Commentary on: “The Future of Gaming Disorder Research and Player Protection: What Role Should the Video Gaming Industry and Researchers Play?”

International Journal of Mental Health and Addiction - Griffiths and Pontes (2019) outlined a need for the video gaming industry to take responsibility in gamer protection in their paper titled,...     

Problematic Gaming and Subjective Well-Being: How Does Mindfulness Play a Role?

International Journal of Mental Health and Addiction - Video game use becomes problematic when it disrupts the ability to fulfill social and personal responsibilities. It has also been associated...     

Metabolic Syndrome and Bipolar Disorder: What Should Psychiatrists Know?

This paper reviews the association between bipolar disorder (BD) and metabolic syndrome (MetS), focusing on the etiopathogenetic and pathophysiological aspects of this association and on the recommendations for preventing and managing MetS in patients with BD. We conducted a nonsystematic literature review by means of a MEDLINE search. The exact causal relationship between MetS and BD is still uncertain. The side effects of psychotropic medications may be a major contributor to the increased rates of MetS in patients with BD. Other factors such as unhealthy lifestyles, common neuroendocrine and immuno-inflammatory abnormalities, and genetic vulnerability may also play a role in explaining the high rates of MetS in BD. Strategies to prevent and treat the MetS and its cardiovascular consequences in patients with BD include accurate screening and monitoring of the patient and appropriate psychoeducation on weight control, healthy nutrition, and increased physical activity. When deciding on pharmacological therapy for the treatment of the components of the MetS, drug interactions and the effects of the medications on mood must be taken into account.     

Lawyers: A Role to Play in the Detection of Mental Impairment?

Historically, clinical reports have led practitioners to consider that bipolar disorders may be causally related to traumatic brain injury. However, a number of lines of enquiry, including more methodologically rigorous studies, have shed doubt on this. Caution is urged in the medico-legal setting before assuming causality between traumatic brain injury and bipolar disorders.     

Tobacco Use Among Individuals With Schizophrenia: What Role Has the Tobacco Industry Played?

Rates of tobacco use among individuals diagnosed with schizophrenia have been estimated as high as 80%. A variety of hypotheses have been proposed to explain the high rate of tobacco use among this vulnerable group. This study examined the tobacco industry's efforts to establish and promulgate beliefs about schizophrenic individuals' need to smoke and the hazards of quitting. The current study analyzed previously secret tobacco industry documents. The initial search was conducted during January-July 2005 in the Legacy Tobacco Documents Library. The search yielded 280 records dating from 1955 to 2004. Documents indicate the tobacco industry monitored or directly funded research supporting the idea that individuals with schizophrenia were less susceptible to the harms of tobacco and that they needed tobacco as self-medication. The tobacco industry promoted smoking in psychiatric settings by providing cigarettes and supporting efforts to block hospital smoking bans. The tobacco industry engaged in a variety of direct and indirect efforts that likely contributed to the slowed decline in smoking prevalence in schizophrenia via slowing nicotine dependence treatment development for this population and slowing the rate of policy implementation vis-à-vis smoking bans on psychiatric units.     

Autism Spectrum Disorder and Video Games: Restricted Interests or Addiction?

High rates of video game use in Autism Spectrum Disorder (ASD) have often been reported. This might suggest more prevalent video gaming addiction in this population, but elevated video game use could also be explained by restricted interest in video games. We thus reviewed the literature on video game use in ASD to examine the role of vulnerability for video game addiction and the role of restricted interest in video gaming. We conducted a search following PRISMA guidelines. From 511 papers, 15 were included. This review demonstrates that the high rates of video game use in boys and young males with ASD without intellectual disabilities can be predominantly explained by gaming addiction. However, an effect of restricted interest in video games cannot be excluded. Moreover, addictive process and restricted interest may interact. This result raises several issues for differentiating between video game addiction and restricted interest in regard to assessment, overlapping characteristics and interventions. Based on the results, we make recommendations for caregivers and clinicians on the management of problematic video game use in ASD.

     

Does Psychotherapy Research Answer the Questions of Practitioners,and Should It?

“Practitioners have a thorough knowledge of the research literature, draw upon it to guide interventions, and where information is not available, conduct the research necessary to close the gap.” Stricker (1992, p. 543) reminds us of the Boulder Conference more than 40 years ago and the old dream of the scientist-practitioner. Some scientist-practitioners do exist, know the research literature well—and raise questions which jeopardize the self-understanding of many researchers.     

The Comorbidity of ADHD and Bipolar Disorder: Any Less Confusion?

Alzheimer’s disease (AD) is the most common type of dementia and is a significant public health problem that will intensify as the population ages. The behavioral and psychological symptoms of dementia (BPSD) present a significant burden to patients, their families, and their caregivers. The majority of care is provided at home by family caregivers. Caring for a person with AD and other dementias is associated with significant risk to the caregiver’s health and well-being. Healthcare providers must recognize that family caregivers often present as secondary patients. Given the importance of these caregivers to patients with AD and other dementias, it is vital to understand the risk factors that impact caregiver health and well-being. Non-pharmacological interventions can reduce the negative impact of caregiver burden on caregiver health, reduce premature institutionalization of patients, and improve quality of life for patients, their families, and their caregivers. This article summarizes recent relevant research concerning AD and dementia caregiver health and psychosocial interventions.     

Addiction and the Concept of Disorder,Part 2: Is every Mental Disorder a Brain Disorder?

In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. In Part 1, I argued that, even if one accepts Lewis’s critique of the brain evidence presented for the brain-disease view, his arguments fail to establish that addiction is not a disorder. Relying on my harmful dysfunction analysis of disorder, I defended the view that addiction is a medical disorder and a brain disorder. In Part 2, I consider some broader philosophical issues raised by Lewis’s arguments: (1) I consider a larger puzzle, at the heart of the neo-Kraepelinian program in contemporary psychiatry, that is raised by Lewis’s argument that addiction is not a disorder because the brain displays no damage but only normal learning: must all mental disorders be brain disorders, or can mental disorders occur in normal brains? I argue that mental disorders can occur in normal brains. (2) I critique Lewis’s response to the evolutionary “novel environment” approach to explaining why addiction is a disorder. (3) Lewis agrees with brain-disease proponents that interpreting addiction as brain disorder relieves addicts of moral censure, but I argue that moral defect and brain disease are not exclusive. (4) Finally, I consider Lewis’s “developmental-learning” account of addiction that encourages positive and empowering narrativizing of addiction, but I argue that the developmental-learning view is vacuous due to use of an overly broad notion of “development.”     

What Does Sex Have to Do with It? The Role of Sex as a Biological Variable in the Development of Posttraumatic Stress Disorder

Purpose of Review

This review highlights the neurobiological aspects of sex differences in posttraumatic stress disorder (PTSD), specifically focusing on the physiological responses to trauma and presents evidence supporting hormone and neurosteroid/peptide differences from both preclinical and clinical research.

Recent Findings

While others have suggested that trauma type or acute emotional reaction are responsible for women’s disproportionate risk to PTSD, neither of these explanations fully accounts for the sex differences in PTSD. Sex differences in brain neurocircuitry, anatomy, and neurobiological processes, such as those involved in learning and memory, are discussed as they have been implicated in risk and resilience for the development of PTSD. Gonadal and stress hormones have been found to modulate sex differences in the neurocircuitry and neurochemistry underlying fear learning and extinction.

Summary

Preclinical research has not consistently controlled for hormonal and reproductive status of rodents nor have clinical studies consistently examined these factors as potential moderators of risk for PTSD. Sex as a biological variable (SABV) should be considered, in addition to the endocrine and reproductive status of participants, in all stress physiology and PTSD research.

     

The Relationship Between Perceived Family Support and Depressive Symptoms in Adolescence: What is the Moderating Role of Coping Strategies and Gender?

This study examined the moderating role of gender and coping strategies in the relationship between perceived family support, self-esteem and depressive symptoms. Data were used from the My World Survey Second Level (MWS-SL), a national survey of mental health among 6062 young people aged 12–19 years. Conditional process analyses indicated that planned coping moderated the relationship between perceived family support and depressive symptoms for those engaging in low-moderate levels but not high levels of planned coping, and this moderating role was stronger for females than males. Avoidance coping was a moderator for those engaging in moderate-high but not low levels of avoidance coping, and gender also moderated this relationship. Support-focused coping only moderated the perceived family support/depressive symptoms relationship for females. Findings suggest that the strength of the relationship between perceived family support and depressive symptoms depends on level of engagement with a particular coping strategy, and this engagement is a consistently stronger moderator for females.     

The Impact of Dementia on Family Caregivers: What Is Research Teaching Us?

Dementia family caregiving has been the focus of research for decades. Much has been learned about the negative impact of caregiving as well as characteristics that may be protective. This paper explores themes in caregiving pertinent to clinicians and researchers working with dementia family caregivers: the psychological, subjective, and physical outcomes of caregiving, ways in which dementia alters relationships between the patient and caregiver, and strategies for improving outcomes for caregivers. Suggestions for next steps in research and clinical care are made.