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Cabral DAR, Tegge AN, Dwyer CL, Quddos F, Kaur RP, Nguyen J, Athamneh L, Bickel WK. Associations between delay discounting and unhealthy behaviors in substance use recovery. Drug Alcohol Depend 2024; 262:111395. [PMID: 39053430 DOI: 10.1016/j.drugalcdep.2024.111395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Research on delay discounting (DD) is mixed on whether DD is a domain-specific component related to specific behaviors or a domain-general process that cuts across various behaviors. A pivotal group to test the associations between DD and unhealthy behaviors is individuals in recovery from substance use disorders (SUD), as they are moving away from a disorder toward a healthier state. METHODS Individuals in SUD recovery (n = 317) completed the Temptation Scale, the Health Behaviors Questionnaire, and an Adjusting Delay Discounting Task. An exhaustive model space search was performed using linear regression to examine associations between DD with temptation, engagement in unhealthy behaviors, and the total number of unhealthy behaviors participants engage in. We also tested whether remission status is associated with the total number of unhealthy behaviors participants engage in. RESULTS Results revealed that DD was positively associated with poor eating (p<.001), physical inactivity (p=.003), financial irresponsibility (p<.001), risky behaviors (p<.001), lack of personal development goals (p<.001), lack of household savings (p=.004), and lack of health behaviors (p=.003). DD was also positively associated with the total number of unhealthy behaviors participants engage in (p<.001). Participants who were not in remission engaged in more unhealthy behaviors compared to those who were in remission (p<.001). CONCLUSION In a sample of individuals in recovery from SUD, DD is not domain-specific and undergirds engagement in several maladaptive health behaviors that can negatively impact recovery. Thus, DD can be a target for interventions aiming to reduce other maladaptive behaviors in SUD recovery.
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Affiliation(s)
- Daniel A R Cabral
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Candice L Dwyer
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA; Department of Psychology at Virginia Tech, Blacksburg, VA, USA
| | - Fatima Quddos
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Rose P Kaur
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | | | - Liqa Athamneh
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA
| | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, USA.
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Hildebrandt MK, Schwarz K, Dieterich R, Endrass T. Dissociating the Link of Neural Correlates of Inhibition to the Degree of Substance Use and Substance-Related Problems: A Preregistered, Multimodal, Combined Cross-sectional and Longitudinal Study. Biol Psychiatry 2023; 94:898-905. [PMID: 37356556 DOI: 10.1016/j.biopsych.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/15/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Frontal hypoactivation during inhibition is a promising phenotype for substance use disorders (SUDs), but studies comparing individuals with SUDs with unaffected individuals have reported inconsistent results. This may result from distinctive associations of neural correlates of inhibition with the degree of substance use and the severity of substance-related problems-two correlated but distinct facets of SUDs-reflecting a potentially disregarded confounding effect. This preregistered study tested whether frontal hypoactivation during inhibition is specifically linked to substance-related problems in SUDs beyond the degree of substance use. METHODS A stop signal task during functional magnetic resonance imaging, trait self-control, substance use, and substance-related problems in the past 12 months were assessed in 121 (poly)substance users. One hundred seven participants completed a 1-year follow-up. We examined the association between multimodal indicators of inhibition (neural activation in regions of interest, inhibitory performance, trait self-control) and substance-related problems while controlling for the degree of substance use. RESULTS Right inferior frontal gyrus hypoactivation explained variance in substance-related problems beyond the degree of substance use, while hyperactivation in the same region explained variance in the degree of substance use beyond the effects of substance-related problems, both cross-sectionally (problems: Bonferroni-Holm-corrected p = .048; use: p < .01) and prospectively (problems at trend level: p = .096; use: p = .01). Trait and behavioral inhibition were unrelated to problems beyond the effects of substance use (ps > .05). CONCLUSIONS We demonstrated that frontal hypoactivation during inhibition specifically relates to substance-related problems. Interestingly, increased activity may even represent a resilience factor in substance use without SUDs. Future studies should distinguish between processes linked to the degree of substance use and substance-related problems to advance understanding of why some substance users develop SUDs and others do not.
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Affiliation(s)
- Malin K Hildebrandt
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany.
| | - Kristina Schwarz
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany
| | - Raoul Dieterich
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany
| | - Tanja Endrass
- Department of Clinical Psychology and Psychotherapy, TUD Dresden University of Technology, Dresden, Germany
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Zhang Z, Lin Y, Liu J, Zhang G, Hou X, Pan Z, Dai B. Relationship between behavioral inhibition/activation system and Internet addiction among Chinese college students: The mediating effects of intolerance of uncertainty and self-control and gender differences. Front Public Health 2022; 10:1047036. [PMID: 36644769 PMCID: PMC9832708 DOI: 10.3389/fpubh.2022.1047036] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/28/2022] [Indexed: 12/29/2022] Open
Abstract
Background Internet addiction is a global public health issue among college students that is associated with a range of negative outcomes. Especially the COVID-19 pandemic has forced them to shift most of their studies and life activities from offline to online, leading to a growing problem of Internet dependence and even Internet addiction. Although previous studies have indicated that the Behavioral Inhibition/Activation System (BIS/BAS) have important effects on college students' Internet addiction, the mechanisms underlying these associations and gender differences are still unclear. Aims The present study investigated the mediating roles of intolerance of uncertainty and self-control in the association between BIS/BAS and Internet addiction following the Interaction of Person-Affect-Cognition-Execution model. Gender differences in such associations between variables were also tested. Method A total of 747 Chinese college students were surveyed by using Young's Diagnostic Questionnaire for Internet Addiction, BIS/BAS Scales, the Intolerance of Uncertainty Scale and the Brief Self-Control Scale. Results The results from the structural equation modeling analysis showed that BIS was positively related to Internet addiction and that BAS had a negative association with Internet addiction. Moreover, intolerance of uncertainty and self-control mediated the relationships between BIS/BAS and Internet addiction. Multi-group analysis further revealed that the associations between BAS and Internet addiction and between intolerance of uncertainty and Internet addiction were stronger among the male students than among female students. The relationship between self-control and Internet addiction was greater in the female sample than in the male sample. Conclusions These findings extend our understanding of how BIS/BAS influence Internet addiction among college students and suggest that not only should training approaches based on intolerance of uncertainty and self-control be fully considered, but different intervention programs should be focused on gender sensitivity to maximize the intervention effect.
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Affiliation(s)
- Zhihao Zhang
- School of Public Administration, Central South University, Changsha, China
| | - Yan Lin
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Jia Liu
- Transplantation Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Guangyu Zhang
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Xiaowen Hou
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zequan Pan
- School of Public Administration, Central South University, Changsha, China,*Correspondence: Zequan Pan
| | - Bibing Dai
- Department of Psychiatry and Psychology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China,Bibing Dai
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Palzes VA, Kline-Simon AH, Satre DD, Sterling S, Weisner C, Chi FW. Predictors of early and sustained cessation of heavy drinking over 5 years among adult primary care patients. Addiction 2022; 117:82-95. [PMID: 34159681 PMCID: PMC8664973 DOI: 10.1111/add.15612] [Citation(s) in RCA: 2] [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: 01/25/2021] [Revised: 03/11/2021] [Accepted: 06/09/2021] [Indexed: 01/03/2023]
Abstract
AIMS To identify factors asociated with early and sustained cessation of heavy drinking. DESIGN Retrospective cohort study over 5 years. SETTING Kaiser Permanente Northern California, United States. PARTICIPANTS Adults reporting heavy drinking during primary care-based alcohol screening between 1 June 2013 and 31 May 2014. The sample (n = 85 434) was 40.7% female and 33.8% non-white; mean age was 50.3 years (standard deviation = 18.1). MEASUREMENTS Following US guidelines, early and sustained cessation of heavy drinking was defined as reporting lower-risk drinking or abstinence at 1 year and to 5 years after achieving early cessation, respectively. Associations between patient characteristics and service use and cessation outcomes were examined using logistic regression with inverse probability weights addressing attrition. FINDINGS Nearly two-thirds of participants achieved early cessation of heavy drinking. Women [odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.35, 1.44], middle-age (35-64 years: ORs = 1.16-1.19), non-white race/ethnicity (ORs = 1.03-1.57), medical conditions (OR = 1.05, 95% CI = 1.04, 1.06), psychiatric (OR = 1.10, 95% CI = 1.06, 1.15) and drug use disorders (OR = 1.35, 95% CI = 1.17, 1.56) and addiction treatment (OR = 1.19, 95% CI = 1.09, 1.30) were associated with higher odds of early cessation, while older age (≥ 65 years: OR = 0.91, 95% CI = 0.86, 0.96), smoking (OR = 0.81, 95% CI = 0.77, 0.84), higher index drinking levels (exceeding both daily and weekly limits: OR = 0.30, 95% CI = 0.29, 0.32) and psychiatric treatment (OR = 0.91, 95% CI = 0.84, 0.99) were associated with lower odds. Among those who achieved early cessation (n = 19 200), 60.0% sustained cessation. Associations between patient factors and sustained cessation paralleled those observed in analyses of early cessation. Additionally, routine primary care (OR = 1.57, 95% CI = 1.44, 1.71) and addiction treatment post-1 year (OR = 1.41, 95% CI = 1.19, 1.66) were associated with higher odds of sustained cessation. Lower-risk drinking versus abstinence at 1 year was associated with lower odds of sustained cessation (OR = 0.62, 95% CI = 0.57, 0.66). CONCLUSIONS Nearly two-thirds of a large, diverse sample of patients who reported heavy drinking in a Californian health-care system achieved early and sustained cessation of heavy drinking. Vulnerable subgroups (i.e. non-white patients and those with psychiatric disorders), patients who received routine primary care and those who received addiction treatment were more likely to sustain cessation of heavy drinking than other participants.
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Affiliation(s)
- Vanessa A Palzes
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Felicia W Chi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Towards the psychological profile of cryptocurrency early adopters: Overconfidence and self-control as predictors of cryptocurrency use. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02225-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yu TW, Chen YM, Wang CC, Lin CC, Huang KT, Liu YW, Hsu LW, Li WF, Chan YC, Chen CL, Chen CC. Incidence and Risk Factors of Alcohol Relapse after Liver Transplantation: Analysis of Pre-Transplant Abstinence and Psychosocial Features. J Clin Med 2020; 9:jcm9113716. [PMID: 33228157 PMCID: PMC7699606 DOI: 10.3390/jcm9113716] [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: 09/30/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 11/30/2022] Open
Abstract
Alcohol-associated liver disease (ALD) is a common indication for liver transplantation (LT). Alcohol relapse after LT is associated with graft loss and worse prognosis. Over the past 20 years, the number and prevalence of living donor liver transplantations (LDLTs) have increased in Taiwan. The aims of this retrospective study are to analyze the incidence and risk factors of alcohol relapse after LT at a single center in Taiwan. A total of 98 patients with ALD who underwent LT from January 2012 to December 2018 were retrospectively evaluated by chart review. Pre-transplant characteristics as well as psychosocial and alcoholic history were used to test the possible associations among the risk factors studied and post-LT alcohol relapse. The incidence of post-LT alcohol relapse was 16.3%. The median duration of alcohol relapse after liver transplantation was 28.1 months (range: 1–89.4 months). The cumulative incidence was 12% and 19% at 1 year and 3 years after LT, respectively. The most powerful risk factors were a pre-LT abstinence period less than 6 months and younger age of starting alcohol. For predicting alcohol relapse, the accuracy rate of abstinence less than 6 months was up to 83.7%. In summary, pre-abstinence period plays a role in predicting post-LT alcohol relapse. Post-LT interventions should be considered specifically for the patients with short abstinence period. Long-term follow-up, patient-centered counseling, and enhancement of healthy lifestyle are suggested to prevent alcohol relapse.
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Affiliation(s)
- Tien-Wei Yu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (T.-W.Y.); (Y.-M.C.)
| | - Yu-Ming Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (T.-W.Y.); (Y.-M.C.)
| | - Chih-Chi Wang
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
| | - Chih-Che Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
| | - Kuang-Tzu Huang
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Yueh-Wei Liu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
| | - Li-Wen Hsu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
| | - Wei-Feng Li
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
| | - Yi-Chai Chan
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
| | - Chao-Long Chen
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (C.-C.W.); (C.-C.L.); (Y.-W.L.); (L.-W.H.); (W.-F.L.); (Y.-C.C.)
- Correspondence: (C.-L.C.); (C.-C.C.); Tel.: +886-7-731-7123 (ext. 3302) (C.-L.C.); +886-7-731-7123 (ext. 8752) (C.-C.C.)
| | - Chien-Chih Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan; (T.-W.Y.); (Y.-M.C.)
- Correspondence: (C.-L.C.); (C.-C.C.); Tel.: +886-7-731-7123 (ext. 3302) (C.-L.C.); +886-7-731-7123 (ext. 8752) (C.-C.C.)
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Dekkers A, De Ruysscher C, Vanderplasschen W. Perspectives of cocaine users on addiction recovery: a qualitative study following a CRA + vouchers programme. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1687647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Anne Dekkers
- Department of Special Needs Education, Ghent University, Ghent, Belgium
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