International Journal of Mental Health and Addiction

, Volume 16, Issue 6, pp 1373–1393 | Cite as

Using the Syndrome Model of Addiction: a Preliminary Consideration of Psychological States and Traits

  • Howard J. ShafferEmail author
  • Matthew A. Tom
  • Rhiannon C. Wiley
  • Margaret F. Y. Wong
  • Elda M. L. Chan
  • Gordon L. F. Cheng
  • Camilla K. M. Lo
  • Eric K. Y. Ma
  • Ryan H. Y. Wong
  • Mary Lee
Original Article


This article describes a collaborative research project between the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School Teaching Hospital, and the Integrated Centre on Addiction Prevention and Treatment (ICAPT) of the Tung Wah Group of Hospitals (TWGHs) in Hong Kong. The goal of this research is to better understand the syndrome model of addiction by establishing an epidemiology of addiction treatment seekers across various expressions of addiction (e.g., alcohol and other psychoactive drugs, gambling, sexual behaviors, online gaming). This paper presents initial findings about the demographic and psychological characteristics of three groups of treatment seekers in TWGHs in Hong Kong: (1) a group seeking treatment for chemical expressions of addiction (n = 35); (2) a group seeking treatment for behavioral expressions of addiction (n = 125); and (3) a comparison group seeking services (n = 18) unrelated to addiction. The initial findings identified various common psychological vulnerabilities (i.e., trait anxiety, state anxiety, depression, using emotional support and venting as psychological coping, higher levels of attentional impulsiveness) shared among both the behavioral expression and chemical expression groups, and possible unique psychological characteristics associated with each expression of addiction (e.g., coping mechanisms). These findings provide support for conceptualizing addiction as a syndrome.


Syndrome model Addiction Treatment seekers Hong Kong 



We would like to express our gratitude to all of our colleagues and patients from the Integrated Centre on Addiction Prevention and Treatment, Even Centre, and Alcohol Abuse Prevention and Treatment of the Tung Wah Group of Hospitals for their assistance, commitment, and participation in this research project.

Funding Information

This study was funded by the Hong Kong Jockey Club Charities Trust. During the preparation of this article, the Division on Addiction at the Cambridge Health Alliance received funding support from a variety of sources, including the following: Interactive Entertainment, AG; The Foundation for Advancing Alcohol Responsibility (FAAR); National Institutes of Health (i.e., NIDA, NIAAA, NIMH); Substance Abuse and Mental Health Services Administration (SAMHSA); The National Center for Responsible Gambling (NCRG); Massachusetts Council on Compulsive Gambling; The Massachusetts Gaming Commission; The University of Nevada, Las Vegas; and DraftKings. Dr. Shaffer has received funding for consultation from Las Vegas Sands Corp., Davies Ward Phillips & Vineberg, LLP, and the DUNES of Easthampton.

Compliance with Ethical Standards

The ICAPT research ethics committee, consisting of members who were not involved in the daily operation of the treatment centers, reviewed and approved this study and its procedures.

Conflict of Interest

The authors declare that they have no conflicts of interest.


  1. Albanese, M. J. (2003). The self-medication hypothesis: epidemiology, clinical findings and implication. Psychiatric Times, 2003(4), 57–64.Google Scholar
  2. Albanese, M. J., & Shaffer, H. J. (2012). Addiction: the genesis and evolution of an idea and its consequences. In H. J. Shaffer, D. A. LaPlante, & S. E. Nelson (Eds.), APA Addiction Syndrome Handbook, Vol. 1: Foundations, Influences, and Expressions of Addiction (pp. 3–25). Washington, DC: American Psychological Association.Google Scholar
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, Va.: American Psychiatric Association.Google Scholar
  4. Ashe, M. L., Newman, M. G., & Wilson, S. J. (2015). Delay discounting and the use of mindful attention versus distraction in the treatment of drug addiction: a conceptual review: TREATMENT OF DRUG ADDICTION. Journal of the Experimental Analysis of Behavior, 103, 234–248. Scholar
  5. Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32.PubMedCrossRefGoogle Scholar
  6. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation, 1, 82.Google Scholar
  7. Berg, L., Bäck, K., Vinnerljung, B., & Hjern, A. (2016). Parental alcohol-related disorders and school performance in 16-year-olds—a Swedish national cohort study. Addiction, 111(10), 1795–1803. Scholar
  8. Blaszczynski, A., Buhrich, N., & McConaghy, N. (1985). Pathological gamblers, heroin addicts and controls compared on the EPQ ‘Addiction Scale’. British Journal of Addiction, 80(3), 315–319.PubMedCrossRefGoogle Scholar
  9. Boudreau, A., LaBrie, R., & Shaffer, H. J. (2009). Towards DSM-V: “shadow syndrome” symptom patterns among pathological gamblers. Addiction Research and Theory, 17(4), 406–419.CrossRefGoogle Scholar
  10. Byrne, B. M., Stewart, S. M., & Lee, P. W. (2004). Validating the beck depression inventory-II for Hong Kong community adolescents. International Journal of Testing, 4(3), 199–216.CrossRefGoogle Scholar
  11. Carver, C. S. (1997). You want to measure coping but your protocol’too long: consider the brief cope. International Journal of Behavioral Medicine, 4(1), 92–100.PubMedCrossRefGoogle Scholar
  12. Carver, C. S., & Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology, 61, 679–704.PubMedCrossRefGoogle Scholar
  13. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: a theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267–283.CrossRefGoogle Scholar
  14. Chau, J. P., Chang, A. M., & Chang, A. M. (1998). Relationship between premenstrual tension syndrome and anxiety in Chinese adolescents. Journal of Adolescent Health, 22(3), 247–249.PubMedCrossRefGoogle Scholar
  15. Cheng, G. L., Liu, Y.-P., Chan, C. C., So, K.-F., Zeng, H., & Lee, T. M. (2015). Neurobiological underpinnings of sensation seeking trait in heroin abusers. European Neuropsychopharmacology, 25(11), 1968–1980.PubMedCrossRefGoogle Scholar
  16. Connor-Smith, J. K., & Flachsbart, C. (2007). Relations between personality and coping: a meta-analysis. Journal of Personality and Social Psychology, 93(6), 1080–1107.PubMedCrossRefGoogle Scholar
  17. Corrigan, J. D., Adams, R. S., & Larson, M. J. (2013). When addiction co-occurs with traumatic brain injury. The American Journal of Psychiatry, 170(4), 351–354. Scholar
  18. Craig, R. J. (1979). Personality characteristics of heroin addicts: a review of the empirical literature with critique—part I. International Journal of the Addictions, 14(4), 513–532.PubMedCrossRefGoogle Scholar
  19. Dannon, P. N., Lowengrub, K., Sasson, M., Shalgi, B., Tuson, L., Saphir, Y., & Kotler, M. (2004). Comorbid psychiatric diagnoses in kleptomania and pathological gambling: a preliminary comparison study. European Psychiatry, 19(5), 299–302.PubMedCrossRefGoogle Scholar
  20. Deditius-Island, H. K., & Caruso, J. C. (2002). An examination of the reliability of scores from Zuckerman’s Sensation Seeking Scales, Form V. Educational and Psychological Measurement, 62(4), 728–734. Scholar
  21. Druss, B. G., & Walker, E. R. (2011). Mental disorders and medical comorbidity. Retrieved from Princeton, NJ:Google Scholar
  22. Ersche, K. D., Turton, A. J., Pradhan, S., Bullmore, E. T., & Robbins, T. W. (2010). Drug addiction endophenotypes: impulsive versus sensation-seeking personality traits. Biological Psychiatry, 68(8), 770–773.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Eysenck, H. (1997). Addiction, personality and motivation. Human Psychopharmacology: Clinical and Experimental, 12(S2), S79–S87.CrossRefGoogle Scholar
  24. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258.CrossRefGoogle Scholar
  25. Fergus, T. A., & Carmin, C. N. (2014). The validity and specificity of the short-form of the Obsessive Beliefs Questionnaire (OBQ). Journal of Psychopathology and Behavioral Assessment, 36(2), 318–328. Scholar
  26. Gendreau, P., & Gendreau, L. P. (1971). Research design and narcotic addiction proneness. Canadian Psychiatric Association Journal, 16(3), 265–267. Scholar
  27. Goudriaan, A. E., Oosterlaan, J., De Beurs, E., & Van Den Brink, W. (2006). Neurocognitive functions in pathological gambling: a comparison with alcohol dependence, Tourette syndrome and normal controls. Addiction, 101(4), 534–547.PubMedCrossRefGoogle Scholar
  28. Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., Pickering, R. P., & Kaplan, K. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 61(8), 807–816.PubMedCrossRefGoogle Scholar
  29. Grant, J. E., & Kim, S. W. (2005). Quality of life in kleptomania and pathological gambling. Comprehensive Psychiatry, 46(1), 34–37.PubMedCrossRefGoogle Scholar
  30. Gray, J. M., & Wilson, M. A. (2007). A detailed analysis of the reliability and validity of the sensation seeking scale in a UK sample. Personality and Individual Differences, 42(4), 641–651. Scholar
  31. Hasin, D. S., Stinson, F. S., Ogburn, E., & Grant, B. F. (2007). Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 64(7), 830–842. Scholar
  32. Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2017). The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health, 2(8), e356–e366. Scholar
  33. IBM. (2013). IBM SPSS Statistics for Windows, Version 22.0. In: IBM Corp Armonk, NY.Google Scholar
  34. Ilie, G., Adlaf, E. M., Mann, R. E., Ialomiteanu, A., Hamilton, H., Rehm, J., et al. (2014). Associations between a history of traumatic brain injuries and current cigarette smoking, cannabis use, nonmedical opioid use, and elevated psychological distress in a population sample of Canadian adults. Journal of Neurotrauma, 32, 1130–1134. Scholar
  35. Kessler, R. C., Hwang, I., Labrie, R. A., Petukhova, M., Sampson, N. A., Winters, K. C., & Shaffer, H. J. (2008). DSM-IV pathological gambling in the National Comorbidity Survey Replication. Psychological Medicine, 38, 1351–1360. Scholar
  36. Kessler, R. C., Nelson, C. B., McGonagle, K. A., Edlund, M. J., Frank, R. G., & Leaf, P. J. (1996). The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. American Journal of Orthopsychiatry, 66(1), 17–31.PubMedCrossRefGoogle Scholar
  37. Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: focus on heroin and cocaine dependence. American Journal of Psychiatry, 142(11), 1259–1264.PubMedCrossRefGoogle Scholar
  38. Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: a reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244.PubMedCrossRefGoogle Scholar
  39. Khantzian, E. J., & Albanese, M. J. (2008). Understanding addiction as self medication: finding hope behind the pain. Lanham, MD: Rowman & Littlefield.Google Scholar
  40. Konkolÿ Thege, B., Colman, I., el-Guebaly, N., Hodgins, D. C., Patten, S. B., Schopflocher, D., et al. (2015). Social judgments of behavioral versus substance-related addictions: a population-based study. Addictive Behaviors, 42, 24–31. Scholar
  41. Korn, D. A., & Shaffer, H. J. (1999). Gambling and the health of the public: adopting a public health perspective. Journal of Gambling Studies, 15(4), 289–365.PubMedCrossRefGoogle Scholar
  42. Langenbucher, J., Bavly, L., Labouvie, E., Sanjuan, P. M., & Martin, C. S. (2001). Clinical features of pathological gambling in an addictions treatment cohort. Psychology of Addictive Behaviors, 15(1), 77–79.PubMedCrossRefGoogle Scholar
  43. LaPlante, D. A., & Shaffer, H. J. (2002). Evaluating gambling disorders: screening, assessment, and diagnosis. Responsible Gaming Quarterly, 1(2), 6–7,12.Google Scholar
  44. Lawrence, A. J., Luty, J., Bogdan, N. A., Sahakian, B. J., & Clark, L. (2009). Problem gamblers share deficits in impulsive decision-making with alcohol-dependent individuals. Addiction, 104(6), 1006–1015.PubMedPubMedCentralCrossRefGoogle Scholar
  45. Lazarus, R. S. (1993). Coping theory and research: past, present, and future. Psychosomatic Medicine, 55(3), 234–247.PubMedCrossRefGoogle Scholar
  46. Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.Google Scholar
  47. Lee, H. W., Choi, J.-S., Shin, Y.-C., Lee, J.-Y., Jung, H. Y., & Kwon, J. S. (2012). Impulsivity in internet addiction: a comparison with pathological gambling. Cyberpsychology, Behavior and Social Networking, 15(7), 373–377.PubMedCrossRefGoogle Scholar
  48. Leedes, R. (2001). The three most important criteria in diagnosing sexual addictions: obsession, obsession, and obsession. Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention, 8(3–4), 215–226.CrossRefGoogle Scholar
  49. Leeman, R. F., & Potenza, M. N. (2012). Similarities and differences between pathological gambling and substance use disorders: a focus on impulsivity and compulsivity. Psychopharmacology, 219(2), 469–490.PubMedCrossRefGoogle Scholar
  50. Linden, D. J. (2012). The compass of pleasure: how our brains make fatty foods, orgasm, exercise, marijuana, generosity, vodka, learning, and gambling feel so good. New York; London: Penguin.Google Scholar
  51. MacLaren, V. V., Fugelsang, J. A., Harrigan, K. A., & Dixon, M. J. (2011). The personality of pathological gamblers: a meta-analysis. Clinical Psychology Review, 31(6), 1057–1067.PubMedCrossRefGoogle Scholar
  52. Mai, Y., Hu, J., Yan, Z., Zhen, S., Wang, S., & Zhang, W. (2012). Structure and function of maladaptive cognitions in Pathological Internet Use among Chinese adolescents. Computers in Human Behavior, 28(6), 2376–2386. Scholar
  53. Miller, S. C., Baktash, S. H., Webb, T. S., Whitehead, C. R., Maynard, C., Wells, T. S., et al. (2013). Risk for addiction-related disorders following mild traumatic brain injury in a large cohort of active-duty U.S. airmen. American Journal of Psychiatry, 170(4), 383–390. Scholar
  54. Morie, K. P., Yip, S. W., Nich, C., Hunkele, K., Carroll, K. M., & Potenza, M. N. (2016). Alexithymia and addiction: a review and preliminary data suggesting neurobiological links to reward/loss processing. Current Addiction Reports, 3(2), 239–248. Scholar
  55. Morosini, P., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 101(4), 323–329.PubMedGoogle Scholar
  56. Moulding, R., Anglim, J., Nedeljkovic, M., Doron, G., Kyrios, M., & Ayalon, A. (2011). The Obsessive Beliefs Questionnaire (OBQ): examination in nonclinical samples and development of a short version. Assessment, 18(3), 357–374. Scholar
  57. Nelson, S. E., Belkin, K., LaPlante, D. A., Bosworth, L., & Shaffer, H. J. (2015). A prospective study of psychiatric comorbidity and recidivism among repeat DUI offenders. Archives of Scientific Psychology, 3(1), 8–17. Scholar
  58. O’Driscoll, M. P. (2013). Coping with stress: a challenge for theory, research and practice. Stress and health: journal of the International Society for the Investigation of Stress, 29(2), 89–90. Scholar
  59. Patton, J. H., & Stanford, M. S. (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology, 51(6), 768–774.PubMedCrossRefGoogle Scholar
  60. Petry, N. M., Stinson, F., & Grant, B. F. (2005). Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Journal of Clinical Psychiatry, 66(5), 564–574.PubMedCrossRefGoogle Scholar
  61. Potenza, M. N. (2008). The neurobiology of pathological gambling and drug addiction: an overview and new findings. Philosophical Transactions of the Royal Society of London B: Biological Sciences, 363(1507), 3181–3189.PubMedCrossRefGoogle Scholar
  62. Raviv, M. (1993). Personality characteristics of sexual addicts and pathological gamblers. Journal of Gambling Studies, 9(1), 17–30.CrossRefGoogle Scholar
  63. Regier, D. A., Farmer, M. E., Rae, D. S., Locke, B. Z., Keith, S. J., Judd, L. L., & Goodwin, F. K. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. Journal of the American Medical Association, 264(19), 2511–2518.PubMedCrossRefGoogle Scholar
  64. Reuter, J., Raedler, T., Rose, M., Hand, I., Gläscher, J., & Büchel, C. (2005). Pathological gambling is linked to reduced activation of the mesolimbic reward system. Nature Neuroscience, 8(2), 147–148.PubMedPubMedCentralCrossRefGoogle Scholar
  65. Ridgeway, D., & Russell, J. A. (1980). Reliability and validity of the Sensation-Seeking Scale: psychometric problems in form V. Journal of Consulting and Clinical Psychology, 48(5), 1–3.CrossRefGoogle Scholar
  66. Robbins, T. W., & Clark, L. (2015). Behavioral addictions. Current Opinion in Neurobiology, 30, 66–72. Scholar
  67. Shaffer, H. J. (1999). Strange bedfellows: a critical view of pathological gambling and addiction. Addiction, 94(10), 1445–1448.PubMedCrossRefGoogle Scholar
  68. Shaffer, H. J. (2000). Addictive personality. In Encyclopedia of psychology (Vol. 1, pp. 35–36).Google Scholar
  69. Shaffer, H. J. (2003). A critical view of pathological gambling and addiction: comorbidity makes for syndromes and other strange bedfellows. In G. Reith (Ed.), Gambling: who wins? Who loses? (pp. 175–190). New York: Prometheus Books.Google Scholar
  70. Shaffer, H. J., LaPlante, D. A., LaBrie, R. A., Kidman, R. C., Donato, A. N., & Stanton, M. V. (2004). Toward a syndrome model of addiction: multiple expressions, common etiology. Harvard Review of Psychiatry, 12(6), 367–374.PubMedCrossRefGoogle Scholar
  71. Shaffer, H. J., LaPlante, D. A., & Nelson, S. E. (2012a). The APA addiction syndrome handbook (Vol. 1. Foundations, influences, and expressions of addiction). Washington, D.C., American Psychological Association Press.Google Scholar
  72. Shaffer, H. J., LaPlante, D. A., & Nelson, S. E. (Eds.). (2012b). The APA addiction syndrome handbook (Vol. 2. Recovery, prevention, and other issues). Washington, D.C., American Psychological Association Press.Google Scholar
  73. Shaffer, H. J., & Shaffer, P. M. (2016). Behavioral addiction. In H. Friedman (Ed.), Encyclopedia of mental health, second edition (Second ed., Vol. Volume 1, pp. 135–142). Waltham, MA: Academic Press.Google Scholar
  74. Shek, D. T. (1988). Reliability and factorial structure of the Chinese version of the State-Trait Anxiety Inventory. Journal of Psychopathology and Behavioral Assessment, 10(4), 303–317.CrossRefGoogle Scholar
  75. Shek, D. T., Chan, E. M., & Wong, R. H. (2012). Associations between pathological gambling and psychiatric comorbidity among help-seeking populations in Hong Kong. The Scientific World Journal, 2012(11), 1–15. Scholar
  76. Sher, K. J., Gershuny, B. S., Peterson, L., & Raskin, G. (1997). The role of childhood stressors in the intergenerational transmission of alcohol use disorders. Journal of Studies on Alcohol, 58(4), 414–427. Scholar
  77. Spielberger, C. D. (1983). Manual for the State–Trait Anxiety Inventory (Form Y). Palo Alto, CA: Mind Garden.Google Scholar
  78. Taylor, S., Abramowitz, J. S., McKay, D., Calamari, J. E., Sookman, D., Kyrios, M., Wilhelm, S., & Carmin, C. (2006). Do dysfunctional beliefs play a role in all types of obsessive–compulsive disorder? Journal of Anxiety Disorders, 20(1), 85–97.PubMedCrossRefGoogle Scholar
  79. Thorberg, F. A., Young, R. M., Sullivan, K. A., & Lyvers, M. (2009). Alexithymia and alcohol use disorders: a critical review. Addictive Behaviors, 34(3), 237–245.PubMedCrossRefGoogle Scholar
  80. Wang, W., Wu, Y.-X., Peng, Z.-G., Lu, S.-W., Yu, L., Wang, G.-P., et al. (2000). Test of sensation seeking in a Chinese sample. Personality and Individual Differences, 28(1), 169–179.CrossRefGoogle Scholar
  81. Weiss, N. H., Bold, K. W., Sullivan, T. P., Armeli, S., & Tennen, H. (2017). Testing bidirectional associations among emotion regulation strategies and substance use: a daily diary study: emotion regulation and substance use. Addiction, 112, 695–704. Scholar
  82. Yen, J. Y., Ko, C. H., Yen, C. F., Chen, S. H., Chung, W. L., & Chen, C. C. (2008). Psychiatric symptoms in adolescents with Internet addiction: Comparison with substance use. Psychiatry and Clinical Neurosciences, 62(1), 9–16.PubMedCrossRefGoogle Scholar
  83. Zhou, Z., Zhu, H., Li, C., & Wang, J. (2014). Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients. Frontiers in Behavioral Neuroscience, 8, 288. Scholar
  84. Zhu, X., Yi, J., Yao, S., Ryder, A. G., Taylor, G. J., & Bagby, R. M. (2007). Cross-cultural validation of a Chinese translation of the 20-item Toronto Alexithymia Scale. Comprehensive Psychiatry, 48(5), 489–496.PubMedCrossRefGoogle Scholar
  85. Zuckerman, M., Eysenck, S. B., & Eysenck, H. J. (1978). Sensation seeking in England and America: cross-cultural, age, and sex comparisons. Journal of Consulting and Clinical Psychology, 46(1), 139–149. Scholar
  86. Zuckerman, M., & Kuhlman, D. M. (2000). Personality and risk-taking: common bisocial factors. Journal of Personality, 68(6), 999–1029.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Howard J. Shaffer
    • 1
    Email author
  • Matthew A. Tom
    • 1
  • Rhiannon C. Wiley
    • 1
  • Margaret F. Y. Wong
    • 2
  • Elda M. L. Chan
    • 3
  • Gordon L. F. Cheng
    • 4
  • Camilla K. M. Lo
    • 3
  • Eric K. Y. Ma
    • 3
  • Ryan H. Y. Wong
    • 3
  • Mary Lee
    • 3
  1. 1.Division on AddictionCambridge Health Alliance, a Harvard Medical School Teaching HospitalMedfordUSA
  2. 2.Community Services Division, Youth and Family ServicesTung Wah Group of HospitalsSai WanHong Kong
  3. 3.Tung Wah Group of Hospitals Integrated Centre on Addiction Prevention and TreatmentSai WanHong Kong
  4. 4.Department of Clinical PsychologyCastle Peak HospitalTuen MunHong Kong

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