The gambling related cognitions scale (GRCS): development, confirmatory factor validation and psychometric properties

Aims The aims of this study are to develop and validate a measure to screen for a range of gambling-related cognitions (GRC) in gamblers. Design and participants A total of 968 volunteers were recruited from a community-based population. They were divided randomly into two groups. Principal axis factoring with varimax rotation was performed on group one and confirmatory factor analysis (CFA) was used on group two to confirm the best-fitted solution. Measurements The Gambling Related Cognition Scale (GRCS) was developed for this study and the South Oaks Gambling Screen (SOGS), the Motivation Towards Gambling Scale (MTGS) and the Depression Anxiety Stress Scale (DASS-2 1) were used for validation. Findings Exploratory factor analysis performed using half the sample indicated five factors, which included interpretative control/bias (GRCS-IB), illusion of control (GRCS-IC), predictive control (GRCS-PC), gambling-related expectancies (GRCS-GE) and a perceived inability to stop gambling (GRCS-IS). These accounted for 70% of the total variance. Using the other half of the sample, CFA confirmed that the five-factor solution fitted the data most effectively. Cronbach's alpha coefficients for the factors ranged from 0.77 to 0.91, and 0.93 for the overall scale. Conclusions This paper demonstrated that the 23-item GRCS has good psychometric properties and thus is a useful instrument for identifying GRC among non-clinical gamblers. It provides the first step towards devising/adapting similar tools for problem gamblers as well as developing more specialized instruments to assess particular domains of GRC.

Familial influence on offspring gambling: a cognitive mechanism for transmission of gambling behavior in families

Background. The problem-gambling literature has identified a range of individual, cognitive, behavioral and emotional factors as playing important roles in the development, maintenance and treatment of problem gambling. However, familial factors have often been neglected. The current study aims to investigate the possible influence of parental factors on offspring gambling behavior. Method. A total of 189 families (546 individuals) completed several questionnaires including the South Oaks Gambling Screen (SOGS) and the Gambling Related Cognition Scale (GRCS). The relationships were examined using Pearson product-moment correlations and structural equation modeling (SEM) analyses. Results. Results showed that generally parents' (especially fathers') gambling cognitions and gambling behaviors positively correlated with offspring gambling behaviors and cognitions. However, SEM analyses showed that although parental gambling behavior was directly related to offspring gambling behavior, parental cognitions were not related to offspring gambling behavior directly but indirectly via offspring cognitions. Conclusion. The findings show that the influence of parental gambling cognition on offspring gambling behavior is indirect and via offspring cognitions. The results suggest a possible cognitive mechanism of transmission of gambling behavior in the family from one generation to the next.

Desire to drink in low- and high-risk social drinkers: An experimental analogue of impaired control

This study used a novel cue exposure paradigm to investigate the differences between high- and low-risk drinkers in their desire to drink during a drinking session. Fifty-three self-selected participants were assigned to high- or low-risk drinking groups based on their self-reported consumption of alcohol, then compared on their desire to drink over a 90 min paced drinking session. High-risk drinkers showed increasing desire over the session, while low-risk drinkers' desire began to decrease after only a short drinking period. The perceived and actual effects of the alcohol did not appear to be able to account for the difference. Results are discussed with reference to issues of impaired control. Suggestions for future research directions are also offered.

Design options for sample-based mortality surveillance

Background Reliable information on causes of death is a fundamental component of health development strategies, yet globally only about one-third of countries have access to such information. For countries currently without adequate mortality reporting systems there are useful models other than resource-intensive population-wide medical certification. Sample-based mortality surveillance is one such approach. This paper provides methods for addressing appropriate sample size considerations in relation to mortality surveillance, with particular reference to situations in which prior information on mortality is lacking. Methods The feasibility of model-based approaches for predicting the expected mortality structure and cause composition is demonstrated for populations in which only limited empirical data is available. An algorithm approach is then provided to derive the minimum person-years of observation needed to generate robust estimates for the rarest cause of interest in three hypothetical populations, each representing different levels of health development. Results Modelled life expectancies at birth and cause of death structures were within expected ranges based on published estimates for countries at comparable levels of health development. Total person-years of observation required in each population could be more than halved by limiting the set of age, sex, and cause groups regarded as 'of interest'. Discussion The methods proposed are consistent with the philosophy of establishing priorities across broad clusters of causes for which the public health response implications are similar. The examples provided illustrate the options available when considering the design of mortality surveillance for population health monitoring purposes.

Alcohol-related associative strength and drinking behaviours: concurrent and prospective relationships

The first part of this research assessed the longitudinal relationships between alcohol- related associative strength and alcohol use measured at two time- points, 6 months apart. Cross-lagged results support the utility of alcohol- related associative strength to predict drinking behaviours prospectively and vice versa. These results remained after competing explanations of previous use, autocorrelations between memory measures, sensation seeking and background variables of age and gender were accounted for. Findings offer further evidence for an implicit cognitions approach to drinking processes. In the second part of our study, cross-sectional analysis investigated potential mediating mechanisms in the relation of associative strength to quantity and frequency dimensions of drinking. Mediational models provide preliminary evidence that implicit memory processes may have differential effects on quantity and frequency dimensions of drinking behaviours. The results point to the possibility that increasing awareness of implicit alcohol-related associations may have utility in interventions for young adults.

Binge drinking in university students: A test of the cognitive model

The aim of this study was to test the cognitive model [Addict. Behav. 29 (2004) 159] of binge drinking in university students. In Study 1, 202 participants completed the Drinking Expectancy Questionnaire (DEQ), the Drinking Refusal Self-Efficacy Questionnaire (DRSEQ), and the Khavari Alcohol Test (KAT). The results showed that both alcohol expectancies (AEs) and drinking refusal self-efficacy (DRSE) are needed to discriminate between binge, social, and heavy drinkers. In general, binge drinkers tend to have higher AEs than social drinkers, and have slightly lower DRSE. However, young social and binge drinkers can only be discriminated on the basis of their AEs. One hundred and fourteen students were recruited for the second study, to predict which individuals would engage in binge drinking during a 4-week self-monitoring period. Over 80% of predicted binge drinkers binged at least once during the monitoring period. These two studies confirmed the cognitive model of binge drinking, and thus, hold implications for the prevention of binge drinking among adolescents and young adults. (C) 2004 Elsevier Ltd. All rights reserved.

The complexity of drinking: Interactions between the cognitive and behavioural determinants of alcohol consumption

This study expanded the earlier work conducted by this laboratory ( Hasking, P.A. and Oei, T.P.S. (2002a) . The differential role of alcohol expectancies, drinking refusal self-efficacy and coping resources in predicting alcohol consumption in community and clinical samples. Addiction Research and Theory , 10 , 465-494), by examining the independent and interactive effects of avoidant coping strategies, positive and negative expectancies and self-efficacy, in predicting volume and frequency of alcohol consumption in a sample of community drinkers. Differential relationships were found between the variables when predicting the two consumption measures. Specifically, while self-efficacy, seeking social support for emotional reasons and using drugs or alcohol to cope were independently related to both volume and frequency of drinking, complex interactions with positive and negative alcohol expectancies were also found. These interactions are discussed in terms of the cognitive and behavioural mechanisms thought to underlie drinking behaviour.

Drinking refusal self-efficacy questionnaire-revised (DRSEQ-R): a new factor structure with confirmatory factor analysis

The drinking refusal self-efficacy questionnaire (DRSEQ: Young, R.M., Oei, T.P.S., 1996. Drinking expectancy profile: test manual. Behaviour Research and Therapy Centre, University of Queensland, Australia Young, R.M., Oei, T.P.S., Crook, G.M., 1991. Development of a drinking refusal self-efficacy questionnaire. J. Psychopathol. Behav. Assess., 13, 1-15) assesses a person's belief in their ability to resist alcohol. The DRSEQ is a sound psychometric instrument based on exploratory factor analyses, but has not been subjected to confirmatory factor analysis. In total 2773 participants were used to confirm the factor structure of the DRSEQ. Initial analyses revealed that the original structure was not confirmed in the current study. Subsequent analyses resulted in a revised factor structure (DRSEQ-R) being confirmed in community, student and clinical samples. The DRSEQ-R was also found to have good construct and concurrent validity. The factor structure of the DRSEQ-R is more stable than the original structure of the DRSEQ and the revised scale has considerable potential in future alcohol-related research. (c) 2004 Elsevier Ireland Ltd. All rights reserved.

Addition of cue exposure to cognitive-behaviour therapy for alcohol misuse: a randomized trial with dysphoric drinkers

Aim To test whether addition of moderation-orientated cue exposure (CE) or CE after dysphoric mood induction ( emotional CE, ECE) improved outcomes above those from cognitive-behaviour therapy alone (CBT) in people who drank when dysphoric. Design Multi-site randomized controlled trial comparing CBT with CBT + CE and CBT + ECE. Setting Out-patient rooms in academic treatment units in Brisbane and Sydney, Australia. Participants People with alcohol misuse and problems controlling consumption when dysphoric (n = 163). Those with current major depressive episode were excluded. Intervention Eight weekly 75-minute sessions of individual treatment for alcohol problems were given to all participants, with CBT elements held constant across conditions. From session 2, CBT + CE participants resisted drinking while exposed to alcohol cues, with two priming doses of their preferred beverage being given in some sessions. After an initial CE session, CBT + ECE participants recalled negative experiences before undertaking CE, to provide exposure to emotional cues of personal relevance. Measurements Alcohol consumption, related problems, alcohol expectancies, self-efficacy and depression. Results Average improvements were highly significant across conditions, with acceptable maintenance of effects over 12 months. Both treatment retention and effects on alcohol consumption were progressively weaker in CBT + CE and CBT + ECE than in CBT alone. Changes in alcohol dependence and depression did not differ across conditions. Conclusions These data do not indicate that addition of clinic-based CE to standard CBT improves outcomes. A different approach to the management of craving may be required.

Bad apples in bad barrels revisited: Cognitive moral development, just world beliefs, rewards, and ethical decision-making

In this study, we test the interactive effect on ethical decision-making of (1) personal characteristics, and (2) personal expectancies based on perceptions of organizational rewards and punishments. Personal characteristics studied were cognitive moral development and belief in a just world. Using an in-basket simulation, we found that exposure to reward system information influenced managers' outcome expectancies. Further, outcome expectancies and belief in a just world interacted with managers' cognitive moral development to influence managers' ethical decision-making. In particular, low-cognitive moral development managers who expected that their organization condoned unethical behavior made less ethical decisions while high cognitive moral development managers became more ethical in this environment. Low cognitive moral development managers also behaved less ethically when their belief in a just world was high.

The role of alcohol expectancy and drinking refusal self-efficacy beliefs in university student drinking

Aims: University student alcohol misuse is a considerable problem. Alcohol expectancy research has contributed significantly to our understanding of problem drinking in young adults. Most of this research has investigated positive expectancy alone. The current study utilized two measures of alcohol expectancy, the alcohol expectancy questionnaire (AEQ) and the drinking expectancy profile [consisting of the drinking expectancy questionnaire (DEQ) and the drinking refusal self-efficacy questionnaire] to predict severity of alcohol dependence, frequency of drinking, and the quantity of alcohol consumed per occasion. Methods: Measures of drinking behaviour and alcohol expectancy were completed by 174 undergraduate university students. Results: Positive alcohol expectancy factors accounted for significant variance in all three drinking indices, with the DEQ adding additional variance to AEQ scores on frequency and severity of alcohol dependence indices. Negative expectancy did not add incremental variance to the prediction of drinking behaviour in this sample. Drinking refusal self-efficacy and dependence beliefs added additional variance over positive and negative expectancies in the prediction of all three drinking parameters. Conclusions: Positive expectancy and drinking refusal self-efficacy were strongly related to university student drinking. The incorporation of expectancy as a means of informing prevention approaches in tertiary education shows promise.

Technical efficiency:efficiency, change, technical progress and productivity growth in the national health systems of continental African countries

In May 2006, the Ministers of Health of all the countries on the African continent, at a special session of the African Union, undertook to institutionalise efficiency monitoring within their respective national health information management systems. The specific objectives of this study were: (i) to assess the technical efficiency of National Health Systems (NHSs) of African countries for measuring male and female life expectancies, and (ii) to assess changes in health productivity over time with a view to analysing changes in efficiency and changes in technology. The analysis was based on a five-year panel data (1999-2003) from all the 53 countries of continental Africa. Data Envelopment Analysis (DEA) - a non-parametric linear programming approach - was employed to assess the technical efficiency. Malmquist Total Factor Productivity (MTFP) was used to analyse efficiency and productivity change over time among the 53 countries' national health systems. The data consisted of two outputs (male and female life expectancies) and two inputs (per capital total health expenditure and adult literacy). The DEA revealed that 49 (92.5%) countries' NHSs were run inefficiently in 1999 and 2000; 50 (94.3%), 48 (90.6%) and 47 (88.7%) operated inefficiently in 2001, 2002, and 2003 respectively. All the 53 countries' national health systems registered improvements in total factor productivity attributable mainly to technical progress. Fifty-two countries did not experience any change in scale efficiency, while thirty (56.6%) countries' national health systems had a Pure Efficiency Change (PEFFCH) index of less than one, signifying that those countries' NHSs pure efficiency contributed negatively to productivity change. All the 53 countries' national health systems registered improvements in total factor productivity, attributable mainly to technical progress. Over half of the countries' national health systems had a pure efficiency index of less than one, signifying that those countries' NHSs pure efficiency contributed negatively to productivity change. African countries may need to critically evaluate the utility of institutionalising Malmquist TFP type of analyses to monitor changes in health systems economic efficiency and productivity over time. African national health systems, per capita total health expenditure, technical efficiency, scale efficiency, Malmquist indices of productivity change, DEA

Command decisions

The importance of effective command and decision-making training for fire service personnel, is discussed. The existing research in fireground decision making led to the formulation of a model of decision making, recognition primed decision making (RPD). The RPD model proposes that in recognizing a situation, the decision maker generates four by-products of recognition, which include expectancies, plausible goals, relevant cues, and typical actions. The RPD model can be used as a basis for training in decision making which can now be carried out in isolation and at very little cost.

Increased salience of gains versus decreased associative learning differentiate bipolar disorder from schizophrenia during incentive decision making

Background Abnormalities in incentive decision making, typically assessed using the Iowa Gambling Task (IGT), have been reported in both schizophrenia (SZ) and bipolar disorder (BD). We applied the Expectancy-Valence (E-V) model to determine whether motivational, cognitive and response selection component processes of IGT performance are differentially affected in SZ and BD. Method Performance on the IGT was assessed in 280 individuals comprising 70 remitted patients with SZ, 70 remitted patients with BD and 140 age-, sex-and IQ-matched healthy individuals. Based on the E-V model, we extracted three parameters, 'attention to gains or loses', 'expectancy learning' and 'response consistency', that respectively reflect motivational, cognitive and response selection influences on IGT performance. Results Both patient groups underperformed in the IGT compared to healthy individuals. However, the source of these deficits was diagnosis specific. Associative learning underlying the representation of expectancies was disrupted in SZ whereas BD was associated with increased incentive salience of gains. These findings were not attributable to non-specific effects of sex, IQ, psychopathology or medication. Conclusions Our results point to dissociable processes underlying abnormal incentive decision making in BD and SZ that could potentially be mapped to different neural circuits. © 2012 Cambridge University Press.

Attachment anxiety and friendship group identification under attachment threat:the moderating role of priming support network expectations

We examined the role of priming participants' own network expectations on their subsequent identification with their friendship group. We examined this prime alongside attachment anxiety and attachment threat, as predictors of friendship group identification. Previous research has suggested that attachment anxiety is associated with negative network expectations. In this study, we extended this work to show that when a network expectation prime was absent, higher attachment anxiety was associated with lower group identification under attachment threat, compared to a control condition. However, when expectations of support network were primed, attachment threat no longer affected group identification, so that only attachment anxiety predicted group identification. This suggests that priming participants who are high in attachment anxiety with their own network expectancies (which are negative), results in participants dis-identifying with their friendship group, regardless of whether or not they have experienced attachment threat. © 2012 Elsevier Ltd.