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Chang YC, Rubey RL, Ladd BO. Brief emotion regulation strategies to reduce alcohol craving: Mediating role of state difficulties in emotion regulation. Behav Res Ther 2024; 177:104527. [PMID: 38581778 DOI: 10.1016/j.brat.2024.104527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE This study experimentally compared the effects of emotion regulation (ER) strategies on alcohol craving and examined the mediating effect of state difficulties in emotion regulation (S-DER) on the relationship between negative/positive emotion and alcohol craving. METHOD 417 participants (76.74% women, Mage = 20.76 years) endorsing past-month heavy/binge drinking were randomly assigned to one of four ER conditions (positive reappraisal, distancing, distraction, and acceptance). Participants completed state assessments, including negative/positive emotion, S-DER, and alcohol craving, prior to (T0) and after (T1) engaging in a negative emotion induction task. Subsequently, participants completed an ER strategy task based on their assigned ER strategy condition and completed a third state assessment (T2). RESULTS Time had a significant quadratic effect on alcohol craving, such that craving increased from T0 to T1 and decreased from T1 to T2. There was no significant effect of ER strategy condition on craving. Change in S-DER mediated the relationship between the change in negative/positive emotion and the change in craving, with emotional modulation and emotional acceptance facets of S-DER dominating the mediating effect during negative emotion induction and ER strategy induction, respectively. CONCLUSIONS Results suggest interventions targeting S-DER's emotional modulation and acceptance facets could reduce acute craving when experiencing undesired emotions.
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Shuai R, Ahmed-Leitao F, Bloom J, Seedat S, Hogarth L. Brief online negative affect focused functional imagery training (FIT) improves four-week drinking outcomes in hazardous student drinkers: A pilot randomised controlled trial replication in South Africa. Addict Behav Rep 2024; 19:100540. [PMID: 38586438 PMCID: PMC10995806 DOI: 10.1016/j.abrep.2024.100540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 03/04/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024] Open
Abstract
Background Previous study has shown that functional imagery training (FIT) to utilise positive mental imagery in response to negative affect could improve alcohol-related outcomes. The current study aimed to replicate whether this negative affect focused FIT would improve alcohol-related outcomes in hazardous student drinkers in South Africa at four-week follow-up. Methods 50 hazardous student drinkers who reported drinking to cope with negative affect were randomised into two groups. The active group (n = 25) was trained online over two weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas the control group (n = 25) received standard risk information about binge drinking. Outcome measures including alcohol consumption, drinking motives, anxiety and depression, self-efficacy and use of protective behavioural strategies were obtained at baseline and four-week follow-up. Results FIT effects were revealed by three significant group-by-timepoint interactions in a per-protocol analysis: there was a significant decrease in depressive symptoms, drinking to cope and drinking for social reasons from baseline to follow-up in the active group, but not the control group. No effects were observed on alcohol consumption, self-efficacy, protective behaviour strategies and anxiety. Conclusions Preliminary evidence supports that online negative affect focused FIT can improve depression as well as coping and social drinking motives in South African hazardous student drinkers who drank to cope, at four-week follow-up, suggesting that the principles of this FIT approach might be adapted and incorporated into a clinical intervention to test for efficacy in mitigating substance use problems.
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Affiliation(s)
- Ruichong Shuai
- School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Fatima Ahmed-Leitao
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
| | - Jenny Bloom
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Private Bag X1, Matieland, 7602, Stellenbosch, South Africa
| | - Lee Hogarth
- School of Psychology, University of Exeter, Exeter, United Kingdom
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Mirabito G, Verhaeghen P. Remote delivery of a Koru Mindfulness intervention for college students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:897-904. [PMID: 35427456 DOI: 10.1080/07448481.2022.2060708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To examine whether a remote, online, group-based mindfulness intervention results in effects during the COVID-19 pandemic. PARTICIPANTS 111 college students: 58 in the intervention group, 53 in a waitlist control group. METHODS Randomized control trial (RCT) using a 4-week Koru Mindfulness program, investigating pre-to-posttest changes in the intervention group compared to time-yoked control participants. RESULTS Average effect size for all 21 variables measured was 0.48. The intervention produced significant benefits for mindfulness, rumination, worry, mood, stress, anxiety, three out of six aspects of psychological wellbeing (Autonomy, Environmental mastery, Self-acceptance) and physical activity. No significant effect was noted for depression (d = 0.33) or sleep (d = -0.13), and three aspects of psychological wellbeing (Personal growth, Positive relationships, Purpose in life). CONCLUSIONS A remote, online, group-based mindfulness program yielded benefits on stress, anxiety, and mood in college students, even under the dire circumstances of a pandemic.
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Bakou AE, Hardy L, Shuai R, Wright K, Hogarth L. Ultra-Brief Breath Counting (Mindfulness) Training Abolishes Negative Affect-Induced Alcohol Motivation in Hazardous Community Drinkers. Mindfulness (N Y) 2024; 15:653-664. [PMID: 38511200 PMCID: PMC10948464 DOI: 10.1007/s12671-024-02315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 03/22/2024]
Abstract
Objectives Mindfulness therapy improves drinking outcomes arguably by attenuating negative mood-induced drinking, but this mechanism has not been demonstrated in hazardous community drinkers. To address this, three studies tested whether a key ingredient of mindfulness, breath counting, would attenuate the increase in motivation for alcohol produced by experimentally induced negative mood, in hazardous community drinkers. Method In three studies, hazardous community drinkers were randomized to receive either a 6-min breath counting training or listen to a recited extract from a popular science book, before all participants received a negative mood induction. Motivation for alcohol was measured before and after listening to either the breath counting training or the control audio files, with a craving questionnaire in two online studies (n = 122 and n = 111), or an alcohol versus food picture choice task in a pub context in one in-person study (n = 62). Results In Study 1, breath counting reduced alcohol craving. However, since the mood induction protocol did not increase craving, the effect of breath counting in reversing such increase could not be demonstrated. Online breath counting eliminated the increase in alcohol craving induced by negative mood (Study 2) and eliminated the stress-induced increase in alcohol picture choice in the pub environment (Study 3). Conclusions Briefly trained breath counting attenuated negative mood-induced alcohol motivation in hazardous community drinkers. These results suggest that breath counting is a reliable and practical method for reducing the impact of negative emotional triggers on alcohol motivation. Preregistration These studies are not preregistered.
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Affiliation(s)
- Alexandra Elissavet Bakou
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Lorna Hardy
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Ruichong Shuai
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Kim Wright
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
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Rosenthal A, Ebrahimi C, Wedemeyer F, Romanczuk-Seiferth N, Beck A. The Treatment of Substance Use Disorders: Recent Developments and New Perspectives. Neuropsychobiology 2022; 81:451-472. [PMID: 35724634 DOI: 10.1159/000525268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/28/2022] [Indexed: 11/19/2022]
Abstract
Substance-related disorders are complex psychiatric disorders that are characterized by continued consumption in spite of harmful consequences. Addiction affects various brain networks critically involved in learning, reward, and motivation, as well as inhibitory control. Currently applied therapeutic approaches aim at modification of behavior that ultimately leads to decrease of consumption or abstinence in individuals with substance use disorders. However, traditional treatment methods might benefit from recent neurobiological and cognitive neuroscientific research findings. Novel cognitive-behavioral approaches in the treatment of addictive behavior aim at enhancement of strategies to cope with stressful conditions as well as craving-inducing cues and target erroneous learning mechanisms, including cognitive bias modification, reconsolidation-based interventions, mindfulness-based interventions, virtual-reality-based cue exposure therapy as well as pharmacological augmentation strategies. This review discusses therapeutic strategies that target dysregulated neurocognitive processes associated with the development and maintenance of disordered substance use and may hold promise as effective treatments for substance-related disorders.
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Affiliation(s)
- Annika Rosenthal
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Ebrahimi
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Wedemeyer
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anne Beck
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Health and Medical University, Campus Potsdam, Faculty of Health, Potsdam, Germany
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Witarto BS, Visuddho V, Witarto AP, Bestari D, Sawitri B, Melapi TAS, Wungu CDK. Effectiveness of online mindfulness-based interventions in improving mental health during the COVID-19 pandemic: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2022; 17:e0274177. [PMID: 36129900 PMCID: PMC9491555 DOI: 10.1371/journal.pone.0274177] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Psychotherapies, such as mindfulness-based interventions (MBIs), are currently needed to tackle mental health problems. Online MBIs have become promising since face-to-face interventions are limited during the COVID-19 pandemic due to lockdown and social distancing. This systematic review and meta-analysis aimed to investigate the effect of online MBIs in improving mental health, mainly depression, anxiety, and stress. Materials and methods A systematic literature search was conducted according to the PRISMA 2020 guidelines on several databases for eligible studies up to October 17, 2021. Study quality was assessed using the Cochrane’s Risk of Bias 2 tool. Effect sizes were presented as standardized mean difference (Hedges’ g) between the online MBIs and control groups at post-test and follow-up using a random-effects model. Results Eight randomized controlled trials involving 868 participants were included in this meta-analysis. The pooled adherence rate to online MBIs was 94% (95% CI = 91% to 98%). The findings revealed that online MBIs had a statistically significant small to moderate effect in reducing depression (g = -0.32; 95% CI = -0.49 to -0.14; I2 = 0%), a small effect on anxiety (g = -0.25; 95% CI = -0.43 to -0.06; I2 = 27%), and a moderate effect on stress (g = -0.62; 95% CI = -1.09 to -0.16; I2 = 83%). In addition, significant small effects at follow-up were observed for depression (g = -0.26; 95% CI = -0.48 to -0.04; I2 = 0%) and anxiety (g = -0.28; 95% CI = -0.48 to -0.08; I2 = 0%), but not for stress. Conclusion Online MBIs have beneficial effects on mental health, particularly depression, anxiety, and stress, during the COVID-19 pandemic. Given the limitations of the current study, future trials that specifically consider potential effect influencing factors, longer follow-up evaluation, and methodological quality are warranted.
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Affiliation(s)
| | - Visuddho Visuddho
- Medical Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Damba Bestari
- Department of Psychiatry, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Hospital, Surabaya, Indonesia
- Department of Psychiatry, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Brihastami Sawitri
- Department of Psychiatry, Faculty of Medicine Universitas Airlangga/Dr. Soetomo Hospital, Surabaya, Indonesia
- Department of Psychiatry, Universitas Airlangga Hospital, Surabaya, Indonesia
| | | | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- * E-mail:
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Shuai R, Bakou AE, Andrade J, Hides L, Hogarth L. Brief Online Negative Affect Focused Functional Imagery Training Improves 2-Week Drinking Outcomes in Hazardous Student Drinkers: a Pilot Randomised Controlled Trial. Int J Behav Med 2022; 29:346-356. [PMID: 34432263 PMCID: PMC9166857 DOI: 10.1007/s12529-021-10019-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Negative affect plays an important role in motivating problematic alcohol use. Consequently, training imagery-based adaptive responses to negative affect could reduce problematic alcohol use. The current study tested whether personalised online functional imagery training (FIT) to utilise positive mental imagery in response to negative affect would improve drinking outcomes in hazardous negative affect drinking students. METHOD Participants were 52 hazardous student drinkers who drink to cope with negative affect. Participants in the active group (n = 24) were trained online over 2 weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas participants in the control group (n = 28) received standard risk information about binge drinking at university. Measures of daily drinking quantity, drinking motives, self-efficacy and use of protective behavioural strategies were obtained at baseline and 2 weeks follow-up. RESULTS There were three significant interactions between group and time in a per-protocol analysis: the active intervention group showed increased self-efficacy of control over negative affect drinking and control over alcohol consumption and decreased social drinking motives from baseline to 2-week follow-up, relative to the control intervention group. There were no effects on drinking frequency. CONCLUSION These findings provide initial evidence that online training to respond to negative affect drinking triggers by retrieving mental imagery of adaptive strategies can improve drinking-related outcomes in hazardous, student, negative affect drinkers. The findings support the utility of FIT interventions for substance use.
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Affiliation(s)
- Ruichong Shuai
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| | - Alexandra Elissavet Bakou
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
| | - Jackie Andrade
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Leanne Hides
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
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Shuai R, Anker JJ, Bravo AJ, Kushner MG, Hogarth L. Risk Pathways Contributing to the Alcohol Harm Paradox: Socioeconomic Deprivation Confers Susceptibility to Alcohol Dependence via Greater Exposure to Aversive Experience, Internalizing Symptoms and Drinking to Cope. Front Behav Neurosci 2022; 16:821693. [PMID: 35237137 PMCID: PMC8883115 DOI: 10.3389/fnbeh.2022.821693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/07/2022] [Indexed: 11/13/2022] Open
Abstract
Socioeconomic deprivation is associated with greater alcohol problems despite lower alcohol consumption, but the mechanisms underpinning this alcohol harm paradox remain obscure. Fragmented published evidence collectively supports a multistage causal risk pathway wherein socioeconomic deprivation increases the probability of exposure to aversive experience, which promotes internalizing symptoms (depression and anxiety), which promotes drinking alcohol to cope with negative affect, which in turn accelerates the transition from alcohol use to dependence. To evaluate this proposed risk pathway, 219 hazardous drinkers from an undergraduate population completed questionnaires assessing these constructs in a single, cross sectional, online survey. Partial correlation coefficients revealed that each variable showed the strongest unique association with the next variable in the proposed multistage model, when adjusting for the other variables. Bootstrapped serial mediation analysis revealed that the indirect pathway linking all the variables in the proposed serial order was significant, while all other permutations were non-significant. Network centrality analysis corroborated the serial order of this indirect path. Finally, risk ratios estimated by categorizing the variables suggested that socioeconomic deprivation increased the risk of aversive experience by 32%, which increased the risk of internalizing symptoms by 180%, which increased the risk of drinking to cope by 64%, which increased susceptibility to alcohol dependence by 59%. These preliminary findings need to be corroborated by future research, nevertheless, they call for prevention strategies founded on social justice and the minimization of aversive experience in socially deprived individuals to mitigate mental health problems, maladaptive coping and addiction.
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Affiliation(s)
- Ruichong Shuai
- School of Psychology, University of Exeter, Exeter, United Kingdom
| | - Justin J. Anker
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Adrian J. Bravo
- Department of Psychological Sciences, College of William & Mary, Williamsburg, VA, United States
| | - Matt G. Kushner
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Lee Hogarth
- School of Psychology, University of Exeter, Exeter, United Kingdom
- *Correspondence: Lee Hogarth,
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Reis A, Saheb R, Parish P, Earl A, Klupp N, Sperandei S. How I cope at university: Self-directed stress management strategies of Australian students. Stress Health 2021; 37:1010-1025. [PMID: 33939880 DOI: 10.1002/smi.3058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/13/2021] [Accepted: 04/26/2021] [Indexed: 11/07/2022]
Abstract
Universities across the world remain under-resourced and frequently unequipped to provide the required support to the increasing demand of students experiencing mental health problems. While there is a considerable amount of research focusing on university student stress levels, interventions to address them, and coping strategies adopted by students, little research has reported on the strategies students choose to manage their stress and how that relates to their self-identified sources of stress as well as to what universities are offering to support their mental health and wellbeing. The present study provides a contribution in this direction, reporting on a study that surveyed over 3200 students from three large Australian metropolitan universities and interviewed three groups of university staff who provide student wellbeing services. Results highlight differences between what students and staff perceive as main sources of stress and best strategies to address them. In addition, students recommend task-oriented, pro-active coping strategies more often to their peers than engage in them themselves. The findings of the study further reinforce the need to develop an understanding of student coping strategies with a lens considerate of students' perspectives and preferences to authentically support their wellbeing, better informing planning and service delivery.
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Affiliation(s)
- Arianne Reis
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - Rowena Saheb
- Student Experience Office, Western Sydney University, Penrith South, New South Wales, Australia
| | - Patricia Parish
- School of Social Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - Andrea Earl
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - Nerida Klupp
- School of Health Sciences, Western Sydney University, Penrith South, New South Wales, Australia
| | - Sandro Sperandei
- Translational Health Research Institute, Western Sydney University, Penrith South, New South Wales, Australia
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Brief Negative Affect Focused Functional Imagery Training Abolishes Stress-Induced Alcohol Choice in Hazardous Student Drinkers. JOURNAL OF ADDICTION 2021; 2021:5801781. [PMID: 34580617 PMCID: PMC8464424 DOI: 10.1155/2021/5801781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/25/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022]
Abstract
Introduction Imagery-based stress management therapies are effective at reducing alcohol use. To explore the therapeutic mechanism, the current study tested whether brief functional imagery training linked to personal negative affect drinking triggers would attenuate sensitivity to noise stress-induced alcohol seeking behaviour in a laboratory model. Methods Participants were UK-based hazardous student drinkers (N = 61, 80.3% women, aged 18–25) who reported drinking to cope with negative affect. Participants in the active intervention group (n = 31) were briefly trained to respond to personal negative drinking triggers by retrieving an adaptive strategy to mitigate negative affect, whereas participants in the control group (n = 30) received risk information about binge drinking at university. The relative value of alcohol was then measured by preference to view alcohol versus food pictures in two-alternative choice trials, before (baseline) and during noise stress induction. Results There was a significant two-way interaction (p < .04) where the control group increased their alcohol picture choice from baseline to the noise stress test (p < .001), whereas the active intervention group did not (p=.33), and the control group chose alcohol more frequently than the active group in the stress test (p=.03), but not at baseline (p=.16). Conclusions These findings indicate that imagery-based mood management can protect against the increase in the relative value of alcohol motivated by acute stress in hazardous negative affect drinkers, suggesting this mechanism could underpin the therapeutic effect of mood management on drinking outcomes.
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Mindfulness in Treatment Approaches for Addiction — Underlying Mechanisms and Future Directions. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00372-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Purpose of Review
While the treatment of addictive disorders proves to be challenging, new treatment approaches that evolved around the concepts of mindfulness and acceptance have been utilized and investigated in recent years. Our goal is to summarize the efficacy and possible underlying mechanisms of mindfulness-based interventions (MBI) in addictive disorders.
Recent Findings
Various meta-analyses have suggested that MBIs show clinical efficacy in the treatment of addictive disorders. Considering the factors that impact addictive disorders, MBIs have been indicated to augment responsiveness to natural rewards in contrast to addiction-related cues as well as to increase top-down cognitive control, decrease subjective and physiological stress perception, and enhance positive affect.
Summary
In summary, MBIs hold promise in treating addictive disorders while larger randomized controlled trials with longitudinal study designs are needed to confirm their utility. Newest clinical endeavors strive to enhance the clinical utility of MBIs by augmentation or personalization.
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Dyer ML, Board AG, Hogarth L, Suddell SF, Heron JE, Hickman M, Munafò MR, Attwood AS. State anxiety and alcohol choice: Evidence from experimental and online observational studies. J Psychopharmacol 2020; 34:1237-1249. [PMID: 32854598 PMCID: PMC7604879 DOI: 10.1177/0269881120940913] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Experimental studies have investigated the effects of physical, psychological and pharmacological stressors (that induce state anxiety) on alcohol outcomes. However, no study has investigated the effects of state anxiety on alcohol outcomes, and the moderating role of drinking to cope (DTC) motives, using the 7.5% carbon dioxide (CO2) challenge. AIMS We aimed to investigate the relationships between state anxiety and alcohol-related outcomes (primarily alcohol choice). We also explored whether DTC motives moderated these relationships. METHODS We conducted two experiments using the 7.5% CO2 challenge (Studies 1 and 2) and an observational study (Study 3) (ns = 42, 60 and 219, respectively), to triangulate findings. RESULTS In Study 1, experimentally induced state anxiety increased alcohol choice (p < .001, ηp2 = .29). This finding was replicated in Study 2, but the effect was weaker (p = .076, ηp2 = .06). Furthermore, DTC moderated the effect (p = .013, ηp2= .11). However, in Study 3 there was no clear evidence of an association between naturally occurring state anxiety and alcohol choice (b = 0.05, p = .655), or a moderating role of DTC (b = 0.01, p = .852). CONCLUSIONS Experimentally induced, but not naturally occurring, state anxiety increases alcohol choice, although state anxiety levels were lower in the non-manipulated sample.
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Affiliation(s)
- Maddy L Dyer
- UK Centre for Tobacco and Alcohol
Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative
Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Alexander G Board
- Department of Experimental Psychology,
University of Oxford, Oxford, UK
| | - Lee Hogarth
- School of Psychology, University of
Exeter, Exeter, UK
| | - Steph F Suddell
- UK Centre for Tobacco and Alcohol
Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative
Epidemiology Unit at the University of Bristol, Bristol, UK
- National Institute for Health Research
Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
| | - Jon E Heron
- Population Health Sciences, Bristol
Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- National Institute for Health Research
Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
- Population Health Sciences, Bristol
Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol
Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative
Epidemiology Unit at the University of Bristol, Bristol, UK
- National Institute for Health Research
Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
| | - Angela S Attwood
- UK Centre for Tobacco and Alcohol
Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative
Epidemiology Unit at the University of Bristol, Bristol, UK
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13
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Garey L, Zvolensky MJ, Spada MM. Third wave cognitive and behavioral processes and therapies for addictive behaviors: An introduction to the Special Issue. Addict Behav 2020; 108:106465. [PMID: 32480245 DOI: 10.1016/j.addbeh.2020.106465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Third wave cognitive and behavioral therapies have garnered significant attention in the study and treatment of addiction. Such treatments employ a process-oriented, transdiagnostic approach to mitigate problematic thought and behavioral patterns and consequences associated with substance use. Although initial evidence is promising, much remains unknown regarding the impact of third wave processes on substance use behavior and treatment outcomes. Additionally, more work is needed to elucidate the potential of novel third wave treatments on substance use outcomes. If proven successful, third wave processes and therapies may hold the key to disrupt the huge financial, societal, and personal burden associated with addiction. This Special Issue highlights recent, scientifically rigorous, clinically applicable advances in current understanding of third wave cognitive and behavioral processes and therapies for substance use. Research presented in this Special Issue covers topics ranging from the role and application of mindfulness in the etiology of substance use behavior, treatment outcomes, and familial support; the potential of transdiagnostic factors as important considerations for vulnerable groups; and the development and refinement of novel technological and integrated interventions. This Special Issue is organized into three parts classified as third wave processes and substance use behavior; third wave processes in traditional substance use treatment and their malleability; and third wave treatments for substance use among special populations. It is hoped that this issue will alert readers to the significance of this work, illustrate the many domains currently being explored via process-oriented, transdiagnostic treatment, and identify promising and impactful areas for research.
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Affiliation(s)
- Lorra Garey
- University of Houston, Department of Psychology, Fred J. Heyne Building, Suite 104, Houston, TX 77204, USA.
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Fred J. Heyne Building, Suite 104, Houston, TX 77204, USA; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, 1155 Pressler Street, Houston, TX 77030, USA; Health Institute, Houston, TX 77204, USA
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Hogarth L, Field M. Relative expected value of drugs versus competing rewards underpins vulnerability to and recovery from addiction. Behav Brain Res 2020; 394:112815. [PMID: 32707138 PMCID: PMC7495042 DOI: 10.1016/j.bbr.2020.112815] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/13/2022]
Abstract
Behavioural economic theories of addiction contend that greater expected value of drug relative to alternative non-drug rewards is the core mechanism underpinning vulnerability to and recovery from addiction. To evaluate this claim, we exhaustively review studies with human drug users that have measured concurrent choice between drugs vs. alternative rewards, and explored individual differences. These studies show that drug choice can be modulated by drug cues, drug devaluation, imposition of costs/punishment and negative mood induction. Regarding individual differences, dependence severity was reliably associated with overall drug preference, and self-reported drug use to cope with negative affect was reliably associated with greater sensitivity to mood induced increases in drug choice. By contrast, there were no reliable individual differences in sensitivity to the effect of drug cues, drug devaluation or punishment on drug choice. These findings provide insight into the mechanisms that underpin vulnerability to dependence: vulnerability is conferred by greater relative value ascribed to drugs, and relative drug value is further augmented by negative affective states in those who report drug use coping motives. However, dependence does not appear to be characterised by abnormal cue-reactivity, habit learning or compulsion. We then briefly review emerging literature which demonstrates that therapeutic interventions and recovery from addiction might be attributed to changes in the expected relative value of drug versus alternative rewards. Finally, we outline a speculative computational account of the distortions in decision-making that precede action selection in addiction, and we explain how this account provides a blueprint for future research on the determinants of drug choice, and mechanisms of treatment and recovery from addiction. We conclude that a unified economic decision-making account of addiction has great promise in reconciling diverse addiction theories, and neuropsychological evaluation of the underlying decision mechanisms is a fruitful area for future research and treatment.
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Affiliation(s)
- Lee Hogarth
- Lee Hogarth, School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, UK.
| | - Matt Field
- Department of Psychology, University of Sheffield
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Martín-Hernández P, Ramos J, Zornoza A, Lira EM, Peiró JM. Mindfulness and Job Control as Moderators of the Relationship between Demands and Innovative Work Behaviours. REVISTA DE PSICOLOGÍA DEL TRABAJO Y DE LAS ORGANIZACIONES 2020. [DOI: 10.5093/jwop2020a9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hogarth L. Addiction is driven by excessive goal-directed drug choice under negative affect: translational critique of habit and compulsion theory. Neuropsychopharmacology 2020; 45:720-735. [PMID: 31905368 PMCID: PMC7265389 DOI: 10.1038/s41386-020-0600-8] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 12/09/2019] [Accepted: 12/18/2019] [Indexed: 01/21/2023]
Abstract
Drug addiction may be a goal-directed choice driven by excessive drug value in negative affective states, a habit driven by strong stimulus-response associations, or a compulsion driven by insensitivity to costs imposed on drug seeking. Laboratory animal and human evidence for these three theories is evaluated. Excessive goal theory is supported by dependence severity being associated with greater drug choice/economic demand. Drug choice is demonstrably goal-directed (driven by the expected value of the drug) and can be augmented by stress/negative mood induction and withdrawal-effects amplified in those with psychiatric symptoms and drug use coping motives. Furthermore, psychiatric symptoms confer risk of dependence, and coping motives mediate this risk. Habit theory of addiction has weaker support. Habitual behaviour seen in drug-exposed animals often does not occur in complex decision scenarios, or where responding is rewarded, so habit is unlikely to explain most human addictive behaviour where these conditions apply. Furthermore, most human studies have not found greater propensity to habitual behaviour in drug users or as a function of dependence severity, and the minority that have can be explained by task disengagement producing impaired explicit contingency knowledge. Compulsion theory of addiction also has weak support. The persistence of punished drug seeking in animals is better explained by greater drug value (evinced by the association with economic demand) than by insensitivity to costs. Furthermore, human studies have provided weak evidence that propensity to discount cost imposed on drug seeking is associated with dependence severity. These data suggest that human addiction is primarily driven by excessive goal-directed drug choice under negative affect, and less by habit or compulsion. Addiction is pathological because negative states powerfully increase expected drug value acutely outweighing abstinence goals.
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Affiliation(s)
- Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
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Does acute stress influence the Pavlovian-to-instrumental transfer effect? Implications for substance use disorders. Psychopharmacology (Berl) 2020; 237:2305-2316. [PMID: 32506233 PMCID: PMC7351872 DOI: 10.1007/s00213-020-05534-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/22/2020] [Indexed: 11/25/2022]
Abstract
RATIONAL The ability of conditioned stimuli to affect instrumental responding is a robust finding from animal as well as human research and is assumed as a key factor regarding the development and maintenance of addictive behaviour. OBJECTIVES While it is well known that stress is an important factor for relapse after treatment, little is known about the impact of stress on conditioned substance-associated stimuli and their influence on instrumental responding. METHODS We administered in the present study a Pavlovian-to-instrumental transfer (PIT) paradigm with stimuli associated with smoking- and chocolate-related rewards using points in a token economy to light to moderate smokers who also indicated to like eating chocolate. After completion of the first two phases of the PIT paradigm (i.e. Pavlovian training and instrumental trainings), participants were randomly allocated to the socially evaluated cold pressor test or a control condition before the final phase of the PIT paradigm, the transfer phase, was administered. RESULTS The presentation of a smoking-related stimulus enhanced instrumental responding for a smoking-related reward (i.e. 'smoking-PIT' effect) and presentation of a chocolate-related stimulus for a chocolate-related reward (i.e. 'chocolate-PIT' effect) in participants aware of the experimental contingencies as indicated by expectancy ratings. However, acute stress did not change (i.e. neither enhanced nor attenuated) the 'smoking-PIT' effect or the 'chocolate-PIT' effect, and no overall effect of acute stress on tobacco choice was observed in aware participants. CONCLUSIONS The established role of stress in addiction appears not to be driven by an augmenting effect on the ability of drug stimuli to promote drug-seeking.
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