With high rates of cannabis use in college students and increasing legalization of cannabis, psychometrically sound scales of cannabis consumption remain a high research priority. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU; Cuttler & Spradlin, 2017) assesses daily sessions, frequency, age of onset, and quantity of marijuana, concentrates, and edibles consumed. Preliminary psychometric properties have been established in a population of college students using cannabis legally. The current study aims to evaluate the psychometric properties of the DFAQ-CU in college students using cannabis illicitly. Participants (N=114) were 18- to 58-years-old (M=21.25). They completed the DFAQ-CU, Drug Use Disorders Identification Test (DUDIT), and Buss Perry Aggression Questionnaire (BPAQ). Analyses were performed using the original factor structures. The factor analysis will be replicated once the full sample has been obtained (~400 by 02/2021). Cronbach's alphas ranged from.32 to.92, with some factors showing stronger reliability (e.g., frequency) than others (e.g., daily sessions). Bivariate correlations indicated daily sessions (r(54)=.32, p=.02), frequency (r(53)=.50, p<.001), marijuana quantity (r(78)=.32, p=.004), and edible (r(25)=.54, p=.006) factors demonstrated high convergent validity with the DUDIT total score. The age of onset and concentrate quantity factors did not. All factors were significantly divergent from the BPAQ. Overall, the original six-factor scale appears to have a poor fit within a college student population with illicit use. Notably, the concentrate quantity and daily sessions factors have poor internal consistency and convergent validity. These will be further explored upon completion of data collection.

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In the United States, at least 65% of adults have gambled and/or played a video game in the past year. An emerging form of entertainment combines gambling and video game play and has led to an approximately $30 billion per year industry. Despite an explosion in growth, this form of potentially high-risk behavior has received little research attention. This paper will present a systematic review of the available peer-reviewed and grey literature related to gambling on video games. Our review identifies three major methods of combining gambling and video games. First is betting directly on the outcomes of eSports, either with money or via skin gambling. Second is gambling within video games where players purchase a chance to win a valued prize or consumable virtual item (e.g., loot box, prize crate, gacha). Prizes change the within game experience, from superficial items that change an in-game character’s appearance to items that substantially improve a player’s chance of winning. Further, if desired, these items can be sold for actual money in secondary marketplaces. Third, there are gamified casino games with the sequential, skill-based feel of video games and real money at stake. Implications: This paper is the first comprehensive review of this nascent literature. Results will provide clinicians with important insights into the language and behaviors of clients who gamble on video games. Further, findings may have future policy implications as some gambling on video games is potentially accessible to underage gamblers.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18876号 / 医博第3987号 / 新制||医||1008(附属図書館) / 31827 / 京都大学大学院医学研究科医学専攻 / (主査)教授 髙橋 良輔, 教授 小泉 昭夫, 教授 宮本 享 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Objective: Opioid use disorder (OUD) remains a major public health problem within Canada and worldwide. Increasing our understanding of psychiatric comorbidity in this population is the focus of this thesis. Methods: We used observational cohort data from two prospective studies of individuals with OUD receiving opioid agonist treatment (OAT). These data allowed us to examine risk factors for psychological symptoms and psychiatric comorbidities, to examine differences between youth and adults, and to assess the sensitivity and specificity of self-reported diagnoses against those made using a validated tool. We linked cohort data to Provincial health administrative data holdings to explore mental healthcare service use and associated costs. Discoveries: This work provides new information on psychiatric comorbidity among individuals receiving treatment for OUD and carries implications that can inform future research to shape clinical care. The main conclusions drawn from this work were: 1) routine assessment of psychological symptoms, including suicidal ideation, in this population is warranted; 2) self- report of psychiatric disorders is not sufficiently sensitive to identify psychiatric comorbidity and other methods such as validated tools should be considered; 3) trauma and post-traumatic stress disorder are common in individuals with OUD and their impact may not be captured by solely measuring substance-related outcomes in treatment; 4) youth with OUD differ from adults in their health risk behaviours and psychiatric comorbidities and likely require distinct services and supports; and 5) outpatient non-substance-related mental healthcare for individuals with OUD is provided largely by primary care physicians for whom increased resources and training are needed, and emergency department visits and hospitalizations (which are costlier to the system) are not uncommon. Conclusion: Psychiatric comorbidity is prevalent in OUD and integrated mental health and addictions treatment requires clinical and research attention. Future studies are needed to test interventions and build an evidence base to inform clinical management. / Thesis / Doctor of Philosophy (PhD) / Opioid addiction has led to the deaths of tens of thousands of Canadians and many more people worldwide. Many individuals with opioid addiction also have other mental health problems that can be barriers to recovery from opioid use. Our current healthcare services are disconnected, and most people do not have access to treatments that can help with both addiction and other mental health problems at the same time. We conducted five studies looking at mental health problems within people who have opioid addiction. We focused on understanding risk factors, diagnoses, treatment, and use of mental healthcare services for individuals with opioid addiction and other mental health problems. Our findings provide new information on unmet mental health needs for people with opioid addiction. This information will help treatment programs, doctors, and policy makers better understand who needs more supports and consider how to improve services.

Social isolation during adolescence can have long lasting negative effects in both humans and animal models. In mice, post-weaning social isolation leads to increased addiction-like behaviors in adulthood. However, little is known about how post-weaning social isolation alters the brain. Stress during development can lead to persistent restructuring of neurons. Changes in dendritic spines can be long-lasting and have been theorized to play an important role in the maintenance of cocaine craving. We found that post-weaning isolation led to a persistent increase in spine density in adulthood within both the core and shell regions of the nucleus accumbens in male mice, but not female mice. In contrast, in the infralimbic cortex, post-weaning social isolation led to an increase in spine density only in female mice. This study highlights the long-lasting, sex-specific effects of post-weaning isolation. Microglia have been shown to assist in both the formation and elimination of dendritic spines, and are activated following exposure to stress and cocaine. Therefore, we hypothesized that microglia may be involved in the restructuring of dendritic spines during post-weaning isolation, and contribute to addiction-like behavior in adulthood. We examined whether inhibiting microglia with minocycline during the first three weeks of post-weaning isolation altered the impact of isolation in cocaine seeking. Isolated animals that received minocycline showed increased cocaine seeking in adulthood compared to group housed mice and isolated mice that received saline. Minocycline and isolation also caused sex-specific alterations in spine density. The findings of these studies provide insight into the mechanisms by which social isolation during adolescence increases vulnerability to addiction later in life. / Psychology

In light of the current opioid epidemic, the past 20 years have made it clear that parental life experiences can significantly impact the behavior and neurobiology of their offspring. Preclinical studies indicate that addiction reflects the interaction of an individual’s environment, genetics, and epigenetic modifications they inherit from their parents. Epigenetic mechanisms - including DNA methylation, histone modification, and small non-coding RNAs – refer to the complex interaction between genes and the environment, which produce heritable changes in germ cells that are transmitted to offspring to ultimately influence the brain development and subsequent vulnerability to develop a substance use disorder. The overarching goal of this dissertation was to characterize the behavioral and neurobiological effects of paternal morphine exposure on addiction-related endpoints in offspring. A highly translational rodent model of paternal morphine self-administration was used to produce first-generation (F1) male and female adolescent and adult offspring. As a reference, offspring derived from morphine-exposed fathers were called morphine-sired offspring, and offspring from saline-exposed fathers were called saline-sired offspring. In chapter 2, we revealed that male morphine-sired progeny are more sensitive over time to the pain-relieving effects of morphine. In the periaqueductal grey, an important pain-related brain region, we identified gene expression changes in regulators of G-protein signaling proteins that could partly account for this phenotype. In chapter 3, we demonstrated that adult morphine-sired male offspring self-administered more morphine; were more motived to earn morphine infusions compared to controls; and had more baseline mu-opioid receptor binding in the ventral tegmental area. Next, in chapter 4, we found that a drug-abstinence period of 90 consecutive days following 60 days of morphine exposure in sires was sufficient to prevent morphine-sired males from self-administering more morphine than controls. In chapter 5, we showed that this addiction-like phenotype did not extend to adolescent male or female offspring. Lastly, in chapter 6, using the incubation of craving paradigm, we found that paternal morphine exposure significantly reduced cue-induced active lever pressing for heroin in morphine-sired males. Taken together, these results add to the growing body of literature that show paternal preconception experiences can impact behavioral and neurobiological endpoints in offspring, perhaps via a(n) epigenetically inherited mechanism(s) in the germline. / Psychology

Over the last three decades, social justice-oriented evangelical Christians of various political stripes have become increasingly concerned about the problem of human trafficking. This issue has brought together Christians concerned about pornography and sex addiction, the social effects of immigration policy, and the exploitation of the poor in a globalized world. Widespread evangelical interest in the problem of human trafficking – particularly sex trafficking – has created an entire industry of non-profit service providers, foundations, advocacy organizations, missions, and parachurch ministries devoted to “ending modern slavery.” Their advocacy has spread beyond overtly religious spaces, and the movement to end human trafficking has become one of the most significant religious and humanitarian movements of the twenty-first century. Why has “ending modern slavery” become a special calling for American evangelical Christians, and what does this tell us about evangelical humanitarianism? How do everyday Christians – from non-profit CEOs and legal advocates to lay volunteers and social workers – conceptualize human trafficking as a distinct category of human exploitation, come to feel a particular calling toward anti-trafficking work, and imagine possible solutions to this humanitarian and moral crisis? My project centers on an ethnographic study of a faith-based, anti-trafficking non-profit organization in New York City, Restore NYC, and intervenes in broader political and academic conversations about the nature of American evangelicalism; the neoliberalism of faith-based humanitarianism; and gender, affect, and genre in the “rescue industry.” I use ethnography, archival research, and popular media analysis to explicate the motivations, tactics, ideology, and theology of the contemporary anti-trafficking movement, while positioning it within the longer history of evangelical humanitarianism.

Internet is today described as a new platform for sex and sexual encounters with unlimited access to anonymous sex, cybersex and pornography due to the expansion of Internet throughout the word. Computers provide new technology and the possibility of constant access via phones, tablets and computers. Even though many people claim this is something positive it has also been discussed in terms of sexual exploitation, abuse and dependence. Risks expected to increase in line with the technological development that is taking place. The purpose of this study is therefore to explore the capacity of different health facilities to cater the need of care in regard to an increased number of people, with risk to develop a behaviour that could be classified as sex addiction. The study is based on interviews with four professionals at three different health facilities in Malmö with the intention to find out how different health facilities look at the concept of sex addiction, when a behaviour transitioning to become an addiction and what treatment they recommend.According to respondents a behaviour become an addiction when the patient/client experience the consequences of the behaviour as negative or when the behaviour becomes compulsive. In addition, all stated that they never would ascribe a patient/client as a sex addict and all were careful in their use of the term sex addiction. Additionally it became clear that there are individual differences in course of action taken by the professionals within these health facilities.

Syftet med denna uppsats var att undersöka hur ett projekt startas upp, leds och drivs då det är kopplat till socialt arbete och efterbehandling för hemlösa kvinnor med missbruksproblematik. Bakgrunden är en tidigare b-uppsats som visade på brister i eftervården för dessa kvinnor. Examensarbetet har gjorts genom en litteraturstudie där vi undersökt projekt och projektledning, samt en halvstrukturerad personlig intervju och en telefonintervju med en nyckelperson med erfarenhet av projektarbete. Resultatet visade på att det är viktigt med samarbete och nätverk då det oftast finns många aktörer som kan hjälpa målgruppen, så som socialtjänsten, beroendecenter samt Röda Korset. Genom ett lösningsfokuserat arbete och en upplevelsebaserad metod kan målgruppen få hjälp att komma tillbaka in i samhället och få ett självständigt och värdigare liv. I projekt är det även viktigt med uppföljningar och utvärderingar för att man ska få en lärdom och en kunskapsbas genom projektet, då kan projektet bistå framtida liknande projekt. För att undvika problem i projektet är det viktigt med tydliga mål, roller och ansvarsfördelningar. Om dessa områden tidigt klargörs kan många framtida problem undanröjas. / The purpose of this paper was to examine how a project is being started, led and executed when it is connected to social work and post-rehabilitation of homeless women with a substance abuse. The background of this paper lies in a former paper on B-level that showed a lack in the post-rehabilitation of these women. This was done with the help of a literature study where projects and project management has been examined, a semi-structured personal interview and a telephone interview with a key person who had experience with project management. The result showed the importance of collaboration and networking though there are often many participants that can help the target group, such as social service, addiction-centers and organizations like the Red Cross. Through solution-focused work and experience based method the target group can achieve a way back into society and get an independent and worthy life. In projects it is of great importance to follow up and evaluate to gain learning and knowledge throughout the process, only then the project can contribute with wisdom and experience to other future projects. To avoid problems it is important to stake out clear goals, roles and responsibility-divisions. If these areas are straightened out early in the project a lot of future difficulties can be eliminated.