OBJECTIVE:This individual participant data meta-analysis aimed to investigate the effectiveness of cognitive behavioral therapy with a trauma focus (CBT-TF) for posttraumatic stress disorder (PTSD). Furthermore, we examined the effect of moderators on PTSD symptom severity. METHOD:This study included randomized controlled trials comparing CBT-TF to an inactive or active comparison group for adults with PTSD. The primary and secondary outcomes were PTSD symptom severity and remission, respectively. Moderators included sociodemographic and clinical variables. RESULTS:Twelve studies compared CBT-TF with inactive (n = 625) and 11 with active comparison conditions (n = 706). The one-stage individual participant data meta-analysis found that CBT-TF was more effective than inactive comparison conditions (β = -0.78; OR = 2.34) and not significantly different from active comparison conditions (β = 0.02; OR = 0.53) in reducing PTSD symptom severity and achieving PTSD remission, respectively. When comparing CBT-TF with inactive treatments, moderator analysis found that divorced participants had greater PTSD symptoms postintervention following CBT-TF than participants who were single, cohabitating, or married receiving CBT-TF, both in the completer (β = 0.93) and full-sample (β = 0.59) analyses. For the active treatment comparison, moderator analysis found that participants taking psychotropic medication had lower PTSD symptoms following CBT-TF than those not taking psychotropic medication in the completer analysis (β = -0.39). CONCLUSION:Based on our moderator analyses, further research is needed to understand the effect of psychotropic medication on the CBT-TF intervention process. Moreover, divorced participants with PTSD receiving CBT-TF might benefit from enhanced support. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Preloading of alcohol and/or drugs before an event has been examined in the research literature for the past two decades. Despite the considerable interest and scrutiny on the behaviour, there are limited, if any, attempts to conceptualise a theoretical understanding of why people preload before an event. Here we propose a Theory of Preloading (TOP)—a general cognitive-behavioural motivational model for alcohol and drug preloading. This conceptualisation reviewed and borrowed relevant cognitive, motivational and behavioural constructs from previous models—i.e., the Motivational Model of Alcohol Use, (Cox Klinger, 2011), PRIME theory (West, 2007); SORCK analysis (Kanfer Sanslow, 1965)—applied to the target behaviour of preloading with alcohol and/or drugs. The TOP proposed that a central construct of affective management—guided by distal and cognitive factors—contributes to decisional factors for preloading. Consequential reinforcers and punishers create a reinforcement loop that feeds back into distal and immediate environmental factors for preloading, increasing the likelihood of future occurrences of preloading behaviours. Our proposed theoretical formulation concludes with practical and clinical implications, along with future directions for testing the model.

Background: Violence within nighttime entertainment districts (NEDs) has been blamed on problematic masculinity and has predominantly been attributed to excessive alcohol intake and steroid use in men. In this report we conducted two studies to: (1) ascertain whether researchers could act as third-party raters of body weight and muscle mass in NED patrons; and (2) to examine the relationship between body self-image, inebriation, alcohol preloading behaviors and drug use in the NEDs. Methods: Study 1 employed an observational approach to establish inter-rater reliability for ratings of muscle mass and weight. In Study 2 data (n = 2,745) were collected through breathalyzing and questionnaires to examine individuals' self-image and drinking and drug-taking behaviors. Results: Participants' self-ratings of muscle and weight significantly differed from researchers' ratings, with males perceiving themselves as less muscular and females perceiving themselves as heavier. Perceived weight and muscle size did not relate to alcohol levels, but an interaction was found for female steroid users who perceived themselves as less muscular. Conclusions: Findings indicated a distortion in participants' perceived body image, with a desire for muscularity among both males and females. These results underscore the complex interplay between self-perception, societal ideals, and drug use in young NED patrons.

We investigated the relationship between preloading motivations, alcohol consumption, intoxication, and alcohol related harms (ARHs), sampled in a night-time entertainment district (NED). The sample comprised 2,159 (1,109 males; 1,050 females) patrons entering Brisbane NEDs (Queensland, Australia) on Thursday, Friday, and Saturday nights between 9:00 pm and 1:00 am. We measured the patrons primary preloading motivations, their estimations of standard drinks consumed at preloading, their level of alcohol intoxication by breathalyser and their past experience of ARHs in the NED. 'Socialising' (29.98%) and 'saving money' (25.17%) were the most prominent preloading motivations followed by 'multiple' motivations (12.52%), and then by emotional motivations (2.46-4.02%). Minor significant differences were observed between preloading motivations in alcohol intoxication, but not for alcohol consumption. 'Get as drunk as possible' and 'feel comfortable/relaxed' preloading motivations were associated with higher occurrences of past ARHs. Individuals who preload often exceed recommended drinking guidelines to prevent ARHs before the night-out begins. Our findings suggest that it is the emotionally motivated alcohol consumers who are more likely to have experienced past harms in the NED. Implications for theoretical developments of preloading and the prevention of harmful preloading are discussed.

We sought to determine whether various ion scanner devices could provide a practical alternative in field-based research, where affordable and accessible drug screening is needed for comprehensive and ongoing investigation. In Study 1, off-site sample analysis proved inconclusive, rendering Protocols A and B impractical for ongoing drug screening. Conversely, Study 2’s on-site, real-time analysis (Protocol C) emerged as a more effective method. The Itemizer3, particularly in Protocol C, excelled in discerning drug users. Comparing admitted drug use rates in both studies, the mere presence of an objective measure, confirmational or not, likely facilitated more truthful participant responses, highlighting the efficacy of real-time, on-site drug screening using IMS/ITMS technologies. All samples analyzed off-site in Study 1 were found to be inconclusive. As such, Protocols A and B were not feasible for on-going drug screening and monitoring. Conversely, the results of Study 2 Protocol C demonstrated that harvesting samples directly off participants on-site and analyzing these in-real time to be a more efficacious method. Our findings in Protocol C also show that the Itemizer3 was better at identifying those who did not use drugs from those who did. Looking at the incidence rates of admitted drug use in Studies 1 and 2, we find that simply having an objective measure present (irrespective of whether it is confirmational or not) likely resulted in us obtaining more truthful responses from participants about their use of drugs. Our results underscore IMS/ITMS practicality for on-site NED drug screening.

Background Available empirical evidence on participant-level factors associated with dropout from psychotherapies for post-traumatic stress disorder (PTSD) is both limited and inconclusive. More comprehensive understanding of the various factors that contribute to study dropout from cognitive-behavioural therapy with a trauma focus (CBT-TF) is crucial for enhancing treatment outcomes.Objective Using an individual participant data meta-analysis (IPD-MA) design, we examined participant-level predictors of study dropout from CBT-TF interventions for PTSD.Methods A comprehensive systematic literature search was undertaken to identify randomised controlled trials comparing CBT-TF with waitlist control, treatment-as-usual or another therapy. Academic databases were screened from conception until 11 January 2021. Eligible interventions were required to be individual and in-person delivered. Participants were considered dropouts if they did not complete the post-treatment assessment.Findings The systematic literature search identified 81 eligible studies (n=3330). Data were pooled from 25 available CBT-TF studies comprising 823 participants. Overall, 221 (27%) of the 823 dropped out. Of 581 civilians, 133 (23%) dropped out, as did 75 (42%) of 178 military personnel/veterans. Bivariate and multivariate analyses indicated that military personnel/veterans (RR 2.37) had a significantly greater risk of dropout than civilians. Furthermore, the chance of dropping out significantly decreased with advancing age (continuous; RR 0.98).Conclusions These findings underscore the risk of premature termination from CBT-TF among younger adults and military veterans/personnel.Clinical implication Understanding predictors can inform the development of retention strategies tailored to at-risk subgroups, enhance engagement, improve adherence and yield better treatment outcomes.

Abstract Introduction The phenomenon of youth preloading with alcohol is related to increased rates of assault, injury and arrest. We have no empirical, field-based, research on the impact of preloading and alcohol use at a large-scale public event. Method Random samples of patrons were breathalysed (BrAC) on entry and exit of a horse racing/music event (n = 286), and questioned regarding their preloading, spending, and group characteristics. Results 79% of participants sampled at entry and 85% at exit reported preloading prior to the event. Of those who preloaded, 87% were observed to have BrAC readings over zero (with a mean BrAC of .071 at a median time of day of 12.29 pm). No differences were found between genders on preloading or BrAC at entry. Group size was found to explain 9% of the unique variance in entry BrAC. Those patrons who preloaded had significantly higher BrAC at exit, with preloading accounting for almost identical variance to the number of reported drinks consumed within the venue. Implications Preloading at large-scale public events is highly endorsed by both male and female youth and is associated with a pattern of continued drinking throughout the course of the event. Interventions to manage risk are suggested.

Bushman and Anderson (2021) have recently argued that the evidence of harm after playing violent video games is so strong that this effect should be our starting point for future research. They base this claim on an argument that: (a) many professional bodies agree with this opinion; (b) strong theories, such as their General Aggression Model (GAM), predict such outcomes; (c) experimental and meta-analytic studies back such a claim; and (d) people who do not obtain this effect are in the minority and their studies have methodological shortcomings or they misanalyze their data. It is argued here that this is not consistent with the precepts of falsificationism and that: (a) their argument from authority is problematic; (b) they appear unconcerned with, or unaware of, increasing null studies, particularly missing out international research or preregistered studies; (c) the majority of research groups outside of Bushman/Anderson and their coauthors do not concur with their results; and (d) there are theories (e.g., the Immersive Media Prediction model) which better account for the data than their GAM. It is also argued that when theories and data collide it is the theories that need revision not the data, demand effects of researchers are strong in gaming research, and Bushman and Anderson's results may themselves have been influenced by their methodology rather than accurately describing a naturally occurring weakness in the human condition. It is also argued that we need a more collegial approach to gaming research and make suggestions to facilitate this shift.

Background: Field research into the preloading phenomena has rarely examined how patrons move and transition into target events. We conceptualised three phases of the night (PotN) - entering, within and leaving - which a patron can be intercepted by a research group. Our research tested the differences between the PotN on preloading, preloading motivations and alcohol consuming behaviours in a popular night-time entertainment district (NED). Methods: The sample comprised 1,585 young-adult patrons (934 Men, 651 Women; ages 18-27 years) collected in a cross-sectional design over three PotN. We measured the patron's preloading motivations, current alcohol intoxication and backloading intentions between three different phases of a night-out on Thursday, Friday and Saturday nights, from 9:00p.m. - 4:00 a.m. in Brisbane NEDs (Queensland, Australia). Results: The phases contributed to a difference in preloading rates - one that decreased over the night (p <.001). Between the phases, the motivation of 'saving money' (approximate to 45%) decreased as a reason for preloading and to 'socialise' (approximate to 20%) increased. Enhancement-based preloading motivations (i.e., 'enjoy the feeling' and 'get drunk') were related to increased alcohol intoxication and backloading intentions at different PotN. However, 'saving money' motivations were also associated with a decrease in alcohol intoxication and backloading intentions (i.e., planning to return home to continue alcohol consumption). Conclusions: Preloading is valued highly by patrons when proximal to the actual preloading. There is a difference between the PotN on preloading rates, preloading motivations, intentions to backload and drinking outcomes as patrons shift from preloading, to entering the NED, to eventually leaving.

BackgroundPast research has either focused on alcohol or drug preloading before a night out, but not on the interaction between them. With increased risks of harm through interaction effects, we wished to build upon previous research in this area. We sought to determine who drug preloads, why do people engage in this practice, what drug/s are people using, and how inebriated they are as they enter the NED. Additionally, we examined what impact varying levels of police presence has on the collections of sensitive data in this context.MethodsWe captured estimates of drug and alcohol preloading from 4723 people entering nighttime entertainment districts (NEDs) in Queensland, Australia. Data collection occurred under three varying conditions of police presence (i.e., no police present, police present but not engaging with participants, and police engaging with participants).ResultsPeople who admitted to preloading drugs were found to be younger in age than non-drug admitters, more likely to be male than female, use one type of drug (mostly stimulants) rather than multiple (if we exclude alcohol), significantly more intoxicated upon arrival, and more subjectively affected from their use of alcohol and drugs as Breath Approximated Alcohol Concertation levels increased. People were more likely to admit having used drugs in the absence of police, but this had only a small effect.ConclusionsPeople who drug preload are a vulnerable subset of the youth population that is susceptible to experiencing harms in this context. As they drink more alcohol, they experience higher affects than those who do not report to also take drugs. Police engagement through service rather than force may mitigate some risks. Further enquiry is needed to better understand those who engage in this practice and to have quick, cheap, objective tests of what drugs these people are using.

Background: Nighttime entertainment districts attract many people who pre-load with alcohol and other substances before entering licensed venues. Despite the harms and dangers associated with both alcohol pre-loading and drug use respectively, there is a paucity of research on drug and polysubstance pre-loading. Objectives: The primary objectives of this scoping review are to systematically map out the body of existing literature on drug and polysubstance pre-loading, discuss methodological potentials and pitfalls in field-based research, identify gaps in knowledge, and derive practical implications and opportunities for future research. Methods: Using the PRISMA (ScR) guidelines, we conducted a search of Medline, PsycINFO, Embase, Scopus, CINAHL, Social Services Abstracts, Sociological Abstracts, and Web of Science databases. We followed this up by conducting an author and citation analysis of relevant articles. Results: Of the 632 data sources identified, 338 articles were reviewed after removing duplicates. Overall, only nine articles were included and thematically analyzed. In our review and analysis of the literature, we find people who drug pre-load to be a particularly vulnerable subset of the population. We also posit that the point-of-entry design has greater sensitivity than the commonly used portal-in design. From this, we also draw attention to various time points where field-based researchers can provide intervention. Conclusions: Given the high prevalence of young adults engaging in the behavior, clinicians should consider pre-loading behaviors when assessing for risk and vulnerability. Field-based research would elucidate the full breadth and scope of the growing pre-loading phenomenon and the dangers associated with this practice.

Background: Governments frequently introduce legislation to reduce drunkenness and violence in night-time entertainment districts (NEDs). However, there is no study which has looked at inebriation of a large sample of young people exiting a NED. We investigated Breath Approximated Blood Alcohol Concentration (BrAC; grams per decilitre, g/dl) levels as people left Brisbane (Australia) NEDs and measured the effects of preloading, energy drink usage, time of night and gender differences on exit intoxication. Methods: We systematically assessed patrons between November 2015 to March 2019 by administering surveys and breathalysing them as they exited the NEDs. We then analysed only those under the age of 26 years old (n = 3,211) as there was a natural break in the data on energy drink usage for those aged over 25 years old. Findings: This study found that young drinkers leave the NED with an average BrAC of 0.094 g/dl. Consistent with hypotheses, the exit BrAC was significantly and meaningfully higher in preloaders (medium effect size). These preloaders also came into the NEDs later but stayed for the same length of time as non-preloaders. BrAC levels did not significantly differ for those who did or did not use energy drinks during the night. As predicted, gender was not associated with a meaningful difference in alcohol intoxication and consumption. The time of night that patrons were interviewed was positively associated with inebriation levels, however, this association was small (r & AP; 0.1).Discussion: With preloading being such a strong predictor for end of night intoxication, and length of time spent in the NED equal between those who do or do not preload, we suggest that to have people less inebriated, they should be encouraged into the NED earlier rather than focusing on their leaving time.

On July 1, 2017, the mandatory use of identification (ID) scanners as a prerequisite to licenced venue entry came into effect in all 15 major night-time entertainment districts (NEDs) across Queensland (Australia). This relatively contemporary situational crime prevention technique functions to (1) supplement traditional door-staff enforced control access and (2) increase personal accountability by reducing perceived anonymity inside licenced venues. The current study examined the association between the ID scanner legislation and violent crime rates in the Fortitude Valley NED (Brisbane, Queensland), a leading hotspot for street violence. Police crime data was examined one year before ID scanner enforcement, and one year after, with each year matched quarterly to test Pearson’s chi-square contingencies by time of year. Violent summary offences (less serious violent offences) increased substantially in the first three months following the ID scanner legislative change, while general summary offences (i.e., public nuisance) and indictable offences (e.g., assaults) remained statistically unchanged. The introduction of ID scanners was the only legislative change that occurred in the Fortitude Valley NED during data collection, suggesting a highly probable link to the observed spike in violent offences. Potential determinants of this upsurge in violence are discussed, including inefficient queue management and increased provocations for violence in queues to nightclubs resulting from the prolonged ID scanning process.

Background: Throughout this investigation we sought to determine whether Ion Mobility Spectrometry (IMS) and Ion Trap mobility Spectrometry (ITMS) could provide a practical alternative in field-based research, where affordable drug screening is needed for comprehensive and on-going investigation.Methods: We conducted two studies and assessed three different research protocols to determine the most viable approach. In Protocol A we focused exclusively on harvesting analytes off breathalyser tubes and analysed these in a laboratory using an ion scanner (500DT Smith Detection Ion Scanner). In Protocol B we harvested analytes off a breathalyser tube and business card that had been handled by participants. Samples collected were again analysed in laboratory using various ion scanners (500DT Smith Detection; Hardened Mobile Trace; Biosens 600). In the second study (Protocol C), we harvested samples directly off participants in Queensland’s Nigh-Time Entertainment Districts and completed the analysis on-site and in-real time using the Itemizer 3.Findings: All samples analyzed off-site in Study 1 were found to be inconclusive. As such, Protocols A and B were not feasible for on-going drug screening and monitoring. Conversely, the results of Study 2 Protocol C demonstrated that harvesting samples directly off participants on-site and analysing these in-real time to be the preferred method. Our findings in Protocol C also show that the Itemizer3 was better at identifying those who did not use drugs from those who did. Looking at the incidence rates of admitted drug use in Studies 1 and 2, we find that simply having an objective measure present (irrespective of whether it is confirmational or not) likely resulted in us obtaining more truthful responses from participants about their use of drugs. Conclusions: In effect, our results demonstrate that there is practical utility in using ITMS to screen for drugs inside NEDs.

Field researchers often use categorical systems to record primary preloading motivations , while survey researchers use continuous systems to examine preloading motivation ratings . We tested the psychometric properties of the two systems for measuring preloading motivations. Six hundred and eight-one undergraduate students and social media recruited participants (178 males; 503 females) completed an online survey pertaining to their last preloading experience. We measured preloading motivations by the categorical and continuous systems, general drinking motivations, estimations of preloaded standard drinks and harm. Measurements of preloading motivations by categorical (primary motivation) and continuous systems (motivation ratings) were concordant. The continuous system of preloading motivations held mix concurrence with general drinking motivations, implying conceptual differences between the two constructs. ‘Enhancement-based’ preloading motivations had strong relationships with estimations of preloaded standard drinks, while general drinking motivations for ‘coping’ were strong correlates of harm. Preloading motivations can be measured through either categorical or continuous systems. Implications for future psychometric measurement development is discussed.

Background There is a growing emphasis on reducing alcohol fueled violence. We do not know whether legislation to close nighttime entertainment districts (NEDs) earlier leads to decreased intoxication and fear of violence within the NED. Methods We collected data before restrictive alcohol legislation (n = 2,670 participants) and again after legislation was introduced (n = 1,926 participants). Patrons were systematically assessed with surveys and breathalyzers as they exited Brisbane NEDs. Results Consistent with a 2-hour reduction in closing times, people left the NED substantially earlier. The exit intoxication levels of people did not change between pre- and post-legislation. After the legislation was introduced perceived risk of violence increased. Conclusions Perceived alcohol scarcity leads to increased preloading. With only restrictive legislation on alcohol sales, people do not drink to lower levels of inebriation.

Alcohol hangover (AH) has been associated with poor sleep due to the negative effects of alcohol intoxication on sleep quantity and sleep quality. The aim of the current study was to further explore the relationship between AH severity and sleep using a naturalistic study design. A further aim was to determine whether quantitative aspects of sleep were a mediating influence on the relationship between AH severity and cognitive performance. As part of the naturalistic study design, 99 drinkers were recruited following a night of drinking in an Australian state capital, with breath alcohol concentration (BrAC) measured as participants were leaving the entertainment district. The following morning at home, participants answered online questions regarding their drinking behaviour on the previous evening, current AH symptoms and sleep quality. Participants also completed an online version of the Trail-Making Test B (TMT-B) to assess cognitive performance. The findings reveal the duration of nightly awakenings to be negatively related to six individual AH symptoms as well as overall AH severity. The number of nightly awakenings, sleep quality and total sleep time correlated with four AH symptoms including overall AH severity. Total AH severity accounted for a moderate amount of variance (11%) in the time to complete the TMT-B. These findings confirm that alcohol consumption negatively affects sleep, which is related to higher next-day hangover severity ratings and poorer cognitive performance.

Objective: Two common mood induction procedures (MIPs) use autobiographical recall (AR) or video clips. The first relies upon internal generation of mood states whereas the second presents external information to elicit emotion. Often new video clips are created for each experiment. However, no study has examined the efficacy and specificity of a freely available video clip compared to AR for use in other studies. Method: In the present experiment, participants watched either video clips or engaged in autobiographical recall to induce an emotional state. Participants were 53 University first year psychology students who took part for course credit. Results: The anger video clip was more effective compared to AR at increasing the target emotion (anger) and decreasing the non-target emotions - happiness and serenity. Compared to baseline both the video and AR anger scores were higher than sadness scores. Conclusion: The response to recalling personal events is more influenced by personality characteristics such as trait anger and neuroticism compared to the response to the video stimulus, which proved a cleaner stimulus. Implications for future research in both mood induction and media are discussed.

The General Aggression Model is one of the major frameworks that studies use to conceptualise the relationship between violent video games and aggression. Although commonly used, this model incorporates important personological and media characteristics into its formulation at a minimal level. As such, the purpose of the current research was to investigate the effect of four media types (violent video game, non-violent video game, violent book, and violent television show) on state anger and behavioural aggression. Analysis revealed no differences in state anger and behavioural aggression between the four media types. Regression analysis suggests that individuals with higher levels of impulsivity, increased emotional reactivity to the media, and frustration with the content of the media are more likely to have a higher state anger response to media exposure. Behavioural aggression was higher for those participants less disturbed by the media and with higher trait anger. Overall, these results suggest that personality and frustration are better predictors of anger and aggression in the context of media exposure. Implications for models of media aggression (such as the Immersive Media Prediction model) and future research are discussed.

Background: Pre-loading of alcohol and other drugs has become a prevalent start to nights out in many countries. Studies into pre-loading have been using different operational definitions and descriptions, leading to confusion and debate in the research literature. Purpose/Objective: We wish to propose a full taxonomy so that research into preloading, of any substances, can be specific and standardized. Methods: We address this problem by analyzing (1) terminology used throughout the literature, (2) the evolving nature of this phenomenon, and (3) the operational components comprising this substance use practice. Additionally, we provide a context and rationale for how we view pre-loading in relation to the broader event-level session. Results: Our results propose a full operational definition and taxonomy of pre-loading to be used, and built upon, by researchers. We also provide a visual representation of pre-loading within an event-level session and provide a method to facilitate consistency across cultures. Conclusions: We propose that this system will lead to greater specificity and higher reliability in the interpretation of research results.