The Promise of Social Robots and BCI Video Games for Treating ADHD

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• Attention deficit hyperactivity disorder is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity according to Cervantes and colleagues (2023)  definition. The current treatments for children living with ADHD combine different approaches, such as pharmacological, behavioral, cognitive, and psychological treatment (Cervantes et al., 2023). The computer science research community has been working on developing non-pharmacological treatments that are based on novel technologies for dealing with ADHD (Cervantes et al., 2023).

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Social Robots

Therapists use these social robots to mediate between the therapist and some children living with ADHD. According to Cervantes and colleagues (2023), they can provide companionship and support to children with ADHD and they can also teach social skills.

Brain-computer interface video games

BCI video games use a brain-computer interface to measure the player's brain activity and can be used to improve attention, focus, and activity.

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Cervantes and colleagues (2023) set out to perform a systematic review from an interdisciplinary approach to the current state of these two technologies these were the two main questions: 

• 1 How have social robots and BCI video games been evaluated? 
•  Are there still open challenges in social robots and BCI video games to improve their impact and benefit on children living with ADHD?

🟨🟨Their search strategy🟥🟥

1. Four major online databases were used: PubMed, Engineering Village, IEEE Xplore, and Scopus.
2. The search was limited to papers published from January 2010 to 15 June 2022.

• 🟥The search strategy for study 1: Social Robots for Dealing with ADHD was developed to identify papers that met the following criteria:

1.  They were published in peer-reviewed journals.
2. They were written in English.
3. They investigated the use of social robots or BCI video games for the treatment of ADHD.
4. The search strategy was based on the keywords "social robot", "BCI video game", "ADHD", and "treatment".
5. Out of 332 results, the researchers ended up evaluating 17 papers in the final S. L. R.
   
   

🟨Their search for Study 2: BCI Video Games for Dealing with ADHD

Cervantes and colleagues (2023) ended up with 19 papers.

🟦🟦🟦🟦🟦🟦What they found🟦🟦🟦🟦🟦🟦

🟦The review was conducted from an interdisciplinary approach, and the results were organized into two sections: engineering and healthcare.

 Engineering:

•  The engineering section focused on the type of applications developed, the most common robots used, and the input signals and environments used.
• The most common applications were for supporting rehabilitation therapies, and the most common robots used were humanoid robots.
• The real environment was the most common environment used in robot-based applications.
• The most common environments used in BCI video game applications were 3D, 2D, virtual reality, and mixed reality.

Healthcare:

• The healthcare section focused on the main characteristics of participants involved in trials, the results reported in each study, and whether these technologies can significantly reduce ADHD symptoms or improve any skill ability.
• The majority of participants in trials were children living with ADHD.
• The most common results reported were that these technologies can reduce attention deficit and improve some skills, such as learning, writing, spatial memory, working memory, communication, and interaction.
• Only two applications, Focus Pocus and EndeavorRx, are commercialized and prescribed for treating children living with ADHD.

Limitations of the study🟩🟩🟩🟩🟩🟩🟩🟩🟩🟩🟩🟩

Cervantes and colleagues (2023) stated that the following were challenges identified during the systematic literature review for developing computational systems based on social robots or BCI video games to treat ADHD:

• 🟩Diagnosing ADHD: There are three different subtypes of ADHD, and people with ADHD can also have other neurodevelopmental disorders. This makes it difficult to develop a general system for diagnosing ADHD.
• 🟩Customizing cognitive training exercises: Cognitive training exercises need to be customized according to the individual's characteristics, such as the subtype of ADHD, the level of ADHD, and the person's preferences. This can be challenging to do.
  
• 🟩Capturing and maintaining attention: Children with ADHD can easily lose interest in tasks, so it is important for cognitive training exercises to be engaging and interesting.
• 🟩Long-term studies: Most studies on social robots and BCI video games for ADHD have been short-term. More long-term studies are needed to see how effective these technologies are in the long run.
• 🟩Certification: Some social robots and BCI video games for ADHD have been approved for use, but many are still in the development stage. It can be difficult to get these technologies certified because they are relatively new.
• 🟩Avoiding physical harm: Some social robots can pose physical harm to children, so it is important to design them safely.
• 🟩Compromised social-emotional development: Children with ADHD can form strong emotional attachments to social robots. This could potentially compromise their social-emotional development.

These are just some of the challenges that researchers and engineers face in developing and using social robots and BCI video games for ADHD. More research is needed to address these challenges and to develop effective and safe technologies for helping children with ADHD.

🟩🟩🟩🟩🟩🟩What this all means🟦🟦🟦🟦🟦🟦🟦🟦

• Researchers looked at 36 systems that use social robots or BCI video games to help people with ADHD. Some systems help diagnose ADHD, others help with cognitive training, and others help study the brain. Most systems are still being developed and tested, but some have shown promise in helping people with ADHD. Researchers need to do more studies to see how well these systems work in real-world settings. Some people with ADHD have had positive experiences with these systems, but others have had negative experiences. Developers need to make sure that these systems are flexible and can be customized for each individual.

References

Cervantes, J.-A., López, S., Cervantes, S., Hernández, A., & Duarte, H. (2023). Social Robots and Brain-Computer Interface Video Games for Dealing with Attention Deficit Hyperactivity Disorder: A Systematic Review. Brain Sciences, 13(8), 1172. https://doi.org/10.3390/brainsci13081172

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Frotteurism

 Frotteurism is a disorder characterized by sexual excitement at rubbing one's genitals against or touching the body of a non-consenting person. It is similar to voyeurism in that it reflects an inappropriate and persistent interest in something that many people enjoy in a consensual context (Hooley et al. 2019). Roughly 8 to 10 percent of men have a lifetime history of touching or rubbing against someone they did not know in a sexual way without their consent according to Hooley and colleagues (2019).  Some people have speculated that frotteurs are more likely to commit other sexual offenses, but there is no evidence to support this claim. People who are regularly on crowded buses or subway trains are often victims of frotteurism.

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Dsm-5 Criteria for frotteurism

1. Over a period of at least 6 months, recurrent and intense sexual arousal from touching or rubbing against a nonconsenting person, as manifested by fantasies, urges, or behaviors.
2. The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033

Could Gaming Addictions Become a Public Health Crisis???

Here is What One Study Found

• Video games provide relaxation and entertainment for billions of people; however, these games can sometimes lead to obsession or addiction (Kuperczko et al., 2022).
• Over the past two decades, there have been cases of people dying while playing video games for extended periods of time, and unfortunately, there have been cases of homicide or suicide where video games were a motivating factor (Kuperczko et al., 2022).

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Kuperczko and colleagues (2022) state that between 1995 and 2017 internet use has gone from less than one percent to forty-six percent. This growth has also spawned an internet gaming disorder. People with IGD may spend several hours a day gaming, and in extreme cases may spend days online with little food or drink intake or sleep, leading to adverse or fatal physiological conditions.

Kuperczko and colleagues (2022) have determined that there has not been a substantial review of these deaths in medical or health science literature, nor have they found any studies or case reports. Kuperczko and colleagues (2022) set out to investigate the real size of the problem of death linked to playing video games, if these subjects were addicted to gaming, the connection between gaming and death, and the possible reasons leading to death.

🟩🟩🟩🟩🟩🟩 Their Methods of Investigation 🟩🟩🟩🟩🟩🟩

• 🟥The researchers compiled all of the instances where the act of playing video games was linked to the player's death.

1. Their first search was a Google search using the keywords death, die, and video game which led them to numerous cases in online newspapers, blogs, and video portals. This search yielded a small collection of cases
2. Their second scientific search via Pubmed did not yield any relevant publications (Kuperczko et al., 2022).

🟦🟦🟦🟦🟦🟦🟦🟦🟦Their Results🟦🟦🟦🟦🟦🟦🟦🟦🟦

• They ended up with 24 cases up to the end of 2021 (Kuperczko et al., 2022):

1. Only one of the reported victims of gaming-related death was female, and little is known about her gaming habits.
2. Internet addiction among females typically involves social media rather than gaming, with IGD being seven times more common among male adolescents.
3. Deaths appear to be linked to action-rich games, which are less popular among females, and competitiveness in games may lead males to play for extended periods without pausing.
4. The victims were mostly adolescents or young adults, with ages ranging from 11 to 40 years.
   
5. The first victims were in their twenties, an age group that was among the first to become familiar with computer games and experience IGD as an emerging problem.
6. Over time, the age range of victims broadened as former teens and young adults aged into their thirties and the spread of computers, the internet, and games reached younger age groups.
7. More than half of the cases occurred in Southeast Asia, where internet cafes are popular and provide a cheap alternative to owning a personal computer and paying for internet access, electricity, and games.
8. Internet cafes also offer cheap food and drinks, as well as private rooms for sleeping or showering, allowing customers to remain inside for days without supervision.
9. In contrast, cases from Western regions typically occurred at home due to the lower popularity of internet cafes and the expansion of home-based internet access points.
10. The recent spread of smartphones has led to changes in internet access and gaming, with the first gaming deaths linked to smartphones also appearing.

⬛⬛⬛⬛⬛Limitations of the Study⬛⬛⬛⬛⬛⬛

• The authors acknowledge that the search for cases may not have been complete and that there may be other cases that were not reported.
• They also note that the quality of source data was sometimes poor and that the exact cause of death was often unconfirmed or speculative.
• Despite these limitations, the authors believe that their findings are important and that they raise awareness of the potential risks of excessive video game playing.
• The search for cases was limited to English-language sources, like international electronic newspapers.

And while these numbers may appear small, it is definitely something worth monitoring. One death is too many deaths especially if they could have been prevented.

 References

Kuperczko, D., Kenyeres, P., Darnai, G., Kovacs, N., & Janszky, J. (2022). Sudden gamer death: non-violent death cases linked to playing video games. BMC Psychiatry, 22(1). https://doi.org/10.1186/s12888-022-04373-5

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Voyeur Eyes Only

 

Voyeurism

• Voyeurism is believed to be the most common paraphilic disorder (Hooley, et al. 2019). Someone can be diagnosed with voyeuristic disorder if they have recurrent, intense sexually arousing fantasies, urges, or behaviors involving the observation of unsuspecting people who are undressing or of couples engaging in sexual activity (Hooley et al. 2019). Voyeurism is often accompanied by exhibitionism, and it is also associated with interest in sadomasochism and cross-dressing.

Why do some people adopt this behavior?    

• Here are the DSM-5 criteria for a Voyeuristic Disorder:

• 🟦Over a period of at least 6 months, recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity, as manifested by fantasies, urges, or behaviors. 
• 🟦The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• 🟦The individual experiencing the arousal and/or acting on the urges is at least 18 years of age.

Voyeurism is not usually linked to other serious crimes. Most people have voyeuristic urges, but they are usually prevented by the risk of being caught and ethical concerns about privacy.

References

 Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033

When is a Paraphilia not a Paraphilia??

When a Paraphilia Becomes a Disorder

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 Paraphilic disorders are characterized by recurrent, intense sexual fantasies, urges, or behaviors that are atypical in terms of their targets, context, or participants, and that cause significant distress or impairment in the individual's life. These urges and behaviors generally involve (Hooley et al., 2019) :

1. abnormal targets of sexual attraction such as objects or children\
2. unusual courtship behaviors such as watching someone undress without their consent or exposing themselves to others without consent.
3. the desire for pain and suffering of oneself or other people.

🟥Paraphilias challenge the authors of DSM editions for two main reasons (Hooley et al, 2019):

1. Some paraphilias are considered pathological even if the person experiencing the symptoms does not experience any distress.
2. Some other categories of paraphilia may be compatible with psychological health and happiness if all parties are of age and willfully consent.

The DSM-5 distinguishes between paraphilias and paraphilic disorders (Hooley et al. 2019).

🟥Paraphilias are defined as unusual sexual interests that cause no harm to either person or others.

🟥Paraphilic disorders - are defined when paraphilias cause suffering to anyone involved.

• Although mild forms of these conditions occur in many people's lives, a person with the disorder is distinguished by the intensity and the exclusivity with which their sexuality focuses on the acts or objects in question (Hooley, et al. 2019).  For instance, in some cases, orgasm is not attainable without these acts or objects.
• These disorders can also be compulsive requiring someone to orgasm as often as four to ten times per day.
• Most people with paraphilic disorders are male.

 The DSM-5 recognizes eight specific paraphilic disorders that can be classified into several different subtypes (Hooley, et al. 2019): 

1. Voyeuristic
2. Exhibitionistic
3. Frotteuristic
4. Sexual sadism
5. Sexual Masochism
6. fetishistic
7. transvestic 
8. pedophilic

There is also another specified paraphilic disorder which includes several rare disorders (Hooley et al. 2019):

• Scatologia - obscene phone calls
• Necrophilia - the sexual desire for corpses
• Zoophilia - sexual interest in animals
• Apotemnophilia - sexual excitement and desire about having a limb amputated
• Coprophilia - sexual arousal to feces

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033

“The Triple Threat: Exploring the Interplay of ADHD, Insomnia, and Internet Gaming Disorder”

Does ADHD affect the relationship between circadian typologies, insomnia, IGD

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• Recently a study was done to evaluate the relationships between circadian typologies, insomnia, and internet gaming disorder and how ADHD affects this relationship.

Researchers took three groups of 69 young adults (Lin et al., 2023) :

1. A group with Internet Gaming Disorder
2. A control group - comprising age and sex-matched nongamers
3. A group of gamers without IGD was established through diagnostic interviews.

• The participants with IGD exhibited lower composite scale of morningness scores and thus a higher eveningness preference (Lin et al., 2023).
• The group with IGD scored higher on the Pittsburgh insomnia rating scale.
• The participants with IGD and ADHD exhibited lower CSM scores but higher PRIS_20 scores than the participants with IGD but without ADHD (Lin et al., 2023).

🟥These findings indicate that participants with IGD experienced more severe insomnia and preferred to be awake more in the evening.

🟥ADHD exacerbated the eveningness preference and insomnia of the subjects with IGD.

🟥The study suggests that we need to pay close attention to sleep problems in people with IGD and especially in those with ADHD

🟥Why is this study important?

• Well gaming technology has advanced considerably in recent decades, and more people have access to the internet. And now there is a new global mental health concern which is Internet Gaming Disorder or IGD.
• The DSM-5-TR notes that IGD must cause "significant impairment or distress" in several aspects of a person's life ( 2023).
• Scholars have found that excessive internet gaming is associated with maladaptive gaming beliefs and can lead to psychological consequences such as depression and interpersonal impairment
• Because inadequate or nonrestorative sleep can remarkably reduce a person’s quality of life, understanding the association between IGD and sleep is crucial. Research has indicated that IGD is related to low sleep quality, limited sleep time, and subjective insomnia. Insufficient experimental evidence is currently available regarding the sleep patterns of individuals with IGD.

🟥Therefore understanding circadian typologies among individuals with IGD is essential

References

Lin, Y. J., Yen, J.-Y., Lin, P.-C., Liao, H.-Y., & Ko, C.-H. (2023). Circadian typologies and insomnia in individuals with internet gaming disorder comorbid with attention deficit/hyperactivity disorder. Scientific Reports, 13, 12764. https://doi.org/10.1038/s41598-023-39462-2

(2023). internet Gaming (J. ShererM.D., Ed.) [Review of internet Gaming]. American Psychiatric Association; American Psychiatric Association. Retrieved September 2, 2023, from https://www.psychiatry.org/patients-families/internet-gaming

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Introspection

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• The founders of experimental psychology used the methods of experimental introspection which involved asking subjects to focus on their personal reflections and then relate them to outside signals.
• Most of the subjects were male and asked to rate their experiences on a one to ten-point scale. Psychologists at the time believed that introspection could be used to study mental elements such as sensations and feelings.

🟩There were limitations of introspection

🟩Introspection was not appropriate for studying complex psychological processes.

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Mary Calkins' self-psychology

Calkins was a psychologist who understood the limitations of introspection. Her new approach to psychology focused on the self which had three founding concepts (Shiraev, 2016) :

1. The self
2. The object
3. The self's relation or attitude toward that object.

Two levels of the self  (Shiraev, 2016):

1. contents of consciousness
2. environment in which the content unfolds.

• Calkins's self-psychology was influenced by the work of William James, another early psychologist who was critical of introspection.
• Introspection in psychology declined by the early 20th century
• Calkins's self-psychology was also influenced by the work of the philosopher Josiah Royce, who argued that the self is not a fixed entity, but rather a process of becoming.
• James proposed a theory of the self that emphasized its dynamic and ever-changing nature.

References

 Shiraev, E. (2016). Personality Theories: A Global View. SAGE Publications, Inc. (US). https://bookshelf.vitalsource.com/books/9781506300795