Topiramate Combined with Cognitive Restructuring for the Treatment of Gambling Disorder: A Two-Center,Randomized, Double-Blind Clinical Trial

Gambling disorder (GD) is a prevalent condition for which no pharmacological treatment has yet been approved, although there is evidence that topiramate can reduce impulsivity in GD and craving in various addictive behaviors. The goal of this study was to investigate the effectiveness of topiramate combined with cognitive restructuring for GD in a two-center, randomized, double-blind clinical trial. Participants were individuals seeking outpatient treatment for GD (n = 30), treated with either topiramate or placebo combined with a brief cognitive intervention, over a 12-week period, the dose of topiramate being tapered up during the first 8 weeks. The main outcome measures were gambling craving, behavior, and cognitive distortions; impulsivity; depression and social adjustment. Topiramate proved superior to placebo in reducing gambling craving (P = 0.017); time and money spent gambling (P = 0.007 and P = 0.047, respectively); cognitive distortions related to gambling (P = 0.003); and social adjustment (P = 0.040). We found no significant effects on impulsivity or depression. These findings are in contrast with data from a previous clinical trial with topiramate for GD. In the current study, we found that topiramate affects features specifically related to gambling addiction and had no significant effect on associated phenomena such as impulsiveness and depression. We believe that this response could be due to synergistic interaction between topiramate and the cognitive intervention.     

Supporting strengths-based child welfare practice through a dual professional family assessment program

ABSTRACT

Despite the strong need for family-centered, strengths-based practice approaches in child welfare, full-scale implementation remains limited. This qualitative study depicts a specialized Integrated Assessment (IA) program that—though designed primarily to enhance the quality of clinical family assessments—was found to support frontline child welfare caseworkers in their implementation of family-centered, strengths-based practices. Caseworkers differentiated the support of the IA screener from that of their supervisor and reported that the additional support was particularly valuable on complex cases. Key factors for replication and implications for training and professional development are discussed.     

Chronic care,integrated care,and mental health: Moving the needle now

Healthcare reform is currently a hot topic in the United States, and the Chronic Care Model has frequently been cited as the foundation of recent attempts to integrate mental health and physical health care. However, challenges exist to fully integrated care that have delayed adequately meeting the multiple needs of mental health service recipients. This article highlights multiple changes that can be incorporated into mental health care now, derived from the Chronic Care Model, to better meet clients’ physical and mental health needs. These changes include focusing on population-level data and incorporating technology and multidisciplinary teams in treatment and prevention efforts.     

Achieving the Optimal Vaginal State: Using Vaginal Products and Study Gels in Uganda,Zimbabwe, and South Africa

Preferences and practices related to the vaginal condition have implications for the use of vaginal HIV prevention products. The authors used qualitative methods to explore narratives relating to the vaginal state amongst women in South Africa, Uganda, and Zimbabwe who had previously participated in a biomedical HIV prevention trial. They investigated women's behaviors related to optimizing the vaginal state, experiences and perceptions of the gel's effect on the vaginal state and on penile-vaginal intercourse, women's narratives on male partner perceptions, and how preferences relating to the vaginal state may have interfered with gel use.     

Program Knowledge and Racial Disparities in Savings Outcomes in a Child Development Account Experiment

This study investigated whether participants’ program knowledge was associated with savings outcomes in Child Development Accounts and whether differences in program knowledge explained racial and ethnic disparities in savings outcomes. We used data collected from White, Black, American Indian, and Hispanic treatment participants in the SEED for Oklahoma Kids (SEED OK) experiment (N?=?1126). Analysis results indicated that knowledge of SEED OK program features was low, especially among members of minority groups. Logit and Tobit regressions showed that program knowledge was positively related to the likelihood of holding a SEED OK account and to individual savings amounts. Gaps in program knowledge were associated with racial disparities in savings outcomes. If Whites and minorities had the same levels of program knowledge, gaps in savings outcomes would have significantly narrowed. The findings call for the development of policy designs and communication tools to enhance knowledge of program features among households with Child Development Accounts, especially racial- and ethnic-minority households.     

Engaging Youth in Municipal Government: Moving Toward a Youth-Centric Practice

Youth councils are one mechanism to engage youth in community governance; yet, there is scant research to guide practice. This study examined the extent to which youth are engaged in the origin, structure, and activities of municipal youth councils. Interviews were conducted with 24 adult stakeholders involved in the operations of youth councils. Data were analyzed using thematic analysis. Results demonstrated that youth-centric practice builds upon theoretical frames of positive youth development, social justice, and civic engagement. Youth-centric practice consists of youth representation, leadership, initiative, and decision-making. Results can assist practitioners and policy makers in engaging youth in municipal government.     

La revolución digital: mobile media use in contemporary Cuba

ABSTRACT

Recent scholarship on mobile internet use in the Global South highlights access disparities, along with shifting social practices that accompany greater web connectivity. Cuba is part of the Global South, and ranks among the least internet connected countries in the world. Venegas’[2010. Digital dilemmas: The state, the individual, and digital media in Cuba. New Brunswick, NJ: Rutgers University Press] thorough account of technology use in Cuba positions Cuban digital media as an assemblage of political, economic, historical, and global factors. Recently, however, mobile digital technologies in Cuba have undergone rapid transformation. Continuing tensions between the US and Cuba remain part of how the country's infrastructure and internet practices develop in location-specific ways. In this paper, we utilize ethnographically-informed data to provide a case study of the mobile internet adaptations in Havana, Cuba. Specifically, we draw upon Sutko and de Souza e Silva [2010. Location-aware mobile media and urban sociability. New Media & Society, 13(5), 807–823] framework for location-aware mobile media and urban sociability to examine the unique communication and coordination practices of Havana internet culture. Additionally, Massey [2005. For space. London: Sage] and Wiley and Packer [2010. Rethinking communication after the mobilities turn. The Communication Review, 13(4), 263–268] notions of space allow investigation of Cuban cultural technologies within a larger social field. These theoretical lenses enable interrogation of mobile device adaptations on mobility, sociability, and space to position Cuban media use as an assemblage of local and global forces.     

When i’m right you’re wrong: attitude correctness facilitates anger and approach motivation toward opposing individuals

Attitude correctness and attitude clarity define the broader concept, attitude certainty. Repeating one’s attitude to oneself causes attitude clarity, while learning that the majority of others agree with you causes attitude correctness. The current research tests how attitude correctness influences emotions and behavioral intentions toward individuals with opposing attitudes. We predicted that compared to clarity, those high in attitude correctness would feel more anger toward an opposing individual and a stronger desire to confront, oppose, and argue with them. Results across two studies supported predictions; believing that you hold the same attitude as the majority sparks feelings of anger toward individuals with differing viewpoints. The current work contributes to our understanding of heated debates and ugly confrontations.     

Effects of Physical and Emotional Maternal Hostility on Adolescents’ Depression and Reoffending

This study examines whether (1) mothers vary in the way they express hostility toward their delinquent adolescent offspring, (2) different types of maternal hostility differentially affect adolescents’ depression and recidivism, and (3) adolescent depression serves as a mechanism through which maternal hostility predicts later reoffending. The sample consists of 1,216 male first‐time offenders, aged 13–17 years (M = 15.80, SD = 1.29). Confirmatory factor analysis supported the premise that maternal hostility could be distinguished into two subtypes: emotional and physical hostility. Adolescent offenders who experienced emotional or physical hostility by their mothers reported greater depressive symptoms and reoffending 6 months later. Further, the relation between maternal hostility (of each type) and adolescent reoffending was partially explained by depressive symptomology.