The Relationship Between Dissociative Experiences and Cannabis Use: a Systematic Review

An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors

This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial–parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.

A trauma model of substance use: Elaboration and preliminary validation

The current study expands on and integrates previous theoretical models concerning the pathways that link child maltreatment to substance use disorder. The proposed model, based on the self-medication hypothesis, suggests that experiences of neglect and abuse during childhood can lead to substance use and abuse both directly and indirectly, via dissociation resulting from failed attempts to integrate experiences of maltreatment in childhood. The model was tested on ten substances (painkillers, stimulants, sedatives, marijuana, cocaine, ecstasy, hallucinogens, heroin, inhalants, and methamphetamine) via structural equation modeling (SEM) in a sample comprising 1040 community-dwelling adults (67 % women) aged between 18 and 78 (M = 29.55, SD = 11.37). Fit indexes of the SEM were good, thus supporting the hypothesized model. Specific forms of child maltreatment were related to increased use of specific substances; however, experience of childhood neglect (both physical and emotional) was found to have a central role in predicting use of most substances. Although no single pathway can fully explain the origins of substance abuse, the current study provides evidence of a critical developmental pathway to it, with implications for theory and clinical practice.

Association patterns of cannabis abuse and dependence with risk of problematic non-substance-related dysregulated and addictive behaviors

Co-occurrence of drug misuse with other dysregulated behaviors is common. This study was aimed at exploring the associations between the risk of presenting a clinically relevant condition involving non-substance-related addictive or dysregulated behaviors (as measured by the MultiCAGE CAD-4 screening), and cannabis abuse/dependence (CAST/SDS) scores, and the role of gender therein. Participants were recruited using stratified probabilistic sampling at the University of Granada. Mann-Whitney’s U tests were used to compare male and female students in SDS and CAST scores. Associations between gender and MultiCAGE scores were estimated using the γ ordinal correlation index, and tested with χ². For each MultiCAGE dimension, a Poisson-family mixed-effects model was built with either SDS or CAST as the main input variable, while controlling for nicotine and alcohol dependence, and relevant sociodemographic variables. Incidence rate ratios (IRR) were computed for SDS/CAST effects, and the significance threshold was family-wise Bonferroni-corrected. Gender differences were significant for cannabis dependence/abuse and all MultiCAGE scores for non-substance-related conditions, with males showing higher risk scores for excessive gambling, excessive internet use, excessive video gaming, and hypersexuality, and females presenting higher scores in dysregulated eating and compulsive buying. Cannabis dependence and abuse were significantly associated with a higher risk of problematic video gaming. These associations were mostly driven by males. Importantly, although risk of problematic video gaming was specifically associated with cannabis abuse/dependence, there was only a weak non-significant association between problematic video gaming and alcohol use scores. Risk of alcohol use problems, in turn, was strongly associated with all other non-substance-related problems (problematic gambling, excessive Internet use, dysregulated eating, compulsive buying, and hypersexuality). These differential associations can cast light on the etiological similarities and dissimilarities between problematic substance use and putative addictive behaviors not involving drugs.

Researching unexplained phenomena: empirical-statistical validity and reliability of the Multivariable Multiaxial Suggestibility Inventory-2 (MMSI-2)

Anomalous phenomena are unexplained occurrences, such as paranormal experiences, that challenge the ontological bases of current scientific knowledge and are considered scientifically impossible. Problematically, some scientific research yields significant statistical results in favor of the existence of telepathy, precognition, mind-matter interaction, and mediumship. The current study presents and statistically justifies the Multivariable Multiaxial Suggestibility Inventory-2 (MMSI-2), a new psychological instrument to measure and detect the main psychological explanations for anomalous experiences. A nonprobabilistic sample of 3,224 subjects without a psychiatric history were recruited from the general population of Spain. Exploratory factor analysis (EFA) was used to examine the internal structure of the MMSI-2's 174 items. Direct oblimin and promax oblique rotations were applied as criteria for axis rotation. Cronbach's alpha coefficients and their ordinal transformation were also calculated, and gender-differentiated scales for the raw MMSI-2 scale scores were developed. The first-order factorial solution yielded a total of 16 factors that explained 92.84% of the variance. Of these, 10 corresponded to the psychological variables cited in the background literature, four classified the anomalous phenomena according to their sensory mode, and two represented prototype control scales for this class of psychometric inventory. The higher-order EFA grouped the MMSI-2 scales into four macrofactors that together explained 97.737% of the variance. Satisfactory reliability rates were obtained (alphas>0.8). The full version of the MMSI-2 with 174 items is a valid and reliable psychometric instrument for evaluating anomalous phenomena and the theoretically concomitant psychological variables. Similarly, the scaling of scores can be used in psychological assessment as a screening tool to identify clinically suspected psychological variables.