The Effectiveness of Multidimensional Counseling in the Intervention of Student Anxiety This research was motivated by the phenomenon of students’ anxiety in the school, with the intervention purpose of innovating the quality of the counseling process, through a multidimensional model. Student anxiety affects their study performance in class, especially with the absence of proper attention; therefore, the multidimensional counseling tool is proposed to resolve this challenge. This study involved 7 students who have anxiety problems, and the Hamilton Anxiety Rating Scale was the instrument used for analyzing the data accessed on www.osf.io/7rd5w/, using a single-subject research design A-B-A and JASP. Therefore, the results identified multidimensional counseling as a tool capable of reducing student anxiety. I.I. is a licensed private counselor at the Indonesian Counselors Association, professionally in the areas of mental health, crisis, and internet addiction intervention. The remaining authors declare no conflict of interest. Reprints: Ifdil Ifdil, MPd, PhD, Kons, Department of Guidance and Counseling, Faculty of Education, State University of Padang, Jl. Prof. Dr. Hamka Air Tawar, Padang 25131, West Sumatera, Indonesia (e-mail: ifdil@konselor.org). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Methamphetamine Use Behavior, Abnormal Symptoms, and Domestic Violence Among Drug Users in Thailand Objective: Methamphetamine, a highly addictive drug producing manifold effects within users’ bodies, impacts users, families, partners, and the society in many negative ways. Thailand punishes drug use severely, but also offers treatment programs for rehabilitation. This study assessed demographic characteristics and drug use behaviors associated with the psychosocial impacts of methamphetamine use, including direct behavioral effects, psychological and physical symptoms, and domestic violence. Materials and Methods: In this cross-sectional study, 1969 Thai methamphetamine users participating in a treatment program were interviewed using a structured questionnaire. Cluster sampling was implemented: 77 provinces were divided into 8 clusters, representing each area of Thailand. Statistical analysis involved frequency distributions, percentages, mean, SD, χ2, multiple logistic regressions, and odds ratio with 95% confidence interval at a significance level of P <0.05. Results: About 70.40% (n=1386) of participants demonstrated abnormal symptoms, and 24.88% (n=490) had demonstrated domestic violence; younger users had a higher likelihood of demonstrating both. Abnormal symptoms associated with participants’ age group and use duration were statistically significant. χ2 test showed significant differences in indirect behavioral effects, psychological symptoms, and all physical symptoms between use durations of under and over a year. Single participants and those who used methamphetamine once per day had a lower risk (6%) of demonstrating domestic violence; unemployed participants (15%) and young participants (12%) had a greater risk. Conclusions: Treatment programs should provide additional knowledge with regard to harm reduction, dealing with abuse, and reduction of domestic violence. Programs targeting young users should be created. Supported by ISAN Academic Network, Khon Kean University. The authors declare no conflict of interest. Reprints: Manop Kanato, PhD, Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand (e-mail: manopkanato@gmail.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Characteristics of Individuals Who Receive Pharmacotherapy While in Treatment For Opioid Use Disorder in the United States Objective: Treatments that include pharmacotherapy are the standard of care for opioid use disorder (OUD), but they are underutilized. This paper uses a large sample of treatment admissions for OUD in the United States to examine characteristics predictive of receiving treatments that include pharmacotherapy. Methods: Data come from the 2014 Treatment Episode Dataset—Admissions. Generalized linear regression models were utilized to assess the association of receiving pharmacotherapy treatment with a number of demographic, treatment, and disorder characteristics. Results: Less than one third of treatment admissions for an OUD involved pharmacotherapy. Among the factors most associated with receiving pharmacotherapy treatment were referring oneself to treatment, as opposed to a medical or nonmedical professional, and receiving treatment in a nonintensive outpatient setting, as opposed to intensive outpatient or residential settings. Conclusion: Encouraging professionals to refer clients to programs that offer treatments that include pharmacotherapy, and incorporating pharmacotherapy into a greater diversity of treatment settings, could help increase access to evidence-based care for OUD. The paper was not subject to the Congressional Budget Office’s regular review and editing process. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Congressional Budget Office. No official endorsement by the U.S. Department of Health and Human Services is intended or should be inferred. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Office of the Assistant Secretary for Planning and Evaluation or the U.S. Department of Health and Human Services. The authors declare no conflict of interest. Reprints: Ryan Mutter, PhD, Health, Retirement, and Long-Term Analysis Division, Congressional Budget Office, 441 D St SW, Washington, DC 20515 (e-mail: ryan.mutter@cbo.gov).Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website, www.addictiondisorders.com. Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Factors Influencing Change in Behavior Among Residents With Drug Addiction in a Mental Hospital in Ghana Objective: The objective of this study was to explore the factors that influence the achievement of the state of sobriety in a drug addiction rehabilitation center. Materials and Methods: A qualitative research approach using an exploratory descriptive design was used. In-depth interviews of 12 residents who received care at a drug addiction rehabilitation center in southern Ghana were interviewed using a semistructured interview guide. The participants (residents) were purposively selected for the study from December 2015 to May 2016. The average length of each interview was about an hour. All interviews were audiotaped, transcribed verbatim, and analyzed using content analysis. Results: The research revealed that the attitude of health professionals/counselors, residents, and their social support network influenced the change process. Moreover, discomfort produced by drugs/substances and a broadened knowledge base in drugs/substances influenced change. Conclusions: The factors that influenced behavior change were multifactorial. However, positive and negative human factors and the rehabilitation program were instrumental. No single change agent could bring about the desired behavioral change in drug addiction rehabilitation. The authors declare no conflict of interest. Reprints: Wisdom M.K. Avor, Mphil, BScN, RMN, District Health Directorate, P.O. Box 124, Aburi—Akuapem, Eastern Region 03428, Ghana (e-mail: avwisdom@gmail.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Neuropsychology as a Method of Diagnosis and Treatment of Internet Addiction Objective: Nowadays, the widespread use of the internet has resulted in the creation of the phenomenon of addiction to the internet. Internet addiction constitutes a new kind of mental disorder that is caused by the excessive use of the internet to a point that it interferes with daily life. In our research, we detected and recorded the electrophysiological brain characteristics of addicted users. Materials and Methods: Our research focused on 28 Greek pupils of an average age of 13.3 years. For the detection of those pupils addicted to the internet, we administered the Internet Addiction Test. When the results of the test were evaluated, 14 students were selected for having the characteristics of internet-addicted users. Those selected underwent a clinical assessment with the use of Event-Related Potentials (P300 waveform). Thereafter, we compared the results collected from the first group (internet-addicted users) to the data received from the application of the P300 wave on the 14 pupils of the control group (pupils who were not addicted to the internet). After the assessment, the group of children with internet addiction characteristics received rehabilitation treatment. Results: After the rehabilitation process of the internet-addicted pupils, both groups were tested once more, and the electrophysiological results received revealed that the internet-addicted group presented similar P300 latency values to that of the control group. Discussion: The findings of this research are significant, taking into account the rapid rise of internet addiction globally and the importance of introducing and ultimately having at our disposal a reliable tool that can detect internet addiction. Conclusion: The findings of this research provide us with significant insights on how we can use neuropsychology in our effort to deal with the phenomenon of internet addiction. The authors declare no conflict of interest. Reprints: Apostolos I. Fotis, Department of Special Education, University of Thessaly, Iasonos & Argonauton st., 382 21 Volos, Greece (e-mail: fotis@uth.gr). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Can High Altitude Exacerbate a Remittent Alcohol Use Disorder in a Patient With a History of Panic Attacks? Background: Several studies have already investigated the brief and long-term neurological effects of exposure to high altitudes and the related sequelae of hypoxia on memory and cognition, but few authors have discussed the question of psychic symptoms during high-altitude activities. These authors suspect that the reexacerbation or worsening of psychiatric symptoms may well be the expression of maladaptive behaviors in response to changes in environmental conditions. Case Report: We describe the case of a patient with a history of sporadic Panic Attacks with elements of the panic-agoraphobic spectrum (social phobia and separation anxiety) who, in a specific social context during adolescence, tended to misuse alcohol for recreational and disinhibitory purposes to solve his relational problems in the social sphere. After many years of abstinence, this patient decided to accept exposure to high altitudes at work and developed a serious alcohol use disorder, including the progressive worsening of his functioning in the social and working dimensions. Discussion: We propose that, because of the daily experiencing of high altitudes at work, the patient’s anxiety levels rose sharply, but unconsciously and automatically, according to a mode of copying previously enacted in adolescence (through social phobia and the use of alcohol to become disinhibited); he also implemented binge drinking behaviors for self-medicative and antianxiety purposes, which gradually triggered a mechanism of alcohol dependence. I.M. served as a board member for Indivior, Molteni, Mundipharma, D&A Pharma, CT Sanremo, Lundbeck, Gilead, Merck & Co., Angelini. The remaining authors declare no conflict of interest. Reprints: Manuel Glauco Carbone, MD, Department of Experimental and Clinical Medicine, School of Psychiatry, University of Pisa, Via Roma, 67, 56100 Pisa, Italy (e-mail: manuelglaucocarbone@gmail.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Effectiveness of Neurolinguistic Programming in Reducing Sport Anxiety in Athletes This research was motivated by the phenomenon of anxiety experienced by athletes during exercise. Sport anxiety is a condition/nature/response associated with exercise, indicating anxiety, worry, and panic experienced by athletes before competing. Sport anxiety has the possibility of affecting the performance of athletes in competition. If proper attention is not given to this occurrence, it may limit the performance of athletes in competitions. One tool that can be used to reduce sport anxiety is neurolinguistic programming. Six athletes were used as athletes in this research. Sport Anxiety Scale-2 was the instrument used to analyze data using a single-subject research design A-B-A-B. The results of the study found that neurolinguistic programming can reduce an athlete’s sport anxiety. T.H.S. is a licensed counselor at the Indonesian Counselors Association and a private counselor, is a professional in sports counseling, mental health counseling and crisis counseling. The remaining authors declare no conflict of interest. Reprints: Tjung Hauw Sin, MPd, Kons, Department of Sport Coaching, Faculty of Sport Science, Universitas Negeri Padang, Jl. Prof. Dr. Hamka, Air Tawar Padang, West Sumatera 25131, Indonesia (e-mail:tjunghauwsin@konselor.org). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Implementing Medication-assisted Treatment For Opioid Use Disorder in Residential Programs No abstract available

FACES OF HPPD: Hallucinogen Persisting Perception Disorder Patient Survey Results and a Descriptive Analysis of Patient Demographics, Medical Background, Drug Use History, Symptoms, and Treatments Objective: The purpose of the present study was to obtain patient information across a wide geography about medical history, drug use, symptoms, and treatments of individuals diagnosed with hallucinogen persisting perception disorder (HPPD). Methods: The study was an internet survey that yielded 26 HPPD patients from North America (81%), Europe (12%), and South America (almost 8%), predominantly male (73%), white (92%), with a median age of 24.5 (range, 18 to 63) years, who have been living with HPPD from a period of <1 year to well over 10 years. Results: History of preexisting mood disorders was reported (100%). Previous hallucinogen drugs used include lysergic acid diethylamide, psilocybin, 3,4-methylenedioxymethamphetamine, and mescaline in highest frequencies. There is a high percentage of current use of benzodiazepines (34.6%) and dependency (78% of those using). Current marijuana use is present for 19%, of which all claim dependency. All patients reported experiencing long-term and ongoing symptoms such as depersonalization (92.3%), visual snow, floaters, trailing afterimages and anxiety (96.2% for each factor). Suicide ideation was pronounced (over 69%). HPPD treatments included benzodiazepines (50%), neuroleptics (23%), anticonvulsants (35%), and receiving counseling (62%). Conclusions: HPPD is an understudied mental disorder that has a complex and unpredictable nature with overlapping psychiatric, psychological, and neurological symptoms. Controlled, evidence-based clinical studies are needed for improvements in diagnosing and treating HPPD. There is concern for patients’ well-being, particularly concerning high reported suicide ideation and dependency on drugs currently used (even if they are prescribed). Improved education for health care professionals and patients is also needed. D.M.L.: ORCID ID: 0000-0002-3315-6357. The author declares no conflicts of interest. Reprints: Doreen M. Lewis, PhD, Vellichor Research, 12121 Little Road, Box 329, Hudson, FL 34667 (e-mail: doreen@vellichorresearch.com). Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved

Peer Recovery Provides Sustainable Avenues for Addiction Treatment, but is Not a One-Size-Fits-All Proposition No abstract available