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Soder HE, Wardle MC, Schmitz JM, Lane SD, Green C, Vujanovic AA. Baseline resting heart rate variability predicts post-traumatic stress disorder treatment outcomes in adults with co-occurring substance use disorders and post-traumatic stress. Psychophysiology 2019; 56:e13377. [PMID: 30968959 PMCID: PMC6650323 DOI: 10.1111/psyp.13377] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 03/15/2019] [Accepted: 03/22/2019] [Indexed: 01/21/2023]
Abstract
Post-traumatic stress disorder (PTSD) symptoms are highly prevalent among individuals with substance use disorders (SUD), presenting a difficult-to-treat, complex comorbidity. Prognostic factors for treatment outcomes may characterize heterogeneity of the treated population and/or implicate mechanisms of action that are salient for improving treatments. High frequency heart rate variability (HF-HRV) is a suggested biomarker for emotion regulation-the ability to generate appropriate emotional responses via the influence of the parasympathetic nervous system on the heart. This initial study investigated the utility of baseline resting HF-HRV for predicting PTSD symptoms and substance use outcomes following treatment of 37 SUD participants with comorbid PTSD symptoms. Participants completed either standard cognitive- behavioral therapy (CBT) for SUD or a novel treatment of integrated post-traumatic stress and substance use that combined CBT for SUD with cognitive processing therapy for PTSD. Analyses demonstrated that higher HF-HRV predicted greater reduction in PTSD symptoms following both types of treatment. This suggests prognostic value of HF-HRV as a predictor of PTSD treatment outcomes; those with poorer autonomic emotional regulation may not respond as well to psychotherapy in general. This hypothesis-generating analysis identifies a putative biomarker that might have utility in treatment prediction.
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Affiliation(s)
- Heather E Soder
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas
| | - Margaret C Wardle
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Joy M Schmitz
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas
| | - Scott D Lane
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas
| | - Charles Green
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas
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102
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Cavicchioli M, Prudenziati F, Movalli M, Ramella P, Maffei C. The Severity of Personality Pathology: A Risk Factor for Concurrent Substance Use Disorders in Alcohol Use Disorder. J Dual Diagn 2019; 15:159-171. [PMID: 31088228 DOI: 10.1080/15504263.2019.1612131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: Co-occurrence of substance use disorders (CO-substance use disorders) among individuals with alcohol use disorder (AUD) is largely recognized as a critical clinical issue. However, the specific clinical variables involved are still unclear. The recent findings are controversial in pointing out the unique contribution of both impulsivity and emotion dysregulation on CO-substance use disorders. Furthermore, the co-variation between AUD and other substance use disorders includes different aspects of maladaptive personality functioning (i.e., overall severity and specific features). Therefore, this study aims at clarifying the role of impulsivity, emotional dysregulation, and severity of personality pathology on CO-substance use disorders among treatment-seeking individuals with AUD. Methods: One hundred ninety-three treatment-seeking individuals with AUD (DSM-IV-TR) were consecutively recruited. Impulsivity (Barratt Impulsiveness Scale [BIS-11]), emotional dysregulation (Difficulties in Emotion Regulation Scale [DERS]), and personality pathology (Structured Clinical Interview for DSM-IV Axis II Personality Disorder [SCID-II]) were assessed after a 2-week detoxification period. The analyses were based on several stepwise forward logistic regressions. The total score of BIS-11 and DERS together with the number of SCID-II criteria were considered, in following the order, as independent variables controlling for the comorbidity with other lifetime Axis I disorders. CO-substance use disorders was the dependent variable (i.e., any CO-substance use disorders, benzodiazepine and cannabis/cocaine use disorders). Results: The number of SCID-II criteria was the only significant predictor of overall CO-substance use disorders, odds ratio (OR) = 1.16; 95% confidence interval (CI) [1.07, 1.26], p < .01, and cannabis/cocaine use disorders, OR = 1.19; 95% CI [1.08, 1.31], p < .01. On the contrary, DERS total score was the most robust predictor of benzodiazepine use disorder, OR = 1.02; 95% CI [1.01, 1.04], p < .01, albeit the severity of maladaptive personality functioning was also significantly associated with this disorder, OR = 1.09; 95% CI [1.00, 1.18], p < .05. Conclusions: The severity of maladaptive personality pathology represents one of the main aspects involved in CO-substance use disorders among individuals with AUD. This dimension predicts the CO-substance use disorders above and beyond specific personality dimensions and other psychiatric conditions. Therefore, personality functioning should be precisely assessed and personality pathology should be addressed in the framework of AUD treatments for promoting effective long-term outcomes.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Francesca Prudenziati
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Pietro Ramella
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele" , Milan , Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital , Milan , Italy
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103
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Worden B, Levy HC, Das A, Katz BW, Stevens M, Tolin DF. Perceived emotion regulation and emotional distress tolerance in patients with hoarding disorder. J Obsessive Compuls Relat Disord 2019; 22:100441. [PMID: 32818134 PMCID: PMC7430655 DOI: 10.1016/j.jocrd.2019.100441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Emotional distress tolerance (EDT) and emotion regulation (ER) appear to be highly relevant to hoarding pathology, as excessive saving and/or acquiring may be motivated by emotional avoidance or other attempts to regulate negative affect. While findings with nonclinical samples have suggested and EDT/ER predicts hoarding symptoms, there is little data on clinical samples. The aim of the current study was to examine several self-report measures of EDT and ER in individuals with HD (n = 87) and age-matched nonclinical controls (n = 46), and to explore whether this was predictive of treatment compliance and/or outcome in group CBT for HD. Results suggested that, the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) total score, DERS goals and awareness subscales, and Intolerance of Uncertainty Scale (IUS; Buhr & Dugas, 2002) were predictive of hoarding severity. However, EDT/ER did not change with treatment, did not mediate treatment outcome, and did not predicted treatment retention, compliance, or outcome. Results suggest that some EDT/ER constructs, such as uncertainty intolerance, difficulty persisting in goal behaviors when upset, and low emotional awareness, may explain significant variance in HD symptoms, although they did not appear to be mechanisms of change in CBT for HD.
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Affiliation(s)
| | | | | | | | - Michael Stevens
- Institute of Living, Hartford, CT
- Yale University School of Medicine
| | - David F. Tolin
- Institute of Living, Hartford, CT
- Yale University School of Medicine
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104
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Parent MC, Gobble TD, Rochlen A. Social Media Behavior, Toxic Masculinity, and Depression. PSYCHOLOGY OF MEN & MASCULINITY 2019; 20:277-287. [PMID: 38250140 PMCID: PMC10798810 DOI: 10.1037/men0000156] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Social media/social networks (SM/SNs), while ubiquitous in their use, have not been well integrated into psychological theory or practice. Most research addressing SM/SNs has examined frequency and modality of SM/SN use, rather than the valence of online interactions or potential mental health consequences of use. Further, SM/SN use has also not been well integrated with relevant paradigms from the psychology of men and masculinities paradigms. The present study contributes to both of these research need areas by testing the associations among SM/SN use, toxic masculinity, positive or negative SM/SN interactions, and depression among a sample of 402 men. Results of a structural equation modeling analysis indicated that SM/SN use and toxic masculinity were associated with depression. Positive and negative SM/SN interactions mediated the relationship between SM/SN use and depression indicators, and negative SM/SN interactions mediated the relationship between toxic masculinity and depression. Implications for future research directions and for working with men who use SM/SNs are discussed.
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Affiliation(s)
- Mike C Parent
- Department of Educational Psychology, University of Texas at Austin
| | - Teresa D Gobble
- Department of Educational Psychology, University of Texas at Austin
| | - Aaron Rochlen
- Department of Educational Psychology, University of Texas at Austin
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105
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Alcohol Abstinence Prediction on the Basis of Conservation of Resources Theory by Stevan E. Hobfoll a Study of Polish Alcohol-Dependent Persons in the Early Phase of Recovery. PSYCH 2019. [DOI: 10.3390/psych1010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Striving for permanent alcohol abstinence can be difficult to achieve or even impossible, which in turn often results in discontinuation of treatment. The main area of interest among researchers dealing with the problem of alcohol dependence is the ability to maintain abstinence. Despite numerous studies in this area, there is still no unambiguous data on the factors affecting the recovery process of alcohol-dependent persons. The main goal of this publication is to present the Conservation of Resources Theory (COR) by S. Hobfoll as an alternative concept to understanding alcohol dependence and to answer whether maintaining abstinence can be predicted, and what kind of resources play a key role in alcohol dependence recovery. A series of two comparisons of independent variables (level, gain and loss of resources) were made in the first and sixth month after the beginning of therapy. Questionnaire longitudinal studies of 350 alcohol-dependent persons were used. Research results show that distribution of resources is of great significance in maintaining abstinence. It is important for the alcohol-dependent person’s recovery process to have the opportunity to gain resources. Experiencing loss of resources in the beginning of treatment often determines their return to drinking. The project provides empirical support for research on the role of supportive factors in an alcohol-dependent person’s recovery process.
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106
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Romero-Martínez Á, Vitoria-Estruch S, Moya-Albiol L. Emotional and autonomic dysregulation in abstinent alcoholic men: An idiosyncratic profile? Alcohol 2019; 77:155-162. [PMID: 30664984 DOI: 10.1016/j.alcohol.2019.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/03/2019] [Accepted: 01/14/2019] [Indexed: 01/29/2023]
Abstract
Men who misuse alcohol tend to experience negative affect, which may entail difficulties in regulating emotions to cope effectively with stressful or anxiety-provoking situations, thus increasing the risk of alcohol relapse. This dysphoric state has been associated with alexithymia, which compromises an individual's abilities to acknowledge, recognize, and regulate emotional states. A physiological correlate of emotional regulation is autonomic flexibility, as shown by emotional dysregulation in men who misuse alcohol being correlated with reduced parasympathetic activation to control heart rate variability during stress and/or conflict situations. Hence, the main aim of this study was to investigate whether long-term abstinent alcoholic (LTAA) men exhibit higher levels of negative affect and sympathetic activation (cardiovascular and electrodermal) in response to acute standardized laboratory stress than non-alcoholic controls. In addition, we hypothesized that the higher the alexithymic traits, the greater would be the increase in negative affect and sympathetic activation in response to stress, especially in LTAAs. Our data demonstrated that LTAAs experienced slightly greater increases in anxiety, states of anger, and worsening of mood than controls. Moreover, they exhibited lower high-frequency heart rate variability, respiratory sinus arrhythmia values, shorter pre-ejection periods, and higher respiratory rates than controls. Finally, alexithymic traits imply greater worsening of mood and sympathetic predominance (shorter pre-ejection periods and smaller magnitude of response), with the associations being stronger in LTAAs. These findings indicate a different emotional and cardiovascular response to psychosocial stress in LTAA than non-alcoholic men. Improving our knowledge of the way this population reacts to stress may help identify risk factors for alcohol relapse.
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107
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The Sequential Indirect Effect of Negative Urgency on Drinking Consequences Through Distress Intolerance and Drinking Motives: Initial Examination in College Students Reporting Past Month Alcohol Use. Int J Ment Health Addict 2019; 17:479-492. [PMID: 33953647 DOI: 10.1007/s11469-019-00068-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Identification of cognitive and affective vulnerabilities among college drinkers may aid in developing focused interventions that promote a reduction in the prevalence of alcohol use. Negative urgency (NU) and distress intolerance (DI) evidence concurrent, unique, and synergistic relations with drinking motives and negative consequences of alcohol use. Utilizing a sequential multiple mediation framework to investigate a comprehensive model of these variables, we examined NU as a behavioral risk factor that potentiates the development of DI, thereby contributing to drinking motives that increase the risk of problematic use in young adults. A diverse sample of undergraduate students (N = 616; M age= 19.1, SD=1.4, range=18-25; 50.6% female; 60.6% Caucasian; recruited between September 2015 and Spring 2017) reporting past month alcohol use completed an online questionnaire battery. The results suggested that NU may contribute to negative alcohol use outcomes via its relation to DI and the motivation to drink in order to cope with negative emotional states and conform to social pressure. These findings suggest that NU may be a primary intervention target in young adults.
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108
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Reese ED, Conway CC, Anand D, Bauer DJ, Daughters SB. Distress tolerance trajectories following substance use treatment. J Consult Clin Psychol 2019; 87:645-656. [PMID: 31008636 DOI: 10.1037/ccp0000403] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Distress tolerance (DT), the ability to withstand aversive internal states, represents an important risk factor for substance use relapse and a potential treatment target. Neurobiological research in substance using populations suggests that continued substance use could erode DT, whereas abstinence could bolster it. The current study characterized trajectories of behavioral and self-reported indices of DT and examined the prospective effect of substance use on DT trajectories among those seeking treatment for substance use. METHOD Individuals (N = 263, Mage = 42.68, SD = 11.8, 70.7% male, 94.7% African American) in residential substance use treatment completed subjective (Distress Tolerance Scale) and behavioral (Mirror Tracing Persistence Task-computerized version) DT measures, as well as report of daily substance use (timeline follow-back) over 5 assessment time-points from pretreatment to 12 months posttreatment. Latent curve modeling estimated DT trajectories and their associations with substance use behavior, including abstinence duration (days until first use) and substance use frequency (percentage of substance use days between assessments). RESULTS Self-reported and behavioral DT indicators both exhibited positive, nonlinear change over time (standardized slope parameter estimates: Distress Tolerance Scale β = 0.61, p < .01; Mirror Tracing Persistence Task β = 0.34, p < .01). Abstinence duration was associated with greater improvement in behavioral (β = .20, p = .03) DT specifically. Frequency of use was statistically significantly associated with attenuated behavioral DT at 6-month (β = -.12, p = .03) and 12-month follow-ups (β = -.08, p = .045). CONCLUSIONS DT appears to improve appreciably posttreatment, and return to substance use may shape the degree of this improvement. Collectively, these findings support the conceptualization of DT as a malleable treatment target and emphasize the benefit of abstinence on improvement in DT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Elizabeth D Reese
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | - Deepika Anand
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Daniel J Bauer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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109
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Grigorian HL, Brem MJ, Garner A, Florimbio AR, Wolford-Clevenger C, Stuart GL. Alcohol Use and Problems as a Potential Mediator of the Relationship between Emotion Dysregulation and IPV Perpetration. PSYCHOLOGY OF VIOLENCE 2019; 10:91-99. [PMID: 33224553 PMCID: PMC7678751 DOI: 10.1037/vio0000237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Alcohol use/problems and emotion dysregulation are associated with increased intimate partner violence (IPV) perpetration. Additionally, alcohol use is an overt coping mechanism for dysregulated emotion. While past research has examined alcohol use/problems as a mediator between emotion dysregulation and IPV, research is limited within clinical samples. The current study sought to fill this gap by examining a theoretical model by which emotion dysregulation and alcohol use/problems influence IPV perpetration in a sample of men arrested for domestic violence. Consistent with prior research, it was hypothesized that alcohol use/problems would mediate the relationship between emotion dysregulation and psychological aggression. Additionally, we hypothesized that emotion dysregulation would positively associate with increased alcohol use/problems, which would relate to increased physical assault perpetration through psychological aggression perpetration. METHOD Using a cross-sectional sample of 391 men arrested for domestic violence and court-referred to Batterer Intervention Programs (BIP), the present study used structural equation modeling to examine proposed pathways from emotion dysregulation to IPV perpetration directly and indirectly through alcohol use/problems. RESULTS Alcohol use/problems explained the relation between emotion dysregulation and psychological aggression perpetration. In addition, emotion dysregulation related to psychological aggression which explained the relation between alcohol use/problems and physical assault perpetration. CONCLUSIONS These findings underline the importance of assessing and addressing emotion dysregulation and alcohol use/problems as risk factors for IPV in existing BIP as well as within theoretical models.
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110
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Relationships Between Components of Emotional Intelligence and Suicidal Behavior in Alcohol-dependent Patients. J Addict Med 2019; 12:24-30. [PMID: 28901998 DOI: 10.1097/adm.0000000000000358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The importance of investigating various emotional skills in assessment of suicide risk in alcohol-dependent (AD) individuals has recently become the focus of increasing interest. The objective of this study was to explore the relationships between self-reported components of emotional intelligence and lifetime prevalence of suicide attempts in a clinical sample of AD subjects. METHODS A group of 80 inpatients entering an alcohol treatment program in Warsaw, Poland, was recruited. Baseline information about demographics, psychopathological symptoms, personality, and severity of alcohol problems was obtained. The Schutte Self-Report Emotional Intelligence Test was utilized for assessment of emotional processing. Lifetime history of suicide attempts was obtained from the MINI International Neuropsychiatric Interview. RESULTS After accounting for affect-related suicide risk factors (severity of depression, anxiety, neuroticism), and also other significant predictors (eg, age, sex, history of childhood abuse), mood regulation/optimism deficits remained a significant correlate of lifetime suicide attempts in AD patients. In the mediation models, mood regulation appeared to fully mediate the relationship between history of suicide attempts and depression, and also neuroticism. CONCLUSIONS The results of this study support the evidence that poor mood regulation might be related to the risk for suicidal behavior in AD individuals. These findings point towards the significance of addressing the issue of emotion-related skills in the therapy of those AD subjects who are at risk for suicide.
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111
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Evren C, Karabulut V, Alniak I, Evren B, Carkci OH, Yilmaz Cengel H, Ozkara Menekseoglu P, Cetin T, Bozkurt M, Umut G. Emotion dysregulation and internalizing symptoms affect relationships between ADHD symptoms and borderline personality features among male patients with substance use disorders. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1595271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Cuneyt Evren
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Vahap Karabulut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Izgi Alniak
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Bilge Evren
- Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey
| | - Ozlem Helin Carkci
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Hanife Yilmaz Cengel
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Pelin Ozkara Menekseoglu
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Turan Cetin
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Muge Bozkurt
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Gokhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
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112
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Schick MR, Weiss NH, Contractor A, Dixon-Gordon KL, Spillane NS. Depression and risky alcohol use: an examination of the role of difficulties regulating positive emotions in trauma-exposed individuals. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:323-332. [PMID: 30848960 DOI: 10.1080/00952990.2019.1572759] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The co-occurrence of depression and risky alcohol use is clinically relevant given their high rates of comorbidity and reciprocal negative impact on outcomes. Emotion dysregulation is one factor that has been shown to underlie this association. However, literature in this area has been limited in its exclusive focus on emotion dysregulation stemming from negative emotions. OBJECTIVES The goal of the current study was to extend research by exploring the role of difficulties regulating positive emotions in depression symptom severity, risky alcohol use, and their association. METHODS Participants were 395 trauma-exposed adults recruited from Amazon's Mechanical Turk (MTurk) platform (56.20% female, Mage = 35.55) who completed self-report questionnaires. RESULTS Zero-order correlations among depression symptom severity, the three subscales of difficulties regulating positive emotions, and risky alcohol use were positive. Two subscales of difficulties regulating positive emotions-nonacceptance of positive emotions and difficulties controlling impulsive behavior when experiencing positive emotions-accounted for the relationship between depression symptom severity and risky alcohol use. CONCLUSION Results suggest the importance of incorporating techniques focused on improving positive emotion regulation skills in interventions for risky alcohol use among individuals with depression.
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Affiliation(s)
- Melissa R Schick
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Nicole H Weiss
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Ateka Contractor
- b Department of Psychology , University of North Texas , Denton , TX , USA
| | - Katherine L Dixon-Gordon
- c Department of Psychological and Brain Sciences , University of Massachusetts Amherst , Amherst , MA , USA
| | - Nichea S Spillane
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
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113
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Bottiroli S, Galli F, Viana M, De Icco R, Bitetto V, Allena M, Pazzi S, Sances G, Tassorelli C. Negative Short-Term Outcome of Detoxification Therapy in Chronic Migraine With Medication Overuse Headache: Role for Early Life Traumatic Experiences and Recent Stressful Events. Front Neurol 2019; 10:173. [PMID: 30899242 PMCID: PMC6416203 DOI: 10.3389/fneur.2019.00173] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/11/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Early traumatic experiences and Stressful episodes appear to be associated to the development and perpetuation of chronic pain disorders and to dependence-related behaviors. Objective: The present study evaluated whether these factors can be predictors, together with psychiatric conditions, of the outcome of a detoxification treatment in patients suffering from chronic migraine and medication-overuse headache in a 2-month follow-up. Methods: Consecutive patients undergoing a detoxification program as therapy for treating chronic migraine and medication overuse headache at the Pavia Headache Center were analyzed. During this program, lasting about 1 week, all patients received the standard CARE in-patient withdrawal protocol, which consisted in discontinuing abruptly the overused drug(s) and receiving daily detoxification therapy. Data on childhood traumatic events and recent stressful ones were analyzed by means of the Childhood Trauma Questionnaire and Stressful life-events Questionnaire. Psychiatric conditions were evaluated using the Structured Clinical Interview for Diagnostic and Statistical Manual of mental disorders. Results: A total of 166 (80% females; mean age 44.7) patients completed the follow-up at 2 months after the detoxification program: of these 118 (71%) (78% females; mean age 44.7) stopped overuse and reverted to an episodic pattern of headache (Group A); 19 (11%) (89% females; mean age 41.3) kept overusing and maintained a chronic pattern of headache (Group B); and 29 (18%) (79% females; mean age 46.9) stopped overuse without any benefit on headache frequency (Group C). At the multivariate analyses, a higher number of early life emotional distress (Odds Ratio 11.096; p = 0.037) arose as a prognostic factor for the outcome in Group B, while major depression during life-time (Odds Ratio 3.703; p = 0.006) and higher number of severe stressful episodes in the past 10 years (Odds Ratio 1.679; p = 0.045) were prognostic factors for the outcome of Group C. Conclusions: Data suggest that early life traumas and stressful events have a negative impact on the outcome of the detoxification program in subjects overusing acute medication for headache. The history of emotional childhood traumas is associated to the failure to cease overuse, whereas recent very serious life events are associated to the persistence of headache chronicity.
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Affiliation(s)
- Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy.,Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Federica Galli
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Viana
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Headache Group, Department of Basic and Clinical Neurosciences, King's College London, London, United Kingdom.,Headache Center, Institute of the Neurocenter of Southern Switzerland (NSI), Regional Hospital Lugano, Lugano, Switzerland
| | - Roberto De Icco
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Vito Bitetto
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marta Allena
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefania Pazzi
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Grazia Sances
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science Centre, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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114
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Orlowski S, Bischof A, Besser B, Bischof G, Rumpf HJ. Deficits in emotion regulation strategies among problematic and pathological gamblers in a sample of vocational school students. J Behav Addict 2019; 8:94-102. [PMID: 30663330 PMCID: PMC7044603 DOI: 10.1556/2006.7.2018.136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND AIMS Deficits in emotion regulation (ER) are associated with mental disorders. To date, there are hardly any studies focusing on the role of ER strategies in the context of gambling behavior. The aim of this study was to investigate the association between specific ER strategies and pathological as well as problematic gambling in a proactively recruited sample. METHODS A large and unselected sample (n = 4,928) has been screened proactively and systematically in vocational schools. We assessed the Affective Style Questionnaire to measure ER strategies and the Stinchfield questionnaire for assessing problematic and pathological gambling. Associations were investigated with linear and multinomial logistic regression analyses. RESULTS The analyses showed a significant negative correlation between the subscales "Adjusting" and "Tolerating" and the Stinchfield sum score. Lower scores on these subscales were associated with a higher number of endorsed Stinchfield items. A lower score on the ER strategies "Adjusting" [conditional odds ratio (COR) = 0.95, confidence interval (CI) = 0.91-0.99] and "Tolerating" [COR = 0.95, CI = 0.92-99] led to a higher chance of being classified as a pathological gambler. In problematic gambling, on a subthreshold level, only "Tolerating" turned out to be significant [COR = 0.96, CI = 0.93-0.99]. DISCUSSION AND CONCLUSIONS For the first time, deficits in specific ER strategies were identified as independent risk factors for problematic and pathological gambling in a large and proactively recruited sample. ER skills, especially acceptance-focused strategies, should be considered in prevention and psychotherapy.
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Affiliation(s)
- Svenja Orlowski
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany,Corresponding author: Svenja Orlowski; Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Phone: +49 451 500 98759; Fax: +49 451 500 98754; E-mail:
| | - Anja Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Bettina Besser
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Gallus Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
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115
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Nosratabadi M, Halvaiepour Z. Psychological Determinants of Drug Abuse among Male Adolescents in Isfahan: A Structural Model. Int J Prev Med 2019; 10:27. [PMID: 30967913 PMCID: PMC6413519 DOI: 10.4103/ijpvm.ijpvm_23_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 10/15/2017] [Indexed: 11/04/2022] Open
Abstract
Background: Drug abuse is one of the most prevalent public health problems around the world and Iran too. Drug abuse is influenced by various psychosocial factors. This study aimed to explain the relationship model of drug abuse based on perceived criticism, mindfulness, and emotion regulation in Isfahan male adolescents. Methods: This was a correlational cross-sectional study. A total of 350 male students were randomly selected from different high schools in Isfahan during the period of 2015–2016 academic year. Four questionnaires including the probability of drug abuse questionnaire, emotion regulation inventory, Mindful Attention Awareness Scale, and perceived criticism scale were employed. Data were analyzed using Chi-square and correlation coefficient, besides; Structural equation modeling was used to model the direct and indirect relationships between variables. In this regard, SPSS and AMOS softwares were used. Results: Out of the whole subjects, 49.7% had score above the median, indicating more likely to be drug abuser. There was a significant correlation between emotional reappraisal (r = −0.40), expressive suppression (r = −0.38), mindfulness (−0.57), and criticism (r = 0.57) with drug abuse among male adolescents (P < 0.001). Moreover, criticism through the emotional self-regulation had indirect effects on drug abuse. Totally 69% of the variance in drug abuse was explained by the study variables. Conclusions: In total, the results of this study revealed that high levels of drug abuse among students can be considered as a crucial issue, regarding the significant effects of psychological factors, adaptive emotion-regulation strategies, as well as school and family-based Psycho-social skills, are recommended.
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Affiliation(s)
- Mehdi Nosratabadi
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zohreh Halvaiepour
- Department of Education and Psychology, University of Isfahan, Isfahan, Iran
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116
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Fillo J, Kamper-DeMarco KE, Brown WC, Stasiewicz PR, Bradizza CM. Emotion regulation difficulties and social control correlates of smoking among pregnant women trying to quit. Addict Behav 2019; 89:104-112. [PMID: 30286396 DOI: 10.1016/j.addbeh.2018.09.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/14/2018] [Accepted: 09/25/2018] [Indexed: 01/21/2023]
Abstract
Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01163864.
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117
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Cho SB, Su J, Kuo SIC, Bucholz KK, Chan G, Edenberg HJ, McCutcheon VV, Schuckit MA, Kramer JR, Dick DM. Positive and negative reinforcement are differentially associated with alcohol consumption as a function of alcohol dependence. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2019; 33:58-68. [PMID: 30667237 PMCID: PMC6459181 DOI: 10.1037/adb0000436] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A multistage model of drug addiction in which individuals' motivations for use change as they develop problems is widely accepted; however, the evidence for this model comes mostly from animal work and cross-sectional studies. We used longitudinal data to test whether positive and negative reinforcement associated with alcohol consumption differed as a function of alcohol dependence (AD). Specifically, we tested whether (a) positive reinforcement is more strongly associated with alcohol consumption than is negative reinforcement among individuals without AD, (b) negative reinforcement is more strongly associated with AD than is positive reinforcement, and (c) in the presence of AD, the association between positive reinforcement and alcohol consumption becomes weaker, whereas the association with negative reinforcement becomes stronger. We included assessments between Ages 18 and 30 years from participants who indicated they ever had a drink (N = 2,556; 51.6% female) from the Collaborative Study on the Genetics of Alcoholism Prospective Study. Results from generalized estimating equations indicated that positive, but not negative, reinforcement was associated with alcohol consumption among individuals without AD. Both positive and negative reinforcement were associated with AD, but the association was stronger with negative reinforcement. Results from the multilevel growth model indicated that the association between negative reinforcement and alcohol consumption became stronger with the presence of AD, whereas the association between positive reinforcement and alcohol consumption did not differ as a function of AD. We provide empirical evidence that positive and negative reinforcement are differentially associated with alcohol consumption as a function of AD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Seung Bin Cho
- Department of Psychology, Virginia Commonwealth University
| | - Jinni Su
- Department of Psychology, Virginia Commonwealth University
| | | | | | - Grace Chan
- Department of Psychiatry, University of Connecticut
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University
| | | | - Marc A Schuckit
- Department of Psychiatry, University of California at San Diego
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118
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Rose EJ, Picci G, Fishbein DH. Neurocognitive Precursors of Substance Misuse Corresponding to Risk, Resistance, and Resilience Pathways: Implications for Prevention Science. Front Psychiatry 2019; 10:399. [PMID: 31258493 PMCID: PMC6586742 DOI: 10.3389/fpsyt.2019.00399] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/21/2019] [Indexed: 12/22/2022] Open
Abstract
Studies of substance misuse prevention generally focus on characteristics that typify risk, with the assumption that the prevalence of the problem will be optimally reduced by identifying, targeting, and reducing or eliminating risk factors. However, this risk-centered approach neglects variations in individual-level and environmental characteristics that portend differential pathways that are distinguishable by timing of substance use initiation (e.g., early versus delayed), the likelihood of use escalation versus eventual desistance, and enduring abstinence, despite exposure to significant risk factors. Considering the various underpinnings of these distinct substance use trajectories is critical to a more nuanced understanding of the effects, potency, and malleability of factors that are known to increase risk or confer protection. Here, we discuss three pathways relative to substance use patterns and predictors in the context of adversity, a well-known, highly significant influence on propensity for substance misuse. The first pathway is designated as "high risk" based on early onset of substance use, rapid escalation, and proneness to substance use disorders. Individuals who defy all odds and eventually exhibit adaptive developmental outcomes despite an initial maladaptive reaction to adversity, are referred to as "resilient." However, another categorization that has not been adequately characterized is "resistant." Resistant individuals include those who do not exhibit problematic substance use behaviors (e.g., early onset and escalation) and do not develop substance use disorders or other forms of psychopathology, despite significant exposure to factors that normally increase the propensity for such outcomes (e.g. trauma and/or adversity). In this paper, we apply this conceptualization of risk, resistance, and resilience for substance misuse to a more fine-grained analysis of substance use pathways and their corresponding patterns (e.g., non-use, initiation, escalation, desistance). The significance of the progression of neurocognitive functioning over the course of development is discussed as well as how this knowledge may be translated to make a science-based determination of intervention targets. This more encompassing theoretical model has direct implications for primary prevention and clinical approaches to disrupt risk pathways and to optimize long-term outcomes.
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Affiliation(s)
- Emma Jane Rose
- Program for Translational Research on Adversity and Neurodevelopment (P-TRAN), The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Giorgia Picci
- Program for Translational Research on Adversity and Neurodevelopment (P-TRAN), The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA
| | - Diana H Fishbein
- Program for Translational Research on Adversity and Neurodevelopment (P-TRAN), The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, USA.,Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
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119
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Jakubczyk A, Trucco EM, Klimkiewicz A, Skrzeszewski J, Suszek H, Zaorska J, Nowakowska M, Michalska A, Wojnar M, Kopera M. Association Between Interoception and Emotion Regulation in Individuals With Alcohol Use Disorder. Front Psychiatry 2019; 10:1028. [PMID: 32116829 PMCID: PMC7008234 DOI: 10.3389/fpsyt.2019.01028] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/30/2019] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Sensing body-related information includes interoceptive sensibility (the tendency to focus on internal body sensations) and accuracy (precision in perceiving real internal processes). Interoception and emotion regulation have both been linked to alcohol use disorder (AUD). However, the association between these factors have not been investigated within a clinical group of individuals with AUD. OBJECTIVES The current study examines associations between emotion regulation and interoceptive accuracy and sensibility among individuals with AUD and healthy controls (HCs). METHODS The sample comprised 165 individuals meeting criteria for AUD and 110 HCs. Interoceptive sensibility was assessed with a self-report measure (the Private Body Consciousness subscale) and interoceptive accuracy - with a behavioral measure (the Schandry test). Emotion regulation domains: non-acceptance of negative emotions, inability to engage in goal-directed behaviors when experiencing negative emotions, difficulties controlling impulsive behaviors when experiencing negative emotions, limited access to effective emotion regulation strategies, and lack of own emotional awareness and clarity were assessed with the Difficulties in Emotion Regulation Scale (DERS). Associations between interoception and emotion regulation were assessed while controlling for sleep problems, depressive symptoms, age, and sex. RESULTS Higher interoceptive accuracy was negatively associated with DERS subscale of non-acceptance of negative emotions in the AUD group (but not in the HC group). Higher interoceptive sensibility was significantly associated with problems in controlling impulsive behaviors when experiencing negative emotions. This association was moderated by symptoms of AUD. Higher interoceptive sensibility was associated with higher emotional awareness, but only in the HC group. CONCLUSIONS Individuals with AUD who are more interoceptively accurate may be more effective in regulating their emotions. On the other hand, individuals with AUD who are more interoceptively sensible, may have problems with controlling their behaviors while experiencing negative emotional states.
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Affiliation(s)
- Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology and the Center for Children and Families, Florida International University, Miami, FL, United States.,Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Anna Klimkiewicz
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Justyna Zaorska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Aneta Michalska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.,Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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120
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Thorberg FA, Young RM, Hasking P, Lyvers M, Connor JP, London ED, Huang YL, Feeney GFX. Alexithymia and Alcohol Dependence: The Roles of Negative Mood and Alcohol Craving. Subst Use Misuse 2019; 54:2380-2386. [PMID: 31429362 DOI: 10.1080/10826084.2019.1650773] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Alexithymia is a personality trait associated with emotion regulation difficulties. Up to 67% of alcohol-dependent patients in treatment have alexithymia. Objectives: The objective of this study was to investigate the direct and indirect effects of alexithymia, negative mood (stress, anxiety, and depression) and alcohol craving on alcohol dependence severity. Methods: Three hundred and fifty-five outpatients (mean age = 38.70, SD = 11.00, 244 males, range 18-71 years) undergoing Cognitive-Behavioral Therapy for alcohol dependence completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS-21), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Use Disorders Identification Test (AUDIT) prior to the first treatment session. Results: Alexithymia had an indirect effect on alcohol dependence severity, via both negative mood and alcohol craving (b = 0.03, seb = 0.008, 95% CI: 0.02-0.05). An indirect effect of negative mood on alcohol dependence via alcohol craving was also observed (b = 0.12, seb = 0.03, 95% CI: 0.07-0.16). Conclusions/importance: Alexithymia worked through negative mood and alcohol craving leading to increased alcohol dependence severity, indicating that craving had an indirect effect on the relationship between alexithymia and alcohol dependence severity. Targeting alcohol craving and negative mood for alcohol-dependent patients with alexithymia seems warranted.
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Affiliation(s)
- Fred Arne Thorberg
- National Centre for Dual Diagnosis, Innlandet Hospital Trust, Brumunddal, Norway.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,School of Psychology and Counseling, Queensland University of Technology, Brisbane, QLD, Australia.,Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA.,School of Psychology, University of Queensland, Brisbane, QLD, Australia.,Department of Psychology, Bond University, Gold Coast, QLD, Australia
| | - Ross McD Young
- Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Michael Lyvers
- Department of Psychology, Bond University, Gold Coast, QLD, Australia
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland, Brisbane, QLD, Australia.,Discipline of Psychiatry, The University of Queensland, Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Edythe D London
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Ya-Ling Huang
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, QLD, Australia.,Department of Respiratory Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast, QLD, Australia
| | - Gerald F X Feeney
- Centre for Youth Substance Abuse Research, Faculty of Health, The University of Queensland, Brisbane, QLD, Australia.,Alcohol & Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia
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121
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Maffei C, Cavicchioli M, Movalli M, Cavallaro R, Fossati A. Dialectical Behavior Therapy Skills Training in Alcohol Dependence Treatment: Findings Based on an Open Trial. Subst Use Misuse 2018; 53:2368-2385. [PMID: 29958050 DOI: 10.1080/10826084.2018.1480035] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Dialectical behavior therapy (DBT) has demonstrated efficacy in treating disorders such as alcohol dependence that are characterized by emotional dysregulation. Preliminary evidence has revealed the feasibility of DBT skills training (ST) as a stand-alone treatment for such disorders. Although emotional dysregulation plays a significant role in alcohol dependence, there are no previous reports of using DBT-ST to treat it. OBJECTIVES The aim of this study was to evaluate the duration of abstinence and changes in emotional regulation in a 3-month DBT-ST program for alcohol-dependent patients and to look for relations between abstinence and emotional regulation. METHODS We administered the Difficulties in Emotion Regulation Scale (DERS) and used urine toxicology screening to monitor alcohol/substance intake among the 244 subjects admitted to the program. RESULTS Among the 157 patients who completed the treatment, 73.2% were abstinent at the end of the program, and their emotional regulation improved. Improvement was independent of the initial severity of both alcohol use and emotional dysregulation. For substance use outcomes, we found a partial mediation role of improved emotional regulation. CONCLUSIONS This is the first open trial to show improved alcohol-related behavior and emotional regulation in alcohol-dependent patients treated with DBT-ST and to posit a partial but significant relation between improved emotional regulation and alcohol use outcomes. In the treatment of alcohol dependence, emotional regulation may be a relevant factor for therapists to consider.
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Affiliation(s)
- Cesare Maffei
- a Department of Psychology , University Vita-Salute San Raffaele , Milano , Italy.,b Unit of Clinical Psychology and Psychotherapy , San Raffaele-Turro Hospital , Milano , Italy
| | - Marco Cavicchioli
- a Department of Psychology , University Vita-Salute San Raffaele , Milano , Italy.,b Unit of Clinical Psychology and Psychotherapy , San Raffaele-Turro Hospital , Milano , Italy
| | - Mariagrazia Movalli
- a Department of Psychology , University Vita-Salute San Raffaele , Milano , Italy.,b Unit of Clinical Psychology and Psychotherapy , San Raffaele-Turro Hospital , Milano , Italy
| | | | - Andrea Fossati
- a Department of Psychology , University Vita-Salute San Raffaele , Milano , Italy.,b Unit of Clinical Psychology and Psychotherapy , San Raffaele-Turro Hospital , Milano , Italy
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122
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Kajanoja J, Scheinin NM, Karukivi M, Karlsson L, Karlsson H. Alcohol and tobacco use in men: the role of alexithymia and externally oriented thinking style. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:199-207. [DOI: 10.1080/00952990.2018.1528267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jani Kajanoja
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora M. Scheinin
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Max Karukivi
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Unit of Adolescent Psychiatry, Satakunta Hospital District, Pori, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
- Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
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123
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Noel J. Recognition and treatment of mood dysregulation in adults with intellectual disability. Ment Health Clin 2018; 8:264-274. [PMID: 30397568 PMCID: PMC6213889 DOI: 10.9740/mhc.2018.11.264] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Mood dysregulation is a common feature in the psychopathology of people with intellectual disability (ID) and co-occurring behavioral/psychiatric disorders. It can present with a host of dangerous behaviors, including aggression, self-injury, and property damage. There are special techniques that are used to assess these behaviors in people with ID, that can eventually inform an appropriate approach to pharmacologic and nonpharmacologic treatment. Two case studies are presented that illustrate the elements in the assessment and treatment of mood dysregulation in ID.
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Affiliation(s)
- Jason Noel
- (Corresponding author) Associate Professor, University of Maryland School of Pharmacy, Baltimore, Maryland,
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124
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Grant M, Salsman NL, Berking M. The assessment of successful emotion regulation skills use: Development and validation of an English version of the Emotion Regulation Skills Questionnaire. PLoS One 2018; 13:e0205095. [PMID: 30281666 PMCID: PMC6169969 DOI: 10.1371/journal.pone.0205095] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 09/19/2018] [Indexed: 12/22/2022] Open
Abstract
Emotion regulation has become an important topic in mental health and psychotherapy research. Skills supposingly relevant for adaptive responses towards emotions include the abilities to be consciously aware of emotions, identify and correctly label emotions, understand what has caused and maintains one’s present emotions, modify the intensity or duration of one's emotions, accept and tolerate undesired emotions, confront situations likely to cue negative emotions, and provide effective self-support when working to cope with challenging emotions. To economically assess these abilities, a self-report measure has been developed in German and validated in various studies. To facilitate the use of the measure in English speaking countries, we have developed and validated an English version of the Emotion Regulation Skills Questionnaire (ERSQ) in a student sample (n = 263) and a sample of individual clinical sample (n = 35). Findings from this study provide significant evidence for the reliability and validity of the ERSQ. Thus, the measure can be used to assess a broad range of important emotion regulation skills in an economic way.
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Affiliation(s)
- Michaela Grant
- Department of Clinical Psychology and Psychotherapy, University of Mainz, Mainz, Rhineland Palatinate, Germany
- * E-mail:
| | - Nicholas L. Salsman
- Department of Clinical Psychology, Xavier University, Cincinnati, Ohio, United States of America
| | - Matthias Berking
- Department of Clinical Psychology und Psychotherapy, University of Erlangen-Nueremberg, Erlangen, Bavaria, Germany
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125
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Aase DM, Gorka SM, Greenstein JE, Proescher E, Crane NA, Everett LK, Hassan I, Osborn A, Schroth C, Kennedy-Krage A, Phan KL. Cognitive reappraisal moderates the relationship between PTSD symptoms and alcohol use over time in post-9/11 U.S. military veterans. Drug Alcohol Depend 2018; 191:159-164. [PMID: 30118943 DOI: 10.1016/j.drugalcdep.2018.06.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 05/06/2018] [Accepted: 06/26/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Rates of comorbid alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) are increasing among post-9/11 veterans, and emotion regulation problems have been identified as a feature of both disorders. However, no studies to date have explored how individual differences in emotion regulation may moderate the relationship between PTSD symptoms and alcohol use. We evaluated how two core emotion regulation strategies - one adaptive (i.e., cognitive reappraisal) and one maladaptive (i.e., expressive suppression) are related to PTSD symptoms and alcohol use over one-year. METHODS A total of 71 post-9/11 veterans (12 female, 59 male) completed a baseline screening and at least two follow-up assessments over the course of 12 months which included measures of emotion regulation, PTSD symptoms, and alcohol use. A mixed growth model was utilized to determine if changes in PTSD symptoms covaried with alcohol use over time and whether this relation was moderated by frequency of use of emotion regulation strategies. RESULTS In general, higher PTSD symptoms were significantly associated with greater alcohol use, but cognitive reappraisal moderated this relationship. Specifically, at low cognitive reappraisal, greater PTSD symptoms were associated with greater alcohol use. At high cognitive reappraisal, there was no significant association between PTSD symptoms and alcohol use. CONCLUSIONS Findings from the present study suggest that baseline individual differences in cognitive reappraisal influence the relation between PTSD symptoms and alcohol use. For post-9/11 veterans, high levels of cognitive reappraisal may serve as a protective factor against ongoing alcohol use.
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Affiliation(s)
- Darrin M Aase
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA; Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA; College of Health and Human Services, Governors State University, 1 University Parkway, University Park, IL 60484, USA.
| | - Stephanie M Gorka
- Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
| | - Justin E Greenstein
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA; Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
| | - Eric Proescher
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA; Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
| | - Natania A Crane
- Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
| | - Llashe-Kaye Everett
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA
| | - Ikram Hassan
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA
| | - Amanda Osborn
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA
| | - Christopher Schroth
- Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
| | - Amy Kennedy-Krage
- Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
| | - K Luan Phan
- Mental Health Service Line, Jesse Brown VA Medical Center, 820 S. Damen Ave., Chicago, IL 60612, USA; Department of Psychiatry, University of Illinois at Chicago, 1747 Roosevelt Road, Chicago, IL 60608, USA
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126
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Cavicchioli M, Movalli M, Maffei C. Difficulties with emotion regulation, mindfulness, and substance use disorder severity: the mediating role of self-regulation of attention and acceptance attitudes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:97-107. [DOI: 10.1080/00952990.2018.1511724] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University “Vita-Salute San Raffaele”, Milan, Italy
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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127
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Duffy KA, McLaughlin KA, Green PA. Early life adversity and health-risk behaviors: proposed psychological and neural mechanisms. Ann N Y Acad Sci 2018; 1428:151-169. [PMID: 30011075 PMCID: PMC6158062 DOI: 10.1111/nyas.13928] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/06/2018] [Accepted: 06/18/2018] [Indexed: 12/18/2022]
Abstract
Early life adversity (ELA) is associated with poorer health in adulthood, an association explained, at least in part, by increased engagement in health-risk behaviors (HRBs). In this review, we make the case that ELA influences brain development in ways that increase the likelihood of engaging in HRBs. We argue that ELA alters neural circuitry underpinning cognitive control as well as emotional processing, including networks involved in processing threat and reward. These neural changes are associated psychologically and behaviorally with heightened emotional reactivity, blunted reward responsivity, poorer emotion regulation, and greater delay discounting. We then demonstrate that these adaptations to ELA are associated with an increased risk of smoking cigarettes, drinking alcohol, and eating high-fat, high-sugar foods. Furthermore, we explore how HRBs affect the brain in ways that reinforce addiction and further explain clustering of HRBs.
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Affiliation(s)
- Korrina A. Duffy
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Paige A. Green
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD
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128
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Weiss NH, Forkus SR, Contractor AA, Schick MR. Difficulties regulating positive emotions and alcohol and drug misuse: A path analysis. Addict Behav 2018; 84:45-52. [PMID: 29625262 DOI: 10.1016/j.addbeh.2018.03.027] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/23/2018] [Accepted: 03/23/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Alcohol and drugs are widely used among college students. Emotion dysregulation has been identified as a key mechanism in the etiology, maintenance, and treatment of alcohol and drug misuse. Yet, research in this area has been limited by its narrow focus on dysregulation stemming from negative emotions. The goal of the current study was to extend past research by examining the relation of difficulties regulating positive emotions to alcohol and drug misuse. METHODS Participants were 311 college students (Mage = 19.24; 66.1% female; 66.0% White) who completed measures assessing difficulties regulating positive emotions and alcohol and drug misuse. RESULTS Structural equational modeling was used to model the relation between difficulties regulating positive emotions and alcohol and drug misuse. In a hypothesized structural model, higher levels of difficulties regulating positive emotions were found to relate to greater alcohol and drug misuse. Moreover, an alternative model provided support for an association of greater drug (but not alcohol) misuse to higher levels of difficulties regulating positive emotions. CONCLUSIONS If replicated, findings may suggest the utility of targeting difficulties regulating positive emotions in treatments aimed at reducing alcohol and drug misuse among college students.
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129
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Jakubczyk A, Trucco EM, Kopera M, Kobyliński P, Suszek H, Fudalej S, Brower KJ, Wojnar M. The association between impulsivity, emotion regulation, and symptoms of alcohol use disorder. J Subst Abuse Treat 2018; 91:49-56. [PMID: 29910014 PMCID: PMC6020846 DOI: 10.1016/j.jsat.2018.05.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/11/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022]
Abstract
Emotion dysregulation and impulsivity are important factors influencing the development and course of alcohol dependence. However, few empirical studies investigate the association between different aspects of impulsivity (cognitive, attentional, behavioral), emotion regulation, and alcohol use disorder symptoms in the same model. The goal of this study was to assess the association between emotion regulation and different facets of impulsivity among patients with an alcohol use disorder and healthy controls. The sample was comprised of 273 individuals: 180 participants with an alcohol use disorder undergoing inpatient alcohol treatment and 93 healthy controls. Emotion regulation was assessed using the Schutte Self-Report Emotional Intelligence Test subscale. Impulsivity was assessed with Barratt's Impulsiveness Scale (BIS-11). Statistical models tested both the BIS-11 total score, as well as three secondary factors (non-planning, attentional, and motor impulsivity). Findings indicate that individuals with alcohol use disorder symptoms were characterized by poor emotion regulation and high levels of impulsivity in all analyzed domains. Moreover, path analytic models indicated that after accounting for demographic factors (i.e., biological sex, age, education) there was evidence for a significant indirect effect of alcohol use disorder symptomatology on non-planning and attentional impulsivity via emotion regulation. There was no association between emotion regulation and motor impulsivity. These findings indicate the importance of targeting emotion regulation skills as well as behavioral control when treating patients with alcohol use disorder.
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Affiliation(s)
- Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology and the Center for Children and Families, Florida International University, Miami, FL, USA; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
| | - Paweł Kobyliński
- National Information Processing Institute, Laboratory of Interactive Technologies, Warsaw, Poland
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Sylwia Fudalej
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Kirk J Brower
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
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130
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Stover CS, Carlson M, Patel S, Manalich R. Where's Dad? The Importance of Integrating Fatherhood and Parenting Programming into Substance Use Treatment for Men. CHILD ABUSE REVIEW (CHICHESTER, ENGLAND : 1992) 2018; 27:280-300. [PMID: 31608341 PMCID: PMC6788805 DOI: 10.1002/car.2528] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 05/12/2018] [Indexed: 04/25/2023]
Abstract
Large numbers of men enter substance use disorder treatment each year, yet very little attention is paid to the fatherhood and parenting status of these men. Substance use treatment programs rarely incorporate a parenting component into their treatment planning, despite increased success of women's treatment programs that focus on gender and motherhood. This paper provides: 1) a review of the literature on the fathering of substance using men, what has been learned from substance use disorder treatment for mothers, and the implications for children and families; 2) pilot quantitative and qualitative outcomes on implementation of a fatherhood focused intervention for men in a residential substance use treatment program; and 3) recommendations for the application of these findings for fathers in substance use disorder treatment and the implications of program modifications and increased focus on fathers for child welfare.
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Affiliation(s)
| | - Melissa Carlson
- Department of Mental Health Law and Policy, University of South Florida
| | - Sarika Patel
- Department of Mental Health Law and Policy, University of South Florida
| | - Raquel Manalich
- Department of Mental Health Law and Policy, University of South Florida
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131
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Ram D, George M, Gowdappa B. Correlation of cognitive functions with emotional dysregulation in alcohol dependence: A preliminary study. Indian J Psychiatry 2018; 60:307-311. [PMID: 30405256 PMCID: PMC6201679 DOI: 10.4103/psychiatry.indianjpsychiatry_183_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
CONTEXT AND AIMS Dysfunction of cognition and emotion is known in alcohol dependence; however, their relationship in alcohol dependence is unknown. Thus, this study aimed to know the level of emotional dysregulation and cognitive functions and their correlation in patients with alcohol dependence. MATERIALS AND METHODS In this hospital-based cross-sectional study, 120 patients with alcohol dependence were consecutively recruited and assessed with sociodemographic and clinical pro forma, Montreal Cognitive Assessment (MoCA), and Difficulty in Emotional Regulation Scale-Short Form (DERS-SF). STATISTICAL ANALYSIS Descriptive statistical, Kruskal-Wallis H, and regression analysis. RESULTS Results revealed a mild level of cognitive impairment (mean MoCA score = 0 23.76) and high levels of emotional dysregulation (mean DERS-SF score = 0 26.90). On linear regression analysis (R 2 = 0.266, df = 0 1, F = 0 42.782, P =0.000), the score on MoCA had statistically significant negative association with score on DERS-SF (P = 0.001). CONCLUSIONS Cognitive impairment and emotional dysregulation are inversely related in patients with alcohol dependence. Improving the dysfunction may improve the outcome of alcohol dependence.
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Affiliation(s)
- Dushad Ram
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Manju George
- Department of Psychiatry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - Basawanna Gowdappa
- Department of Medicine, JSS Medical College and Hospital, Mysore, Karnataka, India
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132
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Somkuwar SS, Quach LW, Quigley JA, Purohit DC, Fannon MJ, Koob GF, Mandyam CD. Ethanol Reinforcement Elicits Novel Response Inhibition Behavior in a Rat Model of Ethanol Dependence. Brain Sci 2018; 8:brainsci8070119. [PMID: 29949891 PMCID: PMC6070985 DOI: 10.3390/brainsci8070119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/12/2018] [Accepted: 06/22/2018] [Indexed: 12/14/2022] Open
Abstract
Lower impulse control is a known risk factor for drug abuse vulnerability. Chronic experience with illicit drugs is suggested to enhance impulsivity and thereby perpetuate addiction. However, the nature of this relationship (directionality, causality) with regard to alcohol use disorder is unclear. The present study tested the hypothesis that higher impulsivity is observed during chronic intermittent ethanol vapor inhalation (CIE; a model of ethanol dependence) and subsequent abstinence from CIE in adult Wistar rats. Impulsivity was tested using a differential reinforcement of low rates 15 s (DRL15) schedule using either nondrug reward (palatable modified sucrose pellets) or sweetened ethanol. A decrease in the efficiency of earning reinforcers (expressed as % reinforcers/responses) is indicative of a decrease in response inhibition or an increase in impulsivity. The efficiency of reinforcement and amount of reinforcers earned were unaltered in CIE and control animals when the reinforcer was sucrose. When the reinforcer was sweetened ethanol, the efficiency of reinforcement increased in CIE rats compared with controls only during protracted abstinence. Responding for sweetened ethanol under a progressive-ratio schedule was more rapid in CIE rats during protracted abstinence. Contrary to the initial hypothesis, impulsivity did not increase in rats with a history of CIE; instead, it decreased when ethanol was used as the reinforcer. Furthermore, although the efficiency of ethanol reinforcement did not differ between CIE and control animals during CIE, CIE rats escalated the amount of sweetened ethanol consumed, suggesting that behavioral adaptations that are induced by CIE in rats that are tested under a DRL15 schedule appear to be targeted toward the maximization of ethanol intake and thus may contribute to escalation and relapse.
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Affiliation(s)
| | - Leon W Quach
- VA San Diego Healthcare System, San Diego, CA 92161, USA.
| | | | | | | | - George F Koob
- National Institute on Drug Abuse, Baltimore, MD 21224, USA.
| | - Chitra D Mandyam
- VA San Diego Healthcare System, San Diego, CA 92161, USA.
- The Scripps Research Institute, La Jolla, CA 92037, USA.
- Department of Anesthesiology, University of California San Diego, San Diego, CA 92093, USA.
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133
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Wong CCY, Paulus DJ, Lemaire C, Leonard A, Sharp C, Neighbors C, Brandt CP, Zvolensky MJ. Emotion Dysregulation: An Explanatory Construct in the Relation Between HIV-Related Stigma and Hazardous Drinking among Persons Living with HIV/AIDS. STIGMA AND HEALTH 2018; 4:293-299. [PMID: 31777759 DOI: 10.1037/sah0000113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The prevalence of hazardous alcohol use among people living with HIV/AIDS (PLHIV) is common and related to numerous health problems among individuals in this group. Stigma is associated with hazardous drinking among stigmatized groups, but this relationship has yet to be examined among PLHIV. Moreover, there is a lack of research in identifying the mechanisms underlying this association. Emotion dysregulation is one potential construct that may explain the association between stigma and hazardous alcohol use among PLHIV. The present study examined the indirect effect of HIV stigma and hazardous alcohol use via emotion dysregulation. The sample included 98 PLHIV (60.2% male, M age = 48.40, SD = 7.75). Results indicated significant and medium-sized indirect effects of HIV stigma and its subfacets (enacted stigma and negative self-image) in terms of hazardous alcohol use via emotion dysregulation. Alternative models did not yield significant indirect effects. The results document an indirect association between HIV stigma and hazardous alcohol use via emotion dysregulation. These findings may provide novel, initial empirical insight into the nature of the stigma-hazardous drinking relation among PLHIV.
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Affiliation(s)
- Celia C Y Wong
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Daniel J Paulus
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Chad Lemaire
- Legacy Community Healthcare, Houston, Texas, United States
| | - Amy Leonard
- Legacy Community Healthcare, Houston, Texas, United States
| | - Carla Sharp
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Clayton Neighbors
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States
| | - Charles P Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States.,Department of Psychiatry, Baylor College of Medicine, 1 Baylor Plaza, Houston TX, 77030, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX, 77204, United States.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas, United States
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Garland EL, Hanley AW, Bedford CE, Zubieta JK, Howard MO, Nakamura Y, Donaldson GW, Froeliger B. Reappraisal deficits promote craving and emotional distress among chronic pain patients at risk for prescription opioid misuse. J Addict Dis 2018; 37:14-22. [PMID: 29863439 DOI: 10.1080/10550887.2018.1459148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: A subset of chronic pain patients misuse prescription opioids as a means of regulating negative emotions. However, opioid misuse may result in deficits in emotion regulation strategies like reappraisal by virtue of the deleterious effects of chronic opioid exposure. Aims: The aim of this study was to characterize differences in reappraisal use among chronic pain patients at risk for opioid misuse and those who report taking opioids as prescribed. Methods: A sample of 127 pain patients receiving chronic opioid analgesic pharmacotherapy were classified as at risk for opioid misuse (n = 62) or taking opioids as prescribed (n = 65) using the Current Opioid Misuse Measure (COMM). The Emotion Regulation Questionnaire (ERQ) characterized use of emotion regulation strategies including reappraisal and expressive suppression. Participants also reported levels of opioid craving, emotional distress, and pain severity. Results: Patients at risk for opioid misuse reported significantly less reappraisal use (M = 25.31, SD = 7.33) than those who reportedly took opioids as prescribed (M = 30.28, SD = 7.50), p<.001, but did differ with regard to suppression strategies. Reduced reappraisal use was associated with higher opioid craving and emotional distress that mediated the association between reappraisal deficits and opioid misuse risk. Further, there was a significant indirect effect of opioid misuse on emotional distress via reappraisal use. Discussion: Opioid misuse risk was associated with reduced use of reappraisal, which in turn was associated with dysregulated negative emotions and increased appetitive drive towards consuming opioids. Studying individual differences in emotion regulation may yield efficacious intervention and prevention approaches to stem the rising tide of the prescription opioid crisis.
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Affiliation(s)
- Eric L Garland
- a College of Social Work , Center for Mindfulness and Integrative Health Intervention Development, University of Utah , Salt Lake City , Utah , USA
| | - Adam W Hanley
- a College of Social Work , Center for Mindfulness and Integrative Health Intervention Development, University of Utah , Salt Lake City , Utah , USA
| | - Carter E Bedford
- a College of Social Work , Center for Mindfulness and Integrative Health Intervention Development, University of Utah , Salt Lake City , Utah , USA
| | - Jon-Kar Zubieta
- b Department of Psychiatry , University of Utah , Salt Lake City , Utah , USA
| | - Matthew O Howard
- c School of Social Work , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Yoshio Nakamura
- d Pain Research Center , University of Utah , Salt Lake City , Utah , USA
| | - Gary W Donaldson
- d Pain Research Center , University of Utah , Salt Lake City , Utah , USA
| | - Brett Froeliger
- e Department of Neuroscience , Medical University of South Carolina , Charleston , South Carolina , USA
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135
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Wang K, Burton CL, Pachankis JE. Depression and Substance Use: Towards the Development of an Emotion Regulation Model of Stigma Coping. Subst Use Misuse 2018; 53:859-866. [PMID: 29125383 PMCID: PMC5884706 DOI: 10.1080/10826084.2017.1391011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The comorbidity between depression and substance use problems is well-documented, yet little research has investigated how stigma associated with one's depression might relate to alcohol and drug use. The current study examined the association between depression-related stigma and substance use coping and considered the role of emotion dysregulation (i.e., difficulty in monitoring, evaluating, and modulating one's emotional reactions) as a mechanism underlying this association. A sample of individuals who self-identified as having current or remitted depression (N = 218) completed self-report measures of depression-related stigma, emotion dysregulation, and tendency to rely on alcohol or drugs to cope with psychological distress. Depression-related stigma was positively associated with emotion dysregulation, which was in turn associated with a greater tendency to engage in substance use coping. These findings provide initial support for the role of stigma as a contributor to maladaptive coping responses, such as substance use, among people living with depression. Further, they underscored the potential utility of targeting emotion dysregulation in stigma coping and substance abuse prevention intervention efforts.
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Affiliation(s)
- Katie Wang
- a Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, School of Public Health , Yale University , New Haven , Connecticut , USA
| | - Charles L Burton
- b Center for Interdisciplinary Research on AIDS , Yale University , New Haven , Connecticut , USA
| | - John E Pachankis
- a Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, School of Public Health , Yale University , New Haven , Connecticut , USA
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136
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Stoops WW, Hardy L, Mathew AR, Hitsman B. Negative mood-induced alcohol-seeking is greater in young adults who report depression symptoms, drinking to cope, and subjective reactivity. Exp Clin Psychopharmacol 2018; 26:138-146. [PMID: 29389212 PMCID: PMC5896502 DOI: 10.1037/pha0000177] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Acute negative mood powerfully motivates alcohol-seeking behavior, but it remains unclear whether sensitivity to this effect is greater in drinkers who report depression symptoms, drinking to cope, and subjective reactivity. To examine these questions, 128 young adult alcohol drinkers (ages 18-25) completed questionnaires of alcohol use disorder symptoms, depression symptoms, and drinking to cope with negative affect. Baseline alcohol choice was measured by preference to enlarge alcohol versus food thumbnail images in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music, before alcohol choice was tested. Subjective reactivity was indexed by increased sadness pre- to post-mood induction. Baseline alcohol choice correlated with alcohol dependence symptoms (p = .001), and drinking coping motives (ps ≤ .01). Mood induction increased alcohol choice and subjective sadness overall (ps < .001). The mood-induced increase in alcohol choice was associated with depression symptoms (p = .007), drinking to cope (ps ≤ .03), and subjective reactivity (p = .007). The relationship between mood-induced alcohol choice and drinking to cope remained significant after covarying for other drinking motives. Furthermore, the three predictors (depression, drinking to cope, and subjective reactivity) accounted for unique variance in mood-induced alcohol choice (ps ≥ .03), and collectively accounted for 18% of the variance (p < .001). These findings validate the pictorial alcohol choice task as sensitive to the relative value of alcohol and acute negative mood. The findings also accord with the core prediction of negative reinforcement theory that sensitivity to the motivational impact of negative mood on alcohol-seeking behavior may be an important mechanism that links depression and alcohol dependence. (PsycINFO Database Record
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Affiliation(s)
| | | | - Amanda R Mathew
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
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137
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Kopera M, Trucco EM, Jakubczyk A, Suszek H, Michalska A, Majewska A, Szejko N, Łoczewska A, Krasowska A, Klimkiewicz A, Brower KJ, Zucker RA, Wojnar M. Interpersonal and intrapersonal emotional processes in individuals treated for alcohol use disorder and non-addicted healthy individuals. Addict Behav 2018; 79:8-13. [PMID: 29227790 DOI: 10.1016/j.addbeh.2017.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 12/04/2017] [Accepted: 12/04/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Prior work largely confirms the presence of various emotional processing deficits among individuals with an alcohol use disorder (AUD); however, their specificity and relevance still warrant investigation. The aim of the current study was to compare selected aspects of emotional processing (i.e., mental state recognition, alexithymia, and emotional intelligence) between individuals treated for an AUD and healthy individuals. METHODS The AUD sample consisted of 92 abstinent men with AUD who were participating in an 8-week inpatient abstinence-based treatment program in Warsaw, Poland. The healthy control (HC) group consisted of 86 men recruited from the Medical University of Warsaw and the Nowowiejski Hospital administrative staff. Baseline information about demographics, psychopathological symptoms, and severity of alcohol problems was obtained. Mental states recognition was assessed using the Reading the Mind in the Eyes Test (RMET). Alexithymia was measured with the Toronto Alexithymia Scale (TAS-20). The Schutte Self-Report Emotional Intelligence Test (SSEIT) was used to measure emotional intelligence (EI). RESULTS AND CONCLUSIONS After accounting for potentially confounding variables (demographics, severity of depression, anxiety symptoms) in MANCOVA models, patients with AUD presented deficits in identification and description of their own emotional states, as well as lower emotion regulation skills when compared to HCs. No between-group differences were observed in self-reported recognition of other people's emotions, social skills, and a behavioral measure of mental states recognition. Specific rather than general emotion-processing deficits in participants with AUD were identified, suggesting problems with processing of intrapersonal emotional signals.
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Affiliation(s)
- Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology, Center for Children and Families, Florida International University, Miami, FL, USA; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Aneta Michalska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | | | - Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Poland; Department of Bioethics, Medical University of Warsaw, Poland
| | - Agata Łoczewska
- Department of Psychiatry, Bielański Hospital, Warsaw, Poland
| | | | - Anna Klimkiewicz
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
| | - Kirk J Brower
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Robert A Zucker
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland; Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
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Characteristics of DSM-5 Alcohol Use Disorder Diagnostic Orphans in College: An Overlooked Group of Drinkers. ADDICTIVE DISORDERS & THEIR TREATMENT 2018. [DOI: 10.1097/adt.0000000000000116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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139
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Sniewski L, Farvid P, Carter P. The assessment and treatment of adult heterosexual men with self-perceived problematic pornography use: A review. Addict Behav 2018; 77:217-224. [PMID: 29069616 DOI: 10.1016/j.addbeh.2017.10.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/17/2017] [Accepted: 10/11/2017] [Indexed: 01/27/2023]
Abstract
Self-Perceived Problematic Porn Use (SPPPU) refers to an individual who self-identifies as addicted to porn because they feel they are unable to regulate their porn consumption, and that use interferes with everyday life. Although porn addiction has not been formally classified as its own distinct behavioral addiction, therapists and clinicians are advised to educate themselves on the current state of literature pertaining to pornography consumption given the widespread availability and consumption of sexually explicit material online. This review article begins with a general overview of pornography and porn use so that therapists and researchers can discern between non-intrusive and problematic pornography consumption patterns within their practice and understand the common characteristics of those that most commonly present with SPPPU. Thereafter, an overview and examination of therapeutic interventions for SPPPU will be identified and analysed. Finally, the review concludes with recommendations for therapists, clinicians, and future research.
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Dunn EC, Nishimi K, Gomez SH, Lott AP, Bradley B. Developmental timing of trauma exposure and emotion dysregulation in adulthood: Are there sensitive periods when trauma is most harmful? J Affect Disord 2018; 227:869-877. [PMID: 29254068 PMCID: PMC5805641 DOI: 10.1016/j.jad.2017.10.045] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/18/2017] [Accepted: 10/27/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND This study aimed to determine whether there were sensitive periods when a first exposure to trauma was most associated with emotion dysregulation symptoms in adulthood. METHODS Adult participants came from a public urban hospital in Atlanta, GA (n = 1944). Lifetime trauma exposure was assessed using the Traumatic Events Inventory (TEI). Multiple linear regression models were used to assess the association between the developmental timing of first trauma exposure, classified as early childhood (ages 0-5), middle childhood (ages 6-10), adolescence (ages 11-18), and adulthood (ages 19+), on adult emotion dysregulation symptoms, measured using the abbreviated Emotion Dysregulation Scale. RESULTS Participants exposed to trauma at any age had higher emotion dysregulation scores than their unexposed peers. However, participants first exposed to child maltreatment or interpersonal violence during middle childhood had higher emotion dysregulation scores relative to those first exposed during other developmental stages; these developmental timing differences were detected even after controlling for sociodemographic factors, exposure to other trauma, and frequency of exposure to trauma. Further, after controlling for current psychiatric symptoms, the effect of other interpersonal trauma exposure in middle childhood was diminished and first exposure to other interpersonal violence in early childhood was associated with significantly lower emotion dysregulation symptoms. LIMITATIONS Limitations of this study include the use of retrospective reports and absence of complete information about trauma severity or duration. CONCLUSION These findings should be replicated in other population-based samples with prospective designs to confirm the importance of developmental timing of trauma on later emotion dysregulation.
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Affiliation(s)
- Erin C. Dunn
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA,Department of Psychiatry, Harvard Medical School, Boston, MA,Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA,Correspondence: Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, Simches Research Building 6th Floor (room 6.252), Boston, MA 02114. Phone: 617 726 9387; Fax: 617 726 0830.
| | - Kristen Nishimi
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA,Harvard T.H. Chan School of Public Health, Boston, MA
| | - Stephanie H. Gomez
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA
| | - Abigail Powers Lott
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA,Atlanta VA Medical Center, Atlanta, GA
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141
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MacIntyre JM, Ruscio AC, Brede E, Waters AJ. Emotion dysregulation and negative affect: Laboratory and EMA investigations in smokers. Addict Behav Rep 2018; 7:65-70. [PMID: 29687075 PMCID: PMC5910452 DOI: 10.1016/j.abrep.2018.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/27/2017] [Accepted: 01/05/2018] [Indexed: 12/04/2022] Open
Abstract
Introduction Difficulties in emotion regulation are associated with addictive behaviors, including smoking. Difficulties in emotion regulation may underlie large, rapid changes in negative affect that can increase likelihood of relapse. We investigated the association between emotion regulation ability and negative affect in smokers assessed both in the laboratory and in the field using Ecological Momentary Assessment. Methods Adult community smokers (N = 44) carried a personal digital assistant (PDA) for two weeks and were instructed to complete assessments of negative affect multiple times per day. Participants were instructed that they could smoke as much or as little as they liked. The Difficulties in Emotion Regulation Scale (DERS) and the Positive and Negative Affect Schedule (PANAS) were completed at three lab visits. Results Participants with higher average DERS scores reported greater negative affect at lab visits. When a participant reported a DERS score at a lab visit higher than their individual average, they also reported higher negative affect at that lab visit. Participants with higher baseline DERS scores reported more labile negative affect during EMA than those with lower baseline DERS scores, and they also reported a higher maximum level of negative affect during EMA. Discussion and conclusions Overall, the findings suggest that changes in emotion regulation are associated with negative affect and that emotion regulation ability is related to both the intensity and lability of negative affect. A better understanding of momentary changes in emotion regulation and negative affect may lead to improved interventions for preventing substance use relapse. Emotion regulation show variability, and changes in emotion regulation are associated with changes in negative affect Emotion regulation ability is associated with the intensity of negative affect assessed using EMA Emotion regulation ability is associated with the lability of negative affect assessed using EMA
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Affiliation(s)
- Jessica M MacIntyre
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Aimee C Ruscio
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Emily Brede
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Andrew J Waters
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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142
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Schoenleber M, Berghoff CR, Gratz KL, Tull MT. Emotional lability and affective synchrony in posttraumatic stress disorder pathology. J Anxiety Disord 2018; 53:68-75. [PMID: 29197703 PMCID: PMC5748357 DOI: 10.1016/j.janxdis.2017.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/26/2017] [Accepted: 11/27/2017] [Indexed: 11/17/2022]
Abstract
This study examined the relations of PTSD pathology to both the lability of three specific emotions (anxiety, anger, self-conscious emotions [SCE]) and the extent to which changes in one emotional state co-occur with changes in another emotional state (i.e. affective synchrony). Moreover, given evidence that emotional responding in PTSD may be heightened in response to trauma-related cues, these relations were explored in the context of a trauma cue versus neutral cue. Trauma-exposed patients in residential substance use disorder treatment (N=157) completed a diagnostic interview and two laboratory sessions involving presentation of neutral and individualized trauma scripts. State anxiety, anger, and SCE were assessed at five points throughout each laboratory session. Hierarchical linear modeling indicated that participants (regardless of PTSD status) exhibited greater lability of all emotions following the trauma script versus neutral script. Only anger lability was elevated among those with (versus without) a current PTSD diagnosis following the neutral script. Results also revealed synchrony (i.e., positive covariation) between each possible pair of emotions, regardless of PTSD status. Findings suggest that concurrent changes in anxiety and anger may be especially relevant to PTSD symptom severity.
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Affiliation(s)
- Michelle Schoenleber
- Department of Psychology, St. Norbert College, 100 Grant St., De Pere, WI 54115, United States.
| | - Christopher R Berghoff
- Department of Psychology, University of South Dakota, 414 E. Clark St., Vermillion, SD 57069, United States.
| | - Kim L Gratz
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606-3390, United States.
| | - Matthew T Tull
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606-3390, United States.
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143
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Lukas CA, Ebert DD, Fuentes HT, Caspar F, Berking M. Deficits in general emotion regulation skills-Evidence of a transdiagnostic factor. J Clin Psychol 2017; 74:1017-1033. [PMID: 29244206 DOI: 10.1002/jclp.22565] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 08/31/2017] [Accepted: 09/21/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Deficits in emotion regulation (ER) skills are discussed as a transdiagnostic factor contributing to the development and maintenance of various mental disorders. However, systematic comparisons of a broad range of ER skills across diagnostic groups that are based on comparable definitions and measures of ER are still rare. METHOD Therefore, we conducted two studies assessing a broad range of ER skills with the Emotion Regulation Skills Questionnaire in individuals meeting criteria for mental disorders (N1 = 1448; N2 = 137) and in a general population sample (N = 214). RESULTS Consistent across the two studies, participants in the clinical samples reported lower general and lower specific ER skills than participants in the general population sample. Also consistent across the two studies, diagnostic subgroups of the clinical samples differed significantly with regard to general and specific ER skills. CONCLUSION The studies provide evidence that deficits in ER are associated with various forms of psychopathology. However, mental disorders seem to differ with regard to how strongly they are linked to ER skills.
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144
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Emotion Dysregulation in Comorbid Posttraumatic Stress Disorder and Substance Use Disorders: A Narrative Review. MILITARY PSYCHOLOGY 2017. [DOI: 10.1037/mil0000157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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145
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Betka S, Pfeifer G, Garfinkel S, Prins H, Bond R, Sequeira H, Duka T, Critchley H. How Do Self-Assessment of Alexithymia and Sensitivity to Bodily Sensations Relate to Alcohol Consumption? Alcohol Clin Exp Res 2017; 42:81-88. [DOI: 10.1111/acer.13542] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/25/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Sophie Betka
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
- SCALab; CNRS UMR 9193; University of Lille; Lille France
| | - Gaby Pfeifer
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
| | - Sarah Garfinkel
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| | - Hielke Prins
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
| | - Rod Bond
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
| | | | - Theodora Duka
- Behavioural and Clinical Neuroscience; School of Psychology; University of Sussex; Brighton United Kingdom
| | - Hugo Critchley
- Brighton and Sussex Medical School; Clinical Imaging Science Centre; Brighton United Kingdom
- Sackler Centre for Consciousness Science; University of Sussex; Brighton United Kingdom
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146
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Estévez A, Jáuregui P, Sánchez-Marcos I, López-González H, Griffiths MD. Attachment and emotion regulation in substance addictions and behavioral addictions. J Behav Addict 2017; 6:534-544. [PMID: 29280395 PMCID: PMC6034944 DOI: 10.1556/2006.6.2017.086] [Citation(s) in RCA: 165] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/07/2017] [Accepted: 12/03/2017] [Indexed: 11/19/2022] Open
Abstract
Background Risky behaviors have been related to emotional regulation and attachment, which may constitute risk factors for developing an addictive behavior. However, there may also be differences between substance and non-substance-related addictions. Aims This study aimed to examine the relationship of emotional regulation and attachment, with substance (alcohol and drug abuse), and non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use) in adolescents and emerging adults. The study also aimed to examine gender differences for such predictors. Methods The sample comprised 472 students aged 13-21 years recruited from high schools and vocational education centers. Results Findings demonstrated that emotion regulation was predictive of all addictive behaviors assessed in this study (alcohol and drug abuse, gambling disorder, video game addiction, and problematic Internet use), whereas attachment predicted non-substance-related addictions (gambling disorder, video game addiction, and problematic Internet use). In addition, gender differences were found, with females scoring significantly higher in maternal and peer attachment, whereas males scored significantly higher in gambling disorder and video game addiction. Conclusion The findings may be useful for preventive and clinical interventions conducted with youth regarding addictive behaviors.
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Affiliation(s)
- Ana Estévez
- Department of Personality, Psychological Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Paula Jáuregui
- Department of Personality, Psychological Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Inmaculada Sánchez-Marcos
- Department of Personality, Psychological Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Hibai López-González
- Department of Personality, Psychological Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
- International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
| | - Mark D. Griffiths
- International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
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147
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Wegen K, van Dijke A, Aalbers A, Zedlitz A. Dissociation and under-regulation of affect in patients with posttraumatic stress disorder with and without a co-morbid substance use disorder. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2017. [DOI: 10.1016/j.ejtd.2017.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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148
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Ebert DD, Hopfinger L, Bockting CLH, Berking M. Emotion Regulation Protects Against Recurrence of Depressive Symptoms Following Inpatient Care for Major Depressive Disorder. Behav Ther 2017; 48:739-749. [PMID: 29029672 DOI: 10.1016/j.beth.2017.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 11/19/2022]
Abstract
Relapse following response in psychotherapy for major depressive disorder (MDD) is a major concern. Emotion regulation (ER) has been discussed as a putative emerging and maintaining factor for depression. The purpose of the present study was to examine whether ER protects against recurrence of depression over and above residual symptoms of depression following inpatient care for MDD. ER skills (ERSQ-ES) and depression (HEALTH-49) were assessed in 193 patients with MDD (age, M = 47.4, SD = 9.6, 75.1% female, 100% Caucasian) at treatment discontinuation, 3 and 12 months after treatment. Multiple hierarchical regressions were used to examine general and specific ER as predictors of depressive symptoms at follow-ups. Higher general ER predicted lower depression over and beyond residual symptoms of depression at 3-month follow-up among treatment responders but not among treatment nonresponders. With regard to specific ER skills, readiness to confront and acceptance of undesired emotions predicted lower depressive symptoms beyond residual symptoms of depression 12 months, respectively 3 and 12 months after treatment. Findings of the present study indicate that targeting general ER might be more important for remitted and less important for nonremitted patients. Enhancing ER should hence be realized in a sequential treatment design, in which a continuation phase treatment with a specific focus on ER directly follows, once patients sufficiently responded to treatment. Acceptance of undesired emotion and readiness to confront situations that cue these emotions appear to be particularly important for protecting against recurrence of depression. Future research should clarify whether findings can be generalized to outpatient care.
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149
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Roos CR, Witkiewitz K. A contextual model of self-regulation change mechanisms among individuals with addictive disorders. Clin Psychol Rev 2017; 57:117-128. [PMID: 28866435 PMCID: PMC6152904 DOI: 10.1016/j.cpr.2017.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/23/2017] [Accepted: 08/20/2017] [Indexed: 12/13/2022]
Abstract
Numerous behavioral treatments for addictive disorders include components explicitly aimed at targeting self-regulation (e.g., coping and emotion regulation). We first provide a summary of key findings to date among studies that have examined self-regulation as a mechanism of behavior change (MOBC) in behavioral treatments for addictive disorders. Based on our review, we conclude that the role of self-regulation as a MOBC across behavioral treatments for addictive disorders is not well-characterized and findings are inconsistent across studies. For example, our review indicates that there is still inconsistent evidence that coping is a unique MOBC in cognitive-behavioral approaches for addictive behaviors. We propose that there has been slow progress in understanding self-regulation as a MOBC in addiction treatment because of a lack of attention to contextual factors. Accordingly, in the second half of this paper, we propose a contextual model of self-regulation change mechanisms, which emphasizes that the role of various facets of self-regulation as MOBC may depend on contextual factors in the immediate situational context (e.g., fluctuating internal and external cues) and in the broader context in which an individual is embedded (e.g., major life stressors, environmental conditions, dispositions). Additionally, we provide specific recommendations to guide future research for understanding both between-person and within-person self-regulation MOBC in addiction treatment. In particular, we provide key recommendations for how to capitalize on intensive longitudinal measurement methods (e.g., ecological momentary assessment) when bringing a contextual perspective to the study of self-regulation as MOBC in various addiction treatments.
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Affiliation(s)
- Corey R Roos
- Department of Psychology, Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM, 87106, Mexico.
| | - Katie Witkiewitz
- Department of Psychology, Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM, 87106, Mexico
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150
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Wilks C, Yin Q, Ang SY, Matsumiya B, Lungu A, Linehan M. Internet-Delivered Dialectical Behavioral Therapy Skills Training for Suicidal and Heavy Episodic Drinkers: Protocol and Preliminary Results of a Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e207. [PMID: 29070480 PMCID: PMC5677770 DOI: 10.2196/resprot.7767] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 08/03/2017] [Accepted: 09/10/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The need to develop effective and accessible interventions for suicidal individuals engaging in heavy episodic drinking (HED) cannot be understated. While the link between alcohol use and suicidality is a complex one that remains to be elucidated, emotion dysregulation may play a key role in alcohol-related suicide risk in these individuals. OBJECTIVE In the current study, an 8-week Internet-delivered dialectical behavior therapy (DBT) skills training intervention was developed and preliminarily evaluated for suicidal individuals who engage in HED to regulate emotions. The aim of the study is to evaluate the feasibility and effectiveness of the therapist-assisted and Internet-delivered intervention, and to inform the design of a subsequent full-scale study. METHODS The study was a pilot randomized controlled trial comparing participants receiving immediate-treatment (n=30) to waitlist controls (n=29) over a period of 16 weeks. Intervention effects will be assessed longitudinally using hierarchical linear modeling and generalized estimating equations, along with analyses of effect sizes and clinically significant change. The primary outcomes are suicidal ideation, alcohol problems, and emotion dysregulation. Secondary outcomes include alcohol-related consequences, reasons for living, skills use, and depression. RESULTS The trial is ongoing. A total of 60 individuals returned their informed consent and were randomized, of whom 59 individuals were intended to treat. A total of 50 participants in the study were retained through the 16-week enrollment. CONCLUSIONS There is a dearth of evidence-based treatment for individuals presenting with high risk and complex behaviors. Furthermore, computerized interventions may provide a beneficial alternative to traditional therapies. The particular clinical features and treatment needs of suicidal individuals who also engage in HED constitute key domains for further investigation that are needed to consolidate the design of appropriate interventions for this high-risk population. TRIAL REGISTRATION Clinicaltrials.gov NCT02932241; https://clinicaltrials.gov/ct2/show/NCT02932241 (Archived by WebCite at http://www.webcitation.org/6uJHdQsC2).
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Affiliation(s)
- Chelsey Wilks
- Behavioral Research and Therapy Clinics, Department of Psychology, University of Washington, Seattle, WA, United States
| | - Qingqing Yin
- Behavioral Research and Therapy Clinics, Department of Psychology, University of Washington, Seattle, WA, United States
| | - Sin Yee Ang
- Behavioral Research and Therapy Clinics, Department of Psychology, University of Washington, Seattle, WA, United States
| | - Brandon Matsumiya
- Department of Psychology, University of Central Florida, Orlando, FL, United States
| | | | - Marsha Linehan
- Behavioral Research and Therapy Clinics, Department of Psychology, University of Washington, Seattle, WA, United States
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