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Flynt S, Koscinski B, Accorso C, Knapp A, Gorka S, Suhr J, Austin M, Allan NP. A One-Arm Pilot Trial of a Telehealth CBT-Based Group Intervention Targeting Transdiagnostic Risk for Emotional Distress. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.23.24306218. [PMID: 38712129 PMCID: PMC11071586 DOI: 10.1101/2024.04.23.24306218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
The COVID-19 pandemic had a significant impact on mental health, straining an already overburdened healthcare system. A modular, transdiagnostic approach to treating psychopathology may be ideal to target common transdiagnostic risk factors for emotional distress and related disorders likely to be impacted by circumstances related to this once-in-a-lifetime environmental stressor. Anxiety sensitivity (AS), or fear of anxious arousal, intolerance of uncertainty (IU), or distress when confronted with uncertainty, and loneliness are three transdiagnostic risk factors impacted by the pandemic and robust predictors of emotional distress beyond that. We completed a pilot feasibility, acceptability, and utility trial of Coping Crew, our group, telehealth-delivered transdiagnostic treatment protocol in 17 participants who completed the intervention (M age = 22.00, SD = 4.46; 71% female). The intervention and study protocol were feasible to deliver and were rated as acceptable and useful to address intervention targets. Evidence was mixed regarding feasibility, acceptability, and usefulness of the mobile app component. Sixteen of 17 participants (94%) completed at least one survey a day on 80% of the days but only 6 participants (35%) completed at least 80% of the mobile app surveys delivered over the course of the intervention. Most participants rated use of the app as acceptable and relevant to psychological improvements made due to the intervention. Sizeable effect size reductions in transdiagnostic risk factors were found at post-intervention and maintained at 1- and 3-month follow-up, supporting next steps in the development of this modular transdiagnostic treatment.
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Affiliation(s)
- Sierra Flynt
- Department of Psychology, Ohio University, Athens, OH, USA
| | | | | | - Ashley Knapp
- Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Stephanie Gorka
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
| | | | | | - Nicholas P. Allan
- Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, United States
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2
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Kim AJ, Stewart SH, Sherry SB, McGrath DS, Mushquash CJ, Olthuis JV, Mushquash AR. Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates. Eat Behav 2024; 52:101843. [PMID: 38217932 DOI: 10.1016/j.eatbeh.2024.101843] [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: 08/15/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.
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Affiliation(s)
- Andy J Kim
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada.
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Simon B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, B3H4R2, Canada; Department of Psychiatry, Dalhousie University, B3H2E2, Canada.
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, T2N1N4, Canada.
| | | | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, E3B5A3, Canada.
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3
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Schmidt NB, Capron D, Raines AM, Albanese B, Short N, Mathes BM, Morabito DM, Saulnier K, Allan N. Evaluating the long-term (Three Year) durability of brief interventions targeting risk factors for psychopathology. J Anxiety Disord 2023; 96:102710. [PMID: 37058765 DOI: 10.1016/j.janxdis.2023.102710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/28/2023] [Accepted: 03/31/2023] [Indexed: 04/16/2023]
Abstract
Despite their brevity, prior work indicates that computer-based interventions can substantially impact risk factors for psychopathology including anxiety sensitivity (AS), thwarted belongingness (TB), and perceived burdensomeness (PB). However, very few studies have assessed the long-term (> 1 year) effects of these interventions. The primary aim of the current study was to evaluate post-hoc, the long-term (3 year) durability of brief interventions targeting risk factors for anxiety and mood psychopathology using data from a pre-registered randomized clinical trial. Moreover, we were interested in evaluating whether mitigation in these risk factors mediated long-term symptom change. A sample determined to be at-risk for anxiety and mood pathology based on elevations on several risk factors (N = 303) was randomly assigned to one of four experimental conditions focused on: (1) reducing TB and PB; (2) reducing AS, (3) reducing TB,PB, and AS; or (4) a repeated contact control condition. Participants were assessed at post-intervention, one, three, six, 12, and 36 month follow-ups. Participants in the active treatment conditions showed sustained reductions in AS and PB through long-term follow-up. Mediation analyses suggested that reductions in AS mediated long-term reductions in anxiety and depression symptoms. These findings suggest that brief and scalable risk reduction protocols have long-term durability and efficacy both in terms of reducing risk factors for psychopathology.
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Affiliation(s)
- Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA.
| | - Daniel Capron
- School of Psychology, University of Southern Mississippi, 118 College Dr., Hattiesburg, MS 39406, USA
| | - Amanda M Raines
- School of Medicine, Louisiana State University, New Orleans, LA 70112, USA; Southeast Louisiana Veterans Healthcare System, 2400 Canal Street, New Orleans, LA 70119, USA
| | - Brian Albanese
- Department of Psychological & Brain Sciences, Texas A&M University, 4235 TAMU, College Station, TX 77843, USA
| | - Nicole Short
- Department of Psychology, University of Nevada Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, USA
| | - Brittany M Mathes
- Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA
| | - Danielle M Morabito
- Department of Psychology, Florida State University, 1107 W Call Street, Tallahassee, FL 32304, USA
| | - Kevin Saulnier
- Department of Psychology, Ohio University, Porter 200, Athens, OH 45701, USA
| | - Nicholas Allan
- Department of Psychology, Ohio University, Porter 200, Athens, OH 45701, USA
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4
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Yue Y, Zou L, Li H, Xia Y, Ren Z, Yang F, Kong D, Re G, Luo H, Zhang Z, Wang K, Zhu M. Therapeutic effect of implanted and non-invasive vagus nerve stimulation on heroin-induced anxiety. Biochem Biophys Res Commun 2023; 652:46-54. [PMID: 36809704 DOI: 10.1016/j.bbrc.2023.02.041] [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: 01/25/2023] [Revised: 02/01/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Abstract
Substance addiction causes anxiety, which in turn reinforces the maintaining of substance use, resulting in a vicious circle. And this circle is one of the reasons why addiction is so hard to cure. However, there is no treatment involved in addiction-induced anxiety at present. We tested whether VNS (vagus nerve stimulation) can improve heroin-induced anxiety, and made a comparison between nVNS (transcervical vagus nerve stimulation) and taVNS (transauricular vagus nerve stimulation) on therapeutic effect. Mice were subjected to nVNS or taVNS before heroin administration. By observing c-Fos expression in the NTS (nucleus of the solitary tract), we assessed vagal fiber activation. Using the OFT (open field test) and the EPM (elevated cross maze test), we evaluated the anxiety-like behaviors of the mice. Using immunofluorescence, we observed the proliferation and activation of microglia in the hippocampus. And ELISA was used to measure the levels of proinflammatory factors in the hippocampus. Both nVNS and taVNS significantly increased the expression of c-Fos in the nucleus of solitary tract, suggesting the feasibility of nVNS and taVNS. The anxiety level of heroin-treated mice was significantly increased, microglia in the hippocampus was significantly proliferated and activated, and the proinflammatory factors (IL-1β, IL-6, TNF-α) in the hippocampus were significantly up-regulated. Crucially, both nVNS and taVNS reversed the above changes caused by heroin addiction. SIGNIFICANCE: It was confirmed that the therapeutic effect of VNS on heroin-induced anxiety may be an effective treatment method to break the "addiction-anxiety" cycle and provides some insights for subsequent treatment of addiction.
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Affiliation(s)
- Yingbiao Yue
- National Health Commission Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, 650032, China
| | - Lei Zou
- Department of Hepatobiliary Surgery, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan, China
| | - Hong Li
- Narcotics Control Bureau of the Ministry of Public Security of Yunnan Province, Kunming, 650032, China
| | - Yu Xia
- Peking University Health Science Center, Beijing, 100191, China
| | - Zhouyang Ren
- Narcotics Control Bureau of the Ministry of Public Security of Yunnan Province, Kunming, 650032, China
| | - Fazhen Yang
- Narcotics Control Bureau of the Ministry of Public Security of Yunnan Province, Kunming, 650032, China
| | - Deshenyue Kong
- National Health Commission Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, 650032, China
| | - Guofen Re
- National Health Commission Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, 650032, China
| | - Huayou Luo
- Department of Gastrointestinal and Hernia Surgery, First Affiliated Hospital of Kunming Medical University, Kunming, 650032, China
| | | | | | - Mei Zhu
- First Affiliated Hospital of Kunming Medical University, Kunming, China.
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5
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Zvolensky MJ, Shepherd JM, Clausen BK, Kabel KE, Kauffman BY, Garey L, McGrew SJ, Vujanovic AA. Anxiety Sensitivity Among Trauma-Exposed Non-Hispanic Black Adults: Relations to Posttraumatic Stress. J Nerv Ment Dis 2023; 211:273-280. [PMID: 36252272 PMCID: PMC10049966 DOI: 10.1097/nmd.0000000000001609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The non-Hispanic Black population experiences trauma-related disparities. One potentially important individual difference construct for posttraumatic stress is anxiety sensitivity. There is limited work on anxiety sensitivity among non-Hispanic Black persons, and no research has focused on this construct in terms of posttraumatic stress among this population. This study sought to build on this limited knowledge by exploring whether this construct was uniquely associated with more severe posttraumatic stress among this population. Participants included non-Hispanic Black trauma-exposed adults ( N = 121; Mage = 21.79 years). Results indicated that anxiety sensitivity was related to more severe overall posttraumatic stress and greater severity of each posttraumatic stress symptom cluster; all effects were evident after adjusting for the variance accounted for by age, sex, education, subjective social status, neuroticism, and number of traumatic event types experienced (lifetime). The study provides the first empirical evidence that, among a trauma-exposed non-Hispanic Black sample of adults, anxiety sensitivity is related to more severe posttraumatic stress symptoms. This intraindividual difference factor could be a focus of intervention programming for this trauma disparity population.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | | | - Bryce K. Clausen
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Shelby J. McGrew
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
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6
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Psarianos A, Chryssanthopoulos C, Paparrigopoulos T, Philippou A. The Role of Physical Exercise in Opioid Substitution Therapy: Mechanisms of Sequential Effects. Int J Mol Sci 2023; 24:ijms24054763. [PMID: 36902190 PMCID: PMC10003472 DOI: 10.3390/ijms24054763] [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: 01/07/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
It is generally accepted that chronic opioid use is associated with structural and functional changes in the human brain that lead to an enhancement of impulsive behavior for immediate satisfaction. Interestingly, in recent years, physical exercise interventions have been used as an adjunctive treatment for patients with opioid use disorders (OUDs). Indeed, exercise has positive effects on both the biological and psychosocial basis of addiction, modifying neural circuits such as the reward, inhibition, and stress systems, and thus causing behavioral changes. This review focuses on the possible mechanisms that contribute to the beneficial effects of exercise on the treatment of OUDs, with emphasis placed on the description of a sequential consolidation of these mechanisms. Exercise is thought to act initially as a factor of internal activation and self-regulation and eventually as a factor of commitment. This approach suggests a sequential (temporal) consolidation of the functions of exercise in favor of gradual disengagement from addiction. Particularly, the sequence in which the exercise-induced mechanisms are consolidated follows the pattern of internal activation-self-regulation-commitment, eventually resulting in stimulation of the endocannabinoid and endogenous opioid systems. Additionally, this is accompanied by modification of molecular and behavioral aspects of opioid addiction. Overall, the neurobiological actions of exercise in combination with certain psychological mechanisms appear to promote its beneficial effects. Given the positive effects of exercise on both physical and mental health, exercise prescription is recommended as a complement to conventional therapy for patients on opioid maintenance treatment.
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Affiliation(s)
- Alexandros Psarianos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Thomas Paparrigopoulos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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7
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Zvolensky MJ, Kauffman BY, Smit T, Matoska CT, Mayorga NA, Gallagher M, Garey L. Anxiety sensitivity and its association with perceived barriers for quitting, smoking inflexibility, and severity of quit problems among Black smokers. J Ethn Subst Abuse 2022:1-18. [PMID: 36190317 PMCID: PMC10067536 DOI: 10.1080/15332640.2022.2129538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
Black individuals who smoke in the United States experience health disparities related to tobacco use (e.g., greater nicotine dependence, less success in quitting smoking) and interoceptive distress (e.g., somatic symptoms, anxiety). Individual difference factors that amplify interoceptive distress and contribute to poorer smoking behaviors and outcomes warrant further attention and investigation. Thus, the present study sought to explore the association between anxiety sensitivity and clinically-relevant smoking variables of perceived barriers for quitting, smoking inflexibility, and problems experienced during past quit attempts. Participants in the current study included 98 Black adult smokers (71.4% male; Mage = 44.08 years, SD = 11.44 years). Results indicated greater levels of anxiety sensitivity were associated with greater levels of perceived barriers for quitting smoking (b = 0.10, SE = 0.08, p = 0.01), smoking inflexibility (b = 0.02, SE <.001, p <.001), and problems experienced during past smoking quit attempts (b = 0.17, SE = 0.07, p = 0.02). Clinical implications and future directions are further discussed as it relates to anxiety sensitivity and efforts to reduce or quit smoking for this health disparities population.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | | | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Matthew Gallagher
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
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8
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Zvolensky MJ, Kauffman BY, Garey L, Buckner JD. Abstinence phobia among adult African American/Black cannabis users. Addict Behav 2022; 132:107344. [PMID: 35569320 PMCID: PMC10029065 DOI: 10.1016/j.addbeh.2022.107344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE African American/Black individuals experience significant health disparities, particularly as it relates to cannabis use. As such, there is a need to identify intrapersonal factors related to more severe patterns of use among this subpopulation. Worry about quitting or reducing cannabis as a result of the anticipated anxiety-related states during deprivation (i.e., abstinence phobia) is one factor that is theoretically important in the context of cannabis-related disparities. METHOD The current study sought to examine the cross-sectional association between abstinence phobia and cannabis use problems, perceived barriers for cannabis cessation, and cannabis withdrawal symptoms. Participants included 83 African American/Black cannabis users (31.3% female, Mage = 38.12, SD = 10.42). RESULTS Cannabis abstinence phobia was associated with greater severity of cannabis use problems, more perceived barriers for quitting cannabis use, and more severe cannabis withdrawal symptoms. CONCLUSIONS Abstinence phobia may represent an underrecognized intervention target for addressing cannabis use problems and quit success.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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Gokarakonda SB, Boydstun JM, Yilanli M, Han X, Kumar N, Oliveto AH, Mancino MJ. Impact of state and trait anxiety severity on retention and phase advancement in an outpatient buprenorphine treatment program. Am J Addict 2022; 31:219-225. [PMID: 35243715 DOI: 10.1111/ajad.13266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/19/2022] [Accepted: 02/06/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Comorbid anxiety is common among buprenorphine patients and may lead to poorer outcomes. This study aimed to examine the prevalence and impact of anxiety severity, measured by the State-Trait Anxiety Inventory (STAI) form Y-1 & Y2 scale, on treatment outcomes (retention and phase advancement) among outpatient buprenorphine-treated patients. METHODS A retrospective chart review of 94 patients admitted to an outpatient buprenorphine treatment program was conducted. Patients were dichotomized into high and low severity groups based upon an STAI State Anxiety (S-Anxiety) and STAI Trait Anxiety (T-Anxiety) score ≥60 and <60, respectively. Associations of anxiety severity on successful phase advancement and retention during the first 90 days of treatment were assessed. RESULTS Twenty-one of 94 (22%) participants reported high S-Anxiety and had a significantly greater likelihood of phase advancement (OR = 12.80, 95% CI = [1.19, 136.71]) than those with low S-Anxiety. No significant associations were found between either S-Anxiety or T-Anxiety and treatment retention. Current alcohol use and UDS negative test results for THC or amphetamines were each associated with phase advancement. THC negative UDS test results were associated with 90-day treatment retention. DISCUSSION AND CONCLUSIONS Contrary to prior reports, buprenorphine patients with higher state anxiety severity demonstrated similar retention and more rapid phase advancement than those with lower state anxiety severity. SCIENTIFIC SIGNIFICANCE To our knowledge, this is the first study to quantify current anxiety severity using the STAI scale and evaluate its impact on treatment outcomes among buprenorphine-treated patients.
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Affiliation(s)
- Srinivasa B Gokarakonda
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jacob M Boydstun
- Addiction Psychiatrist, Springwoods Behavioral Health, Fayetteville, Arkansas, USA
| | - Musa Yilanli
- Department of Psychiatry, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Xiaotong Han
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Nihit Kumar
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Alison H Oliveto
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Michael J Mancino
- Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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10
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Clark AE, Goodwin SR, Marks RM, Belcher AM, Heinlein E, Bennett ME, Roche DJO. A Narrative Literature Review of the Epidemiology, Etiology, and Treatment of Co-Occurring Panic Disorder and Opioid Use Disorder. J Dual Diagn 2021; 17:313-332. [PMID: 34582313 PMCID: PMC9487392 DOI: 10.1080/15504263.2021.1965407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Panic disorder is a debilitating psychiatric disorder that often co-occurs with substance use disorders. Given the current opioid epidemic, the high reported rates of comorbid panic disorder and opioid use disorder are particularly concerning. In this narrative review, we describe the literature on panic disorder and opioid use disorder co-occurrence. METHODS 86 studies, 26 reviews, 2 commentaries, and 5 guidelines pertaining to opioid use disorder, panic disorder, and their comorbidity were identified using all EBSCO databases, PubMed, and Google Scholar. RESULTS First, we review epidemiological literature on the prevalence of the comorbid condition above and beyond each disorder on its own. Additionally, we discuss the challenges that complicate the differential diagnosis of panic disorder and opioid use disorder and contribute to difficulties establishing rates of comorbidity. Second, we review three theoretical models that have been proposed to explain high rates of co-occurring panic disorder and opioid use disorder: the precipitation hypothesis, the self-medication hypothesis, and the shared vulnerability hypothesis. Third, we outline how co-occurring panic and opioid use disorder may impact treatment for each condition. CONCLUSION Based on findings in the field, we provide recommendations for future research as well as treatment considerations for co-occurring panic and opioid use disorders.
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Affiliation(s)
- Ashton E Clark
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | - Shelby R Goodwin
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | | | | | - Emily Heinlein
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
| | - Melanie E Bennett
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA.,Baltimore VA Medical Center, Baltimore, Maryland, USA
| | - Daniel J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, Maryland, USA
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11
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Pridy CB, Watt MC, Romero-Sanchiz P, Lively CJ, Stewart SH. Reasons for Listening to Music Vary by Listeners' Anxiety Sensitivity Levels. J Music Ther 2021; 58:463-492. [PMID: 34453176 DOI: 10.1093/jmt/thab014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Listening to music aids regulation of emotional arousal and valence (positive vs. negative). Anxiety sensitivity (AS; fear of arousal-related sensations) increases the risk for emotion dysregulation and associated coping behaviors such as substance use and exercise avoidance. The relationship between AS and music listening, however, has received very little attention. This study (1) used exploratory factor analysis of 53 items drawn from three previously validated measures of reasons for music listening to identify the core reasons for listening to music among university students and (2) explored associations between AS and reasons for music listening. Undergraduates (N = 788; 77.7% women; Mage = 19.20, SDage = 2.46) completed the Anxiety Sensitivity Index-3, Motives for Listening to Music Questionnaire, Barcelona Musical Reward Questionnaire, and Brief Music in Mood Regulation Scale. Six core reasons for music listening were identified: Coping, Conformity, Revitalization, Social Enhancement, Connection, and Sensory-Motor. Over and above age and gender, AS was associated with Coping and Conformity-reasons that involve relief from aversive emotions. AS also was associated with listening for Connection reasons. AS was not associated with Revitalization, Social Enhancement, or Sensory-Motor-reasons that involve rewards such as heightened positive emotions. Results suggest that individual differences may influence why people incorporate music listening into their day-to-day lives. Further longitudinal and experimental research is needed to establish directionality and causality in the observed relationship of AS to relief-oriented reasons for music listening. Findings may guide music therapists' efforts to tailor treatment for individuals at risk for anxiety and related mental health problems.
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Affiliation(s)
| | - Margo C Watt
- Dalhousie University, Halifax, NS, Canada.,St. Francis Xavier University, Antigonish, NS, Canada
| | | | - Christopher J Lively
- St. Francis Xavier University, Antigonish, NS, Canada.,Memorial University of Newfoundland, St. John's, NL, Canada
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12
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Raines AM, Ennis CR, Allan NP, McGrew SJ, Walton JL, Rogers AH, Zvolensky MJ, Schmidt NB, Laurel Franklin C. Anxiety sensitivity and substance use: Differential levels across individuals primarily using opioids, cannabis, or stimulants. Addict Behav 2021; 116:106791. [PMID: 33497865 DOI: 10.1016/j.addbeh.2020.106791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants. METHODS The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital. RESULTS AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis. CONCLUSIONS Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.
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13
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Rogers AH, Zvolensky MJ, Ditre JW, Buckner JD, Asmundson GJG. Association of opioid misuse with anxiety and depression: A systematic review of the literature. Clin Psychol Rev 2021; 84:101978. [PMID: 33515811 DOI: 10.1016/j.cpr.2021.101978] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/19/2020] [Accepted: 11/29/2020] [Indexed: 12/14/2022]
Abstract
The opioid epidemic is a public health problem associated with a host of negative outcomes. Although clinicians recognize covariation between opioid misuse with anxiety and depressive symptoms and disorders, research on this topic has only recently accumulated. Progress in this domain is impeded by the lack of systematic and integrative research to better understand and treat these co-occurring problems. This paper represents the first attempt to systematically review the empirical literature examining relations between opioid use and misuse, and anxiety and depression. In the first section, we define key terms and describe the article selection strategy. In the second section, we review the prevalence of anxiety and depressive symptoms among individuals who use and misuse prescription and illicit opioids. In the third section, we review the magnitude of associations between anxiety and depressive symptoms and disorders with opioid misuse, as well as highlight studies examining the longitudinal and temporal sequence of the relations between these variables. In the fourth section, we focus on experimental therapeutics, reviewing what is known about individual difference and transdiagnostic vulnerability factors for anxiety and depression that might contribute to opioid misuse and its symptoms. Finally, we discuss current knowledge gaps and present a heuristic model to guide future research.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; HEALTH Institute, University of Houston, Houston, TX, United States.
| | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, United States
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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14
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Garke MÅ, Isacsson NH, Sörman K, Bjureberg J, Hellner C, Gratz KL, Berghoff CR, Sinha R, Tull MT, Jayaram-Lindström N. Emotion dysregulation across levels of substance use. Psychiatry Res 2021; 296:113662. [PMID: 33406445 DOI: 10.1016/j.psychres.2020.113662] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022]
Abstract
Emotion dysregulation has shown to be of importance in the onset and maintenance of psychiatric disorders, including substance use disorders. How difficulties in emotion regulation differ across levels of substance use, and whether these relations are influenced by co-occurring psychiatric disorders, is less clear. This study aimed to identify difficulties in emotion regulation across the spectrum of substance use and evaluate the influence of co-occurring psychiatric symptoms. Self-reported emotion regulation difficulties, substance use, and other psychiatric symptoms were assessed in one community sample (n = 843) and two inpatient clinics, with substance use disorder populations (n = 415). Data were merged and analyzed with regression models and correlations. Emotion dysregulation was distributed across different levels of substance use, and significantly associated with substance use severity and frequency. High substance use severity and frequency was significantly associated with high scores on the emotion dysregulation facet specifically involving difficulties controlling impulsive behaviors. Psychiatric symptoms did not significantly influence the association between substance use and emotion dysregulation. Results indicate an association between emotion dysregulation and the frequency and severity of substance use, and also suggest that difficulties controlling impulsive behaviors may be a potentially useful treatment target for individuals with substance dependence.
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Affiliation(s)
- Maria Å Garke
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden.
| | - Nils Hentati Isacsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Karolina Sörman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Johan Bjureberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Clara Hellner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Kim L Gratz
- Department of Psychology, University of Toledo, USA
| | | | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, Yale University, USA.
| | | | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
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15
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Anxiety and Opioid Use Disorder: Potential Targets for Treatment and Prevention. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-020-00350-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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16
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Stathopoulou G, Gold AK, Hoyt DL, Milligan M, Hearon BA, Otto MW. Does anxiety sensitivity predict addiction severity in opioid use disorder? Addict Behav 2021; 112:106644. [PMID: 32987306 DOI: 10.1016/j.addbeh.2020.106644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/03/2020] [Accepted: 09/02/2020] [Indexed: 01/23/2023]
Abstract
Increased anxiety sensitivity (AS), or the fear of anxiety-related cognitive, social, and physical symptoms which are misinterpreted as having harmful implications, has shown a relationship with substance use disorders. People with substance use disorders also experience addiction-related problems across domains of life functioning. However, few studies have evaluated the relationship between elevated AS and addiction-related problems across specific life areas. We evaluated, first, whether AS predicted addiction-related problems in a sample of treatment-refractory outpatients with opioid use disorders and, second, whether sex moderated the relationship between AS and addiction-related problems in this sample. Participants with treatment-refractory opioid use disorders (n = 92, 53.3% male) completed baseline assessments of AS (the Anxiety Sensitivity Index) and addiction-related problems (the Addiction Severity Index). Baseline AS total score was a significant independent predictor of both baseline Addiction Severity Index medical status (β = 0.29, t = 2.84, p = .006) and psychiatric status (β = 0.30, t = 2.99, p = .004) composite scores but was not associated with social, employment or legal difficulties. These findings were maintained when controlling for drug use severity, though baseline AS total score became a significant predictor of baseline legal difficulties (β = -0.23, t = -2.25, p = .027). There was no moderating role of sex on the relationship between baseline AS and addiction-related problems. Our findings suggest that, regardless of sex, elevated AS predicts increased addiction-related medical and psychiatric problems, and decreased legal problems when accounting for drug use severity, in outpatients with opioid use disorders.
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17
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Stewart JL, Khalsa SS, Kuplicki R, Puhl M, T1000 Investigators, Paulus MP. Interoceptive attention in opioid and stimulant use disorder. Addict Biol 2020; 25:e12831. [PMID: 31617639 DOI: 10.1111/adb.12831] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 08/05/2019] [Accepted: 08/25/2019] [Indexed: 12/20/2022]
Abstract
Blunted anterior insula activation during interoceptive perturbations has been associated with stimulant (cocaine and amphetamine) use disorder (SUD) and is related to risk for and prognosis of SUD. However, little is known whether these interoceptive alterations extend to opioid use disorder (OUD). This exploratory study used the same experimental probe during functional magnetic resonance imaging (fMRI) to test the hypothesis that SUD and OUD exhibit interoceptive discrepancies characterized by subjective ratings and activation within the insula. Recently, abstinent individuals diagnosed with current SUD (n = 40) or current OUD (n = 20) were compared with healthy individuals (CTL; n = 30) on brain and self-report responses during an interoceptive attention task known to elicit insula activation. Participants selectively attended to interoceptive (heartbeat and stomach) and exteroceptive signals during blood-oxygen-level-dependent fMRI recording. Groups and conditions were compared on (a) activation within probabilistic cytoarchitectonic segmentations of the insula and (b) self-reported stimulus intensity. First, SUD showed amplified ratings of heart-related sensations but attenuation of dorsal dysgranular insula activity relative to CTL. Amplified ratings were linked to drug use recency, while attenuation was normalized with greater past-year stimulant use. Second, SUD and OUD showed attenuation of dorsal dysgranular insula activity during attention to stomach sensations relative to CTL. Taken together, these results are consistent with altered neural processing of interoceptive signals in drug addiction, particularly as a function of SUD. Future studies will need to determine whether interoceptive metrics help to explain substance use disorder pathophysiology and are useful for predicting outcomes.
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Affiliation(s)
- Jennifer L. Stewart
- Laureate Institute for Brain Research Tulsa Oklahoma USA
- Department of Community Medicine, Oxley Health Sciences University of Tulsa Tulsa Oklahoma USA
| | - Sahib S. Khalsa
- Laureate Institute for Brain Research Tulsa Oklahoma USA
- Department of Community Medicine, Oxley Health Sciences University of Tulsa Tulsa Oklahoma USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research Tulsa Oklahoma USA
| | - Maria Puhl
- Laureate Institute for Brain Research Tulsa Oklahoma USA
| | | | - Martin P. Paulus
- Laureate Institute for Brain Research Tulsa Oklahoma USA
- Department of Community Medicine, Oxley Health Sciences University of Tulsa Tulsa Oklahoma USA
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18
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A computerized anxiety sensitivity intervention for opioid use disorders: A pilot investigation among veterans. Addict Behav 2020; 104:106285. [PMID: 32006788 DOI: 10.1016/j.addbeh.2019.106285] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/26/2019] [Accepted: 12/30/2019] [Indexed: 11/20/2022]
Abstract
The opioid epidemic is having a disproportionate impact on veterans. Indeed, veterans are twice as likely to die from an accidental overdose than members of the general population, even after accounting for gender and age distribution. Although many veterans seek treatment, a large proportion drop out prematurely and/or relapse highlighting the need to identify malleable factors that may contribute to the recovery process. One such variable is anxiety sensitivity (AS; i.e., fear of anxious arousal). AS is elevated in opioid use populations and is a predictor of treatment dropout among opioid users. Importantly, research suggests that AS is highly malleable; although, no studies have systematically examined such protocols among opioid users. To this end, the purpose of the proposed study was to test the acceptability, feasibility, and utility of a brief, one-session Computerized Anxiety Sensitivity Treatment (termed CAST) delivered to veterans seeking services for an opioid use disorder (OUD). Veterans (n = 16) were assessed at baseline and also at one-week and one-month following CAST. All veterans completed the protocol and reported being interested and engaged during the intervention. Further, small to medium reductions in psychopathology and substance use outcomes were found. Although more work is needed, the current study provides preliminary support for the effectiveness of a brief AS-focused intervention among veterans seeking treatment for an OUD.
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19
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Langdon KJ, Ramsey S, Scherzer C, Carey K, Ranney ML, Rich J. Development of an integrated digital health intervention to promote engagement in and adherence to medication for opioid use disorder. Addict Sci Clin Pract 2020; 15:16. [PMID: 32349790 PMCID: PMC7191734 DOI: 10.1186/s13722-020-00189-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/17/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Buprenorphine-naloxone is an evidence-based treatment for Opioid Use Disorder. However, despite its efficacy, nearly half of participants are unsuccessful in achieving stabilization (i.e., period of time following medication induction in which medication dose is adjusted to be effective in reducing cravings/withdrawal, minimize potential side effects, and eliminate illicit substance use). This paper presents the study design and protocol for a digital health intervention designed to promote engagement in and adherence to buprenorphine treatment, offered through an outpatient addiction treatment center, through motivational enhancement and distress tolerance skills training. Personalized feedback interventions represent a promising method to effectively motivate engagement in and adherence to buprenorphine treatment. These interventions are generally brief, individually tailored, and have the potential to be delivered via mobile platforms. Distress tolerance, a transdiagnostic vulnerability factor, has been implicated in the development and maintenance of substance use. Targeting distress tolerance may improve substance use treatment outcomes by promoting the ability to persist in goal-directed activity even when experiencing physical or emotional distress. METHODS The study aims are to: (1) develop and refine an interactive computer- and text message-delivered personalized feedback intervention that incorporates distress tolerance skills training for persons who have elected to initiate outpatient buprenorphine treatment (iCOPE); (2) examine the feasibility, acceptability, and preliminary efficacy of iCOPE for increasing abstinence, adherence, and retention in treatment compared to a treatment as usual comparison condition; and, (3) examine potential mechanisms that may underlie the efficacy of iCOPE in improving outcomes, including motivation, distress tolerance, self-regulation, and negative affect. DISCUSSION Results of this study will be used to determine whether to proceed with further testing through a large-scale trial. This work has the potential to improve treatment outcomes by reducing illicit opioid use, increasing adherence/retention, and preventing future overdose and other complications of illicit opioid use. Trial Registration NCT03842384.
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Affiliation(s)
- Kirsten J Langdon
- Department of Psychiatry, Rhode Island Hospital, 146 West River Street, Suite 11A, Providence, RI, 02904, USA.
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, USA.
| | - Susan Ramsey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, USA
- Department of Medicine, Alpert Medical School of Brown University, Providence, USA
- Division of General Internal Medicine, Department of Medicine, Rhode Island Hospital, Providence, USA
| | - Caroline Scherzer
- Department of Psychiatry, Rhode Island Hospital, 146 West River Street, Suite 11A, Providence, RI, 02904, USA
- Department of Emergency Medicine, Alpert Medical School Brown University, Providence, USA
| | - Kate Carey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, USA
- Brown University School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA
| | - Megan L Ranney
- Department of Emergency Medicine, Alpert Medical School Brown University, Providence, USA
- Emergency Digital Health Innovation Program, Brown University, Providence, USA
| | - Josiah Rich
- Department of Medicine, Alpert Medical School of Brown University, Providence, USA
- Department of Epidemiology, Brown University School of Public Health, Providence, USA
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20
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Kelly ME, Guillot CR, Quinn EN, Lucke HR, Bello MS, Pang RD, Leventhal AM. Anxiety sensitivity in relation to cigarette smoking and other substance use in African American smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:669-679. [PMID: 32162964 DOI: 10.1037/adb0000573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety sensitivity (AS)-fearfulness of anxiety symptoms-has been implicated in the etiology of emotional disorders (e.g., depressive and anxiety disorders) and linked to cigarette smoking and other substance use (SU). However, studies examining AS in relation to SU primarily have been conducted with racially/ethnically heterogeneous or mostly European American samples. Hence, this cross-sectional study involving secondary analysis of baseline data focused on investigating associations of AS with cigarette smoking and other SU in a sample of 630 non-treatment-seeking African American smokers (37.3% female; M age = 49.6 years; M cigarettes smoked per day = 15.4). After screening out individuals with non-nicotine substance dependence, participants reported their demographics, AS, dysphoria symptoms (i.e., depression and anxiety symptoms), and SU. In regression analyses controlling for dysphoria symptoms, age, education level, income level, and years of regular smoking, AS was positively associated with tobacco withdrawal severity (β = .12, p = .007), overall smoking motives (β = .17, p < .001), alcohol use problems (β = .12, p = .005), and other (non-nicotine, nonalcohol) SU problems (β = .16, p < .001). Though lacking the passage of time between assessments needed to provide strong evidence of mediation, unplanned analyses further revealed indirect associations of AS with several SU variables through dysphoria symptoms. Current findings are consistent with those found in prior samples and suggest that AS is similarly related to SU in African Americans, who may benefit from interventions that have been helpful in improving AS, dysphoria symptoms, and SU in other groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Mariel S Bello
- Department of Psychology, University of Southern California
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
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21
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Zvolensky MJ, Rogers AH, Shepherd JM, Vujanovic AA, Bakhshaie J. Anxiety sensitivity and opioid misuse and dependence among trauma-exposed adults with chronic pain. J Behav Med 2020; 43:174-184. [PMID: 32072365 DOI: 10.1007/s10865-020-00142-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 02/14/2020] [Indexed: 12/12/2022]
Abstract
It is unclear if anxiety sensitivity may serve as mechanism underlying the relation between posttraumatic stress symptom severity and opioid misuse and dependence among trauma-exposed persons with chronic pain. Therefore, the current study evaluated the explanatory role of anxiety sensitivity in the relations between posttraumatic stress symptom severity and opioid misuse and dependence. Participants included 294 trauma-exposed adults with chronic pain (71.4% female, Mage = 37.79 years, SD = 10.85, Mpain rating = 7.32/10) that reported current moderate to severe chronic pain and prescription opioid use. Participants were recruited via an online national survey in the United States of America. There were statistically significant indirect effects of posttraumatic stress symptom severity via anxiety sensitivity in relation to opioid misuse and dependence. The indirect effects of the reverse models for opioid misuse and dependence also were significant and suggest the potential for bi-directional relations; however, the magnitude of the effect was smaller in the tests of specificity than in the original models. The present findings provide initial empirical evidence that greater posttraumatic stress symptom severity is related to anxiety sensitivity, which in turn, is associated with increased opioid misuse and dependence among trauma-exposed individuals with chronic pain.
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Affiliation(s)
- Michael J Zvolensky
- Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA.
- Department of Behavioral Sciences, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| | - Andrew H Rogers
- Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA
| | - Justin M Shepherd
- Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA
| | - Anka A Vujanovic
- Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA
| | - Jafar Bakhshaie
- Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA
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22
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Tull MT, Edmonds KA, Forbes CN, Richmond JR, Rose JP, Anestis MD, Gratz KL. Examining Relationships between Gender, Opioid Dependence, and Distress Tolerance among Patients in Substance Use Disorder Treatment. Subst Use Misuse 2020; 55:1327-1334. [PMID: 32193972 PMCID: PMC8177557 DOI: 10.1080/10826084.2020.1741632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Opioid abuse/dependence is associated with multiple negative outcomes relative to other forms of substance abuse/dependence, including relapse. Research identifying modifiable characteristics associated with opioid dependence and associated negative outcomes may inform the development of targeted interventions for this high-risk population. One factor warranting investigation is low distress tolerance (DT). Purpose/Objectives: In a sample of patients in substance use disorder (SUD) treatment, the present study examined DT levels among patients with current opioid dependence versus no history of opioid dependence, as well as the moderating role of gender. We predicted that patients with opioid dependence would exhibit lower DT than those without a history of opioid dependence, and that women with opioid dependence would exhibit lower levels of DT than men with opioid dependence. Methods: A sample of 203 patients in residential SUD treatment were administered a series of diagnostic interviews and a behavioral measure of DT. Results: DT did not differ significantly as a function of opioid dependence. However, there was a significant opioid dependence by gender interaction, such that men with current opioid dependence exhibited significantly lower levels of DT than women with opioid dependence and men without a history of opioid dependence. Conclusions/Importance: Findings highlight a modifiable characteristic associated with opioid dependence among men that may be targeted in interventions.
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Affiliation(s)
- Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Keith A Edmonds
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | | | | | - Jason P Rose
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA
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23
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Dixon LJ, Cohen RT, Baer MM, Gratz KL, Tull MT. Relations of anxiety sensitivity dimensions to nonsuicidal self-injury frequency and versatility among patients with substance use disorders. J Clin Psychol 2019; 75:1613-1625. [PMID: 30995353 DOI: 10.1002/jclp.22784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/28/2019] [Accepted: 03/28/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Despite the theoretical and empirical relevance of anxiety sensitivity (AS) to nonsuicidal self-injury (NSSI), few studies have investigated this association. This study examined the incremental validity of AS dimensions in NSSI frequency and versatility, above and beyond emotion dysregulation and relevant covariates (racial/ethnic background, negative affectivity). AS dimensions were expected to account for additional unique variance in NSSI outcomes. METHOD Participants included 204 patients (50.5% female) with substance use disorders in residential treatment. RESULTS In this sample, 37.2% reported a history of NSSI. The hierarchical regression models revealed a unique positive association between AS social concerns and NSSI outcomes when adjusting for model variables. In contrast, AS physical concerns were uniquely negatively associated with NSSI outcomes. CONCLUSION Findings provide support for AS social concerns as a vulnerability for engagement in NSSI behaviors and highlight this particular AS dimension as a potential treatment target for NSSI prevention and intervention programs.
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Affiliation(s)
- Laura J Dixon
- Department of Psychology, University of Mississippi, Oxford, Mississippi
| | - Rivka T Cohen
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Margaret M Baer
- Department of Psychology, University of Toledo, Toledo, Ohio
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, Ohio
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, Ohio
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24
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Rogers AH, Shepherd JM, Orr MF, Bakhshaie J, McHugh RK, Zvolensky MJ. Exploring anxiety sensitivity in the relationship between pain intensity and opioid misuse among opioid-using adults with chronic pain. J Psychiatr Res 2019; 111:154-159. [PMID: 30771621 DOI: 10.1016/j.jpsychires.2019.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/25/2019] [Accepted: 02/07/2019] [Indexed: 10/27/2022]
Abstract
Opioid misuse is a significant public health problem. Chronic pain is one highly prevalent factor that is strongly associated with increased risk for opioid misuse. Anxiety sensitivity (fear of anxiety related physical sensations) is an individual difference factor consistently linked to pain experience, and separately, heroin use. The present study examined if anxiety sensitivity may be one factor related to the relationship between pain intensity and opioid misuse among opioid-using adults with chronic pain. Results indicated that anxiety sensitivity total score was significantly associated with the relationship between pain intensity and current opioid misuse, as well as pain intensity and severity of opioid dependence. Overall, results suggest that anxiety sensitivity may be an important assessment and intervention target to ultimately reduce the rates of opioid misuse among adults with chronic pain.
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Affiliation(s)
| | | | - Michael F Orr
- Department of Psychology, University of Houston, USA
| | | | - R Kathryn McHugh
- Department of Psychiatry, McLean Hospital & Harvard Medical School, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA; HEALTH Institute, University of Houston, USA.
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25
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Rogers AH, Kauffman BY, Bakhshaie J, McHugh RK, Ditre JW, Zvolensky MJ. Anxiety sensitivity and opioid misuse among opioid-using adults with chronic pain. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:470-478. [PMID: 30896985 DOI: 10.1080/00952990.2019.1569670] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: The opioid epidemic is a significant public health crisis, and this problem is particularly prevalent among individuals with chronic pain. Accordingly, there is an urgent need for interventions to mitigate the risk for opioid misuse and opioid use disorder among people with pain. Given that mental health problems, specifically anxiety, are common among people who misuse opioids, it is important to examine factors that link mental health problems with opioid misuse to ultimately inform the development of novel interventions. Anxiety sensitivity, a transdiagnostic vulnerability factor defined as the fear of anxiety-related physical sensations, may be one important mechanism in elevated opioid misuse among persons with chronic pain. Objective: Therefore, the current cross-sectional study examined anxiety sensitivity (and construct sub-facets) as a predictor of opioid misuse among adults with chronic pain. Method: Adults reporting chronic pain and prescription opioid use completed an online survey. Results: Anxiety sensitivity was associated with multiple aspects of opioid misuse, including current opioid misuse, severity of opioid dependence, and number of opioids used to get high. The magnitude of effects ranged from medium to large. Associations between anxiety sensitivity and opioid misuse were observed over and above the variance accounted for by age, sex, income, education, perceived health, and pain severity. Conclusion: These findings suggest that anxiety sensitivity may be an important treatment target among adults with chronic pain who misuse opioids. Future research should continue to explore the explanatory relevance of anxiety sensitivity in opioid misuse among individuals with chronic pain.
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Affiliation(s)
- Andrew H Rogers
- a Department of Psychology, University of Houston , Houston , TX , USA
| | - Brooke Y Kauffman
- a Department of Psychology, University of Houston , Houston , TX , USA
| | - Jafar Bakhshaie
- a Department of Psychology, University of Houston , Houston , TX , USA
| | | | - Joseph W Ditre
- c Department of Psychology, Syracuse University , Syracuse , NY , USA
| | - Michael J Zvolensky
- a Department of Psychology, University of Houston , Houston , TX , USA.,d Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston , TX , USA.,e HEALTH Institute, University of Houston , Houston , TX , USA
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Depleting adult dentate gyrus neurogenesis increases cocaine-seeking behavior. Mol Psychiatry 2019; 24:312-320. [PMID: 29507372 DOI: 10.1038/s41380-018-0038-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 01/16/2018] [Accepted: 02/02/2018] [Indexed: 12/11/2022]
Abstract
The hippocampus is the main locus for adult dentate gyrus (DG) neurogenesis. A number of studies have shown that aberrant DG neurogenesis correlates with many neuropsychiatric disorders, including drug addiction. Although clear causal relationships have been established between DG neurogenesis and memory dysfunction or mood-related disorders, evidence of the causal role of DG neurogenesis in drug-seeking behaviors has not been established. Here we assessed the role of new DG neurons in cocaine self-administration using an inducible transgenic approach that selectively depletes adult DG neurogenesis. Our results show that transgenic mice with decreased adult DG neurogenesis exhibit increased motivation to self-administer cocaine and a higher seeking response to cocaine-related cues. These results identify adult hippocampal neurogenesis as a key factor in vulnerability to cocaine addiction.
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Stein AT, Medina JL, Rosenfield D, Otto MW, Smits JAJ. Examining experiential avoidance as a mediator of the relation between anxiety sensitivity and depressive symptoms. Cogn Behav Ther 2018; 49:41-54. [DOI: 10.1080/16506073.2018.1546768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Johnna L. Medina
- Stanford University School of Medicine, Stanford, California, USA
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Jacquart J, Dutcher CD, Freeman SZ, Stein AT, Dinh M, Carl E, Smits JAJ. The effects of exercise on transdiagnostic treatment targets: A meta-analytic review. Behav Res Ther 2018; 115:19-37. [PMID: 30473437 DOI: 10.1016/j.brat.2018.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The present study meta-analytically reviewed the effects of exercise on four transdiagnostic treatment targets: anxiety sensitivity (AS), distress tolerance (DT), stress reactivity (SR), and general self-efficacy (GSE). METHODS We conducted systematic searches of peer-reviewed studies in bibliographical databases (Cochrane Library, psychINFO, PubMed) before April 1, 2018. Only randomized controlled trials (RCT) evaluating the effect of exercise on AS, DT, SR, or GSE using at least one validated outcome instrument in a sample of adolescents (≥13 years old) or adults were selected. We employed a meta-analysis of effects using random-effects pooling modeling for each treatment target. RESULTS The systematic search yielded 28 RCTs meeting eligibility criteria. Exercise interventions had a large effect on reducing AS (six studies, Hedges's g = 0.72, p = .001), a medium effect on increasing GSE (eight studies, Hedges's g = 0.59, p < .001), and a small effect on reducing SR (ten studies, Hedges's g = 0.32, p < .001). Evidence from four studies suggested that exercise interventions had a small but non-significant effect on increasing DT (Hedges's g = 0.21, p = .26). CONCLUSIONS This meta-analysis provides preliminary evidence exercise can engage certain transdiagnostic targets. Further research is required to optimize exercise intervention parameters to achieve the strongest effects on these important mechanistic variables.
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Affiliation(s)
- Jolene Jacquart
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA.
| | - Christina D Dutcher
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Slaton Z Freeman
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Aliza T Stein
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Mike Dinh
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Emily Carl
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
| | - Jasper A J Smits
- Department of Psychology and Institute for Mental Health Research, The University of Texas at Austin, 305 E 23rd Street Stop E9000, Austin, TX, 78712-1043, USA
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Horenstein A, Potter CM, Heimberg RG. How does anxiety sensitivity increase risk of chronic medical conditions? CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12248] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Arielle Horenstein
- Adult Anxiety Clinic of Temple; Department of Psychology; Temple University; Philadelphia Pennsylvania
| | - Carrie M. Potter
- Department of Psychiatry of Cambridge Health Alliance; Harvard Medical School; Boston Massachusetts
| | - Richard G. Heimberg
- Adult Anxiety Clinic of Temple; Department of Psychology; Temple University; Philadelphia Pennsylvania
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Griffin ML, McDermott KA, McHugh RK, Fitzmaurice GM, Weiss RD. Grit in patients with substance use disorders. Am J Addict 2016; 25:652-658. [PMID: 27759947 PMCID: PMC5484735 DOI: 10.1111/ajad.12460] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 09/19/2016] [Accepted: 10/02/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Grit is an emerging concept in positive psychology, defined as the ability to be persistent and focused in pursuit of long-term goals. This concept has received a great deal of interest recently because of its robust ability to predict success and well-being across a wide variety of domains. The study aim was to examine the clinical relevance of the construct of grit among patients with substance use disorders. METHODS Inpatients on a detoxification unit were enrolled from September 2013 to August 2015 (N = 673). Psychometric properties of the Short Grit Scale (Grit-S) were reported. We then examined sociodemographic and clinical variables that might be associated with grit in this population. RESULTS In this sample of patients with substance use disorders, the total Grit-S demonstrated strong psychometric properties. Grit-S scores were higher among older patients and those who were employed; scores were lower among those never married, diagnosed with a co-occurring psychiatric disorder, or who had used heroin during the past month, according to bivariate analyses. Grit-S scores remained associated with age, employment, and presence of a co-occurring psychiatric disorder in adjusted analysis. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This study provides initial support for the utility of the Grit-S among those with substance use disorders; this novel measure has not been previously reported in clinical populations. Research examining grit prospectively is needed to determine whether the links between grit and outcomes observed in other populations apply to patients with substance use disorders. (Am J Addict 2016;25:652-658).
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Affiliation(s)
- Margaret L. Griffin
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | | | - R. Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Garrett M. Fitzmaurice
- Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, MA 02478, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115, USA
| | - Roger D. Weiss
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Ramsey SE, Rounsaville D, Hoskinson R, Park TW, Ames EG, Neirinckx VD, Friedmann P. The Need for Psychosocial Interventions to Facilitate the Transition to Extended-Release Naltrexone (XR-NTX) Treatment for Opioid Dependence: A Concise Review of the Literature. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 10:65-8. [PMID: 27512336 PMCID: PMC4975246 DOI: 10.4137/sart.s39067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/06/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022]
Abstract
Given the increase of opioid dependence and opioid-related morbidity and mortality, improving treatment options for individuals with opioid dependence warrants increased attention. This article provides a concise review of work in this area. Remission from opioid dependence can be very difficult to sustain, particularly in the absence of opioid replacement or opioid antagonist therapy. For those who wish to transition from opioid use or opioid replacement therapy to opioid antagonist therapy, a significant challenge can be the period of withdrawal symptoms that must be endured prior to the initiation of opioid antagonist therapy. Studies that have incorporated psychosocial interventions into detoxification protocols have found that they can result in improved treatment outcomes. Interventions based on Acceptance and Commitment Therapy have shown promise in the treatment of clinical disorders that present with symptoms similar to those of opioid withdrawal and have been found to positively impact outcomes among those tapering from methadone. However, the use of an Acceptance and Commitment Therapy-based intervention has yet to be studied among opioid-dependent patients transitioning to XR-NTX, and its value to those transitioning to XR-NTX is currently unknown.
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Affiliation(s)
- Susan E Ramsey
- Rhode Island Hospital, Providence, RI, USA.; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.; Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | | | - Tae Woo Park
- Rhode Island Hospital, Providence, RI, USA.; Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
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Tull MT, Schulzinger D, Schmidt NB, Zvolensky MJ, Lejuez CW. Development and Initial Examination of a Brief Intervention for Heightened Anxiety Sensitivity Among Heroin Users. Behav Modif 2016; 31:220-42. [PMID: 17307936 DOI: 10.1177/0145445506297020] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Anxiety sensitivity (AS) recently has been identified as a potential cognitive vulnerability underlying substance use problems, with some evidence specifically indicating its relevance to heroin. Focusing on the potential utility of interventions centered on increasing willingness to have anxiety-related sensations reduce vulnerability for relapse following substance use treatment, the current article describes the development of a brief (6 session) behavioral treatment for heightened AS among heroin users. The treatment consists of the following components: (a) psychoeducation about anxiety; (b) interoceptive exposure exercises; and (c) skills-training focused on heightening emotional acceptance, tolerance, and nonevaluative awareness (to facilitate willingness). Preliminary data on this treatment are provided in the form of a case study with a 46-year-old African American man in an inner-city residential substance use treatment facility. Results indicate reductions in AS (especially physical concerns), as well as corresponding decreases in heroin cravings and improvements in emotion regulation.
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Affiliation(s)
- Matthew T Tull
- Center for Addictions, Personality, and Emotion Research and the University of Maryland at College Park, MD 20742, USA.
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Capron DW, Bujarski SJ, Gratz KL, Anestis MD, Fairholme CP, Tull MT. Suicide risk among male substance users in residential treatment: Evaluation of the depression-distress amplification model. Psychiatry Res 2016; 237:22-6. [PMID: 26921047 PMCID: PMC4774244 DOI: 10.1016/j.psychres.2016.01.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/23/2016] [Accepted: 01/26/2016] [Indexed: 11/24/2022]
Abstract
Suicide is a leading cause of death and is significantly elevated among those with substance use disorders (SUDs). However, specific mechanisms of suicide in this population have been relatively understudied. The depression-distress amplification model posits that one pathway to increased suicide risk is through the intensification of depressive symptoms by anxiety sensitivity cognitive concerns. However, this model has not been tested in populations with SUDs. The current study tested the depression-distress amplification model of suicide risk and examined the relation of anxiety sensitivity to suicide risk in a sample of men in residential SUD treatment. Consistent with prior work, anxiety sensitivity cognitive concerns were significantly associated with suicide risk. Moreover, and consistent with the depression-distress amplification model, anxiety sensitivity cognitive concerns related to elevated suicide risk among those with a current major depressive episode specifically, above and beyond insomnia (another risk factor for suicide) and relevant covariates. The results of this study corroborate the relevance of anxiety sensitivity cognitive concerns and the depression-distress amplification model to suicide risk in an at-risk clinical sample of SUD patients. Findings suggest the importance of assessing anxiety sensitivity cognitive concerns and targeting this vulnerability through brief interventions to reduce suicide risk.
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Affiliation(s)
- Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA; Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA.
| | - Sarah J Bujarski
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA; Department of Psychology, University of Arkansas, Fayetteville, AR, USA
| | - Kim L Gratz
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Matthew T Tull
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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Viana AG, Stevens EN. Parental Threatening Behaviors and Offspring Substance Use: The Moderating Role of Anxiety Sensitivity. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016. [DOI: 10.1080/1067828x.2014.926848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Neuroscience of resilience and vulnerability for addiction medicine. PROGRESS IN BRAIN RESEARCH 2016; 223:3-18. [DOI: 10.1016/bs.pbr.2015.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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36
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Schlauch RC, Crane CA, Houston RJ, Molnar DS, Schlienz NJ, Lang AR. Psychometric Evaluation of the Substance Use Risk Profile Scale (SURPS) in an Inpatient Sample of Substance Users Using Cue-Reactivity Methodology. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2015; 37:231-246. [PMID: 26052180 PMCID: PMC4456031 DOI: 10.1007/s10862-014-9462-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The current project sought to examine the psychometric properties of a personality based measure (Substance Use Risk Profile Scale; SURPS: introversion-hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) designed to differentially predict substance use preferences and patterns by matching primary personality-based motives for use to the specific effects of various psychoactive substances. Specifically, we sought to validate the SURPS in a clinical sample of substance users using cue reactivity methodology to assess current inclinations to consume a wide range of psychoactive substances. Using confirmatory factor analysis and correlational analyses, the SURPS demonstrated good psychometric properties and construct validity. Further, impulsivity and sensation-seeking were associated with use of multiple substances but could be differentiated by motives for use and susceptibility to the reinforcing effects of stimulants (i.e., impulsivity) and alcohol (i.e. sensation-seeking). In contrast, introversion-hopelessness and anxiety sensitivity demonstrated a pattern of use more focused on reducing negative affect, but were not differentiated based on specific patterns of use. Taken together, results suggests that among those receiving inpatient treatment for substance use disorders, the SURPS is a valid instrument for measuring four distinct personality dimensions that may be sensitive to motivational susceptibilities to specific patterns of alcohol and drug use.
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Affiliation(s)
- Robert C Schlauch
- Robert C. Schlauch and Alan R. Lang, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306. Cory A. Crane, Danielle S. Molnar, Nicolas J. Schlienz and Rebecca J. Houston, Research Institute on Addictions, University at Buffalo, 1021 Main St., Buffalo, NY 14203
| | - Cory A Crane
- Robert C. Schlauch and Alan R. Lang, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306. Cory A. Crane, Danielle S. Molnar, Nicolas J. Schlienz and Rebecca J. Houston, Research Institute on Addictions, University at Buffalo, 1021 Main St., Buffalo, NY 14203
| | - Rebecca J Houston
- Robert C. Schlauch and Alan R. Lang, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306. Cory A. Crane, Danielle S. Molnar, Nicolas J. Schlienz and Rebecca J. Houston, Research Institute on Addictions, University at Buffalo, 1021 Main St., Buffalo, NY 14203
| | - Danielle S Molnar
- Robert C. Schlauch and Alan R. Lang, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306. Cory A. Crane, Danielle S. Molnar, Nicolas J. Schlienz and Rebecca J. Houston, Research Institute on Addictions, University at Buffalo, 1021 Main St., Buffalo, NY 14203
| | - Nicolas J Schlienz
- Robert C. Schlauch and Alan R. Lang, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306. Cory A. Crane, Danielle S. Molnar, Nicolas J. Schlienz and Rebecca J. Houston, Research Institute on Addictions, University at Buffalo, 1021 Main St., Buffalo, NY 14203
| | - Alan R Lang
- Robert C. Schlauch and Alan R. Lang, Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL 32306. Cory A. Crane, Danielle S. Molnar, Nicolas J. Schlienz and Rebecca J. Houston, Research Institute on Addictions, University at Buffalo, 1021 Main St., Buffalo, NY 14203
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37
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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38
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Capron DW, Allan NP, Ialongo NS, Leen-Feldner E, Schmidt NB. The depression distress amplification model in adolescents: A longitudinal examination of anxiety sensitivity cognitive concerns, depression and suicidal ideation. J Adolesc 2015; 41:17-24. [PMID: 25754194 DOI: 10.1016/j.adolescence.2015.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 01/14/2015] [Accepted: 02/13/2015] [Indexed: 11/17/2022]
Abstract
Adolescents with comorbid anxiety and depression are at significantly increased risk of suicide. The recently proposed depression distress amplification model appears to have promise for explaining the relations between anxiety, depression, and suicidality, but it has not been tested in adolescents. Participants were 524 adolescents followed over two years. Baseline data for the current report were collected by trained interviewers while the adolescents were in eighth grade. Data were obtained in the same manner when the adolescents were in tenth grade. Baseline anxiety sensitivity cognitive concerns significantly predicted suicidal ideation two years later, above and beyond baseline suicidal ideation and depression. Further, consistent with the depression distress amplification model, anxiety sensitivity cognitive concerns interacted with depressive symptoms to predict suicidal ideation. This report extends the empirical and theoretical support for a relationship between anxiety sensitivity cognitive concerns and suicidality.
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Affiliation(s)
- Daniel W Capron
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA.
| | - Nicholas P Allan
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
| | - Nicholas S Ialongo
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
| | | | - Norman B Schmidt
- Florida State University, 1107 W. Call St., Tallahassee, FL, 32306, USA
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Wolitzky-Taylor K, Guillot CR, Pang RD, Kirkpatrick MG, Zvolensky MJ, Buckner JD, Leventhal AM. Examination of anxiety sensitivity and distress tolerance as transdiagnostic mechanisms linking multiple anxiety pathologies to alcohol use problems in adolescents. Alcohol Clin Exp Res 2015; 39:532-9. [PMID: 25706521 DOI: 10.1111/acer.12638] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 11/20/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multiple forms of anxiety psychopathology are associated with alcohol use problems in adolescents. Yet, the mechanisms underlying this association are unclear. Anxiety sensitivity (AS) and distress tolerance (DT) represent 2 distinct, conceptually relevant transdiagnostic constructs implicated in multiple manifestations of anxiety that may also underlie alcohol use problems and thereby explain why people with anxiety are more likely to have alcohol problems. METHODS The current cross-sectional study examined whether AS and DT accounted for (i.e., statistically mediated) the relationship between manifest indicators of the 3 common anxiety phenotypes (generalized anxiety, social anxiety, and panic disorders) and alcohol problems in a sample of 534 high school students (14 to 15 years old). RESULTS Multiple manifestations of anxiety were associated with greater alcohol use problems. AS statistically mediated multiple anxiety-alcohol associations, but DT did not. CONCLUSIONS These findings provide preliminary evidence suggesting AS may be an important transdiagnostic target for alcohol prevention programs for those in early adolescence that experience elevated anxiety symptoms.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Psychiatry and Behavioral Sciences , University of Southern California, Los Angeles, California
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40
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Stein MD, Herman DS, Moitra E, Hecht J, Lopez R, Anderson BJ, Brown RA. A preliminary randomized controlled trial of a distress tolerance treatment for opioid dependent persons initiating buprenorphine. Drug Alcohol Depend 2015; 147:243-50. [PMID: 25510307 PMCID: PMC4297723 DOI: 10.1016/j.drugalcdep.2014.11.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/04/2014] [Accepted: 11/13/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Buprenorphine opioid agonist treatment (OAT) has established efficacy for treating opioid dependency but early relapse rates are high and are often associated with withdrawal-related or emotional distress. METHODS To determine whether a novel distress tolerance (DT) intervention during buprenorphine initiation decreases opioid relapse, we conducted a preliminary randomized controlled trial with opioid-dependent outpatients. Participants received buprenorphine-naloxone induction and 3-months of maintenance buprenorphine plus seven, 50-min manualized, individual sessions (DT vs. health education (HE) control) over a 28-day period, linked to clinician medication dosing visits, and beginning 2 days prior to buprenorphine induction. Primary outcomes included use of illicit opioids (positive defined as any self-reported use in the prior 28 days or detected by urine toxicology) and treatment drop out. RESULTS Among 49 participants, the mean age was 41 years, 65.3% were male. Persons randomized to DT had lower rates of opioid use at all three monthly assessments, and at 3-months, 72% of HE participants were opioid positive compared with 62.5% of DT participants. Rates of dropout were 24% and 25% in the HE and DT arms, respectively. CONCLUSIONS This distress tolerance treatment produced a small, but not statistically significant reduction in opioid use during the first three months of treatment although no differences were found in drop-out rates between conditions. If replicated in a larger study, DT could offer clinicians a useful behavioral treatment to complement the effects of buprenorphine.
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Affiliation(s)
- Michael D. Stein
- Alpert Medical School of Brown University, Department of Medicine, Providence, RI
,Butler Hospital, Providence, RI
| | - Debra S. Herman
- Alpert Medical School of Brown University, Department of Medicine, Providence, RI
,Butler Hospital, Providence, RI
| | - Ethan Moitra
- Alpert Medical School of Brown University, Department of Medicine, Providence, RI
,Butler Hospital, Providence, RI
| | | | | | | | - Richard A. Brown
- Alpert Medical School of Brown University, Department of Medicine, Providence, RI
,Butler Hospital, Providence, RI
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Akça ÖF, Ağaç Vural T, Türkoğlu S, Kılıç EZ. Anxiety sensitivity: changes with puberty and cardiovascular variables. Pediatr Int 2015; 57:49-54. [PMID: 25040018 DOI: 10.1111/ped.12443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/04/2014] [Accepted: 06/24/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anxiety sensitivity (AS) is a relatively stable dispositional variable that may increase the risk for anxiety-related symptoms, particularly panic attack, among individuals of all age groups. Changes in AS during adolescence in healthy individuals, however, has not been previously investigated. The aim of this study was therefore to investigate the relationship of AS with puberty level, pulse rate, and blood pressure in healthy adolescents. METHODS The sample consisted of 133 healthy adolescents (70 boys, 63 girls) aged 10-17 years. Puberty stage (i.e. Tanner stage), pulse rate, and blood pressure of each participant were determined. The Childhood Anxiety Sensitivity Inventory was used to identify AS. The correlations between AS and the clinical variables were assessed. RESULTS AS was negatively correlated with pubertal stage when age and gender were controlled. Also, AS was correlated with diastolic blood pressure when age, gender, and pubertal stage were controlled (P < 0.05). Neither systolic blood pressure nor heart rate were correlated with AS. CONCLUSION AS, which is reported to be a trait-like variable, may change during adolescence, due to the effect of pubertal growth and blood pressure interacting with AS during adolescence.
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Affiliation(s)
- Ömer Faruk Akça
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
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Capron DW, Lamis DA, Schmidt NB. Test of the depression distress amplification model in young adults with elevated risk of current suicidality. Psychiatry Res 2014; 219:531-5. [PMID: 25063018 DOI: 10.1016/j.psychres.2014.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 06/27/2014] [Accepted: 07/06/2014] [Indexed: 11/17/2022]
Abstract
Suicide is a leading cause of death among young adults and the rate of suicide has been increasing for decades. A depression distress amplification model posits that young adults with comorbid depression and anxiety have elevated suicide rates due to the intensification of their depressive symptoms by anxiety sensitivity cognitive concerns. The current study tested the effects of anxiety sensitivity subfactors as well as the depression distress amplification model in a very large sample of college students with elevated suicide risk. Participants were 721 college students who were at elevated risk of suicidality (scored>0 on the Beck Scale for Suicide Ideation). Consistent with prior work, anxiety sensitivity cognitive concerns, but not physical or social concerns, were associated with suicidal ideation. Consistent with the depression distress amplification model, in individuals high in depression, anxiety sensitivity cognitive concerns predicted elevated suicidal ideation but not among those with low depression. The results of this study corroborate the role of anxiety sensitivity cognitive concerns and the depression distress amplification model in suicidal ideation among a large potentially high-risk group of college students. The depression distress amplification model suggests a specific mechanism, anxiety sensitivity cognitive concerns, that may be responsible for increased suicide rates among those with comorbid anxiety and depression.
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Affiliation(s)
- Daniel W Capron
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA.
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Brown RA, Bloom EL, Hecht J, Moitra E, Herman DS, Stein MD. A pilot study of a distress tolerance treatment for opiate-dependent patients initiating buprenorphine: rationale, methodology, and outcomes. Behav Modif 2014; 38:730-59. [PMID: 24973401 PMCID: PMC4876823 DOI: 10.1177/0145445514538279] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Buprenorphine, an opioid that is a long-acting partial opiate agonist, is an efficacious treatment for opiate dependence that is growing in popularity. Nevertheless, evidence suggests that many patients will lapse within the first week of treatment and that lapses are often associated with withdrawal-related or emotional distress. Recent research suggests that individuals' reactions to this distress may represent an important treatment target. In the current study, we describe the development and outcomes from a preliminary pilot evaluation (N = 5) of a novel distress tolerance (DT) treatment for individuals initiating buprenorphine. This treatment incorporates exposure-based and acceptance-based treatment approaches that we have previously applied to the treatment of tobacco dependence. Results from this pilot study establish the feasibility and acceptability of this approach. We are now conducting a randomized controlled trial of this treatment that we hope will yield clinically significant findings and offer clinicians an efficacious behavioral treatment to complement the effects of buprenorphine.
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Affiliation(s)
- Richard A Brown
- Alpert Medical School of Brown University/Butler Hospital, Providence, RI, USA
| | - Erika Litvin Bloom
- Alpert Medical School of Brown University/Butler Hospital, Providence, RI, USA
| | - Jacki Hecht
- Alpert Medical School of Brown University/Butler Hospital, Providence, RI, USA
| | - Ethan Moitra
- Alpert Medical School of Brown University/Butler Hospital, Providence, RI, USA
| | - Debra S Herman
- Alpert Medical School of Brown University/Butler Hospital, Providence, RI, USA
| | - Michael D Stein
- Alpert Medical School of Brown University/Butler Hospital, Providence, RI, USA
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Kosiba JD, Gonzalez A, O'Cleirigh C, Safren SA. Medication Adherence and HIV Symptom Distress in Relation to Panic Disorder Among HIV-Positive Adults Managing Opioid Dependence. COGNITIVE THERAPY AND RESEARCH 2014; 38:458-464. [PMID: 26146476 DOI: 10.1007/s10608-014-9608-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Panic disorder (PD) occurs at greater rates among those with HIV compared to those without HIV. Rates of PD may be elevated among those with opioid dependence (persons who inject drugs, PWID). Persons with HIV experience common bodily symptoms as a result of the disease and these symptoms overlap with those of PD which may contribute to a "fear of fear" cycle present in PD. HIV-positive, PWID represent an at-risk population in terms of poor medication adherence. HIV symptoms and HIV medication side-effects commonly overlap with panic symptoms and may affect HIV medication adherence. The aim of this investigation was to examine the impact of PD on HIV-related symptom distress and HIV medication adherence in HIV-positive adults (N = 131) in treatment for opioid use. Those with a diagnosis of PD evidenced greater levels of HIV symptom distress and lower levels of medication adherence than those without current PD. Results highlight the clinical importance of assessing for and treating PD among individuals with HIV that are prescribed antiretroviral therapy. Future work would benefit from examining observed associations longitudinally and identifying potential mechanisms involved.
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Affiliation(s)
- Jesse D Kosiba
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Adam Gonzalez
- Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA; The Fenway Institute, Boston, MA, USA
| | - Steven A Safren
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Cambridge, MA, USA; The Fenway Institute, Boston, MA, USA
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Connecting the pathology of posttraumatic stress and substance use disorders: monoamines and neuropeptides. Pharmacol Biochem Behav 2013; 117:61-9. [PMID: 24333548 DOI: 10.1016/j.pbb.2013.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 11/19/2013] [Accepted: 12/01/2013] [Indexed: 11/23/2022]
Abstract
Posttraumatic stress disorder (PTSD) co-occurs highly with substance use disorders (SUDs), yet the neurobiological basis for this comorbid relationship remains unclear. PTSD and SUDs result in similar pathological states including impulsive behavior, reward deficiency, and heightened stress sensitivity. Hence, PTSD and SUD may depend on overlapping dysfunctional neurocircuitry. Here we provide a short overview of the relationship between comorbid PTSD and SUD, as well as the potential role of select neurotransmitter systems that may underlie enhanced vulnerability to drug abuse in the context of PTSD.
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Stewart AM, Kalueff AV. The behavioral effects of acute Δ⁹-tetrahydrocannabinol and heroin (diacetylmorphine) exposure in adult zebrafish. Brain Res 2013; 1543:109-19. [PMID: 24216135 DOI: 10.1016/j.brainres.2013.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 10/31/2013] [Accepted: 11/01/2013] [Indexed: 01/02/2023]
Abstract
The use of psychotropic drugs in clinical and translational brain research continues to grow, and the need for novel experimental models and screens is becoming widely recognized. Mounting evidence supports the utility of zebrafish (Danio rerio) for studying various pharmacological manipulations, as an alternative model complementing the existing rodent paradigms in this field. Here, we explore the effects of acute 20-min exposure to two commonly abused psychotropic compounds, Δ(9)-tetrahydrocannabinol (THC) and heroin, on adult zebrafish behavior in the novel tank test. Overall, THC administration (30 and 50 mg/L) produces an anxiogenic-like reduction of top swimming, paralleled with a slower, continuous bottom swimming. In contrast, heroin exposure (15 and 25 mg/L) evoked a hyperlocomotor response (with rapid bouts of bottom swimming and frequent 'bouncing' motions) without altering anxiety-sensitive top/bottom endpoints. The behavioral effects of these two compounds in zebrafish seem to parallel the respective rodent and human findings. Collectively, this emphasizes the growing significance of novel emerging aquatic models in translational drug abuse research and small molecule screening.
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Affiliation(s)
- Adam Michael Stewart
- Zebrafish Neuroscience Research Consortium (ZNRC) and ZENEREI Institute, 309 Palmer Court, Slidell 70458, USA; Department of Neuroscience, University of Pittsburgh, A210 Langley Hall, Pittsburgh, PA 15260, USA
| | - Allan V Kalueff
- Zebrafish Neuroscience Research Consortium (ZNRC) and ZENEREI Institute, 309 Palmer Court, Slidell 70458, USA; Department of Pharmacology and Neuroscience Program, Tulane University Medical School, 1430 Tulane Avenue, New Orleans, LA 70112, USA.
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Capron DW, Norr AM, Macatee RJ, Schmidt NB. Distress tolerance and anxiety sensitivity cognitive concerns: testing the incremental contributions of affect dysregulation constructs on suicidal ideation and suicide attempt. Behav Ther 2013; 44:349-58. [PMID: 23768663 DOI: 10.1016/j.beth.2012.12.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 12/02/2012] [Accepted: 12/08/2012] [Indexed: 11/16/2022]
Abstract
Empirical work has suggested relationships among suicide-related outcomes and several constructs related to affect dysregulation, notably anxiety sensitivity (AS) and distress tolerance (DT). However, important questions remain, including the relative contributions of these affect regulation variables as well as the direct contribution of DT on suicidal ideation and prior attempts. The current study sought to better elucidate the nature of these relationships by examining AS, DT, and suicidal ideation and attempt in a clinical sample (N=192). Consistent with prior work and prediction, findings revealed a significant relationship between the AS cognitive concerns subfactor and suicidal ideation and suicide attempt history after accounting for the effects of DT, gender, and depressive symptoms. In addition, depressive symptoms significantly moderated the relationship between the AS cognitive concerns subfactor and suicidal ideation. After accounting for the influence of AS, analyses revealed that DT approached significance in predicting suicidal ideation, but did not significantly predict suicide attempt history. These results suggest that elevated AS cognitive concerns are particularly relevant to suicide in the context of depressive symptoms. Clinicians may benefit from implementing AS reduction strategies with individuals who endorse elevated suicide risk as well as elevated AS cognitive concerns.
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Rosenbaum DL, White KS. The Role of Anxiety in Binge Eating Behavior: A Critical Examination of Theory and Empirical Literature. Health Psychol Res 2013; 1:e19. [PMID: 26973904 PMCID: PMC4768578 DOI: 10.4081/hpr.2013.e19] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/03/2013] [Accepted: 01/04/2013] [Indexed: 11/23/2022] Open
Abstract
The purpose of this manuscript is to expand the understanding of binge eating by reviewing the role of aspects of negative affect. Specifically, this paper will present evidence for further investigation of the bearing that anxiety may have in binge eating development and maintenance. A comprehensive review of the literature regarding the relation of binge eating and anxiety was performed. Valuable contributions have been made to the binge eating literature regarding some aspects of negative affect (i.e., depression); however, outside of bulimia nervosa studies, much of the theoretical and empirical binge eating research to date has not directly addressed the role of anxiety. Research supports expansion of investigations of negative emotionality and binge eating to include specific study of anxiety. Greater inclusivity and specificity in the unique contributions of various negative emotions may further the development of temporal models and intervention efforts.
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Affiliation(s)
- Diane L Rosenbaum
- Department of Psychology, University of Missouri - Saint Louis , St. Louis, MO, USA
| | - Kamila S White
- Department of Psychology, University of Missouri - Saint Louis , St. Louis, MO, USA
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Fareed A, Eilender P, Haber M, Bremner J, Whitfield N, Drexler K. Comorbid Posttraumatic Stress Disorder and Opiate Addiction: A Literature Review. J Addict Dis 2013; 32:168-79. [DOI: 10.1080/10550887.2013.795467] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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