Background and aimsExtreme sports athletes are often labeled “adrenaline junkies” by the media, implying they are addicted to their sport. Research suggests during abstinence these athletes may experience withdrawal states characteristic of individuals with an addiction (Celsi, Rose, & Leigh, 1993; Franken, Zijlstra, & Muris, 2006; Willig, 2008). Despite this notion, no research has directly explored withdrawal experiences of extreme sports athletes.MethodsUsing semi-structured interviews, we explored withdrawal experiences of high (n = 4) and average-ability (n = 4) male rock climbers during periods of abstinence. We investigated the psychological and behavioral aspects of withdrawal, including craving, anhedonia, and negative affect; and differences in the frequency and intensity of these states between groups.ResultsDeductive content analysis indicated support for each of the three categories of anhedonia, craving, and negative affect. Consistent with existing substance addiction literature, high-ability climbers recalled more frequent and intense craving states and negative affect during abstinence compared with average-ability climbers. No differences in anhedonic symptoms between high and average-ability participants were found.ConclusionsRock climbing athletes appear to experience withdrawal symptoms when abstinent from their sport comparable to individuals with substance and behavioral addictions. The implications of these findings and suggestions for future research are discussed.

Background: Recent research evidence has suggested that gambling is a public health concern. A number of studies report the association between gambling activity and increased instances of various other harms, including substance misuse and psychological disorders. In parallel to alcohol misuse, it is also becoming clear that gambling related harm is more of a continuum of harm, as opposed to traditionally accepted categorisations of gambling behavior: safe and responsible or "problem" and harmful. Previous effective treatment models for alcohol misuse have considered a public health approach to develop interventions. As such, the current research seeks to use a public health approach to both investigate the extent of gambling harm across Wales, and to identify upstream predictors of harm to inform future interventions. Method: A triangulation of data collection methods was utilized across Wales, UK. Two hundred and forty-eight participants completed a quantitative survey relating to gambling behavior and related harm, which included the Problem Severity Gambling Index, the Gambling Commission measure of frequency, The Gambling Motives Questionnaire and the Fast Alcohol Screening tool. Ninety-eight of these participants completed a qualitative subsection. Structured interviews were conducted with 20 individuals from 11 service providers. Semi-structured interviews were conducted for the five case studies of individuals who had previously sought help for gambling. The geographical density and distribution of Licensed Gambling Outlets was also mapped in local areas. Results: The findings provide further evidence of a continuum of gambling related harm. Twenty seven percent of survey participants demonstrate some indicators of risk of gambling harm. Social, cultural and environmental contexts play a role in initiation and maintenance of gambling behavior and the subsequent related harm. Accounts from individuals corroborated the quantitative findings. Conclusions: Findings from this Welsh sample are in line with and add support to the growing international research evidence that gambling harms are a universal issue that cross cultures. It is clear that action is needed by legislators at a policy level and that broadening the focus of intervention to a public health level is necessary to develop effective strategies for harm reduction.

Background: Neuropsychological assessment is central to identifying and determining the extent of Alcohol-Related Cognitive Impairment (ARCI). The present systematic review aimed to synthesize and discuss the evidence appraising the neuropsychological tests used to assess ARCI in order to support clinicians and researchers in selecting appropriate tests for use with this population.Methods: We searched for studies investigating the psychometric, diagnostic and practical values of tools used in the screening, diagnosis, and assessment of Korsakoff's Syndrome (KS), Alcohol-Related Dementia (ARD), and those with a specific diagnosis of Alcohol-Related Brain Damage (ARBD). The following databases were searched in March 2016 and again in August 2018: MEDLINE, EMBASE, Psych-INFO, ProQuest Psychology, and Science Direct. Study quality was assessed using a checklist designed by the authors to evaluate the specific factors contributing to robust and clearly reported studies in this area. A total of 43 studies were included following the screening of 3646 studies by title and abstract and 360 at full-text. Meta-analysis was not appropriate due to heterogeneity in the tests and ARCI samples investigated in the studies reviewed. Instead, review findings were narratively synthesized and divided according to five domains of assessment: cognitive screening, memory, executive function, intelligence and test batteries, and premorbid ability. Effect sizes (d) were calculated to supplement findings.Results: Overall, several measures demonstrated sensitivity to the cognitive deficits associated with chronic alcoholism and an ability to differentiate between gradations of impairment. However, findings relating to the other psychometric qualities of the tests, including those important for the accurate assessment and monitoring of ARCI (e.g., test-retest reliability), were entirely absent or limited. Additionally, the synthesis of neuropsychological outcomes presented here supports the recent impetus for a move away from discrete diagnoses (e.g., KS, ARD) and the distinctions between them toward more broad and inclusive diagnostic conceptualizations of ARCI, thereby recognizing the heterogeneity in presentation.Conclusions: Based on the evidence reviewed, provisional recommendations for appropriate tests in each domain of assessment are presented, though further validation of most tests is warranted. Review findings can support efficient and evidenced-based test-selection and guide future research in this area.

Background Gambling advertising is well-funded and has become increasingly sophisticated in recent years. As the presence and pervasiveness of gambling advertising increases, there is a corresponding need for empirical understanding of the characteristics and trends associated with emergent gambling advertisements and marketing. However, there is limited data on this rapidly evolving phenomenon. Methods A rapid review was undertaken of the empirical research (2015–2020) that focused upon the content, delivery and structural features incorporated within emerging gambling advertising. Results Twenty-five studies were included in the review. The majority of these studies were conducted in either the UK or Australia; two jurisdictions that have unique and particularly liberal gambling environments. The literature suggests that emergent gambling advertising content is targeted, positively framed and in some instances, may overrepresent riskier bets. The sporting and social media spheres are densely populated with such advertisements that involve both direct and indirect marketing strategies. In relation to the online environment, there is evidence to suggest the emergence of more interactive advertisements that prompt user engagement. In addition, financial incentivisation has diversified and is often subject to strict and esoteric conditions. Despite these emergent trends, little provision is devoted to adequately displaying harm reductive or responsible gambling content within gambling advertising. Conclusions Overall, there is a paucity of research and lack of methodological diversity concerning the characteristics of advertising within the literature. The barriers to investigating emerging gambling advertising are discussed alongside future research priorities. It is important for this research area to expand in order to appropriately inform ethical industry marketing and effective harm-reduction strategies. [Pre-registered online via Prospero: CRD42020184349].

A multiple baseline across groups design was used to examine the effects of an imagery intervention on perceptions of collective efficacy. Members (n = 10) from an international wheelchair basketball team were separated into three regional intervention groups. Each group completed a 4 week, video-aided, motivational general–mastery (MG-M) type imagery program with team content. Collective efficacy was measured via the Collective Efficacy Inventory (Callow, Hardy, Markland, & Shearer, 2004). Collective efficacy increased for the South group and became more consistent for the Midlands group. No changes were reported for the North group. Social validation measures indicated potential mechanisms via imagery effects on individual perceptions of self-efficacy and then collective efficacy. The results provide partial support for the use of MG-M type imagery interventions to enhance both individual and team perceptions of collective efficacy in elite wheelchair basketball.

Craving for caffeine has received little empirical attention, despite considerable research into the potential for caffeine dependence. The main aim of this study was to develop, and initially validate, a multi-item, multidimensional instrument to measure cravings for caffeine. Participants were 189 caffeine consumers who completed the Questionnaire of Caffeine Cravings, which was based on the Questionnaire of Smoking Urges (QSU), in one of five naturally occurring periods of abstinence; 1-15 min; 16-120 mins; 3-7 h; 12-48 h and +48 h. Exploratory factor analysis suggested a three-factor solution best described the data; Factor 1 reflected strong desires, intentions and positive reinforcement; Factor 2 reflected mild/general positive and negative reinforcement and Factor 3 reflected functional/mood-based negative reinforcement. Significantly higher Factor 1 and Factor 2 scores were recorded for high frequency users; significantly higher Factor 1 and Factor 3 scores were recorded as a function of increased levels of dependence. Duration of abstinence did not significantly effect cravings across all three factors. Regression analyses suggested level of dependence best predicted both current cravings and frequency of daily use. These findings suggest caffeine cravings may be conceptualized multidimensionally and further validates the use of multidimensional, multi-item instruments. Cravings for caffeine may manifest and be detected across varying levels of dependence and, frequency of use and independently of duration of abstinence.

Summary In comparison to jurisdictions, such as Australia, limited research has focused upon the perceptions and reported effects of gambling advertising within the unique gambling environment of the UK. An online qualitative survey was conducted with 62 young adult gamblers in the UK. The survey investigated the place, meaning and influence of gambling advertising within the lives of the participants. Demographic data were analyzed using descriptive statistics, with qualitative data interpreted using inductive thematic analysis techniques. Three themes were identified. Firstly, young adults were highly cognizant of UK gambling advertising strategies. Second, young adults were able to describe the influence of gambling advertising including its normalizing effect and proliferation of misleading messages. Finally, young adults perceived that current harm minimization strategies, including responsible gambling messages, were ineffective. Many were supportive of increased regulation of gambling advertising. The findings indicate that young adults are aware of the potential risks associated with gambling advertising and are supportive of regulatory reform. It is important that the views and perspectives of young adults are fully considered by regulators and policy makers in the UK, particularly as they are a potential target demographic for the industry.

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