IFT Institut für Therapieforschung

Abstract Decision making in the context of addiction is characterized by altered values regarding risk and reward, but the long-term and reciprocal relationship between value-based decision-making and addictive behavior remains poorly understood. In this study, 338 individuals (19–27 years, 59% female) from a community sample participated in a baseline assessment, including clinical interviews on addictive behaviors (quantity of use, frequency of use, DSM-5 criteria) and a task battery to assess four facets of value-based decision-making (delay aversion, risk-seeking for gains and losses, and loss aversion). Follow-up assessments were conducted after 3 and 6 years, with 75% and 71% of participants retained, respectively. Using random-intercept cross-lagged panel models (RI-CLPM) controlled for age, gender, IQ, and the baseline addiction level, we examined the bidirectional relationships between value-based decision-making and addictive behavior. Our findings demonstrate temporal stability in both decision-making and addictive behavior, but provide limited evidence for predictive cross-lagged relationships. While prior research indicates that altered value-based decision-making is a predictor of addictive behavior, our findings suggest that its impact may be more limited or context-dependent, highlighting the importance of multifaceted approaches to understanding addiction.

Abstract: Aim: Empirical evidence suggests that Internet Use Disorders (IUDs) can be considered as disorders due to addictive behaviors that are related to impairment and are of clinical relevance. Currently, no guidelines following a standardised methodology are available. Methods: Based on a narrative review, the evidence supporting guidelines for IUDs is reported. The methodological approach underlying the guideline recommendations is described. Results: In addition to gaming disorder, which has been included in the 11th revision of the International Classification of Diseases (ICD-11), meta-level criteria support that Social Network Use Disorder, Shopping Disorder and Pornography Use Disorder can be considered as specified disorders due to addictive behaviours. Mechanisms based on etiological models of IUDs are comparable to other addictive disorders and warrant classification as such. The development of the recommendations in this guideline followed the method­ology of the S1 guidelines of the German Association of the Scientific Medical Societies (AWMF) and was based primarily on systematic literature reviews. Twelve German professional associations and societies were involved and approved the guideline. Conclusions: The recommendations of this guideline serve as an aid for the diagnosis and treatment of IUDs. Updates are important to keep up with the rapidly evolving field.

Disturbances of circadian rhythms and everyday structures are hallmarks of alcohol use disorder (AUD). Recurring activities such as sleep, activity, and meals represent time cues, so called Zeitgebers, that synchronize the circadian system. With our newly developed therapy approach for AUD patients, we aim to reduce relapses and alcohol consumption in AUD patients undergoing a withdrawal program by strengthening their circadian rhythms. We aim to achieve the improvement of circadian rhythms with personalized structure plans for daily Zeitgeber activities, which are used in parallel with the standard therapy at our clinic. The DAILY pilot study is a six-week monocentric trial with a controlled, randomized, single-blinded, parallel-group design. 41 AUD patients participated in the pilot study and were randomly assigned to an intervention group (IG) or a control group (CG). The variability of daily activities was significantly lower in the IG group than in the CG group. Of the IG participants, two had relapsed during the study (<12%), whereas ten relapsed in the CG group (>60%). The relapsing IG participants recorded a total of three alcohol consumption days, while the CG participants recorded 52 consumption days. Abstinent participants showed significantly less variability in the times of their daily activities than relapsed participants. In addition, our analyses indicate that craving for alcohol is related to variability in the time of getting up and that craving and temporal variability increase before relapses. Moreover, the general well-being of the IG participants improved more than that of the CG participants. The data from this pilot study show that following a personalized daily structure plan helps AUD patients to remain abstinent during withdrawal therapy. The analyses indicate that temporal variability of daily activities and the risk of relapse are correlated. On the one hand, adherence to the daily structure may prevent relapse, on the other hand, an increase in variability may be a helpful predictor of approaching relapse. In our view, these data justify a continuation of the DAILY study with the addition of further measurements such as the determination of endogenous circadian rhythms. https://drks.de, identifier DRKS00019093.

The legalization of cannabis for medical and recreational purposes has progressed internationally. Cannabis and cannabinoids are advocated for a plethora of medical indications. An increasing number of medical and nonmedical users regularly consume large doses of delta-9-Tetrahydrocannabinol (THC), the main active component of cannabis. Aim: to summarize the evidence on (1) risks of recreational cannabis use and (2) effectiveness and safety of medicinal cannabis. Findings on recreational use: Cannabis is mostly used to experience its acute rewarding effects. Regular use of high THC products can produce addiction (cannabis use disorder or CUD). Acute consumption of high THC doses (including unintentionally) can cause time-limited mental, gastrointestinal, and cardiovascular problems and motor vehicle accidents. Chronic patterns of cannabis use have been associated with multiple adverse outcomes that are of particular concern among adolescents and young adults, such as, disrupted learning, impaired cognitive performance, reduced educational attainment and an increased risk of CUD, psychosis/schizophrenia, mood and anxiety disorders and suicidal behaviors. There is debate about the extent to which cannabis use is a cause of these adverse outcomes. Physical health risks (e.g., respiratory and cardiovascular, prematurity and restricted fetal growth, hyperemesis syndrome among others) have also been linked with repeated consumption of cannabis with a high THC content. Findings on medical cannabis use: Herbal cannabis, medicines from extracted or synthetized cannabinoids—often used as adjuvants to standard medicines—may produce small to modest benefits. This is primarily the case in treating chronic pain, muscle spasticity, chemotherapy-induced nausea and vomiting, and refractory epilepsy (in the case of cannabidiol, CBD). The evidence is inconclusive on their value in treating mental disorders and other medical conditions. Safety: Cannabis-based medicine is generally well tolerated. There is a risk of mild to moderate adverse effects and CUD.

The use of high-potency cannabis products is associated with an increased risk of mental disorders. This study investigates whether the rising THC concentration in Germany is associated with an increase in cannabis-related diagnoses. The number of insured persons with at least one cannabis-related ICD-10 F12 diagnosis (e.g., harmful use, dependence) in outpatient care was provided by statutory health insurance funds between 2009 and 2021. The dependent variable is the ratio of (a) the number of insured persons with at least one F12 diagnosis to (b) all insured persons who have used cannabis in the last year. Information on THC concentration in cannabis flower was provided by law enforcement agencies. Using generalised mixed linear models, the dependent variable was predicted by the median THC concentration in cannabis flower. The regression results show that an increase in THC concentration by one percentage point is significantly associated with an increase in the proportion of diagnoses (women: +0.17; men: +0.42). THC concentration positively predicted the proportion of diagnoses in all 16 federal states for men and in 15 federal states for women. Compared to low-potency products, using high-potency products may pose additional health risks, which may be particularly pronounced in men. Acknowledging the limitations of the ecological study design and uncertainties inherent to the analysed data, further investigations on the sex-specific impact of THC exposure are required. Limiting the THC concentration in cannabis products and closely monitoring THC consumption in the population appears necessary.

Just as receptive emotional abilities, productive emotional abilities are essential for social communication. Although individual differences in receptive emotional abilities, such as perceiving and recognizing emotions, are well-investigated, individual differences in productive emotional abilities, such as the ability to express emotions in the face, are largely neglected. Consequently, little is known about how emotion expression abilities fit in a nomological network of related abilities and typical behavior. We developed a multitask battery for measuring the ability to pose emotional expressions scored with facial expression recognition software. With three multivariate studies (n1 = 237; n2 = 141; n3 = 123), we test competing measurement models of emotion posing and relate this construct with other socio-emotional traits and cognitive abilities. We replicate the measurement model that includes a general factor of emotion posing, a nested task-specific factor, and emotion-specific factors. The emotion-posing ability factor is moderately to strongly related to receptive socio-emotional abilities, weakly related to general cognitive abilities, and weakly related to extraversion. This is strong evidence that emotion posing is a cognitive interpersonal ability. This new understanding of abilities in emotion communication opens a gateway for studying individual differences in social interaction.

A Inteligência Artificial (IA) tem gerado um impacto profundo na Educação, abrindo oportunidades para a personalização do ensino, ao adaptar conteúdos de forma dinâmica às necessidades individuais dos alunos. Além disso, a IA facilita a identificação de padrões de aprendizagem, permitindo a criação de ambientes mais interativos, imersivos e envolventes. No entanto, é fundamental considerar os desafios associados ao seu uso, garantindo que a IA seja aplicada de maneira responsável, inclusiva e que respeite a diversidade dos alunos. Esta pesquisa objetiva realizar uma revisão narrativa da literatura sobre o uso da IA na educação, com foco na formação de professores para o uso dessa tecnologia em sala de aula. Para tanto, explora benefícios e preocupações em torno da utilização da IA na educação, por meio de uma revisão narrativa. A análise revela que, embora o impacto da IA no ensino seja positivo, ele exige atenção cuidadosa para assegurar que sua implementação seja equilibrada e ética.

Introduction: The aim of the present study was to examine for the first time the factorial, construct, and predictive validity of the motivation for treatment (MfT) scale in a cohort of patients undergoing inpatient-qualified alcohol withdrawal treatment with the goal of referring patients to further treatment. The MfT scale has previously been evaluated in different settings of substance abuse treatment, revealing factorial ambiguity. To the best of our knowledge, the present study is the first study that conducted comprehensive factor analyses versus separate analyses of the factors conducted in prior studies in order to clarify the aforementioned factorial ambiguity. Methods: A total of 249 patients (mean age 45.2 years (SD = 10.3); 34.4% females) with alcohol dependence were assessed. Data were obtained from four inpatient clinics specialized in qualified alcohol withdrawal treatment in Germany. First, confirmatory factor analyses were carried out to examine the fit of the four models discussed in the literature. Second, an exploratory factor analysis was conducted. Correlations of the new factors with other motivational constructs and referral to a subsequent treatment were investigated as measures of construct and predictive validity. Results: None of the four models showed an acceptable fit to the data in confirmatory analyses. The exploratory analysis suggested to eliminate seven items because of inappropriate factor loadings and resulted in a shortened MfT scale, which consists of three factors based on 17 items. For the latent variables “problem recognition,” “desire for help,” and “treatment readiness,” satisfactory composite reliability was found with 0.82, 0.80, and 0.78, respectively. Evidence for predictive validity was found in the correlation between “treatment readiness” and referral to a subsequent treatment. Discussion/Conclusion: The new shortened MfT scale exhibited remarkable parsimony, which is desirable in settings such as withdrawal treatment, where patients frequently are cognitively or physically impaired. Despite its briefness, construct and predictive validity were better than in the original version of the MfT scale. The factorial validity of the suggested scale needs to be corroborated in further research.