little representation in the global literature.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/brb3.497

Decision-making, cognitive distortions and alcohol use in adolescent problem and non-problem gamblers: an experimental study

In the psychological literature, many studies have investigated the neuropsychological and behavioral changes that occur developmentally during adolescence. These studies have consistently observed a deficit in the decision-making ability of children and adolescents. This deficit has been ascribed to incomplete brain development. The same deficit has also been observed in adult problem and pathological gamblers. However, to date, no study has examined decision-making in adolescents with and without gambling problems. Furthermore, no study has ever examined associations between problem gambling, decision-making, cognitive distortions and alcohol use in youth. To address these issues, 104 male adolescents participated in this study. They were equally divided in two groups, problem gamblers and non-problem gamblers, based on South Oaks Gambling Screen Revised for Adolescents scores. All participants performed the Iowa Gambling Task and completed the Gambling Related Cognitions Scale and the Alcohol Use Disorders Identification Test. Adolescent problem gamblers displayed impaired decision-making, reported high cognitive distortions, and had more problematic alcohol use compared to non-problem gamblers. Strong correlations between problem gambling, alcohol use, and cognitive distortions were observed. Decision-making correlated with interpretative bias. This study demonstrated that adolescent problem gamblers appear to have the same psychological profile as adult problem gamblers and that gambling involvement can negatively impact on decision-making ability that, in adolescence, is still developing. The correlations between interpretative bias and decision-making suggested that the beliefs in the ability to influence gambling outcomes may facilitate decision-making impairment

Compulsive Buying Behavior: Clinical Comparison with Other Behavioral Addictions

Compulsive buying behavior (CBB) has been recognized as a prevalent mental health disorder, yet its categorization into classification systems remains unsettled. The objective of this study was to assess the sociodemographic and clinic variables related to the CBB phenotype compared to other behavioral addictions. Three thousand three hundred and twenty four treatment-seeking patients were classified in five groups: CBB, sexual addiction, Internet gaming disorder, Internet addiction, and gambling disorder. CBB was characterized by a higher proportion of women, higher levels of psychopathology, and higher levels in the personality traits of novelty seeking, harm avoidance, reward dependence, persistence, and cooperativeness compared to other behavioral addictions. Results outline the heterogeneity in the clinical profiles of patients diagnosed with different behavioral addiction subtypes and shed new light on the primary mechanisms of CBB

Self-reported impulsivity and inhibitory control in problem gamblers

Impulsivity is considered a core feature of problem gambling, however, self-reported impulsivity and inhibitory control may reflect disparate constructs. We examined self-reported impulsivity and inhibitory control in 39 treatment-seeking problem gamblers and 41 matched controls using a range of self-report questionnaires and laboratory inhibitory control tasks. We also investigated differences between treatment-seeking problem gamblers who prefer strategic (e.g., sports-betting) and non-strategic (e.g., electronic gaming machines) gambling activities. Treatment-seeking problem gamblers demonstrated elevated self-reported impulsivity, more go errors on the Stop Signal Task and a lower gap score on the Random Number Generation task than matched controls. However, overall we did not find strong evidence that treatment-seeking problem gamblers are more impulsive on laboratory inhibitory control measures. Furthermore, strategic and non-strategic problem gamblers did not differ from their respective controls on either self-reported impulsivity questionnaires or laboratory inhibitory control measures. Contrary to expectations, our results suggest that inhibitory dyscontrol may not be a key component for some treatment-seeking problem gamblers

Extensive Internet Involvement—Addiction or Emerging Lifestyle?

In the discussions for the future DSM-5, the Substance-Related Disorders Work Group has been addressing “addiction-like” behavioral disorders such as “Internet addiction” to possibly be considered as potential additions for the diagnostic system. Most research aiming to specify and define the concept of Internet addiction (or: Excessive/Compulsive/Problematic Internet Use—PIU), takes its point of departure in conventional terminology for addiction, based in established DSM indicators. Still, it is obvious that the divide between characteristics of addiction and dimensions of new lifestyles built on technological progress is problematic and far from unambiguous. Some of these research areas are developing from the neurobiological doctrine of addiction as not being tied to specific substances. The concept of “behavioral addictions”, based on biological mechanisms such as the reward systems of the brain, has been launched. The problems connected to this development are in this study discussed and reflected with data from a Swedish survey on Internet use (n = 1,147). Most Swedes (85%) do use the Internet to some degree. The prevalence of excessive use parallels other similar countries. Respondents in our study spend (mean value) 9.8 hours per week online at home, only 5 percent spend more than 30 hours per week. There are both positive and negative social effects at hand. Many respondents have more social contacts due to the use of Internet, but there is a decline in face-to-face contacts. About 40% of the respondents indicate some experience of at least one problem related to Internet use, but only 1.8% marked the presence of all problems addressed. Most significant predictors for problem indicators, except for age, relate to “time” and time consuming activities such as gaming, other activities online or computer skills

A Communal Language for Decision Making in Team Invasion Sports

Invasion team sports coaches are faced with the problem of developing players who, in any given situation, can make decisions that lead to successful outcomes. Research into human decision making has established three widely accepted perspectives, which sports coaching has used to understand player decision making and inform practice: information processing, ecological psychology and naturalistic decision making. As a result, coaches are challenged with perspective-specific terminology and having to draw connections between similar findings that are explained in quite different ways. This conceptual paper presents a plainer account of player decision making by proposing a communal language within a conceptual framework for decision making in invasion team sports. It is hoped that the proposed language and framework will, together, facilitate knowledge exchange between researchers and coaches for the betterment of player development

Assessing decision-making in elite academy footballers using real-world video clips

The aim of this experiment was to investigate whether there were differences in decision-making skills between different age groups (Under 16, 18 and 23) of elite academy footballers on a video-based task of real-life football scenarios. It also explored the relationship between individual performance on the task and the performance of the footballers on the pitch, as rated by three independent expert football coaches. This allowed us to examine whether this task is useful in predicting real-world decision-making skills. The results show that there was a significant difference in response times between response time was statistically significantly lower in U23 compared to U18 and U16 and there was no statistically significant difference between the U16 and the U18 groups, but no significant difference between age groups on the accuracy of response. The under 23 age group responded significantly quicker when compared to the under 18 and under 16 age group most quickly, then the U18, and finally, U16 footballers were the slowest on the task. In terms of comparing coaches' opinion about the players' decision-making skills and players performance on the task, there was a positive correlation between accuracy on the task and general decision-making skills rated by the coaches, suggesting that coaches have a good insight on what players can actually do as. However, coaches ratings of decision-making skills and response times on the task did not correlate suggesting that coaches are not aware of the speed of decision-making, and that this is only measurable by a representative task

Neural correlates of cue‐induced changes in decision‐making distinguish subjects with gambling disorder from healthy controls

In addiction, there are few human studies on the neural basis of cue-induced changes in value-based decision making (Pavlovian-to-instrumental transfer, PIT). It is especially unclear whether neural alterations related to PIT are due to the physiological effects of substance abuse or rather related to learning processes and/or other etiological factors related to addiction. We have thus investigated whether neural activation patterns during a PIT task help to distinguish subjects with gambling disorder (GD), a nonsubstance-based addiction, from healthy controls (HCs). Thirty GD and 30 HC subjects completed an affective decision-making task in a functional magnetic resonance imaging (fMRI) scanner. Gambling-associated and other emotional cues were shown in the background during the task. Data collection and feature modeling focused on a network of nucleus accumbens (NAcc), amygdala, and orbitofrontal cortex (OFC) (derived from PIT and substance use disorder [SUD] studies). We built and tested a linear classifier based on these multivariate neural PIT signatures. GD subjects showed stronger PIT than HC subjects. Classification based on neural PIT signatures yielded a significant area under the receiver operating curve (AUC-ROC) (0.70,p= 0.013). GD subjects showed stronger PIT-related functional connectivity between NAcc and amygdala elicited by gambling cues, as well as between amygdala and OFC elicited by negative and positive cues. HC and GD subjects were thus distinguishable by PIT-related neural signatures including amygdala-NAcc-OFC functional connectivity. Neural PIT alterations in addictive disorders might not depend on the physiological effect of a substance of abuse but on related learning processes or even innate neural traits